SYNCHRONOUS ORAL  SQUAMOUS CELL CARCINOMA IN A  PATIENT WITH SYSTEMIC LUPUS ERYTHEMATOSUS: AN UNCOMMOM PRESENTATION

Gerardo Gilligan; Federico Garola; Pedro Benavides; Bruno Augusto Benevenuto de Andrade; René Panico

doi:10.5327/2525-5711.472

Authors

Gerardo Gilligan Oral Medicine Department. Facultad de Odontología. Universidad Nacional de Córdoba https://orcid.org/0000-0002-5201-1444
Federico Garola Oral Medicine Department. Facultad de Odontología. Universidad Nacional de Córdoba https://orcid.org/0000-0001-8639-2057
Pedro Benavides Oral Medicine Department. Facultad de Odontología. Universidad Nacional de Córdoba https://orcid.org/0009-0004-7852-0804
Bruno Augusto Benevenuto de Andrade Department of Oral Pathology and Diagnosis. Federal University of Rio de Janeiro https://orcid.org/0000-0002-3259-606X
René Panico Oral Medicine Department. Facultad de Odontología. Universidad Nacional de Córdoba https://orcid.org/0000-0002-5833-5546

DOI:

https://doi.org/10.5327/2525-5711.472

Keywords:

lupus, autoinmune diseases, oral, cancer

Abstract

Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect multiple organs, including the oral mucosa. Although SLE has been recognized as an oral potentially malignant disorder (OPMD), malignant transformation within lupus-related oral lesions is exceptionally rare.

Case report: This report describes a 77-year-old woman with SLE who developed three synchronous oral carcinomas—two verrucous carcinomas and one conventional oral squamous cell carcinoma (OSCC)—after years of chronic, treatment-refractory mucosal lesions. Histopathological examination revealed multifocal epithelial dysplasia and carcinoma, suggesting a phenomenon of field cancerization (FC). The patient, who lacked classical risk factors such as tobacco or alcohol use, was treated successfully with radiotherapy, achieving complete remission and no recurrence after 18 months of follow-up. The present report highlights the potential role of chronic inflammation and long-term immunosuppression in oral carcinogenesis in SLE. It also underscores the diagnostic challenges in differentiating lupus lesions from other OPMDs and the importance of serial biopsies for early detection of dysplastic transformation.

Conclusion: The coexistence of FC and SLE has not been previously reported, and this case contributes novel clinical and histopathological evidence supporting the inclusion of SLE among conditions predisposing to multifocal oral cancer.

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