Malignant tumours mimicking periapical lesions: A report of three cases and literature review

Apical periodontitis shows radiographic signs such as widening of the periodontal ligament and periapical radiolucency, which differ in extent depending on the stage of the lesion. However, other lesions can be associated with or coincidental to the apical region, representing developmental lesions and benign or malignant tumours. This article describes three cases of malignant tumours, a central mucoepidermoid carcinoma (CMEC), a chondroblast osteosarcoma and an osteosarcoma of the jaw (OSJ) that presented as periapical lesions. Endodontists must be aware of unsuccessful treatment, persistent pain, signs of paraesthesia, a rapid growth rate and delayed response to therapy associated with atypical features. Complementary examinations, such as biopsy and computed tomography, can allow the early diagnosis of malignant tumours, leading to a better prognosis and thus increased survival rates and improvement in quality of life.

Automated summary

Apical periodontitis can present with radiographic signs like widening of the periodontal ligament and periapical radiolucency, but may also be associated with other developmental lesions and benign or malignant tumours. Endodontists should be vigilant for atypical features of malignant tumours, and complementary examinations such as biopsy and computed tomography can aid in early diagnosis for better prognosis and improved quality of life.