CASE REPORT   

European Journal of Oral and Maxillofacial Surgery 2017 December;1(3):98-101

DOI: 10.23736/S2532-3466.17.00125-4

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Inverted papilloma of oral cavity masquerading as verrucous carcinoma: a diagnostic dilemma

Hari J. PILLAI ¹ ✉, Samir GUPTA ², Divya SHELLY ³, Khushdeep K. SHERGILL ⁴

¹ Department of Surgery, Armed Forces Medical College, Pune, India; ² Command Hospital, Southern Command, Pune, India; ³ Department of Pathology, Armed Forces Medical College, Pune, India; ⁴ Department of Pathology, Armed Forces Medical College, Pune, India

Inverted papillomas are rare benign tumors of ectodermal origin in the respiratory mucosa. Inverted ductal papillomas of oral cavity (IDPOC) are histologically similar tumors differing considerably in clinical presentation and prognosis. We present an interesting case of 73 years old male, who presented to our center with an ulceroproliferative growth over buccal mucosa since 18 months. Due to high index of suspicion of verrucous carcinoma on clinical presentation and imaging, patient underwent a composite resection with posterior segmental mandibulectomy and selective neck node dissection of ipsilateral side. Histopathology of the specimen revealed IDPOC, with all surgical margins and lymph nodes free of tumor. The patient, while on follow-up was detected to have recurrence of the disease at the same location. Inverted ductal papillomas and NSIPs, though histologically similar, differ considerably in clinical presentation and prognosis. Their histopathologic recognition with immunohistochemistry is imperative for planning surgical management. Excision of the lesion is the cornerstone of management as there had been no recurrences reported so far in literature. Our case report is the first in literature to report a recurrent IPDOC and this would open up an arena for compelling research in newer treatment modalities for IPDOC.

KEY WORDS: Papilloma - Mouth - Carcinoma, verrucous