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Oral Radiology Jan 2020The radiology of the most important and/or frequent lesions affecting the bones of the face and jaws has been set out in this review and pictorial essay. (Review)
Review
INTRODUCTION
The radiology of the most important and/or frequent lesions affecting the bones of the face and jaws has been set out in this review and pictorial essay.
METHODS
The latter is composed of multiple images displaying one or more key radiological features derived from almost every one of the most important and/ or frequent lesion affecting the face and the jaws. These images have been grouped together in 18 figures, each served by a detailed and free-standing legend. These lesions are outlined in a flowchart, which focuses on one or at most two radiological features in turn.
RESULTS
It begins with those lesions that could indicate systemic disease, such as multiple lesions, and then proceeds onward to single lesions. The first of these single lesions are the neoplasms which need not only an early diagnosis, but also complete ablation in the majority of cases. Cystic lesions are then next, including consideration of the frequently occurring non-cysts such as simple bone cysts and lingual bone defects which require no treatment. Finally, it ends with the periapical radiolucency of inflammatory origin.
CONCLUSION
The most important and/or frequent lesions affecting the bones of the face and jaws that present to the oral and maxillofacial clinician can be considered systematically en route to the 'periapical radiolucency of inflammatory origin,' which is one of the most usually encountered lesions in clinical dentistry.
Topics: Diagnosis, Differential; Face; Humans; Jaw; Jaw Neoplasms
PubMed: 30758774
DOI: 10.1007/s11282-019-00367-4 -
Journal of Dentistry For Children... Jan 2020Ameloblastic fibro-odontoma (AFO) is a rare, benign, and mixed odontogenic tumor that consists of both ectodermal and mesenchymal elements. AFO is more prevalent in...
Ameloblastic fibro-odontoma (AFO) is a rare, benign, and mixed odontogenic tumor that consists of both ectodermal and mesenchymal elements. AFO is more prevalent in young children and adolescents than in adults and is usually found in the molar area associated with a failure of tooth eruption. The purpose of this report is to discuss the differential diagnosis and treatment of a three-year-old girl diagnosed with an AFO around a primary canine. The manifestations of the lesion resembled localized periodontal disease caused by an enamel pearl. Excision and curettage were done and the separated dental hard tissue was confirmed from the enamel structure of the primary canine. In addition to the hard tissue, pulpy and soft tissues were removed together and were histologically examined, confirming the diagnosis of AFO.
Topics: Adolescent; Child; Child, Preschool; Dental Enamel; Female; Humans; Mandibular Neoplasms; Molar; Odontogenic Tumors; Odontoma; Tooth Eruption
PubMed: 32151310
DOI: No ID Found -
Journal of Oral Pathology & Medicine :... Aug 2022To investigate and compare the demographic data, occurrence of recurrence and metastasis, and survival prognosis between ameloblastic carcinoma (AC) and metastasizing... (Review)
Review
PURPOSE
To investigate and compare the demographic data, occurrence of recurrence and metastasis, and survival prognosis between ameloblastic carcinoma (AC) and metastasizing ameloblastoma (MA), based on appropriate and currently accepted eligible diagnostic criteria, in a systematic review of the literature.
METHODS
An electronic search was undertaken, last updated in December 2021. Eligibility criteria included publications having enough clinicopathological information to confirm the diagnosis of these tumors.
RESULTS
Seventy-seven publications reporting 85 ACs and 43 MAs were included. Both tumors were more frequent in mandible and showed different clinical profiles regarding patients' sex and age. There was no difference in the estimated cumulative survival between patients diagnosed with these tumors. Metastases mainly affected the lungs, followed by cervical lymph nodes. The mean time between the first metastasis and the last follow-up was higher for MA (p = 0.021). In addition, MA patients remained alive longer than AC patients after the first metastasis diagnosis (p = 0.041). Considering only the cases that metastasized, a higher ratio of AC patients died in comparison to MA patients (p = 0.003). The occurrence of recurrence was associated with a conservative primary treatment with both AC (p < 0.001) and MA tumors (p = 0.017). Multiple recurrent events were associated with conservative primary therapies with MA (p < 0.001) but not with AC (p = 0.121).
