Pathways involved in the spread of buccal carcinoma on contrast-enhanced multislice CT.
OBJECTIVES
To explore how buccal carcinoma spread, using contrast-enhanced multislice CT (CEMSCT).


METHODS
We retrospectively analysed the extent of lesions in 56 patients with primary buccal squamous cell carcinoma (SCCA). Abnormal manifestations on CEMSCT at oral subsites and involved adjacent structures were documented and evaluated, which were compared with the results of surgery and histopathology.


RESULTS
Infiltration and spread to oral subsites and/or adjacent structures was confirmed in 33 patients (58.9%). The opening of the Stensen duct was the most commonly invaded oral subsite (72.7%); other sites included the gingivobuccal sulcus (60.6%), pterygomandibular raphe (54.5%), gingiva (24.2%), retromolar trigone (24.2%), orbicularis oris (18.2%) and the floor of mouth (15.2%). Of the involved adjacent structures, the buccal space was the most common site of spread (69.7%), followed by the masticatory muscles and spaces (57.6%), bone (54.5%), skin and subcutaneous fat (39.4%), pharynx (30.3%), investing fascia (15.2%) and the base of the skull (6.1%). CEMSCT manifestations of the involvement in buccal SCCAs had correlations with pathological findings (p < 0.05). The sensitivities, specificities and accuracies of two radiologists' evaluation on buccal carcinoma involvement were 50.00%, 23.21% and 73.21%; and 51.79%, 32.14% and 83.93%, respectively.


CONCLUSIONS
Buccal SCCAs could superficially and deeply spread to multiple oral subsites and/or adjacent structures. CEMSCT could delineate their spread pathways and extents.
['Xu|S-S|SS|', 'Li|D|D|', 'Zhou|Y|Y|', 'Sheng|B|B|', 'Zeng|C|C|', 'Zhong|S-X|SX|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D002294:Carcinoma, Squamous Cell D002681:China D003287:Contrast Media D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D009062:Mouth Neoplasms D009361:Neoplasm Invasiveness D012189:Retrospective Studies D012680:Sensitivity and Specificity D014057:Tomography, X-Ray Computed
contrast-enhanced multislice computed tomography head and neck neoplasms neoplasm staging