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Oh HJ, Yoon HJ, Huh KH, Kim B, Kwon IJ, Kim SM, Park JY, Choi SW, Lee JH. Surgical management and final outcomes of chondrosarcoma of the temporomandibular joint: case series and comprehensive literature review. World J Surg Oncol 2023; 21:253. [PMID: 37596637 PMCID: PMC10439660 DOI: 10.1186/s12957-023-03143-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 08/08/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Surgical management for chondrosarcoma of the temporomandibular joint (TMJ) is challenging due to the anatomical location involving the facial nerve and the functional joint. The purpose of this case series was to analyze the largest number of TMJ chondrosarcoma cases reported from a single institution and to review the literature about chondrosarcoma involving the TMJ. METHODS Ten TMJ chondrosarcoma patients at Seoul National University Dental Hospital were included in this study. Radiographic features, surgical approaches, histopathologic subtypes, and treatment modalities were evaluated. All case reports of TMJ chondrosarcoma published in English from 1954 to 2021 were collected under PRISMA guidelines and comprehensively reviewed. RESULTS The lesions were surgically resected in all 10 patients with efforts to preserve facial nerve function. Wide excision including margins of normal tissue was performed to ensure adequate resection margins. All TMJs were reconstructed with a metal condyle except one, which was reconstructed with vascularized costal bone. At last follow-up, all patients were still alive, and there had been no recurrence. Among 47 cases (patients from the literature and our cases), recurrence was specified in 43 and occurred in four (9.5%). CONCLUSIONS For surgical management of TMJ chondrosarcoma, wide excision must consider preservation of the facial nerve. Reconstruction using a metal condyle prosthesis and a vascularized free flap is reliable. A more conservative surgical approach correlates with a favorable prognosis for facial nerve recovery. Nevertheless, wide excision is imperative to prevent tumor recurrence. In cases in which the glenoid fossa is unaffected by the tumor, it is deemed unnecessary to reconstruct the glenoid fossa within an oncological setting.
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Affiliation(s)
- Hyun Jun Oh
- Oral Oncology Clinic, National Cancer Center, Goyang, Korea
| | - Hye-Jung Yoon
- Department of Oral Pathology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Kyung-Hoe Huh
- Department of Oral and Maxillofacial Radiology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Bongju Kim
- Dental Life Science Research Institute, Innovation Research & Support Center for Dental Science, Seoul National University Dental Hospital, Seoul, Korea
| | - Ik-Jae Kwon
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Soung Min Kim
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Joo Yong Park
- Oral Oncology Clinic, National Cancer Center, Goyang, Korea
| | - Sung Weon Choi
- Oral Oncology Clinic, National Cancer Center, Goyang, Korea
| | - Jong-Ho Lee
- Oral Oncology Clinic, National Cancer Center, Goyang, Korea.
- Dental Life Science Research Institute, Innovation Research & Support Center for Dental Science, Seoul National University Dental Hospital, Seoul, Korea.
