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1.
Niger J Clin Pract ; 23(5): 691-696, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32367878

RESUMO

Background: Locally advanced inoperable orofacial malignancies do present clinically, and constitute a significant public health burden worldwide. Objective: To determine the prevalence and clinical characteristics of Stage IV locally advanced inoperable orofacial malignancies for consecutive patients. Materials and Methods: A 24-year retrospective study was undertaken, and data obtained from hospital register, case files, and histopathological reports of patients were recorded in a proforma. The variables studied were age, sex, type of lesion and site, duration of lesion, tobacco/alcohol use, and socioeconomic status of the patients and clinical features of the lesions. Results: Twenty-six patients presented, giving a prevalence of 11.2%. The most common lesion was adenoid cystic carcinoma, 23.1%. Males accounted for 18 (69.2%) cases and females, 8 (30.8%) giving a male to female ratio of 2.3:1. The ages ranged from 21 to 65 years, mean (SD) 48.6 (7.3) years. The gender distribution was clinically and statistically significant in favor of the males (P = 0.001). The patients were in the low socioeconomic class and 20 (76.9%) indulged in chronic use of tobacco and alcohol. The duration of the lesions ranged from 1.8 to 3.1 years. The maxilla/facial skin was the commonest site (46.2%). Clinically and statistically, the relativity of site distribution of lesions was significant (P = 0. 002). The clinical features occurred in combination resulting in an average of 10 symptoms and signs in each patient. Conclusion: The synopsis of these lesions shows that all have undergone metastasis; salivary gland malignancies were most common with maxilla as the commonest site.


Assuntos
Neoplasias Faciais/epidemiologia , Neoplasias Bucais/epidemiologia , Adulto , Idoso , Neoplasias Faciais/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Nigéria/epidemiologia , Estudos Retrospectivos , Adulto Jovem
5.
Plast Reconstr Surg ; 145(4): 779e-787e, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32221223

RESUMO

BACKGROUND: Dermoid cysts are benign lesions lined by keratinizing squamous epithelium that also contain epidermal adnexa (hair follicles, hair shafts, sebaceous glands, and both apocrine and eccrine sweat glands) and mesodermal derivatives (smooth muscle fibers, vascular stroma, nerves, and collagen fibers). Craniofacial dermoid cysts represent approximately 7 percent of all dermoids and have an incidence ranging between 0.03 and 0.14 percent. METHODS: The authors conducted a single-center, consecutive, nonrandomized comparative case series over a 20-year period of all patients treated surgically for craniofacial dermoid at the Royal Children's Hospital in Melbourne, Australia. Six hundred forty-seven patients had craniofacial dermoids and adequate information to be included in the study. The authors also conducted a thorough review of the literature using the MEDLINE and Embase databases. RESULTS: Six hundred forty-seven patients amounted to 655 lesions in our case series. The age at surgery ranged from 2 months to 18 years, with an average age of 25.65 months. The depth of the lesions was stratified using a classification system, and the risk of intracranial extension was assessed using these data. Midline nasal lesions are established as high risk by other studies, but frontal, temporal, and occipital lesions were found to be as risky if not more risky for intracranial extension. CONCLUSIONS: Several classification systems for craniofacial dermoid cysts have used both broader anatomical locations and physical characteristics to group these lesions and identify those warranting preoperative imaging. The authors propose a system using more specific classification of anatomical location to assist in the prompt identification of high-risk lesions and facilitate sound preoperative planning. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.


Assuntos
Encéfalo/diagnóstico por imagem , Cisto Dermoide/patologia , Neoplasias Faciais/patologia , Neoplasias Cutâneas/patologia , Crânio/diagnóstico por imagem , Adolescente , Austrália , Encéfalo/patologia , Criança , Pré-Escolar , Cisto Dermoide/classificação , Cisto Dermoide/diagnóstico por imagem , Cisto Dermoide/cirurgia , Face , Neoplasias Faciais/classificação , Neoplasias Faciais/diagnóstico por imagem , Neoplasias Faciais/cirurgia , Feminino , Humanos , Lactente , Imagem por Ressonância Magnética , Masculino , Invasividade Neoplásica/diagnóstico por imagem , Invasividade Neoplásica/patologia , Planejamento de Assistência ao Paciente/normas , Guias de Prática Clínica como Assunto , Cuidados Pré-Operatórios/métodos , Cuidados Pré-Operatórios/normas , Medição de Risco , Neoplasias Cutâneas/classificação , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/cirurgia , Crânio/patologia , Tomografia Computadorizada por Raios X , Ultrassonografia
6.
Sci Rep ; 10(1): 4300, 2020 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-32152445

