title: A clinicoradiological study of odontogenic carcinomas and their impact on clinical diagnosis.
abstract: OBJECTIVE
  To investigate the clinical and radiological characteristics of odontogenic carcinomas (OCs) and evaluate their impact on early clinical diagnosis.
  
  
  METHODS
  The clinical and radiological features of all patients with OCs in our pathology record from January 1988 to December 2009 were retrospectively reviewed. The impact on a tentative diagnosis before final histological examination of clinical, panoramic and CT features was investigated.
  
  
  RESULTS
  Of 474 cases with malignant jaw tumours, 417 (88%) were gingival squamous cell carcinomas (SCCs) and 27 (6%) were OCs. The average age of the patients with OCs was significantly lower than that of those with gingival SCCs. 20 OCs were in the mandible and 7 were in the maxilla. 22 OC patients (81%) had pain and/or swelling as an initial symptom of the disease. Although the majority of OCs showed irregularly contoured radiolucency, one-third of the cases showed cyst-like radiolucency totally or partially surrounded by a sclerotic rim on panoramic radiography. Permeative or gross cortical bone destruction and mass extension outside the jaw bone were found on CT and a diagnosis of malignant tumour was more common. Mass extension outside the cortex had a significant influence on malignant diagnosis. However, 22% of the patients were still clinically diagnosed as having osteomyelitis after CT.
  
  
  CONCLUSIONS
  Although CT was useful to obtain a diagnosis of malignant tumour in OC patients, 22% of patients were clinically diagnosed as having osteomyelitis even after CT. When an osteomyelitis case is resistant to conventional therapy and gross bone destruction and/or mass extension is found on CT, a histopathological examination should be done.
authors.affiliation: Tokyo Medical and Dental University, Tokyo, Japan. mizue.i@kamakuranet.ne.jp
authors.forename: M
authors.initials: M
authors.lastname: Ida
authors.forename: A
authors.initials: A
authors.lastname: Tetsumura
authors.forename: A
authors.initials: A
authors.lastname: Kuribayashi
authors.forename: N
authors.initials: N
authors.lastname: Okada
authors.forename: T
authors.initials: T
authors.lastname: Kurabayashi
mesh_terms: D000367:Age Factors; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D055088:Early Detection of Cancer; D005260:Female; D005887:Gingival Neoplasms / Q000000981:diagnostic imaging; D006801:Humans; D007570:Jaw Cysts / Q000000981:diagnostic imaging; D007571:Jaw Diseases / Q000000981:diagnostic imaging; D007573:Jaw Neoplasms / Q000000981:diagnostic imaging; D008297:Male; D008339:Mandibular Neoplasms / Q000000981:diagnostic imaging; D008441:Maxillary Neoplasms / Q000000981:diagnostic imaging; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009808:Odontogenic Tumors / Q000000981:diagnostic imaging*; D010019:Osteomyelitis / Q000000981:diagnostic imaging; D011862:Radiography, Panoramic; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed