Gingival Squamous Cell Carcinoma: Diagnostic Challenges and Clinical Implications

Oral squamous cell carcinoma (OSCC) is one of the highly invasive malignancies globally, accounting for the vast majority of all oral cancers, that is, more than 90%. Carcinomas of the gingiva represent a distinct subgroup of OSCC, constituting approximately 12% of all OSCC cases. These neoplasms might mimic the inflammatory and reactive state of the periodontium, often leading to a delay in diagnosis and hence, poorer prognosis. A case of gingival squamous cell carcinoma in a 48-year-old female patient has been reported here, in which the patient had no risk factors for the development of this neoplasm. The patient presented with a 3-month history of pain and burning sensation in the lower left back region of the jaw. Clinical examination showed a proliferative lesion extending from the marginal gingiva to the buccal vestibule adjacent to teeth 36 and 37. Given the clinical manifestations and differential diagnosis of infectious granulomatous lesions and malignant neoplasms, an excisional biopsy was performed and a diagnosis of well-differentiated squamous cell carcinoma was made. The patient was subsequently referred to the Oral and Maxillofacial Surgery Department for further treatment, which included surgical excision of the tumor with segmental mandibulectomy and selective neck dissection. The patient is still being monitored one and a half years after the treatment and does not show any signs of recurrence. Therefore, the lesion must be identified early to start treatment, stop metastases, and enhance the prognosis.