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      Primary intraosseous squamous cell carcinoma mimicking periapical disease: a case report

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          Abstract

          Primary intraosseous squamous cell carcinoma (PIOSCC) is a rare carcinoma, which arises within the jaws without connection to the oral mucosa and presumably develops from a remnant of odontogenic epithelium. We present a case of solid type PIOSCC in a 52-year-old male patient complaining of dull pain on his left lower molar. In this case, early stage PIOSCC mimicking a periapical lesion might lead to a one-year delay in treatment due to the misdiagnosis of osteomyelitis after extraction of the third molar. The clinical, radiological, and histologic features are described. In this case, there was initial radiographic evidence for PIOSCC mimicking a periapical lesion. Incautious radiographic interpretation and treatment procedures had delayed the correct diagnosis and resulted in extensive bony destruction during the patient's disease progression.

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          Malignant ameloblastoma or ameloblastic carcinoma.

          Pieter J Slootweg, R Müller (1984)
          The World Health Organization defines malignant ameloblastoma as a lesion exhibiting features of an ameloblastoma in primary and metastatic growths. To cases collected from the literature we have added two of our own cases in which features of an ameloblastoma were coupled with malignant behavior. It was noted that the diagnosis of "malignant ameloblastoma" is at present used in a rather indiscriminate way, resulting in the grouping of lesions that exhibit considerable differences in biological behavior and histomorphology. This might be due to the fact that the WHO classification emphasizes metastasis as a diagnostic criterion but is rather vague in defining histopathologic aspects. It is advocated that the term malignant ameloblastoma be reserved for those lesions that, in spite of a seemingly innocuous histology, have given origin to metastatic growths, while the WHO classification should be modified to include ameloblastic carcinoma as a diagnostic term for lesions that combine features of an ameloblastoma with a less-differentiated histomorphology.
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            Primary intraosseous carcinoma of the jaws. Review and update of odontogenic carcinomas.

            R Elzay (1982)
            According to the World Health Organization (WHO) classification system, primary intraosseous carcinoma (PIOC) of the jaw is the terminology recommended in lieu of primary intra-alveolar epidermoid carcinoma (PIAEC) of the jaw. Malignification of odontogenic cysts is now considered a separate entity. Therefore, data garnered from previous case series on PIAEC are not applicable to PIOC. This study reviews the literature on PIOC, excluding central carcinoma cases which arose in odontogenic cysts. Twelve cases were found. The PIOC has a predilection for males (3:1), is noted chiefly in adults, occurs most frequently in the mandible, is histologically nonkeratinizing in 58 percent of the cases, and exhibits peripheral palisading in 58 percent of the cases. A plexiform or alveolar pattern was noted in 67 percent of the cases. The prognosis is quite poor, with only 40 percent of the patients surviving more than 2 years. A modification of the WHO classification system to include "ameloblastic carcinoma" is suggested.
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              Primary intraosseous carcinoma of the mandible with probable origin in an odontogenic cyst.

              Thomas Mustoe, Joseph A. Waldron (1989)
              Primary intraosseous carcinoma of the jaws (PIOC) is an uncommon lesion, but may not be as rare as commonly believed. Since the putative source of the epithelium giving rise to an intraosseous carcinoma is the epithelium involved in odontogenesis, these lesions are often designated as odontogenic carcinomas. These tumors may theoretically arise (1) from the lining of odontogenic cysts, (2) from other epithelial odontogenic tumors, or (3) de novo from presumed odontogenic rests. While not included in most classifications of PIOC, it appears logical to also include intraosseous mucoepidermoid carcinomas as a fourth type of PIOC. A case of primary intraosseous squamous cell carcinoma of the mandible, with evidence of origin in an odontogenic cyst, is presented. The recent literature on carcinomas arising in jaw cysts is reviewed.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Imaging Sci Dent
                Journal ID (iso-abbrev): Imaging Sci Dent
                Journal ID (publisher-id): ISD
                Title: Imaging Science in Dentistry
                Publisher: Korean Academy of Oral and Maxillofacial Radiology
                ISSN (Print): 2233-7822
                ISSN (Electronic): 2233-7830
                Publication date (Print): December 2012
                Publication date (Electronic): 23 December 2012
                Volume: 42
                Issue: 4
                Pages: 265-270
                Affiliations
                Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University, Seoul, Korea.
                [* ]Department of Oral and Maxillofacial Radiology, Kangdong Sacred Heart Hospital, Hallym Medical Center, Seoul, Korea.
                Author notes
                Correspondence to: Prof. Yong-Suk Choi. Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul 130-701, Korea. Tel) 82-2-958-9406, Fax) 82-2-965-1256, omrcys@ 123456khu.ac.kr
                Article
                DOI: 10.5624/isd.2012.42.4.265
                PMC ID: 3534183
                PubMed ID: 23301215
                SO-VID: 4602d7a2-74b6-4952-99bc-04704101570e
                Copyright © Copyright © 2012 by Korean Academy of Oral and Maxillofacial Radiology
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 22 April 2012
                Date revision received : 24 May 2012
                Date accepted : 04 June 2012
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Dentistry
                Keywords: carcinoma, squamous cell,head and neck neoplasms,periapical disease,mandible
                Data availability:
                ScienceOpen disciplines: Dentistry
                Keywords: carcinoma, squamous cell, head and neck neoplasms, periapical disease, mandible

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