ABSTRACT Paracoccidioidomycosis (PCM) is a neglected systemic mycosis in Latin America that frequently involves the oral cavity. We herein describe two rare cases of synchronous mucocutaneous PCM and oral squamous cell carcinoma (OSCC) in 42‐ and 48‐year‐old men from an endemic area of Southeast Brazil. Clinically, both patients presented with painful, ulcerated oral lesions exhibiting granular/moriform features and multifocal involvement. PCM was confirmed by histopathological examination demonstrating pseudoepitheliomatous hyperplasia and granulomatous inflammation with fungal yeast forms, supported by Grocott‐Gomori methenamine silver staining. Fungal culture yielded cerebriform colonies with multiple budding yeasts. Chest radiography demonstrated PCM‐related pulmonary involvement in both patients, and one also exhibited cutaneous disease. Itraconazole was prescribed for both patients; however, treatment was discontinued in one case due to resumption of alcohol consumption and in the other due to homelessness. In both cases, OSCC involved the floor of the mouth; one patient underwent surgical resection, whereas the other is currently receiving chemoradiotherapy. Given that OSCC may coexist with oral PCM, clinicians should maintain a high index of suspicion when evaluating granulomatous/moriform oral lesions and perform timely, multi‐site biopsies, particularly in endemic areas.
Arruda et al. (2026) studied this question.