Jaw tumor

Definition

A jaw tumor is a group of neoplasms localized in the jaw. The clinical picture is determined by the primary lesion’s localization and the degree of tumor malignization. The first signs of neoplastic neoplasm of the upper jaw are similar to the symptoms of chronic maxillary sinusitis. When the mandibular bone is affected, intact teeth acquire mobility of 2-3 degrees, and numbness of the lower lip occurs. Disseminated cancer of the jaw proceeds with intense pain syndrome. Diagnosis of the disease includes the collection of complaints, clinical examination, radiography, pathohistologicexamination. Treatment of jaw cancer is combined. Along with tumor removal, courses of radiation therapy are indicated.

General information

Jaw cancer is a pathological process of primary or secondary origin based on the transformation of healthy bone tissue cells into tumor cells. Malignant neoplasms of the upper jaw are more often diagnosed. In 60% of cases, the neoplastic process develops from the epithelial tissue lining the maxillary sinuses. 

The histologic structure of jaw cancer is predominantly squamous cell keratinizing. The main group of patients who come to the clinic is people aged 45-50. Ophthalmologists and otorhinolaryngologists, along with the surgeon-oncologist, examine the patient. Treatment of malignant neoplasm is combined. The prognosis for jaw cancer is unfavorable; a five-year survival rate is observed in 30% of patients.

Causes

In central (true) jaw cancer, the tumor originates from the Malasse islets. Secondary neoplasms occur when cancer cells sprout deep into the bone tissue from the maxillary sinus, alveolar process, palate, lateral surfaces of the tongue, and floor of the mouth. Most often, the neoplastic process of the upper jaw develops in patients against the background of chronic inflammation of the mucosa of the maxillary sinus. The prolonged course of maxillary sinusitis leads to the transformation of epithelial tissue cells.

The primary causes of secondary jaw cancer can also be trauma to the mucosa, exposure to ionizing radiation, bad habits (smoking, chewing tobacco), occupational hazards (working in hot shops or dusty rooms), and improper diet (excessive use of spicy, spicy foods). In addition, there is a risk of developing cancer of the jaw of metastatic origin in cancer patients with tumors of the kidneys, stomach, and lungs.

Symptoms of jaw cancer

In the initial stage of carcinogenesis, there are usually no complaints. In jaw cancer originating from the maxillary sinus epithelium, patients indicate nasal congestion, difficulty breathing, and mucous discharge with an admixture of blood. When the primary tumor is localized in the upper-internal corner of the maxillary sinus, in addition to the above symptoms, thickening and deformation of the lower medial wall of the orbit occur.

In jaw cancer develops due to the spread of malignant tumor cells into the bone from the lateral sinus; there is numbness of the skin and mucosa of the suborbital area. Patients complain of severe pain in the area of the molars. With tumors of the lower jaw, there may be paresthesia of the lower lip and chin tissues. Intact teeth become mobile. The III-IV stage of jaw cancer is indicated by the development of exophthalmos, impaired mouth opening, and the onset of neurological symptoms.

The bone tissue’s neoplastic process causes jaw deformation, and there is a high risk of pathological fractures. Without proper treatment, areas of ulceration may appear on the skin. If the primary focus of lesions in jaw cancer is a malignant tumor of the mucous membrane, the examination reveals a cancerous ulcer or mucosal overgrowths. A neoplasm with the endophytic type of growth is a crater-shaped ulcerous surface with an infiltrated bottom and compacted edges. In exophytic tumors in the oral cavity, mushroom-shaped growths with a pronounced infiltrate at the base are found.

Diagnosis

Diagnosis of jaw cancer is based on the analysis of complaints, physical examination data, and radiological, histological, and radioisotope examination methods. During the examination of patients with jaw cancer, the dentist detects asymmetry, facial deformity, and possibly skin ulceration. Often, with cancer of the jaw, diagnose paresthesia of the area that corresponds to the localization of the malignant tumor. In the course of palpatory examination, bone thickening is detected. Teeth located in the area of the lesion are mobile. The vertical percussion sign is positive.

In jaw cancer of secondary origin, an ulcer with signs of malignization or papillary growths is detected on the mucosa, at the base of which a pronounced infiltrate is detected by palpation. Lymph nodes in patients with jaw cancer are enlarged, thickened, and painless.

Radiographically, diffuse bone rarefaction is found in jaw cancer. There is no reparative or periosteal reaction. A cytological examination of the material taken from the ulcer surface is performed to confirm the diagnosis. With primary cancer of the jaw, a pathohistological analysis of the trepanned section of the affected bone is performed. A radioisotope method can also be used to detect a malignant tumor.

Jaw cancer is differentiated with chronic osteomyelitis, specific jaw diseases, and benign and malignant odontogenic and osteogenic tumors. The patient is examined by a maxillofacial surgeon, oncologist, ophthalmologist, and otorhinolaryngologist.

Jaw cancer treatment

When jaw cancer is detected, combined treatment is used. Along with the removal of the neoplasm, a course of pre- and postoperative radiation therapy is performed. At the preparatory stage in dentistry, impressions are taken to manufacture prostheses to replace the defect. Regarding mobile teeth, adhere to conservative tactics, as the risk of dissemination of cancer cells by the network of lymphatic vessels increases after surgery. If several enlarged mobile cervical lymph nodes or at least one fused lymph node are detected in jaw cancer, a cervical dissection is performed.

Vanach, Kreil, or fascial excision of subcutaneous tissue may be used depending on the clinical situation. The affected area of bone tissue in jaw cancer is resected together with the periosteum. If the tumor sprouts into adjacent areas, radical surgery is performed, expanding the boundaries of the surgical field. In the case of the spread of jaw cancer to the base of the skull, the use of gamma radiation is indicated. The prognosis of jaw cancer depends on the stage of the disease, age, immune status of the patient, and choice of treatment method.

All these treatment options are available in more than 510 hospitals worldwide (https://doctor.global/results/diseases/jaw-tumor). For example, Mandibular resection can be performed in these countries for following approximate prices:

Turkey $10.5 K in 16 clinics

China $26.5 K in 2 clinics

Germany $32.8 K in 12 clinics

Israel $38.8 K in 5 clinics

United States $48.4 K in 10 clinics.