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Head and Neck Pathology Mar 2022The 5 edition of the World Health Organization (WHO) Classification of Head and Neck Tumours (2022) comes out only five years after the previous edition, however it...
The 5 edition of the World Health Organization (WHO) Classification of Head and Neck Tumours (2022) comes out only five years after the previous edition, however it presents important updates that run in parallel with the rapid progression involving the increasingly sophisticated molecular investigation and its interpretation, some of which already have therapy-related impact. This manuscript provides an overview of the leading changes introduced in the classification of Odontogenic and Maxillofacial Bone Tumours that encompasses cysts of the jaws, odontogenic tumours, giant cell lesions and bone cysts, and bone and cartilage tumours. This is the first edition that Essential and Desirable Diagnostic Features were added for each entity, so that the most important clinical, microscopic and/or radiologic features were encapsulated and briefly highlighted. Surgical ciliated cyst was added to the group of odontogenic cysts, adenoid ameloblastoma was a newly recognized benign epithelial odontogenic tumour, and segmental odontomaxillary dysplasia was introduced in the group of fibro-osseous tumours and dysplasia. In addition, rhabdomyosarcoma with TFCP2 rearrangement, was introduced into the group of malignant jawbone tumours. The unique genetic aberrations distinguish it from other types of rhabdomyosarcomas. On the other hand, melanotic neuroectodermal tumour of infancy and osteoid osteoma were deleted from the benign bone and cartilageneous tumours, as was the hematolymphoid tumour of solitary plasmacytoma of bone. We systematically reviewed each entity in this chapter and provided important updated findings for selected topics that can further aid in the diagnostic process for challenging cases, broaden insights on the logic of the present classification, and finally, emphasize the potential that some of the molecular results may have in the near future to set new treatment approaches.
Topics: Bone Neoplasms; DNA-Binding Proteins; Head and Neck Neoplasms; Humans; Odontogenic Cysts; Odontogenic Tumors; Transcription Factors; World Health Organization
PubMed: 35312978
DOI: 10.1007/s12105-021-01404-7 -
Sultan Qaboos University Medical Journal Aug 2023Papilliferous keratoameloblastoma (PKA) is a rare entity, and not much is known about its clinicodemographic features or biological nature. This review aimed to provide... (Review)
Review
Papilliferous keratoameloblastoma (PKA) is a rare entity, and not much is known about its clinicodemographic features or biological nature. This review aimed to provide clarity regarding the characterisation of the demographic, clinical, radiological and histopathological features of PKA. Case reports of PKA were identified through a systematic search across multiple databases. The search yielded a total of 10 cases, half of which were of Indian origin. All the cases invariably occurred in the mandibular posterior region and involved the right side; only one case primarily involved the left side of the mandible. PKA should be considered a variant of the conventional ameloblastoma that is towards the more aggressive end of the spectrum. It tends to occur in older individuals (in their fifth decade or older), with a marked propensity to occur in the right mandibular posterior region. Surgical resection with diligent follow-up is warranted in the treatment of PKA.
Topics: Humans; Aged; Ameloblastoma; Mandible; Thorax
PubMed: 37655071
DOI: 10.18295/squmj.5.2023.021 -
Sultan Qaboos University Medical Journal Aug 2022This article aimed to collectively present the demographic, clinical, radiographic and histopathological features as well as the treatment performed along with its... (Review)
Review
This article aimed to collectively present the demographic, clinical, radiographic and histopathological features as well as the treatment performed along with its outcome for all the cases of adenoid ameloblastoma with dentinoid (AAD) reported in scientific literature till date. Ameloblastoma and adenomatoid odontogenic tumours are the most common odontogenic neoplasms. However, AAD, a hybrid variant of the two lesions, is found to be extremely rare. The lesion comprises of characteristic histopathological features of ameloblastoma and adenomatoid odontogenic tumour and shares certain clinical characteristics with either of the entities. AAD may be considered to be present at the more aggressive end of spectrum of benign odontogenic neoplasms. Owing to the frequent tendency of the lesions to be underdiagnosed, careful histopathological screening of submitted biopsies is warranted. With the increase in number of reported cases in the recent years, it is likely to be included as a separate entity in the upcoming World Health Organization classification.
