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Wahyudi M, Alaztha Z. Chondrosarcoma arising in monostotic fibrous dysplasia treated with total femur resection and megaprothesis: A case report. Int J Surg Case Rep 2021; 85:106194. [PMID: 34293652 PMCID: PMC8319740 DOI: 10.1016/j.ijscr.2021.106194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 07/08/2021] [Accepted: 07/08/2021] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Fibrous dysplasia is tumor like lesions of bone which develop as substitution of bone by an expansion of fibrous connective tissue mixed with hard trabeculae. Chondrosarcomas is one of common malignant primary bone tumor derived from heterogenous group of neoplasm producing chondroid matrix. Chondrosarcoma arising in fibrous dysplasia, especially in monostotic fibrous dysplasia is a very rare case. CASE REPORT A 54-year-old male presented with chief complaint of pain on left thigh. Patient with history of pathological fracture on left femoral diaphysis 3 years ago due to fibrous dysplasia and had underwent curettage, open reduction, and internal fixation at other hospital. Plain radiography revealed expansive lytic lesion, interrupted periosteal reaction with plate and screw attached to the lesion, and soft tissue mass. MRI T2FS sequence showed hyperintense mass extending from subtrochanteric to distal of left femoral diaphysis. Histopathological result from biopsy suggested chondrosarcoma. CONCLUSIONS Malignant transformation of monostotic type was less frequently compared to polyostotic type. Among all malignant transformation cases, alteration to chondrosarcoma was more scarce than other malignancy such as osteosarcoma and fibrosarcoma. Wide surgical margin and reconstruction in chondrosarcoma provide good local control and functional outcome.
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Affiliation(s)
- Muhammad Wahyudi
- Department of Orthopaedic and Traumatology, Fatmawati General Hospital, Indonesia
| | - Ziad Alaztha
- Department of Orthopaedic and Traumatology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Indonesia.
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2
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Imaging of advanced craniofacial fibrous dysplasia associated with McCune-Albright syndrome: A case report. Eur J Radiol Open 2020; 7:100208. [PMID: 33102631 PMCID: PMC7569405 DOI: 10.1016/j.ejro.2019.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 12/08/2019] [Indexed: 01/27/2023] Open
Abstract
The fibrous dysplasia of bone is painless, benign, and slowly progressive bone lesion. It may rarely become aggressive by compression of adjacent organs or malignant transformation. This disease falls within the scope of a McCune-Albright syndrome in less than 7 % of cases. The authors reported the case of a 25-year-old woman, living in the countryside, who suffered from a severe craniofacial fibrous dysplasia which has begun since her childhood with no medical care. Her clinical picture was that of McCune-Albright syndrome, and CT scan revealed advanced dysplasia with endocranial compression.
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3
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Pacino GA, Cocuzza S, Tonoli G, Boscolo Rizzo P, Tirelli G, Tofanelli M, Ciprandi G, La Mantia I, Maniaci A, Da Mosto MC, Spinato G. Jawbone fibrous dysplasia: retrospective evaluation in a cases series surgically treated and short review of the literature. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 92:e2021018. [PMID: 33682826 PMCID: PMC7975924 DOI: 10.23750/abm.v92i1.9904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 06/16/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM OF THE WORK Fibrous dysplasia is a fibro-osseous osteopathy in which the normal bone architecture is replaced by fibrous tissue and non-functional trabeculae-like osseous structures. In head and neck area monostotic or polyostotic lesions cause a progressively expanding destructive bone swelling producing cosmetic deformities and functional impairments. The aim of this article is to present a retrospective review of a clinical case series with pathologically confirmed jawbone fibrous dysplasia for over an 8-year-period. MATERIAL AND METHODS Clinical presentation and radiographic features of fibrous dysplasia affecting the jawbone skeletal area, surgical procedures performed including the reconstructive methods employed and clinical outcomes were analysed for each patient. RESULTS Seven cases were classified as having monostotic fibrous dysplasia while the others four cases were classified as having polyostotic form. The mandible was most commonly involved. The most common presenting features included marked facial deformity, intraoral bulging, malocclusion and dental alterations. Aesthetic and/or functional impairments were the major indications for surgical treatment in all the patients of this series. Six patients underwent bone remodelling while in the remaining cases subtotal or total resection was performed. Bone reconstruction by means of autologous free bone grafts or revascularized free bone flaps was made in three cases. CONCLUSION The choice of the tailored therapeutic approach should be evaluated according the patient's age, rate of growth, anatomic location, type of involvement and the presence or not of functional disturbances and cosmetic alterations. Surgery remains the best therapeutic option.
