Background:Eighty-five percent of peri-implant malignancies are oral squamous cell carcinomas (OSCCs), and most of them are misdiagnosed as peri-implantitis because of their clinical and radiological presentation; few studies have focused on addressing and solving the diagnostic issues related to peri-implant OSCCs.Objectives:The study aimed to describe the clinicopathological features of peri-implant OSCCs and to report the staging issues related to the diagnosis of these lesions.Methods:This retrospective cohort study included patients who received a diagnosis of and treatment for peri-implant OSCCs at the Unit of Dentistry of the “Aldo Moro” University of Bari (Italy) from 2018 to 2024. By using descriptive statistics, the authors highlighted the diagnostic issues related to the clinical presentation, radiological features, and histology of peri-implant OSCCs.Results:A total of 13 women and 8 men with a mean age of 70.6 ± 11.7 years met the inclusion criteria; the medical history of the participants showed potentially malignant disorders (OPMDs) in 52.4% of patients, whereas 14.3% had already developed an OSCC. The patients showed 24 peri-implant OSCCs; the clinical presentation was leuko-erythroplakia-like (41.7%) or erythroplakia-like (58.3%), thus simulating peri-implantitis; in addition, 52.0% of dental implants involved had a probing pocket depth ≥ 10 mm, further mimicking peri-implantitis. Panoramic radiograms and cone beam computed tomography were of little use in studying bundle bone–implant interfaces; in particular, the tomography showed circumferential bone resorption only in peri-implantitis-like OSCCs. In total, 91.6% of histological examinations of OSCCs showed peri-implantitis-like inflammation; early-stage lesions (pTNM I-II) accounted for 33.3%, whereas late-stage lesions (pTNM III-IV) accounted for 66.7%; lymph nodal metastases occurred in 25.0% and 62.5%, respectively. The mean follow-up was 3.4 ± 1.0 years; all patients with OPMDs had poorly differentiated tumors and thus showed a worse prognosis than those without OPMDs (mean disease-free survival of 15.5 ± 7.7 months and 44.7 ± 12.1 months, respectively).Conclusions:The results of the study showed that peri-implant OSCCs occurred most frequently in patients with OPMDs or previous OSCC; in addition, peri-implant OSCCs required demolition rather than conservative excision, and the prognosis of patients strictly depended on the grade of the cancer. In the authors’ experience, the clinical–radiological presentation simulating peri-implantitis was the feature that concurred most in complicating the diagnosis of those tumors.
背景：种植体周围恶性肿瘤中85%为口腔鳞状细胞癌（OSCCs），因其临床表现和影像学特征与种植体周围炎相似，多数被误诊；目前鲜有研究关注并解决与种植体周围OSCCs相关的诊断问题。目的：本研究旨在描述种植体周围OSCCs的临床病理特征，并报告与这些病变诊断相关的分期问题。方法：这项回顾性队列研究纳入2018年至2024年间在意大利巴里大学"阿尔多·莫罗"分校牙科中心接受种植体周围OSCCs诊断和治疗的患者。通过描述性统计分析，作者重点阐述了与种植体周围OSCCs临床表现、影像学特征及组织学相关的诊断问题。结果：共21例患者（女性13例，男性8例）符合纳入标准，平均年龄70.6±11.7岁；52.4%的患者有潜在恶性口腔疾病（OPMDs）病史，14.3%曾有OSCC病史。共发现24处种植体周围OSCCs病变：临床表现呈白红斑样（41.7%）或红斑样（58.3%），与种植体周围炎表现相似；52.0%受累种植体探诊深度≥10mm，进一步模拟种植体周围炎特征。全景片和锥形束CT对束状骨-种植体界面的评估价值有限；特别是CT仅在与种植体周围炎相似的OSCCs中显示环形骨吸收。91.6%的OSCCs组织学检查显示种植体周围炎样炎症；早期病变（pTNM I-II期）占33.3%，晚期病变（pTNM III-IV期）占66.7%；淋巴结转移率分别为25.0%和62.5%。平均随访3.4±1.0年：所有OPMDs患者均表现为低分化肿瘤，其预后较无OPMDs者更差（平均无病生存期分别为15.5±7.7个月和44.7±12.1个月）。结论：研究结果表明种植体周围OSCCs最常发生于OPMDs或既往OSCC患者；此外，种植体周围OSCCs需行根治性切除而非保守切除，患者预后严格取决于肿瘤分级。根据作者经验，模拟种植体周围炎的临床-影像学表现是导致此类肿瘤诊断复杂化的最主要特征。
Peri-Implant Oral Squamous Cell Carcinoma (OSCC): Clinicopathological Features and Staging Issues
肿瘤(癌症)患者之家