Gingival Squamous Cell Carcinoma Masquerading as Localized Periodontal Disease in the Maxilla: A Case Report

Elnaz Jalali1, Jyoti Mago2, *, Aditya Tadinada3
1 Department of Oral and Maxillofacial Radiology, Oral and Maxillofacial Radiology Practice, Dallas, Texas
2 Department of Oral and Maxillofacial Radiology, University of Nevada, Las Vegas, NV 89154, USA
3 School of Dental Medicine, University of Connecticut, Farmington, CT 06030, USA

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© 2022 Jalali et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Oral and Maxillofacial Radiology, University of Nevada, Las Vegas, NV 89154, USA;



Squamous cell carcinoma is a malignant neoplasm of epithelium. In the U.S., carcinoma of the gingiva constitutes 4% to 16% of all oral carcinomas. This case report highlights such a case in maxillary gingiva and emphasizes the vital role of dental professionals, especially periodontists and endodontists, in being cognizant that an inflammatory lesion can mimic a serious condition like squamous cell carcinoma.

Case Presentation:

A patient who visited the screening clinic for an ulcerated lesion in the gingiva was otherwise healthy with no associated history of tobacco or any traumatic/persistent traumatic events.

The patient was treated for pseudoepitheliomatous hyperplasia based on the current condition and negative history of malignancy. On three months of follow-up, computed tomography radiographic evaluation and a biopsy were done, which were positive for the malignancy. Follow-up after six months includes PET, Head MRI, and chest X-ray examinations to rule out any metastatic entity.


A six-month follow-up radiographic examination revealed metastasis of the entity. Additional findings include pleural effusion and underlying infections.


Early diagnosis is the key to the treatment plan. It further highlights the role of advanced imaging as a vital tool in determining the extent of the disease. Therefore, any persistent lesion exhibiting features that are not responding to conventional gingival and periodontal treatment options for more than two weeks should be referred for further evaluation to rule out cancer.

Keywords: Gingiva, Squamous cell, Carcinoma, Periodontal disease, Mimic, Gum.