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Affiliation(s)
| | - Salvatore Cocuzza
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", ENT Section; University of Catania- Italy.
| | - Giovanni Tonoli
- Otorhinolaryngology Department, Provincial Rovigo Hospital (Italy).
| | - Paolo Boscolo Rizzo
- Department of Neurosciences, Section of Otolaryngology and Regional Centre for Head and Neck Cancer, University of Padova, Treviso, Italy.
| | - Giancarlo Tirelli
- Department of Otorhinolaryngology-Head and Neck Surgery, Cattinara Hospital, University of Trieste, Trieste, Italy.
| | - Margherita Tofanelli
- Department of Otorhinolaryngology-Head and Neck Surgery, Cattinara Hospital, University of Trieste, Trieste, Italy.
| | | | - Ignazio La Mantia
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", ENT Section; University of Catania- Italy.
| | - Antonino Maniaci
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", ENT Section; University of Catania- Italy.
| | - Maria Cristina Da Mosto
- Department of Neurosciences, Section of Otolaryngology and Regional Centre for Head and Neck Cancer, University of Padova, Treviso, Italy.
| | - Giacomo Spinato
- Department of Neurosciences, Section of Otolaryngology and Regional Centre for Head and Neck Cancer, University of Padova, Treviso, Italy; Department of Surgery, Oncology and Gastroenterology, Section of Oncology and Immunology, University of Padova, Padova, Italy.
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4
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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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5
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de Souza LL, Pontes FSC, Fonseca FP, da Mata Rezende DS, Vasconcelos VCS, Pontes HAR. Chondrosarcoma of the jaw bones: a review of 224 cases reported to date and an analysis of prognostic factors. Int J Oral Maxillofac Surg 2018; 48:452-460. [PMID: 30528199 DOI: 10.1016/j.ijom.2018.11.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 10/25/2018] [Accepted: 11/14/2018] [Indexed: 12/13/2022]
Abstract
The objective was to integrate the available published data on chondrosarcoma (CHS) of the jaw bones into a comprehensive analysis of its clinical and histological features, treatment, and prognostic factors. An electronic search was undertaken in October 2017. To be eligible, the publication had to provide sufficient clinical/histological data to confirm the diagnosis. One hundred and ten publications (224 cases of CHS) were identified and included. There was a slightly higher prevalence of CHS in males than in females. Most subjects with CHS were in the second to fifth decades of life. The most common symptom was swelling and the most commonly observed location was the maxilla. Histologically, most tumours were of the conventional type and were low grade tumours. The treatment of choice was tumour resection. Histological grade, treatment with chemotherapy alone, and the presentation of recurrence or metastasis were found to be significant independent prognostic factors: patients who presented high-grade tumours, who received chemotherapy alone as the treatment of choice, and those who presented recurrence or metastasis were more likely to have a worse prognosis. In addition, radical surgery associated with radiotherapy as the treatment protocol showed a better prognosis.
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Affiliation(s)
- L L de Souza
- Oral Surgery and Pathology Department, João de Barros Barreto University Hospital/Federal University of Pará, Belém, Pará, Brazil.
| | - F S C Pontes
- Oral Surgery and Pathology Department, João de Barros Barreto University Hospital/Federal University of Pará, Belém, Pará, Brazil
| | - F P Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - D S da Mata Rezende
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - V C S Vasconcelos
- Oral Surgery and Pathology Department, João de Barros Barreto University Hospital/Federal University of Pará, Belém, Pará, Brazil
| | - H A R Pontes
- Oral Surgery and Pathology Department, João de Barros Barreto University Hospital/Federal University of Pará, Belém, Pará, Brazil; Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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6
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Abtahi J, Ajan A. Malignant Transformation of Ossifying Fibroma into Parosteal Osteosarcoma with High-grade Component: Presentation of an Unusual Case and Review of the Literature. Open Dent J 2018. [DOI: 10.2174/1874210601812011059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Parosteal Osteosarcoma of the Jaw (POSJ) is a rare entity that is associated with a high survival rate. Several case reports and case series of POSJ have been published in the literature, but few authors have described development of this tumor by possible transformation from a fibro-osseous neoplasm.
