The importance of clinical and radiological findings for the definitive histopathologic diagnosis of benign fibro-osseous lesions of the jaws: Study of 276 cases.

PURPOSE: Benign fibro-osseous lesions (BFOLs) are heterogeneous intraosseous disease processes sharing overlapping histopathologic features and demonstrate a wide range of biological behavior. The aim of this study is to highlight the importance of clinical and radiological findings for the definitive histopathologic diagnosis of benign fibro-osseous lesions of the jaws. MATERIALS AND METHODS: This is a cross-sectional retrospective study evaluating the three main groups of BFOLs: Cemento-osseous dysplasia, ossifying fibromas, and fibrous dysplasia. Previously diagnosed BFOL cases were searched for thoroughly from the archives of Istanbul University, Institute of Oncology, Department of Tumor Pathology in between 2005 and 2015. Clinical and radiological data of these cases were identified and recorded. The histopathologic features were reevaluated from the H&E-stained slides. RESULTS: A total of 276 BFOL cases were identified and reevaluated for the study. The most common BFOL type was cemento-osseous dysplasia (n = 135), followed by cemento-ossifying fibroma (n = 77), fibrous dysplasia (n = 53) and juvenile ossifying fibroma (n = 11). The female/male ratio was 3.4:1 with a strong predilection for the 4th decade (n = 102). The mandible (n = 209) was the predominantly affected jaw. Prominent osteoblastic rimming around the bony lesion was commonly observed for cemento-ossifying fibroma (n = 60/77), followed by cemento-osseous dysplasia (n = 23/135). Predominant ossification patterns showed some differences among the groups. The most common radiological feature was the mixed radiolucent/radiopaque internal structure. CONCLUSION: Our results document various clinical, radiological and histopathologic findings of BFOLs. Even some histopathologic differences are observed, clinical and radiographic correlation is mandatory prior to the definitive histopathologic diagnosis of BFOLs for the prevention of possible misdiagnoses or inappropriate treatments.

Evaluation of the osteopontin in oral peripheral and central giant cell granuloma.

AIM: Peripheral giant cell granuloma (PGCG) and central giant cell granuloma (CGCG) of the jaws are benign proliferations of spindle-shaped mesenchymal cells and multinucleated giant cells. Despite the histopathologic similarities, they have markedly different clinical behavior. PGCG shows low recurrence rate whereas CGCG shows a variable clinical behavior ranging from nonaggressive lesions to aggressive lesions characterizing by pain, rapid growth, and high recurrence rate. Therefore, the aim of the study was to compare CGCG with PGCG by immunohistochemistry using Ki-67, osteopontin (OPN), and integrin αvantibodies. SUBJECTS AND METHODS: Twenty PGCG and 20 CGCG were selected for immunohistochemical evaluation of OPN, integrin αv, and Ki-67 in multinucleated giant cells and mononucleated cells of PGCG and CGCG. RESULTS: PGCG showed higher Ki-67 immunoreactivity in mononucleated cells compared to CGCG (P < 0.05). There was no reactivity with Ki-67 in multinucleated giant cells of both groups. Mononucleated cells in CGCGs demonstrated increased OPN and integrin αvexpressions in comparison with PGCGs (P < 0.05). CONCLUSIONS: The clinic behavior of CGCG being more aggressive than PGCG might be explained by the high expression of OPN and integrin αv. Further studies are necessary to evaluate the other OPN receptors and their role on the biologic behavior of these lesions.

Cavernous lymphangioma of the tongue in an adult: a case report.

Lymphangioma is a benign hamartomatous lesion caused by congenital malformation of the lymphatic system. This benign tumor is detected most commonly at birth or in early childhood but rarely in adults. On clinical examination, most lymphangiomas contain clear lymph fluid, but some may present as transparent vesicles containing red blood cells due to hemorrhage. In addition, lymphangioma may occur in association with hemangioma. This tumor occurs most commonly in the head and neck area, but rarely in the oral cavity. The dorsum of the tongue is the most common location in the mouth, followed by the lips, buccal mucosa, soft palate, and floor of the mouth. There are various treatment approaches for lymphangioma, but surgical excision is the preferred method. We present a case of a 26-year-old man with lymphangioma on the anterior dorsal part of the tongue, not associated with any dysfunction in mastication or speech disorders.

Glandular Odontogenic Cyst: Case Series.

Glandular odontogenic cyst (GOC) is an uncommon and aggressive jaw cyst with a high recurrence rate. It may grow into a large size. Diagnosis of the cyst is challenging since it may be confused with some other jaw cysts and malignancies. Treatment methods vary from conservative surgery to radical bone resection. In this case series, we briefly present five cases of GOC diagnosed and treated at our clinic. Thorough histopathological diagnosis and long-term follow-up are necessary in patients with GOC.

Odontogenic lesions in a pediatric population: Review of the literature and presentation of 745 cases.

OBJECTIVES: Pediatric odontogenic lesions are rare clinical entities and are not well addressed in the otolaryngology literature. Knowledge of the biologic and clinical behavior of these lesions and their basic features such as location and age are key aspects for otolaryngologists in developing an early clinical differential diagnosis, such that they can provide adequate treatment. METHODS: Six thousand histologically-diagnosed odontogenic lesions from a 40-year period were reviewed. Pediatric patients (745 cases, 12.7%) aged up to 17 years were selected and reevaluated. The patients were divided into three age groups according to dentition periods: primary dentition (0-5 years), mixed dentition (6-12 years), and permanent dentition (13-17 years). Clinical data, including age, sex, and location, were collected from pathology records. RESULTS: Of the total of 745 cases, 596 specimens (80%) were diagnosed as odontogenic cysts and 149 specimens (20%) were diagnosed as odontogenic tumors. The most frequent odontogenic cysts were radicular cysts (48.4%), followed by dentigerous cysts (16.7%). The most common odontogenic tumor was odontoma (8.05%). CONCLUSION: This study shows that all odontogenic lesions in the pediatric group are benign. Odontogenic tumors are relatively rare in this age group. Knowledge of the biological and histopathological behaviors of odontogenic lesions and their basic features such as location and age is a key aspect for developing an early clinical differential diagnosis and providing adequate treatment.

