What are the clinical manifestations of central jaw cancer

Central mandibular cancer is called primary mandibular cancer. It was first used to define squamous cell carcinoma originating in the mandible. Now it mostly refers to malignant tumors originating from non-mesenchymal tissues in the mandible, including glandular and epithelial. Epithelial origin mainly comes from the remaining cells of the enamel epithelium of the tooth germ, including the remaining cells of the enamel epithelium of the tooth germ remaining in the periodontal ligament, the residual embryonic epithelium during the fusion of the facial processes, the lining of odontogenic cysts, etc., as well as the malignant transformation of benign odontogenic tumors such as odontogenic keratocystic tumors and ameloblastomas, mostly squamous cell carcinomas. Glandular origin can be glandular epithelial carcinomas caused by the transformation of salivary gland epithelium, sinus epithelium or odontogenic cyst epithelial lining ectopically located in the mandible. There are many types, the most common of which is mucoepidermoid carcinoma.

In general, central mandibular cancer is relatively rare in clinical practice, the cause is still unclear, and there is a lack of characteristic clinical manifestations and imaging changes. It is discovered late and has a poor prognosis.

[Clinical manifestations] Squamous cell carcinoma in central mandibular cancer is more common in patients aged 60 to 79 years, with slightly more men than women; adenocarcinoma is more common in patients aged 50 to 59 years, with slightly more women. The most common site of occurrence is the mandible, especially the mandibular molar area. There are no subjective symptoms in the early stage, and toothache and local pain will appear later, followed by numbness of the lower lip. Clinically, we should be vigilant about the occurrence of unexplained numbness of the lower lip, and perform X-ray examination in time to identify whether central mandibular cancer has occurred. As the tumor grows, the affected teeth become loose or even fall off, the tumor passes through the alveolar socket, and the tumor appears on the buccal and lingual side of the alveolar process or the vestibule groove, with poor mobility. The tumor invades the bone and facial soft tissue, causing facial bulging. In the late stage, the tumor breaks through the bone and invades the masticatory muscles, resulting in limited mouth opening. The tumor can spread along the inferior alveolar nerve canal, and even beyond the midline to the opposite side. More than 50% of patients may experience lymph node metastasis in the submandibular and deep upper cervical regions. In the late stage, distant metastasis may occur through the bloodstream. Among them, the adenoid cystic carcinoma type has a higher rate of hematogenous metastasis, 1/4 of which metastasize to the lungs, and half of the patients can survive with the tumor.