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Nakai Y, Nakai F, Matsuki Y, Hanai R, Nakagawa K, Takayama Y, Matsuo C, Higuchi S, Miyazaki R, Sukegawa S, Miyake M. Treatment of mandibular Ewing’s sarcoma in a child: A rare case and literature review. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2022. [DOI: 10.1016/j.ajoms.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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2
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Outcomes in Pediatric Maxillofacial Reconstruction With Vascularized Fibular Flaps: A Systematic Review. J Craniofac Surg 2022; 33:1346-1351. [PMID: 35184106 DOI: 10.1097/scs.0000000000008511] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 01/06/2022] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND The purpose of this study was to examine the complications and outcomes after maxillofacial reconstruction using the free fibular flap in the pediatric population. METHODS A systematic review and descriptive analysis were conducted using data variables, including study characteristics; patient characteristics; postoperative complications (major and minor); surgical revision; and dental rehabilitation. RESULTS The systematic review resulted in 1622 articles, 55 of which met inclusion criteria for this study. The 55 articles consisted of 17 case series and 38 case reports with level III/IV and level V of evidence, respectively. Of the 155 identified pediatric patients, the rate of major complications was 13.5% and minor complications was 24.5%. The most common complication was mild growth distortion (n = 7) at the recipient site. Complications at the donor site were less common. During follow-up, 29 patients (18.7%) underwent or awaited surgical revision, and 43 patients (27.7%) underwent or awaited dental rehabilitation. CONCLUSIONS Our study suggests that the free fibular flap for pediatric maxillofacial reconstruction is safe and reliable. Additionally, surgical revision to correct the functional impairments resulting from primary reconstruction using the free fibular flap is relatively common.
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Chen J, Yuan T, Liu X, Hua B, Dong C, Liu Y, Quan G. Ewing's Sarcoma/Peripheral Primitive Neuroectodermal Tumors in Bronchus. Am J Med Sci 2018; 357:75-80. [PMID: 30314832 DOI: 10.1016/j.amjms.2018.08.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 07/03/2018] [Accepted: 08/15/2018] [Indexed: 11/19/2022]
Abstract
Ewing sarcoma/peripheral primitive neuroectodermal tumors (ES/pPNET), a member of the Ewing sarcoma family of tumors, is a malignant soft tissue tumor with small undifferentiated neuroectodermal cells. Primary trachea-bronchial ES/pPNET is very rare. The most common pulmonary ES is due to a metastasis. We describe a case of ES/pPNET which originated in the left basal trunk bronchus. The patient was a 30-year-old male, presenting with irritable cough and fever for 10 days. A tumor of 60 mm in diameter was found in the left basal trunk bronchus, extending to the left lower lobe. No distant metastases were detected. Histopathological examination revealed a malignancy of ES/pPNET with a diffuse proliferation of round cells, a Flexner-Wintersteiner rosette formation and positive staining for CD99. The patient was successfully treated with a combination of left lower lobectomy and adjuvant chemotherapy and has remained disease-free for approximately 18 months at follow-up. This case highlights that ES/pPNET should be considered as a differential diagnosis in cases of trachea-bronchial tumors.
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MESH Headings
- Adult
- Bronchi/pathology
- Bronchial Neoplasms/diagnosis
- Bronchial Neoplasms/diagnostic imaging
- Bronchial Neoplasms/drug therapy
- Bronchial Neoplasms/surgery
- Humans
- Male
- Neuroectodermal Tumors, Primitive, Peripheral/diagnosis
- Neuroectodermal Tumors, Primitive, Peripheral/diagnostic imaging
- Neuroectodermal Tumors, Primitive, Peripheral/drug therapy
- Neuroectodermal Tumors, Primitive, Peripheral/surgery
- Sarcoma, Ewing/diagnosis
- Sarcoma, Ewing/diagnostic imaging
- Sarcoma, Ewing/drug therapy
- Sarcoma, Ewing/surgery
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Affiliation(s)
- Jun Chen
- Department of Medical imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Tao Yuan
- Department of Medical imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiao Liu
- Department of Medical imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Bei Hua
- Department of Medical imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Chenfeng Dong
- Department of Medical imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yawu Liu
- Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland; * Now Jun Chen works in The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Guanmin Quan
- Department of Medical imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
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Iatrou I, Theologie-Lygidakis N, Schoinohoriti O, Tzermpos F, Mylonas AI. Ewing's sarcoma of the maxillofacial region in Greek children: Report of 6 cases and literature review. J Craniomaxillofac Surg 2018; 46:213-221. [DOI: 10.1016/j.jcms.2017.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 11/02/2017] [Accepted: 12/08/2017] [Indexed: 11/28/2022] Open