Uncommon benign tumour of the skin: infraorbital pilomatricoma.

Pilomatricoma is a relatively rare tumour of the skin derived from primitive basal cells of epidermis that differentiate into hair matrix cells. It comprises approximately 1% of all benign skin tumours. The most common sites for pilomatricomas are the head, neck and upper extremities. A 44-year-old woman, admitted to our department, underwent an orthopantomography examination, which revealed a well-circumscribed 1.6×1.4 mm radiopaque mass superimposed between the medial wall of the right maxillary sinus and lateral wall of the nasal cavity. Clinically, it was firm and mobile, and remained attached to the underlying skin when palpated. A cone beam CT scan was performed to ascertain its location and anatomic relations. Subsequently, it was totally excised under local anaesthesia. Histopathological evaluation of the lesion reported it to be a pilomatricoma.

Frank-ter Haar syndrome--additional findings?

Frank-ter Haar syndrome is a genetic disease that is transmitted by autosomal recessive pattern with characteristic features such as megalocornea or glaucoma, a prominent coccyx, heart defects, developmental delays, brachycephaly, a wide anterior fontanel, finger flexion deformities, full cheeks and micrognathia. Dentomaxillofacial features of this syndrome are not well documented in the literature. We present of a 21-year-old male with Frank-ter Haar syndrome and some features that may be linked with this syndrome not reported before in the literature.

Familial gigantiform cementoma with Ehlers - Danlos syndrome: A report of 2 cases.

Ehlers-Danlos syndrome is an autosomal dominant hereditary disorder of connective tissue, while familial gigantiform cementoma is a condition that usually manifests as multiple radiopaque cementum-like masses throughout the jaws. This case report discusses the oral management and prosthetic rehabilitation of two patients presenting familial gigantiform cementoma with Ehlers-Danlos Syndrome.

Clinical and histopathological investigation of odontomas: review of the literature and presentation of 160 cases.

PURPOSE: The purpose of the present study was to evaluate the clinical and histopathologic aspects of different types of odontomas. MATERIALS AND METHODS: One hundred sixty odontoma cases sent to the Institute of Oncology, Department of Tumor Pathology, Istanbul University from 1971 through 2010 were investigated. These tumors were compared by age of patient, gender of patient, localization, histopathologic type, clinical diagnosis, and clinical and microscopic features. RESULTS: Odontomas were classified histopathologically as complex, compound, or mixed. Of all investigated cases, 99 were complex, 57 were compound, and 4 were mixed odontomas. The mean age at diagnosis was 27.9 years, and odontomas were diagnosed most frequently at 10 to 19 years of age. CONCLUSIONS: From the perspective of community health, the presence of odontomas within the jaws is important because these constitute 21% to 67% of all odontogenic tumors. The present study showed 2 interesting findings that differed from previous studies. These are the lower incidence rate of odontomas within the category of odontogenic tumors and the higher incidence of complex odontomas over compound odontomas.

Odontogenic and nonodontogenic cysts in Istanbul: analysis of 5088 cases.

BACKGROUND: The aim of this study was to determine the prevalence of 5088 odontogenic and nonodontogenic cysts over a 40-year period in the Turkish population and to compare results with findings in the literature. METHODS: The records of odontogenic and nonodontogenic cysts, occurring during 1971 to 2010, were collected and analyzed for anatomic site, age range, and sex distribution. RESULTS: Among 5088 odontogenic and nonodontogenic cyst biopsies, 5003 cases (98.3%) were classified as odontogenic, whereas only 85 cases (1.7%) were nonodontogenic. In the former group, the most frequent diagnosis was radicular cyst (52.09%), followed by odontogenic keratocyst (20.6%) and dentigerous cyst (10.39%). Maxilla to mandible ratio was 1.13:1. The mean age of patients was 36.33 years (range, 2-87 years). The cysts were slightly more prevalent among male patients (57.70%). CONCLUSIONS: The knowledge of the biological behavior and clinicopathologic features of jaw cysts constitute key aspects to provide early diagnosis and adequate surgery.

Primary non-Hodgkin's lymphoma of the rectum.

BACKGROUND: Primary rectal lymphoma is a very uncommon disease, therefore, it has received little attention in the literature. Because of their rarity, rectal lymphomas are generally included in the group of large intestine lymphomas. CASE REPORT: We report here a case of primary rectal B-cell lymphoma in a 67-year-old woman. The tumor was originally located in the rectum without evidence of any other lymphoma-involved organ. Histological findings revealed diffuse large B-cell lymphoma. The clinical stage was IE according to the Ann Arbor system. International prognostic index (IPI) was I (low-intermediate risk). We preferred a non-surgical, organ-sparing treatment which started with chemotherapy followed by radiation. 12 months after the end of therapy, there is no sign of tumor recurrence in our patient. CONCLUSION: We suggest that histology-specific multidrug chemotherapy followed by radiotherapy seems to be a therapeutic approach that is appropriate fort this rare tumor.