Central carcinoma of the jaw. A survey of 28 cases in the Japanese literature.

A survey of the Japanese literature revealed 28 well-documented cases of central carcinoma of the jaws. There was no sex predominance and the mandible was the site of involvement in 26 cases. The most common initial symptom was local swelling, which was followed in order of frequency by spontaneous pain, paraesthesia of the lower lip, discomfort, loosening of teeth and trismus. On clinical examination, local swelling which was often accompanied by variable symptoms was an almost constant finding. Radiographic appearance varied from unilocular to worm-eaten type radiolucencies which were often surrounded by indistinct margins on close examination. Radical surgery, combined with irradiation and/or chemotherapy was the principal treatment in most cases, but there were 4 cases in which the lesions were simply excised under a tentative diagnosis of cyst; local recurrence was noted in 5 cases. Regional lymph node metastasis and lung metastasis were observed in 8 and 2 cases, respectively. No definite conclusion was drawn with regard to the prognosis because of the short follow-up period. Histologically, epidermoid carcinoma was most frequently seen, but odontogenic cyst was confirmed to be the site of origin in 3 cases only.