{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T19:25:48Z","timestamp":1773689148449,"version":"3.50.1"},"reference-count":30,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Eighty-five percent of peri-implant malignancies are oral squamous cell carcinomas (OSCCs), and most of them are misdiagnosed as peri-implantitis because of their clinical and radiological presentation; few studies have focused on addressing and solving the diagnostic issues related to peri-implant OSCCs. Objectives: The study aimed to describe the clinicopathological features of peri-implant OSCCs and to report the staging issues related to the diagnosis of these lesions. Methods: This retrospective cohort study included patients who received a diagnosis of and treatment for peri-implant OSCCs at the Unit of Dentistry of the \u201cAldo Moro\u201d University of Bari (Italy) from 2018 to 2024. By using descriptive statistics, the authors highlighted the diagnostic issues related to the clinical presentation, radiological features, and histology of peri-implant OSCCs. Results: A total of 13 women and 8 men with a mean age of 70.6 \u00b1 11.7 years met the inclusion criteria; the medical history of the participants showed potentially malignant disorders (OPMDs) in 52.4% of patients, whereas 14.3% had already developed an OSCC. The patients showed 24 peri-implant OSCCs; the clinical presentation was leuko-erythroplakia-like (41.7%) or erythroplakia-like (58.3%), thus simulating peri-implantitis; in addition, 52.0% of dental implants involved had a probing pocket depth \u2265 10 mm, further mimicking peri-implantitis. Panoramic radiograms and cone beam computed tomography were of little use in studying bundle bone\u2013implant interfaces; in particular, the tomography showed circumferential bone resorption only in peri-implantitis-like OSCCs. In total, 91.6% of histological examinations of OSCCs showed peri-implantitis-like inflammation; early-stage lesions (pTNM I-II) accounted for 33.3%, whereas late-stage lesions (pTNM III-IV) accounted for 66.7%; lymph nodal metastases occurred in 25.0% and 62.5%, respectively. The mean follow-up was 3.4 \u00b1 1.0 years; all patients with OPMDs had poorly differentiated tumors and thus showed a worse prognosis than those without OPMDs (mean disease-free survival of 15.5 \u00b1 7.7 months and 44.7 \u00b1 12.1 months, respectively). Conclusions: The results of the study showed that peri-implant OSCCs occurred most frequently in patients with OPMDs or previous OSCC; in addition, peri-implant OSCCs required demolition rather than conservative excision, and the prognosis of patients strictly depended on the grade of the cancer. In the authors\u2019 experience, the clinical\u2013radiological presentation simulating peri-implantitis was the feature that concurred most in complicating the diagnosis of those tumors.<\/jats:p>","DOI":"10.3390\/cancers17132149","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T05:53:13Z","timestamp":1750917193000},"page":"2149","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Peri-Implant Oral Squamous Cell Carcinoma (OSCC): Clinicopathological Features and Staging Issues"],"prefix":"10.3390","volume":"17","author":[{"given":"Luisa","family":"Limongelli","sequence":"first","affiliation":[{"name":"Odontostomatology Unit, Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70125 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4012-0782","authenticated-orcid":false,"given":"Fabio","family":"Dell\u2019Olio","sequence":"additional","affiliation":[{"name":"Odontostomatology Unit, Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70125 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4810-1201","authenticated-orcid":false,"given":"Antonio","family":"D\u2019Amati","sequence":"additional","affiliation":[{"name":"Pathology Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1287-4285","authenticated-orcid":false,"given":"Eliano","family":"Cascardi","sequence":"additional","affiliation":[{"name":"Pathology Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7323-6405","authenticated-orcid":false,"given":"Marta","family":"Forte","sequence":"additional","affiliation":[{"name":"Odontostomatology Unit, Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70125 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2490-9484","authenticated-orcid":false,"given":"Rosaria Arianna","family":"Siciliani","sequence":"additional","affiliation":[{"name":"Odontostomatology Unit, Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70125 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfonso","family":"Manfuso","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgery Unit, Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70125 