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Omami G, Yeoh M. Malignant Lesions of the Oral Region. Dent Clin North Am 2024; 68:319-335. [PMID: 38417993 DOI: 10.1016/j.cden.2023.09.006] [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] [Indexed: 03/01/2024]
Abstract
This article focuses on the radiographic presentations of various malignant conditions that affect the oral region and delineates the role of CT, MR imaging, and PET in oral cancer imaging.
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Affiliation(s)
- Galal Omami
- Division of Oral Diagnosis, Oral Medicine, and Oral Radiology, Department of Oral Health Practice, University of Kentucky College of Dentistry, 770 Rose Street, MN320, Lexington, KY 40536, USA.
| | - Melvyn Yeoh
- Division of Oral and Maxillofacial Surgery, University of Kentucky College of Dentistry, 770 Rose Street, D-528, Lexington, KY 40536, USA
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2
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Mohanty S, Bansal N, Verma A, Urs AB. Mandibular primary intraosseous carcinoma arising from long-standing odontogenic keratocyst. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:e8-e15. [PMID: 38155014 DOI: 10.1016/j.oooo.2023.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/06/2023] [Accepted: 07/10/2023] [Indexed: 12/30/2023]
Abstract
Primary intraosseous carcinoma (PIOC) of the jaw is a rare neoplasm arising from the lining epithelium of odontogenic cysts or de novo from odontogenic epithelial rests that has no communication with the surrounding mucosa of the upper aerodigestive tract. We present a case of PIOC ex-odontogenic keratocyst (PIOC ex-OKC) in a 35-year-old male. Histopathologic examination revealed a cystic lesion with a fibrous capsule lined by corrugated parakeratinized stratified squamous epithelium resting on a basal cell layer composed of columnar cells exhibiting palisaded hyperchromatic nuclei, features consistent with OKC. Surgical treatment consisted of bilateral crestal and crevicular incision, a reflection of the flap, breaking of all OKC locules, creation of a continuous cavity, and fitting of a decompression mold around the mandibular teeth. This case highlights the importance of knowing the features of PIOC and considering PIOC in the differential diagnosis of malignant tumors of odontogenic epithelium for timely surgical treatment.
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Affiliation(s)
- Sujata Mohanty
- Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, Bahadur Shah Zafar Marg, New Delhi - 110002, India.
| | - Neeraj Bansal
- Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, Bahadur Shah Zafar Marg, New Delhi - 110002, India.
| | - Anjali Verma
- Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, Bahadur Shah Zafar Marg, New Delhi - 110002, India.
| | - Aadithya B Urs
- Department of Oral and Maxillofacial Pathology, Maulana Azad Institute of Dental Sciences, Bahadur Shah Zafar Marg, New Delhi - 110002, India.
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3
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Alamri M, Violante T, Schellati N, Hinchy NV, Aguirre A. Maxillary radiolucency in a 39-year-old man. J Am Dent Assoc 2023; 154:1112-1118. [PMID: 36526453 DOI: 10.1016/j.adaj.2022.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/27/2022] [Accepted: 10/05/2022] [Indexed: 12/15/2022]
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4
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Yamagata K, Fukuzawa S, Inoue Y, Uchida F, Ishibashi-Kanno N, Ito H, Bukawa H. A Case of Primary Intraosseous Squamous Cell Carcinoma Arising in Dentigerous Cyst of Mandible. J Maxillofac Oral Surg 2023; 22:505-510. [PMID: 37122779 PMCID: PMC10130249 DOI: 10.1007/s12663-022-01718-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/03/2022] [Indexed: 11/25/2022] Open
Abstract
Primary intraosseous squamous cell carcinoma (PISCC) arising from dentigerous cysts (DCs) is rare. Herein, we present a rare case of a 35 year-old Japanese man with PISCC arising from a DC. Clinicians should be aware of the potential for malignant changes to SCC in asymptomatic DCs and should conduct follow-up. Moreover, histological examination of the entire specimen should be performed even if the lesion is suspected to be benign.
