Malignant tumors of the mandible and maxilla.

Malignant tumors of the mandible and maxilla are grouped into primary tumors that originate within the mandible and secondary lesions, predominantly oral cancers and metastatic lesions, that involve the mandible secondarily. The most common malignant tumors of the mandible represent SCCs of the oral cavity, notably carcinoma of the floor of the mouth and gingiva that invade the mandible secondarily. Metastatic disease, most commonly from the breast and lung, are not an uncommon malignant lesion in the mandible and may be the first manifestation of a malignant lesion outside the head and neck. The osteogenic sarcoma is the most common sarcomatous lesion in the mandible and is suggested when a bone-forming matrix with sclerosis is found within the tumor on CT images. Some benign lesions may mimic a malignant tumor on imaging studies. In such cases, a biopsy is indicated to establish the diagnosis by histopathologic means. CT is indicated for assessment of bone destruction in the mandible before surgery or radiation therapy. MR imaging is the optimal modality for the assessment of marrow involvement and evaluation of the extraosseous soft tissue component. Finally, conventional films, frequently a Panorex view, are the initial radiographic examinations in suspected lesions.