Quality of life and functional outcomes in tongue cancer patients: a long-term, prospective, comparative study

Background: The tongue has an indispensable role in communication, swallowing and breathing. Tongue cancer treatment involves direct resection of the tumor and surrounding tissue, which can limit many essential functions of the tongue. There are few patient-reported quality of life studies involving tongue cancer exclusively. There is also a lack of data on the outcomes of quality of life regarding different reconstructive methods, adjuvant nonsurgical therapies and other predicting factors. Our objective is to assess the quality of life, functional status, and predicting factors in patients with tongue cancer up to one year after surgical resection. Material and Methods: Thirty-six patients with tongue cancer were prospectively identified between October of 2017 and January 2021. Patients were examined before and one, three, six and twelve months after surgical resection with the validated University of Washington Quality of Life questionnaire (UW-QOL). Data collection included patient age, sex, TNM staging, size of resection, neck dissection, tracheostomy, reconstructive method and adjuvant therapies. Outcome scores were compared using the Friedman test. Multiple linear regression analysis was used to identify the predictors of quality of life and functional status. Results: The use of UWQOL scores as dependent variables revealed the following predicting factors: age, tobacco use, radiotherapy, chemotherapy, reconstruction method and neck dissection. Conclusions: The most relevant findings in our study are that flap reconstruction becomes increasingly necessary when a glossectomy resection is over 45 mm, in order to maintain tongue function. We established that the reconstructive flap type does not influence quality of life in the long term. Also, we have found that cervical sentinel node biopsy provides better quality of life over neck dissection in the first 3 months after surgery. (AU)

Hematoma intraorbitario secundario a hiperémesis gravídica / Intraorbital hematoma secondary to hyperemesis gravidarum

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Bilateral Cutaneous Fistula After the Placement of Zygomatic Implants.

Zygomatic implants are used to restore function in patients with highly edentulous atrophic maxillae, in which it is not possible to place conventional implants. The aim of this paper is to present a case of bilateral cutaneous fistula after placement of zygomatic implants and the treatment performed to resolve the condition, as well as to establish a hypothesis regarding the etiology of these lesions. Presented is a 59-year-old woman with an atrophic edentulous maxilla who received four zygomatic implants. At 8 months and 31 months after implant placement on the right and left sides, respectively, the patient developed inflammatory lesions in the lateral aspect of both orbits that evolved toward developing a fistula within weeks. The patient underwent surgery in both cases. Complications of zygomatic implants are relatively common but rarely involve the loss or removal of implants. In this case, the patient retained her implants, and several months after resection of both fistulae, the patient is asymptomatic without recurrence of the lesions. The probable cause of the occurrence of the fistula could be an accumulation of sinus mucosa remnants, periosteum, and bone particles at the malar level as a result of poor irrigation at the time of implant placement.

Intraosseous dentinogenic ghost cell tumor: Case report and treatment review / Tumor dentinogénico de células fantasmas tipo central (intraóseo): un caso clínico y revisión del tratamiento

Dentinogenic ghost cell tumors (DGCT) are uncommon neoplasms classified as solid variants of calcifying odontogenic cyst and are defined as a locally invasive neoplasm, characterized by ameloblastoma-like islands of aberrant keratinization of odontogenic epithelium in the form of ghost cells in association with dysplastic dentin. We present the case of a 46-year-old woman who was referred to us due to dental mobility and swelling of the jaw. The different imaging and histological studies confirmed the diagnosis of a dentinogenic ghost cell tumor. Treatment was based on aggressive local resection with adequate safety margins, and monitoring the patient for detection of recurrences. The purpose of this paper was to describe a case of DGCT and the treatment adopted in our case, and to provide a review of the treatment of the cases reported in the indexed literature (AU)

El tumor dentinogénico de células fantasma (TDCF) es una rara neoplasia clasificada como una variante sólida del quiste odontogénico calcificante, definida como una neoplasia localmente invasiva caracterizada por la presencia de islas ameloblastomatosas con queratinización aberrante en forma de células fantasma, coexistiendo con displasia dentinaria. Presentamos un caso clínico de una paciente de 46 años que nos consultó por presentar movilidad dental con inflamación a nivel mandibular. Los estudios radiológico e histológico revelaron el diagnóstico de tumor dentinogénico de células fantasma. Se realizó resección local amplia con márgenes, revisando periódicamente a la paciente para detectar recidivas. El objetivo de este artículo es presentar un caso clínico de un TDCF, describir el tratamiento realizado en nuestro caso y revisar el tratamiento realizado en los casos publicados en la literatura indexada (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 (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.

Localized Leishmaniasis of the oral mucosa. A report of three cases.

The term leishmaniasis comprises a group of diseases caused by different species of a protozoon called Leishmania. Leishmaniasis is found worldwide, and is considered to be endemic in 88 countries. There are three main clinical forms of leishmaniasis: visceral leishmaniasis, cutaneous leishmaniasis and mucocutaneous leishmaniasis. Exclusive involvement of the mucosa is very rare. We present a series of three cases of mucosal leishmaniasis located in the oral cavity. The fact that all three cases were recorded in Spain (an area where L. infantum is endemic), suggests that the latter was the causal agent. The only manifestation of leishmaniasis disease in the described cases was the appearance of an oral lesion. Treatment was provided in the form of meglumine antimoniate in two patients, with a favorable response. One of the patients left the hospital after diagnosis, without receiving treatment, and the subsequent course is not known. A review is made of the literature on the subject.

