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Dermatology Online Journal Mar 2024Osteonecrosis of the jaw is a recognized complication associated with bevacizumab. Here, we present a patient with squamous cell carcinoma of the tonsil who experienced...
Osteonecrosis of the jaw is a recognized complication associated with bevacizumab. Here, we present a patient with squamous cell carcinoma of the tonsil who experienced minimal skin fibrosis following intensity-modulated radiation therapy. Subsequently, the patient developed rectal adenocarcinoma and encountered osteonecrosis of the jaw after receiving two cycles of bevacizumab. Close monitoring, accompanied by thorough examination to detect early signs of osteonecrosis of the jaw, should be considered for patients who have undergone radiation therapy in the head and neck region and are receiving bevacizumab or other medications known to be associated with osteonecrosis of the jaw.
Topics: Humans; Bevacizumab; Carcinoma, Squamous Cell; Radiotherapy, Intensity-Modulated; Tonsillar Neoplasms; Male; Osteonecrosis; Adenocarcinoma; Rectal Neoplasms; Antineoplastic Agents, Immunological; Middle Aged; Jaw Diseases
PubMed: 38762867
DOI: 10.5070/D330163297 -
The British Journal of Oral &... Jun 2024Rosai-Dorfman disease (RDD) is a rare histiocytic disorder with an unclear aetiology, and commonly presents with painless, bilateral cervical lymphadenopathy. Extranodal...
Rosai-Dorfman disease (RDD) is a rare histiocytic disorder with an unclear aetiology, and commonly presents with painless, bilateral cervical lymphadenopathy. Extranodal presentation in the absence of nodal involvement has been reported to have a predilection for the head and neck with less than 20 cases involving the jaw bones and sinuses. We present an interesting case of unifocal RDD of the infratemporal space in the absence of nodal involvement in a 61-year-old female treated with surgical excision and adjuvant radiation therapy.
Topics: Humans; Histiocytosis, Sinus; Female; Middle Aged; Tomography, X-Ray Computed
PubMed: 38762361
DOI: 10.1016/j.bjoms.2024.04.014 -
Prague Medical Report 2024Salivary gland neoplasms account for 3% of all head and neck tumours. Pleomorphic adenoma (PA) is the most common salivary gland tumour that mainly occurs in the parotid...
Salivary gland neoplasms account for 3% of all head and neck tumours. Pleomorphic adenoma (PA) is the most common salivary gland tumour that mainly occurs in the parotid gland, followed by minor salivary glands of the oral cavity, however, the occurrence of PA inside the jaw bones is exceedingly rare and very few cases have been reported in the literature. Inside jaw bones these lesions tend to imitate large osteolytic lesions encompass a diagnostic challenge. An exhaustive review of the literature revealed only 10 cases of central pleomorphic adenoma. We present a rare case of primary PA that occurred inside the mandible and was provisionally diagnosed as ameloblastoma.
Topics: Humans; Male; Adenoma, Pleomorphic; Ameloblastoma; Diagnosis, Differential; Mandibular Neoplasms; Adult
PubMed: 38761048
DOI: 10.14712/23362936.2024.14 -
Zhongguo Xiu Fu Chong Jian Wai Ke Za... May 2024To explore the feasibility and effectiveness of mixed reality technology for localizing perforator vessels in the repair of mandibular defects using free fibular flap.
OBJECTIVE
To explore the feasibility and effectiveness of mixed reality technology for localizing perforator vessels in the repair of mandibular defects using free fibular flap.
METHODS
Between June 2020 and June 2023, 12 patients with mandibular defects were repaired with free fibular flap. There were 8 males and 4 females, with an average age of 61 years (range, 35-78 years). There were 9 cases of ameloblastomas and 3 cases of squamous cell carcinomas involving the mandible. The disease duration ranged from 15 days to 2 years (median, 14.2 months). The length of mandibular defects ranged from 5 to 14 cm (mean, 8.5 cm). The area of soft tissue defects ranged from 5 cm×4 cm to 8 cm×6 cm. Preoperative enhanced CT scans of the maxillofacial region and CT angiography of the lower limbs were performed, and the data was used to create three-dimensional models of the mandible and lower limb perforator vessels. During operation, the mixed reality technology was used to overlay the three-dimensional model of perforator vessels onto the body surface for harvesting the free fibular flap. The length of the fibula harvested ranged from 6 to 15 cm, with a mean of 9.5 cm; the size of the flap ranged from 6 cm×5 cm to 10 cm×8 cm. The donor sites were sutured directly in 7 cases and repaired with free skin grafting in 5 cases.
