Jaw Cysts and Tumors
Cysts and tumors may develop in the jawbones and surrounding facial structures. Most are benign (noncancerous), but in rare cases they can represent jaw cancer or other malignant conditions. Some lesions grow slowly, while others expand more aggressively, damaging bone, affecting sinuses or nerves, and displacing teeth. Accurate diagnosis by an oral and maxillofacial surgeon in Yerevan, supported by CBCT or CT imaging, is essential to determine the nature and extent of the lesion. In most cases, treatment involves surgical removal, with careful preservation of surrounding structures and follow-up to reduce the risk of recurrence.
OVERVIEW
WHAT ARE JAW CYSTS AND TUMORS?
Jaw cysts and tumors are growths that can form from bone (including teeth) and soft tissue in your mouth. A jaw cyst is a sac of fluid or semi-liquid material. A jaw tumor is a solid mass that forms when abnormal cells clump together. Both growths are usually benign (noncancerous). This means that, although they may grow and impact tissue in your face and mouth, they usually don't spread to other parts of your body.
In rare instances, jaw cysts or tumors are malignant (cancerous). Healthcare providers refer to them as jaw cancer. Without treatment, malignant jaw cysts and tumors can spread to body parts other than your jaw.
It's essential to get any new growth in your jaw or mouth checked. Even if a tumor or cyst is benign, some types can still hurt and damage your jaw or displace teeth.
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TYPES OF JAW CYSTS AND TUMORS
There are several types of jaw cysts and tumors. Providers classify them based on whether they're benign or malignant. They also consider whether they start in tissue involved in tooth development (odontogenic cysts and tumors) or from other tissue (nonodontogenic cysts and tumors).
The most common types of benign jaw cysts and tumors include:
• Ameloblastoma: A slow-growing odontogenic tumor that usually forms in your lower jaw near your back teeth (molars). It's usually benign, but some forms of ameloblastoma may become malignant over time. Even benign tumors can grow big enough to change the structure of your jaw or damage your teeth.
• Central giant cell granuloma: The most common benign non-odontogenic tumor. It usually forms in the front part of your lower jaw, but it can also develop in your upper jaw. Most tumors only cause painless swelling in your jaw. But fast-growing tumors can cause painful swelling and displace teeth.
• Dentigerous cysts: The second most common odontogenic cyst. They're slow-growing cysts that form around the tissue of teeth that haven't pushed into your mouth (erupted) yet. They usually form near your back teeth (molars). Sometimes, they appear near the teeth on either side of your upper front teeth (upper canines).
• Odontogenic keratocysts: Slow-growing cysts that usually form near your molars. Smaller keratocysts aren't usually painful, but large cysts can cause painful swelling. These cysts may be a sign of an inherited condition called Gorlin syndrome. This condition increases your risk of odontogenic keratocysts and some forms of skin cancer.
• Odontogenic myxoma (myxofibroma): A benign, slow-growing tumor. But these tumors can grow big enough to damage your jaw and displace your teeth.
• Odontoma: The most common benign odontogenic tumor. One type usually forms in your lower jaw and contains multiple tooth-like structures (compound type). The other type usually forms in your upper jaw and contains unusual masses that don't resemble teeth (complex type).
• Periapical cysts: The most common type of jaw cyst. They form when there's an injury to a tooth that causes inflammation.
Malignant jaw cysts and tumors include rare forms of:
• Carcinoma: Cancer that starts in the tissue lining your organs, internal passageways and skin.
• Sarcoma: Cancer that starts in bone or surrounding soft tissue.
• Carcinosarcoma: Cancer that's a mix of both carcinoma and sarcoma.
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HOW COMMON ARE JAW CYSTS AND TUMORS?
Jaw cysts and tumors are uncommon, and malignant types are especially rare.
Research shows that people in some regions may be more likely to develop them than in other areas. For example, odontogenic tumors account for just 1% of atypical oral (mouth) growths in North America but nearly 20% in some African countries.
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SYMPTOMS AND CAUSES
WHAT ARE THE SYMPTOMS OF A CYST OR TUMOR IN MY JAW?
