Jaw malignancies: signs that should alert the dentist.

– Malignant lesions of the jaw-bones may mimic odontogenic infections and other disease conditions in the oral cavity in presentation, leading to late diagnosis by the unwary clinician. The purpose of this paper is to illustrate clinical features and radiographic appearance that should make the dentist thinking in a diagnosis of a malignant tumour of the jaw. The authors present 3 cases of malignancies in the jawbones and discuss the diagnostic lessons from each one. In dental practice malignant tumours of the jawbones are challenging to diagnose because the dentist is not familiar with its manifestations. Misdiagnosis of a malignant lesion as benign one or as an infective disease may delay the diagnosis and the treatment witch will increase the mortality, worsen the prognosis and explain the morbidity associated with the treatment of the large lesions. In fact, malignancies should be considered in the differential diagnosis of inflammatory and reactive lesions that are common to the oral region. Several signs may lead to the discovery of the disease such as pain, numbness, swelling, mobility of teeth, toothache, paresthesia of the mental nerve.. . (Table I). When swelling, odontogenic pain or tooth mobility is present without signs of infection or traumatism, a neoplastic origin should be ruled out. A thirty nine year-old woman was referred to the unit of the oral medicine and oral surgery for the management of a swelling that had occurred two months after a dental extraction that did not heal. According to the referral, she initially had an odontalgia and a mobility of the first maxillary molar without dental decay or periodontal disease. After the dental extraction, the swelling had rapidly increased twice in volume. At the extraoral examination, the patient had a facial asymmetry (Fig. 1), and the skin over-lying of the swelling was normal in colour and texture. But upon palpation, we note a slight paresthesia of the infraorb-tary area and there was no involvement of the cervicofacial Correspondence: [email protected] Fig. 1. Patient with a facial asymmetry. lymphatic chain. Intraoral examination showed a non healing of the socket twenty day after dental extraction. It could be noticed that the swelling was extended from the canine region until the tuberosity and it streped over the vestibular and palatal sides (Fig. 2). The overlying mucosa was inflamed. A radiographic exam was ordered encompassing a panoramic (Fig. 3) and a Blondeau radiographies (Fig. 4): they showed a radiolucent …