Primary squamous cell carcinoma of the gingiva: A case report

Squamous cell carcinoma is the most common malignancy involving the head and neck region. Primary gingival squamous is a subset of oral squamous cell carcinoma but it exhibits numerous attributes different from other oral carcinomas. It can present as a variety of different lesions distinguishing itself as a unique entity. We report a case of primary squamous cell carcinoma occurring on the gingiva.

A 40 year old male patient presented with the complaint of growth in the right lower gum region associated with pain since two months. His personal history revealed he was a gutka chewer and chews 5 packets of gutka per day since past 5 years. On intraoral examination, blanching of lower labial mucosa, right and left buccal mucosa and soft palate was evident. On palpation fibrous bands could be felt. An ulceroproliferative growth was evident both labially and lingually involving marginal, interdental and attached gingiva on the right side of the mandible in relation to #31,#41,#42,#43,#44,#45 &#46. A provisional diagnosis of a malignant growth involving the labial and lingual gingiva and alveolar mucosa on the right side of mandibular anterior region and oral submucous fibrosis was made.

Radical Neck dissection, wide tumor excision and segmental mandibulectomy extending from distal aspect of # 35to distal aspect of #48 was carried out under general anaesthesia.Mandibular reconstruction was done using a recon plate.

This is a case of primary squamous cell carcinoma occurring on the gingiva. This report demonstrates that even though oral cancers involving the periodontium are a relatively rare occurrence, they should not be overlooked and vigilant oral examination should be carried out. It also highlights importance of utilizing histopathological examination to confirm diagnosis of the suspicious lesions.