Cystic Squamous Cell Carcinomas of the Jaws: Twelve Cases Highlighting Histopathological Pitfalls

• Published in: International journal of surgical pathology Vol. 28; no. 6; p. 624
• Main Authors: Barrett, Andrew W, Garg, Montey, Armstrong, Daniel, Bisase, Brian S, Newman, Lawrence, Norris, Paul M, Shelley, Michael, Tighe, John V, Hyde, Nicholas C, Chaston, Nicola J, Gulati, Aakshay
• Format: Journal Article
• Language: English
• Published: United States 01.09.2020
• Subjects: Aged; Aged, 80 and over; Cysts - pathology; Female; Humans; Jaw Neoplasms - pathology; Male; Middle Aged; Squamous Cell Carcinoma of Head and Neck - pathology; oral cavity; verrucous carcinoma; carcinoma cuniculatum
• ISSN: 1940-2465
• DOI: 10.1177/1066896920903388

Cystic squamous cell carcinomas (SCCs) of the jaws, including carcinoma cuniculatum, are rare, slow growing, and relentlessly invasive. The aim of this article is to present 12 cases, 4 of which were designated as carcinoma cuniculatum on the basis of deeply endophytic, anastomosing channels of cystic stratified squamous epithelium and keratin microabscesses. The other 8 were also cystic, but more heterogeneous morphologically and were diagnosed as well differentiated SCCs. Six patients were female, 6 were male (mean age = 74.0 years, range = 50-94 years). Six tumors affected the mandible, 6 the maxillary alveolus with or without extension into the hard palate. All patients underwent primary resection with neck dissection and were staged as T4a N0 M0. In 4 patients, diagnosis was delayed as a result of superficial biopsies and/or confusing histopathology. Cystic SCCs of the jaws can be difficult to diagnose and clinicoradiological correlation is essential. Long-term follow-up is mandatory.