Imaging Sci Dent.  2017 Dec;47(4):255-259. 10.5624/isd.2017.47.4.255.

CT evaluation of underlying bone sclerosis in patients with oral squamous cell carcinoma: A preliminary retrospective study

• Jo GD
• Yi WJ
• Heo MS
• Lee SS
• Choi SC
• Huh KH

• KMID: 2397840
• DOI: http://doi.org/10.5624/isd.2017.47.4.255

Abstract

PURPOSE
Underlying bone sclerosis is frequently observed in clinical settings when oral squamous cell carcinoma (OSCC) invades the jaw bone. The aim of this study was to assess the prevalence and characteristics of underlying bone sclerosis in patients with OSCC.
MATERIALS AND METHODS
We retrospectively reviewed the computed tomographic (CT) images of 131 patients who underwent mandibulectomy between January 2012 and December 2015 to treat OSCC. The presence, degree, and extent of underlying bone sclerosis were assessed on CT images and correlated with the following imaging patterns of bone invasion: cortical invasion, medullary invasion with a smooth margin, and medullary invasion with an irregular margin. The chi-square test was used to determine the relationships between the variables.
RESULTS
The prevalence of underlying bone sclerosis on CT images was 70.1% (47 of 67). The prevalence was 85.7% (42 of 49) in patients with medullary invasion, but it was 27.8% (5 of 18) in patients with only cortical invasion, indicating a significant increase in the prevalence of underlying bone sclerosis in patients with medullary invasion (P < .05). Aggressive patterns of bone invasion were associated with increases in the degree and extent of the underlying bone sclerosis (P < .05).
CONCLUSION
More than two-thirds of OSCC cases with bone invasion showed underlying bone sclerosis. On CT images, reactive sclerosis in the remaining margin of the alveolar bone should not be used as the primary means to differentiate periodontal inflammatory lesions from those resulting from OSCC.

Keyword

Carcinoma, Squamous Cell; Sclerosis; Mandible; Tomography, X-ray Computed

MeSH Terms

Carcinoma, Squamous Cell*
Epithelial Cells*
Humans
Jaw
Mandible
Prevalence
Retrospective Studies*
Sclerosis*
Tomography, X-Ray Computed

Figure

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  Fig. 1 Coronal computed tomographic images using the bone window setting (A) and soft-tissue window setting (B) showing subtle underlying bone sclerosis that is confined to the alveolar bone portion (arrow) and has a cortical invasion pattern.

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  Fig. 2 Coronal computed tomographic images using the bone window setting (A) and soft-tissue window setting (B) showing prominent underlying bone sclerosis that is confined to the alveolar bone portion (arrow) and has a smooth medullary invasion pattern.

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  Fig. 3 Coronal computed tomographic images using the bone window setting (A) and soft-tissue window setting (B) showing prominent underlying bone sclerosis that has spread to the basal bone portion (arrow) and has an irregular medullary invasion pattern.

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