ABSTRACT
Necrotizing ulcerative periodontitis (NUP) is a painful and debilitating condition seen mostly in an immunocompromised state. Although squamous cell carcinoma (SCC) on gingiva is not uncommon, its presentation as a benign necrotizing lesion on gingiva is rare. Such presentations may lead to delayed diagnosis and poor prognosis. This report describes a case of a 34-year-old male presenting clinically with NUP around mandibular posterior teeth. Clinical features were misleading, but the histological findings established the diagnosis of well-differentiated SCC. Immunohistochemistry also showed features of epithelial-mesenchymal transition with decreased expression of E-cadherin and increased vimentin expression showing local invasion and metastasis. The patient was referred to the oncology department for evaluation of possible metastasis and further management of carcinoma.
ABSTRACT
Gingival enlargement is a common periodontal pathology seen in medically compromised patients. Although it is not the disease itself, certain medications used to treat these chronic diseases are known to precipitate the gingival enlargement. Periodontitis (PD) and gingival enlargement have been reported increasingly in patients with chronic renal failure. Severe enlargement is detrimental to esthetics and function while having a negative impact on the overall oral health-related quality of life. Treatment of such cases requires comprehensive periodontal management by a specialist, keeping in mind the medically compromised state of the patient. This report presents a case of severe PD with generalized gingival enlargement in a 45-year-old male who was a known case of Stage 4 chronic kidney disease, obstructive uropathy, and hypertension. Gingival enlargement was managed by gingivectomy and gingivoplasty. Six months' follow-up showed no sign of recurrence.