Topics: Adenoids; Ameloblastoma; Biopsy; Humans; Odontogenic Tumors
PubMed: 36072074
DOI: 10.18295/squmj.9.2021.127 -
Asian Pacific Journal of Cancer... Nov 2022Ameloblastoma is regarded as the second most prevalent odontogenic tumor in the light of its prevalence, clinical characteristics, greater incidence of tumor recurrence,... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Ameloblastoma is regarded as the second most prevalent odontogenic tumor in the light of its prevalence, clinical characteristics, greater incidence of tumor recurrence, and therapeutic challenges. The aim of this systematic review was to establish the prevalence of ameloblastoma in the Indian subcontinent and to establish a national epidemiologic profile for these lesions.
MATERIAL AND METHODS
A systematic review was undertaken based on the PRISMA guidelines in search of epidemiologic studies concerning odontogenic tumors and ameloblastoma that are listed by PubMed, EBSCO, and Google Scholar embracing the period from January 2010 to December 2021, to evaluate the prevalence rate in India. A total of 277 publications were retrieved, of which 27 articles were selected, based on the World Health Organization classification of odontogenic tumors.
RESULTS
The affected individuals were on average in the third decade of life, with a higher male predominance. The majority of the tumors were multilocular radiolucencies in the posterior mandible, with follicular and plexiform histopathological features. The most common type of malignant lesion is ameloblastic carcinoma. Over 60% of follicular ameloblastoma recurred more frequently than the other types of ameloblastoma.The random effect model shows overall point estimate of 4.83 with 95% confidence interval (4.44 -5.26).
CONCLUSION
The systematic study indicates a slight male predisposition to ameloblastoma, with a peak incidence in the third decade of life and the mandible as the preferred anatomical site. The solid/multicystic ameloblastoma is the most prevalent histopathologic pattern. More epidemiological research on the prevalence rate of ameloblastoma is required, particularly in India, in an effort to accurately determine the national epidemiological profile of ameloblastoma.
Topics: Male; Humans; Female; Ameloblastoma; Prevalence; India; Odontogenic Tumors; Genotype
PubMed: 36444570
DOI: 10.31557/APJCP.2022.23.11.3601 -
Indian Journal of Dental Research :... 2022Ameloblastoma is a benign, locally aggressive neoplasm that needs extensive surgical resection. The goal of this article is to obtain an in-depth review of benign... (Review)
Review
Ameloblastoma is a benign, locally aggressive neoplasm that needs extensive surgical resection. The goal of this article is to obtain an in-depth review of benign ameloblastomas to determine the available level of evidence and the possible benefit of targeted therapeutics for the treatment of ameloblastoma and BRAF V600E mutation in ameloblastoma. An electronic literature search was conducted according to PRISMA guidelines in PubMed/MEDLINE, EBSCO, and Web of Science for eligible studies published between 1975 and 2021. The systematic review is registered with INPLASY (INPLASY202260018). The review included 2 case series and 17 case reports. The histopathological type, anatomic location, expression of BRAF mutation, additional mutations, and molecular-targeted therapies of the 19 reviewed articles were summarized and tabulated. Interestingly, the majority of the primary site of ameloblastoma was located in the mandible (80.9%) compared to the maxilla (17%). The tumour size was reported in nine of the included studies. Most of the included studies in the review exhibited ameloblastoma with BRAF V600E mutations and responded to molecular-targeted therapies. Molecular therapies employing BRAF and/or MEK inhibitors in ameloblastoma with BRAF V600E mutations proved to be an appropriate treatment based on the limited available evidence. It is essential further to deepen our understanding at the clinical and molecular level to enhance the precision of management of ameloblastoma.
Topics: Humans; Ameloblastoma; Molecular Targeted Therapy; Mutation; Proto-Oncogene Proteins B-raf
PubMed: 36656197
DOI: 10.4103/ijdr.ijdr_456_22 -
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 -
Frontiers in Oral Health 2021Malignant odontogenic tumours (MOTs) arise either from the tooth forming tissues, their developmental residues or from existing odontogenic epithelial or mesenchymal...
