tumor of the jaw
DESCRIPTION
vaseghi abolfazlTRANSCRIPT
Tumours of the Jaws
Benign tumorThese lesions may be unsightly or
may be traumatised repeatedly, for example during shaving. Odontogenic cysts & non-odontogenic
tumor Soft tissue tumor and hard tissue
tumor
Malignant tumor The majority of these lesions spread
slowly over years but some may spread more rapidly to involve lymph glands in the local area or more distant areas. All will cause great damage if neglected.
Management of benign or malignant tumor Biopsy Surgical treatment Radiotherapy Chemotherapy
Tumor: Is a mass of cells,
tissues or organs resembling those normally present but arranged atypically and behave abnormally.
Behavior is very essential and is of great importance.
Classification: Histogenetic:
Epithelial origin connective tissue
origin
Histological: Degree of
differentiation. Well moderate poorly
differentiated
Clinical behavior: Benign:
slowly growing and expanding causing pressure atrophy but remain within the capsule.
Very few mitosis could be seen. Malignant:
Invade surrounding tissues and locally invasive. Progressive growth and metastasize to distant
organs, embolic spread due to lack of cell adhesion
Mitosis.Intermediate:
Locally invasive, no metastasis. Basal cell carcinoma and Ameloblastoma
Oral lesion are Carcinomas:
Non‑secreting epithelial Squamous cell
90% Secreting epithelial
Adenocarcinoma 5%
Sarcomas: Lymphomas Others
Early diagnosis is very essential for management
Clinical diagnosis from the signs and symptoms
Referral for essential investigation
CLINICAL DIAGNOSIS OF ORAL CANCER
Symptoms vary according to the site of the lesion painless in the early stages
painful and tender when secondarily infected or involves a sensory nerve
painless lump or ulcer on the lip
Posteriorly no symptom until it reach a size of 2‑3 cm swelling, pain and difficulty in deglutition
absence of symptoms until the tumor metastasize to regional lymph nodes hard lump on the neck
late symptoms: pain due to secondary infection or nerve
involvement excessive salivation difficulty in deglutition, speech haemorrhage
Within bone: painless swelling involving the buccal and lingual or
palatal sulci teeth become loose and painful ‑acute alveolar
abscess edentulous pt. the denture does not fit denture hyperplasia anaesthesia of the upper or lower lip and the cheek.
Carcinoma of lip: age 50‑70 years. Male
lower class. Predisposition factor:
dirty, jagged and stained teeth
irritation. tobacco smoker leukoplakia. intense solar radiation ‑
blistering cheilitis due to sunshine.
Carcinoma of tongue Anterior 2/3, affect males Posterior 1/3 equal in both sexes. Age over 60 years.
Predisposing factors: Female with cancer tongue suffer from
Paterson‑Kelly syndrome. Bad oral hygiene Heavy alcoholic with element of Vit.B deficiency.
Producing precancerous mucosal atrophy Syphilitic and leukoplakia. 25% and 5%. Superficial glossitis, papilloma, fissures and
non‑specific ulcers.
Clinically: Painless swelling Painful infected ulcer, referred pain to the ear. Excessive salivation, marked factor oris,
haemorrhage loss of mobility due to fixation to the floor of
the mouth.
Malignant Tumors Fixation occur at first on one side, when tongue is protruded it deviate toward the affected side
indurations, fungation or ulceration which spread to the floor of the mouth and alveolar process and from post. 1/3 to the fauces, valleculae and epiglottis bilaterally.
Spread to regional lymph nodes. Death: Inhalation bronchopneumonia,
haemorrhage, cachexia and starvation and asphyxia.
Carcinoma of the mouth: Floor of the mouth.
Typical malignant ulcer extend to alveolar process & tongue.
The cheek: warty and proliferative.
The alveolar process: warty, nodules or proliferative.
Palate: spread extensively before involving bone
papillary or ulcerative. Soft palate and fauces:
Poor prognosis. bilateral Lymph node involvement
Proliferative, fungating lesion spread to base of tongue.
Pain, dysphagia and death due to erosion of carotid artery