Squamous cell carcinoma is a rare consequence of lupus erythematosus and it is generally associated with skin lesions rather than with oral mucosa. This paper reports a patient diagnosed with systemic lupus erythematosus who developed a squamous cell carcinoma on the palate as an outcome of a persistent ulcer, a frequent lesion in patients with this disease and, in fact, clinical criterion for its diagnosis. A 38-year-old female patient diagnosed with systemic lupus erythematosus 12 years previously, who attended the dental school for routine dental control. The patient was being treated with prednisone 10 mg per day and cyclophosphamide 750 mg per month until 10 months prior to her diagnostic biopsy. She had, however, been previously treated with chloroquine. Oral lesions started 6 months before consultation as symptomatic multiple ulcers on the palate. After topical treatment with steroids for 1 month, the lesions regressed except for the central lesion, from which an incisional biopsy was taken and a well differentiated squamous cell carcinoma was diagnosed. The oncological phase consisted of partial palatectomy. To date, 3 years after surgery, the patient is free from malignant lesions. Lupus erythematosus is considered a potentially malignant disorder, although the cause for neoplasic transformation in these patients is still not clear, but cyclophosphamide consumption may be implicated; the case emphasizes the importance of periodical oral evaluation of such patients. Repeated biopsies should be performed if there is failure to respond to conventional therapy.
Introduction: Peripheral ossifying fibroma is a non-neoplasic, reactive lesion of the gingiva with osseous production that occurs mostly in women. Lesions tend to be "small" in size but there have been reports of uncommon huge peripheral ossifying fibromas. Case Report: We report a case of a Venezuelan female patient with a gigantic peripheral ossifying fibroma in the anterior mandibular region, sized 5.3x4.5x3.2 cm, arising from the gum between right lateral incisor (42) and right canine (43). Conclusion: Peripheral ossifying fibroma is a reactive lesion which may reach giant dimensions. Management and possible factors implicated in such overgrowth cases are discussed. This is a case of a gigantic reactive lesion that may be mistaken by a true neoplasm. After removal and oral hygiene control, lesion has not recurred on a five-year follow-up period.
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