ABSTRACT
Fibro-osseous lesions is a class of diseases with obvious similarities in clinical manifestations and pathological features, which has been attracting the attention of clinicians and pathologists. The latest WHO 2022 Classification (5th edition) included six of these diseases (cemento-osseous dysplasia, segmental odontomaxillary dysplasia, fibrous dysplasia, juvenile trabecular ossifying fibroma, psammomatoid ossifying fibroma and familial gigantiform cementoma) in the " fibro-osseous tumours and dysplasias ", and put forward new ideas on the diagnosis and treatment of these diseases. According to the latest WHO 2022 Classification (5th edition), the clinical and pathological features, diagnosis and differential diagnosis of these six diseases were described.
Subject(s)
Humans , Fibroma, Ossifying/pathology , Diagnosis, Differential , Cementoma/pathology , Jaw Neoplasms , Facial BonesABSTRACT
Objetivos: O carcinoma adenoide cístico é uma lesão rara e agressiva. O presente trabalho visa relatar o caso de uma ressecção de carcinoma adenoide cístico e manutenção do arcabouço ósseo realizado por meio de sonda de Foley insuflada com soro fisiológico. Relato do caso: Um paciente submetido a ressecação de um carcinoma adenoide cístico em maxilla com destruição de soalho de órbita foi relatado. O caso foi realizado no Hospital Josina Machel em Luanda, Angola. A região apresenta uma considerável escassez de materiais de fixação e outros mais, o que impossibilita reconstruções maxilofaciais com a excelência necessária. A realização de enxertos microvascularizados ou implantes customizados torna-se inviável devido aos custos e tecnologia dispendida para tal. Conclusão: A sonda de Foley mostra-se como uma alternativa viável nos casos de reconstrução de terço médio de face com envolvimento de seio maxilar e soalho de órbita em locais de mais difícil acesso... (AU)
Objectives: Adenoid cystic carcinoma is a rare and aggressive lesion. The present work aims to report the case of a resection of adenoid cystic carcinoma and maintenance of the bone framework performed using a Foley catheter insufflated with saline solution. Case report: A patient who underwent resection of an adenoid cystic carcinoma in the maxilla with destruction of the orbital floor was reported. The case was carried out at Hospital Josina Machel in Luanda, Angola. The region has a considerable shortage of fixation materials and others, which makes maxillofacial reconstructions with the necessary excellence impossible. The realization of microvascularized grafts or customized implants becomes unfeasible due to the costs and technology used for this purpose. Conclusion: The Foley catheter is a viable alternative in cases of reconstruction of the middle third of the face with involvement of the maxillary sinus and orbital floor in areas that are more difficult to access... (AU)
Objetivos: El carcinoma adenoide quístico es una lesión rara y agresiva. El presente trabajo tiene como objetivo reportar el caso de una resección de carcinoma quístico adenoide y mantenimiento de la estructura ósea realizada mediante sonda de Foley insuflada con suero fisiológico. Caso clínico: Se reporta un paciente que fue sometido a resección de un carcinoma adenoide quístico en el maxilar con destrucción del piso orbitario. El caso se llevó a cabo en el Hospital Josina Machel de Luanda, Angola. La región tiene una escasez considerable de materiales de fijación y otros, lo que imposibilita las reconstrucciones maxilofaciales con la excelencia necesaria. La realización de injertos microvascularizados o implantes personalizados se vuelve inviable por los costes y la tecnología utilizada para tal fin. Conclusión: La sonda de Foley es una alternativa viable en los casos de reconstrucción del tercio medio de la cara con afectación del seno maxilar y suelo orbitario en zonas de más difícil acceso... (AU)
Subject(s)
Humans , Female , Middle Aged , Orbit/surgery , Orbit/pathology , Maxillary Sinus Neoplasms , Jaw Neoplasms , Carcinoma, Adenoid Cystic , Maxillary Sinus , Wounds and InjuriesABSTRACT
