Malignant tumors of jaw l Oral radiology MCQs for dental students

Radiographic interpretation in malignant tumors of the jaw l Oral radiology MCQs for dental students 

Imoportant notes in radiographic interpretation malignant tumors in jaw

1. Osteoid osteoma: There is predilection for mandible. Small lesion with severe pain is characteristic feature of this disease. Radiographically, osteoid osteoma appears as characteristic central radiolucent area surrounded by the zone of sclerosis, called nidus.
2. Central haemangioma: It is compressible, pulsatile swelling which bruits on auscultation. Pumping tooth syndrome is characteristic feature of this disease. The margin of lesion is well demarcated and corticated. Honeycomb or soap-bubble appearance can be seen. Bony spicule may radiate from the margin of the lesion, running perpendicular to the lesion causing ‘sunray’ appearance.
3. Desmoplastic fibroma: It presents with swelling. It presents as well-defined radiolucency. Small lesions are completely radiolucent with well-defined or ill-defined border.
4. Squamous cell carcinoma: The presenting complaint of the patient is mass or ulcer in the oral cavity. Paraesthesia may result. Squamous cell carcinoma usually presents as fungating, papillary exophytic growth. There is irregular, semicircular or saucer-shaped bone destruction. Margins of the lesion are irregular and ill defined; floating teeth appearance is present.
5. Metastatic carcinoma: Mandible is more commonly affected site in the metastatic carcinoma as it is rich in haemopoietic marrow. An earlier symptom is nodule present in the oral cavity. It may present as of osteoclastic variety or osteoblastic variety. In osteoblastic variety typical ‘salt and pepper’ appearance is seen.
6. Malignant melanoma: It can be superficial spreading melanoma, nodular melanoma and lentigo maligna melanoma. It starts as pigmentation which can advance into ulcerated growth. It presents as ill-defined radiolucency with ill-defined margin.
7. Verrucous carcinoma: Verrucous carcinoma appears as papillary growth. Surface is pebbly and covered by white leukoplakic film. Radiologically in some cases, there may be underlying erosion of bone.
8. Osteosarcoma: Patient complains of pain and swelling of the affected area. Pathological fracture can occur. The following features can be seen: sunray/sunburst appearance, Codman triangle and second infiltration of tumours in the periodontal ligament space which causes widening of periodontal ligament.
9. Chondrosarcoma: Swelling is the most common complaint of the patient. It is painless. Loosening of teeth is also a common sign. Radiolucency consists of scattered and variable radio-opaque foci due to calcification of cartilage matrix.
10. Burkitt lymphoma: African form is common in jaw while American form is common in abdomen. Swelling of the affected jaw is present. Margins of the radiolucency are ragged. Small radio-opaque foci are scattered, producing ‘moth-eaten’ appearance.
11. Multiple myeloma: It is also called myelomatosis. There is gingival enlargement or epulis. ‘Punched-out’ bone destruction is the most striking feature of this disease. Margins are well defined.
12. Ewing sarcoma: Intermittent pain and swelling are the earliest features of the disease. It is osteolytic lesion. It has irregular or ill-defined margin.
13. Hodgkin lymphoma: It is malignant lymphoproliferative disorder. Patient is having enlarged, non-tender, discrete mass of lymph nodes. Nodes are typical rubbery in consistency. Pel–Ebstein fever is present.
14. Leukaemia: It occurs due to bone marrow suppression and infiltration, dyspnoea, headache and lymph node enlargement. Ill-defined radiolucent area is present which is patchy in distribution. ‘Moth-eaten’ appearance and onion peel appearance are present.