| disease | Jawbone Cancer |
Malignant tumors in the oral and maxillofacial region are most commonly carcinomas, with squamous cell carcinoma being the most prevalent among them. In China, oral and maxillofacial squamous cell carcinoma predominantly occurs in individuals aged 40-60, with a higher incidence in males than females. Common sites include gingival carcinoma, carcinoma of tongue, buccal carcinoma, palatal carcinoma, and maxillary sinus carcinoma, while jaw carcinoma is relatively rare. In regions north of the Yangtze River, oral carcinoma accounts for
- 45-
- 6% of all systemic malignant tumors, whereas south of the Yangtze River, it ranges from 1
bubble_chart Diagnosis
Malignant tumors in the oral and maxillofacial region are most commonly carcinomas, with squamous cell carcinoma being the most prevalent among them. In China, oral and maxillofacial squamous cell carcinoma predominantly occurs between the ages of 40 and 60, with a higher incidence in males than in females. Common sites include carcinoma of the gingiva, carcinoma of tongue, carcinoma of the cheek, carcinoma of the palate, and carcinoma of the maxillary sinus, while carcinoma of the jawbone is relatively rare. In the region north of the Yangtze River in China, oral cancer accounts for 1.45-5.6% of all malignant tumors in the body, whereas south of the Yangtze River, it accounts for 1.75-5.18%. In India, this proportion can be as high as over 40% of all malignant tumors. Carcinoma of the jawbone primarily arises from residual cells of the ameloblastic epithelium of the tooth germ. These epithelial cells may persist in the periodontal membrane, cyst linings, or result from malignant transformation of ameloblastoma. Histologically, it can manifest as either squamous cell carcinoma or glandular epithelial carcinoma.
[Auxiliary Examination]1. For cases with typical clinical manifestations and localized tumors, the examination should primarily focus on the scope of "A."
2. For cases with atypical clinical manifestations, difficult differential diagnosis, large tumors closely related to surrounding critical structures, or suspected metastasis, the examination may include the scope of "B" and "C."
1. A rapidly growing mass in the jawbone region, accompanied by pain, numbness of the lower lip, and loosening or loss of teeth.
2. X-ray films show irregular moth-eaten destruction.
3. Pathological histological examination confirms the diagnosis.
bubble_chart Treatment Measures
Treatment Measures:
Surgery is the primary method for treating jaw cancer, and selective neck lymph node dissection is generally performed, which can be combined with radiotherapy or chemotherapy after surgery.
For general surgical preventive anti-infection, sulfa drugs (such as compound formula co-trimoxazole) or drugs mainly effective against Gram-positive bacteria (such as erythromycin, penicillin, etc.) are selected. For larger surgical procedures, especially those involving bone grafting or complex repairs, combination therapy is usually employed, commonly including: drugs effective against Gram-positive bacteria (such as penicillin) + drugs effective against Gram-negative bacteria (such as gentamicin) + drugs effective against anaerobic bacteria (such as metronidazole). For severe infections before or after surgery, or for large and complex surgical wounds, effective antibiotics can be chosen based on clinical conditions and drug sensitivity tests. Chemotherapy can be used in combination before or after surgery, but due to its severe side effects, it should be administered under strict medical supervision, including monitoring of blood counts.
The exact cause of oral cancer is not yet fully understood, but the current consensus is that most oral cancers are related to environmental factors. External factors such as heat, chronic injury, ultraviolet radiation, X-rays, and other radioactive substances can all be carcinogenic.
Additionally, internal factors such as neuropsychiatric factors, endocrine factors, the body’s immune status, and genetic factors have been found to be associated with the occurrence of oral cancer. Therefore, the prevention of oral cancer lies in reducing external irritants and enhancing the body's disease resistance. Similar to maxillary sinus cancer, early diagnosis of jaw cancer is difficult and often confused with alveolar abscess, mandibular osteomyelitis, or neuritis. Thus, high vigilance is necessary, and early imaging and other auxiliary examinations should be conducted. If needed, a diseased tooth can be extracted, and tissue from the tooth socket can be scraped for pathological examination. Moreover, surgery is the first-line treatment for this condition, with radiotherapy or chemotherapy as adjuncts to improve cure rates. However, the latter two should not be used as primary treatments to avoid delaying treatment. Unverified folk remedies, whether applied externally or taken internally, should be avoided as they may stimulate tumor growth, delay treatment, and result in missed treatment opportunities.
Cure Standards
1. Cured: After treatment, the original follicular tumor and metastatic sources have been completely removed or disappeared, and the wound has largely healed.
2. Improved: After treatment, the tumor has shrunk, and symptoms have alleviated.
