Sarcomatous neoplasms can affect not only the bones of the limbs and spine, but also the jaws.
Jaw sarcomas are not considered to be a particularly common pathological phenomenon, however, they are detected much more often than cancers and grow mainly from cartilaginous and connective tissue elements of the maxillofacial zone. Similar formations are more often found in 20-45-year-old patients, mostly men.
Species and causes of pathology
Mandibular sarcomas can form as:
- Chondrosarcomas;
- Fibrosarcoma;
- Osteogenic tumor;
- Ewing sarcomas, etc.
The causes of maxillary tumors practically do not differ from similar formations of other localization. This:
- Radiation exposure;
- Unfavorable heredity;
- Contact with carcinogens such as lead, cobalt, etc.;
- An unfavorable environment, such as a poor environmental situation, polluted urban air toxins, etc.; Unhealthy addictions such as drug addiction, alcohol abuse or tobacco use imply direct contact with carcinogens. Particularly oncotoxic is nicotine;
- Presence in the anamnesis of tumor pathologies. Such a factor indicates a predisposition to malignant processes.
Symptoms of the lower and upper jaw sarcoma
Sarcomatum formations may be located on the upper or lower jaw.
They are considered especially insidious, because they are characterized by an uncharacteristic clinic and rapid development.
In the process of determining the exact diagnosis, sarcoma is confused with a variety of ailments such as periodontitis, gingival fibromatosis, gingivitis or osteomyelitis.
The clinical picture of such tumors differs in individuality and can be clearly manifested not only in large-scale formations, but also in small sarcomas.
The main manifestations of sarcomatous tumors of maxillofacial localization are:
- Pain syndrome. It is difficult for a patient to determine the localization of pain, which is prone to strengthening in the area of the teeth, located in relative proximity to the tumor. Soreness may be of a shooting character, giving into the temporal region, or manifest as pulling discomfort;
- With the lower jaw location of the , the shakiness and loss of teeth, burning sensation and gum feeling are noted.
- Facial deformation. With further development, there are deformation disorders of bone tissues, their destruction( if there is a central location of the tumor).In the region of the cheek appears a swelling of the compaction, the face swells;
- If the tumor is located in the maxilla , the symptomatology is supplemented with sucronic nasal discharge, problems with nose breathing, exophthalmus, which is associated with the germination of the tumor into the orbit and nasal cavity;
- As the formation grows, has difficulty in chewing food , jaw joint, there is a noticeable increase in pain syndrome;
- Numbness of some facial areas. With mandibular localization, numbness of lower lip and chin is observed, which indicates the presence of mechanical compression of the tumor by nerve endings;
- Submandibular and oral tissues undergo carcinogenic infiltration. Often, the tumor process extends to the cervical region.
Stages of development of
Staging of sarcomatous formations is determined in accordance with the size of the primary tumor site, the prevalence beyond the organ and surrounding tissues, the presence of lymphatic and distant metastases.
- 1st stage. The tumor is small in size, no more than a centimeter, beyond the original focus does not go. If the tumor is detected at this stage, then the treatment will be successful, the patient has every chance to finally get rid of the disease.
- 2nd stage. Education increases, sprouts in all the jaw layers, disrupts the functionality of the jaw. Such formations do not, in fact, go beyond the jaw, however, when they are removed, a more extensive operation will be required. Recovery is possible, but the probability of relapse is high.
- 3rd stage. Sarcomatogenic formation sprouts into neighboring tissues, can metastasize into lymph nodes of regional importance. The results of treatment are usually disappointing, in almost all cases there are relapses.
- Stage 4 is considered terminal. Tumor usually reaches a gigantic size, disintegrate and cause bleeding. There are metastases in any lymph nodes, typically the presence of metastasis in distant organs such as the lungs, brain, etc. The prognosis is negative.
Diagnosis of the disease
Sarcomatous formation of maxillofacial localization requires a comprehensive diagnostic approach, because at first they have a symptomatology similar to other pathologies.
The doctor collects an anamnesis and conducts an examination, after which the patient is sent for examination, which prescribes such procedures:
- Laboratory examination of urine, blood, including oncomarkers;
- Radiographic examination( side view, front view);
- Histological diagnosis of material obtained from biopsy;
- Radionuclide study.
Diagnosis is vital, because an incorrect diagnosis leads to the onset of sarcoma, which is fraught with complications, up to a lethal outcome.
Treatment of the pathology of
The basis of therapy for the jaw sarcoma is surgical treatment, involving the removal of the affected area.
Sarkomatoznye education is resistant to radiation, so this type of therapy is not applied to them. Chemotherapy is used as an auxiliary technique before and after surgery.
The operation is performed as a resection - excision of the tumor within the healthy structures. Similar removal can be carried out in different ways:
- Resection without disruption of jaw continuity or with impairment;
- Half or segmental resection with exarticulation( dissection) of the affected element;
- A wide resection with the gripping of soft tissue structures.
The most optimal technique is selected by a specialist after a careful study of the type of sarcomatous tumor, its stage, metastasis and general well-being of the oncological patient.
Such operations are considered rather complicated and highly traumatic, they are performed with endotracheal anesthesia. At the same time, the patient is transfused.
This waiting period is necessary not only to prevent relapses, but also for regeneration, so that in the future the transplant can fully take root.
Life expectancy
Prognosis for sarcomatous maxillofacial structures is unfavorable.
Statistically, only a fifth of patients after resection have a 5-year survival rate. The remaining 80% of patients experience relapses and eventually die.