Ref: Maxillofacial Imaging ,T A Larheim , P L Westesson 2006 Malignant Jaw tumors By: Nour-Eldin Mohammed Ref: Maxillofacial Imaging ,T A Larheim , P L Westesson 2006

Squamous Cell Carcinoma Synonyms: Epidermoid carcinoma Clinical Features Most common malignancy of oral cavity Males more frequent than females Older age groups (50 years and older), but also younger than 30 years Most frequent in tongue,floor of mouth,mandibular gingiva; retromolar trigone, and anterior tonsillar pillar, soft palate

Clinical photograph shows leukoplakia that transformed to gingival cancer Intraoral panoramic view shows diffuse bone destruction

Coronal CT image Coronal T2- fat suppressed MRI Squamous cell carcinoma, maxilla; 70-year-old female with some bleeding from tender soft tissue mass of right gingival mucosa.

Mucoepidermoid Carcinoma Clinical Features Swelling with or without pain Mandible, posterior regions, more frequent than maxilla Females more frequent than males (unlike most oral carcinomas) Fourth and fifth decades, but may occur in any age group Spread to regional lymph nodes in less than 10%

Panoramic view Axial CT image Coronal CT image Coronal T1-weighted post-Gd MRI

Adenoid Cystic Carcinoma Clinical Features Most commonly seen in minor salivary glands of head and neck, usually palate. Mostly as a painless mass, slowly growing Unlike most carcinomas, seldom metastasizes to regional lymph nodes Lung most common site of metastasis Perineural spread in more than 50%; frequent distant metastasis Slight female predominance Fourth to sixth decades

Axial CT image Axial T2-weighted MRI Coronal T1-weighted pre-Gd MRI Coronal T1-weighted post-Gd

Non-Hodgkin’s Lymphoma Clinical Features Non-Hodgkin’s lymphoma of extranodal sites (as opposed to Hodgkin’s lymphoma which is predominantly nodal) Extranodal involvement may include maxillary sinus and maxilla or, less frequently, mandible All age groups, adults in particular Burkitt’s lymphoma affects children; shows rapid growth and may involve one or both jaws

Non-Hodgkin’s lymphoma, maxilla; 49-year-old male painless swelling

Multiple Myeloma Clinical Features (Myeloma) Most common primary bone malignancy in adults Males more frequent than females Older age groups (50 years) Bone pain, malaise Plasmacytoma is a solitary form of myeloma

Osteosarcoma Clinical Features Only 5–10% in head and neck; mostly in jaws Usually painless swelling in jaws Mandible slight predominance Males slight predominance May occur in any age group; peak in fourth decade Prognosis of jaw sarcoma is poor

Chondrosarcoma Clinical Features Mostly in adults in fourth to sixth decades Less aggressive, more slowly growing than osteosarcoma Better prognosis; metastasizes more seldom than osteosarcoma Mandible and maxilla, but rare

Ewing Sarcoma Clinical Features Only 1–4% in head and neck area; most commonly mandible Hard swelling, pain or pain-free Males more frequent than females Usually first and second decades, but may occur at any age

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