ORAL CUNICULATUM CARCINOMA : A RARE VARIANT OF SQUAMOUS CELL CARCINOMA

Oral carcinoma cuniculatum is a rare variant of squamous cell carcinoma, recently recognized as a distinct entity in the 2022 WHO classification. It is characterized by slow but locally aggressive growth, a deceptive clinical presentation, and a distinctive histopathological architecture with endophytic proliferation of deep keratin-filled crypts. We report the case of an 80-year-old woman with type 2 diabetes who presented with a palatal lesion evolving over seven years. Imaging revealed an infiltrative soft tissue mass without evidence of bone destruction. Histopathological examination confirmed the diagnosis of oral carcinoma cuniculatum. The main differential diagnoses include verrucous carcinoma and conventional squamous cell carcinoma, highlighting the importance of careful clinico-pathological correlation to avoid frequent misdiagnosis. The recommended treatment is wide surgical excision with clear margins, while radiotherapy should be avoided due to the risk of anaplastic transformation. Despite its locally destructive potential, the prognosis remains favorable, as regional and distant metastases are exceptionally rare. Greater awareness and early recognition are essential to optimize management and improve patient outcomes.