RESULTS
Thirty perforator vessels were located by mixed reality technology before operation, with an average of 2.5 vessels per case; the distance between the exit point of the perforator vessels located before operation and the actual exit point ranged from 1 to 4 mm, with a mean of 2.8 mm. All fibular flaps survived; 1 case had necrosis at the distal end of flap, which healed after dressing changes. One donor site had infection, which healed after anti-inflammatory dressing changes; the remaining incisions healed by first intention, and the grafts survived smoothly. All patients were followed up 8-36 months (median, 21 months). The repaired facial appearance was satisfactory, with no flap swelling. Among the patients underwent postoperative radiotherapy, 2 patients had normal bone healing and 1 had delayed healing at 6 months.
CONCLUSION
In free fibular flap reconstruction of mandibular defects, the use of mixed reality technology for perforator vessel localization can achieve three-dimensional visualization, simplify surgical procedures, and reduce errors.
Topics: Humans; Male; Middle Aged; Female; Adult; Free Tissue Flaps; Aged; Fibula; Mandible; Plastic Surgery Procedures; Carcinoma, Squamous Cell; Mandibular Neoplasms; Mandibular Reconstruction; Perforator Flap; Ameloblastoma
PubMed: 38752246
DOI: 10.7507/1002-1892.202402027 -
Clinical Oral Investigations May 2024This study aimed to evaluate the diagnostic accuracy of contrast-enhanced computed tomography (CT) in detecting bone invasion in oral squamous cell carcinoma (OSCC)...
OBJECTIVES
This study aimed to evaluate the diagnostic accuracy of contrast-enhanced computed tomography (CT) in detecting bone invasion in oral squamous cell carcinoma (OSCC) patients and to explore clinicopathological factors associated with its reliability.
MATERIALS AND METHODS
417 patients underwent preoperative contrast-enhanced CT followed by radical surgery. The presence or absence of bone invasion served as the outcome variable, with histopathologic examination of the resection specimen considered the gold standard. Statistical analyses, comprising correlation analyses and the determination of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), were conducted.
RESULTS
CT exhibited 76.85% sensitivity, 82.20% specificity, 47.14% PPV, and 89.67% NPV. False-positive and false-negative rates were 11.27% and 5.99%, respectively. Artifacts affected assessment in 44 patients, but not in those with bone invasion. Tumor size, depth of invasion (DOI), tumor localization at the upper jaw, lymphatic invasion, and perineural invasion correlated with incorrect identification of bone invasion (Chi-square, p < 0.05).
CONCLUSIONS
Despite utilizing thin-section CT, notable false-positive and false-negative results persisted. Patients with T3 tumors, DOI ≥ 10 mm, or upper jaw tumors are at higher risk for misidentification of bone invasion. Combining multiple methods may enhance diagnostic accuracy, and the integration of artificial intelligence or tracking electrolyte disturbances by tumor depth profiling shows promise for further assessment of bone invasion before histopathology.
CLINICAL RELEVANCE
Surgeons should consider these insights when planning tumor resection. Supplementary imaging may be warranted in cases with high risk factors for misidentification. Further methodological advancements are crucial for enhancing diagnostic precision.
Topics: Humans; Female; Male; Neoplasm Invasiveness; Mouth Neoplasms; Middle Aged; Tomography, X-Ray Computed; Contrast Media; Carcinoma, Squamous Cell; Aged; Sensitivity and Specificity; Adult; Reproducibility of Results; Predictive Value of Tests; Aged, 80 and over; Neoplasm Staging; Retrospective Studies; Bone Neoplasms
PubMed: 38748270
DOI: 10.1007/s00784-024-05705-3 -
BMC Veterinary Research May 2024Hypoxia is a detrimental factor in solid tumors, leading to aggressiveness and therapy resistance. OMX, a tunable oxygen carrier from the heme nitric...
