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Article Dans Une Revue Journal of Stomatology, Oral and Maxillofacial Surgery Année : 2020

Mandible extensive intra osseous destructive lesion, a diagnostic challenge

Résumé

Intraosseous verrucous carcinoma of the mandible is a rare situation often confused with chronic osteomyelitis. Despite the low aggressively of the tumor, prognosis is poor because of delayed diagnosis. We report 3 cases, from three different hospitals, initially diagnosed with a chronic osteomyelitis of the mandible after wisdom extraction. Imaging, bacteriological and histological samples supported each time this interpretation. The 3 patients worsened with intraosseous extension of the lesions and outflow of whitish and purulent debris. Only extensive resection with mandibulectomy allow the pathologists to identify the tumor. Adjuvant radiotherapy or radiochemiotherapy followed the surgery. One patient is in clinical remission. In front of mandible lesion resistant to antibiotic therapy and sequestrum resection, atypical squamous cell carcinoma must be evoked. MRI and CT-scan are not able to distinguish osteomyelitis and intraosseous verrucous carcinoma. Presence of whitish lysed and debris of keratin must draw the attention. Firm evidence must be provided to the pathologist but samples should be wide and thick.

Domaines

Neurobiologie
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Dates et versions

hal-02469386 , version 1 (21-09-2022)

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Paternité - Pas d'utilisation commerciale

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Agathe Lafarge, Nicolas Sigaux, Benoit Magnin, Arnaud Depeyre, Carole Chevenet, et al.. Mandible extensive intra osseous destructive lesion, a diagnostic challenge. Journal of Stomatology, Oral and Maxillofacial Surgery, 2020, 121 (4), pp.445-449. ⟨10.1016/j.jormas.2019.10.002⟩. ⟨hal-02469386⟩
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