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

• 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
• ISSN: 1329-1947; 1747-4477
• DOI: 10.1111/aej.12723

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.