Tumors of the maxillomandibular complex are a heterogeneous group of lesions with a wide spectrum of clinical and histopathological characteristics. Aim: To evaluate the prevalence of odontogenic and non-odontogenic tumors associated with maxillary bones in a Reference Center for Oral Lesions. Methods: A cross-sectional study based on the medical records of a Reference Center for Oral Lesions at the State University of Feira de Santana, from 2006 to 2018. The data was initially analyzed in a descriptive manner. For bivariate analysis, Pearson's chi-square test was applied. The level of significance was set at 5%, where p≤ 0.05 is considered significant. Results: The prevalence of tumors was 2.27%. The average age of the individuals was 22.2 (± 15.1) years, the majority being up to 39 years (79.59%) and female (69.40%). A statistically significant difference was observed in relation to age (p = 0.00), as well as regarding the location of tumors in the anterior or posterior region (p = 0.02). Odontogenic tumors were benign, with odontoma being most frequent (46.90%), followed by ameloblastoma (16.30%). As for the non-odontogenic, neurofibroma (4.10%) and osteoma (4.10%) were the most common across the benign, while osteosarcoma accounted for 6.10% of cases. Conclusion: Odontogenic tumors were the most frequent in women, with age up to 39 years, odontoma being most common in the posterior region of the mandible. Among nonodontogenic tumors, central neurofibroma and osteoma were the most common. Osteosarcoma was more frequent in men over 40 years old and in the mandible region
Subject(s)
Pathology, Oral , Jaw Neoplasms/epidemiology , Cross-Sectional Studies , DiagnosisABSTRACT
O mixoma odontogênico é um tumor benigno que acomete os maxilares, de rara ocorrência que tem origem a partir do componente ectomesenquimatoso de um germe dentário, seja ao nível da papila dentária, ao nível do folículo ou ainda ao nível do ligamento periodontal. Tem predileção pelo sexo feminino, podendo comprometer com mais significância a faixa etária da segunda à quarta década de vida. O tratamento dos mixomas odontogênicos pode ser conservador ou radical. Com relação à escolha do tratamento, deve o cirurgião levar em consideração principalmente a extensão do envolvimento da lesão. O tratamento conservador pode ser considerado como primeira escolha, evitando efeitos associados a morbidade, comprometimento de estruturas anatômicas nobres e diminuição da qualidade de vida. Por se tratar de lesão recidivante, métodos complementares de tratamento têm sido empregados, tais como osteotomia periférica, uso do nitrogênio líquido e a solução de Carnoy. Este trabalho teve como objetivo relatar um caso de mixoma odontogênico em corpo mandibular de paciente do sexo feminino, leucoderma, 25 anos, solteira, natural de Recife-PE- Brasil, tratado de forma conservadora através de curetagem, osteotomia periférica e uso de solução de Carnoy, que até o presente momento não ocorreu sinais de recidiva... (AU)
Odontogenic myxoma is a rare benign tumor that affects the jaws. It´s originates from the ectomesenchymatous component of a dental germ, either at the level of the dental papilla, at the level of the follicle or at the level of the periodontal ligament. It has a predilection for the female sex, being able to compromise with more significance the age group from the 2nd to the 4th. decade of life. The treatment of odontogenic myxomas can be conservative or radical. Regarding the choice of treatment, the surgeon must take into account mainly the extent of the lesion's involvement. Conservative treatment can be considered as the first choice, avoiding effects associated with morbidity, impairment of noble anatomical structures and decreased quality of life. As it is a recurrent lesion, complementary treatment methods have been used, such as peripheral osteotomy, use of liquid nitrogen and Carnoy's solution. This study aimed to report a case of odontogenic myxoma in the mandibular body of a female patient, leucoderma, 25 years old, single, born in Recife-PE- Brazil, treated conservatively through curettage, peripheral osteotomy and use of a solution of Carnoy, that until now there have been no signs of recurrence... (AU)
Subject(s)
Humans , Female , Adult , Osteotomy , Jaw Neoplasms , Mandible , Myxoma , Conservative Treatment , Jaw , NeoplasmsABSTRACT
Squamous odontogenic tumor (SOT) is a rare benign neoplasm of the jaw that likely arises from remnants of the dental lamina. It is a slow-growing lesion, with a radiolucent appearance in the central variant. Microscopically, SOT shows islands of squamous epithelium supported by fibrous stroma. In rare cases, squamous odontogenic tumor-like proliferation (SOT-LP) can be observed arising from odontogenic cysts (SOT-LPOC). Herein, we describe the case of a 42-year-old man who presented with discreet bleeding in the maxillary gingiva. Imaging revealed a well-defined, ovoid-shaped lesion with sclerotic margins involving tooth #18 in the intraosseous location. Fine needle aspiration supported the cystic nature of the lesion. After surgery, microscopy revealed a dentigerous cyst showing SOT-LP features. There was no recurrence after a 3-year follow-up. To the best of our knowledge, this is the first report of a dentigerous cyst showing SOT-LP features in the maxilla. Such cysts should be identified to avoid misdiagnosis, with the finding having therapeutic and prognostic implications.
