Original article / research
Role of Contrast Enhanced Computed Tomography in Assessing Tumour Spread Patterns and Staging of Buccal Carcinoma: A Retrospective Observational Study
TC01-TC05
Correspondence
Dr. Deepshikha Arora,
Junior Resident, Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences (AIIMS), Nagpur-441108, Maharashtra, India.
E-mail: drdeepshikha.radio@gmail.com
Introduction: Buccal mucosa is one of the common subsites of oral cavity cancers. Buccal carcinoma usually shows contiguous extension, involving adjoining anatomical structures; accurate assessment of its extent is necessary for appropriate patient management. Contrast Enhanced Computed Tomography (CECT) is an important imaging modality that helps with disease staging, assessment of preoperative surgical resectability, and radiation planning.
Aim: To evaluate the anatomical pathways of tumour spread and staging characteristics of buccal carcinoma using CECT.
Materials and Methods: This retrospective study was conducted at the Department of Radiodiagnosis and Interventional Radiology, Bhopal Memorial Hospital & Research Center, Bhopal, Madhya Pradesh (MP), India, from November 2023 to October 2024. Total of 100 patients of all age groups with clinically suspected cases of buccal carcinoma were evaluated by a 256-slice multislice CECT machine. The abnormal manifestations measured included involvement of adjacent anatomical structures such as the gingivobuccal sulcus, alveolar ridge, retromolar trigone, masticator space, mandible, skin, floor of mouth, tongue, and regional lymph nodes, were systematically documented on CECT. The imaging findings were subsequently confirmed by histopathological examination of the surgical specimen and/or biopsy samples wherever available. All continuous variables were measured using the mean and SD, and categorical variables using frequencies and percentages.
Results: A total of 100 patients (85 histopathologically confirmed) with clinically suspected buccal mucosal lesions were evaluated. The patient ages ranged from 20 to 70 years, with a mean of 48.6 years. There were 72 males and 28 females (male:female ratio 2.6:1). Histopathological examination confirmed squamous cell carcinoma in 85 patients, while the remaining 15 patients had premalignant conditions. The most common site involved was the parotid duct orifice, seen in 65.4% (56/85) of cases, followed by the gingivobuccal sulcus, 60.2% (51/85). Other sites showing contiguous infiltration included the overlying subcutaneous fat and skin 45.3% (39/85), lips and angle of the mouth 21.2% (18/85), retromolar trigone 25.6% (22/85), mandibular alveolus 43.5% (37/85), maxillary alveolus 38.7% (33/85), muscles of the masticator space 48.2% (41/85), floor of the mouth 30.2% (26/85), oropharynx 30.6% (26/85), maxillary sinus/pterygomaxillary fissure 29.2% (25/85), pterygoid plates 25.4% (22/85), high infratemporal fossa (i.e., above the mandibular notch) 30.6% (26/85), and the base of the skull with intracranial extension 15.7% (13/85)
Conclusion: In this study, CECT effectively demonstrated the extent of buccal carcinoma and the various anatomical pathways of locoregional tumour spread.