Abstract
Background
Primary bone tumours of the jaw are rare tumoral entities and do substantially differ from other bone tumours of the human body with respect of their frequently encountered unusual radiological appearances. The reason for that may be confined to the co-existence of two closely neighbored but different anatomical structures (i.e., tooth-forming apparatus and jaw bones with adjacent gingiva) and some tumour pathologies which are nearly excusively encountered in the jaw bones only (e.g., ameloblastoma, ossifying fibroma, ghost cell carcinoma).
This paper would like to highlight some basic principles of the diagnostic approach and possibilities of radiological differentiation of such tumour-suspicious changes within the gnathic system are elucidated and discussed.
Method
The paper presented here is substantially based on the most recent classification of odontogenic and maxillofacial tumours (5th edition, 2022) which serves as a scaffold for the selection of typical tumour entities. Due to the educational character of this paper, only important jaw tumours worth mentioning and their characteristics are subject to be extracted from the literature and further discussed.
The main focus was put onto both the description of radiological tumoral appearance and the rational selection of a radiological diagnostic work-up. In order to better visualize this difficult field of tumour entities, much attention has been paid on a comprehensive pictorial essay.
Conclusions
For radiologists, it is their foremast task to detect, describe, and to classify bone tumours of the jaw when they are found intentionally or accidentally, resp. A close co-operation with their clinical partners is of upmost importance to gain information about patient’s history and clinical presentation. It is readily reasonable that radiologists are mostly able to provide only a suggestion of the presented tumour entity but this expert opinion would be very helpful to further narrow down the list of potential differential diagnoses (e.g., differentiation of a cyst vs. solid tumour osteolysis, identification of jaw osteomyelitis vs. tumoral infiltration, recognizing of secondary tumour involvement of the jaw).
Key Points
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primary bone tumours of the jaw are very rare, moreover difficult to differentiate radiologically, and do need therefore histological proof;
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profound knowledge about tumour characteristics (location within the jaw, relationship to the tooth, bony destructive pattern) may allow a rough orientation and classification;
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matrix-forming tumours and dysplasias of the jaw facilitates their radiological differentiation and classification;
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in contrary, osteolyses should be thoroughly scrutinized for the more frequent gnathic cysts in differentiation of rather rare solid primary tumours;
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an interdisciplinary round-table discussion amongst well-experienced maxillofacial surgeons and specialized radiologists may be appropriate to avoid severe misinterpretations.
Citation Format
Keywords
jaws - odontogenic and non-odontogenic tumours - odontogenic and non-odontogenic dysplasias