CONCLUSION
In addition to some demographic differences, ACs that metastasize present a worse prognosis than MA. As conservative procedures are associated with multiple recurrent events, this treatment modality should be avoided for both tumors.
Topics: Ameloblastoma; Carcinoma; Humans; Mandible; Mandibular Neoplasms; Odontogenic Tumors
PubMed: 35822408
DOI: 10.1111/jop.13334 -
Ear, Nose, & Throat Journal Sep 2021
Topics: Calcinosis; Female; Humans; Infratemporal Fossa; Jaw Neoplasms; Mandibular Condyle; Medical Illustration; Middle Aged; Osteochondroma; Skull Base Neoplasms; Tomography, X-Ray Computed
PubMed: 32126817
DOI: 10.1177/0145561320910681 -
Ear, Nose, & Throat Journal Aug 2021
Topics: Aged; Ameloblastoma; Diagnosis, Differential; Humans; Jaw; Jaw Neoplasms; Male; Medical Illustration
PubMed: 31608678
DOI: 10.1177/0145561319880977 -
The American Journal of Case Reports Oct 2022BACKGROUND Brown and jaw tumors are rare entities of poorly understood etiology that are regarded as end-stage of bone remodeling in patients with long-lasting and... (Review)
Review
Association Between Parafibromin Expression and Presence of Brown Tumors and Jaw Tumors in Patients with Primary Hyperparathyroidism: Series of Cases with Review of the Literature.
BACKGROUND Brown and jaw tumors are rare entities of poorly understood etiology that are regarded as end-stage of bone remodeling in patients with long-lasting and chronic hyperparathyroidism. Jaw tumors are mainly diagnosed in jaw tumors syndrome (HPT-JT syndrome) and are caused by mutation in the CDC73 gene, encoding parafibromin, a tumor suppressing protein. The aim of this work is to present 4 cases of patients in whom the genetic mutation of the CDC73 gene and clinical presentation coexist in an unusual setting that has not yet been described. CASE REPORT We present cases of 4 patients with primary hyperparathyroidism. Three were diagnosed with brown tumors (located in long bones, ribs, iliac, shoulders) and 1 with brown and jaw tumors. Expression of parafibromin in affected parathyroid tissues were analyzed. In patients without positive parafibromin staining, we searched for CDC73 mutation using next-generation sequencing. Parafibromin staining was positive in 1 patient with brown tumors and was negative in 2 individuals with brown tumors and 1 with brown and jaw tumors. CDC73 mutation was detected in two-thirds of patients (60%) with negative staining for parafibromin and brown tumors. MEN1 mutation was found in the patient with brown tumor and positive staining for parafibromin. CONCLUSIONS Patients with hyperparathyroidism and coexistence of brown tumors or jaw tumors might have decreased expression of parafibromin in parathyroid adenoma tissue, which might be caused by CDC73 mutation and suggest a genetic predisposition. Further research on much larger study groups is needed.
Topics: Humans; Hyperparathyroidism, Primary; Tumor Suppressor Proteins; Jaw Neoplasms; Parathyroid Neoplasms; Fibroma; Transcription Factors
PubMed: 36271606
DOI: 10.12659/AJCR.936135 -
Medicine Feb 2020Jaw phosphaturic mesenchymal tumors (PMTs) are a rare neoplasm with uncertain histogenesis. This study aimed to clarify the clinical and pathological features of jaw...