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Khadembaschi D, Jafri M, Praveen P, Parmar S, Breik O. Does neoadjuvant chemotherapy provide a survival benefit in maxillofacial osteosarcoma: A systematic review and pooled analysis. Oral Oncol 2022; 135:106133. [DOI: 10.1016/j.oraloncology.2022.106133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 09/14/2022] [Accepted: 09/17/2022] [Indexed: 11/06/2022]
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Al Laham O, Abdul Khalek G, Alboushi H, Al Mohammad AAH, Almaydaani M, Alhanwt A. An extremely scarce incidence of primary Undifferentiated Pleomorphic Sarcoma of the Scalp of a 52-year-old female - A Case Report. Int J Surg Case Rep 2022; 99:107685. [PMID: 36150332 PMCID: PMC9568790 DOI: 10.1016/j.ijscr.2022.107685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/17/2022] [Accepted: 09/18/2022] [Indexed: 12/01/2022] Open
Abstract
Introduction and importance Sarcomas are malignant mesenchymal-cell tumors that comprise 1 % of all adult tumors. Undifferentiated Pleomorphic Sarcoma comprises a vastly rare subtype. It mostly occurs in males in their 6th decade of life. However, their exact incidence remains poorly demarcated, especially those occurring in the scalp. Since they lack any disease-specific presentations, we should maintain high clinical suspicion when presented with similar cases. Case presentation Herein, we demonstrate the clinical case of a 52-year-old Middle Eastern female, who presented to the outpatient clinic complaining of a one-year history of progressively growing protuberance in her right side of the scalp. It was painful and rapidly increased in size. Presurgical radiological assessment suspected a cystic formation. Utter resection of the mass was achieved, and histopathological analysis diagnosed it as a primary Undifferentiated Pleomorphic Sarcoma. Clinical discussion Meticulous surgical resection was the cornerstone treatment of our patient. Radiological imaging in addition to clinical suspicion was utilized for preoperative assessment. This patient has had a successful post-surgical recovery. She has been surveilled for 6 months so far with no evidence of tumor recurrence, metastasis, or clinical complications. Conclusion It is especially rare to see a primary Undifferentiated Pleomorphic Sarcoma in any patient population. It's even rarer that it occurs in such a patient demographic. Hence, it's vital that we document cases of this rare malignancy because that would lead the way in conducting informative clinical studies which enable physicians to select the proper treatment modality. Sarcomas are malignant mesenchymal-cell tumors that comprise 1 % of all adult tumors. Undifferentiated Pleomorphic Sarcoma comprises a rare subtype. It mostly occurs in males in their 6th decade. UPS showed higher tendencies to occur in males rather than females and favored the White rather than African race. To establish a final diagnosis relies on competent histopathological and immunohistochemical analysis. The ideal management of UPS occurring in the head and neck is utter surgical resection with free margins of 2 cm.
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Ram H, Kumar S, Singh SN, Kumar P, Singh G, Ganguly R, Sagar M, Howlader D. Head and neck sarcomas-clinicopathological findings, treatment modalities and its outcome - A retrospective study. Ann Maxillofac Surg 2021; 11:280-286. [PMID: 35265499 PMCID: PMC8848714 DOI: 10.4103/ams.ams_366_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 09/16/2021] [Accepted: 09/29/2021] [Indexed: 11/04/2022] Open
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Evaluation of primary lateral neck mass in adults: Cross sectional study. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.703630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
OBJECTIVE To describe the incidence, types, features, treatment and outcomes of head and neck sarcoma managed at a treatment center in eastern China. METHODS Cases of head and neck soft tissue sarcoma and osteogenic sarcoma treated at the Stomatology Hospital of Nanjing University between 2008 and 2018 were retrospectively analyzed. Patient characteristics, site of lesion, main presenting symptoms, treatment, histology, local recurrence, development of metastatic disease, duration of follow-up and survival rates are described and compared. RESULTS Sixty-three patients were diagnosed with head or neck sarcoma of which 42.9% had soft tissue sarcoma and 57.1% had osteogenic sarcoma. Of soft tissue sarcoma patients, the most frequently observed histologies were fibrosarcoma and malignant fibrous histiocytoma. Of 36 cases of osteogenic sarcoma, osteosarcoma, and fibrosarcoma of bone were most frequent. Mean latency period between initial symptoms and clinical presentation was 4.5 months. Radical resection was performed on 56 patients. For 33 patients, resection and radiotherapy were used and 10 patients received a triple combination of resection, chemotherapy and radiotherapy. Within the observation period, 17 patients died. CONCLUSIONS Head and neck sarcomas, although rare, can represent a variety of pathological diagnoses. Surgery remains the main intervention although the data suggest chemotherapy, radical resection and irradiation as treatment. Outcomes are poor with high rates of local recurrence. Positive prognostic factors were tumor-free resection margins and choice of therapy. Due to the rarity of head and neck sarcoma, information remains limited and choice of treatment should be within the focus of clinical multi-center studies.
