Verrucous carcinoma of the oral mucosa: An epidemiological and follow-up study of patients treated with surgery in 5 last years

INTRODUCTION: Oral Verrucous Carcinoma (OVC) is described apart of the Squamous Cell Carcinoma (SCC) due to its specific properties. The objective of our study is to show our series of cases of OVC and to compare with the SCC in terms of clinical manifestations, epidemiology, histopathology, treatment and follow-up. MATERIAL AND METHODS: This is a retrospective study of all the OVC treated in our department between January-2007 and December-2011. The analyzed variables were sex, age, localization in the oral cavity, histopathology, number of biopsies needed to diagnose OVC, TNM classification, treatment and recurrences during follow-up. RESULTS: Our sample was composed by n=14 patients, 57% female, with a mean age of 69.14 years. The most common localization was buccal mucosa (n=5). Seven patients were diagnosed of OVC with the first biopsy. TNM classification was: pT1: 7 patients, pT2: 3 patients, pT3: 3 patients, pT4: 1 patient. No cervical metastases were observed either in cervical neck dissection or during the follow-up of the patients. The treatment was surgery with clinical resection margins up to 1 cm in all cases, followed by radiotherapy in selected cases. Only n=1 patient (7.69%) presented a recurrence after 34 months of follow-up. The overall survival rate was 92.85%. CONCLUSIONS: In our population, OVC represents the 6.16% of all oral cavity and oropharynx cancer, and is more frequent in female patients above 70 years old. It uses to rise over a previous lesion, and usually affects the buccal mucosa. In patients with high suspicious lesions, more than one biopsy may be needed to diagnose OVC. No patient showed cervical dissemination. In our experience, treatment based on local resection, without cervical neck dissection, could be a good option for these patients (AU)

Verrucous carcinoma of the oral mucosa: an epidemiological and follow-up study of patients treated with surgery in 5 last years.

INTRODUCTION: Oral Verrucous Carcinoma (OVC) is described apart of the Squamous Cell Carcinoma (SCC) due to its specific properties. The objective of our study is to show our series of cases of OVC and to compare with the SCC in terms of clinical manifestations, epidemiology, histopathology, treatment and follow-up. MATERIAL AND METHODS: This is a retrospective study of all the OVC treated in our department between January-2007 and December-2011. The analyzed variables were sex, age, localization in the oral cavity, histopathology, number of biopsies needed to diagnose OVC, TNM classification, treatment and recurrences during follow-up. RESULTS: Our sample was composed by n=14 patients, 57% female, with a mean age of 69.14 years. The most common localization was buccal mucosa (n=5). Seven patients were diagnosed of OVC with the first biopsy. TNM classification was: pT1: 7 patients, pT2: 3 patients, pT3: 3 patients, pT4: 1 patient. No cervical metastases were observed either in cervical neck dissection or during the follow-up of the patients. The treatment was surgery with clinical resection margins up to 1 cm in all cases, followed by radiotherapy in selected cases. Only n=1 patient (7.69%) presented a recurrence after 34 months of follow-up. The overall survival rate was 92.85%. CONCLUSIONS: In our population, OVC represents the 6.16% of all oral cavity and oropharynx cancer, and is more frequent in female patients above 70 years old. It uses to rise over a previous lesion, and usually affects the buccal mucosa. In patients with high suspicious lesions, more than one biopsy may be needed to diagnose OVC. No patient showed cervical dissemination. In our experience, treatment based on local resection, without cervical neck dissection, could be a good option for these patients.

Burkitt´s lymphoma: A child´s case presenting in the maxilla. Clinical and radiological aspects

Burkitt´s lymphoma (BL) is a neoplasm which, despite its very aggressive behaviour is potentially curable. It typicallyaffects the paediatric population. BL belongs to the non-Hodgkin lymphomas group, and is the first humantumour undoubtedly related to a viral origin (Epstein-Barr virus). Two main clinical subtypes are recognized:endemic or African type, and sporadic type; HIV associated BL constitutes a third type. Although common inendemic BL, maxillary involvement is rare in sporadic cases. This, together with the clinical lack of specificity associatedto this location, makes diagnosis difficult. New chemotherapeutic protocols achieve a high survival rate.Most important prognostic factors are location and tumour stage. We report a paediatric case of BL presenting inthe maxilla, with a review and a description of the characteristics of the disease (AU)

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Burkitt's lymphoma: a child's case presenting in the maxilla. Clinical and radiological aspects.

Burkitt's lymphoma (BL) is a neoplasm which, despite its very aggressive behaviour is potentially curable. It typically affects the paediatric population. BL belongs to the non-Hodgkin lymphomas group, and is the first human tumour undoubtedly related to a viral origin (Epstein-Barr virus). Two main clinical subtypes are recognized: endemic or African type, and sporadic type; HIV associated BL constitutes a third type. Although common in endemic BL, maxillary involvement is rare in sporadic cases. This, together with the clinical lack of specificity associated to this location, makes diagnosis difficult. New chemotherapeutic protocols achieve a high survival rate. Most important prognostic factors are location and tumour stage. We report a paediatric case of BL presenting in the maxilla, with a review and a description of the characteristics of the disease.

Gingival neurofibroma in a neurofibromatosis type 1 patient.