BACKGROUND
Hypoxia is a detrimental factor in solid tumors, leading to aggressiveness and therapy resistance. OMX, a tunable oxygen carrier from the heme nitric oxide/oxygen-binding (H-NOX) protein family, has the potential to reduce tumor hypoxia. [F]Fluoromisonidazole ([F]FMISO) positron emission tomography (PET) is the most widely used and investigated method for non-invasive imaging of tumor hypoxia. In this study, we used [F]FMISO PET/CT (computed tomography) to assess the effect of OMX on tumor hypoxia in spontaneous canine tumors.
RESULTS
Thirteen canine patients with various tumors (n = 14) were randomly divided into blocks of two, with the treatment groups alternating between receiving intratumoral (IT) OMX injection (OMX IT group) and intravenous (IV) OMX injection (OMX IV group). Tumors were regarded as hypoxic if maximum tumor-to-muscle ratio (TMR) was greater than 1.4. In addition, hypoxic volume (HV) was defined as the region with tumor-to-muscle ratio greater than 1.4 on [F]FMISO PET images. Hypoxia was detected in 6/7 tumors in the OMX IT group and 5/7 tumors in the OMX IV injection group. Although there was no significant difference in baseline hypoxia between the OMX IT and IV groups, the two groups showed different responses to OMX. In the OMX IV group, hypoxic tumors (n = 5) exhibited significant reductions in tumor hypoxia, as indicated by decreased TMR and HV in [F]FMISO PET imaging after treatment. In contrast, hypoxic tumors in the OMX IT group (n = 6) displayed a significant increase in [F]FMISO uptake and variable changes in TMR and HV.
CONCLUSIONS
[F]FMISO PET/CT imaging presents a promising non-invasive procedure for monitoring tumor hypoxia and assessing the efficacy of hypoxia-modulating therapies in canine patients. OMX has shown promising outcomes in reducing tumor hypoxia, especially when administered intravenously, as evident from reductions in both TMR and HV in [F]FMISO PET imaging.
Topics: Animals; Dogs; Misonidazole; Positron Emission Tomography Computed Tomography; Dog Diseases; Female; Tumor Hypoxia; Male; Neoplasms; Thiosemicarbazones; Coordination Complexes
PubMed: 38741109
DOI: 10.1186/s12917-024-04061-4 -
Indian Journal of Dental Research :... Oct 2023Ossifying fibromas are rare, non-aggressive benign tumours of the bone, commonly involving the posterior mandible in middle-aged individuals with a female predilection.
INTRODUCTION
Ossifying fibromas are rare, non-aggressive benign tumours of the bone, commonly involving the posterior mandible in middle-aged individuals with a female predilection.
FINDINGS
Clinical manifestations include asymptomatic expansion of the mandible with infrequent maxillary lesions, pain, malocclusion, and compromised quality of life including aesthetic perception. Owing to multiplicity of features, tendency of recurrence, and possibility of malignant transformation, the diagnosis, treatment, and post-operative management of ossifying fibroma are always a challenge.
TAKEAWAY LESSONS
Study aims to report a clinical case of extensive swelling involving the coronoid process and condyle on the right side to crossing the mid-line of the mandible with compromised functions and aesthetics. The article describes the clinical, histopathological, and radiological features of the case. The possible treatment and challenges encountered are discussed.
Topics: Humans; Fibroma, Ossifying; Mandibular Neoplasms; Female; Radiography, Panoramic; Adult
PubMed: 38739833
DOI: 10.4103/ijdr.ijdr_134_21 -
Indian Journal of Dental Research :... Oct 2023Although numerous syndromic and non-syndromic odontogenic lesions of the jaws have been documented in the literature, there are very few cases of simultaneous benign and...