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de Carvalho WRS, de Souza LL, Pontes FSC, Uchôa DCC, Corrêa DL, de Cáceres CVBL, Lopes MA, Santos-Silva AR, Vargas PA, de Andrade BAB, Romañach M, Gomez RS, Costa SFDS, Batista AC, Mendonça EF, Pinto DDS, Gondak R, da Cruz Perez DE, Nonaka C, Dos Santos JN, Libório-Kimura TN, Câmara J, Ramôa Pires F, de Souza LB, Martins MD, de Almeida OP, Fonseca FP, Pontes HAR. A multicenter study of oral sarcomas in Brazil. Oral Dis 2019; 26:43-52. [PMID: 31605560 DOI: 10.1111/odi.13211] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 07/20/2019] [Accepted: 07/22/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the prevalence of oral sarcomas from geographic regions of Brazil. MATERIALS AND METHODS A cross-sectional study was conducted on biopsies obtained from January 2007 to December 2016 at twelve Brazilian oral and maxillofacial pathology centres. Gender, age, evolution time, clinical aspects, tumour location, tumour size at diagnosis, radiographic aspects and histopathological diagnosis were evaluated. Data were analysed using descriptive statistical methods. RESULTS From 176,537, a total of 200 (0.11%) oral sarcomas were reported, and the most prevalent were osteosarcomas (74 cases; 37%) and Kaposi's sarcomas (52 cases; 26%). Males were more affected than females at a mean age of 32.2 years old (range of 3-87 years). The most common symptoms were swelling¸ localised pain and bleeding at a mean evolution time of 5.14 months (range <1-156 months). The lesions were mostly observed in the mandible (90 cases; 45%), with a mean tumour size of 3.4 cm (range of 0.3-15 cm). Radiographically, the lesions presented a radiolucent aspect showing cortical bone destruction and ill-defined limits. CONCLUSIONS Oral sarcomas are rare lesions with more than 50 described subtypes. Osteosarcomas and Kaposi's sarcomas were the main sarcomas of the oral cavity in Brazil.
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Affiliation(s)
- Waldner Ricardo Souza de Carvalho
- Service of Oral Pathology, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil.,Oral Diagnosis Department (Pathology and Semiology), Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Lucas Lacerda de Souza
- Service of Oral Pathology, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | | | | | - Davi Lavareda Corrêa
- Service of Oral Pathology, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | | | - Márcio Ajudarte Lopes
- Oral Diagnosis Department (Pathology and Semiology), Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department (Pathology and Semiology), Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Pablo Agustin Vargas
- Oral Diagnosis Department (Pathology and Semiology), Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | | | - Mário Romañach
- Oral Pathology, Dental School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Sara Ferreira Dos Santos Costa
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | | | | | - Rogério Gondak
- Department of Pathology, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | - Cassiano Nonaka
- Post-graduate Program of Dentistry, State University of Paraíba, Campina Grande, Brazil
| | - Jean Nunes Dos Santos
- Laboratory of Oral Surgical Pathology, School of Dentistry, Federal University of Bahia, Salvador, Brazil
| | | | - Jeconias Câmara
- Department of Pathology and Legal Medicine, Federal University of Amazonas, Manaus, Brazil
| | - Fábio Ramôa Pires
- Oral Pathology, Dental School, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lélia Batista de Souza
- Postgraduate Program in Oral Pathology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Manoela Domingues Martins
- Department of Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Oslei Paes de Almeida
- Oral Diagnosis Department (Pathology and Semiology), Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Hélder Antônio Rebelo Pontes
- Service of Oral Pathology, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil.,Oral Diagnosis Department (Pathology and Semiology), Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Osteogenic sarcoma of the skull: long-term outcome of a rare tumor. Childs Nerv Syst 2018; 34:2149-2153. [PMID: 30120533 DOI: 10.1007/s00381-018-3937-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 07/26/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Osteogenic sarcoma of the skull is uncommon and long-term outcome is not well defined. We review the literature and present a pediatric case of calvarial osteogenic sarcoma with good long-term oncological and cosmetic outcome and excellent quality of life. This case presented major surgical challenges, which are detailed. CASE DESCRIPTION A 6-year-old boy presented with a painless 5 cm × 5 cm lump over the vertex region. He was neurologically normal. Imaging showed an extensive bony lesion with intradural extension. After incisional biopsy showed probable low grade osteosarcoma, a complete en bloc resection with margins was attempted via a concentric craniotomy around the lesion after embolization to reduce blood loss. Invasion of the brain by the tumor precluded the complete en bloc resection, but gross total resection was achieved. The final pathology was consistent with a low-grade osteosarcoma and adjuvant chemotherapy was provided. Follow-up for 8 years has shown no recurrence with good cosmetic and functional outcome.
