Primary intraosseous mandibular carcinoma arising from an odontogenic cyst

[摘要] Introduction:primary intraosseous squamous cell carcinoma is an infrequent malignant neoplasm. Objective:present a clinical case of primary intraosseous carcinoma arising from an odontogeniccyst in body regions to the left mandibular branch. Clinicalcase: a 68-year-old male patient presented with "discomfort" in his mandible.Oral examination revealed cortical expansion at the level of 37. Orthopantomographyshowed a radiolucent area with definite borders. Curettage and histologicaltesting confirmed the preliminary diagnosis of residual cyst. Some four monthslater the patient presented again with very intense pain in the mandibular angleregion with slight paresthesia of the left lower lip area associated on physicalfacial examination with lower and submandibular genian edema, and on oral examinationwith abnormal left mandibular bone mobility. Orthopantomography revealed a radiolucentimage of irregular, imprecise borders and pathological mandibular fracture.It was decided to immobilize and take a sample for biopsy, which reported moderatelydifferentiated epidermoid carcinoma. Therefore, radical surgical treatment wasperformed with neck management plus postoperative radiotherapy and chemotherapy. Conclusion: evolution of a residual cyst into a primary intraosseouscarcinoma is an infrequent condition in the maxillofacial region. In the caseherein presented diagnosis was made by exclusion. The symptoms of intense painand paresthesia were crucial to the preliminary diagnosis. Application of anoncological approach based on radical surgery with neck management and radio-and chemotherapy resulted in local-regional control.

[学科分类] 基础医学

[关键词] maxillomandibular neoplasms;squamous cell carcinoma;osseous cysts;mandible.