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Mandibular invasion of lower gingival carcinoma in the molar region: its clinical implications on the surgical management

Authors
 S.-X. Hong  ;  I.-H. Cha  ;  E.-W. Lee  ;  J. Kim 
Citation
 INTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, Vol.30(2) : 130-138, 2001 
Journal Title
INTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY
ISSN
 0901-5027 
Issue Date
2001
MeSH
Adult ; Aged ; Aged, 80 and over ; Alveolar Process/diagnostic imaging ; Alveolar Process/pathology ; Bone Density ; Bone Marrow/diagnostic imaging ; Bone Marrow/pathology ; Carcinoma, Squamous Cell/diagnostic imaging ; Carcinoma, Squamous Cell/pathology* ; Carcinoma, Squamous Cell/surgery ; Curettage ; Female ; Gingival Neoplasms/diagnostic imaging ; Gingival Neoplasms/pathology* ; Gingival Neoplasms/surgery ; Humans ; Male ; Mandible/diagnostic imaging ; Mandible/pathology ; Mandibular Neoplasms/diagnostic imaging ; Mandibular Neoplasms/pathology* ; Mandibular Neoplasms/surgery ; Mandibular Nerve/pathology ; Middle Aged ; Molar ; Mouth Mucosa/pathology ; Neoplasm Invasiveness ; Osteotomy ; Radiography, Panoramic ; Statistics, Nonparametric ; Tomography, X-Ray Computed ; Tooth Extraction
Keywords
gingival cancer ; mandibular invasion ; pattern of spread
Abstract
The spread pattern of a tumour and its extent in the mandible are important in the management of gingival cancer. Sixteen patients with gingival squamous cell carcinoma (SCC) involving the mandible in the molar region were included in this study. Resection specimens of the mandibular bone and adjacent cancer were histologically analysed to identify the type and characteristics of invasion and were compared with the radiological features. Our results showed that the actual width of invasion was underestimated to a greater extent than the actual depth of invasion. For horizontal aspects, four dentate cases had horizontal intramedullary spread underneath intact mucosa or cortical bone extended from the main foci of tumour that infiltrated through the occlusal surface. For vertical aspects, nerve invasion took place in only one of 16 specimens, while five cases showed downward infiltration beyond the inferior alveolar canal without nerve involvement, so that the pattern of tumour spread was mostly transmedullary rather than perineural in previously non-irradiated cases. These cases with deep infiltration showed the infiltrative type of invasion in the dentate mandible. And when the tumour was related with previous dental extractions or curettage, it tended to be more extensive than what was predicted from an imaging point of view. These pathological and clinical features affecting the tumour spread should be considered in the management of gingival SCC in the molar region.
Full Text
http://www.sciencedirect.com/science/article/pii/S0901502700900304
DOI
10.1054/ijom.2000.0030
Appears in Collections:
2. College of Dentistry (치과대학) > Dept. of Oral Pathology (구강병리학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Oral and Maxillofacial Surgery (구강악안면외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jin(김진)
Cha, In Ho(차인호) ORCID logo https://orcid.org/0000-0001-8259-2190
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/142290
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