PATTERNS OF SPREAD OF SQUAMOUS-CELL CARCINOMA TO THE RAMUS OF THE MANDIBLE

Patterns of spread of squamous cell carcinoma to the ramus of the mand ible have been studied. In nonirradiated mandibles, tumor in the ramus was found to have spread in continuity from tumor within the body. In 22 of 27 specimens (81.5%) with established invasion of the molar reg ion of the body, tumor spread was either confined to the body or to th e body and the anterior part of the ramus. The remaining five cases sh owed extensive spread within the ramus. It was concluded that a more c onservative approach to resection of the ramus may be safe on patholog ic grounds in the nonirradiated mandible. In postirradiation mandibles , direct invasion through cortical bone was seen in addition to direct spread from the body. Tumor spread to the ramus was seen in nine of 1 2 specimens (75%), and in each case was both diffuse and extensive. It was concluded that a conservative approach to resection of the ramus is not safe on pathologic grounds after radiotherapy. (C) 1993 John Wi ley & Sons, Inc.