Cutaneous odontogenic sinus simulating a basal cell carcinoma: case report and literature review

A woman was referred for Mohs' microscopically controlled surgical excision of a presumptive basal cell carcinoma located on her nasolabial fold. During examination, pus was expressed from the nodulocystic lesion and an intraoral palpation revealed a fibrous sinus tract extending from the skin lesion to the gingiva of a severely carious tooth. There was roentgenographic evidence of a periapical abscess. The diagnosis was revised to that of a cutaneous odontogenic sinus. The possibility of a draining dental sinus to the skin should be seriously considered when evaluating a suspected basal cell carcinoma in the perioral region--especially in an individual with a history of extensive dental treatments, antecedent oral trauma, or markedly carious teeth.