[Oral maxillofacial-head and neck tumor and holistic integrative medicine].

The advance of clinical diagnosis and treatment in oral and maxillofacial-head and neck tumors has been through the process of specialization and multidisciplinary cooperation. In most cases, a single discipline cannot meet the requirements of diagnosis and treatment, which needs the cooperation of oral and maxillofacial surgery, otolaryngology and oncology approach and therapeutic method such as surgery, radiotherapy and chemotherapy. Holistic integrative medicine aims at integrating the most effective clinical practice experience and patients' individual situation and prognosis, establishing new medical mode conforming to the modern concept and fulfilling the medical system adapting to the specific characteristics of the diseases.

Clinicopathological Study of Primary Intraosseous Squamous Cell Carcinoma of the Jaw and a Review of the Literature.

PURPOSE: Primary intraosseous squamous cell carcinoma (PIOSCC) is a rare malignant odontogenic tumor that originates from odontogenic epithelial remnants. It is often difficult to diagnose PIOSCC definitively; hence, extraction or surgical treatment is performed before the initial diagnosis in most cases. The present study examined new insights into and prognostic factors of patients with PIOSCC admitted to the authors' department. MATERIALS AND METHODS: An extensive record review was conducted of patients who underwent radical surgery for PIOSCC from January 2001 through December 2014. RESULTS: Of all cases of OSCC, the frequency of PIOSCC was 1.45%. The 2-year relapse-free survival (RFS) and overall survival (OS) rates were 50.0 and 41.6% in all cases, respectively. Three patients underwent surgery or tooth extraction before the initial diagnosis; in fact, intervention before initial diagnosis was found to be an important poor prognostic factor for RFS and OS. In contrast, patients who were not treated before the initial diagnosis was made did not exhibit any locoregional recurrence. CONCLUSIONS: The treatment of PIOSCC should be similar to that for oral cancer with at least clinical stage T3N0 in the National Comprehensive Cancer Network clinical practice guidelines. In addition, cases of PIOSCC that are not treated before the initial diagnosis are more likely to obtain a good prognosis.

Treatment of a maxillary fibrosarcoma in an adult alpaca.

CASE DESCRIPTION: An approximately 5-year-old sexually intact male alpaca was evaluated because of a right-sided maxillary mass that had recurred after previous surgical debulking. CLINICAL FINDINGS: Clinical, radiographic, and CT examination revealed an approximately 1.5-cm-diameter soft tissue mass associated with expansile osteolysis of the maxillary alveolar bone, beginning at the level of the right maxillary third premolar tooth extending caudally to the level of the rostral roots of the second molar tooth. TREATMENT AND OUTCOME: Right partial maxillectomy was performed, and histologic examination revealed an incompletely excised fibrosarcoma with osseous metaplasia. External beam radiation therapy to the tumor bed was initiated 1 month after surgery. Computerized planning was performed, and a total radiation dose of 48 Gy was prescribed in eleven 4.4-Gy fractions. Follow-up CT evaluations 6 and 58 weeks after radiation therapy was completed revealed no evidence of tumor recurrence. No clinical evidence of tumor recurrence was detected through 110 weeks after radiation therapy. CLINICAL RELEVANCE: The oral fibrosarcoma in the alpaca described here was successfully treated with surgical excision and adjuvant radiation therapy, resulting in excellent quality of life of the treated animal.

Ossifying fibroma in a Hong Kong community: the clinical and radiological features and outcomes of treatment.

OBJECTIVES: The aim of this study was to evaluate the principal clinical and radiological features of a consecutive series of cases of ossifying fibroma (OF) affecting a Hong Kong Chinese community and to determine their outcome by follow-up. METHODS: All cases were accompanied by appropriate radiography and were histopathologically confirmed as fibro-osseous lesions. RESULTS: The clinical and radiological presentations, differential diagnoses and outcomes of follow-up of 24 consecutive patients with OFs were reviewed. All patients were female. The mean age at first presentation was 38.0 years. The oldest reported patient first presenting with OF was 80 years old. Most OFs (58%) were discovered incidentally. The maxilla and mandible were affected in 4 and 20 cases, respectively. Only 7 cases, out of the 15 cases for which provisional diagnosis was available, included OF. 16 patients were followed up for a mean of 5.3 years, of whom 12 discharged themselves after a mean of 3.0 years. Only one lesion recurred. CONCLUSIONS: OF in this community predominantly affects females. Although gynaecological history was not included in the clinical notes, there is a clear possibility of reactivation of OF growth at the menopause. Other potentially important contributing factors are "traditional Chinese medicine" and the progressive reduction in the degree of water fluoridation. Although most patients were followed up, this was only for a few years. Nevertheless, one case actually recurred during follow-up. Therefore, patients with OF should be encouraged to maintain follow-up for a longer period.

[Maxilla-mandibular brown tumors as a first sign of parathyroid adenoma]. / Tumeurs brunes maxillomandibulaires révélant un adénome parathyroïdien.

OBJECTIVES: Through a novel observation of parathyroid adenoma revealed by brown tumors of the jaws and a review of the literature, the authors describe this rare mode of primary hyperparathyroidism discovery. MATERIAL AND METHODS: The patient was a 23-year-old woman who consulted for a recurrent tumefaction of the maxillary; histology showed reparative giant cell granuloma. RESULTS: The clinical examination found an osseous tumefaction in continuity with the zygomatic bone and a gingival tumefaction on the mandible symphysis. The radiological findings showed two osteophytic lesions: mandibular and maxillary. The phosphocalcic metabolism was disturbed and the parathormone rate was high. The etiologic search consisted of a MRI of the neck, which showed a mass behind the thyroid gland, suggesting a parathyroid adenoma. The diagnosis was confirmed at surgical exploration. After removal of this tumor, the blood calcium rate dropped sharply and the bone tumefaction progressively regressed. CONCLUSION: Brown tumors are a rare mode of parathyroid adenoma discovery, and the jaw location is exceptional. The diagnosis is based on the parathormone rate, and radiological exams generally find the etiology. Treatment is based on surgery of the parathyroid adenoma.

Granuloma periférico de células gigantes: caso clínico y revisión de la literatura / The peripheral giant cell granuloma: clinical case and review of literature review

El granuloma periférico de células gigantes, es una lesión exofítica que se sitúa en la zona gingival y en el hueso alveolar, de carácter benigno y etiología no muy bien definida. Representa el 7 por ciento de los tumores benignos de los maxilares. En este trabajo, describimos un caso en una mujer de 13 años de edad, con una lesión de crecimiento rápido, localizada en el maxilar superior y realizamos una revisión bibliográfica, estudiando los aspectos epidemiológicos, clinicopatológicos y los posibles tratamientos de este proceso. (AU)