• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.6
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• pp.543-546
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• 2001

Primary intraosseous carcinoma(PIOC) is defined as a squamous cell carcinoma arising within the jaw, having no initial connection with the oral mucosa. The squamous cell carcinoma within the bone can be presumably developed from residues of the odontogenic epithelium, therefore, it is seen in the jaw only. Metastatic carcinoma from another primary site should be excluded in the diagnosis of Primary Intraosseous Carcinoma. This is a case of 62-year-old man, who initially diagnosed as odontogenic cyst on maxilla, but its pathologic examination was diagnosed as squamous cell carcinoma with odontogenic cyst. We treated this patient with partial maxillectomy, modified radical neck dissection(mRND), and postoperative radiation therapy.

• Imaging Science in Dentistry
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• v.49 no.1
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• pp.71-77
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• 2019

Primary intraosseous squamous cell carcinoma is a rare malignant central jaw tumor derived from odontogenic epithelial remnants. Predominantly, it affects mandible, although both jaw bones may be involved. This report describes a 60-year-old man who was initially misdiagnosed with a periapical infection related to the right lower wisdom tooth. After four months, the patient presented to a private dental clinic with a massive swelling at the right side of the mandible. Panoramic radiographs and advanced imaging revealed a lesion with complete erosion of the right ramus, which extended to the orbital floor. A biopsy from the mandibular angle revealed large pleomorphic atypical squamous cells, which is the primary microscopic feature of a poorly differentiated squamous cell carcinoma.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.31.1-31.8
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• 2018

Background: Verrucous carcinoma (VC) accounts for 1-10% of cases of squamous cell carcinoma (SCC) in the oral cavity, and 75% of VC occur in the oral cavity. Only 3% of primary intraosseous squamous cell carcinomas (PIOSCC), which means SCC occurring primarily in the bone, are VC. Verrucous carcinoma arising from odontogenic cysts (OC) is very rare, with only seven cases reported to date. Case presentation: This study reported a case of a patient who underwent partial maxillectomy and neck dissection for VC that occurred in the right anterior maxilla. The patient was admitted to the emergency department at our institution 8 years ago and showed cystic lesions in the anterior maxilla on facial computed tomography (CT) images. Treatment through other departments including assessment of laceration in the mental region and only suture was performed. This report highlights a very rare case of VC in the right anterior maxilla arising from a previous cystic lesion. Conclusions: Since PIOSCC can arise from OC, appropriate treatment of intraosseous cysts and regular radiologic evaluation are necesssary. Surgical exicision of the primary lesion without neck dissection can lead to good prognosis for patients with primary intraosseous verrucous carcinoma.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.2
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• pp.200-208
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• 1997

The WHO separates odontogenic carcinomas into three groups : malignant ameloblastoma, primary intraosseous carcinoma(PIOC), and carcinomas arising from odontogenic epithelium including those arising from odontogenic cysts. In WHO criteria, primary intraosseous carcinoma is defined as a squamous cell carcinoma arising within the jaw, having no connection with the oral mucosa, and no developing from residues of odontogenic epithelium. This is a case of 52-year old man who had prolonged jaw pain and final diagnosis was primary intraosseous carcinoma(PIOC) on mandible. We obtained successful result after composite resection combined with hemimandibulectomy, RND, following reconstruction with latissmus dorsi myocutaneous flap, and postoperative radiation therapy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.3
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• pp.263-267
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• 2007

Primary intraosseous carcinoma (PIOC) is a rare odontogenic carcinoma defined as a squamous cell carcinoma arising within a jaw having no initial connection with the oral mucosa, and probably developing from residues of the odontogenic epithelium. PIOC appears more common in male than female, especially at posterior portion of the mandible. Radiographic features of PIOC show irregular patterns of bone destruction with ill defined margins. It could be sometimes misdiagnosed as the cyst or benign tumor because it shows well defined margins. If it couldn't be done appropriate treatment initially, PIOC shows extremely aggressive involvement, extensive local destruction and spreads to the overlying soft tissue. Therefore accurate diagnosis in early state is necessary. The diagnosis criteria proposed for PIOC are : (1) absence of ulcer formation, except when caused by other factors, (2) histologic evidence of squamous cell carcinoma without a cystic component or other odontogenic tumor cell, and (3) absence of another primary tumor on chest radiograph obtained at the time of diagnosis and during a follow-up period of more than 6 month(Suei et al., 1994).