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Casaroto AR, DA Silva Sampieri MB, Soares CT, DA Silva Santos PS, Yaedu RYF, Damante JH, Lara VS. Ewing's Sarcoma Family Tumors in the Jaws: Case Report, Immunohistochemical Analysis and Literature Review. In Vivo 2017; 31:481-491. [PMID: 28438883 PMCID: PMC5461465 DOI: 10.21873/invivo.11087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 03/27/2017] [Accepted: 03/31/2017] [Indexed: 12/26/2022]
Abstract
Due to the low incidence of the Ewing's Sarcoma (ES) family tumors, the available epidemiology is likely to be unreliable, and at present, there are no standard diagnostic or clinical guidelines outlining their management. This report describes a case of peripheral primitive neuroectodermal tumor (ES/pPNET) which initially mimicked cystic lesions, and describes a comparison between ES and ES/pPNET in the jaws by the World Health Organization classification. This review addressed 63 cases published in the English literature between 1950 and 2016. The majority of cases were ES. Both ES and ES/pPNET mimicked other benign entities such as traumatic, cystic and inflammatory lesions. The patients who died of their disease had a history of metastatic tumors, and primary tumor located in the mandible and maxilla for ES and ES/pPNET, respectively. The differentiation of the ES family tumors from other small blue-cell tumors may be difficult and requires familiarity with histological and immunohistochemical features.
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Affiliation(s)
- Ana Regina Casaroto
- Department of Oral Pathology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil
| | | | | | | | | | - José Humberto Damante
- Department of Stomatology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil
| | - Vanessa Soares Lara
- Department of Oral Pathology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil
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Chatzistefanou I, Kabesi S, Paraskevopoulos K, Koliouskas D, Antoniades K. Ewing's Sarcoma of Mandible: An Impressive Case of Spontaneous Mandible Regeneration. Int J Clin Pediatr Dent 2016; 9:273-277. [PMID: 27843262 PMCID: PMC5086018 DOI: 10.5005/jp-journals-10005-1376] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 02/21/2016] [Indexed: 11/23/2022] Open
Abstract
Ewing's sarcoma (ES) is an uncommon aggressive bone malignancy that mainly affects children and adolescents. Mandible involvement is quite rare and usually represents metastasis from another skeletal site. Combined therapy including wide surgical resection and preoperative and postoperative chemotherapy has been demonstrated as the mainstay of therapeutic approach. As improved therapeutic modalities have significantly increased survival over the last decades, functional and esthetic reconstruction of the postmandibulectomy defect is usually necessary for patient's total rehabilitation. We report a case of ES of the mandible with special consideration to the postresection spontaneous structural and functional regeneration of the mandible. HOW TO CITE THIS ARTICLE Chatzistefanou I, Kabesi S, Paraskevopoulos K, Koliouskas D, Antoniades K. Ewing's Sarcoma of Mandible: An Impressive Case of Spontaneous Mandible Regeneration. Int J Clin Pediatr Dent 2016;9(3):273-277.
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Affiliation(s)
- Ioannis Chatzistefanou
- Resident, Department of Oral and Maxillofacial Surgery, Papanikolaou General Hospital, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Sotiria Kabesi
- Student, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Paraskevopoulos
- Resident, Department of Oral and Maxillofacial Surgery, Papanikolaou General Hospital, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Dimitrios Koliouskas
- Consultant and Chief, Department of Pediatrics, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Antoniades
- Professor, Department of Oral and Maxillofacial Surgery, Papanikolaou General Hospital, Aristotle University of Thessaloniki Thessaloniki, Greece
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Goswami M, Bhushan U, Jangra B. Goldenhar Syndrome: A Case Report with Review. Int J Clin Pediatr Dent 2016; 9:278-280. [PMID: 27843263 PMCID: PMC5086019 DOI: 10.5005/jp-journals-10005-1377] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 02/27/2016] [Indexed: 11/23/2022] Open
Abstract
Goldenhar syndrome is a rare condition which is characterized by a multitude of anomalies involving craniofacial structures, vertebrae, internal organs and usually occurs unilaterally. The etiology of this syndrome is unclear since it varies genetically and is linked to a plethora of reasons. Herein, we report a case of Goldenhar syndrome with hemifacial microsomia and microtia along with systemic involvement which was clinically and radio-graphically assessed. Many classical signs of the syndrome were present in the patient along with few rare ones. The various aspects of this rare disease have been discussed with emphasis on timely diagnosis and multidisciplinary approach to manage it. HOW TO CITE THIS ARTICLE Goswami M, Bhushan U, Jangra B. Goldenhar Syndrome: A Case Report with Review. Int J Clin Pediatr Dent 2016;9(3):278-280.
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Affiliation(s)
- Mridula Goswami
- Professor and Head, Department of Pedodontics and Preventive Dentistry Maulana Azad Institute of Dental Sciences, Delhi, India
| | - Urvashi Bhushan
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry Maulana Azad Institute of Dental Sciences, Delhi, India
| | - Babita Jangra
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry Maulana Azad Institute of Dental Sciences, Delhi, India
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Abstract
Ewing sarcoma (ES) is a primary bone malignant neoplasm and is the second most common primary malignancy of the bone found in childhood and adolescence after osteosarcoma. ES has an annual frequency in the population younger than 20 years of approximately 2.9 per million. ES occurs most frequently in the long bones of the extremities and pelvis and very rarely in the jaw. Recently, it was revealed that chromosomal translocation t(11;22)(q24;q12), which fuses the EWS gene on chromosome 22 and the FLI-1 gene on chromosome 11, occurs in most cases of ES. We report here a rare case of mandibular ES in a 10-year-old child with chromosomal translocation t(21;22)(q22;q12) in which the EWS gene is fused with the ERG gene on chromosome 21.
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Ewing's Sarcoma of Mandible: A Very Rare Disease and Review of Indian Literature. Indian J Surg Oncol 2014; 5:81-4. [PMID: 24669171 DOI: 10.1007/s13193-014-0293-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 01/21/2014] [Indexed: 10/25/2022] Open
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Keshani F, Jahanshahi G, Attar BM, Kalantari M, Razavi SM, Hashemzade Z, Tavakoli P. Ewing's sarcoma in mandibular similar to dental abscess. Adv Biomed Res 2014; 3:62. [PMID: 24627870 PMCID: PMC3950843 DOI: 10.4103/2277-9175.125841] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Accepted: 01/15/2013] [Indexed: 11/22/2022] Open
Abstract
Ewing's sarcoma is a rare malignant neoplasm that comprises approximately 4-6% of primary bone tumors. In most cases, femur and pelvis are affected, and less commonly the head and neck areas (in the jaws, usually the mandible). These tumors have been reported more frequently in males, mostly aged 5-20 years old. Systemic symptoms and signs such as fever, weight loss, anemia, leukocytosis, and elevated erythrocyte sedimentation rate (ESR) may be the first signs in oral Ewing's sarcoma. Such signs and symptoms are also seen in odontogenic infections and abscess. In one case, the patient went to a dentist with pain, swelling, and abscess similar to odontogenic infection and patient's tooth was pulled due to misdiagnosis. This tumor has an aggressive clinical behavior and is identified with rapid growth and high probability of metastasis at diagnosis. Thus, it is necessary to differentiate it from a dental abscess. As for the treatment of Ewing's sarcoma, first the tumor must undergo chemotherapy to reduce its size and, eventually, it undergoes extensive surgery. This case report deals with a 16-year-old patient wrongly diagnosed with odontogenic infection and abscess, and hospitalized. As the symptoms did not remit, biopsy was carried out and the patient was operated on with Ewing's sarcoma diagnosis.
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Affiliation(s)
- Forouz Keshani
- Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Isfahan, Iran
| | | | | | - Mahsa Kalantari
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Isfahan, Iran
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Iatrou I, Theologie-Lygidakis N, Tzerbos F, Schoinohoriti O. Oro-facial tumours and tumour-like lesions in Greek children and adolescents: An 11-year retrospective study. J Craniomaxillofac Surg 2013; 41:437-43. [DOI: 10.1016/j.jcms.2012.11.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2012] [Revised: 11/13/2012] [Accepted: 11/14/2012] [Indexed: 10/27/2022] Open
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12
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Gomes MF, Martins LG, Alves MGO, de Morais Gouvêa Lima G, de Cássia Araújo Rocha R, das Graças Vilela Goulart M. Interdisciplinary approach to the management of Ewing sarcoma: a case report. SPECIAL CARE IN DENTISTRY 2012; 32:265-9. [PMID: 23095070 DOI: 10.1111/j.1754-4505.2012.00282.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Ewing sarcoma is a common primary bone malignancy occurring in childhood and adolescence. This case report describes a 4-year-old female patient who had Ewing sarcoma in the left clavicular region. The patient underwent total excision of the left clavicle and subsequently developed periodontitis and multiple carious lesions after chemotherapy. Caries risk and salivary flow rate tests were performed, followed by periodontal treatment, topical fluoride application, restoration of caries, and oral hygiene instruction. The care of this patient demonstrates that an interdisciplinary approach is essential to eliminate all foci of infection, minimize morbidity, and improve the patient's general health before, during, and after oncological treatment.