Objective:
We present a rare occurrence of parosteal osteosarcoma with involvement of the posterior maxilla, orbit floor, and infra-temporal fossa in a 20-year-old man. Furthermore, we performed a literature review regarding clinical, radiological, and histological features; treatment strategies; and etiology/pathophysiology.
Methods:
A PubMed search yielded a total of 74 articles and the articles were sorted according to their corresponding key area of focus.
Results:
This was a case of POSJ with high-grade component in the maxillofacial region of a 20-year old male. Co-expression of MDM2 and CDK4 was confirmed. At 2.5-year follow-up, the patient had died. The literature review revealed 18 articles including 20 cases of POSJ. Four cases represent the possible development of this tumor by transformation from a fibro-osseous neoplasm: Two cases of fibrous dysplasia, one case of cemento-ossifying fibroma, and the case of Ossifying Fibroma (OF) in the present study.
Conclusion:
In conclusion, we found an unusual case of POSJ of the midface in a patient with a previous diagnosis of OF in the same region. To our knowledge, there have been no previous reports of development of POSJ in OF. Furthermore, this is the first described case of high-grade surface osteosarcoma in the craniofacial region.
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7
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Pereira TDSF, Gomes CC, Brennan PA, Fonseca FP, Gomez RS. Fibrous dysplasia of the jaws: Integrating molecular pathogenesis with clinical, radiological, and histopathological features. J Oral Pathol Med 2018; 48:3-9. [PMID: 30376190 DOI: 10.1111/jop.12797] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Fibrous dysplasia is a non-neoplastic developmental process that affects the craniofacial bones, characterized by painless enlargement as a result of bone substitution by abnormal fibrous tissue. Postzygotic somatic activating mutations in the GNAS1 gene cause fibrous dysplasia and have been extensively investigated, as well as being helpful in the differential diagnosis of the disease. Fibrous dysplasia may involve one (monostotic) or multiple bones (polyostotic), sporadically or in association with McCune-Albright syndrome, Jeffe-Lichenstein syndrome, or Mazabreud syndrome. This review summarizes the current knowledge on fibrous dysplasia, emphasizing the value of integrating the understanding of its molecular pathogenesis with the clinical, radiological, and histopathological features. In addition, we address important aspects related to the differential diagnosis and patient management.
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Affiliation(s)
- Thaís Dos Santos Fontes Pereira
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Carolina Cavalieri Gomes
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Peter A Brennan
- Department of Oral and Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, UK
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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8
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Martini M, Klausing A, Heim N, Fischer HP, Sommer A, Reich RH. Fibrous dysplasia imitating malignancy. J Craniomaxillofac Surg 2018; 46:1313-1319. [PMID: 29859820 DOI: 10.1016/j.jcms.2018.05.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 04/06/2018] [Accepted: 05/07/2018] [Indexed: 11/19/2022] Open
Abstract
Fibrous dysplasia is a benign bone disease, presenting as monostotic or polyostotic lesions, or as part of a syndrome (McCune-Albright/Mazabraud). Its clinical course shows a variegated picture and the progression of its growth is unpredictable. In the workup of 39 fibrous dysplasia cases in the cranio-facial area, four cases presented fast growth tendencies, of which two patients with McCune-Albright syndrome showed malignant-like rapid growth. This local aggressive form is extremely rare, and the concept of this issue has not been clearly defined. With regard to the speed of growth a volumetric-time analysis in one of our cases demonstrated a 74 days tumor doubling rate with an exponential growth curve. According to the literature the aggressive form presented extra-cranially mainly at an adult age, whereas its appearance in our cranio-facial patient collective was much younger. Distinguishing nonmalignant and malignant aggressive forms is difficult and highly inconsistent in the literature. We therefore implemented a quantitative growth measure analysis to define aggressive forms based on progression and speed of growth and impartial of type of FD, localization or functional incapacity. Due to our study findings and literature review we state a prevalence of an aggressive form might be possibly about 5 %.
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Affiliation(s)
- Markus Martini
- Department of Maxillofacial and Plastic Surgery, (Head: Prof. Dr. Dr. R. H. Reich), University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.
| | - Anne Klausing
- Department of Maxillofacial and Plastic Surgery, (Head: Prof. Dr. Dr. R. H. Reich), University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
| | - Nils Heim
- Department of Maxillofacial and Plastic Surgery, (Head: Prof. Dr. Dr. R. H. Reich), University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
| | - Hans-Peter Fischer
- Department of Pathology, (Head: Prof. Dr. G. Kristiansen), University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
| | - Alexandra Sommer
- Department of Radiology, (Head: Prof. Dr. H. H. Schild), University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
| | - Rudolf Hermann Reich
- Department of Maxillofacial and Plastic Surgery, (Head: Prof. Dr. Dr. R. H. Reich), University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
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9
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Pack SE, Al Share AA, Quereshy FA, Baur DA. Osteosarcoma of the Mandible Arising in Fibrous Dysplasia-A Case Report. J Oral Maxillofac Surg 2016; 74:2229.e1-2229.e4. [PMID: 27425882 DOI: 10.1016/j.joms.2016.06.174] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 06/13/2016] [Accepted: 06/13/2016] [Indexed: 11/18/2022]
Abstract
Fibrous dysplasia (FD) is a benign fibro-osseous lesion that typically behaves as a painless, slowly expanding tumor. On rare occasion, FD will undergo malignant transformation. When sarcomatous change occurs, osteosarcoma is the typical variant, followed by chondrosarcoma and fibrosarcoma. The incidence of malignant change varies from 1 to 4% depending on whether the disease is mono-ostotic or polyostotic and syndromic (McCune-Albright or Jaffe-Lichtenstein syndrome). Despite the low incidence of malignant change, the potential lethality of this disease behooves treating surgeons to be keenly aware of the signs and symptoms indicative of malignancy. This report documents a case of spontaneous transformation of FD into osteosarcoma in the setting of longstanding craniomaxillofacial FD in a 39-year-old woman.
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Affiliation(s)
- Sean E Pack
- Chief Resident, Department of Oral and Maxillofacial Surgery, Case Western Reserve University and University Hospitals/Case Medical Center, Cleveland, OH
| | - Ahmad A Al Share
- Research Fellow, Department of Oral and Maxillofacial Surgery, Case Western Reserve University and University Hospitals/Case Medical Center, Cleveland, OH
| | - Faisal A Quereshy
- Residency Program Director and Assistant Professor, Department of Oral and Maxillofacial Surgery, Case Western Reserve University and University Hospitals/Case Medical Center, Cleveland, OH
| | - Dale A Baur
- Department Chair, Division Chief, and Associate Professor, Department of Oral and Maxillofacial Surgery, Case Western Reserve University and University Hospitals/Case Medical Center, Cleveland, OH.
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10
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Fibrous dysplasia of mandible—Report of a case presenting with a rare clinical course. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2014. [DOI: 10.1016/j.ajoms.2013.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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11
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Other Bone Diseases. Oral Radiol 2014. [DOI: 10.1016/b978-0-323-09633-1.00023-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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12
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Lee JS, FitzGibbon EJ, Chen YR, Kim HJ, Lustig LR, Akintoye SO, Collins MT, Kaban LB. Clinical guidelines for the management of craniofacial fibrous dysplasia. Orphanet J Rare Dis 2012; 7 Suppl 1:S2. [PMID: 22640797 PMCID: PMC3359960 DOI: 10.1186/1750-1172-7-s1-s2] [Citation(s) in RCA: 148] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Fibrous dysplasia (FD) is a non-malignant condition caused by post-zygotic, activating mutations of the GNAS gene that results in inhibition of the differentiation and proliferation of bone-forming stromal cells and leads to the replacement of normal bone and marrow by fibrous tissue and woven bone. The phenotype is variable and may be isolated to a single skeletal site or multiple sites and sometimes is associated with extraskeletal manifestations in the skin and/or endocrine organs (McCune-Albright syndrome). The clinical behavior and progression of FD may also vary, thereby making the management of this condition difficult with few established clinical guidelines. This paper provides a clinically-focused comprehensive description of craniofacial FD, its natural progression, the components of the diagnostic evaluation and the multi-disciplinary management, and considerations for future research.
