# Missed diagnosis of primary intraosseous squamous cell carcinoma - A case report

## TL;DR

A 40-year-old man was initially misdiagnosed with a tooth infection but later found to have a rare jaw cancer.

## Contribution

This case report highlights the diagnostic challenges of primary intraosseous squamous cell carcinoma.

## Key findings

- The patient was initially misdiagnosed with a periapical infection.
- Advanced imaging revealed total erosion of the left mandibular ramus.
- Biopsy showed acute inflammation with giant cells, delaying correct diagnosis.

## Abstract

Odontogenic epithelial remains are the source of the uncommon malignant central jaw tumour known as primary intraosseous squamous
cell carcinoma. Although both jaw bones may be affected, the mandible is typically affected. We describe a 40-year-old man who was first
misdiagnosed with a periapical infection involving his lower left wisdom tooth. Two years later, the patient arrived at our outpatient
department (OPD) with a significant swelling on the left side of the jaw. Advanced imaging and panoramic radiography showed a lesion
with total erosion of the left ramus. The mandibular angle biopsy (Fine Needle Aspiration Cytology)) showed acute suppurative
inflammation with a large number of giant cells.