RESUMEN
Primary intraosseous squamous cell carcinoma (PIOSCC) is a rarely reported neoplasm resulting from malignant transformation of a dentigerous cyst of the mandible or maxilla. Until 2010, only 116 cases had been described. The diagnosis of PIOSCC is difficult because of non-specific symptoms. A case of a 66-year-old patient with PIOSCC arising from a dentigerous cyst of the mandible is presented. Both pathologists and clinicians should be aware of the probability of malignant transformation of dentigerous cysts during the two-stage treatment. The patient should be subject to regular clinical and radiographic examination.
Asunto(s)
Carcinoma de Células Escamosas/patología , Transformación Celular Neoplásica , Quiste Dentígero/complicaciones , Neoplasias Mandibulares/patología , Anciano , Biopsia , Carcinoma de Células Escamosas/diagnóstico por imagen , Carcinoma de Células Escamosas/etiología , Carcinoma de Células Escamosas/cirugía , Quiste Dentígero/diagnóstico por imagen , Quiste Dentígero/patología , Quiste Dentígero/cirugía , Diagnóstico Diferencial , Humanos , Masculino , Mandíbula/patología , Neoplasias Mandibulares/diagnóstico por imagen , Neoplasias Mandibulares/etiología , Neoplasias Mandibulares/cirugía , Maxilar/patología , Polonia , Radiografía PanorámicaRESUMEN
The aim of the study was to assess the value of the chemiluminescent light and 1% tolonium chloride as a diagnostic aid in the early detection of oral cancer/premalignant epithelial lesions. Thirty consecutive patients with 41 visually identified oral lesions suggestive of being premalignant underwent chemiluminescence and tolonium chloride examination followed by incisional biopsy with histopathologic evaluation. The biopsies of 34 lesions (82.92%) revealed no dysplasia, 3 lesions (7.32%) revealed mild dysplasia, 3 lesions (7.32%) demonstrated severe dysplasia, and 1 lesion (2.44%) was malignant (squamous cell carcinoma). The chemiluminescent examination improved the brightness (58.54% of the cases), sharpness (56.1% of the cases), texture (60.98% of the cases), and size of the lesion (53.66% of the cases). With references to serious pathologies, 7 cases (100.0%) were brighter, and size was more visualized in 6 cases (85.71%) when using chemiluminescence examination than under incandescent light. Twenty-five (73.53%) of nonserious pathology and 7 (100.0%) of serious pathology (6 dysplasias, 1 squamous cell carcinoma) were positively stained by toluidine blue. Three (8.82%) of nonserious pathology and 0 (0.0%) of serious pathology lesions were identified as true negatives when toluidine blue staining was used. The overall toluidine blue sensitivity and specificity were 81.8% and 37.5%, respectively. Chemiluminescent light demonstrates better visualization (brightness, size) of serious pathology lesions in comparison with conventional clinical oral examination under incandescent light. Toluidine blue demonstrates 100% sensitivity in staining serious pathology. The ViziLite Plus system may help the practitioner to visualize oral pathologies that are not readily detectable with conventional incandescent lighting.
