Malignant tumours mimicking periapical lesions: A report of three cases and literature review

Abstract

Apical periodontitis shows radiographic signs such as widening of the periodontal ligament and periapical radiolucency, which differ in extent depending on the stage of the lesion. However, other lesions can be associated with or coincidental to the apical region, representing developmental lesions and benign or malignant tumours. This article describes three cases of malignant tumours, a central mucoepidermoid carcinoma (CMEC), a chondroblast osteosarcoma and an osteosarcoma of the jaw (OSJ) that presented as periapical lesions. Endodontists must be aware of unsuccessful treatment, persistent pain, signs of paraesthesia, a rapid growth rate and delayed response to therapy associated with atypical features. Complementary examinations, such as biopsy and computed tomography, can allow the early diagnosis of malignant tumours, leading to a better prognosis and thus increased survival rates and improvement in quality of life.

Predictors of periapical bone healing associated with teeth having large periapical lesions following nonsurgical root canal treatment or retreatment: A cone beam computed tomography‐based retrospective study

“…Evangelista et al. (2022) emphasized that endodontists should be aware of unsuccessful treatments, rapid growth rates or a delayed response to treatment. They concluded that complementary examinations, such as biopsy and computed tomography, would allow early diagnosis of malignant tumours.…”

“…Ortega et al (2007) that lesions should be studied histopathologically, especially large lesions, because they could be odontogenic tumours, such as ameloblastoma or malignant lesions. Evangelista et al (2022) emphasized that endodontists should be aware of unsuccessful treatments, rapid growth rates or a delayed response to treatment. They concluded that complementary examinations, such as biopsy and computed tomography, would allow early diagnosis of malignant tumours.…”