[Primary intraosseous carcinoma of the jaws: results of treatment of 9 cases and proposed classification].
BACKGROUND
Primary intraosseous carcinoma of the jaws is a rare squamous cell carcinoma arising in the jaw, having no initial connection with the oral mucosa and presumably developing from residues of the odontogenic epithelium.


OBJECTIVE
To present 9 cases and to propose a staging system of primary intraosseous carcinoma of the jaws.


METHODS
Careful assessment of the clinical, radiological and histological examination of the specimens identified 9 patients with primary intraosseous carcinoma of the jaws.


RESULTS
The male/female ratio was 8/1 and the mean age of patients at the time of diagnosis was 61.7 years. All lesions were located in the mandible. Usually, clinical symptoms had benign aspect and delay the diagnosis. Radiographic features were unilocular osteolytic lesion and ill-defined margins were usually noted with a mean tumor size of 3.4 centimeters. The mean delay of the diagnosis was 4.9 months. Surgery at the tumor site consisted of hemi-mandibulectomy in all cases. All patients but one had neck dissection. The postoperative radiotherapy mean dose was 62.6 Gy. Histologically, most squamous cell carcinomas were well differentiated with keratinization. All lymph nodes metastasis had capsular involved. Complications occurred in 2 cases. Four patients had recurrences in the mean delay of 13.8 months. The estimated overall 2-and 5-years survival was 65% and 46.5% respectively.


CONCLUSIONS
Primary intra-osseous carcinoma of the jaws is a rare tumor none classified by UICC with poor prognosis. We recommend an aggressive treatment with postoperative radiotherapy. We propose a computer tomographic classification: T1 (tumor strictly intra-osseous), T2 (tumor with cortical destruction without involvement of adjacent soft-tissues) and T3 (tumor involvement of adjacent soft-tissues).
Zwetyenga
N
N
Service de Chirurgie Maxillo-Faciale et Stomatologie, CHU de Bordeaux, 33076 Bordeaux-cedex France. zwetyenga@aol.com
Majoufre-Lefebvre
C
C
Pinsolle
V
V
Rivel
J
J
Faucher
A
A
Siberchicot
F
F
D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008334:Mandible / Q000601:surgery; D008336:Mandibular Diseases / Q000175:diagnosis; D008339:Mandibular Neoplasms / Q000145:classification / Q000175:diagnosis / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D009808:Odontogenic Tumors / Q000145:classification / Q000175:diagnosis / Q000601:surgery*; D010014:Osteolysis / Q000175:diagnosis; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome