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Furmah P, Aminoshariae A, Mupparapu M, Syed AZ. Frequency of spontaneous osteosarcomatous transformation of craniofacial fibrous dysplasia: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 135:678-685. [PMID: 36828758 DOI: 10.1016/j.oooo.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 11/10/2022] [Accepted: 12/16/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVE A systematic review was undertaken to examine the spontaneous of craniofacial fibrous dysplasia (FD) into osteosarcoma (OS). STUDY DESIGN Five databases were searched, and data were evaluated in 2 subsets: (1) frequency analysis involving only cross-sectional studies that specifically examined patients for osteosarcomatous transformation, thereby allowing a calculation of the frequency of transformation of craniofacial FD, and (2) case analysis of case reports and case series of FD that underwent osteosarcomatous transformation. Quality assessment of the studies in the frequency and case analyses was performed. RESULTS Seven cross-sectional studies involving 779 patients in the frequency analysis documented transformation of craniofacial FD into OS in 13 patients, for a frequency of 1.67%. Of the 18 separate cases of osteosarcomatous transformation in the case analysis, 11 (61.1%) occurred in females, 11 (61.1%) developed from monostotic FD, and 7 (38.9%) arose in the mandible, with 5 in the maxilla (27.8%) and 6 (33.3%) in other craniofacial sites. The mean age of the patients at the time of malignant diagnosis was 36.4 years, with an average of 11.3 years from FD diagnosis to the appearance of OS. The quality of the articles ranged from fair to excellent. CONCLUSIONS The risk of osteosarcomatous transformation of craniofacial FD is low, but the possibility of transformation should be taken into consideration by clinicians, as this will guide treatment and follow-up regimens.
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Affiliation(s)
- Poonam Furmah
- Department of Oral and Maxillofacial Medicine and Diagnostic Sciences at CWRU School of Dental Medicine, Cleveland, OH, USA
| | - Anita Aminoshariae
- Department of Endodontics at CWRU, School of Dental Medicine, Cleveland, OH, USA
| | - Mel Mupparapu
- University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
| | - Ali Z Syed
- Department of Oral and Maxillofacial Medicine and Diagnostic Sciences at CWRU School of Dental Medicine, Cleveland, OH, USA.
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Okuda M, Kobayashi S, Gabata T, Yamamoto N, Nojima T. Undifferentiated Pleomorphic Sarcoma Arising in a Fibrous Dysplasia Confirmed by GNAS Mutation Analysis: A Case Report. JBJS Case Connect 2020; 10:e20.00157. [PMID: 33438968 DOI: 10.2106/jbjs.cc.20.00157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE We report the case of a 78-year-old woman with undifferentiated pleomorphic sarcoma (UPS) of the proximal femur arising in a previous site of fibrous dysplasia (i.e., a liposclerosing myxofibrous tumor) that had been treated 4 years earlier with curetted surgery. GNAS mutation was detected in both the previous benign lesion and the UPS. CONCLUSION Genetic analysis is useful in demonstrating the origin of the tumor especially in fibrous dysplasia with severe degeneration that have undergone malignant transformation.
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Affiliation(s)
- Miho Okuda
- Department of Radiology, Kanazawa University Hospital, Kanazawa, Japan
| | - Satoshi Kobayashi
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Toshifumi Gabata
- Department of Radiology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Norio Yamamoto
- Department of Advanced and Innovative Musculoskeletal Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Takayuki Nojima
- Department of Diagnostic Pathology, Kanazawa University Hospital, Kanazawa, Japan
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Tufano M, Ciofi D, Amendolea A, Stagi S. Auxological and Endocrinological Features in Children With McCune Albright Syndrome: A Review. Front Endocrinol (Lausanne) 2020; 11:522. [PMID: 32849305 PMCID: PMC7417367 DOI: 10.3389/fendo.2020.00522] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 06/26/2020] [Indexed: 01/09/2023] Open
Abstract
McCune-Albright syndrome is a rare and challenging congenital sporadic disease involving the skin and skeletal and endocrine systems with a prevalence ranges from one in 100,000 to 1,000,000. In addition to the classical triad of fibrous dysplasia of bone, café au lait pigmented skin lesions and precocious puberty, other multiple endocrinological features, including hyperthyroidism, growth hormone excess, hypercortisolism, and hypophosphatemic rickets, have been reported. A brief review of the syndrome in children is here reported.
