J Korean Assoc Oral Maxillofac Surg.  2015 Apr;41(2):78-83. 10.5125/jkaoms.2015.41.2.78.

Mandibular intraosseous squamous cell carcinoma lesion associated with odontogenic keratocyst: a case report

Affiliations
  • 1Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea. kuksjs@pusan.ac.kr
  • 2Department of Oral and Maxillofacial Surgery, Ulsan University Hospital, Ulsan, Korea.

Abstract

Squamous cell carcinoma (SCC) is the most common malignant tumor in the oral cavity, and it accounts for about 90% of all oral cancers. Several risk factors for oral SCC have been identified; however, SCC associated with odontogenic keratocysts have rarely been reported. The present study describes the case of a 36-year-old man with SCC of the right ramus of the mandible, which was initially diagnosed as a benign odontogenic cyst. He underwent enucleation at another hospital followed by segmental mandibulectomy and fibular free flap reconstruction at our institution. In this case, we introduce a patient with oral cancer associated with odontogenic cyst on the mandible and report a satisfactory outcome with wide resection and immediate free flap reconstruction.

Keyword

Odontogenic cyst; Squamous cell carcinoma; Anatomic models; Free tissue flaps

MeSH Terms

Adult
Carcinoma, Squamous Cell*
Free Tissue Flaps
Humans
Mandible
Mandibular Osteotomy
Models, Anatomic
Mouth
Mouth Neoplasms
Odontogenic Cysts*
Risk Factors

Figure

  • Fig. 1 Clinical intraoral finding.

  • Fig. 2 Preoperative radiographic imaging. A. Computed tomography imaging (the line indicates squamous cell carcinoma lesion with cyst on mandibular right posterior site). B, C. Magnetic resonance imaging.

  • Fig. 3 Intra-operative reconstructive plating before segmental mandibulectomy.

  • Fig. 4 Final soft tissue specimen showing squamous cell carcinoma (SCC) lesion with cyst. A. Cyst site (H&E staining, ×20). B. SCC site (H&E staining, ×20) adjacent to the cyst. C. SCC site (H&E staining, ×100). D. SCC site (H&E staining, ×200).

  • Fig. 5 Postoperative specimen showing squamous cell carcinoma (SCC) bone lesions. A. SCC bone invasion site (H&E staining, ×40). B. SCC bone lesion (H&E staining, ×100). C. SCC bone lesion (H&E staining, ×200). D. SCC bone lesion (H&E staining, ×400).

  • Fig. 6 Rapid prototype (RP) model. RP model of mandible (a), required bone graft design with resin block (b), RP model-fibular resin model (c).

  • Fig. 7 Pre- and postoperative panoramic views. A. Preoperative state. B. Postoperative three month. C. Postoperative one year.

  • Fig. 8 Postoperative face change. A. Preoperative state. B. Three month later. C. One year later.


Cited by  1 articles

Sequential treatment from mandibulectomy to reconstruction on mandibular oral cancer – Case review II: mandibular anterior and the floor of the mouth lesion of basaloid squamous cell carcinoma and clear cell odontogenic carcinoma
Jae-Young Yang, Dae-Seok Hwang, Uk-Kyu Kim
J Korean Assoc Oral Maxillofac Surg. 2021;47(3):216-223.    doi: 10.5125/jkaoms.2021.47.3.216.


Reference

1. Mohtasham N, Babazadeh F, Jafarzadeh H. Intraosseous verrucous carcinoma originating from an odontogenic cyst: a case report. J Oral Sci. 2008; 50:91–94. PMID: 18403890.
Article
2. Marx RE, Stern D. Oral and maxillofacial pathology: a rationale for diagnosis and treatment. Hanover Park: Quintessence Publishing;2012.
3. Shafer WG, Hine MK, Levy BN. A textbook of oral pathology. 4th ed. Philadelphia: W.B. Saunders;1983. p. 271–273.
4. Loos D. Central epidermoid carcinoma of the jaws. Dtsch Monatsschr Zahnheilk. 1913; 31:308.
5. Schwimmer AM, Aydin F, Morrison SN. Squamous cell carcinoma arising in residual odontogenic cyst. Report of a case and review of literature. Oral Surg Oral Med Oral Pathol. 1991; 72:218–221. PMID: 1923401.
6. Keszler A, Piloni MJ. Malignant transformation in odontogenic keratocysts. Case report. Med Oral. 2002; 7:331–335. PMID: 12415216.
7. Tan B, Yan TS, Shermin L, Teck KC, Yoke PC, Goh C, et al. Malignant transformation of keratocystic odontogenic tumor: two case reports. Am J Otolaryngol. 2013; 34:357–361. PMID: 23374486.
Article
8. Gardner AF. The odontogenic cyst as a potential carcinoma: A clinicopathologic appraisal. J Am Dent Assoc. 1969; 78:746–755. PMID: 4887224.
Article
9. Bodner L, Manor E, Shear M, van der Waal I. Primary intraosseous squamous cell carcinoma arising in an odontogenic cyst: a clinicopathologic analysis of 116 reported cases. J Oral Pathol Med. 2011; 40:733–738. PMID: 21689161.
10. Pindborg JJ, Kramer IRH, Torioni H. Histologic typing of odontogenic tumours, cysts, and allied lesions. Geneva: World Health Organization;1971. p. 35.
11. Elzay RP. Primary intraosseous carcinoma of the jaws. Review and update of odontogenic carcinomas. Oral Surg Oral Med Oral Pathol. 1982; 54:299–303. PMID: 6957827.
12. Waldron CA. Oral epithelial tumors. In : Thoma KH, Gorlin RJ, Goldman HM, editors. Thoma's oral pathology. 4th ed. St. Louis: Mosby;1970. p. 846–847.
13. Shear M. Primary intra-alveolar epidermoid carcinoma of the jaw. J Path. 1969; 97:645–651. PMID: 5354042.
Article
14. Bereket C, Bekçioğlu B, Koyuncu M, Sener I, Kandemir B, Türer A. Intraosseous carcinoma arising from an odontogenic cyst: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013; 116:e445–e449. PMID: 22921445.
Article
15. Areen RG, McClatchey KD, Baker HL. Squamous cell carcinoma developing in an odontogenic keratocyst. Arch Otolaryngol. 1981; 107:568–569. PMID: 7271558.
16. Harjani B, Singh RK, Pal US, Singh G. Locking v/s non-locking reconstruction plates in mandibular reconstruction. Natl J Maxillofac Surg. 2012; 3:159–165. PMID: 23833491.
Article
Full Text Links
  • JKAOMS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr