PRIMARY INTRA-ALVEOLAR CARCINOMA
PRIMARY INTRA-ALVEOLAR CARCINOMA DEFINITION
These are rare malignant neoplasm of epithelial tissue origin, which develop as central jaw lesions with no indication that they have originated from the surface epithelium or they have metastasized from other distant sites.
The tumor arises from the cell rests of the odontogenic epithelium or from the epithelial remnants at the site of the fusion between two embryonic processes.
PRIMARY INTRA-ALVEOLAR CARCINOMA CLINICAL FEATURES:
- Age: Middle aged adult are often affected
- Sex: There is slight male predication.
PRIMARY INTRA-ALVEOLAR CARCINOMA PRESENTATION:
- Primary intra-alveolar carcinoma often causes rapid expansion and destruction of the jaw bones.
- Pain and paresthesia are very common features of this lesion
- Often there is unexplained loosening of the teeth
- Perforation of cortical plates and pathological fractures of bone may sometime occurs
- Extraction of teeth often results in no healing of the socket and sometimes the tumor mass may protrudes from the no healed wound.
PRIMARY INTRA-ALVEOLAR CARCINOMA RADIOLOGICAL FEATURES:
- Expansion and distortion of the cortical palates of the jawbones are common
- There can be perforation of the cortical palates or occasional pathological fractures
- There can severe destruction of the alveolar bone with loosening and displacements of the regional teeth.
PRIMARY INTRA-ALVEOLAR CARCINOMA HISTOPATHOLOGY:
- Excessive proliferation of neoplastic epithelial cells either in the form of diffuse sheets or epithelial islands
- The neoplastic cells often exhibit definite signs of malignancy- like cellular pleomorphism, nuclear hyperchromatism and increased abnormal mitosis, etc.
- Areas of acanthotic changes with epithelial pearl formation.
PRIMARY INTRA-ALVEOLAR CARCINOMA DIFFERENTIAL DIAGNOSIS:
- Metastatic carcinoma
PRIMARY INTRA-ALVEOLAR CARCINOMA TREATMENT:
Radical Surgical excision with regional lymph node dissection. Prognosis is poor.