Subject(s)
Humans , Male , Adult , Dentigerous Cyst/pathology , Jaw Neoplasms/pathology , Odontogenic Tumor, Squamous/pathologyABSTRACT
La urgencia en la práctica odontológica incluye no solo la atención de pacientes con dolor e infección, sino también la atención de pacientes que presentan patologías con presunción diagnóstica de agresividad y/o malignidad. El objetivo de este estudio fue analizar la incidencia de las patologías bucomaxilares biopsiadas en el Servicio de Urgencias y Orientación de Pacientes (SUyOP), y diagnosticadas en el Laboratorio de Patología Quirúrgica de la Cátedra de Anatomía Patológica (LPQ-CAP) de la Facultad de Odontología de la Universidad de Buenos Aires (FOUBA), en un período del Aislamiento Social Preventivo y Obligatorio de la pandemia COVID-19. Se realizó un estudio observacional, descriptivo y retrospectivo de pacientes que se presentaron para la atención odontológica en el período de tiempo comprendido entre el 20 de marzo al 21 de junio de 2020. Se registraron los pacientes que presentaron lesiones bucales con indicación de biopsia. Del total de pacientes evaluados (4854), 48 presentaron patologías con presunción diagnóstica de agresividad y/o malignidad. Las patologías más frecuentes fueron las neoplasias malignas (21 casos), siendo la entidad prevalente el carcinoma de células escamosas. Para el LPQ-CAP, las muestras biópsicas remitidas por el SUyOP representaron el 44% del total de las muestras recibidas. Si bien la incidencia de patologías bucomaxilares biopsiadas y diagnosticadas fue baja (1%) es de destacar que el diagnóstico histopatológico correspondió, en la mayoría de los casos, a patologías neoplásicas. De allí la importancia de la atención de urgencia a pacientes que presentan lesiones con presunción diagnóstica de malignidad/agresividad (AU)
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Mouth Neoplasms/epidemiology , Jaw Neoplasms/epidemiology , COVID-19 , Argentina , Precancerous Conditions/diagnosis , Schools, Dental , Social Isolation , Biopsy/methods , Carcinoma, Squamous Cell/epidemiology , Epidemiology, Descriptive , Retrospective Studies , Emergencies , Age and Sex Distribution , Observational Study , Ambulatory CareABSTRACT
Abstract Lesions denominated fibro-osseous lesions of the jaw constitute a diversified group of disorders, in which the normal bone architecture is replaced by fibroblasts, collagen fibers and immature bone. At present, the World Health Organization recognizes four variants of these lesions, namely: bone-cement dysplasia, fibrous dysplasia, ossifying fibroma and Familial gigantiform cementoma. Fibrous dysplasia may present in the monostotic form, affecting one single bone or an isolated craniofacial region; and in the Polyostotic form, involving two or more bones of the skeleton, and eventual association with syndromic conditions. The patient, C.P.G., 43 years old, sought attendance due to symptomatic increase in the region of the mandibular body on the right side. Imaging exams revealed craniofacial areas with ground-glass aspect, beyond the extensive mandibular radiolucent lesion. During the physical exam, spots of the Café au lait type disposed on the right side of the body were identified, in addition to uncoordinated gait with distinct shortening of the right leg. Additional radiographic exams showed evidence of skeletal dissemination of the disease. The patient denied any sexual precocity, and the final diagnosis was fibrous dysplasia, expressed by means of the Jaffe-Lichtenstein syndrome, in association with a simple bone cyst.
Resumo As denominadas lesões fibro-ósseas dos maxilares constituem um grupo diversificado de desordens nas quais a arquitetura óssea normal é substituída por fibroblastos, fibras colágenas e osso imaturo. Atualmente a Organização Mundial de Saúde reconhece quatro variantes destas lesões, sendo elas: a displasia cemento-óssea, a displasia fibrosa, o fibroma ossificante e cementoma gigantiforme familiar. A displasia fibrosa pode ser apresentar na forma monostótica, acometendo um único osso ou a região craniofacial isoladamente, e a forma poliostótica, envolvendo dois ou mais ossos do esqueleto, com eventual associação com condições sindrômicas. Paciente C.P.G., 43 anos, procurou atendimento devido aumento volumétrico sintomático na região de corpo mandibular do lado direito. Exames imaginológicos revelaram áreas craniofaciais com aspecto de vidro fosco ou despolido, além de extensa lesão radiolúcida mandibular. Durante o exame físico foram identificadas manchas do tipo café com leite dispostas do lado direito do corpo, além de marcha descoordenada com nítido encurtamento da perna direita. Novos exames radiográficos evidenciaram a disseminação esquelética da doença. O paciente negou qualquer precocidade sexual e o diagnóstico final foi de displasia fibrosa, expressa por meio da síndrome de Jaffe-Linchtenstein, em associação com um cisto ósseo simples.
Subject(s)
Humans , Adult , Bone Cysts , Cementoma , Jaw Neoplasms , Fibrous Dysplasia of Bone , Facies , Immunologic Deficiency Syndromes , NeutropeniaABSTRACT
Peripheral Ameloblastoma (PA) is a benign odontogenic tumor, arising from the cell rest of Serres, reduced enamel epithelium and basal cells of the surface epithelium. Peripheral ameloblastoma is a rare odontogenic neoplasm occurring commonly in the mandibular gingiva. PA clinically resembles other peripherally occurring lesions like pyogenic granuloma, peripheral ossifying fibroma, peripheral giant cell granuloma, and squamous papilloma. The recurrence rate of PA is 16-19% which demands a straight follow up. We report a case of recurrent peripheral ameloblastoma occurring in a 72-year old male located in the mandibular lingual gingiva in relation to the 44, 45 element's regions. The patient had a primary lesion excised from the same site 6 years before which was diagnosed as ameloblastoma.
