Presentation
Ulcer on surface of mandible
Patient Data
Dental caries, with the erosion of multiple crowns.
Periapical lucency surrounds the mandibular third molars bilaterally, as well as the left mandibular premolar.
Destruction of the alveolar process of the right hemimandible may be due to direct invasion by the patient's known squamous cell carcinoma.
Case Discussion
There is destruction of the right hemimandible. In this case it results from direct extension from a primary SCC of floor of mouth.
Mandibular destruction may also occur from infection, or infiltration from myeloma or metastatic disease.
The extent of bone destruction is best assessed with CT. Soft tissue, nodal and perineural involvement is preferably evaluated with contrast enhanced MRI