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Tudor-Green B, Fonseca FP, Gomez RS, Brennan PA. Current update on the diagnosis and management of head and neck hard tissue sarcomas. J Oral Pathol Med 2017; 46:667-673. [DOI: 10.1111/jop.12573] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2017] [Indexed: 12/29/2022]
Affiliation(s)
- Ben Tudor-Green
- Department of Plastic and Reconstructive Surgery; Royal Devon & Exeter Hospital; Exeter UK
- 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; Belo Horizonte Brazil
| | - Ricardo S. Gomez
- Department of Oral Surgery and Pathology; School of Dentistry; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| | - Peter A. Brennan
- Department of Oral and Maxillofacial Surgery; Queen Alexandra Hospital; Portsmouth UK
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10
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König M, Osnes TA, Lobmaier I, Bjerkehagen B, Bruland ØS, Sundby Hall K, Meling TR. Multimodal treatment of craniofacial osteosarcoma with high-grade histology. A single-center experience over 35 years. Neurosurg Rev 2016; 40:449-460. [PMID: 27858303 DOI: 10.1007/s10143-016-0802-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 10/06/2016] [Accepted: 11/09/2016] [Indexed: 11/28/2022]
Abstract
High-grade craniofacial osteosarcoma (CFOS) is an aggressive malignancy with a poor prognosis. Our goals were to evaluate treatment outcomes in those treated at a single referral institution over 35 years and to compare our results to the available literature. A retrospective analysis of all 42 patients treated between 1980 and 2015 at Oslo University Hospital, Norway, identified in a prospectively collected database, was conducted. Mean follow-up was 79.6 months. Overall survival at 2 and 5 years was 70.5 and 44.7%, respectively. The corresponding disease-specific survival rates were 73.0 and 49.8%. Treatment was surgery only in eight cases. Additional therapy was administered in 34 patients: chemotherapy in nine, radiotherapy in seven, and a combination of these in 18 cases. Stratified analysis by resection margins demonstrated significantly better survival at 2 and 5 years after radical surgical treatment. Neoadjuvant chemotherapy and subsequent adequate surgery resulted in better survival than surgery alone. Half of the patients either had a primary or familial cancer predisposition. This is the largest single-center study conducted on high-grade CFOS to date. Our experience indicates that neoadjuvant chemotherapy with complete surgical resection significantly improved survival, compared to surgery alone.
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Affiliation(s)
- Marton König
- Department of Neurosurgery, Oslo University Hospital - Rikshospitalet, 4950 Nydalen, Oslo, 0424, Norway. .,Department of Neurology, Ostfold Hospital Trust, 300, Gralum, 1714, Norway. .,Institute of Clinical Medicine, University of Oslo, 1711 Blindern, Oslo, 0318, Norway.