Subject(s)
Humans , Female , Aged , Ameloblastoma/diagnosis , Jaw Neoplasms , Odontogenic Tumors , Neoplasm Recurrence, LocalABSTRACT
O ameloblastoma é um tumor odontogênico epitelial benigno caracterizado por crescimento lento localmente agressivo, alta morbidade e grande potencial de recidiva. Apesar dos avanços em bioinformática que levaram ao desenvolvimento de tecnologias que permitiram o estudo das ciências "ômicas", há escassos estudos de proteômica em ameloblastomas. O nosso objetivo, portanto, foi realizar uma análise quantitativa do perfil proteômico de ameloblastomas em comparação a folículos pericoronários. No presente estudo, nós utilizamos a estratégia de proteômica shotgun para identificação de proteínas usando a combinação de cromatografia líquida e espectrometria de massas em tandem (liquid chromatography-tandem mass spectrometry; LC-MS/MS). Também foram realizadas análises de cluster e de enriquecimento funcional das proteínas que apresentaram abundâncias alteradas nos ameloblastomas. Nesse estudo realizou-se ainda avaliação do status de mutação em BRAF nos casos de ameloblastoma. Por fim, a validação dos resultados da etapa de proteômica foi feita por meio de imunoistoquímica. A análise proteômica quantitativa comparativa resultou na identificação de 1.353 proteínas. Os ameloblastomas mostraram um perfil proteômico distinto daquele encontrado nos folículos dentais, com 33 proteínas super-reguladas e 21 para sub-reguladas. As proteínas super-reguladas estão envolvidas no metabolismo da glicose e nas vias de biossíntese de macromoléculas, indicando um mecanismo adaptativo de crescimento do tumor, enquanto a maioria das proteínas sub-reguladas desempenha papéis importantes na produção de energia celular mitocondrial e na regulação do metabolismo de oxidorredutase, sugerindo disfunção mitocondrial e resposta ao estresse oxidativo. BRAF p.V600E foi detectado na maioria dos ameloblastomas e pode estar relacionado à indução de fluxo glicolítico, assim como ao estresse oxidativo. Para investigar a ativação do sistema antioxidante, nós avaliamos a imunoexpressão da enzima antioxidante denominada glutationa S-transferase ômega 1 (GSTO1), que foi super-regulada nos ameloblastomas. Os ameloblastomas mostraram imunoexpressão de GSTO1 difusa e com intensidade moderada a forte, enquanto uma imunoexpressão fraca ou negativa de GSTO1 foi observada nos folículos pericoronários. Nossa hipótese é que o ameloblastoma apresenta reprogramação metabólica glicolítica com alta geração de precursores biossintéticos. Além disso, foi observada uma baixa abundância de componentes respiratórios mitocondriais, o que está possivelmente associado à disfunção mitocondrial. Nós identificamos pela primeira vez alterações em vias metabólicas críticas que não só contribuem para a elucidação da patogênese do ameloblastoma, mas também podem ser alvos terapêuticos potenciais para esses tumores
Ameloblastoma is a benign epithelial odontogenic tumor characterized by slow but locally aggressive growth, high morbidity and great potential for recurrence. Despite the advances in bioinformatics that led to the development of technologies that allowed the study of omics sciences, there are scarce studies of proteomics in ameloblastomas. Our aim was to perform a quantitative analysis of the proteomic profile of ameloblastomas compared to dental follicles. In the present study, we performed shotgun proteomics to identify proteins using the combination of liquid chromatography and tandem mass spectrometry (LC-MS/MS). We also performed cluster and functional enrichment analyses of proteins with altered abundances in ameloblastomas. This study also carried out an assessment of the BRAF mutation status in cases of ameloblastoma. Finally, the validation of the results of the proteomics step was performed using immunohistochemistry. Quantitative comparative proteomic analysis resulted in the identification of 1,343 proteins. Ameloblastomas were shown to harbor a proteomic profile distinct from that found in dental follicles, with 33 over-regulated and 21 down-regulated proteins. Overregulated proteins are involved in glucose metabolism and biosynthesis pathways, indicating an adaptative tumor growth mechanism. Most of the down-regulated proteins play prominent roles in cellular mitochondrial energy production and oxidoreductase metabolism regulation, suggesting mitochondrial dysfunction and oxidative stress response. BRAF p.V600E was detected in most ameloblastomas and it may be related to the induction of glycolytic flux, as well as oxidative stress. To investigate the activation of the antioxidant system, we assessed the immunoexpression of the antioxidant enzyme glutathione S-transferase omega 1 (GSTO1), which was up-regulated in ameloblastomas. Ameloblastomas showed diffuse and moderate to strong GSTO1 immunoexpression, whereas weak or negative imunoexpression was observed in dental follicles. We hypothesize that ameloblastoma presents metabolic reprogramming towards a more glycolytic state with high biosynthetic precursor generation. In addition, a low abundance of mitochondrial respiratory components possibly associated with mitochondrial dysfunction was observed. We were able to identify for the first-time alterations in critical metabolic pathways, which not only contribute to the elucidation of ameloblastoma pathogenesis but also could be potential targets for drug therapy in these tumors.
