Head and Neck Pathology

, Volume 13, Issue 4, pp 652–655 | Cite as

Carcinoma Cuniculatum of the Alveolar Mucosa: A Rare Variant of Squamous Cell Carcinoma

  • B. SivapathasundharamEmail author
  • B. Kavitha
  • V. M. Padmapriya
Sine qua non Clinicopathologic Correlation


Carcinoma cuniculatum is one of the variants of squamous cell carcinoma. It is significantly rare with an incidence rate < 1% compared to other histological variants of squamous cell carcinoma. Various etiologic factors implicated are trauma, HPV, chronic inflammation and alcohol consumption but real causative agent still remains unclear. Initially it resembles plantar wart which slowly progress to bulky exophytic mass in the sole of the foot, where cases have been reported first. In the oral cavity it presents clinically as an exophytic growth and slowly invades the jaw and destroys the underlying bone. Microscopically it exhibits as both exophytic and endophytic epithelial masses along with well differentiated and pronounced hyperkeratosis. Treatment includes surgical resection alone unlike other variants which are treated by radiation with or without chemotherapy. Here we present a case of carcinoma cuniculatum occurred in alveolar mucosa of a 47 years old female. It presented as an exophytic growth in mandibular alveolar region, with histological features consistent with carcinoma cuniculatum.


Cuniculatum Carcinoma Rare variant of squamous cell carcinoma 


  1. 1.
    Odell EW, Morgan PR. Texbook of biopsy pathology of the oral tissue. London: Chapman & Hall medical; 1988. pp. 233–6.Google Scholar
  2. 2.
    Aird I, Johnson HD, Lennox B, Stansfeld AG. Epithelioma cuniculatum: a variety of squamous carcinoma peculiar to the foot. Br J Surg. 1954;42:245–50.CrossRefGoogle Scholar
  3. 3.
    Flieger S, Owinski T. Epithelioma cuniculatum an unusual form of mouth and jaw neoplasm. Czas Stomatol. 1977;30:395–401.PubMedGoogle Scholar
  4. 4.
    Datar UV, Kale A, Mane D. Oral carcinoma cuniculatum: a new entity in the clinicopathological spectrum of oral squamous cell carcinoma. J Clin Diagn Res. 2017;11:ZD37–9.PubMedPubMedCentralGoogle Scholar
  5. 5.
    Lew W, Tark KC, Chun SI. Epithelioma cuniculatum arising from striate keratoderma. Ann Dermatol. 1992;4:83–6.CrossRefGoogle Scholar
  6. 6.
    Sepúlveda I, Spencer L, Platin E, Bravo F. Maxillary cuniculatum carcinoma: a case report and literature review. Int J Odontostomat. 2012;6:281–4.CrossRefGoogle Scholar
  7. 7.
    Arisi M, Zane C, Edu I, Battocchio S, Petrilli G, Calzavara-Pinton PG. Carcinoma cuniculatum of the foot invading the bone mimicking a pseudo-epitheliomatous reaction to an acute osteomyelitis. Dermatol Ther (Heidelberg). 2016;6:95–9.CrossRefGoogle Scholar
  8. 8.
    Raguse JD, Mennking H, Scholmann HJ, Bier J. Manifestation of carcinoma cuniculatum in the mandible. Oral Oncol Extra. 2006;42:173–75.CrossRefGoogle Scholar
  9. 9.
    Sivapathasundram B, Rajendran R. Epithelial tumors of the oral cavity. In: Sivapathasundram B, Shafer WG, Hine MK, Levy BM, editors. Shafer’s textbook of oral pathology. 8th ed. New Delhi: Elsevier Publishers; 2016. pp. 133–80.Google Scholar
  10. 10.
    Sun Y, Kuyama K, Burkhardt A, Yamamoto H. An immunohistochemical study of oral carcinoma cuniculatum. Int J Oral Med Sci. 2012;10:333–43.CrossRefGoogle Scholar
  11. 11.
    Padilla RJ, Murrach VA. Carcinoma cuniculatum of the oral mucosa: a potentially underdiagnosed entity in the absence of clinical correlation. Oral Surg Oral Med Oral Pathol Oral Radiol 2014;118:684–93.CrossRefGoogle Scholar
  12. 12.
    Fonseca FP, Pontes HA, Pontes FS, de Carvalho PL, Senal-Filho M, Jorge J, et al. Oral carcinoma cuniculatum: two cases illustrative of a diagnostic challenge. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;116:684–93.CrossRefGoogle Scholar
  13. 13.
    Barnes L, Eveson JW, Reichart P, Sidransky D. Tumours of the oral cavity and oropharynx: squamous cell carcinoma. In: Barnes L, Eveson JW, Reichart P, Sidransky D, editors. Pathology and genetics of head and neck tumours. Lyon: WHO/IARC Press; 2005. pp. 163–75.Google Scholar
  14. 14.
    Thavaraj S, Cobb A, Kalavrezos N, Beale T, Walker DM, Jay A. Carcinoma cuniculatum arising in the tongue. Head Neck Pathol. 2012;6:130–34.CrossRefGoogle Scholar
  15. 15.
    Kubik MJ, Rhatigan RM. Carcinoma cuniculatum: not verrucous carcinoma. J Cutan Pathol. 2012;39:1083–7.CrossRefGoogle Scholar
  16. 16.
    Allon D, Kaplan I, Manor R, Calderon S. Carcinoma cuniculatum of the jaw: a rare variant of oral carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94:601–8.CrossRefGoogle Scholar

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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • B. Sivapathasundharam
    • 1
    Email author
  • B. Kavitha
    • 1
  • V. M. Padmapriya
    • 2
  1. 1.Department of Oral PathologyMeenakshi Ammal Dental College and HospitalChennaiIndia
  2. 2.Meenakshi Ammal Dental College and HospitalChennaiIndia

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