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0472-5338","authenticated-orcid":false,"given":"Eugenio","family":"Maiorano","sequence":"additional","affiliation":[{"name":"Pathology Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianfranco","family":"Favia","sequence":"additional","affiliation":[{"name":"Odontostomatology Unit, Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70125 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2992-893X","authenticated-orcid":false,"given":"Chiara","family":"Copelli","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgery Unit, Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70125 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9819-6229","authenticated-orcid":false,"given":"Saverio","family":"Capodiferro","sequence":"additional","affiliation":[{"name":"Odontostomatology Unit, Interdisciplinary Department of Medicine, Aldo Moro University of Bari, 70125 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"key":"ref_1","first-page":"e23","article-title":"Relationship between Oral Cancer and Implants: Clinical Cases and Systematic Literature Review","volume":"17","year":"2012","journal-title":"Med. Oral Patol. Oral Cir. Bucal"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/s40729-017-0109-z","article-title":"Primary Peri-Implant Oral Intra-Epithelial Neoplasia\/Carcinoma in Situ: A Case Report Considering Risk Factors for Carcinogenesis","volume":"3","author":"Noguchi","year":"2017","journal-title":"Int. J. Implant Dent."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1038\/sj.bdj.2016.863","article-title":"Is there an Association between Dental Implants and Squamous Cell Carcinoma?","volume":"221","year":"2016","journal-title":"Br. Dent. J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1016\/j.joms.2016.02.008","article-title":"Primary Oral Malignancy Imitating Peri-Implantitis","volume":"74","author":"Raiser","year":"2016","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1007\/s12105-021-01402-9","article-title":"Update from the 5th Edition of the World Health Organization Classification of Head and Neck Tumors: Tumours of the Oral Cavity and Mobile Tongue","volume":"16","author":"Muller","year":"2022","journal-title":"Head Neck Pathol."},{"key":"ref_6","first-page":"339","article-title":"Histologic Subtypes of Oral Squamous Cell Carcinoma: Prognostic Relevance","volume":"73","author":"Pereira","year":"2007","journal-title":"J. (Can. Dent. Assoc.)"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.47162\/RJME.61.4.22","article-title":"Oral Cancer Histopathological Subtypes in Association with Risk Factors: A 5-Year Retrospective Study","volume":"61","author":"Roi","year":"2020","journal-title":"Rom. J. Morphol. Embryol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s40729-024-00527-0","article-title":"Clinical Retrospective Analysis of Peri-Implant Oral Malignancies","volume":"10","author":"Seo","year":"2024","journal-title":"Int. J. Implant Dent."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"17","DOI":"10.3322\/caac.21763","article-title":"Cancer Statistics, 2023","volume":"73","author":"Siegel","year":"2023","journal-title":"CA Cancer J. Clin."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1902\/cap.2015.150041","article-title":"Oral Squamous Cell Carcinoma Mimicking Peri-Implantitis","volume":"6","author":"Chang","year":"2016","journal-title":"Clin. Adv. Periodontics"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.joms.2012.06.184","article-title":"Peri-Implant Primary Squamous Cell Carcinoma: A Case Report with 5 Years\u2019 Follow-Up","volume":"71","author":"Marini","year":"2013","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s40729-022-00409-3","article-title":"Squamous Cell Carcinoma around a Subperiosteal Implant in the Maxilla and the Association of Chronic MECHANICAL irritation and Peri-Implantitis: A Case Report","volume":"8","author":"Watanabe","year":"2022","journal-title":"Int. J. Implant Dent."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"S313","DOI":"10.1002\/JPER.17-0739","article-title":"Peri-Implant Diseases and Conditions: Consensus Report of Workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions","volume":"89","author":"Berglundh","year":"2018","journal-title":"J. Periodontol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1055\/s-0040-1715779","article-title":"Peri-Implantitis Update: Risk Indicators, Diagnosis, and Treatment","volume":"14","author":"Rokaya","year":"2020","journal-title":"Eur. J. Dent."