RESUMO

Reconstruction of composite oral and maxillofacial defects using free flaps is challenging. The key to such delicate reconstruction lies in the evaluation of the defect. However, few reports have described the clinical classification of these difficult defects. In this study, we proposed a classification method and developed different reconstructive solutions using free flap techniques according to this classification. This classification method was established based on two parameters (the elements and distribution of the missing tissues). Among the 17 patients with composite oral and maxillofacial defects included in this study, 8 patients presented with type A defects, one patient presented with a type B defect, and the other 8 patients presented with type C defects. No type D defects were observed in this study. Three types of free flaps were used to reconstruct the respective types of composite defects. Perforator-based ALT flaps were used to reconstruct Type A defects. Branch-based ALT flaps were used to reconstruct Type B defects. For Type C defects, two reconstructive solutions were used, including a well-designed fibular flap and a perforator-based ALT flap with or without a metal plate for bony reconstruction. All flaps survived after surgery. This classification system may help select and design specific free flaps for reconstructing composite oral and maxillofacial defects.


Assuntos
Carcinoma de Células Escamosas/cirurgia , Neoplasias Faciais/cirurgia , Retalhos de Tecido Biológico/transplante , Neoplasias Maxilares/cirurgia , Neoplasias Bucais/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/classificação , Procedimentos Cirúrgicos Reconstrutivos/métodos , Adolescente , Adulto , Idoso , Carcinoma de Células Escamosas/patologia , Neoplasias Faciais/patologia , Feminino , Humanos , Masculino , Neoplasias Maxilares/patologia , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Adulto Jovem
9.
Int J Pediatr Otorhinolaryngol ; 131: 109879, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31951980

RESUMO

OBJECTIVE: The aim of this study is to determine the relative frequency, demographic distribution and clinicopathological features of pediatric oral and maxillofacial cancer (POMC). METHODS: Medical records were retrospectively reviewed for all cancer cases diagnosed from 1986 to 2016 affecting patients aged 19 years and younger. Demographic variables, anatomical site, and histopathological diagnoses were collected and analyzed by descriptive statistics. RESULTS: Fifty-five (0.77%) POMCs were found among 7181 pediatric malignancies. Mean age at diagnosis was 8 years and patients aged 5-9 years presented the higher prevalence of malignant tumors (40%). White male patients were more frequently affected (78.18% and 65.45%, respectively). The most common cancer type was lymphomas (52.73%) followed by sarcomas (27.27%) and carcinomas (20%). Burkitt lymphoma (32.73%), rhabdomyosarcoma (14.55%), diffuse large B-cell lymphoma (9.09%), and mucoepidermoid carcinoma (9.09%) were the most common histopathological diagnoses. The main affected anatomical site was the oropharynx (38.18%), followed by salivary glands (30.91%), maxillofacial bone (20%), and oral cavity (10.91%). CONCLUSION: POMC has a low incidence; however, highly aggressive tumors, such as lymphomas and sarcomas, are common in this scenario. A better knowledge about the clinicopathological distribution of POMC may contribute to early diagnosis and improve survival rates.


