Malignant lesions in the anterior maxilla

Area of Science:

• Oral and Maxillofacial Radiology
• Oncology
• Pathology

Background:

• The anterior alveolar ridge of the maxilla frequently harbors pathologies, often involving bone and detectable via radiography.
• While many present as periapical radiolucencies of inflammatory origin (PRIO) near non-vital teeth, a subset represents more severe conditions, including malignancies.
• Distinguishing these from benign lesions and other malignancies like non-Hodgkin lymphomas (NHL) is critical.

Purpose of the Study:

• To highlight the differential diagnosis of bone pathologies in the anterior maxilla.
• To emphasize the importance of identifying malignancies, particularly squamous cell carcinomas (SCCs) and non-Hodgkin lymphomas (NHL), within this region.
• To provide context referencing the 2017 WHO Classification of Head and Neck Tumours for rarer malignancies.

Main Methods:

• Radiological assessment of anterior maxillary pathologies.
• Histopathological evaluation for definitive diagnosis.
• Literature review and classification referencing the WHO guidelines.

Main Results:

• Periapical radiolucencies of inflammatory origin (PRIO) are common but require differentiation from neoplastic processes.
• Squamous cell carcinomas (SCCs) can arise from odontogenic epithelial remnants within the alveolus, distinct from mucosal invasion.
• Non-Hodgkin lymphomas (NHL) represent a rarer differential diagnosis within the anterior maxilla.

Conclusions:

• Accurate radiological and pathological assessment is crucial for differentiating benign inflammatory lesions from malignant neoplasms in the anterior maxilla.
• Awareness of SCCs and NHL arising within the alveolar bone is essential for timely and appropriate management.
• The 2017 WHO Classification provides a framework for understanding and diagnosing rarer malignancies in this anatomical site.