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Not all swellings are dental abscesses: A cautionary tale Prateek Biyani Rachael Lundgren Alexandra Thompson Robert Orr Dental Update 2024 48:4, 707-709.
Authors
PrateekBiyani
BDS (Hons), MFDS RCPS(Glasg), Cert Med Ed, FHEA,
Specialty Doctor in Oral and Maxillofacial Surgery, Chesterfield Royal Hospital, Chesterfield
Carcinomas of the maxillary antrum are rare and tend to present late, leading to poor survival rates. Two-thirds of cases will present with oral symptoms or facial swelling. Dentists should be aware of suspicious clinical and radiographic signs, which may help in early detection and treatment. We present the case of a 48-year-old female complaining of facial swelling. In preceding months, she had visited her GP and dentist numerous times, receiving antibiotics from each for suspected sinusitis and a dental abscess, respectively. Subsequent investigations confirmed an SCC of the right maxillary antrum, which unfortunately, could only be treated palliatively.
CPD/Clinical Relevance: The reader should understand the classic findings for a maxillary antrum carcinoma. They should also increase their confidence and awareness in identifying red flag signs and symptoms.
Article
The incidence of head and neck cancer in the UK continues to rise. There were 12,238 new cases from 2015 to 2017, with a 20% increase in cases recorded in the last 10 years.1 Carcinomas of the maxillary antrum account for around 1.5% of these cases, with an annual incidence of 0.5–1.0 per 100,000.2,3 Squamous cell carcinomas are the most common malignancy in the maxillary sinus, but these have a survival rate of only 29%.4 This case report highlights and discusses the diagnostic difficulties with a case of squamous cell carcinoma in the maxillary antrum, a relatively rare pathology, which is often mistaken for dental disease. More importantly, it discusses the barriers in identification and referral of antral carcinomas, but also other head and neck cancers from primary care.
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