Treatment

The incisional biopsy was performed under local anesthesia while the surgery was performed under general anesthesia. The anterior maxillary alveolar ridge was surgically excised to involve the anterior four incisors. A previously fashioned dental prosthesis was inserted in the site of the maxillary defect, and the cavity was packed with Xeroform gauze.

Incisional and excisional biopsy

The histology of the incisional and excisional specimens was similar; both showed proliferative epithelium invading the underlying fibrous connective tissue in the form of broad islands and sheets of epithelial cells (Figure 3). The neoplastic epithelial cells showed evidence of loss of maturation, large nuclei with prominent nucleoli, high mitotic activity, individual cell keratinization and keratin pearls (Figure 4).

Figure 3 H & E stained section at 100X magnification demonstrating confluent, proliferative, neoplastic epithelial cells cut tangentially.

 

Figure 4. H & E stained section at 200x magnification demonstrating high mitotic activity, large nuclei with prominent nucleoli, nuclear and cellular disorganization, etc, all features of neoplastic epithelial cells.