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