Assuntos
Carcinoma/epidemiologia , Neoplasias Faciais/epidemiologia , Linfoma/epidemiologia , Neoplasias Maxilares/epidemiologia , Neoplasias Bucais/epidemiologia , Sarcoma/embriologia , Adolescente , Adulto , Fatores Etários , Idoso , Brasil/epidemiologia , Carcinoma/patologia , Criança , Pré-Escolar , Neoplasias Faciais/patologia , Feminino , Humanos , Incidência , Lactente , Linfoma/patologia , Masculino , Neoplasias Maxilares/patologia , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Prevalência , Estudos Retrospectivos , Sarcoma/patologia , Taxa de Sobrevida , Adulto Jovem
10.
Cell Mol Life Sci ; 77(13): 2507-2525, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31900624

RESUMO

The Tasmanian devil (Sarcophilus harrisii) is the only mammalian species known to be affected by multiple transmissible cancers. Devil facial tumours 1 and 2 (DFT1 and DFT2) are independent neoplastic cell lineages that produce large, disfiguring cancers known as devil facial tumour disease (DFTD). The long-term persistence of wild Tasmanian devils is threatened due to the ability of DFTD cells to propagate as contagious allografts and the high mortality rate of DFTD. Recent studies have demonstrated that both DFT1 and DFT2 cancers originated from founder cells of the Schwann cell lineage, an uncommon origin of malignant cancer in humans. This unprecedented finding has revealed a potential predisposition of Tasmanian devils to transmissible cancers of the Schwann cell lineage. In this review, we compare the molecular nature of human Schwann cells and nerve sheath tumours with DFT1 and DFT2 to gain insights into the emergence of transmissible cancers in the Tasmanian devil. We discuss a potential mechanism, whereby Schwann cell plasticity and frequent wounding in Tasmanian devils combine with an inherent cancer predisposition and low genetic diversity to give rise to transmissible Schwann cell cancers in devils on rare occasions.


Assuntos
Neoplasias Faciais/veterinária , Marsupiais , Animais , Neoplasias Faciais/genética , Neoplasias Faciais/patologia , Humanos , Neoplasias da Bainha Neural/genética , Neoplasias da Bainha Neural/veterinária , Células de Schwann/fisiologia
11.
J Cutan Pathol ; 47(1): 47-51, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31381162

RESUMO

Cutaneous metastases from hepatocellular carcinoma (HCC) are extremely rare and can represent a sign of an underlying malignancy or relapse/progression from an existing tumor. We report a case of a cutaneous metastasis arising in a patient with metastatic HCC following orthotopic liver transplantation. Diagnosis is a multistep process as cutaneous HCC metastases must be differentiated from primary cutaneous malignancies as well as other cutaneous metastases. Making this even more challenging, HCC metastases have heterogeneous clinical and histologic appearances. Therefore, the use of immunohistochemical stains, including hepatocyte paraffin-1, arginase-1, and glypican-3, and correlation with the clinical context are essential for a correct diagnosis.


Assuntos
Carcinoma Hepatocelular , Neoplasias Faciais , Neoplasias Hepáticas , Transplante de Fígado , Proteínas de Neoplasias/metabolismo , Neoplasias Cutâneas , Carcinoma Hepatocelular/metabolismo , Carcinoma Hepatocelular/patologia , Neoplasias Faciais/metabolismo , Neoplasias Faciais/patologia , Neoplasias Faciais/secundário , Fibrose/cirurgia , Humanos , Neoplasias Hepáticas/metabolismo , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Neoplasias Cutâneas/metabolismo , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/secundário
14.
J Cutan Pathol ; 47(3): 202-206, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31675118

RESUMO

Neurofibromas are benign neoplasms of the peripheral nerve sheath, characterized by the proliferation of Schwann cells, perineural cells and endoneural fibroblasts. Their occurrence in the oral and maxillofacial complex is uncommon. This study aimed to evaluate the clinical and histopathological characteristics of neurofibromas of the oral and maxillofacial complex excised at our institution over a 48-year period. Using light microscopy, two previously trained oral pathologists re-evaluated all hematoxylin and eosin slides. From a total of 15,375 cases diagnosed at a referred Oral Pathology Service, 24 cases were diagnosed as neurofibromas. Eighteen neurofibroma patients were female, with a mean age of 39.1 years. Three patients presenting neurofibromas exhibited neurofibromatosis type I. Clinically, most of the lesions presented as asymptomatic nodules, and the most frequent sites were the tongue (n = 6; 25.0%), gingiva (n = 6; 25.0%) and intraosseous maxillary bone region (n = 3; 12.5%). Histopathologically, the lesions were predominantly well delimited, exhibiting interlocking bundles of spindle-shaped cells that usually displayed wavy nuclei, associated with delicate collagen fibers. Thus, knowledge of their clinical and histopathological features by dentists and oral pathologists is essential for the correct diagnosis of these lesions.


