Primary Intraosseous Squamous Cell Carcinoma Arising from a Dentigerous Cyst of the Maxillary Wisdom Tooth

Abstract

The World Health Organization defines primary intraosseous squamous cell carcinoma (PIOSCC) as a squamous cell carcinoma (SCC) arising primarily within the jaws and having no connection with the oral mucosa. Here, we report a case of PIOSCC in which it was difficult to differentiate the condition from pericoronitis of an impacted maxillary wisdom tooth. The patient was a 27-year-old pregnant woman with a pain in the right maxillary wisdom tooth. The pain was diagnosed as pericoronitis of the right maxillary wisdom tooth, and the tooth was extracted under local anesthesia. During extraction, soft tissue was observed in the coronal part of the tooth, and it was diagnosed as SCC arising in a dentigerous cyst. Because the tumor may still be present, surgical resection was performed under general anesthesia. There has been no recurrence or metastasis at the 1-year follow-up. This case was histopathologically considered from being a benign odontogenic tumor to a malignant tumor. However, it revealed an extensive aberrant type and invasion equivalent to SCC. Thus, the histopathological diagnosis was PIOSCC arising from a dentigerous cyst. Although advanced cases of PIOSCC have been published, diagnosis of PIOSCC in the early stages is rare. In this case, we diagnosed pericoronitis of an impacted maxillary wisdom tooth and extracted the tooth. Therefore, we discovered it accidentally. In the early stages, diagnosis can be difficult both clinically and histopathologically.

Clinico-pathological study of malignant odontogenic tumours from a national referral centre

“…A major limitation of our study was the inability to obtain complete clinical, radiographic and long-term outcome data for our patients due to the study design and reliance on retrospective data. Very little is known regarding the aetiopathogenesis MOTs with most believed to arise de-novo though a proportion of cases also do arise from pre-existing benign lesions such as odontogenic cysts or tumours [ 2 , 33 – 36 ]. In our cohort of patients, two cases of PIOC-NOS were believed to have arisen from the epithelial lining of odontogenic cysts and one case of ameloblastic carcinoma was thought to have been preceded by an ameloblastoma.…”

Primary intraosseous carcinoma arising in dentigerous cyst: Case report

“…After cross-checking the last 3 reviews on the subject, only 35 cases have been reported from 1958 to 2015 [ [2] , [3] , [4] ]. In addition two other cases were published in 2017 and 2020 in English literature [ 5 , 6 ].…”

A primary intraosseous squamous cell carcinoma case report and literature review. The new WHO classification

“…Primary intraosseous carcinoma (PIOC) is rare. The incidence is low and approximately 200 cases are reported in the literature 2–5 …”