Jaw phosphaturic mesenchymal tumors (PMTs) are a rare neoplasm with uncertain histogenesis. This study aimed to clarify the clinical and pathological features of jaw PMTs.We reviewed the clinical records of 39 patients diagnosed with PMTs in the jaws, and investigated clinical and morphologic characteristics, histologic subtypes, and immunophenotypes of all cases.Microscopic analyses revealed 2 major histologic tumor subtypes: "phosphaturic mesenchymal tumors of mixed epithelial and connective tissue" (PMTMECT), and "phosphaturic mesenchymal tumors of mixed connective tissue" (PMTMCT). PMTMECTs and PMTMCTs accounted for 29 and 10 cases of PMTs, respectively. Most PMTMECT diagnoses were made predominantly in males aged <45 years, and the incidence was similar in both the mandible and maxilla. In contrast, patients with PMTMCTs are predominantly females aged ≥45 years, and all tumors were in the mandible. Histologically, PMTMECT had lower cellularity and a more elongated and spindled mesenchymal component with less elaborate intrinsic microvasculature than PMTMCT. Immunohistochemically, the epithelia of all PMTMECTs was immunoreactive for AE1/AE3. Other immunohistochemical staining of PMTMECTs revealed positive expression of vimentin, SATB2, ERG, CD99, Bcl-2, CD56, S-100, D2-40, CD68, SMA, and CD34 in either one or both components. Immunohistochemical staining of PMTMCTs was diffusely positive for vimentin and a varied ratio of positivity for SATB2, ERG, CD99, Bcl-2, CD56, S-100, D2-40, CD68, SMA, and CD34, but negative for AE1/AE3. Most patients were cured by complete resection, except 2 patients who had repeated recurrences, one of which also had multiple metastasis.Jaw PMT can be divided into 2 major histological subtypes. PMTMECTs are more common than are PMTMCTs, and can transform into malignant PMTMCTs during the progression. PMTMECTs were more commonly observed in males and the incidence was similar in both the maxilla and mandible. PMTMCTs were almost always observed in the mandible of females. Compared with PMTMCTs, PMTMECTs have an admixture of epithelial components with less prominent vasculature and lower cellularity. There were no statistically significant differences in the expression of immunohistochemical markers except AE1/AE3 between PMTMECTs and PMTMCTs. However, immunohistochemical markers have great significance for differentiating other mesenchymal tumors.
Topics: Biomarkers, Tumor; Female; Humans; Jaw Neoplasms; Male; Sex Factors; Survival Analysis; Treatment Outcome
PubMed: 32049812
DOI: 10.1097/MD.0000000000019090 -
Future Oncology (London, England) Jul 2021
Topics: Bone Neoplasms; Combined Modality Therapy; Humans; Jaw Neoplasms; Plasmacytoma
PubMed: 34047196
DOI: 10.2217/fon-2021-0316 -
The Journal of Craniofacial Surgery May 2022Guidelines for pediatric mandibular reconstruction (PMR) are not well-established. One must consider the growing craniofacial skeleton, mixed dentition, long-term dental...
INTRODUCTION
Guidelines for pediatric mandibular reconstruction (PMR) are not well-established. One must consider the growing craniofacial skeleton, mixed dentition, long-term dental occlusion, need for secondary reconstruction, and speech development. The traditional guideline (bone defect > 5 cm) for use of vascularized bone grafts (VBG) is not applicable given the variation of pediatric mandibular size and growth. We seek to propose a novel algorithm for PMR.
MATERIALS AND METHODS
An Institutional Review Board approved retrospective review of patients who underwent PMR for tumor resections between 2005 and 2019 evaluated patients' demographics, complications, resection index (RI) (resection length to mandibular length), and surgical outcomes. Outcomes based on RI were analyzed to establish guidelines for VBG utilization.
RESULTS
Twenty-four patients underwent PMR at a mean age of 9.1 years (range: 1 - 18). The mandibular defect (mean± standard deviation) fornon-VBG (n = 18) and VBG (n = 6) was 6.6 ± 3.0 cm and 12.8 ± 4.3 cm, respectively. The VBG group had fewer return trips to the operating room (P = 0.028) and fewer major complications (P = 0.028). When non-VBG with RI > 32% were compared to <32%, there was statistically less returns to the operating room for complications and a lower rate of early (< 30 days) major complications.
DISCUSSION
Our algorithm proposes an RI cutoff of 32% for VBG use for PMR. Patients with a sizable soft tissue defect, previous chemotherapy and/or radiation, planned adjuvant chemotherapy and/or radiation therapy, or a history of failed non-VBG should undergo reconstruction using VBG.
Topics: Algorithms; Bone Transplantation; Child; Humans; Mandible; Mandibular Neoplasms; Mandibular Reconstruction; Retrospective Studies; Treatment Outcome
PubMed: 34636762
DOI: 10.1097/SCS.0000000000008116 -
BMJ Case Reports Sep 2020
Topics: Adult; Humans; Male; Mandibular Neoplasms; Medical Illustration; Osteoma
PubMed: 32967947
DOI: 10.1136/bcr-2020-238225