Odontogenic tumors are quite uncommon lesions of the jaws. They may be derived from odontogenic ectoderm or ectomesenchyme layers. Odontogenic tumors are always considered as a differential diagnosis for any kind of new growth in the jaws. They have a great variety in their presentation either clinically or radiographically which are discussed below.
Etiology Of Odontogenic Tumors
The odontogenic jaw tumors originate from cells and tissues that are involved in normal tooth development only. Other tumors that affect the jaws can be non-odontogenic, meaning that they can develop from other tissues within the jaws that are not related to the teeth like bone or soft tissue cells. Generally, the cause of jaw tumors is not known however, some are associated with gene changes, genetic mutations or genetic syndromes etc.
The genetic mutation affects the cell cycle, especially the G1- S checkpoint, which stimulates the formation of odontogenic tumors. Studies suggested that mutations in ameloblastin, KRAS, and P53 genes are mostly related to the development of odontogenic tumors.
People suffering with
nevoid basal cell carcinoma syndromewhich is also known as
Gorlin-Goltz syndrome, lack a gene that suppresses tumors. This syndrome results in the development of multiple odontogenic keratocysts within the jaws, multiple basal cell skin cancers and other characteristics tumors and cysts.
The common symptoms which we can see in all types of tumors are mentioned below, some may also include extra symptoms depending on the type of tumor
- Swelling or pain in the jaw can be seen
- Painless, hard, slow expanding swelling in the jaw or around the teeth which is affected
- The affected teeth becomes mobile
- Sometimes the tooth doesn’t erupt completely if it is an erupting tooth.
The doctor ask for complete medical history, as well as a physical examination is done including palpation of the site and also includes examination of oral cavity, jaw and teeth. Some or all of the below-mentioned tests may also be prescribed
- Computerized tomography scan also called a CT or CAT scan
- Magnetic resonance imaging also called as MRI
- Biopsy can be done
The type of treatment may depend on few things, including whether the tumor is benign or malignant. The treatment options for odontogenic tumors are mentioned below
Surgical removal of the tumor is the most common form of treatment for completely eradicating the tumor without any reoccurrence. For benign tumors, surgery may be the only treatment suggested.
The radiation therapy can help stop the growth of abnormal cells in specific areas of the body. Radiation therapy uses high energy rays from a specialized machine to damage or kill abnormal cells causing the tumor.
Chemotherapy is used in cases of advanced or aggressive tumor growths, that can help in stopping the growth of abnormal cells or tumor causing cells throughout the body. Chemotherapy is a systemic treatment, meaning it is injected to the bloodstream through which it travels throughout the body to kill or slow down the growth of targeted cells. Different groups of chemotherapy drugs work in different ways to fight with the cancer cells to destroy the tumors. Chemotherapy can be given in following ways
- Given as a pill to swallow
- Given in the form of an injection into the muscle or fat tissues
- Introduced intravenously (directly to the bloodstream through veins)
- Also given intrathecally (directly into the spinal column with a needle)