case_images: PMC4795141_01
case_images: Preoperative view of the lesion
case_images: JISP-20-75-g001.jpg
case_images: PMC4795141_01_JISP-20-75-g001.jpg
case_images: F1
case_images: On intra-oral examination, a desquamated gingival lesion [Figure 1] was seen on the marginal and attached gingiva extending from the distal aspect of 35 to mesial aspect of 37 measuring approximately about 3.5 cm x 1 cm in size and was bright red in color with slightly elevated margins and bleeding on slight provocation.
case_images: Intraoral periapical radiograph
case_images: JISP-20-75-g002.jpg
case_images: PMC4795141_01_JISP-20-75-g002.jpg
case_images: F2
case_images: The preoperative intraoral periapical radiograph and orthopantogram [Figures 2 and 3] revealed horizontal bone loss mesial to 35 regions, but there was no aggressive bony destruction around this area.
case_images: Preoperative orthopantogram
case_images: JISP-20-75-g003.jpg
case_images: PMC4795141_01_JISP-20-75-g003.jpg
case_images: F3
case_images: The preoperative intraoral periapical radiograph and orthopantogram [Figures 2 and 3] revealed horizontal bone loss mesial to 35 regions, but there was no aggressive bony destruction around this area.
case_images: H and E, x4 showing Islands of malignant squamous epithelial cells invading into connective tissue stroma
case_images: JISP-20-75-g004.jpg
case_images: PMC4795141_01_JISP-20-75-g004.jpg
case_images: F4
case_images: Sections from the biopsied specimens stained with hematoxylin and eosin [Figures 4 and 5] revealed neoplastic squamous epithelial cells invading the connective tissue stroma arranged in form of Islands and sheets exhibiting increased nuclear-cytoplasmic ratio, cellular pleomorphism, nuclear hyperchromatism, individual cell keratinization, abnormal and atypical mitotic figures, and keratin pearl formation.
case_images: H and E, x40 demonstrating individual neoplastic squamous epithelial Islands with keratin pearl formation
case_images: JISP-20-75-g005.jpg
case_images: PMC4795141_01_JISP-20-75-g005.jpg
case_images: F5
case_images: Sections from the biopsied specimens stained with hematoxylin and eosin [Figures 4 and 5] revealed neoplastic squamous epithelial cells invading the connective tissue stroma arranged in form of Islands and sheets exhibiting increased nuclear-cytoplasmic ratio, cellular pleomorphism, nuclear hyperchromatism, individual cell keratinization, abnormal and atypical mitotic figures, and keratin pearl formation.
case_images: Chest radiograph with no evidence of secondary malignancy
case_images: JISP-20-75-g006.jpg
case_images: PMC4795141_01_JISP-20-75-g006.jpg
case_images: F6
case_images: To rule out metastasis in the lung, chest X-ray was advised and was found to be clear [Figure 6].
case_images: Postoperative view Figure
case_images: JISP-20-75-g007.jpg
case_images: PMC4795141_01_JISP-20-75-g007.jpg
case_images: F7
case_images: The patient underwent surgical extraction from 41 to 38 with peripheral osteotomy leaving 2-3 cm of the inferior border of the mandible [Figure 7].
case_images: Postoperative orthopantogram
case_images: JISP-20-75-g008.jpg
case_images: PMC4795141_01_JISP-20-75-g008.jpg
case_images: F8
case_images: Hemostasis was done and primary closure was achieved [Figure 8].