ABSTRACT Carcinoma cuniculatum (CC) is a rare, well-differentiated variant of oral squamous cell carcinoma, characterised by keratin-filled burrowing channels and minimal cytological atypia. Its innocuous clinical appearance often leads to misdiagnosis and delayed intervention. We report the case of a 48-year-old male with a recurrent exophytic gingival lesion initially diagnosed as inverted follicular keratosis following superficial excision. Rapid regrowth prompted a deeper biopsy, which revealed the characteristic features of CC. Radiographic evaluation demonstrated no osseous involvement. Surgical excision was performed, and the patient was placed under close follow-up. This case highlights the diagnostic challenges associated with CC and emphasises the essential role of deep incisional biopsy in achieving an accurate diagnosis. The discussion integrates relevant literature and reinforces the need for heightened clinical suspicion, particularly in individuals with long-standing tobacco habits. Early identification is critical to prevent recurrence and guide appropriate management.
Syed et al. (Thu,) studied this question.