Subject(s)
Mass Spectrometry , Ameloblastoma , Jaw Neoplasms , Proteomics , Mouth Neoplasms , ImmunohistochemistryABSTRACT
RESUMEN Introducción: El carcinoma ameloblástico es una entidad rara que surge como una neoplasia primaria o a partir de un ameloblastoma preexistente. El colgajo de músculo temporal es una opción terapéutica frecuentemente empleada para la reconstrucción del defecto resultante luego de la exéresis quirúrgica. Objetivo: Presentar un caso clínico de restauración estética y funcional mediante reconstrucción con colgajo temporal de un defecto maxilar por exéresis de carcinoma ameloblástico, dada la infrecuente presentación de esta entidad. Caso clínico: Mujer de 49 años de edad, que refiere "una bola" en el paladar de 9 meses de evolución. Al examen físico facial presenta aumento de volumen en región infraorbitaria izquierda. Se realizó una tomografía axial computarizada en la que se constató la presencia de imagen hiperdensa en seno maxilar izquierdo con calcificación en su interior, produciendo lisis del hueso nasal y hueso cigomático infiltrando partes blandas. Se tomó muestra para biopsia que informó tumor de alto grado de malignidad correspondiente a carcinoma ameloblástico. En estudio radiográfico de tórax no se apreció presencia de metástasis pulmonar. Se realizó maxilarectomía de infra y mesoestructura, resección de la lesión con margen oncológico de seguridad y se reconstruyó el defecto palatino con colgajo pediculado del músculo temporal. Se indicó quimio y radioterapia como terapia adyuvante al tratamiento quirúrgico. Se mantuvo el chequeo posoperatorio mostrándose buena evolución clínica y una epitelización secundaria del músculo temporal en el área palatina con restauración de las funciones. Conclusiones: Se presentó un caso clínico de carcinoma ameloblástico, entidad patológica de escasa frecuencia. La cirugía constituyó el pilar de tratamiento utilizado. Una vez realizada la resección quirúrgica se reconstruyó el defecto palatino, utilizándose el colgajo del músculo temporal, opción útil para lograr el restablecimiento de las funciones estéticas y funcionales como la deglución y fonación(AU)
ABSTRACT Introduction: Ameloblastic carcinoma is a rare condition emerging as a primary neoplasm or from a preexisting ameloblastoma. Temporalis muscle flap is a therapeutic option frequently used for reconstruction of the defect resulting from surgical exeresis. Objective: Present a clinical case of esthetic and functional restoration by reconstruction with temporalis muscle flap of a maxillary defect caused by exeresis of an ameloblastic carcinoma. The case is presented because of the infrequent occurrence of this condition. Clinical case: A female 49-year-old patient reports "a lump" in her palate of nine months evolution. Physical examination finds an increase in volume in the left infraorbital region. Computed axial tomography was indicated, which revealed the presence of a hyperdense image in the left maxillary sinus with internal calcification causing lysis of the nasal bone and the zygomatic bone, and infiltrating soft tissue. A sample was taken for biopsy, which reported a tumor with a high degree of malignancy corresponding to ameloblastic carcinoma. Chest radiography did not show the presence of lung metastasis. Infra- and mesostructure maxillectomy was performed, the lesion was removed with a surgical safety margin, and the palatine defect was reconstructed with a pediculated temporalis muscle flap. Chemo- and radiotherapy were indicated as adjuvants to the surgical treatment. Postoperative follow-up found good clinical evolution and secondary epithelization of the temporalis muscle in the palatine area with restoration of functions. Conclusions: A clinical case was presented of ameloblastic carcinoma, a condition with a low frequency of occurrence. Surgery was the basic component of the treatment applied. Once surgical resection was performed, the palatine defect was reconstructed by means of a temporalis muscle flap, a useful option to achieve the restoration of esthetic and biological functions, such as swallowing and speech(AU)
Subject(s)
Humans , Female , Middle Aged , Surgical Flaps/surgery , Ameloblastoma/diagnostic imaging , Jaw Neoplasms/pathology , Mandibular Reconstruction/methods , Chemoradiotherapy, Adjuvant/methodsABSTRACT
Dermoid cyst (DC) is a cystic lesion of developmental origin and uncertain etiology that rarely affects the floor of the mouth. We report a case of a large lesion found in the submental and submandibular region in a 25-year-old male patient. Computed tomography revealed extensive hypodense lesion in the submental and submandibular space without peripheral enhancement. The microscopical analysis showed a cystic cavity lined by orthokeratinized stratified squamous epithelium. The cystic capsule was composed of dense fibrous connective tissue containing cutaneous attachments, such as sebaceous and sweat glands. The diagnosis of DC was made. The differential diagnosis of expansive sublingual lesions can be clinically challenging due to the similarity with several lesions frequently observed in this region. Herein, we describe a case of extensive DC arising in the floor of the mouth, presenting clinical, imaging, and microscopical features.
Subject(s)
Humans , Male , Adult , Jaw Neoplasms , Dermoid Cyst/pathology , Dermoid Cyst/complications , Dermoid Cyst/diagnostic imaging , Mouth Floor/injuriesABSTRACT
OBJETIVO: Realizar un análisis retrospectivo de pacientes pediátricos sometidos a reconstrucciones con injertos libres microvasculares del territorio maxilofacial en el Hospital Luis Calvo Mackenna entre los años 2014 y 2018. MATERIALES Y MÉTODO: Se realizó un análisis de los casos reconstruidos entre los años indicados. RESULTADOS: Un total de 11 pacientes fueron incluidos en la muestra, 7 hombres y 4 mujeres. El rango de edad de los pacientes fue entre 3 a 17 años (media 10,1). Siete colgajos de fíbula, 3 dorsales y 1 anterolateral de muslo fueron utilizados para reconstrucción. La tasa de éxito de los colgajos fue de un 100%. Discusión: Se realizó una discusión de los colgajos y sus principales indicaciones en pediatría y se compararon los resultados de la revisión con los casos reportados. CONCLUSIÓN: El estudio preoperatorio, una adecuada planificación, la rehabilitación de la oclusión dentaria, la reconstrucción simétrica y mantener el contorno facial deben ser objetivos de la reconstrucción.