Most cysts and tumors are slow-growing and don't cause symptoms. You may not know you have one until they show up incidentally on a dental X-ray or another imaging test related to a head and neck issue.
But large growths that start to take the place of nearby healthy tissue can cause symptoms, including:
• Jaw pain, tenderness or numbness.
• Swelling (may or may not be painless).
• Changes in the way your face looks.
• A new lump on your jawbone (may be hard or soft).
• Changing bite.
• Loose teeth.
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WHAT CAUSES JAW CYSTS AND TUMORS?
Most jaw cysts and tumors form when the cells that eventually form teeth behave abnormally and form masses (tumors) or fluid-filled sacs instead. This is what happens with odontogenic growths. But the cells don't have to be involved in tooth formation to grow abnormally.
Odd cell growth often happens because of DNA changes (genetic mutations). DNA contains the instructions, or code, that tell cells how to grow, including when to stop. Problems with the code can disrupt cell division processes and cause overgrowths.
For example, people with Gorlin syndrome (nevoid basal cell carcinoma syndrome) have mutations that cause cells to continue multiplying and dividing when they shouldn't. As a result, people with the condition often get multiple odontogenic keratocysts and are at increased risk of basal cell carcinoma, the most common skin cancer.
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DIAGNOSIS AND TESTS
HOW ARE JAW CYSTS AND TUMORS DIAGNOSED?
Your healthcare provider will review your symptoms and medical history and perform a physical exam. Imaging tests can show tumors or cysts in and around your jaw. They include:
• X-rays.
• Magnetic resonance imaging (MRI).
• Computed tomography (CT) scan.
You'll also need a biopsy. During a biopsy, a provider removes a sample of fluid or tissue from the growth. A pathologist examines the sample under a microscope to determine the type of cells it contains. This information tells your provider:
• What type of cyst or tumor you have.
• Whether it's benign or malignant.
• Whether it's slow-growing or aggressive.
All these factors help your provider determine the best treatment options.
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MANAGEMENT AND TREATMENT
HOW ARE JAW CYSTS AND TUMORS TREATED?
Most people need surgery to remove the cyst or tumor. In addition to removing the growth, your surgeon may also remove any affected tissue. This includes damaged teeth or parts of your lower or upper jaw. Surgery to remove segments of the lower part of your jaw is called a mandibulectomy. Surgery that removes all or part of your upper jaw is called maxillectomy.
Following surgery, you may need treatments to rebuild your jaw and help with recovery, including:
• Reconstructive surgery: Your provider may remove a segment of bone from another part of your body (like your hip, shoulder blade or lower leg) to make your jaw look like it did before you had a growth.
• Dental implants: You may need artificial teeth to replace the ones that your provider pulled.
• Speech therapy: A speech-language pathologist (SLP) can help improve your speaking if you're having trouble talking and being understood after surgery.
• Nutrition guidance: You may need to meet with a nutrition specialist, like a dietitian or nutritionist, who can advise you on what foods you can safely eat as you heal.
If you have jaw cancer, your healthcare provider may also recommend cancer treatments, including radiation therapy and/or chemotherapy. The best treatment for you depends on the type of tumor or cyst.
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OUTLOOK / PROGNOSIS
WHAT CAN I EXPECT IF I HAVE A JAW CYST OR TUMOR?
Surgery can cure most jaw cysts and tumors. Depending on the type, you may need follow-up visits to monitor new growths.
For example, periapical cysts, odontomas and dentigerous cysts don't usually grow back (recur) after surgery. But central giant cell granuloma, odontogenic myxoma and odontogenic keratocysts often do. Ameloblastoma recurs in up to 20% of people.
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LIVING WITH
WHEN SHOULD I SEEK CARE?
See your healthcare provider if you're experiencing pain or swelling in your jaw or if you notice a change in your appearance, like a lump on your jaw or shifting teeth. It may be a sign of a cyst, tumor or a separate dental condition your provider can treat.
It's especially important to visit your dentist regularly. A routine dental X-ray can show signs of a cyst or tumor when it's still small and isn't causing symptoms.
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source: https://my.clevelandclinic.org/health/diseases/jaw-cysts-tumors