Tumors of the Jaw

Possibly the easiest way to imagine having this condition is to get a bunch of food and to stuff them into the mouth. Now, with your mouth full, imagine doing regular activities like talking, singing, exercising, sleeping, and even eating. Difficult, right?

What this example fails to cover is that an untreated jaw tumor can keep growing in size and at an unprecedented rate. As with every medical condition, early diagnosis and treatment can spell the difference in successful recovery. In this article, we will talk about jaw tumors so we can understand this condition better.

What is it

“Jaw tumors,” also known as odontogenic tumors, refers to an abnormal growth of a mass of tissue, or cysts (lesions that contain liquid or semisolid substance) which affect the jaw. These develop in the jawbone or the soft tissues in the mouth and face.

Conditions vary greatly in size and severity, and most are commonly non-cancerous or non-spreading (benign). Only in rare cases are they cancerous in nature (malignant) and they spread to nearby areas. While this may be the case, these tumors can still be aggressive and they invade the surrounding bone and tissue, displacing your teeth and causing varying facial deformities.

There are different types of tumors and cysts, and since these all grow differently from different causes, a specialized treatment approach is needed depending on the case.

What causes it

Odontogenic tumors originate from the cells and tissues that are involved in normal tooth development. Generally, the cause of these tumors is not known but some are associated with genetic syndromes. An example would be people who have the Gorlin-Goltz syndrome which causes the patient to lack a gene that suppresses tumors. This is an inherited genetic mutation, and it results in the development of several odontogenic keratocysts within the jaws, multiple basal cell skin cancers, and other characteristics.

What are common symptoms

• Ameloblastoma - This is a slow-growing and usually non-cancerous tumor that develops most often in the jaw near the molars. It can invade local structures such as bone and soft tissue. This type can recur after treatment; however, more aggressive surgical treatments can typically reduce the chance of recurrence.

• Central giant cell granuloma - These are benign lesions that often occur in the front portion of the lower jaw. In some cases, the tumor can grow rapidly which causes pain and bone damage. This may also have a tendency to recur even after surgical treatment. Other types are less aggressive and may not carry any symptoms. This type typically requires surgical treatment, but there are rare chances that the tumor may shrink or resolve on its own.

• Dentigerous cyst - This type of lesion originates from tissue that surrounds a tooth before it further erupts into the mouth. This is one of the most common forms of cysts that affects the jaws. This can usually be observed around wisdom teeth that are not fully erupted, but other cases can involve other teeth as well.

• Odontogenic keratocyst - This is a slow-growing, benign cyst that can often cause damage to local structures. It has a tumorlike tendency to recur after surgery and for this it’s also referred to as keratocystic odontogenic tumor. This cyst can often be seen developing in the lower jaw near the third molars.

• Odontogenic myxoma - Occurring most often in the lower jaw, this is a rare, slow-growing, benign tumor. In some cases, the tumor can grow and aggressively invade the jaw and the surrounding tissue, displacing the teeth in the affected area. This type is known to recur after surgery, and so aggressive surgical treatments are given as an option to reduce its chance of recurrence.

• Odontoma - This is known to be the most common odontogenic tumor. While this type typically has no symptoms, this may interfere with tooth development or eruption. Odontomas are made up of dental tissue that grows around a tooth in the jaw. They may look like a tooth with an odd shape, or a small or large calcified tumor. This may also be observed with some genetic syndromes.

• Other types of cysts and tumors - These include adenomatoid odontogenic tumors, calcifying epithelial odontogenic tumors, ameloblastic fibromas, glandular odontogenic cysts, squamous odontogenic tumors, calcifying odontogenic cysts, cementoblastoma, aneurysmal bone cysts, ossifying fibromas, osteoblastomas and central odontogenic fibromas to name a few

How it’s diagnosed

Regardless if it’s a barely noticeable lump or a large deformity, your PAPRAS doctor will recommend tests prior to your treatment. These may include any or all of the following:

• Imaging studies (such as X-ray, CT scan, or MRI)

• Biopsy - where a sample of tumor or cyst cells is removed for laboratory analysis

With the information derived from your test results, your doctor will be able to come up with a treatment plan that is specialized for your case.

References:

1. Mayo Foundation for Medical Education and Research. “Jaw tumors and cysts.” 11 December 2018, https://www.mayoclinic.org/diseases-conditions/jaw-tumors-cysts/symptoms-causes/syc-20350973. Accessed 15 January 2021.

2. Wolfsdorf, MD, FAAP, Jack. “Odontogenic Tumors.” Nicklaus Children's Hospital, 18 December 2020, https://www.nicklauschildrens.org/conditions/odontogenic-tumors. Accessed 15 January 2021.