A rare case of intraoral schwannoma in gingiva.

BACKGROUND: Schwannomas are benign, slow-growing encapsulated nodular lesions. As for the most benign encapsulated lesions, the treatment of choice is complete removal of the entire tissue with preservation of surrounding tissue. METHODS AND RESULTS: The case presented is that of a 35-year-old female with the chief complaint of swelling on her gums in the lower left posterior region. Through intraoral and extraoral examinations the benign nature of the lesion was established. The excisional biopsy was carried out under local anesthesia, and the specimen was sent for histological examination, which gave a definite diagnosis of oral schwannoma. The patient was recalled at regular intervals so as to check for any recurrence of the lesion or occurrence of new lesions elsewhere in the body. CONCLUSION: The present case reemphasizes the importance of thorough clinical examination along with appropriate investigations, especially histopathological and immunohistochemical, for establishing a definitive diagnosis, which eventually plays an important role in the choice and execution of appropriate treatment at the earliest for the best prognosis and outcomes. KEY POINTS: Why is this case new information? To the best of the author's knowledge, this the first case report of oral schwannoma diagnosed in gingiva in Indian population. This case presented a diagnostic dilemma due to its unusual location. What are the keys to successful management of this case? Schwannomas when completely excised have low rate of recurrence. Accurate diagnosis of the lesion along with complete physical examination and follow-up at regular interval to rule out any recurrences are the keys to successful management of this case. What are the primary limitations to success in this case? Lack of data regarding residual tumor postoperative is a primary limitations to success of the case, as recurrence is associated with subtotal tumor removal.

A case of well-differentiated squamous cell carcinoma in an extraction socket.

Squamous cell carcinomas of the gingiva make up a significant percentage of oral squamous cell carcinomas and are one of the most common causes of death worldwide. Cancers of the gingiva often escape early detection, and hence an early intervention, since their initial signs and symptoms resemble common dental and periodontal infections. This article presents a case of a 29-year-old female patient who presented with a non-healing wound for about 1.5 months post-extraction. The wound was associated with pain and suppuration. A provisional diagnosis of alveolar osteitis was derived at with a differential diagnosis of osteomyelitis and carcinoma of the alveolus. The patient was advised a complete hemogram, orthopantomograph, and intra-oral periapical radiograph of the extraction socket. An incisional biopsy was carried out. Radiographs revealed extensive bone loss, and the biopsy report confirmed the diagnosis of well-differentiated squamous cell carcinoma of the alveolus. Carcinoma of the gingiva often mimics inflammatory lesions and hence is often misdiagnosed. Therefore, any oral lesion should strike a chord of suspicion, and practitioners should base their diagnosis on careful examination, and valid evidence.