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.2
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• pp.62-68
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• 1990

Intraosseous carcinoma of the jaw may arise as metastatic lesions most commonly from breast, lung, kindney and thyroid and also primarily occur from ameloblastoma or odontogenic cyst. Rarely primary intraosseous carcinoma could be originated from the epithelium involved in odontogenesis. According to WHO's classification, primary intraosseous carcinoma is defined as squamous cell carcinoma, occured in the Jaw without connection to the oral mucosa. However, Elzay defined primary intraosseous carcinoma as malignant epithelial tumor related to the odontogenic apparatus, including carcinoma ex-odontogenic cyst, carcinoma ex-ameloblastoma and carcinoma de novo. We experienced 2 cases of intraosseous carcinoma of the jaw. The first case, a 59-year-old man, showed a ill-defined mass on the left maxilla, measuring $8{\times}10cm$ in size. He received radical hemimaxillectomy and was diagnosed as ameloblastic carcinoma. The second case obtained from a 79-year-old woman showed a ill-defined $6{\times}8cm$ sized mass on the left mandibular body area. The mass was surgically removed by partial mandibulaectomy, which was diagnosed as the primary intraosseous carcinoma, probably odontogenic origin.

• Imaging Science in Dentistry
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• v.42 no.4
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• pp.265-270
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• 2012

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.

• Imaging Science in Dentistry
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• v.34 no.1
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• pp.49-54
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• 2004

Primary intraosseous carcinoma (PIOC) is a rare odontogenic carcinoma defined as a squamous cell carcinoma arising within a jaw having no initial connection with the oral mucosa, and presumably developing from residues of the odontogenic epithelium. A 56-year-old patient who complained of delayed healing after extraction of upper left central incisor visited our department. The conventional radiographs showed a bony destructive lesion with ill-defined margin and moth-eaten appearance. On the computed tomographic images, the lesion perforated the labial cortex of alveloar bone, elevated the left nasal floor superiorly, and perforated partially both nasal floor. The magnetic resonance images showed low signal intensity at T2 and Tl weighted images at the area and adjacent soft tissue. Histologically, there were irregular epithelial islands with cell atypia, nuclear hyperchromatism, pleomorphism, atypical mitosis. The final diagnosis was PIOC.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.7
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• pp.3327-3330
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• 2014

Background: The purpose of the study was to analyse the clinicopathological spectrum of benign and malignant odontogenic tumours (OT) in Pakistan. Materials and Methods: This retrospective study was carried out at the Armed Forces Institute of Pathology (AFIP) Rawalpindi. Seven years archival records of histologically diagnosed odontogenic tumours, both benign and malignant, were collected and the lesions re-diagnosed histologically in accordance with the WHO classification of head and neck tumours (2005). Clinical as well as histological data were analysed and frequency of each type of OT was calculated using computer software programme SPSS (version 17). Mean tumour size was calculated and Chi-square test was applied to find associations of age, gender and site with each histological type of tumour. Results: Only 1.7% of the odontogenic tumours diagnosed in this said period were malignant while the remaining 98.3% were benign. Amongst benign lesions, ameloblastoma was the most common (61.3%) type while primary intraosseous squamous cell carcinoma (1.7%) was the only reported malignant tumour. Mean age of the affected patients was $31.7{\pm}16.7$ years with posterior mandible as the commonest site involved. Conclusions: Our study revealed ameloblastoma and primary intraosseous squamous cell carcinoma as the commonest diagnosed benign and malignant tumours respectively. There was a significant difference in age and site of origin of different types of OT at the time of their presentation. However, all the tumours showed male predominance.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.2
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• pp.120-127
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• 2021

Primary intraosseous squamous cell carcinoma (PIOSCC) is very rare type of squamous cell carcinoma (SCC) that occurs within the jaw and arises from remnants of odontogenic epithelium with no connection to the oral mucosa. This study reports two cases of PIOSCC of the mandible. Reported in this article are two cases of PIOSCC of the mandible that were treated with resection and reconstruction using a fibular free flap. The first case was a 36-year-old male patient who complained of right mandibular pain. Computed tomography (CT) and panoramic radiograph revealed a large radiolucency in the mandibular ramus area. At first, an odontogenic keratocyst was tentatively diagnosed, and an excision procedure was carried out at another clinic. A final biopsy after cyst enucleation revealed well-differentiated SCC, so we proceeded with segmental mandibulectomy and reconstruction using a fibular free flap. The second case was a 48-year-old male patient with left mandibular pain. CT and panoramic radiograph revealed irregular radiolucency in the mandibular angle area near tooth #38. At first, osteomyelitis was tentatively diagnosed, and a curettage was carried out. A later biopsy revealed well-differentiated SCC, so segmental mandibulectomy and reconstruction with a fibular free flap were secondarily performed. Our two cases have had no recurrence. The facial appearance of both patients is satisfactory, and the neo-mandibular body created using a fibular bone transfer displays adequate bony volume.