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Affiliation(s)
- Maria Tufano
- Pediatric Unit, Mugello Hospital, Borgo San Lorenzo, Florence, Italy
| | - Daniele Ciofi
- Health Sciences Department, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy
| | | | - Stefano Stagi
- Health Sciences Department, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy
- *Correspondence: Stefano Stagi
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Wagner VP, Carlos R, Romañach MJ, Lopes MA, Speight PM, Vargas PA. Malignant transformation of craniomaxillofacial fibro‐osseous lesions: A systematic review. J Oral Pathol Med 2019; 48:441-450. [DOI: 10.1111/jop.12867] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 04/08/2019] [Accepted: 04/29/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Vivian P. Wagner
- Department of Oral Diagnosis, Piracicaba Dental School University of Campinas Piracicaba São Paulo Brazil
| | - Roman Carlos
- Pathology Department Centro Clinico de Cabeza y Cuello Guatemala City Guatemala
| | - Mário J. Romañach
- Oral Pathology, Department of Oral Diagnosis and Pathology, School of Dentistry Federal University of Rio de Janeiro Rio de Janeiro Brazil
| | - Marcio A. Lopes
- Department of Oral Diagnosis, Piracicaba Dental School University of Campinas Piracicaba São Paulo Brazil
| | - Paul M. Speight
- Department of Oral Pathology, School of Clinical Dentistry University of Sheffield Sheffield UK
| | - Pablo A. Vargas
- Department of Oral Diagnosis, Piracicaba Dental School University of Campinas Piracicaba São Paulo Brazil
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences University of Pretoria Pretoria South Africa
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Malignant transformation of craniofacial fibrous dysplasia: a systematic review of overall survival. Neurosurg Rev 2019; 43:911-921. [DOI: 10.1007/s10143-019-01089-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/18/2019] [Accepted: 02/20/2019] [Indexed: 12/23/2022]
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Luo E, Liu H, Zhao Q, Shi B, Chen Q. Dental-craniofacial manifestation and treatment of rare diseases. Int J Oral Sci 2019; 11:9. [PMID: 30783081 PMCID: PMC6381182 DOI: 10.1038/s41368-018-0041-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/22/2018] [Accepted: 10/28/2018] [Indexed: 02/05/2023] Open
Abstract
Rare diseases are usually genetic, chronic and incurable disorders with a relatively low incidence. Developments in the diagnosis and management of rare diseases have been relatively slow due to a lack of sufficient profit motivation and market to attract research by companies. However, due to the attention of government and society as well as economic development, rare diseases have been gradually become an increasing concern. As several dental-craniofacial manifestations are associated with rare diseases, we summarize them in this study to help dentists and oral maxillofacial surgeons provide an early diagnosis and subsequent management for patients with these rare diseases.
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Affiliation(s)
- En Luo
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hanghang Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qiucheng Zhao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Bing Shi
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Qianming Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Wong SC, Zacharin M. Long-term health outcomes of adults with McCune-Albright syndrome. Clin Endocrinol (Oxf) 2017; 87:627-634. [PMID: 28699175 DOI: 10.1111/cen.13419] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 06/19/2017] [Accepted: 07/06/2017] [Indexed: 12/15/2022]
Abstract
CONTEXT McCune-Albright syndrome (MAS) is associated with numerous health problems. Comprehensive long-term health problems of adults with MAS are less well defined in the literature. OBJECTIVE Our objective is to report comprehensive health outcomes of adults with MAS (>18 years). DESIGN Retrospective case note review of 16 adults with MAS managed by one clinician. Results expressed as median (range). RESULTS The study included 16 adults (seven males) with MAS. Median current age is 29 years (20, 46). Twelve of 16 had craniofacial fibrous dysplasia with five of 12 (42%) with progressive facial asymmetry. Growth hormone excess was observed in six of 16 (38%) and T3-toxicosis in five of 16 (31.3%). Six of the seven men (86%) had abnormalities on testicular ultrasound with one man exhibiting marked atrophy of germ and sertoli cells with reduction in spermatogenesis. Six of the 16 (38%) had cardiorespiratory complications including high output cardiac failure (n,3), hypertension (n,2) and one man with congestive cardiac failure and restrictive lung disease. Six of eight (66%) who had screening endoscopy for upper gastrointestinal polyps show increasing numbers of polyps, with benign histology to date. One woman with a previous history of early puberty presented with early aggressive breast carcinoma, which was positive for GNAS. Two patients had GNAS-positive muscle myomas. Platelet dysfunction with bleeding tendency responsive to platelet transfusion during surgery was seen in four. CONCLUSION A range of complex health problems is encountered in adults with MAS. These have important implications for transition of patients with MAS and adult care. Long-term cancer risk is currently unknown but requires careful follow-up.
