Tumors of the Maxillofacial Bones and Considerations for Bone Invasion

Abstract

Tumors in the maxillofacial region can arise in the soft and hard tissues. Those located in the facial skeleton are rare and can be of odontogenic or osseous origin. No matter whether they are benign or malignant, clinically they are often symptomless for a long time. Even radiologically, their appearance is mostly uniform and lytic. Most lesions expand the jawbones over time, and patients notice painless swellings or facial deformity. Size generally does not help in the differential diagnosis. Delineation, intralesional matrix mineralization and the exact site of origin on the other hand are important clues to the correct diagnosis [1–3]. Although computed tomography (CT) or magnetic resonance imaging (MRI) is much more precise in characterizing the content and delineation of tumors, in most cases it is not possible to establish a diagnosis without biopsy and histologic examination. Biopsies should always be obtained as open biopsies to receive sufficient material in quantity and quality. This is particularly important since some lesions can present histologically similar or can be affected by metaplastic changes due to secondary inflammation which can blur the diagnostic hallmarks. The key to an adequate diagnosis is a close interdisciplinary collaboration between the clinician, the pathologist, and the radiologist. The treatment plan is, of course, crucially dependent on a precise preoperative diagnosis.