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Affiliation(s)
- Kenji Yamagata
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan
| | - Satoshi Fukuzawa
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan
| | - Yutaka Inoue
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan
| | - Fumihiko Uchida
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan
| | - Naomi Ishibashi-Kanno
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan
| | - Hiroyuki Ito
- Department of Oral and Maxillofacial Surgery, Mito Kyodo General Hospital, Mito, Ibaraki Japan
| | - Hiroki Bukawa
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan
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Oriyama T, Goto M, Kawahara K, Shibata A, Nagao T. Intraosseous carcinoma of the anterior maxilla identified as the occult primary tumour of carcinoma of unknown primary. Int J Oral Maxillofac Surg 2022; 51:1510-1515. [PMID: 35346543 DOI: 10.1016/j.ijom.2022.03.005] [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: 10/08/2021] [Revised: 03/05/2022] [Accepted: 03/09/2022] [Indexed: 10/18/2022]
Abstract
Carcinoma of unknown primary (CUP) is defined as lymph node metastasis without a detectable origin until after the initial treatment has been performed. The most common occult primary site in the head and neck, as revealed by a review of the published literature, is the oropharynx. An occult primary site in the oral region is extremely rare. We report a rare case of head and neck CUP (HNCUP) in a 69-year-old female patient, wherein the occult primary lesion was a primary intraosseous carcinoma (PIOC) invading the anterior maxilla. During the course of the initial diagnostic workup, no primary lesion could be identified; however, cervical lymph node metastasis to left levels IB and IIA were observed in the patient. A neck dissection followed by adjuvant radiotherapy was performed. However, the PIOC of the anterior maxilla was identified 6 months after neck treatment and was confirmed as the occult primary tumour of the HNCUP. This case is quite rare and required a comprehensive workup to guide optimal treatment. Careful follow-up or active biopsy should be considered if osteolytic changes are observed in the jaw.
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Affiliation(s)
- T Oriyama
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Chikusa-ku, Nagoya, Japan
| | - M Goto
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Chikusa-ku, Nagoya, Japan.
| | - K Kawahara
- Department of Oral and Maxillofacial Surgery, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan
| | - A Shibata
- Department of Oral and Maxillofacial Surgery, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan
| | - T Nagao
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Chikusa-ku, Nagoya, Japan
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Shergill I, Schlieve T, Williams F, Kim R, Hammer D. Peripheral intraosseous carcinoma arising from a recurrent odontogenic keratocyst. Proc (Bayl Univ Med Cent) 2022; 36:91-92. [PMID: 36578626 PMCID: PMC9762818 DOI: 10.1080/08998280.2022.2134678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Primary intraosseous carcinoma (PIOC) is a distinct clinical and genomic pathology that should be considered when treating aggressive odontogenic cysts refractory to standard treatments. Odontogenic cysts have a very low chance of malignant transformation, with most studies citing an incidence of <0.05%. The pathogenesis of PIOC is multifactorial, with chronic inflammation-induced carcinogenesis being the most cited theory. Early detection is imperative to enhance the patient's prognosis, with the 5-year overall survival rate of PIOC being 38%. This paper presents a case of PIOC and reviews data on its epidemiology, diagnosis, presentation, and treatment.
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Affiliation(s)
- Isherpreet Shergill
- Department of Oral and Maxillofacial Surgery, University of Texas Southwestern/Parkland Memorial Hospital, Dallas, Texas,Corresponding author: Isherpreet Shergill, DDS, MD, Department of Oral and Maxillofacial Surgery, John Peter Smith Hospital, 1500 South Main St., Fort Worth, TX76104 (e-mail: )
| | - Thomas Schlieve
- Department of Oral and Maxillofacial Surgery, University of Texas Southwestern/Parkland Memorial Hospital, Dallas, Texas
| | - Fayette Williams
- Division of Maxillofacial Oncology and Reconstructive Surgery, John Peter Smith Hospital, Fort Worth, Texas
| | - Roderick Kim
- Division of Maxillofacial Oncology and Reconstructive Surgery, John Peter Smith Hospital, Fort Worth, Texas
| | - Daniel Hammer
- Department of Oral and Maxillofacial Surgery, Naval Medical Center, San Diego, California
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Etemadi Sh M, Aghamohseni M, Norouzi A, Sadeghi S, Ranjbarian P. Functional denture obturator for marsupialization of residual cyst: A novel approach. Clin Case Rep 2022; 10:e6641. [PMCID: PMC9701859 DOI: 10.1002/ccr3.6641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 09/21/2022] [Accepted: 11/04/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Milad Etemadi Sh
- Department of Oral and Maxillofacial Surgery, Dental Implants Research Center, Dental Research Institute, School of Dentistry Isfahan University of Medical Sciences Isfahan Iran
| | - MohammadMostafa Aghamohseni