AIM: Carry out a retrospective analysis of pediatric patients undergoing reconstructions with free micro-vascular grafts of the maxillofacial territory at the Luis Calvo Mackenna Hospital during the years 2014 and 2018. MATERIALS AND METHOD: Retrospective analysis of the cases reconstructed during the years 2014 and 2018 was made. RESULTS: A total of 11 patients were included in the sample, 7 men and 4 women. The age range of the patients was between 3 to 17 years (mean 10.1 years) . Seven Fibula flaps, 3 dorsal and 1 anterolateral thigh flaps were used for reconstruction. The success rate of the flaps was 100%. DISCUSSION: A discussion of the flaps and their main indications in pediatrics was made and the results of the review were compared with the cases reported. CONCLUSION: The pre-operative study, adequate planning, the rehabilitation of the dental occlusion, the symmetry reconstruction and maintaining the facial contour must be objective of the reconstruction.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Surgical Flaps/transplantation , Jaw Diseases/surgery , Plastic Surgery Procedures/methods , Microsurgery/methods , Jaw Neoplasms/surgery , Retrospective Studies , Treatment Outcome , Fibula/transplantation , Mandible/surgeryABSTRACT
OBJECTIVES: This study aimed to determine the prevalence of odontogenic cysts, tumors, and other lesions among reports in the archives of the Department of Oral and Maxillofacial Surgery at the Faculty of Dentistry affiliated with Kocaeli University collected over a four-year period.MATERIALS AND METHODS: In this retrospective study, patient records from the archive of the Department of Oral and Maxillofacial Surgery from 2014 to 2018 were reviewed. Patient demographic information (age and sex) and lesion location were recorded and analyzed.RESULTS: From a total of 475 files reviewed, odontogenic cyst was confirmed in 340 cases (71.6%), and odontogenic tumor was confirmed in 52 cases (10.9%). Regarding odontogenic cyst type, the most common was radicular cyst (216 cases), followed by dentigerous cyst (77 cases) and odontogenic keratocyst (23 cases). Among odontogenic tumors, the most frequent was odontoma (19 cases), followed by ossifying fibroma (18 cases) and ameloblastoma (9 cases). Giant cell granuloma was also reported in 35 cases.CONCLUSION: The distribution pattern of odontogenic cysts and tumors in our retrospective study is relatively similar to that reported in the literature. Complete clinical reports for final diagnosis of these lesions and routine follow-up examinations are very important for treatment.
Subject(s)
Humans , Ameloblastoma , Archives , Biopsy , Dentigerous Cyst , Dentistry , Diagnosis , Fibroma, Ossifying , Follow-Up Studies , Granuloma, Giant Cell , Jaw Neoplasms , Odontogenic Cysts , Odontogenic Tumors , Odontoma , Prevalence , Radicular Cyst , Retrospective Studies , Surgery, OralABSTRACT
OBJECTIVE@#To retrospectively analyze the clinical and CT imaging features of desmoplastic ameloblastomas (DA) in comparison with other types of ameloblastomas.@*METHODS@#Patients diagnosed with ameloblastoma histopathologically in Peking University School and Hospital of Stomatology from July 2000 to August 2017 were reviewed to analyze the constituent ratios and characteristics of DA. CT imaging features of DA (28 cases) were investigated in comparison with consecutive cases of solid/multicystic and unicystic ameloblastomas. The following imaging perspectives were analyzed: the border, internal structure, three-dimensional shape, tooth, the periodontium, the cortex and the expansion of the tumors. CT values were measured in the region of interest for quantitative analysis.@*RESULTS@#Among the 1 269 cases of ameloblastomas, 50 (3.9%) were DA, which showed predilections for males (74.0%). The average age of DA was about 43.9 years old, which was higher than the other two types. The anterior incisorcanine region (62.0%) and premolar region (30.0%) were most frequently affected. The incidence rate of DA in mandibule was 56.0% (28/50), which was slightly higher than that of maxilla (44.0%). The DA characteristically showed scallop border and honeycomblike or soapbubble internal structure with bone formation on CT. The mean ratios of height to mesiodistal and buccal-lingual to mesio-distal distances were 0.76 and 0.63, which were higher than the other two types. According to the degree of internal bone formation, three subtypes of DA could be observed: densely ossifying type (I), honeycomb/soap bubble type (II) and sparsely ossifying type (III). The means and standard deviations of CT values of DA were significantly higher than those of the other two types, which were (488.8±164.0) HU (type I), (171.7±102.8) HU (type II), (42.1±8.8) HU (type III).@*CONCLUSION@#CT is helpful for diagnosis of DA, which shows as solid tumor with varying degrees of internal ossification.