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Affiliation(s)
- Mônica Fernandes Gomes
- Department of Biosciences and Oral Diagnosis and Chairman, Bioscience Center for Special Health Care Needs, São José dos Campos Dental School - Univ. Estadual Paulista-UNESP, São Paulo, Brazil
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Manor E, Kapelushnik J, Brennan PA, Bodner L. Chromosomal aberrations in primary Ewing sarcoma of the mandible. Br J Oral Maxillofac Surg 2012; 50:574-6. [DOI: 10.1016/j.bjoms.2011.09.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Accepted: 09/21/2011] [Indexed: 11/30/2022]
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Bakhshi S, Pathania S, Mohanti BK, Thulkar S, Thakar A. Therapy and outcome of primitive neuroectodermal tumor of the jaw. Pediatr Blood Cancer 2011; 56:477-81. [PMID: 21072811 DOI: 10.1002/pbc.22615] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Data pertaining to outcomes in jaw primitive neuroectodermal tumor (PNET) are lacking. Eleven cases of jaw PNET (five maxillary and six mandibular) were treated at our cancer center with the same chemotherapeutic agents from June 2003 to January 2009. Four patients underwent surgery after neoadjuvant chemotherapy and all received local radiotherapy. At median follow-up of 56 months (range: 19-77 months), 7/11 patients are in sustained remission. There was no difference in outcome with respect to site of tumor, and whether surgery was performed or not. These results support the use of chemoradiation as initial modality of treatment rather than going for extensive and mutilating surgery.
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Affiliation(s)
- Sameer Bakhshi
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India.
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Brazão-Silva MT, Fernandes AV, Faria PRD, Cardoso SV, Loyola AM. Ewing's sarcoma of the mandible in a young child. Braz Dent J 2010; 21:74-9. [PMID: 20464325 DOI: 10.1590/s0103-64402010000100012] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Indexed: 11/22/2022] Open
Abstract
Ewing's sarcoma (ES) is a malignancy primarily affecting bone tissue that is commonly diagnosed in adolescents and young adults. Its occurrence in the head and neck region is unusual and generally involves the mandible and maxilla. An extensive review of the literature shows only few cases of the oral ES in patients under the age of 5. This paper reports a rare case of ES of the mandible in a 4-year-old girl, which had been previously misdiagnosed and treated as a dental abscess. In the clinical examination, a hard immobile expansive mass of 5 cm in diameter was observed on the left side of the mandible. Radiographic examination revealed a radiolucent lesion with ill-defined borders and wide vestibular bone plate destruction. Microscopically, the tumor was composed by monotonous small round cells that exhibited immunoreactivity for CD99, vimentin and pancytokeratin. The patient was subjected to multiagent chemotherapy with ifosfamide, carboplatin, etoposide, vincristine, cyclophosfamide and doxorrubycin (VAC/ICE regimen). However, after the first chemotherapeutic cycle, the patient died due to disseminated infection. This case elucidates the importance of professional knowledge of the relevant aspects of malignant lesions such as ES.
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Gosau M, Baumhoer D, Ihrler S, Kleinheinz J, Driemel O. Ewing sarcoma of the mandible mimicking an odontogenic abscess - a case report. Head Face Med 2008; 4:24. [PMID: 18983686 PMCID: PMC2644679 DOI: 10.1186/1746-160x-4-24] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2008] [Accepted: 11/05/2008] [Indexed: 12/16/2022] Open
Abstract
Ewing sarcoma (ES) of the mandible is rare and can be mistaken for inflammation of dental origin. We present a 24-year old male patient which underwent radical tumour surgery and primary reconstruction with a microvascular osteoseptocutaneous free fibular flap as well as postoperative adjuvant chemotherapy. Incomplete osseous tumour resection required a second intervention. This case report recapitulates the clinical and histopathological findings in oral ES, demonstrates its sometimes difficult diagnosis and discusses the (dis-)advantages of primary osseous reconstruction in ablative tumour surgery.
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Affiliation(s)
- Martin Gosau
- Department of Cranio-Maxillo-Facial Surgery, University of Münster, Germany.
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Bilkay U, Tiftikcioglu YO, Temiz G, Ozek C, Akin Y. Free-tissue transfers for reconstruction of oromandibular area in children. Microsurgery 2008; 28:91-8. [DOI: 10.1002/micr.20457] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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