Retromolar trigone squamous cell cancers: A reappraisal of 16 section MDCT for assessing mandibular invasion

Arya, Supreeta; Rane, Pallavi; Sable, Nilesh; Juvekar, Sl; Bal, Munita; Chaukar, Devendra

doi:10.1016/j.crad.2013.08.001

Cited by 23 publications

(9 citation statements)

References 24 publications

(28 reference statements)

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“…MDCT can very precisely determine the involvement of the inferior alveolar nerve (up to 100%). Similar observations were made by Vidiri et al [ 19 , 20 ].…”

Section: Imaging Methods In Oral Cancersupporting

confidence: 91%

Contemporary Diagnostic Imaging of Oral Squamous Cell Carcinoma – A Review of Literature

et al. 2018

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SummaryOral squamous cell carcinoma (OSCC) is the most common cancer of the oral cavity and constitutes 95% of all cancers of this area. Men are affected twice as commonly as women, primarily if they are over 50 years of age. Forty percent of the lesions are localized in the tongue and 30% in the floor of the oral cavity. OSCC often affects upper and lower gingiva, buccal mucous membrane, the retromolar triangle and the palate. The prognosis is poor and the five-year survival rate ranges from 20% (OSCC in the floor of the mouth) to 60% (OSCC in the alveolar part of the mandible). Treatment is difficult, because of the localization and the invasiveness of the available methods. The diagnosis is made based on a histopathological examination of a biopsy sample.The low detection rate of early oral SCC is a considerable clinical issue. Although the oral cavity can be easily examined, in the majority of cases oral SCC is diagnosed in its late stages. It is difficult to diagnose metastases in local lymph nodes and distant organs, which is important for planning the scope of resection and further treatment, graft implantation, and differentiation between reactive and metastatic lymph nodes as well as between disease recurrence and scars or adverse reactions after surgery or radiation therapy.Imaging studies are performed as part of the routine work-up in oral SCC. However, it is difficult to interpret the results at the early stages of the disease. The following imaging methods are used – dental radiographs, panoramic radiographs, magnetic resonance imaging with diffusion-weighted and dynamic sequences, perfusion computed tomography, cone beam computed tomography, single-photon emission computed tomography, hybrid methods (PET/CT, PET/MRI, SPECT/CT) and ultrasound. Some important clinical problems can be resolved with the use of novel modalities such as MRI with ADC sequences and PET.The aim of this article is to describe oral squamous cell carcinoma as it appears in different imaging methods considering both their advantages and limitations.

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“…MDCT can very precisely determine the involvement of the inferior alveolar nerve (up to 100%). Similar observations were made by Vidiri et al [ 19 , 20 ].…”

Section: Imaging Methods In Oral Cancersupporting

confidence: 91%

Contemporary Diagnostic Imaging of Oral Squamous Cell Carcinoma – A Review of Literature

et al. 2018

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“…Imaging is integral in detecting cortical BI, given that clinical examination cannot accurately predict it [ 52 , 53 ]. CECT has priority for this purpose concerning its higher specificity (87–90%) compared to other imaging modalities, such as magnetic resonance imaging [ 54 – 56 ]. In general, the occurrence of BI varies between oral cavity subsites.…”

Section: Discussionmentioning

confidence: 99%

Demographic and imaging features of oral squamous cell cancer in Serbia: a retrospective cross-sectional study

