Paget's disease of the jaws: Histopathological features of a series of 31 cases.

Abstract

The aim of the present study was to analyze the histopathological features of Paget's disease of the jaws observed in a series comprising 31 cases. The study comprised all cases of Paget's disease of the jaws filed in the archives of the Surgical Pathology Laboratory of the Oral Pathology Department, School of Dentistry, University of Buenos Aires, between 1960 and 2018. Their microscopic features were evaluated, and available clinical data and radiographic studies were analyzed. Paget's disease of the jaws accounted for 0.05% of retrieved oral-maxillofacial pathologies. Microscopically, all cases showed lamellar bone trabeculae with the characteristic mosaic pattern. Twenty cases (64%) showed osteoblastic-osteoclastic activity, and all showed areas of necrosis. Cemento-osseous trabeculae were observed in 15 cases (48%), and cementicles were observed in 13 (42%). Osteomyelitis was seen in 11 cases (35%), all of which showed cemento-osseous trabeculae with a mosaic structure, sclerosis and necrosis, and chronic inflammation with abscess formation. Mean age was 61 years (44-85 years); 19 cases were women. Localization was the maxilla in 13 cases (42%), and the disease involved other skeletal bones in five cases. To our knowledge, this is the largest series of Paget's disease of the jaws reported to date. Paget's disease is infrequent in the jaws and has distinct histopathological features that not only differ from those observed at other skeletal sites but also require differential diagnosis from other pathologies affecting the jaws exclusively.