- Dentistry Student, Head of Student Research Committee, Department of Oral and Maxillofacial Surgery Islamic Azad University of Isfahan (Khorasgan) Branch Isfahan Iran
| | - Atefeh Norouzi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry Isfahan University of Medical Sciences Isfahan Iran
| | - Sarina Sadeghi
- Dentistry Student, Department of Oral and Maxillofacial Surgery Islamic Azad University of Isfahan (Khorasgan) Branch Isfahan Iran
| | - Parisa Ranjbarian
- Department of Endodontics, Faculty of Dentistry Islamic Azad University, Isfahan Branch (Khorasgan) Isfahan Iran
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Fan Q, Wang R, Tian R, Su M. Primary Intraosseous Squamous Cell Carcinoma of the Mandible Mimicking Inflammation on FDG PET/CT. Clin Nucl Med 2022; 47:156-158. [PMID: 34132676 DOI: 10.1097/rlu.0000000000003769] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
ABSTRACT Primary intraosseous squamous cell carcinoma (SCC) is an uncommon malignant cancer involving the jaw bones. We herein reported the imaging findings of a primary intraosseous SCC of the mandible in a 47-year-old man. He was diagnosed as cancer of unknown primary in the cervical node. FDG PET/CT revealed a focal hypermetabolic lesion around the tooth root of the right lower molar. MRI showed the lesion had hyperintensity on T2-weighted imaging and significant enhancement on T1-weighted imaging fat saturate images. The final diagnosis of primary intraosseous SCC of mandible was confirmed pathologically.
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Affiliation(s)
- Qiuping Fan
- From the Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Oh HJ, Shin DW, Yoon HJ, Myoung H, Kim SM. Primary intraosseous carcinoma in the pediatric and adolescent mandible. World J Surg Oncol 2022; 20:25. [PMID: 35086533 PMCID: PMC8793206 DOI: 10.1186/s12957-021-02465-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 11/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Primary intraosseous carcinoma (PIOC) is a rare malignant odontogenic tumor that predominantly occurs in males older than 50 years. PIOC can be misdiagnosed as odontogenic cyst because it occasionally shows a well-defined border on radiography. In this study, related literatures of pediatric and adolescent PIOC cases were analyzed under strict PRISMA guidelines along with an adolescent case who was provisionally misdiagnosed as an odontogenic cyst. METHODS All case reports for PIOC published in English from 1966 to 2021 were collected. Cases under the age of 20 were classified as pediatric and adolescent populations in this study. A total of 12 pediatric and adolescent cases including 11 PIOCs from the literature and one new case of a 14-year-old female were analyzed. Clinical and radiographic features, diagnosis and treatment approaches, and prognosis were investigated. RESULTS Ages ranged from 4 to 18 years. The female to male ratio was 1.4:1. Seven cases occurred in the mandible. Swelling was observed in 11 patients. The radiologic borders were well-defined in six cases and corticated in four cases. Tooth displacement and root resorption were observed in four and six cases, respectively. The provisional diagnosis for seven patients was odontogenic cyst and enucleation was performed in six cases including the new case. During the follow-up period, local recurrence occurred in three patients. The pediatric and adolescent PIOC cases with local recurrence showed poor prognosis. The locally recurred lesion in the new case did not decrease in size despite concurrent chemo-radiation therapy. CONCLUSIONS Three-dimensional imaging modalities and incisional biopsy with multiple specimens are necessary to rule out PIOC in the lesions with atypical radiographic findings. PIOC should be diagnosed differentially from odontogenic cyst even in pediatric and adolescent populations to properly manage the disease with poor prognosis.
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Affiliation(s)
- Hyun Jun Oh
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Dong Whan Shin
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Hye-Jung Yoon
- Department of Oral Pathology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Hoon Myoung
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
| | - Soung Min Kim
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
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Chakrabarty B, Pendharkar C, Mehta R, Sen A. Primary intraosseous squamous cell carcinoma presenting as lytic lesion in mandible: Common presentation of an uncommon illness. JOURNAL OF MARINE MEDICAL SOCIETY 2022. [DOI: 10.4103/jmms.jmms_68_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Barrios-Garay K, Agudelo-Sánchez LF, Aguirre-Urizar JM, Gay-Escoda C. Critical assessment of the latest classification of jaw cysts proposed by the World Health Organization (2017). J Clin Exp Dent 2021; 13:e1147-e1153. [PMID: 34824702 PMCID: PMC8601698 DOI: 10.4317/jced.58764] [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: 07/06/2021] [Accepted: 08/24/2021] [Indexed: 11/24/2022] Open
Abstract
Background The fourth edition of the World Health Organization Classification of Head and Neck Tumors was published in January 2017, and includes a classification of odontogenic tumors and odontogenic cysts. The present review assesses the changes made in this new classification in relation to odontogenic and non-odontogenic jaw cysts.