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.oooo.2016.08.023","article-title":"Clinicopathologic Evaluation of malignancy Adjacent to Dental Implants","volume":"123","author":"Kaplan","year":"2017","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.ijom.2022.08.004","article-title":"Do Dental Implants Facilitate Bone Invasion in Patients with Oral Squamous Cell Carcinoma? A Case Series","volume":"52","author":"Verstraeten","year":"2023","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"W8","DOI":"10.1308\/147870809X450584","article-title":"Squamous Cell Carcinoma Presenting as Peri-Implantitis: A Case Report","volume":"91","author":"Gulati","year":"2009","journal-title":"Ann. R. Coll. Surg. Engl."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1111\/cid.12905","article-title":"Histopathological Analysis of Biopsies of \u201cPeri-Implant Inflammatory Lesions.\u201d Everything Is Not What It Seems","volume":"22","year":"2020","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1007\/s10103-019-02932-z","article-title":"Early Tongue Carcinomas (Clinical Stage I and II): Echo-Guided Three-Dimensional Diode Laser Mini-Invasive Surgery with Evaluation of Histological Prognostic Parameters. A Study of 85 Cases with Prolonged Follow-Up","volume":"35","author":"Limongelli","year":"2020","journal-title":"Lasers Med. Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"S36","DOI":"10.14219\/jada.archive.2001.0387","article-title":"Perform a death-defying act: The 90-Second Oral Cancer Examination","volume":"132","author":"Horowitz","year":"2001","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1111\/odi.13873","article-title":"Peri-Implantitis-Like Medication-Related Osteonecrosis of the Jaw: Clinical Considerations and Histological Evaluation with Confocal Laser Scanning Microscope","volume":"28","author":"Tempesta","year":"2022","journal-title":"Oral Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e2","DOI":"10.5037\/jomr.2023.14302","article-title":"Inflammatory Gene Profile and Particle Presence in Peri-Implant Mucosa: A Pilot Study on 9 Patients","volume":"14","author":"Olander","year":"2023","journal-title":"J. Oral Maxillofac. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1053\/j.ro.2023.04.001","article-title":"Differentiating Post-Treatment Changes from Tumor Recurrence in the Oral Cavity and Oropharynx","volume":"58","author":"Tran","year":"2023","journal-title":"Semin. Roentgenol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1111\/adj.12581","article-title":"Peri-Implant Squamous Cell Carcinoma","volume":"63","author":"Ito","year":"2018","journal-title":"Aust. Dent. J."},{"key":"ref_25","first-page":"34","article-title":"Malignancy around Implants in Patients with a History of a Potentially Malignant or Malignant Lesion: A Systematic Review","volume":"72","author":"Gupta","year":"2024","journal-title":"Gen. Dent."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1862","DOI":"10.1111\/odi.13704","article-title":"Oral potentially malignant disorders: A Consensus Report from an International Seminar on Nomenclature and Classification, Convened by the WHO Collaborating Centre for Oral Cancer","volume":"27","author":"Warnakulasuriya","year":"2021","journal-title":"Oral Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.5037\/jomr.2017.8301","article-title":"Oral Cancer around Dental Implants Appearing in Patients With\\without a History of Oral or Systemic Malignancy: A Systematic Review","volume":"8","author":"Pinchasov","year":"2017","journal-title":"J. Oral Maxillofac. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1699","DOI":"10.1111\/odi.13714","article-title":"PD-L1 Expression Patterns in Oral Cancer as an Integrated Approach for Further Prognostic Classification","volume":"27","author":"Calsavara","year":"2021","journal-title":"Oral Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1002\/cre2.590","article-title":"PD-L1 in oral squamous cell carcinoma: A Key Biomarker from the Laboratory to the Bedside","volume":"8","author":"Nocini","year":"2022","journal-title":"Clin. Exp. Dent. Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"100875","DOI":"10.1016\/j.lanepe.2024.100875","article-title":"Cemiplimab in Locally Advanced or Metastatic Cutaneous Squamous Cell Carcinoma: Prospective Real-World Data from the DRUG Access Protocol","volume":"39","author":"Verkerk","year":"2024","journal-title":"Lancet Reg. Health Eur."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/13\/2149\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:58:56Z","timestamp":1760032736000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/13\/2149"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,26]]},"references-count":30,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["cancers17132149"],"URL":"https:\/\/doi.org\/10.3390\/cancers17132149","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,26]]}}}