CENTRAL SQUAMOUS-CELL CARCINOMA OF THE MANDIBLE - COMPUTED TOMOGRAPHIC FINDINGS

Five cases of central squamous cell carcinoma of the mandible were inv estigated with the use of computed tomography. Bucco-lingual extent an d spread along the mandibular division of the trigeminal nerve were ev aluated. Three patients with trismus showed involvement of the massete r or medial pterygoid muscle on computed tomography. involvement of mo re than two landmarks along the trigeminal nerve were observed in case s with both paresthesia of the lower lip and severe pain that resemble d neuralgia. Perineural invasion was confirmed histologically in four cases, and all of these patients had both severe pain and mandibular c anal involvement that could be demonstrated with computed tomography. When localized soft tissue changes are evident along the course of the trigeminal nerve in the region between the mandibular foramen and for amen ovale, ascending perineural spread should be suspected. Computed tomography findings correlated well with clinical symptoms but added i nformation about the spread of the lesion within the surrounding soft tissue.