| | - Terje A Osnes
- Institute of Clinical Medicine, University of Oslo, 1711 Blindern, Oslo, 0318, Norway.,Department of Otorhinolaryngology, Oslo University Hospital - Rikshospitalet, 4950 Nydalen, 0424, Oslo, Norway
| | - Ingvild Lobmaier
- Department of Pathology, Oslo University Hospital - Radiumhospitalet, 4950 Nydalen, Oslo, 0424, Norway
| | - Bodil Bjerkehagen
- Department of Pathology, Oslo University Hospital - Radiumhospitalet, 4950 Nydalen, Oslo, 0424, Norway
| | - Øyvind S Bruland
- Institute of Clinical Medicine, University of Oslo, 1711 Blindern, Oslo, 0318, Norway.,Department of Oncology, Oslo University Hospital - Radiumhospitalet, 4950 Nydalen, Oslo, 0424, Norway
| | - Kirsten Sundby Hall
- Department of Oncology, Oslo University Hospital - Radiumhospitalet, 4950 Nydalen, Oslo, 0424, Norway
| | - Torstein R Meling
- Department of Neurosurgery, Oslo University Hospital - Rikshospitalet, 4950 Nydalen, Oslo, 0424, Norway.,Institute of Clinical Medicine, University of Oslo, 1711 Blindern, Oslo, 0318, Norway
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Chauhan NP, Pai KM, Mutalik S, Balakrishnan R, Valiathan M, Sujir N. A progressively enlarging swelling of the palate. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117:132-7. [DOI: 10.1016/j.oooo.2012.06.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Revised: 06/10/2012] [Accepted: 06/19/2012] [Indexed: 10/27/2022]
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12
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Rapidis AD. Sarcomas of the head and neck in adult patients: current concepts and future perspectives. Expert Rev Anticancer Ther 2014; 8:1271-97. [DOI: 10.1586/14737140.8.8.1271] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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13
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Malignant Diseases. Oral Radiol 2014. [DOI: 10.1016/b978-0-323-09633-1.00024-9] [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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14
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Kämmerer PW, Shabazfar N, Vorkhshori Makoie N, Moergel M, Al-Nawas B. Clinical, therapeutic and prognostic features of osteosarcoma of the jaws – Experience of 36 cases. J Craniomaxillofac Surg 2012; 40:541-8. [DOI: 10.1016/j.jcms.2011.10.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Revised: 09/27/2011] [Accepted: 10/06/2011] [Indexed: 10/15/2022] Open
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15
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Ramos-Murguialday M, Lasa-Menéndez V, Ignacio Iriarte-Ortabe J, Couce M. Chondrosarcoma of the Mandible Involving Angle, Ramus, and Condyle. J Craniofac Surg 2012; 23:1216-9. [DOI: 10.1097/scs.0b013e3182565b80] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abstract
Sarcomas are malignant neoplasms originating from mesodermal tissues and constitute less than 1% of body's tumors, including those of the head and neck region. 5-15% of adult sarcomas are in the head and neck region (20% from bones and cartilages and 80% in soft tissues). Commonly encountered sarcomas in the head and neck region are - osteosarcoma, rhabdomyosarcoma, malignant fibrous histiocytoma, fibrosarcoma and angiosarcoma. This article reviews the available literature on head and neck sarcomas.
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Affiliation(s)
- A S Aljabab
- Head and Neck Surgical Oncology, Department of Surgery, University of Manitoba and Cancer Care Manitoba, 675, Mc Dermot Ave, Winnipeg, R3E 0V9 Canada
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Clinicopathological analysis of head and neck chondrosarcoma: three case reports and literature review. Int J Oral Maxillofac Surg 2012; 41:203-10. [DOI: 10.1016/j.ijom.2011.10.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Revised: 07/19/2011] [Accepted: 10/07/2011] [Indexed: 10/15/2022]
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18
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Santos-Silva AR, Ribeiro ACP, Furuse CF, Simonato LE, Mattar NJ, Soubhia AMP, Miyahara GI. Maxillary osteosarcoma in a young patient undergoing postorthodontic treatment follow-up: the importance of ongoing oral examinations. Am J Orthod Dentofacial Orthop 2011; 139:845-8. [PMID: 21640892 DOI: 10.1016/j.ajodo.2009.09.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2009] [Revised: 09/01/2009] [Accepted: 09/01/2009] [Indexed: 10/18/2022]
Abstract
Osteosarcoma is a common primary malignant tumor in long bones; it generally occurs in young adults. It is considered infrequent in the head and neck regions, where it is usually associated with poor outcomes and rates of survival. From a histopathologic point of view, osteosarcomas are commonly classified as osteoblastic, chondroblastic, or fibroblastic, although several unusual microscopic subtypes have also been reported. The purpose of this article was to present a case report of a maxillary chondroblastic osteosarcoma involving the maxillary sinus and the maxilla of a young woman who was diagnosed during early postorthodontic treatment follow-up. Treatment, prosthetic rehabilitation, and follow-up details are provided. Most importantly, this patient shows the importance of complete and systematic oral examinations during any routine dental treatment.