Material and Methods An electronic search was conducted in the Cochrane Library, PubMed-MEDLINE and Scopus databases using the search terms: “odontogenic cyst” “WHO classification” “update”. Studies written in English and published between January 2005 and April 2020 with a high level of scientific evidence were included, while studies not published in English, epidemiological studies, and studies with a low level of scientific evidence were excluded.
Results The initial search identified 311 articles, and after the deletion of duplicates, 7 studies were selected for full-text assessment. After excluding two studies that failed to provide relevant information and had a low level of scientific evidence, 5 articles were finally included and stratified according to their level of scientific evidence based on the SORT (Strength of Recommendation Taxonomy) criteria.
Conclusions The incorporation of odontogenic and non-odontogenic cysts to the head and neck tumors classification underscores the recognition of the WHO of these important disorders of the jaws. Based on the current evidence, there is controversy as to whether odontogenic keratocysts should be regarded as cystic lesions or as neoplasms, though there is no such controversy in relation to calcifying odontogenic cysts. On the other hand, orthokeratinized odontogenic cysts have been included in the classification as a single entity differentiated from odontogenic keratocysts, while residual cysts have been removed from the classification. Key words:Odontogenic cyst, WHO classification, pseudocyst.
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Affiliation(s)
- Kevin Barrios-Garay
- Dentistry student. Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | | | - José-Manuel Aguirre-Urizar
- MD, DDS, PhD. Chairman and Professor of Oral Medicine, Department of Stomatology II, Faculty of Medicine and Nursery, University of the Basque Country/EHU, Leioa, Spain
| | - Cosme Gay-Escoda
- MD, DDS, MS, PhD, EBOS, OMFS. Chairman and Professor of Oral and Maxillofacial Surgery, Faculty of Medicine and Health Sciences, University of Barcelona. Director of the Master Degree Program in Oral Surgery and Implantology (EHFRE International University/FUCSO). Coordinator/Researcher at the IDIBELL Institute. Head of the Department of Oral Surgery, Implantology and Maxillofacial Surgery, Teknon Medical Center, Barcelona, Spain
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Marin C, Dave M, Hunter KD. Malignant Odontogenic Tumours: A Systematic Review of Cases Reported in Literature. FRONTIERS IN ORAL HEALTH 2021; 2:775707. [PMID: 35048074 PMCID: PMC8757763 DOI: 10.3389/froh.2021.775707] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 10/20/2021] [Indexed: 11/18/2022] Open
Abstract
Background: Malignant odontogenic tumours (MOTs) arise either de novo from the tooth forming tissues, their developmental residues or from existing odontogenic epithelial or mesenchymal neoplasms in the jaws. Their management requires extensive surgery due to their infiltrative nature and risk of metastasis. There is a need to understand the clinical and pathological features of MOTs to inform both treatment algorithms and prognostication. This is an area of diagnostic pathology which presents substantial difficulties in diagnosis, compounded by inconsistent use of terminology. Thus, this systematic review aimed to describe the clinical and pathological features of MOTs with a view to consolidating the literature and defining problematic areas in diagnosis and classification. Methods: An electronic database search was conducted in Web of Science, PubMed/Medline, and Embase. Additionally, the grey literature and reference lists of selected papers searched for completeness. Nine hundred and sixty articles were initially identified. Following removal of duplicates and application of inclusion/exclusion criteria, 312 articles were included for qualitative analysis. Results: The 312 articles encompassed a total of 507 patients with most lesions located within the mandible (74.3%). The most common first histological diagnosis was ameloblastic carcinoma (25.7% of all diagnoses), but there is considerable variation in how and when various diagnostic terms are used, and several misdiagnoses were reported. An initial benign diagnosis was made in 24.7% of patients, followed by a later malignant diagnosis and in this sub-group, the most common benign first diagnosis was ameloblastoma (42.4%). Cervical lymph nodes were the most common site of metastasis (9.3% of patients). With respect to distant metastasis (DM), the lungs were the most common organ affected (11.2% of DM patients) with metastasising ameloblastoma the most commonly reported tumour which metastasised to the lungs. Overall, 26.8% of patients developed recurrence. Conclusion: Overall, the quality of the literature on MOTs is poor. This review of the literature has highlighted variations in diagnostic terms and criteria which has resulted in areas of confusion with potential for misdiagnosis. This consolidation of primary data has identified key areas for targeted research including further discussion on the malignant potential of ameloblastoma.