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Affiliation(s)
- J S Lee
- Department of Oral & Maxillofacial Surgery, University of California San Francisco, San Francisco, CA, USA
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13
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Abstract
The jaws differ in various aspects from all other bones in the skeleton. Embryologically, they are for the major part derived from migrating cells of the cranial neural crest, the so-called ectomesenchyme, and not merely from mesoderm, and they contain teeth. This latter point, especially, results in the presence of lesions that are not found in other bones, a broad variety of odontogenic cysts and tumours. They will be the major topic of this review. Other lesions, not strictly odontogenic but also mainly confined to the jaw bones, are giant cell lesions, fibro-osseous lesions, and the melanotic neuro-ectodermal tumour of infancy. They also will be included in this overview.
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Affiliation(s)
- P J Slootweg
- Department of Pathology, Radboud University, Nijmegen Medical Centre, the Netherlands.
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14
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Van Damme PA, de Wilde PCM, Koot RAC, Bruaset I, Slootweg PJ, Ruiter DJ. Juxtacortical chondrosarcoma of the mandible: report of a unique case and review of the literature. Int J Oral Maxillofac Surg 2005; 34:94-8. [PMID: 15617976 DOI: 10.1016/j.ijom.2004.02.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2004] [Indexed: 11/16/2022]
Abstract
The clinical, radiographic, and pathological features of a juxtacortical chondrosarcoma of the mandible in a 25-year-old Caucasian woman are presented and the differential diagnostic aspects are discussed. To the best of our knowledge, this rare tumor has not previously been reported in the maxillofacial skeleton. Ten years after surgery there is no evidence of local recurrence or metastatic disease. As the prognosis of juxtacortical chondrosarcoma of the long bones seems to be relatively favorable compared with the usual central chondrosarcoma of similar grade of malignancy, this might also be expected for a similar tumor presentation in the maxillofacial skeleton.
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Affiliation(s)
- Ph A Van Damme
- Department of Oral and CranioMaxillofacial Surgery, 6500 HB Nijmegen, The Netherlands.
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15
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Mardinger O, Givol N, Talmi YP, Taicher S. Osteosarcoma of the jaw. The Chaim Sheba Medical Center experience. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2001; 91:445-51. [PMID: 11312461 DOI: 10.1067/moe.2001.112330] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The purpose of this article is to present 14 cases of osteosarcoma of the jaw treated at our medical center from 1989 to 1998. These cases are discussed in the light of a comprehensive review of 774 cases reported in the English literature over the past 3 decades. Differences between osteosarcoma of the jaws and osteosarcoma of the long bones are examined. SUBJECTS AND METHODS The patients ranged in age from 8 to 78 years, the mean age being 33 years. Each patient had a histopathologically established diagnosis of osteosarcoma of the jaw. Records were reviewed for epidemiologic data, treatment modalities, and survival. RESULTS Of the 14 patients, 6 (42%) had tumors in the mandible and 8 (58%) had tumors in the maxilla. Of the mandibular tumors, 5 occurred in the body of the mandible; all maxillary tumors originated in the alveolar ridge and involved the maxillary sinus. The chief complaint was an intraoral or extraoral painless swelling. Histopathologic types included chondroblastic, osteoblastic, fibroblastic, and malignant fibrous histiocytoma-like. Pathologic grade was determined to be high (3 or 4) in 13 cases and low (1) in only 1 mandibular case. All patients underwent surgical resection and immediate reconstruction. Adjuvant therapy included postoperative radiation (5 patients), postoperative chemotherapy (2 patients), and preoperative chemotherapy and postoperative radiation (1 patient). CONCLUSIONS The results of the present study support the literature indicating that osteosarcoma of the jaw differs from osteosarcoma of the long bones in its biological behavior even though they have the same histologic appearance. Because of differences in tumor characteristics, the introduction of chemotherapy did not dramatically alter the prognosis of osteosarcoma of the jaw. Early diagnosis and radical surgery are the keys to high survival rates.