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Affiliation(s)
- Alan Roger Santos-Silva
- Campinas State University (UNICAMP), Piracicaba Dental School, Department of Oral Diagnosis, Semiology Area, Piracicaba, São Paulo, Brazil.
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Garzino-Demo P, Tanteri G, Boffano P, Ramieri G, Pacchioni D, Maletta F, Bianchi CC, Bianchi SD, Berrone S. Chondrosarcoma of the Temporomandibular Joint: A Case Report and Review of the Literature. J Oral Maxillofac Surg 2010; 68:2005-11. [DOI: 10.1016/j.joms.2009.09.077] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2009] [Revised: 08/02/2009] [Accepted: 09/23/2009] [Indexed: 11/15/2022]
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21
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Chondrosarcoma of the jaw: a closer look at its management. J Oral Maxillofac Surg 2008; 66:2349-55. [PMID: 18940505 DOI: 10.1016/j.joms.2006.05.069] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2005] [Revised: 02/08/2006] [Accepted: 05/25/2006] [Indexed: 01/04/2023]
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22
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Fischer DJ, Klasser GD, Epstein JB. Cancer and Orofacial Pain. Oral Maxillofac Surg Clin North Am 2008; 20:287-301, vii. [DOI: 10.1016/j.coms.2007.12.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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23
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Haddad H, Benchakroun N, Sahraoui S, Benider A. [Osteosarcoma of the skull base: a case report]. Neurochirurgie 2007; 53:483-5. [PMID: 18061213 DOI: 10.1016/j.neuchi.2007.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2007] [Accepted: 08/04/2007] [Indexed: 10/22/2022]
Abstract
Osteosarcoma, usually observed in long bones, is the second most frequent primitive malignant bone tumor after myeloma. The skull base is an exceptional localization. We report a case of skull base osteosarcoma managed in our department. A 23-year-old female was admitted for bilateral epistaxis, headache, decreasing visual acuity then blindness. Physical examination revealed bilateral blindness and exophthalmia. Cranial magnetic resonance imaging showed a voluminous mass in the skull base extending to the nasosinusal area. A rhinoseptal surgical approach was used but the tumor was so huge that excision was impossible. The biopsy identified at an osteoblastic osteosarcoma. Search for extension (chest computed tomography and abdominal ultrasonography) was negative. Chemotherapy was to be delivered before combination chemoradiotherapy but the patient died before any treatment could be started. Osteosarcoma of the skull base is very rare. The treatment is based on surgery which should be as complete as possible followed by chemoradiotherapy. Prognosis is poor. Median survival is around six months.
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Affiliation(s)
- H Haddad
- Centre d'oncologie Ibn-Rochd, CHU d'Ibn-Rochd, Casablanca, Maroc.