Subject(s)
Adult , Female , Humans , Male , Ameloblastoma , Jaw Neoplasms , Maxilla , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
El objetivo de este trabajo consiste en describir la técnica original de ventana ósea, enumerar las ventajas que esta nos brinda y Presentar indicaciones y contraindicaciones de la misma. Presentamos dos casos clínicos y estadística de casos que se resolvieron mediante la técnica quirúrgica de ventana ósea de patología ubicada en zona posterior mandibular (AU)
The objective of this work is to describe the original technique of bony window, to enumerate the advantages that this gives us and to present indications and contraindications of the same one. We present two cases and our case statistics that were solved by the surgical technique of bone window of pathology located in the posterior mandibular zone (AU)
Subject(s)
Humans , Female , Adult , Middle Aged , Jaw Cysts , Jaw Neoplasms , Piezosurgery , Argentina , Oral Surgical Procedures , Dental Service, HospitalABSTRACT
Introducción: El ameloblastoma es una neoplasia benigna, que tiende a ser localmente agresiva, con gran tendencia a la recidiva. Es un tumor odontogénico de origen epitelial; el 80 por ciento de los casos se presenta a nivel mandibular, tanto en rama como en ángulo. Suele manifestarse durante la tercera a quinta décadas de la vida. Las características clínicas no son determinantes del comportamiento biológico y tampoco del pronóstico de un ameloblastoma, ni siquiera en muchos de los casos en los que se complementan con radiografías y/o muestras histopatológicas. Objetivo: Informar el manejo quirúrgico del ameloblastoma multiquístico de manera radical a través de una resección amplia y colocación de placa de reconstrucción que funcionó como mantenedor de espacio, debido a su inusual crecimiento rápido. Presentación de l caso: Se describe un caso clínico de un paciente de sexo masculino, quien presenta una lesión tumoral en rama mandibular derecha, con aspecto clínico de un ameloblastoma de tipo folicular, multiquístico, de crecimiento rápido, tratado en el Hospital Universitario del Caribe de Cartagena, Colombia. Se proporcionan datos sobre su aparición clínica como su rápida evolución, los hallazgos histopatológicos y el manejo terapéutico realizado. Conclusiones: Debido a su crecimiento rápido, para este caso en particular, la opción más factible fue llevar a cabo la resección total de la lesión con el objetivo de evitar o disminuir la posibilidad de recidiva, seguido de reconstrucción con placa de osteosíntesis para devolverle la funcionalidad a la articulación temporomandibular y al hueso mandibular, sin dejar a un lado la estética del paciente(AU)
Introduction: Ameloblastoma is a benign neoplasm that tends to be locally aggressive, with a high tendency to relapse. It is an odontogenic tumor of epithelial origin; 80 percent of cases occur at the mandibular level, both in branch and at an angle. It usually manifests during the third to fifth decade of life. The clinical characteristics are not determinants for the biological behavior or the prognosis of an ameloblastoma, even in many of the cases in which they are complemented with radiographs and/or histopathological samples. Objective: To report the surgical management of multicystic ameloblastoma in a radical way through a wide resection and placement of a reconstruction plate that functioned as a space maintainer, due to its unusual rapid growth. Case presentation: A clinical case of a male patient is described, who presents a tumor lesion in the right mandibular branch, with a clinical appearance of a multicystic, fast growing, follicular ameloblastoma, treated at Hospital Universitario del Caribe in Cartagena, Colombia. Data were provided on its clinical appearance, its rapid evolution, the histopathological findings and the therapeutic management performed. Conclusions: Due to its rapid growth, for this particular case, the most feasible option was to carry out the total resection of the lesion in order to avoid or reduce the possibility of relapse, followed by reconstruction with an osteosynthesis plate to restore the functionality of the temporomandibular joint and of the mandibular bone, without leaving aside the aesthetics of the patient(AU)
Subject(s)
Humans , Male , Middle Aged , Ameloblastoma/surgery , Jaw Neoplasms/diagnostic imaging , Odontogenic Tumors/pathology , Mandibular Reconstruction/adverse effectsABSTRACT
IgG4-related disease is a systemic, multifocal, immune-mediated disorder that can affect multiple organs and may present as a tumor, with rare cases described in the maxillofacial region. A female patient, 53 years old, presenting tumor-like mass in the right mandibular region. Magnetic resonance imaging suggested well circumscribed nodular lesion adjacent to the branch / body of the mandible, extending posteriorly to the masseter muscle. During the surgical procedure of excision, a lesion was observed adhering to the right masseter muscle, but it was possible to remove it completely. Histopathological and immunehistochemical analysis suggested diagnosis of IgG4-related disease, furthermore, IgG4 serum count was increased. Actually, the patient continues on periodical followups in our service and by other specialties. Can be concluded that precise diagnosis of this pathology depends on many factors, being challenging and the treatment involves multidisciplinary evaluation due to the possibility of involvement of several other organs.