Malignant odontogenic tumours (MOTs) arise either from the tooth forming tissues, their developmental residues or from existing odontogenic epithelial or mesenchymal neoplasms in the jaws. Their management requires extensive surgery due to their infiltrative nature and risk of metastasis. There is a need to understand the clinical and pathological features of MOTs to inform both treatment algorithms and prognostication. This is an area of diagnostic pathology which presents substantial difficulties in diagnosis, compounded by inconsistent use of terminology. Thus, this systematic review aimed to describe the clinical and pathological features of MOTs with a view to consolidating the literature and defining problematic areas in diagnosis and classification. An electronic database search was conducted in Web of Science, PubMed/Medline, and Embase. Additionally, the grey literature and reference lists of selected papers searched for completeness. Nine hundred and sixty articles were initially identified. Following removal of duplicates and application of inclusion/exclusion criteria, 312 articles were included for qualitative analysis. The 312 articles encompassed a total of 507 patients with most lesions located within the mandible (74.3%). The most common first histological diagnosis was ameloblastic carcinoma (25.7% of all diagnoses), but there is considerable variation in how and when various diagnostic terms are used, and several misdiagnoses were reported. An initial benign diagnosis was made in 24.7% of patients, followed by a later malignant diagnosis and in this sub-group, the most common benign first diagnosis was ameloblastoma (42.4%). Cervical lymph nodes were the most common site of metastasis (9.3% of patients). With respect to distant metastasis (DM), the lungs were the most common organ affected (11.2% of DM patients) with metastasising ameloblastoma the most commonly reported tumour which metastasised to the lungs. Overall, 26.8% of patients developed recurrence. Overall, the quality of the literature on MOTs is poor. This review of the literature has highlighted variations in diagnostic terms and criteria which has resulted in areas of confusion with potential for misdiagnosis. This consolidation of primary data has identified key areas for targeted research including further discussion on the malignant potential of ameloblastoma.
PubMed: 35048074
DOI: 10.3389/froh.2021.775707 -
Annals of Maxillofacial Surgery 2023Odontogenic cysts have the potential to transform into neoplasms. However, the characteristics of those which transformed to neoplastic tissues have not been well... (Review)
Review
BACKGROUND
Odontogenic cysts have the potential to transform into neoplasms. However, the characteristics of those which transformed to neoplastic tissues have not been well described and the exact causes of that phenomenon are not yet clear.
OBJECTIVES
This study aims to describe characteristics of odontogenic cysts that transformed into neoplasms and to look for their potential etiologies.
DATA SOURCES
English-written studies indexed in PubMed, Science Direct, and Proquest were assessed using keywords verified by Medical Subject Headings: 'Odontogenic Cyst' and 'Neoplastic Cell Transformation'.
STUDY ELIGIBILITY CRITERIA
Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines were used as guidance.
PARTICIPANTS
Following steps in PRISMA guidelines, 19 articles were fully reviewed (three case series and 16 case reports) with 27 subjects of 16 males (59%) and 11 females (41%) from 15 to 86 years old.
RESULTS
Cystic origins were eight dentigerous cysts, four odontogenic keratocysts, two residual cysts, one radicular cyst, one calcifying odontogenic cyst, one follicular cyst, one glandular odontogenic cyst, and nine unspecified odontogenic cysts that transformed to ameloblastoma (3 cases) and carcinoma (24 cases).
LIMITATIONS
Neoplastic transformations of odontogenic cysts arose from epithelial remnants of inadequate odontogenic cyst removal and chronic inflammation due to infection. However, the exact causes of their transformations remain unclear.
CONCLUSIONS
Therefore, careful removal of odontogenic cysts and regular postoperative follow-ups are key to prevent recurrence and neoplastic transformation. Future studies are needed to investigate potential causes of neoplastic transformation of odontogenic cysts.
PubMed: 37711539
DOI: 10.4103/ams.ams_226_22 -
Head and Neck Pathology Dec 2022Craniopharyngiomas and ameloblastomas are tumors of epithelial origin, mostly characterized by a benign course, slow growth and for being locally invasive. Some studies... (Review)
Review
BACKGROUND
Craniopharyngiomas and ameloblastomas are tumors of epithelial origin, mostly characterized by a benign course, slow growth and for being locally invasive. Some studies highlight the similarity of these neoplasms, especially regarding histopathological aspects. In this context, the aim of the present study was to carry out a systematic literature review correlating the clinical, radiographic, and histopathological aspects of these two tumors.