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Near-Total Mandible Reconstruction With a Single Fibula Flap Containing Fibrous Dysplasia in McCune Albright Syndrome. J Craniofac Surg 2007; 18:1479-82. [DOI: 10.1097/scs.0b013e3180a772ea] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Smith RB, Apostolakis LW, Karnell LH, Koch BB, Robinson RA, Zhen W, Menck HR, Hoffman HT. National Cancer Data Base report on osteosarcoma of the head and neck. Cancer 2003; 98:1670-80. [PMID: 14534884 DOI: 10.1002/cncr.11716] [Citation(s) in RCA: 104] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Osteosarcoma is the most common primary bone malignancy overall but is encountered infrequently in the head and neck. Limited data are available on the significance of prognostics factors and results of therapy for patients with head and neck osteosarcoma (HNOS). It is known that surgical therapy is critical to successful outcome. The impact of adjuvant chemotherapy has not been defined well. METHODS The National Cancer Data Base has collected data on cases of HNOS by voluntary accrual from participating hospitals. This database was used to assess patient demographics, tumor characteristics, treatment, and outcome for an 11-year period extending from 1985 to 1996. RESULTS The data set contained 496 cases of HNOS. Overall, the 5-year disease-specific survival rate was 59.7%. Factors associated with a poor prognosis were age older than 60 years; nonmandibular tumor location; tumor size > 6 cm; histologic type of osteoblastic, not otherwise specified (NOS); advanced disease stage; nonsurgical initial therapy; and positive margins of resection. Increased use of multimodality therapy was noted during the later years of the study. No substantial difference in the 5-year survival rate was noted between treatment with surgery alone (74.7%) and surgery with adjuvant chemotherapy (71.3%), despite the greater prevalence of tumors with poor prognostic factors in the surgery and adjuvant chemotherapy group. CONCLUSIONS Surgery with clear margins is an important factor in successful therapy for patients with HNOS. Improved survival has been noted within the last 2 decades compared with historic controls. Multiple negative prognostic factors have been identified and should be considered in treatment planning. The role of chemotherapy has not been defined well, but its incorporation into treatment of patients with high-risk tumors may improve survival.
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Affiliation(s)
- Russell B Smith
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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Rosenthal MA, Mougos S, Wiesenfeld D. High-grade maxillofacial osteosarcoma: evolving strategies for a curable cancer. Oral Oncol 2003; 39:402-4. [PMID: 12676262 DOI: 10.1016/s1368-8375(02)00147-1] [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] [Indexed: 10/27/2022]
Abstract
Maxillofacial osteosarcoma is a rare tumour. Curative treatment strategies have evolved to include chemotherapy in addition to definitive surgical resection. To review and report our experience in eight patients with maxillofacial osteosarcomas, we retrospectively reviewed eight patients with high-grade maxillofacial osteosarcoma seen over the last decade at our institution. Our results suggest that a combined surgical and chemotherapy approach provides excellent local disease control and high cure rates.
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Affiliation(s)
- M A Rosenthal
- Department of Medical Oncology and Clinical Haematology, Royal Melbourne Hospital, Parkville, Victoria, Australia 3050.
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Abstract
PURPOSE OF REVIEW This review discusses the classification, etiology, diagnosis, evaluation, treatment, and prognosis of sarcoma of the head and neck region. RECENT FINDINGS Sarcomas account for less than 1% of all malignancies in the United States with only 5 to 15% of these sarcomas occurring in the head and neck region. However, about 1 in 3 pediatric sarcomas will occur in the head and neck region. Occasionally, these tumors are associated with genetic syndromes or previous radiation exposures, but, most commonly, no clear etiology exists. Pathologic classification is critical to the ultimate treatment and prognosis of sarcoma of the head and neck. Osteosarcoma, rhabdomyosarcoma, malignant fibrous histiocytoma, and angiosarcoma are the most common types of sarcoma to occur in the head and neck region; however, up to 20% of head and neck sarcomas will remain unclassified. Surgery has been central to the management of these malignancies with some exceptions in the pediatric population. Adjuvant chemotherapy is being utilized and/or studied for most high-grade sarcomas and adjuvant radiotherapy is important for disease control in high-grade soft-tissue sarcomas. Prognosis is clearly related to tumor grade and margin status. SUMMARY Sarcomas of the head and neck region are rare malignancies often without a clear etiology. Expert pathologic review and classification is critical, as are quality imaging and multidisciplinary management.
