Primary Intraosseous Squamous Cell Carcinoma of the Jaws: 6 New Cases, Experience, and Literature Comparison

Purpose: To analyze the clinical, histologic, radiologic, therapeutic, and prognostic aspects of 6 cases of an uncommon head and neck malignancy and compare these results with data in the literature. Materials and Methods: The medical histories of all patients treated in the Maxillofacial Surgery Unit in San Gerardo Hospital (Monza, Italy) for primitive intraosseous squamous cell carcinoma (PIOSCC) of the jaw were reviewed. All patients were considered suitable for inclusion in the study, specifically those whose oral mucosa had not been compromised and who did not have distant metastases. Results: Six patients were included (4 male, 2 female). The odontogenic origin was histologically shown in only 2 patients. The male-to-female ratio was 2: 1, and the malignancy occurred in the posterior mandible in 50% of cases. The most common symptoms were swelling and pain, but no sensory disturbances were observed. Radiologic findings indicated considerable variation in presentation, including small cystic lesions, which might complicate a pathologic diagnosis. All patients in the study were treated with surgery, and 2 patients received adjuvant radiotherapy. Cervical node metastases were present in 33% of patients. All patients are currently alive and free of disease. Conclusion: PIOSCC is a rare malignancy of the head and neck. Diagnosis can be difficult during the early stages of disease owing to a lack of clinical symptoms or radiologic presentation. Treatment is surgical and, like every other cancer, must be adequate to cure the cancer. (C) 2016 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 74: 541-546, 2016