Assuntos
Neoplasias Faciais/patologia , Neoplasias Maxilares/patologia , Neoplasias Bucais/patologia , Neurofibroma/patologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
16.
Cell Mol Life Sci ; 77(9): 1847-1858, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31375869

RESUMO

Devil facial tumour disease (DFTD) comprises two genetically distinct transmissible cancers (DFT1 and DFT2) endangering the survival of the Tasmanian devil (Sarcophilus harrisii) in the wild. DFT1 first arose from a cell of the Schwann cell lineage; however, the tissue-of-origin of the recently discovered DFT2 cancer is unknown. In this study, we compared the transcriptome and proteome of DFT2 tumours to DFT1 and normal Tasmanian devil tissues to determine the tissue-of-origin of the DFT2 cancer. Our findings demonstrate that DFT2 expresses a range of Schwann cell markers and exhibits expression patterns consistent with a similar origin to the DFT1 cancer. Furthermore, DFT2 cells express genes associated with the repair response to peripheral nerve damage. These findings suggest that devils may be predisposed to transmissible cancers of Schwann cell origin. The combined effect of factors such as frequent nerve damage from biting, Schwann cell plasticity and low genetic diversity may allow these cancers to develop on rare occasions. The emergence of two independent transmissible cancers from the same tissue in the Tasmanian devil presents an unprecedented opportunity to gain insight into cancer development, evolution and immune evasion in mammalian species.


Assuntos
Biomarcadores Tumorais/metabolismo , Neoplasias Faciais/veterinária , Marsupiais/fisiologia , Proteoma/análise , Células de Schwann/patologia , Transcriptoma , Animais , Biomarcadores Tumorais/genética , Neoplasias Faciais/genética , Neoplasias Faciais/metabolismo , Neoplasias Faciais/patologia , Humanos , Células de Schwann/metabolismo
18.
Eur J Dermatol ; 29(5): 490-499, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31789273

RESUMO

Non-melanoma skin cancer (NMSC) is the commonest malignancy worldwide (>80% located in the head and neck area). The aim of this study was to assess risk factors predisposing to local recurrence of NMSC of the middle third of the face (MTF). This was a single-centre retrospective analysis of patients with NMSC of the MTF treated during 1995-2010. Data on epidemiological and tumour characteristics were collected. Survival analysis was performed and log-rank tests were used to compare differences in survival for each variable. A total of 531 patients with basal cell carcinoma (BCC) of the MTF were identified. Most tumours were nodular type (28.4%), located on the nose (34.3%), and confined to the dermis (75.5%). Negative margins were achieved in 91% of cases. Median follow-up time was 35 months and 15.2% of patients developed local recurrence. Incomplete excision was the only variable predisposing to local recurrence. The cohort also included 114 patients with squamous cell carcinoma (SCC). Most tumours were well differentiated (43.9%), located at the zygomatic area (49.1%), excised with negative margins (93%), and confined to the dermis (67.8%). At a median follow-up time of 42 months, local recurrence occurred in 15.7% of patients. Tumour size, depth of invasion, and prior history of head and neck SCC were risk factors for local recurrence. The variables predictive of recurrence of BCC were incomplete excision and for SCC tumour size, depth of invasion, and a prior history of head and neck SCC.


