Mistaken identity of polymorphous low‐grade adenocarcinoma treated as periapical lesion in anterior maxilla: A case report

This report presents a rare case of polymorphous low‐grade adenocarcinoma (PLGA) in the anterior maxilla, mimicking a periapical lesion. A 56‐year‐old male reported with a painless swelling in the maxillary right canine‐premolar region. The patient gave a history of root canal therapy for the same t...

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Bibliographic Details
Published in:Australian endodontic journal 2023-09, Vol.49 (S1), p.470-475
Main Authors: Srirangarajan, Sridharan, Shashidara, R., Ramya, Raghu, Harika, S., Pritham, Shetty N., Ravi, Rao J., Malagi, Prathima, Srikumar, Prabhu, Ashish, Shetty
Format: Article
Language:English
Subjects:
Adenocarcinoma
Anesthesia
Bone healing
Cancer
Case reports
Dental roots
Endodontics
Lesions
Maxilla
Metastases
Polylactide-co-glycolide
Positron emission tomography
Root canals
Teeth
Tomography
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Summary:This report presents a rare case of polymorphous low‐grade adenocarcinoma (PLGA) in the anterior maxilla, mimicking a periapical lesion. A 56‐year‐old male reported with a painless swelling in the maxillary right canine‐premolar region. The patient gave a history of root canal therapy for the same teeth one month ago. On intraoral examination, the involved teeth were restored with ceramic crowns. Radiographic examination revealed inadequate obturation with an ill‐defined radiolucency in the periapical region. 3D cone beam computer tomography (CBCT) revealed erosion of the buccal cortical plate near the apices of the roots. Endodontic re‐treatment was performed on both the teeth. Following this, the lesion was excised and submitted for histopathological analysis wherein it was identified as PLGA. Computerised tomographic (CT) scan and positron emission tomography scan (PET) results showed no regional or distant metastasis. Under general anaesthesia, the teeth were extracted, and wide surgical excision of the anterior maxilla was done till the healthy bone was exposed. Healing was uneventful during the follow‐up period.
ISSN:1329-1947
1747-4477
DOI:10.1111/aej.12723