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Affiliation(s)
- O Mardinger
- Tel Aviv University, Department of Oral & Maxillofacial Surgery, Sapir Medical Center, Kfar Saba, Israel.
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16
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Frodel JL, Funk G, Boyle J, Richardson M. Management of aggressive midface and orbital fibrous dysplasia. ARCHIVES OF FACIAL PLASTIC SURGERY 2000; 2:187-95. [PMID: 10938142 DOI: 10.1001/archfaci.2.3.187] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To discuss cosmetic and functional implications in the evaluation and treatment planning of large, aggressive midfacial fibrous dysplasias. PATIENTS AND METHODS Eight patients (aged 2-38 years) with large fibrous dysplasias of the maxilla, zygomatic, and ethmoid bones requiring varying degrees of intervention and reconstruction were retrospectively reviewed. Patients with smaller lesions of these regions not requiring resection and reconstruction, as well those requiring sinus surgery alone were excluded from this review. RESULTS All fibrous dysplasias in this review were monostotic, 6 originating in the maxilla, 1 in the zygoma, and 1 in the ethmoid. Five lesions (4 maxillary, 1 zygomatic) caused cosmetic deformity without functional deficits and required resection and/or contouring only with minimal reconstruction. The remaining lesions were invasive such that function of the eye and/or dentition was affected. These lesions were treated by aggressive resection and various degrees of reconstruction to optimize function. CONCLUSIONS While fibrous dyplasia is classified as a benign process, local expansion can cause significant functional and aesthetic deformities. Each lesion should be thoroughly evaluated and, when vital structures are involved or threatened, total or subtotal resection should be considered. A variety of options should be available to the surgeon for definitive primary reconstruction.
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Affiliation(s)
- J L Frodel
- Division of Otolaryngology, Plastic and Reconstructive Surgery, Department of Surgery, 2211 Lomas Blvd NE, ACC Second Floor, University of New Mexico Health Sciences Center, Albuquerque, NM 87131-5341, USA
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17
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Osteosarcoma of the Mandible Initially Diagnosed as Atypical Fibro-Osseous Lesion. Oral Maxillofac Surg Clin North Am 1997. [DOI: 10.1016/s1042-3699(20)30360-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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19
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Fibrous Dysplasia of the Facial Bones. Oral Maxillofac Surg Clin North Am 1997. [DOI: 10.1016/s1042-3699(20)30965-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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20
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Ozaki T, Lindner N, Blasius S. Dedifferentiated chondrosarcoma in Albright syndrome. A case report and review of the literature. J Bone Joint Surg Am 1997; 79:1545-51. [PMID: 9378741 DOI: 10.2106/00004623-199710000-00012] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- T Ozaki
- Department of Orthopaedics, University of Münster, Germany
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Yalniz E, Er T, Ozyilmaz F. Fibrous dysplasia of the spine with sarcomatous transformation: a case report and review of the literature. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 1995; 4:372-4. [PMID: 8983661 DOI: 10.1007/bf00300303] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A fibrosarcoma is reported in the spine of a 53-year-old man with polyostotic fibrous dysplasia. There was no history of endocrine disturbances and no previous irradiation. Malignant transformation in fibrous dysplasia is rare. A review of the literature reveals 101 cases of malignant degeneration occurring in fibrous dysplasia. We believe that this is the first report of sarcomatous change arising in an area of fibrous dysplasia in the spine.
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Affiliation(s)
- E Yalniz
- Department of Orthopaedic Surgery, University of Trakya, Edirne, Turkey
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