Document Type : Case Report
Authors
1 Department of Oral and Maxillofacial Radiology, School of Dentistry, Kashan University of Medical Sciences, Kashan, Iran
2 Department of oromaxillofacial pathology, Faculty of dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
3 Private Practice, Oral and Maxillofacial Radiology, Tehran, Iran
Abstract
Introduction: Squamous cell carcinoma (SCC) of the oral cavity typically presents with ulcerative mucosal lesions and osteolytic bone destruction. However, early manifestations may be subtle and lead to misdiagnosis.
Case report: This report describes a 42-year-old female who initially presented with unexplained mobility of the right mandibular second molar . Panoramic radiography revealed saucer shaped erosion with localized sclerosis and asymmetric widening of the periodontal ligament (PDL) space. The tooth was extracted based on a presumed periodontal etiology without histopathological evaluation. One year later, the patient returned with a non-healing extraction site. The second panoramic radiograph demonstrated persistent localized sclerosis without obvious evidence of cortical destruction. Furthermore, conventional panoramic radiography may fail to accurately demonstrate early cortical destruction because of its inherent two-dimensional limitations; therefore, Cone-beam computed tomography (CBCT) can be valuable in suspicious cases. Incisional biopsy confirmed moderately differentiated squamous cell carcinoma. The patient underwent segmental resection and cervical lymph node dissection.
Conclusion: Spontaneous, unexplained tooth mobility of a single tooth in the absence of periodontal disease, accompanied by saucer shaped erosion with sclerosis of the involved bone area, may represent an initial sign of oral squamous cell carcinoma. This case highlights atypical radiographic features of oral SCC that may mimic inflammatory or metastatic conditions, leading to delayed diagnosis.
Highlights
Dorsa Pourzarabi (Scholar)
Shahin Moeini (Scholar)
Keywords
Main Subjects
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