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Affiliation(s)
- Sze Choong Wong
- Developmental Endocrinology Research Group, Royal Hospital for Children, Glasgow, UK
| | - Margaret Zacharin
- Department of Endocrinology, The Royal Children's Hospital, Melbourne, VIC, Australia
- Centre for Hormone Research, Murdoch Children's Research Institute, Melbourne, VIC, Australia
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Abstract
BACKGROUND McCune-Albright syndrome (MAS) includes the triad of poly/monostotic fibrous dysplasia, café-au-lait spots, and hyperfunctioning endocrinopathies. Acromegaly affects around 20% of MAS patients. AIMS The objective was to review all reported cases of acromegaly associated with MAS. METHODS All studies and case reports of acromegaly in patients with MAS were systematically sought in the world literature up to January 2013. We also included new data (from three unreported cases) and updated data on 23 previously reported patients from our two centers. RESULTS We reviewed the cases of 112 patients (65 males). Mean age at diagnosis of acromegaly was 24.4 years (range, 3-64). Among the 40 pediatric patients, 23 (57%) had precocious puberty. GH/IGF-1 excess was suggested by accelerated growth in 85% of pediatric cases. Acromegaly was almost always associated with skull base fibrous dysplasia. Modern imaging techniques (computed tomography or magnetic resonance imaging) revealed an adenoma in 54% of the patients (macroadenoma in more than two-thirds). Median GH levels and mean IGF-1 SD score at diagnosis were 57 μg/L (2.8 to 291 μg/L) and 8 (2.3 to 24), respectively. Hyperprolactinemia was present in 81% (mean, 149 μg/L; range, 21-600). Pituitary surgery, performed in 25 cases, very rarely cured the GH/IGF-1 excess. Somatostatin analogs improved GH/IGF-1 levels in most patients but achieved control of acromegaly in only 17 (30%) of 56 patients. Pegvisomant achieved normal IGF-1 levels in 10 of 13 cases. CONCLUSION Acromegaly, which is present in 20-30% of patients with MAS, raises particular diagnostic and therapeutic issues.
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Affiliation(s)
- Sylvie Salenave
- Assistance Publique-Hôpitaux de Paris (S.S., P.C.), Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Service d'Endocrinologie et des Maladies de la Reproduction, F-94275 Le Kremlin Bicêtre, France; Division of Endocrinology and Diabetes (A.M.B.), and Bone Health Program, Division of Orthopaedics and Sports Medicine, Children's National Medical Center, Washington, DC 20010; Skeletal Clinical Studies Unit (M.T.C.), Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland 20892; and Université Paris-Sud 11 (P.C.), INSERM Unité Mixte de Recherche S693, Faculté de Médecine Paris-Sud, F-94276 Le Kremlin-Bicêtre, France
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Akintoye SO, Boyce AM, Collins MT. Dental perspectives in fibrous dysplasia and McCune-Albright syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 116:e149-55. [PMID: 23953425 DOI: 10.1016/j.oooo.2013.05.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 04/01/2013] [Accepted: 05/29/2013] [Indexed: 12/13/2022]
Abstract
McCune-Albright syndrome (MAS) is a rare multisystem disorder characterized by the triad of polyostotic fibrous dysplasia (FD), endocrine disorders, and café-au-lait skin pigmentation. Ninety percent of MAS patients have FD lesions in the craniofacial area, resulting in significant orofacial deformity, dental disorders, bone pain, and compromised oral health. Maxillomandibular FD is also associated with dental developmental disorders, malocclusion, and high caries index. There are limited data on the outcomes of dental treatments in maxillomandibular FD/MAS patients, because clinicians and researchers have limited access to patients, and there are concerns that dental surgery may activate quiescent jaw FD lesions to grow aggressively. This report highlights current perspectives on dental management issues associated with maxillomandibular FD within the context of MAS.
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Affiliation(s)
- Sunday O Akintoye
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
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