Bone invasion by oral squamous cell carcinoma: Molecular alterations leading to osteoclastogenesis - a review of literature.

Oral squamous cell carcinoma (OSCC) is a growing problem globally. OSCC often arises in close anatomical relation to the jaws and may invade the bone. Bone invasion by OSCC has major implications on tumor staging, choice of treatment, outcome, and quality of life. The difference in cortical or medullary bone invasion has implications for these factors. Treatment protocols used for cortical and medullary invasion differ worldwide. By researching possible pathways a more molecular-based clinical staging and tailor-made therapy can be useful for patients with bone invasion by OSCC. An important molecular step in bone invasion seems to be the activation of osteoclasts. Several direct and indirect pathways can activate osteoclasts. Microbial infections, hypoxia, and the immune system could be of interest.