Jaw cancer - symptoms, diagnosis and treatment

In the oral cavity, not only relatively harmless diseases can develop, but also cancerous diseases. An unhealthy lifestyle significantly increases the risk of developing oral cancer and other cancers.

Cancer of the jaw is called malignant tumors that can give distant metastases. It is diagnosed very rarely, especially in young people. Jaw cancer and jaw cancer are more likely to affect people whose body has been exposed to carcinogenic factors for many years. Factors that contribute to the development of mandibular cancer include: heavy smoking and frequent alcohol consumption. Cancer lesions are usually located in the back of the jaw.

In the group of young and middle-aged people, ameloblastomas are most often diagnosed, i.e. bone tumors. They cause damage to the jawbone and are usually locally malignant, meaning that they infiltrate surrounding tissues but rarely metastasize distantly. Ameloblastoma is rare in children. In a group of small patients, ameloblastoma most often develops as a result of an impacted tooth.

Ameloblastoma is difficult to detect; the disease can develop over many years, gradually destroying the jaw bone and infiltrating the surrounding tissues, but is most often detected incidentally. This is due to the absence of symptoms typical of the disease, prompting a visit to a doctor. Ameloblastoma is visible on radiographs taken before various dental, orthodontic, and cosmetic dentistry procedures. Unfortunately, due to the lack of need for a mandibular x-ray, patients are unaware that they have ameloblastoma until symptoms of advanced disease appear.

Mandibular ameloblastoma develops in the posterior part of the mandible, in the region of the molars, and is less dangerous than maxillary ameloblastoma because it does not infiltrate, for example. maxillary sinus. Ameloblastomas are not among the commonly diagnosed cancers, but it is worth learning more about them so as not to underestimate the symptoms that may indicate this disease.

The risk of developing oral diseases and related complications increases with the refusal of preventive examinations, during which changes that are invisible to the patient, but noticeable to an experienced dentist, can be detected. In many cases, dental checkups detect different types of cancer before they cause symptoms.

Amandibular ameloblastoma is a cancer that develops asymptomatically.

We associate oral diseases, especially dental diseases, with pain. Tooth decay or inflammation of the gums is associated with unpleasant ailments that prompt a visit to a specialist. In some cancers With ameloblastoma of the lower jaw, there is no pain, which makes it difficult to diagnose the disease in the early stages of its development. Ameloblastoma belongs to the group of odontogenic tumors. Some studies suggest that this cancer is related to HPV infection, which is associated with ameloblastoma.

It is worth knowing that the human papillomavirus HPV can be transmitted sexually. This virus also increases the risk associated with the development of other cancers, including cancer of the vulva and cervix, as well as cancer that develops in the soft tissues of the mouth.

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Ameloblastoma most often arises from the remnants of the dental lamina, but can also develop from the cells of the enamel organ, epithelial cells of the odontogenic cyst, cells of the epithelial islets of Maleses.

The place of development of ameloblastoma is mainly the posterior part of the lower jaw. Much less often, ameloblastoma affects the jaw and is formed in the soft tissues and mucous membrane of the alveolar process.

The most frequently diagnosed are benign ameloblastomas and locally malignant ameloblastomas, which infiltrate surrounding tissues, leading, among other things, to bone damage, but they do not cause distant metastases. A small percentage of all ameloblastomas are malignant or metastatic ameloblastomas. If malignant ameloblastoma is suspected, studies are performed to detect ameloblastoma cells in distant metastases, which confirms the diagnosis.

Due to the long absence of symptoms of the disease, ameloblastoma is detected by chance, i.e. before root canal treatment. Concern should be expressed, among other things, sensory disturbances in the lower lip and chin, increased bone mass after tooth extraction, as well as loosening of healthy teeth and sudden onset malocclusion.

Types of ameloblastoma

Ameloblastoma is the general name for several types of tumors. In the mouth may be:

• childhood melanoameloblastoma,

• adenoameloblastoma,

• fibroameloblastoma (fibroameloblastoma),

• odontoameloblastoma.

Another subdivision of ameloblastomas divides these tumors into:

• unilocular ameloblastomas,

• peripheral ameloblastoma,

• metastatic ameloblastomas.

In the medical literature, we can find the above division of ameloblastomas, which includes two more types of tumors, i.e. multilocular ameloblastomas and desmoplastic ameloblastomas, but the new classification does not include them. The division of ameloblastomas also includes a method of interlacing the neoplastic focus. At the same time, they distinguish:

• acanthotic ameloblastomas,

• plexiform ameloblastomas,

• vesicular ameloblastoma,

• mixed ameloblastomas.

As you can see, ameloblastomas represent a large group of tumors that cause numerous diagnostic and therapeutic difficulties. In the case of ameloblastoma of the mandible, complete excision of the tumor can be a serious problem, which should be removed with a supply of healthy tissue.

Ameloblastoma symptoms

As already mentioned, ameloblastoma of the lower jaw does not give symptoms at the beginning of the disease. They appear only in the advanced stage of the disease, when the bones are crushed and the surrounding tissues are involved. Symptoms of ameloblastoma include, among others:

• chronic inflammation at the site of the extracted tooth,

• cheek swelling,

• facial symmetry disorders

• sensory disturbances around the lower lip and chin,

• deformation of the lower jaw in the alveolar region,

• tooth loosening,

• malocclusion.

Pain and exudation of purulent or serous secretions associated with inflammation are not common symptoms of ameloblastoma. In clinical trials, pain was reported in 30% of patients who had other symptoms of this tumor.

Although ameloblastoma is most often a benign tumor or neoplasm characterized by local malignancy, there is a risk of neoplastic transformation of the tumor. In this case, ameloblastoma may begin to metastasize, which poses a threat to the patient. If symptoms suggestive of ameloblastoma appear, a physician should be consulted.

How is ameloblastoma diagnosed?

Most ameloblastomas are discovered incidentally in people who come to the dentist for routine check-ups or who are preparing for various dental procedures, such as root canal treatment or tooth extraction. Tumors are seen on x-ray as bone loss, but histopathology is necessary for a definitive diagnosis. Confirmation of the diagnosis by the result of histopathological examination allows treatment to begin. It does not proceed in the same way for all tumors located within the jawbone. At the stage of diagnosing ameloblastoma, other studies are also carried out, for example, magnetic resonance imaging.

Treatment of ameloblastoma of the mandible

Treatment of ameloblastoma of the lower jaw consists in removing the tumor with a supply of adjacent tissues that are not affected by the pathological process. For ameloblastomas, radical surgery is performed to reduce the risk of tumor recurrence. Only in some cases, the lesion can be removed in the traditional way, including curettage. This method is used very rarely, as it increases the risk of recurrence of the disease and malignancy.

Radical surgery aims to remove the entire tumor and surrounding tissues that may contain its cells. To restore the full functional ability of the patient’s lower jaw, as well as to improve the appearance, which worsens after a radical operation, it is necessary to perform a reconstructive operation, during which tissue is transplanted from the patient’s iliac plate.

Thanks to modern diagnostic methods, it is possible to accurately plan the treatment of ameloblastoma and other tumors of the lower and upper jaw. However, it is important to know that removing the tumor does not equate to a complete cure, since ameloblastoma and other types of jaw cancer can recur even after several or several decades.

ameloblastoma prognosis

In the case of benign and locally malignant ameloblastoma of the lower jaw, the prognosis is favorable. Removal of the focus with a supply of healthy tissue reduces the risk of tumor recurrence. Maxillary ameloblastoma has a worse prognosis because it infiltrates the maxillary sinus as well. A worse prognosis is also associated with malignant ameloblastoma causing metastases.