Neurofibroma is a benign peripheral nerve sheath tumour. It is one of the most frequent tumours of neural origin and its presence is one of the clinical criteria for the diagnosis of type 1 neurofibromatosis (NF-I). Neurofibromatosis type 1 is an autosomal dominantly inherited disease due to an alteration in the long arm of chromosome 17. About 50% of NF-I patients have no family history of the disease. NF-I patients have skin lesions (cafe au lait spots and neurofibromas) as well as bone malformations and central nervous system tumours. Diagnosis is based on a series of clinical criteria. Gingival neurofibroma in NF-I is uncommon. Treatment of neurofibromas is surgical resection. The aim of this paper is to report a case of NF-I with gingival involvement and to review the literature.

Gingival neurofibroma in a neurofibromatosis type 1 patient. Case report

El neurofibroma es un tumor benigno, de los nervios periféricos, desarrollado a partir de la vaina neural. Representa uno de los tumores de origen neurógeno más frecuente y es uno de los criterios clínicos de diagnóstico de neurofibromatosis tipo 1 (NF-I). La NF-I es una enfermedad genética producida por una alteración en el brazo largo del cromosoma 17. La mitad de los casos tienen antecedentes familiares y el 50% son mutaciones nuevas. Los pacientes con NF-I principalmente presentan lesiones en la piel (manchas “café con leche” y neurofibromas), así como malformaciones óseas y tumores del sistema nervioso central. El diagnóstico de la enfermedad se basa en una serie de criterios clínicos. La aparición de neurofibromas en la encía en pacientes con NF-I es poco común El tratamiento de los neurofibromas es la escisión quirúrgica. El objetivo de este artículo es presentar un caso de NF-I con afectación neurofibromatosa de la encía maxilar, diagnosticado y tratado quirúrgicamente en nuestro Servicio de Cirugía Oral y Maxilofacial y realizar una revisión de la literatura

Neurofibroma is a benign peripheral nerve sheath tumour. It is one of the most frequent tumours of neural origin and its presence is one of the clinical criteria for the diagnosis of type 1 neurofibromatosis (NF-I). Neurofibromatosis type 1 is an autosomal dominantly inherited disease due to an alteration in the long arm of chromosome 17. About 50% of NF-I patients have no family history of the disease. NF-I patients have skin lesions (café au lait spots and neurofibromas) as well as bone malformations and central nervous system tumours. Diagnosis is based on a series of clinical criteria. Gingival neurofibroma in NF-I is uncommon. Treatment of neurofibromas is surgical resection. The aim of this paper is to report a case of NF-I with gingival involvement and to review the literature

Histiocitosis de Células de Langerhans en el área maxilofacial en adultos. Informe de tres casos / Langerhans cell histiocytosis in the maxillofacial area in adults. Report of three cases

La Histiocitosis de Células de Langerhans (HCL), es una enfermedad de etiología desconocida, que se caracteriza por la proliferación e infiltración anormal, de órganos, por células de Langerhans patológicas. Afecta predominantementea pacientes en edad pediátrica, siendo en adultos la incidencia de la enfermedad de uno a dos casos por millón de habitantes. Las manifestaciones en cabeza y cuello aparecen en casi un 90% de los casos. El diagnóstico se obtiene por medios anatomopatológicos, siendo necesarias una serie de pruebas, determinantes de extensión, en todos los pacientes diagnosticados de HCL. No existen estudios, controlados, que determinen un tratamiento óptimo para la HCL. El pronósticode esta enfermedad en adultos es generalmente bueno debido a la lenta evolución de la enfermedad y a su buena respuesta al tratamiento. Presentamos una revisión de tres casos de HCL, de 16, 24 y 28 años de edad, con manifestación primaria en el área Maxilofacial. Así mismo, realizamos una revisión de la literatura

Langerhans cell histiocytosis (LCH) is a disease of unknown etiology, characterized by proliferation of pathological Langerhans cells within different organs. It mainly affects children, but adult cases also occur, with an incidence rate of one to two per million. The head and neck are affected in almost 90% of cases. Diagnosis is made by means of histopathologicalanalysis, and imaging studies are necessary in order to determine extent of the disease. There are no controlled trials proposing an optimal treatment protocol for LCH. Prognosis in adults is generally good due to the slow evolution of the disease and its favourable response to treatment. In our report, we present three cases of LCH in patients aged 16, 24, and 28 years respectively, with primary manifestation in the maxillofacial area. A literature review was also conducted

Langerhans cell histiocytosis in the maxillofacial area in adults. Report of three cases.

Langerhans cell histiocytosis (LCH) is a disease of unknown etiology, characterized by proliferation of pathological Langerhans cells within different organs. It mainly affects children, but adult cases also occur, with an incidence rate of one to two per million. The head and neck are affected in almost 90% of cases. Diagnosis is made by means of histopathological analysis, and imaging studies are necessary in order to determine extent of the disease. There are no controlled trials proposing an optimal treatment protocol for LCH. Prognosis in adults is generally good due to the slow evolution of the disease and its favourable response to treatment. In our report, we present three cases of LCH in patients aged 16, 24, and 28 years respectively, with primary manifestation in the maxillofacial area. A literature review was also conducted.