Aggressive Neoplasms That Mimic Chronic Endodontic Lesions: A Multi-Institutional Case Series

This study aimed to report sociodemographic, clinicopathologic and radiological features of 12 cases of aggressive neoplasms that were clinically diagnosed as chronic endodontic lesions. The series comprised seven females (58.33%) and five males (41.67%), with a mean age of 48.9 ± 19.19 years (range: 16-75 years). In six cases (50%), the posterior maxillary region was involved. Internal appearance was radiolucent density (n = 12/100%). Eleven cases (91.67%) exhibited well-defined borders, while one (8.33%) showed ill-defined borders. Histopathologic diagnoses included metastasis (n = 4/33.33%), squamous cell carcinoma (n = 3/25%), mucoepidermoid carcinoma (n = 2/16.68%), acinic cell carcinoma (n = 1/8.33%), Ewing's sarcoma (n = 1/8.33%) and Langerhans cell histiocytosis (n = 1/8.33%). Survival status was retrieved for three patients (25.00%), all of whom were alive at the time of reporting. This study identified seven distinct histological types of aggressive neoplasms that mimic chronic periapical lesions. Given that such lesions often lack clinical or radiological signs of aggressive behaviour, it is imperative that all excised tissue undergo histopathological examination.