Primary intraosseous squamous cell carcinoma mimicking an odontogenic cyst: a case-report

Introduction: A rare case of primary intraosseous squamous cell carcinoma (PIOSCC) emerging from an apical cyst is presented. Main symptoms and findings: An 80-year-old woman presented with an asymptomatic radiolucent lesion in the mandibular premolar region, identified during routine radiographic screening. The lesion was associated with chronic inflammation and prior endodontic treatment. Diagnoses, interventions, and outcomes: Initial management included enucleation of the lesion with extraction of the involved teeth. Histopathology revealed a moderately differentiated PIOSCC. Following oncological evaluation, the patient underwent curative surgery and was scheduled for adjuvant therapy. Conclusion: Although apical cysts are typically benign, rare malignant transformation underscores the necessity for histopathological analysis of all excised lesions. This highlights the importance of vigilant diagnostic and therapeutic approaches for seemingly benign lesions.