Microinvasive Oral Squamous Cell Carcinoma of Gingiva: An Enigma


microinvasive oral squamous cell carcinoma
verrucous leukoplakia


Microinvasive oral squamous cell carcinoma (MIOSCC) of gingiva is an early stage relatively ‘thin’ tumour without invasion of deep tissues. A 55-year-old male reported with the chief complaint of gum swelling in lower right back jaw region for one month. On examination, diffuse, unscrappable, white homogenous plaque extending from 35 to 48 was present with a firm, sessile gingival growth approximately eight millimetre in diameter. A provisional diagnosis of verrucous leukoplakia was made. Hence, biopsy was performed which confirmed MIOSCC and mild dysplasia for different sites. The patient is on regular follow-up and with no signs of recurrence.



Johnson NW, Jayasekara P, Amarasinghe AA. Squamous cell carcinoma and precursor lesions of the oral cavity: Epidemiology and aetiology. Periodontol 2000. 2011 Oct;57(1):19-37.
Shankar AA, Gokul S. The dilemma of microinvasion. Head Neck Oncol. 2014 Jul 18;6(3):30-1.
Pentenero M, Navone R, Motta F, Marino R, Gassino L, Broccoletti R, Gandolfo S. Clinical features of microinvasive stage I oral carcinoma. Oral Dis. 2011 Apr; 17(3):298-303.
Byatnal AA, Natarajan J, Shenoy S, Kamath A, Hunter K, Radhakrishnan R. A 3-dimensional assessment of the depth of tumour invasion in microinvasive tongue squamous cell carcinoma - A case series analysis. Med Oral Patol Oral Cir Bucal. 2015 Nov 1;20(6):e645-50.
Bianchi S, Vezzosi V. Microinvasive carcinoma of the breast. Pathol Oncol Res. 2008;12:105-11.
Carroll WR. Surgery for cancer of the oral cavity. In: Fisher JE, Bland KI. Master of surgery. 5th ed. Lippincott Williams and Wilkins. 2007;1:308
Regmee P, Rimal J, Maharjan IK, Shrestha A, Niroula D, Luitel A, et al. Microinvasion: A clinical dilemma. Kathmandu Univ Med J. 2019;65(1):72-4.