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Affiliation(s)
- Constanza Marin
- Unit of Oral and Maxillofacial Medicine, Pathology and Surgery, University of Sheffield, Sheffield, United Kingdom
- Unidad de Patología y Medicina Oral, Facultad de Odontología, Universidad Andres Bello, Viña del Mar, Chile
| | - Manas Dave
- Division of Dentistry, The University of Manchester, Manchester, United Kingdom
| | - Keith D. Hunter
- Unit of Oral and Maxillofacial Medicine, Pathology and Surgery, University of Sheffield, Sheffield, United Kingdom
- Department of Oral Pathology and Biology, School of Dentistry, University of Pretoria, Pretoria, South Africa
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Bastos VC, Gomez RS, Gomes CC. Revisiting the human dental follicle: From tooth development to its association with unerupted or impacted teeth and pathological changes. Dev Dyn 2021; 251:408-423. [PMID: 34324745 DOI: 10.1002/dvdy.406] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/16/2021] [Accepted: 07/22/2021] [Indexed: 02/06/2023] Open
Abstract
Dental follicles are involved in odontogenesis, periodontogenesis, and tooth eruption. Dental follicles are unique structures, considering that their remnants can persist within the jawbones after odontogenesis throughout life if the tooth does not erupt. Pathological changes may occur in these tissues as individuals age. The changes range from benign to life threatening. Thus, the assessment of age-related changes in dental follicles associated with unerupted teeth is of paramount importance. In this review, we summarize the physiological roles and changes in dental follicles in odontogenesis, tooth eruption, and aging, in addition to the pathological changes associated with these structures. We encourage investigators to consider this peculiar tissue as a unique model and explore its potential to clarify its importance from the viewpoints of developmental biology, tissue physiology, and pathology.
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Affiliation(s)
- Victor Coutinho Bastos
- Department of Oral Surgery and Pathology, Faculty of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.,Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, Faculty of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Carolina Cavaliéri Gomes
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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Oh KY, Kim JE, Cho SD, Yoon HJ, Lee JI, Hong SD. Orthokeratinized odontogenic cyst: A large series and comprehensive literature review with emphasis on synchronous multiple occurrence and neoplastic transformation. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:e72-e82. [PMID: 34511349 DOI: 10.1016/j.oooo.2021.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/21/2021] [Accepted: 07/13/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The objective of this study was to demonstrate the clinical, radiologic, and histologic features of orthokeratinized odontogenic cyst (OOC); determine the characteristics of multiple OOCs; and present rare but significant manifestations of OOC. STUDY DESIGN A clinical, radiologic, and histopathologic study of 65 primary and 2 recurrent OOC cases was performed retrospectively along with a comprehensive literature review. RESULTS OOCs shared similar radiologic findings with odontogenic keratocyst, yet some showed features that have not been previously described: root resorption and radiopaque foci. Histologic review revealed a unique histiocytic lining and some findings suggestive of the multipotentiality of the odontogenic epithelium. The analysis of patients with multiple OOCs demonstrated that multiple OOCs occurred synchronously with a marked predilection for young male adults. Two unusual cases were also identified: an OOC combined with a BRAFV600E ameloblastoma and a recurrent OOC with malignant transformation. CONCLUSIONS This largest series presents previously unreported radiographic and histopathologic features that can be seen in OOC. Multiple OOCs have clinical characteristics distinct from those of solitary cases. The first reported OOC associated with ameloblastoma suggests the involvement of oncogenic mutations in odontogenic tumorigenesis. Although OOC shows a low recurrence rate, the possibility of malignant transformation of recurrent OOCs should be emphasized.
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Affiliation(s)
- Kyu-Young Oh
- Department of Oral Pathology, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Jo-Eun Kim
- Department of Oral and Maxillofacial Radiology, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Sung-Dae Cho
- Department of Oral Pathology, Seoul National University Dental Hospital, Seoul, Republic of Korea; Department of Oral Pathology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Hye-Jung Yoon
- Department of Oral Pathology, Seoul National University Dental Hospital, Seoul, Republic of Korea; Department of Oral Pathology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Jae-Il Lee
- Department of Oral Pathology, Seoul National University Dental Hospital, Seoul, Republic of Korea; Department of Oral Pathology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Seong-Doo Hong
- Department of Oral Pathology, Seoul National University Dental Hospital, Seoul, Republic of Korea; Department of Oral Pathology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea.
