Patterns of spread of squamous cell carcinoma to the ramus of the mandible

• Published in: Head & neck Vol. 15; no. 5; p. 440
• Main Authors: McGregor, A D, MacDonald, D G
• Format: Journal Article
• Language: English
• Published: United States 01.09.1993
• Subjects: Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - radiotherapy; Humans; Mandible - pathology; Mandible - radiation effects; Mandibular Neoplasms - pathology; Mandibular Neoplasms - radiotherapy; Mandibular Nerve - pathology; Mouth Floor - pathology; Mouth Neoplasms - pathology; Neoplasm Invasiveness - pathology
• ISSN: 1043-3074
• DOI: 10.1002/hed.2880150512

Patterns of spread of squamous cell carcinoma to the ramus of the mandible have been studied. In nonirradiated mandibles, tumor in the ramus was found to have spread in continuity from tumor within the body. In 22 of 27 specimens (81.5%) with established invasion of the molar region of the body, tumor spread was either confirmed to the body or to the body and the anterior part of the ramus. The remaining five cases showed extensive spread within the ramus. It was concluded that a more conservative approach to resection of the ramus may be safe on pathologic grounds in the nonirradiated mandible. In postirradiation mandibles, direct invasion through cortical bone was seen in addition to direct spread from the body. Tumor spread to the ramus was seen in nine of 12 specimens (75%), and in each case was both diffuse and extensive. It was concluded that a conservative approach to resection of the ramus is not safe on pathologic grounds after radiotherapy.