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.

Localized leishmaniasis of the oral mucosa. A report of three cases

El término leishmaniasis comprende un grupo de enfermedades causadas por diferentes especies de un protozoo llamado Leishmania. La leishmaniasis se produce en todo el mundo, considerándose endémica en 88 países. Existen tres formas clínicas principales de leishmaniasis: leishmaniasis visceral, leishmaniasis cutánea y leishmaniasis mucocutánea. La afectación de la mucosa, de manera exclusiva, por la Leishmania es muy rara. Presentamos una serie de tres casos de leishmaniasis mucosa localizados en la cavidad oral. El hecho de que todos los casos se produjeran en España, área endémica de L infantum, nos hace presuponer que éste fue el agente causal. La única manifestación de enfermedad de leishmaniasis en los casos descritos, fue la aparición de una lesión oral. Se administró tratamiento con antimoniato de meglumina en dos de ellos, respondiendo favorablemente. Uno de los pacientes abandonó el hospital tras el diagnóstico sin recibir tratamiento y se desconoce la evolución. Realizamos también una revisión de la literatura

The term leishmaniasis comprises a group of diseases caused by different species of a protozoon called Leishmania. Leishmaniasis is found worldwide, and is considered to be endemic in 88 countries. There are three main clinical forms of leishmaniasis: visceral leishmaniasis, cutaneous leishmaniasis and mucocutaneous leishmaniasis. Exclusive involvement of the mucosa is very rare. We present a series of three cases of mucosal leishmaniasis located in the oral cavity. The fact that all three cases were recorded in Spain (an area where L. infantum is endemic), suggests that the latter was the causal agent. The only manifestation of leishmaniasis disease in the described cases was the appearance of an oral lesion. Treatment was provided in the form of meglumine antimoniate in two patients, with a favorable response. One of the patients left the hospital after diagnosis, without receiving treatment, and the subsequent course is not known. A review is made of the literature on the subject

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.

Inflammatory pseudotumor of the parotid gland.

Inflammatory pseudotumor is a term that refers to a reactive pseudoneoplastic disorder that can appear in different locations of the human body. The lung is the most frequently affected organ. The etiology is still unknown. It affects individuals of both sexes and of a wide range of ages. The diagnosis is still difficult and it is based on the histological examination of the lesions composed of four cell-types: histiocytes, myofibroblasts, plasma cells and lymphocytes. With regard to the treatment regimes there is no agreement. Treatment ranges from surgical excision to radiotherapy, chemotherapy or steroids. The purpose of this article is to report one case of inflammatory pseudotumor located in the parotid gland and to make a special point of the difficulty in arriving at a correct diagnosis in order to achieve the most adequate treatment.

Pseudotumor inflamatorio de glándula parótida / Inflammatory pseudotumor of the parotid gland

El término pseudotumor inflamatorio hace referencia a un proceso reactivo y pseudoneoplásico que puede aparecer en diferentes localizaciones del cuerpo humano. El pulmón es el órgano que se afecta con mayor frecuencia. Su etiología sigue siendo desconocida. Afecta a individuos de ambos sexos y con un amplio rango de edad. Su diagnóstico sigue siendo dificultoso y se basa en el examen histológico de las lesiones que están formadas por cuatro elementos fundamentalmente: histiocitos, miofibroblastos, células plasmáticas y linfocitos. A la hora de elegir el tratamiento no hay unanimidad y se incluye desde tratamiento quirúrgico de las lesiones hasta radioterapia, quimioterapia y esteroides. El propósito de este artículo es describir un caso de pseudotumor inflamatorio localizado en glándula parótida, su dificultad para llegar al diagnóstico correcto y realizar así el tratamiento más adecuado

Inflammatory pseudotumor is a term that refers to a reactive pseudoneoplastic disorder that can appear in different locations of the human body. The lung is the most frequently affected organ. The etiology is still unknown. It affects individuals of both sexes and of a wide range of ages. The diagnosis is still difficult and it is based on the histological examination of the lesions composed of four cell-types: histiocytes, myofibroblasts, plasma cells and lymphocytes. With regard to the treatment regimes there is no agreement. Treatment ranges from surgical excision to radiotherapy, chemotherapy or steroids. The purpose of this article is to report one case of inflammatory pseudotumor located in the parotid gland and to make a special point of the difficulty in arriving at a correct diagnosis in order to achieve the most adequate treatment

Rabdomioma adulto del espacio masticatorio. Presentación de un nuevo caso y revisión de la literatura / Adult rhabdomyoma in the masticatory area. New case presentation and review of the literature

El rabdomioma adulto es una neoplasia infrecuente de origen mesenquimal que representa el 2 por ciento de los tumores con diferenciación de músculo esquelético. Solamente se han descrito en la literatura alrededor de 100 casos. Se trata de un tumor benigno que aparece con más frecuencia en cabeza y cuello, con una incidencia mayor en el sexo masculino y con una edad media de presentación de 54 a 60 años.El propósito de este artículo es presentar un nuevo caso de rabdomioma adulto localizado en el espacio masticador, que se presentó como una masa de crecimiento lento que abomba la mucosa yugal y la región temporal izquierda.La localización más frecuente del rabdomioma adulto es la cavidad faríngea. Estos tumores se presentan como una masa única, aunque de forma ocasional lo hacen de forma multifocal. Al tratarse de un tumor de baja incidencia, el diagnóstico correcto puede evitar intervenciones quirúrgicas agresivas (AU)