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15
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Caruso DP, Lee CC, Peacock ZS. What factors differentiate dentigerous cysts from other pericoronal lesions? Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:8-14. [PMID: 34511358 DOI: 10.1016/j.oooo.2021.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 05/04/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the histopathologic outcomes of pericoronal radiolucencies and identify factors predictive of diagnosis. STUDY DESIGN A retrospective cohort study of 258 patients with 280 radiolucent pericoronal lesions undergoing treatment at our institution between 2005 and 2019. The primary predictor variable was lesion size (≥2 cm and <2 cm). The primary outcome variable was histopathologic diagnosis (dentigerous cyst vs other pathologic entity). Descriptive, bivariate, and multiple logistic regression statistics were computed to measure the association between clinical and radiographic variables and histopathologic diagnosis. RESULTS The study sample was composed of 258 patients with 280 histopathologic specimens. There were 218 dentigerous cysts (77.9%) and 62 other pathologic entities (22.1%). Lesions ≥2 cm were 3.20 times more likely to be diagnosed as a nondentigerous cyst pathologic entity (P ≤ .001). After adjusting for jaw (maxilla vs mandible), pain, history of infection, cortical perforation, expansion, and multiple lesions, younger age (P ≤ .001, odds ratio [OR] = 0.950, 95% confidence interval [CI] = 0.929-0.972) and lesion size as a continuous variable (P = .007, OR = 1.06, 95% CI = 1.02-1.11) were independent predictors of other pathologic entities. CONCLUSIONS The majority of pericoronal radiolucent lesions were dentigerous cysts. Younger age and larger lesions were independent predictors of other pathologic entities.
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Affiliation(s)
- Daniel P Caruso
- Resident, Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Cameron C Lee
- Resident, Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Zachary S Peacock
- Assistant Professor, Oral and Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Boston, MA, USA.
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Lee WB, Hwang DS, Kim UK. Sequential treatment from mandibulectomy to reconstruction on mandibular oral cancer - Case review I: mandibular ramus and angle lesion of primary intraosseous squamous cell carcinoma. J Korean Assoc Oral Maxillofac Surg 2021; 47:120-127. [PMID: 33911044 PMCID: PMC8084740 DOI: 10.5125/jkaoms.2021.47.2.120] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/18/2020] [Accepted: 11/20/2020] [Indexed: 11/07/2022] Open
Abstract
Primary intraosseous squamous cell carcinoma (PIOSCC) is very rare type of squamous cell carcinoma (SCC) that occurs within the jaw and arises from remnants of odontogenic epithelium with no connection to the oral mucosa. This study reports two cases of PIOSCC of the mandible. Reported in this article are two cases of PIOSCC of the mandible that were treated with resection and reconstruction using a fibular free flap. The first case was a 36-year-old male patient who complained of right mandibular pain. Computed tomography (CT) and panoramic radiograph revealed a large radiolucency in the mandibular ramus area. At first, an odontogenic keratocyst was tentatively diagnosed, and an excision procedure was carried out at another clinic. A final biopsy after cyst enucleation revealed well-differentiated SCC, so we proceeded with segmental mandibulectomy and reconstruction using a fibular free flap. The second case was a 48-year-old male patient with left mandibular pain. CT and panoramic radiograph revealed irregular radiolucency in the mandibular angle area near tooth #38. At first, osteomyelitis was tentatively diagnosed, and a curettage was carried out. A later biopsy revealed well-differentiated SCC, so segmental mandibulectomy and reconstruction with a fibular free flap were secondarily performed. Our two cases have had no recurrence. The facial appearance of both patients is satisfactory, and the neo-mandibular body created using a fibular bone transfer displays adequate bony volume.
