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Primary intraosseous squamous cell carcinomas are rare tumours arising from odontogenic epithelial remnants. These tumours arise within the jaw, without any communication with the oral mucosa and are not exposed to the usual carcinogens. The mandible is more commonly affected than the maxilla and is characterized by progressive swelling of the jaw, pain and loosening of the teeth. Radiographically, these lesions appear as radiolucent areas with irregular margins. The tumour is locally aggressive and often present with lymphnode metastasis. Radical surgery followed by postoperative radiotherapy is recommended. The overall and disease-free survival is poor, with almost 50% of patients failing loco-regionally within the first 2 years of follow-up Thomas G, Pandey M, Mathew A, Abraham EK, Francis A, Somanathan T, Iype M, Sebastian P, Nair MK (2001). Primary intraosseous carcinoma of the jaw: pooled analysis of world literature and report of two new cases. Int J Oral Maxillofac Surg 30: 349-355..

Figure 1: Primary intraosseous squamous cell carcinoma, cystogenic, non-keratinizing cyst. Dentigerous cyst of a lower wisdom tooth, showing an ill-defined outline.
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