Differential diagnosis of central jaw cancer

What are the differential diagnoses of central mandibular cancer? Central mandibular cancer mainly occurs from the remaining cells of the enamel epithelium of the tooth germ. These epithelial cells can remain in the periodontal ligament, cyst lining, and come from the malignant transformation of ameloblastoma. In terms of tissue type, it can be either squamous cell carcinoma or glandular epithelial carcinoma, and the latter is more common.

Early diagnosis of central mandibular cancer is very important, because misdiagnosis can delay the course of the disease and affect treatment and prognosis. Lower lip numbness is often the first symptom of central mandibular cancer, and X-ray examination should be performed in time.

Testing

The early X-ray manifestation is that the lesion is limited to the cancellous bone in the apical area, showing irregular worm-eaten destruction; it will destroy and infiltrate the compact bone later. In order to confirm the diagnosis, sometimes a tooth in the lesion area can be extracted and a piece of tissue can be scraped from the alveolar socket for pathological examination; if the compact bone has been penetrated to form a mass, biopsy is easier. Central mandibular cancer must be differentiated from chronic osteomyelitis. The latter often has a history of inflammation. In addition to bone destruction, X-rays also show signs of hyperplasia and repair, such as periosteal hyperplasia. If clinical and X-ray cannot be completely differentiated, frozen biopsy should be performed during surgery to rule out central cancer. Neuritis is relatively rare, and numbness may be mild or severe. If there is no bone destruction on X-ray films, if central mandibular cancer comes from cysts or ameloblastoma malignant transformation, it will have X-ray manifestations of cysts and ameloblastoma.

Differential Diagnosis

Like maxillary sinus cancer, central mandibular cancer is difficult to diagnose early and is often easily confused with alveolar abscess, mandibular osteomyelitis, and neuritis clinically. Therefore, clinicians are required to be highly vigilant.