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Affiliation(s)
- Won-Bum Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Dae-Seok Hwang
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Uk-Kyu Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
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Abstract
Dentigerous cysts, also known as follicular cysts, are among the most common developmental cysts of the gnathic bones. The majority of cases are clinically asymptomatic and discovered incidentally on panographic radiographs during routine dental care. The cyst appears as a radiolucency, classically unilocular, associated with the crown of an unerupted or impacted tooth. Usually diagnosed in the 2nd-3rd decade, third molars of the mandible are the most commonly affected teeth. Histologically, dentigerous cysts demonstrate a fibrous or fibromyxoid connective tissue wall lined by squamous epithelium, classically lacking rete ridges. Inflammation may introduce histologic changes, however. The differential diagnosis includes hyperplastic dental follicle, periapical or radicular cyst, unicystic ameloblastoma, odontogenic keratocyst, and other odontogenic cysts and tumors. While the findings are generally classic and pose no diagnostic dilemma, the diagnosis is best made in the context of the appropriate clinical and radiographic setting. Submitted tissue with a lack of history, to include a detailed relationship with the affected tooth, may result in misdiagnosis and subsequent confusion for the clinician. So, despite its simple features, dentigerous cysts are not uncommonly mischaracterized. Therefore a review of a classic case of dentigerous cyst is presented.
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Sathasivam HP, Saw CL, Lau SH. Clinico-pathological study of malignant odontogenic tumours from a national referral centre. BMC Oral Health 2021; 21:129. [PMID: 33736630 PMCID: PMC7977582 DOI: 10.1186/s12903-020-01365-3] [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: 07/05/2020] [Accepted: 12/15/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malignant odontogenic tumours are extremely rare tumours occurring within the jaws. Our study was performed to determine the demographic and clinico-pathological features of malignant odontogenic tumours amongst a multi-ethnic Asian population. METHODS This was a retrospective cross-sectional study of malignant odontogenic tumours diagnosed at the Institute for Medical Research, Malaysia, from 2009 to 2019. All cases were independently reviewed and reclassified following the criteria set out in the latest edition of the World Health Organization 2017 reference text. Demographic and clinico-pathological data were recorded for each case. RESULTS Twenty-four cases of malignant odontogenic tumours were identified. The patients' age ranged from 16 to 79 years with the mean age at diagnosis being 50.8 years (SD = 16.18). There was a male predominance (66.7%) in this cohort of patients. The ethnic distribution appeared to reflect the Malaysian population with most cases seen amongst the Malay ethnic group (66.7%). Ameloblastic carcinoma was the most frequently diagnosed malignant odontogenic tumour (45.8%) and was also predominantly seen in males (90.9%). All patients with clear cell odontogenic carcinoma were females. There was no obvious sex predilection in primary odontogenic carcinoma not otherwise specified (NOS). The mandible (79.2%) was more frequently involved compared to the maxilla. CONCLUSIONS Diagnosis and management of malignant odontogenic tumours are challenging due to the rarity of these tumours. Our study has elucidated the clinico-pathological features of malignant odontogenic tumours seen in a multi-ethnic Asian population.
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Affiliation(s)
- Hans Prakash Sathasivam
- Cancer Research Centre, Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Setia Alam, Malaysia.
| | - Chee Lynn Saw
- Penang Health Services, Ministry of Health Malaysia, Georgetown, Malaysia
| | - Shin Hin Lau
- Cancer Research Centre, Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Setia Alam, Malaysia
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Primary intraosseous malignancies: A 10-year retrospective cohort study. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:153-162. [PMID: 34020918 DOI: 10.1016/j.oooo.2021.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 11/07/2020] [Accepted: 02/02/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE This study aimed to explore the characteristics and prognoses of primary jaw malignancies and identify valuable prognostic factors. STUDY DESIGN Patients who were primarily diagnosed with jaw malignancies at Beijing Stomatological Hospital between 2006 and 2016 were retrospectively reviewed. RESULTS Eighty patients with malignant jaw tumors were enrolled in the study. Squamous cell carcinoma was the most common type (56.2%). The age range of patients varied from 11 to 92 years old (mean age = 51.5 years), and the male-to-female ratio was 2.1:1. Anatomically, the mandible was involved in 82.5% of cases. The estimated disease-free survival and overall survival (OS) rates were 60.6% and 73.2%, respectively. Cox multivariate analysis showed that a smoking history (hazard ratio = 5.015, 95% confidence interval, 1.900-13.235, P = .001) and advanced age (≥60 years; hazard ratio = 2.464, 95% confidence interval, 0.987-6.155, P = .046) were independent prognostic factors for poor OS. CONCLUSION Primary jaw malignancies were more prevalent in the mandible and among males and middle-aged patients. Radical resection of the primary surgery was the basis of a good prognosis, and the choice of postoperative adjuvant therapy may not ultimately affect OS. Patients with a history of smoking and advanced age were at high risk for poor prognosis.