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Affiliation(s)
- Erich M Sturgis
- Department of Head and Neck Surgery, The University of Texas M D Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 441, Houston, TX 77030-4009, USA.
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Abstract
With the exception of pediatric RMS, soft tissue sarcomas only rarely arise in the head and neck region. Soft tissue sarcomas include a diverse array of histologic types because of the variety of mesenchymal tissues from which they originate. The combination of infrequent occurrence, varied pathologic features, and the many potential sites of presentation makes these tumors a challenge for the head and neck oncologist and underscore the need for review by a pathologist experienced with soft tissue tumors. Classification schemes that group sarcomas according to grade have been helpful in providing prognostic information. Although local control of the primary tumor is critical to successful treatment of both high- and low-grade lesions, the high rate of distant metastases in high-grade tumors supports the role of combined modality therapy. Compared with other types of head and neck neoplasms, such as squamous cell carcinoma, soft tissue sarcomas have low rates of regional metastases. Surgery generally has been recommended as the primary method of treatment for achieving local control, except in those high-grade tumors arising in sites not amenable to resection. Exceptions to this principle include RMSs of the orbit, paranasal sinuses, and masticator space in children; these are usually treated with radiotherapy and combined multiagent chemotherapy, thereby avoiding the functional and cosmetic impact of surgery. Also, extensive angiosarcomas of the scalp should be treated with multimodality therapy combining surgery and wide-field radiation therapy in an attempt to achieve local control. Adjuvant radiotherapy is generally recommended for high-grade sarcomas, large tumors, close or positive surgical margins, and certain histologic variants. Systemic chemotherapy is recommended for those tumors with a significant risk of distant metastases. Increasingly, neoadjuvant chemotherapy is being used to determine responsiveness to chemotherapy, which can help physicians select patients who may benefit from systemic postoperative therapy. Traditional predictors of treatment failure for soft tissue sarcomas include larger tumor size, high-grade histology, and positive surgical margins. The advent of more advanced reconstructive techniques, including free tissue transfer, has made more aggressive surgical resection of these tumors possible. Nevertheless, a considerable number of ancillary support staff are critical to the patient's postoperative rehabilitation and eventual return to a satisfactory level of function and quality of life. In the future, the discovery of the molecular pathogenesis of specific tumor types, such as the cytogenetic findings in synovial sarcoma, will improve physicians' prognostic abilities and selection of patients who are most likely to benefit from emerging adjuvant therapies.
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Affiliation(s)
- Bryan O Potter
- Department of Head and Neck Surgery, University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 441, Houston, TX 77030-4009, USA
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Cardoso Guimarães G, Rodrigues De Souza R, Paiva Gadêlha Guimarães A, Filho WD, Valeschka De Matos Granja N, Karan Kalil R, Augusto Soares F, Lopes A. Penile metastasis of chondrosarcoma of the jaw. Urology 2003; 61:837. [PMID: 12670583 DOI: 10.1016/s0090-4295(02)02431-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Metastasis to the penis is an unusual event. Bladder and prostate tumors are the main sources of penile metastasis. Other sites include the rectosigmoid, kidney, and, less frequently, the pancreas, liver, nasopharynx, and lung. Other sources include malignant melanoma and Burkitt's lymphoma. The differential diagnosis includes idiopathic priapism, venereal or infectious disease, tuberculosis, Peyronie's disease, and primary penile tumor. Chondrosarcoma of the jaw is responsible for 10% of all chondrosarcomas that originate with craniofacial bones. Its behavior is usually characterized by local aggression; however, distant metastasis is uncommon. We report a case of chondrosarcoma of the jaw with penile metastasis. This is the first case described in published medical reports.
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Affiliation(s)
- Gustavo Cardoso Guimarães
- Department of Pelvic Surgery, Centro de Tratamento e Pesquisa Hospital do Câncer, A. C. Camargo, São Paulo, Brazil
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