Janović,

Bracanović,

Antić

et al. 2024

BMC Oral Health

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Background The mortality of oral squamous cell cancer (OSCC) in Serbia increased in the last decade. Recent studies on the Serbian population focused mainly on the epidemiological aspect of OSCC. This study aimed to investigate the demographic and imaging features of OSCC in the Serbian population at the time of diagnosis. Methods We retrospectively analyzed computed tomography (CT) images of 276 patients with OSCC diagnosed between 2017 and 2022. Age, gender, tumor site, tumor volume (CT-TV, in cm3), depth of invasion (CT-DOI, in mm), and bone invasion (CT-BI, in %) were evaluated. TNM status and tumor stage were also analyzed. All parameters were analyzed with appropriate statistical tests. Results The mean age was 62.32 ± 11.39 and 63.25 ± 11.71 for males and females, respectively. Male to female ratio was 1.63:1. The tongue (36.2%), mouth floor (21.0%), and alveolar ridge (19.9%) were the most frequent sites of OSCC. There was a significant gender-related difference in OSCC distribution between oral cavity subsites (Z=-4.225; p < 0.001). Mean values of CT-TV in males (13.8 ± 21.5) and females (5.4 ± 6.8) were significantly different (t = 4.620; p < 0.001). CT-DOI also differed significantly (t = 4.621; p < 0.001) between males (14.4 ± 7.4) and females (10.7 ± 4.4). CT-BI was detected in 30.1%, the most common in the alveolar ridge OSCC. T2 tumor status (31.4%) and stage IVA (28.3%) were the most dominant at the time of diagnosis. Metastatic lymph nodes were detected in 41.1%. Conclusion Our findings revealed significant gender-related differences in OSCC imaging features. The predominance of moderate and advanced tumor stages indicates a long time interval to the OSCC diagnosis.

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“…Clinical examination needs to be supplemented by imaging to figure out the sub-clinical spread of the disease. Contrast-enhanced CT has shown high accuracy for detection of mandibular invasion [ 8 - 9 ]. Both CT and MRI have their indications in RMT tumors with MRI having better detailing of soft tissue extension, masticator space involvement, perineural spread, and infratemporal fossa invasion.…”

Section: Discussionmentioning

confidence: 99%

Treatment Outcomes of Rare Retromolar Trigone Squamous Cell Carcinoma Using Combined Modalities

Faisal¹,

Abbas²,

Khaleeq³

et al. 2017

Cureus

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BackgroundRetromolar trigone squamous cell carcinoma is relatively uncommon and due to its complex anatomy has always remained a challenge in terms of loco-regional control and survival. Surgery, radiotherapy, and chemotherapy as combined modalities have been used but high recurrence rates result in poor outcome.MethodsWe have retrospectively evaluated records of 62 patients treated in Head and Neck Oncology unit of Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH and RC), Lahore, Pakistan from 2004 to 2014 who were included based on the criteria of histopathological proven squamous cell carcinoma of retromolar trigone (RMT) treated with radical intent. Diagnostic workup for all patients involved clinical examination, imaging modalities usually magnetic resonance imaging (MRI), computerized tomography (CT), Orthopantomogram (OPG), and chest x-ray (CXR) to evaluate regional and distant metastasis, respectively. Kaplan-Meier survival curves were used to depict survival.ResultsThe study was comprised of 36 male and 26 female patients. Treatment modalities used are surgery only (n = 1), radiotherapy alone (n = 13), radiotherapy followed by surgery (n = 10), chemoradiotherapy (n = 16), induction chemotherapy followed by concurrent chemoradiotherapy (n = 19), induction chemotherapy followed by surgery, and radiotherapy (n = 2). Surgical interventions include wide local excisions (n = 6), marginal mandibulectomy (n = 4), and segmental mandibulectomy (n = 4). Surgical margins were clear in 54%, close in 38%, and involved in 8% of patients. AJCC 7th edition showed cT1 8%, cT2 22%, cT3 14%, and cT4 56% while pT1 2%, pT2 3%, and pT4 8%. During follow-up, 18% patients have come up with local recurrence, 22% showed persistent disease while 9% have presented with distant metastasis. The five-year and overall survivals are 38% and 22%, respectively.ConclusionRetromolar trigone involvement poses many vital structures at risk of involvement. Late presentation results in involvement of masticator space compromising both mouth opening and surgical outcomes. Surgery and radiotherapy have shown comparable results in disease control. Bone invasion has shown poor outcome in terms of loco-regional control and overall survival.

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Retromolar trigone squamous cell cancers: A reappraisal of 16 section MDCT for assessing mandibular invasion

Cited by 23 publications

References 24 publications

Contemporary Diagnostic Imaging of Oral Squamous Cell Carcinoma – A Review of Literature

Contemporary Diagnostic Imaging of Oral Squamous Cell Carcinoma – A Review of Literature

Demographic and imaging features of oral squamous cell cancer in Serbia: a retrospective cross-sectional study

Treatment Outcomes of Rare Retromolar Trigone Squamous Cell Carcinoma Using Combined Modalities

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