Assuntos
Carcinoma Basocelular/patologia , Carcinoma de Células Escamosas/patologia , Neoplasias Faciais/patologia , Recidiva Local de Neoplasia/patologia , Neoplasias Cutâneas/patologia , Idoso , Carcinoma Basocelular/radioterapia , Carcinoma Basocelular/cirurgia , Carcinoma de Células Escamosas/radioterapia , Carcinoma de Células Escamosas/cirurgia , Intervalo Livre de Doença , Neoplasias Faciais/radioterapia , Neoplasias Faciais/cirurgia , Feminino , Seguimentos , Humanos , Metástase Linfática , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Invasividade Neoplásica , Estudos Retrospectivos , Fatores de Risco , Neoplasias Cutâneas/radioterapia , Neoplasias Cutâneas/cirurgia , Carga Tumoral
19.
J Eur Acad Dermatol Venereol ; 33 Suppl 8: 21-24, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31833605

RESUMO

If tumours arise in special locations such as around the eyes, mouth or in the genital area, patients and physicians are challenged by the need for complete removal of the tumour with safety margins and high demands on function and aesthetic aspects. Treatment should be performed by specialized physicians including ophthalmologists, head and neck surgeons, surgical, medical and radiation oncologists. The first-line treatment for most cutaneous malignancies is surgical excision; however, in several situations, such as well-differentiated cutaneous squamous cell carcinomas (cSCC) in the periocular or anal region, radiotherapy is a very reasonable and sometimes treatment of first choice, especially in patients with advanced age. In periocular SCC, radiotherapy with superficial x-ray combined with eye shielding, while in anal SCC, radiotherapy combined with chemotherapy is recommended. However, after failure of local treatment options including surgery and radiotherapy, systemic medications are indicated in order to achieve tumour control or cure. Systemic therapies include immunotherapy, targeted therapy or chemotherapy. Preventive strategies are based on UV protection in facial, and vaccination in HPV associated anogenital SCCs.


Assuntos
Neoplasias do Ânus , Carcinoma de Células Escamosas , Neoplasias Faciais , Neoplasias dos Genitais Femininos , Neoplasias dos Genitais Masculinos , Neoplasias Cutâneas , Neoplasias do Ânus/patologia , Neoplasias do Ânus/terapia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/terapia , Olho , Neoplasias Faciais/patologia , Neoplasias Faciais/terapia , Feminino , Neoplasias dos Genitais Femininos/patologia , Neoplasias dos Genitais Femininos/terapia , Neoplasias dos Genitais Masculinos/patologia , Neoplasias dos Genitais Masculinos/terapia , Humanos , Masculino , Boca , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/terapia
20.
Pan Afr Med J ; 33: 245, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692779

RESUMO

Mohs micrographic surgery (MMS) is a technique allowing for intraoperative histologic assessment of surgical margin of malignant tumors. This study aims to highlight the role of MMS in the achievement of radical healing of basal cell carcinoma (BCC) in our patients. We conducted a study of 29 patients with basal cell carcinoma of the face over a period of 5 years. The median age of patients was 45.8 years (12-80). The sex-ratio M/F was 1.23. One-stage surgical procedure was sufficient to obtain complete resection in 51% of cases. Three-stage surgical procedure was needed in 14% of the cases. The mean duration of one-stage surgical procedure was 1 hour. No complications were reported in the postoperative period and sequelae were simple. The aesthetic and functional result was satisfactory. No recurrence was noted. BCC accounts for approximately 80% of all skin cancers. The decision to use MMS to treat BCC is based on three variables: the seat and the size of the tumor, its histological appearance with the identification of resection margin and its recurrent nature. MMS is currently the most effective method in the treatment of BCC and allows maximum healthy tissue preservation. It is a safe and repeatable surgical procedure based on team work and adapted to the treatment of patients with BCC who are at high risk of recidivism. The aesthetic and functional results are satisfactory. Recurrence rate at 5 years is 10 times lower than with the other methods.


Assuntos
Carcinoma Basocelular/cirurgia , Neoplasias Faciais/cirurgia , Cirurgia de Mohs/métodos , Neoplasias Cutâneas/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Basocelular/patologia , Criança , Neoplasias Faciais/patologia , Feminino , Hospitais Universitários , Humanos , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Marrocos , Estudos Prospectivos , Neoplasias Cutâneas/patologia , Resultado do Tratamento , Adulto Jovem
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