INTRODUCTION
Although numerous syndromic and non-syndromic odontogenic lesions of the jaws have been documented in the literature, there are very few cases of simultaneous benign and malignant jaw lesions.
PATIENT CONCERNS
We present a case of right maxillary squamous cell carcinoma along with several benign odontogenic cystic lesions of the jaws and skeletal abnormalities that meet the criteria for Gorlin-Goltz syndrome.
TAKEAWAY LESSONS
With a review of the literature, the specifics of management and follow-up are discussed.
Topics: Humans; Basal Cell Nevus Syndrome; Odontogenic Cysts; Maxillary Neoplasms; Carcinoma, Squamous Cell; Male; Neoplasms, Multiple Primary; Radiography, Panoramic; Female
PubMed: 38739831
DOI: 10.4103/ijdr.ijdr_9_23 -
Cureus Apr 2024Capillary intraosseous hemangioma is a benign vascular neoplasm that affects bone tissue, yet its occurrence in the jaw bones has been seldom reported in the literature....
Capillary intraosseous hemangioma is a benign vascular neoplasm that affects bone tissue, yet its occurrence in the jaw bones has been seldom reported in the literature. We present a case of a capillary intraosseous hemangioma located in the mandibular symphysis of a 28-year-old male. Initially addressed by the patient's dentist as an infectious lesion of endodontic origin, the sudden worsening of the condition, marked by the development of a rapidly expanding exophytic mandibular lesion and tooth mobility, led to the consideration of various potential diagnoses. Subsequently, an incisional biopsy was performed, triggering multiple episodes of recurrent bleeding, leading to several visits to the emergency department, and prompting an urgent status upgrade for the patient. Upon the histological diagnosis of vascular neoplasm, the patient underwent the excision of the lesion, with a favorable and uneventful evolution, although with expected sequelae. As a result, a temporary prosthetic solution, comprising a Maryland Bridge, was implemented, with plans for guided bone regeneration and implant-supported fixed dental prostheses currently in progress. This case underscores the diagnostic and therapeutic challenges associated with this rare condition. Consequently, achieving the optimal outcome for the patient largely depends on a multidisciplinary approach, emphasizing the critical importance of thorough preoperative assessment, along with a well-devised treatment plan and rapid intervention.
PubMed: 38738024
DOI: 10.7759/cureus.58035 -
Journal of Oral Biosciences Jun 2024Odontogenic tumors arise in the jawbone and originate from cells associated with tooth development. Therefore, understanding odontogenic tumors requires knowledge of all... (Review)
Review
BACKGROUND
Odontogenic tumors arise in the jawbone and originate from cells associated with tooth development. Therefore, understanding odontogenic tumors requires knowledge of all aspects of dental research, including tooth development and eruption. Ameloblastoma is the most common odontogenic tumor.
HIGHLIGHT
Although a benign tumor, ameloblastoma progresses with marked jawbone resorption. Because of its locally aggressive features, it can be treated surgically by resecting the surrounding bone. From a molecular pathology perspective, several genetic mutations and dysregulated signaling pathways involved in ameloblastoma tumorigenesis have been identified. Histopathologically, ameloblastomas consist of peripheral ameloblast-like cells and an inner stellate reticulum. The stromal region consists of fibrovascular connective tissue, showing a characteristic sparse myxoid histology. In general, the tumor microenvironment, including the surrounding non-tumor cells, contributes to tumorigenesis and progression. In this review, we focus on the tumor microenvironment of ameloblastomas. In addition, we present some of our recent studies on osteoclastogenesis, tubulin acetylation-induced cell migration, and hypoxia-induced epithelial-mesenchymal transition in ameloblastomas.
CONCLUSION
Further research on ameloblastomas can lead to the development of new treatments and improve patients' quality of life.
Topics: Ameloblastoma; Humans; Tumor Microenvironment; Cell Transformation, Neoplastic; Cell Movement; Jaw Neoplasms; Osteogenesis; Epithelial-Mesenchymal Transition; Osteoclasts
PubMed: 38734178
DOI: 10.1016/j.job.2024.05.002