A rare tumor in a rare location: giant cell tumor of the sacrum and ilium - case report and current perspectives.

Giant cell tumor (GCT) is considered a locally aggressive, intermediate grade benign bone neoplasm. In rare cases, GCT undergoes malignant degeneration or may cause distant metastasis, mainly in the pulmonary area. Most bone GCTs are situated in the epiphysis or metaphysis of long bones, while GCTs of the pelvis are quite rare. There is no standard treatment protocol for the GCT of pelvic bones. This paper presents the therapeutic management of a rare case of a stage III GCT, situated on the iliac tuberosity, sacral wing and partially the left iliac wing. The chosen treatment consisted in intralesional curettage, high-speed burring, phenolization and hydrogen peroxide lavage. At the six-week follow-up, the patient reported minimal disability. No complications and no local infections were revealed. Healing was confirmed by the two-year postoperative follow-up. This case report demonstrates that intralesional curettage complemented with adjuvant therapies is a viable alternative to wide resection surgery for the treatment of aggressive GCT.

Morphological assessment of the mandibular canal trajectory in edentate subjects.

BACKGROUND: The mandibular canal and its content represent the vital structure, which can complicate dentoalveolar surgical procedures in the posterior region of the mandible. The purpose of the present study was to determine the path the mandibular canal takes in relation to the horizontal and the vertical anatomical reference planes in edentate subjects, in order to minimize the risk of affecting its neurovascular content during various oral surgery procedures. MATERIALS AND METHODS: Morphometric evaluations were performed on 12 dried fully edentulous human mandibles and on cone-beam computed tomography (CBCT) cross-sectional images of the mandible, from 20 patients with either partial or complete edentulism. Both methods were utilized, in three target areas (corresponding to the second premolar, to the first molar and to the second molar regions), in order to measure the distance between the mandibular canal and the following reference points: (i) the lateral (buccal) surface of the mandible (MC-BS distance); (ii) the medial (lingual) surface of the mandible (MC-LS distance); (iii) the alveolar surface of the mandible (MC-AS distance). The results were statistically processed in Stata MP/13 software package using analysis of variance (ANOVA) test. RESULTS: The mandibular canal crossed the trabecular bone from the posterior towards the anterior, and from the lingual towards the buccal, reaching the premolar region, distal to the mental foramen, where it was located in the centre of the trabecular bone, main topographic pattern encountered in 27 (84.37%) of the cases. In five (15.63%) of the cases, in the premolar region, the mandibular canal was located near the buccal cortical plate. The mandibular canal descended from the second molar region towards the premolar region, main topographic pattern found in 28 (87.5%) of the cases. In four (12.5%) cases, the mandibular canal had a descending trajectory in the molar regions and it took a slightly ascending course in the premolar region. CONCLUSIONS: According to the results, the second molar region represents the highest risk area in the accidental injury to the content of the mandibular canal, during various oral surgery procedures.