Imaging Science in Dentistry

Korean Academy of Oral and Maxillofacial Radiology (대한영상치의학회)
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Differential imaging diagnosis of a swelling after extraction in a breast cancer patient with radiotherapy and chemotherapy

방사선치료와 화학요법을 받은 유방암 환자에서 발생한 발치 후 종창의 진단영상학적 감별 진단

  • Huh Kyung-Hoe (Department of Oral and Maxillofacial Radiology, and Dental Research Institute, College of Dentistry, Seoul National University) ;
  • An Byung-Mo (Department of Dentistry, College of Medicine, Hallym University) ;
  • Kim Mi-Ja (Department of Dentistry, College of Medicine, Hallym University) ;
  • Park Kwan-Soo (Department of Oral and Maxillofacial Surgery, Inje University Sanggye Paik Hospital) ;
  • Heo Min-Suk (Department of Oral and Maxillofacial Radiology, and Dental Research Institute, College of Dentistry, Seoul National University)
  • 허경회 (서울대학교 치과대학 구강악안면방사선학교실 및 치학연구소) ;
  • 안병모 (한림대학교 의과대학 치과학교실) ;
  • 김미자 (한림대학교 의과대학 치과학교실) ;
  • 박관수 (인제대학교 상계백병원 구강악안면외과학교실) ;
  • 허민석 (서울대학교 치과대학 구강악안면방사선학교실 및 치학연구소)
  • Published : 2006.09.01
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Abstract

A 60-year-old female, who complained of delayed healing and swelling after extraction of left lower second molar during chemotherapy, visited our department. She had a history of a resection surgery of breast cancer and postoperative radiotherapy. The conventional radiographs showed diffuse permeative bone destruction in posterior mandibular body, which gave the first radiologic impression of osteonecrosis associated with radiotherapy or chemotherapy. And bone metastasis from the breast cancer was also considered in the differential diagnosis. On the enhanced computed tomography (ECT) the posterior mandibular body was occupied by a large expansile lesion showing central low attenuation with peripheral rim enhancement. Magnetic resonance images revealed that the low attenuated area on ECT did not show as high signal intensity as water on T2 weighted image and indicated solid component of a tumor. The final diagnosis was central squamous cell carcinoma. We present the diagnostic imaging features of the patient with special emphasis on the differential diagnosis.

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