Tumoren der Mandibula

A computed

tomography scan of the jaw of a patient with peripheral ossifying fibroma

Osteoma •

Gardner syndrome - Ganzer Fall bei Radiopaedia

Ibrahim, D. Gardner syndrome. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-53473 • CC by-nc-sa 3.0 (modified)

Fibrosarcoma

of the childhood mandible. A: Panoramic radiography at first presentation: A large radiolucent lesion with irregular borders infiltrating the right ramus of the mandible. Displacement of tooth 47. B: Panoramic radiography after 3 months: The growth of the tumour mass is visible with a striking increase of radio-opaque structures.

head-face-med.biomedcentral.com • CC-by-2.0

Fibrosarcoma

of the childhood mandible. Preoperative computed tomography scan in comparison to the scan at first admission, revealing the tumour progression. A: CT before treatment: In the right mandibular angle a heterogenous mass of 3.0 × 3.6 cm is demonstrated, showing a rather sharp margin with cortical destruction. B: CT three months later: The computed tomography scan three months later reveals progression of the tumour mass (4.5 cm), with a further ballooning of the cortical structure and an increase of hard tissue, some osteolytic lesions and a central soft tissue component.

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Tumoren der Mandibula

Läsionen der Mandibula Radiopaedia • CC-by-nc-sa 3.0 • de

Mandibular lesions are myriad and common. The presence of teeth results in lesions that are specific to the mandible (and maxilla) and a useful classification that defines them as odontogenic or non-odontogenic. While it may often not be possible to make a diagnosis on imaging alone, this classification is helpful to narrow the differential.

Classification

Although a histological classification is probably the most scientifically sound, as radiologists, we are presented with an image, and therefore it is easier to classify lesions according to location in the mandible and their appearance. For a detailed classification of odontogenic tumors, many more than even the keenest neuro/head and neck radiologist can ever remember, please refer to the 2005 WHO histological classification of odontogenic tumors.

Below the lesions are divided into cystic and solid. Cystic should not be confused with lytic as solid radiolucent lesions can also appear lytic (see: radiolucent lesions of the jaw).

Cystic lesions

periapical cyst (or radicular cyst): common
dentigerous cyst (or follicular cyst of the mandible): common
odontogenic keratocyst (OKC): uncommon
primordial cyst of the mandible
Stafne cyst (or static bone cavity): uncommon
solitary bone cyst of the mandible (or traumatic or haemorraghic bone cysts)
aneursymal bone cyst (ABC): rare in the mandible
residual cyst of the mandible

Solid lesions

Odontogenic

benign
- odontoma: most common odontogenic tumor
- ameloblastoma: relatively common
- odontogenic myxoma (looks just like an ameloblastoma): rare
- calcifying epithelial odontogenic tumor (or Pindborg tumor) (looks just like an ameloblastoma): rare
- cementoblastoma: rare
- ameloblastic fibroma
- adenomatoid odontogenic tumor: rare
- condensing osteitis of the mandible
malignant
- odontogenic carcinoma (e.g. ameloblastic carcinoma): rare
- odontogenic sarcoma: rare
- odontogenic carcinosarcoma: rare