Professional Documents
Culture Documents
diseases
Done by: FatimaFaisal Marhoon
20102050030
Disease mechanism
Uncontrolled
growth of tissue
Locally invasive
High degree of cellular anaplasia
Ability to metastasize regionally to lymph
node and distantly to other sites
Based of histopathology
Carcinoma (lesion of epithelial origin)
Metastatic lesion from distant sites
Sarcoma (lesions of mesenchymal origin)
Malignancies of hematopoietic system
Clinical features
Displaced teeth
Loosened teeth over a short time
Foul smell
Ulcerations
Presence of indurated or rolled border
Exposure of underlying bone
Hemorrhage
Sensorineural or sensorimotor deficits
Lymphoadenopathy
Weight loss
Dysgeusia
Dysphonia
Dysphagia
Lack of normal healing after oral surgery
Pain or rapid swelling with no obvious dental causes
Most oral cancers occur in men 50 years old and older
Imaging features
Location
Primary carcinoma: more common in tongue,
floor of the moth, tonsillar area, lip, soft palate,
or gingiva and may invade the jaws form any of
these sites
Sarcomas: mandible and posterior regions of
both jaws
Metastatic tumors: posterior mandible and
maxilla, apices of teeth or in the follicle of
developing teeth
Imaging features
Periphery and shape
Ill-defined borders with lack of cortication and
absent of encapsulation
Extend from an area of bone destruction to
region of normal bone (infiltrating pattern)
Finger like extensions
Imaging features
Internal structures
Radiolucent
Residual islands of bone might be present, patchy
destruction with residual internal osseous
structure
Some metastatic tumors (prostate and breast
lesions) abnormal appearing internal sclerotic
osseous architecture
Osteogenic sarcoma produce abnormal bone
radiopaque appearance
Imaging features
Effects on surrounding structure
Teeth appear floating in space
Root resorption (sarcomas, multiple myloma)
Destruction of internal trabecular bone
Destruction of cortical boundaries
Widening of PDL with destruction of lamina dura
Widening of ID canal
Hair one end or Sunburst appearance ,thin
straight spicules of bone (osteosarcoma; metastatic
prostate lesions)
Onion skin like appearance (secondary inflammatory
lesion)
Ill-defined borders
Infiltrating pattern
Floating
teeth
Carcinomas
1.
SQUAMOUS CELL
CARCINOMA
ARISING IN SOFT
TISSUE
Synonym
Epidermoid carcinoma
Disease mechanism
Most common oral malignancy
Malignant tumor originating from surface
epithelium
Etiology: Multifactorial; chronic smoking, alcohol,
mucosal human papillomavirues (tonsiliar and
tongue lesions)
Histopathology: invasion of malignant epithelial
cells into underlying connective tissue, deeper
soft tissue, adjacent bone, regional lymph nodes
and ultimately distant sites.
Clinical features
Most common in males older than 50 years
White, red or mixed patchy lesion
Central ulceration; a rolled or indurated border
Palpable infiltration into adjacent muscle or bone
Pain (variable)
Regional lymphadenopaty with hard lymph nodes
Soft tissue mass, paresthesia, anesthesia,
dysesthesia, foul smell, trismus, loosened teeth or
hemorrhage
Obstruct air ways, the opening of Eustachian
tube or the nasopharynx.
Weight loss, feel unwell
Imaging features
Location
SCC commonly involves lateral border of the
tongue
Bone invasion posterior lingual aspect of the
mandible
Lesions of lip and floor of the mouth invade the
anterior mandible
Lesions of attached gingiva and alveolar bone
mimic inflammatory diseases
Tonsils, soft palate and buccal vestibule
Imaging features
Periphery and shape
Internal structure
Radiolucent
Small islands of residual normal trabecular bone
might be visible in the center of radiolucency
Floating teeth
Destruction of anterior floor
of nasal fossa
Floating teeth
Destruction of bone in
mandibular retromolar area
Irregular
width of ID
canal and
destruction
of its
cortical
borders
Differential diagnosis
1 ) Inflammatory lesions such as Osteomyelitis
Both destructive leaving island of osseous
structure
SCC: profound bone destruction or invasive
characteristics
Osteomyelitis: produces periosteal reaction
2) Periodontal disease
If bone loss from SCC originate in the soft tissue
of the alveolar process
SCC enlargement of extraction socket instead of
healing and new bone formation
Management
Surgery
2. SQUAMOUS
CELL
CARCINOMA
ORIGINATING
FROM BONE
Synonyms
Primary intra osseous carcinoma
Intraavleolar carcinoma
Primary intra Intraavleolar epidermoid
carcinoma
Primary epithelial tumor of the jaw
Central seqaumous cell carcinoma
Primary odontogenic carcinoma
Intramandibular carcinoma
Central mandibular carcinoma
Disease mechanism
Squamous
Clinical features
More common in men
Fourth and eight decade of life
Pain
Pathologic fracture
Sensory nerve abnormalities
Imaging features
Location
More common in mandible
More common in molar region than anterior
aspect of the jaws
Tooth bearing parts of the jaw
Imaging features
Periphery and shape
Ill-defined periphery
Rounded or irregular in shape
Borders demonstrate osseous destruction
varying degrees of extension at periphery
Pathological fractures, step defects
Thinned cortical borders
Soft tissue mass
Imaging features
Internal structures
Radiolucent
Little residual bone within the lesion
center
Imaging features
Differential diagnosis
Periapical cyst or Granulomas
Odontogenic cyst
Metastatic lesion, Multiple myeloma,
Fibrosarcoma, carcinoma arising in a
dental cyst
Surface squamous cell carcinoma
Management
Tumors are excised with their
surrounding osseous structure
Radiation and chemotherapy as adjunctive
therapies