METHODS
Searches were conducted at the Pubmed, Periódicos Capes, Scopus, Science Direct, Web of Science and Scielo databases, according to the following inclusion criteria: publications in English or Spanish, from the 2000s and 2021, comprising case report studies, case series and literature reviews.
RESULTS
Considering clinical and radiographic aspects, it is evident that craniopharyngiomas and ameloblastomas exhibit few similarities. Histopathologically, however, adamantinomatous craniopharyngiomas are the type of tumor that most resembles ameloblastomas, both concerning the formation of palisade epithelial cords and epithelial formations. Regarding to recurrences in cases of craniopharyngioma, it appears that a more radical surgical resection is more related to a lower recurrence rate for both craniopharyngiomas and ameloblastomas. As for the outcome, it was observed that craniopharyngiomas have a greater relationship with possible systemic disorders.
CONCLUSIONS
This histopathological similarity is related to their origin, since both craniopharyngiomas and ameloblastomas share a relationship with the oral cavity, either partially, as in the case of craniopharyngiomas, or totally, as in ameloblastomas, not comprising the same lesion in different locations. It is important to note that the differential morphogenetic evidence observed herein between these lesions opens up a new field of study aiming at better treatment alternatives in the future.
Topics: Humans; Neoplasms
PubMed: 35920974
DOI: 10.1007/s12105-022-01473-2 -
International Journal of Molecular... Jan 2024Craniopharyngiomas present unique challenges in surgical management due to their proximity to critical neurovascular structures. This systematic review investigates... (Review)
Review
Craniopharyngiomas present unique challenges in surgical management due to their proximity to critical neurovascular structures. This systematic review investigates genetic and immunological markers as potential targets for therapy in craniopharyngiomas, assessing their involvement in tumorigenesis, and their influence on prognosis and treatment strategies. The systematic review adhered to PRISMA guidelines, with a thorough literature search conducted on PubMed, Ovid MED-LINE, and Ovid EMBASE. Employing MeSH terms and Boolean operators, the search focused on craniopharyngiomas, targeted or molecular therapy, and clinical outcomes or adverse events. Inclusion criteria encompassed English language studies, clinical trials (randomized or non-randomized), and investigations into adamantinomatous or papillary craniopharyngiomas. Targeted therapies, either standalone or combined with chemotherapy and/or radiotherapy, were examined if they included clinical outcomes or adverse event analysis. Primary outcomes assessed disease response through follow-up MRI scans, categorizing responses as follows: complete response (CR), near-complete response (NCR), partial response, and stable or progressive disease based on lesion regression percentages. Secondary outcomes included treatment type and duration, as well as adverse events. A total of 891 papers were initially identified, of which 26 studies spanning from 2000 to 2023 were finally included in the review. Two tables highlighted adamantinomatous and papillary craniopharyngiomas, encompassing 7 and 19 studies, respectively. For adamantinomatous craniopharyngiomas, Interferon-2α was the predominant targeted therapy (29%), whereas dabrafenib took precedence (70%) for papillary craniopharyngiomas. Treatment durations varied, ranging from 1.7 to 28 months. Positive responses, including CR or NCR, were observed in both types of craniopharyngiomas (29% CR for adamantinomatous; 32% CR for papillary). Adverse events, such as constitutional symptoms and skin changes, were reported, emphasizing the need for vigilant monitoring and personalized management to enhance treatment tolerability. Overall, the data highlighted a diverse landscape of targeted therapies with encouraging responses and manageable adverse events, underscoring the importance of ongoing research and individualized patient care in the exploration of treatment options for craniopharyngiomas. In the realm of targeted therapies for craniopharyngiomas, tocilizumab and dabrafenib emerged as prominent choices for adamantinomatous and papillary cases, respectively. While adverse events were common, their manageable nature underscored the importance of vigilant monitoring and personalized management. Acknowledging limitations, future research should prioritize larger, well-designed clinical trials and standardized treatment protocols to enhance our understanding of the impact of targeted therapies on craniopharyngioma patients.
Topics: Humans; Ameloblastoma; Craniopharyngioma; Imidazoles; Oximes; Pituitary Neoplasms
PubMed: 38255797
DOI: 10.3390/ijms25020723