La enfermedad relacionada con IgG4 es una condición sistémica, multifocal, mediada por una alteración de la respuesta inmune que puede afectar diferentes órganos o puede presentarse como un tumor, raramente descrito en el área maxilofacial. Se describe el caso de una paciente de sexo femenino de 53 años de edad, presentando una masa tumoral en el ángulo mandibular derecho. La resonancia magnética sugirió un área nodular bien delimitada adyacente al cuerpo mandibular y extendida posteriormente hasta el musculo masetero. Durante la escisión quirúrgica, la lesión se presentaba adherida al musculo de forma lateral siendo posible el retiro total de la lesión. El estudio histopatológico e inmunohistoquimico determinó el diagnóstico de enfermedad relacionada con IgG4 presentando un conteo de igG4 aumentado. Actualmente, la paciente continua con seguimiento por la especialidad. Se puede concluir que el diagnóstico preciso de esta patología depende de algunos factores; el tratamiento debe ser multidsciplinario debido a la inclusión de diferentes órganos en la enfermedad.
Subject(s)
Humans , Female , Middle Aged , Autoimmune Diseases/pathology , Immunoglobulin G , Jaw Neoplasms/pathology , Autoimmune Diseases/immunology , Autoimmune Diseases/diagnostic imaging , Immunohistochemistry , Magnetic Resonance Imaging , Jaw Neoplasms/immunology , Jaw Neoplasms/diagnostic imagingABSTRACT
Abstract Introduction: Solitary plasmacytoma is a rare malignant tumor of plasma cells with no evidence of systemic proliferation. There are two known subtypes: extramedullary solitary plasmacytoma and solitary bone plasmacytoma. The etiology is still unknown. Both lesions present a risk of progression to multiple myeloma. A number of approaches have been used for treatment of solitary plasmacytoma. Objective: To carry out a systematic review of the case reports described in the literature, focusing on therapeutic and prognostic aspects. Methods: A search of clinical case reports was performed in the PubMed database using Mesh Terms related to "plasmacytoma" under the following criteria: type of study (case report), articles in English language, conducted in humans, with no publication date limits. Results: Of the 216 articles found, only 21 articles met the pre-established inclusion criteria. Conclusion: The occurrence of solitary bone plasmacytoma in the bones of the face is a rare condition prevalent between the 4th and 6th decades of life, located in the posterior region of the mandible in most cases. Histopathological examination and systemic investigation are mandatory for confirmation of diagnosis.
Resumo: Introdução: O plasmocitoma solitário é um tumor maligno raro de células plasmáticas sem evidência de proliferação sistêmica e engloba dois subtipos: plasmocitoma solitário extramedular e plasmocitoma solitário ósseo. A etiologia ainda é desconhecida. Ambas as lesões apresentam risco de progressão para mieloma múltiplo. Uma série de abordagens tem sido usada para seu tratamento. Objetivo: Realizar uma revisão sistemática da literatura com enfoque nos aspectos terapêuticos e prognósticos. Método: Realizou-se uma busca de relatos de caso clínico na base de dados PubMed com termos de busca relacionados com "plasmocitoma" sob os seguintes critérios: tipo de estudo (relato de caso), artigos na língua inglesa, estudos realizados apenas em humanos, sem limites de data de publicação. Resultados: Dos 216 artigos encontrados, apenas 21 preencheram os critérios de inclusão pré-estabelecidos. Conclusão: A ocorrência de plasmocitoma solitário ósseo nos ossos da face é uma condição rara prevalente entre a 4a e a 6a décadas de vida, localizada na região posterior de mandíbula na maioria dos casos. O exame histopatológico e a investigação sistêmica são mandatórios para confirmação do diagnóstico.
Subject(s)
Humans , Plasmacytoma/therapy , Jaw Neoplasms/therapy , Plasmacytoma/diagnosis , Prognosis , Radiotherapy , Paraproteins/analysis , Jaw Neoplasms/diagnosis , Mandibular Neoplasms/diagnosis , Mandibular Neoplasms/therapy , Disease ProgressionABSTRACT
Ameloblastoma is an uncommon and locally aggressive, benign, odontogenic tumor, with local recurrence when not adequately excised. A rare variant of this neoplasm with the benign features but accompanied with metastases has been described. This rare variant is malignant ameloblastoma and is known to have a poor prognosis. We present the case of a young woman who had recurrent mandibular tumors, which were resected twice and histologically reported as ameloblastoma. Four years later, she presented with pulmonary metastasis and atelectasis. A review of the literature on this very rare neoplasm was also performed.
Subject(s)
Humans , Female , Adult , Ameloblastoma/diagnosis , Jaw Neoplasms , Autopsy , Ameloblastoma/pathology , Odontogenic Tumors , Fatal Outcome , Rare Diseases/diagnosisABSTRACT
Ameloblastoma with granular cell pattern (AGC) is classified as an unusual histological subtype of solid/multicystic ameloblastoma, characterized by granular changes in stellate-like cells located within the inner portion of the epithelial follicles. Studies have revealed that lysosomal overload causes cytoplasmic granularity; however, the mechanism involved remains poorly understood. Here we report on eight cases of granular cell ameloblastoma, in the posterior region of the mandible. The age of the patients included in this case series ranged from 35 -64 years old and 87.5% of cases occurred in non-Caucasians, with a slight gender predilection for men (62.5%). There was no evidence of recurrence, and the majority of the cases were treated with surgical resection (87.5%). All tumors displayed histopathological features consistent with the diagnosis of ameloblastoma with granular cell pattern.