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20
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Li Y, Zuo JL, Tang JS, Shen XY, Xu SH, Xiao JL. Primary nonkeratinizing squamous cell carcinoma of the scapular bone: A case report. World J Clin Cases 2021; 9:976-982. [PMID: 33585647 PMCID: PMC7852629 DOI: 10.12998/wjcc.v9.i4.976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/09/2020] [Accepted: 12/23/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Squamous cell carcinoma (SCC) of bone is usually caused by metastasis from the lungs, bladder, or other sites. Primary SCC of bone most frequently involves the skull bones, and primary involvement of other sites in the skeletal system is extremely rare. To date, only three such cases have been reported, which makes the diagnosis, treatment, and prognosis of this disease a challenge.
CASE SUMMARY A 76-year-old Chinese man presented to our hospital with nonspecific pain and limited mobility in the right shoulder for 4 mo. He underwent three-dimensional computed tomography reconstruction and magnetic resonance imaging of the right shoulder, which revealed an osteolytic destructive lesion in the right scapula with invasion into the surrounding muscles and soft tissues. Ultrasound-guided core needle biopsy detected a malignant tumor, and immunohistochemical analysis revealed a poorly differentiated SCC. Wide excision of the right scapular bone was performed, and pathological examination of the surgical specimen confirmed the diagnosis. At the last follow-up examination within 2 years, the patient was doing well with the pain significantly relieved in the right shoulder.
CONCLUSION Primary SCC of bone is extremely rare at sites other than the skull. Clinicians must exhaust all available means for the diagnosis of primary SCC of the bone, so greater attention can be paid to its timely and effective management. Regular and adequate follow-up is essential to help rule out metastasis and judge the prognosis.
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Affiliation(s)
- Yang Li
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin Province, China
| | - Jian-Lin Zuo
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin Province, China
| | - Jin-Shuo Tang
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin Province, China
| | - Xian-Yue Shen
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun 130033, Jilin Province, China
| | - Sheng-Hao Xu
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin Province, China
| | - Jian-Lin Xiao
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin Province, China
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Ye P, Wei T, Gao Y, Zhang W, Peng X. Primary intraosseous squamous cell carcinoma arising from an odontogenic keratocyst: case series and literature review. Med Oral Patol Oral Cir Bucal 2021; 26:e49-e55. [PMID: 33037806 PMCID: PMC7806341 DOI: 10.4317/medoral.23947] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 09/17/2020] [Indexed: 11/25/2022] Open
Abstract
Background The aim of this study was to investigate the clinicopathologic features of primary intraosseous squamous cell carcinoma arising from an odontogenic keratocyst (PIOSCC ex OKC) and comprehensively improve the understanding of this disease.
Material and Methods We retrospectively investigated five cases of PIOSCC ex OKC at Peking University School and Hospital of Stomatology. We also conducted a systematic review of studies on PIOSCC ex OKC by using online databases from their inception until February 2020.
Results In our series of five cases, all lesions were located in the mandible. Three cases (60%) showed recurrent OKCs and two cases (40%) showed primary OKCs. During the follow-up period, one patient died of local relapse. No patients developed metastasis. On the basis of our literature survey, we selected 22 articles reporting 29 patients with PIOSCC ex OKC. Seven of these patients (24.1%) showed local recurrence, three patients (10.3%) developed cervical metastasis, three patients (10.3%) developed distant metastasis (in the pleura in one case and in the lung in two cases), and seven patients died from the disease during the follow-up period. The disease-specific 5-year survival rate in the study group was 53.2%. Through univariate and multivariate analysis, local recurrence was identified as the only significant independent prognostic factor for survival (P < 0.05).
Conclusions The results suggest that PIOSCC ex OKC is a rare intermediate-grade malignancy. Although elective neck dissection is typically unnecessary, adequate therapy should be applied to achieve the lowest local recurrence rate possible to ensure a favorable survival rate. Key words:Primary intraosseous squamous cell carcinoma, odontogenic keratocyst, prognosis.
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Affiliation(s)
- P Ye
- Peking University School and Hospital of Stomatology 22 Zhongguancun Nandajie, Haidian District Beijing 100081, People's Republic of China
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22
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Kumchai H, Champion AF, Gates JC. Carcinomatous Transformation of Odontogenic Keratocyst and Primary Intraosseous Carcinoma: A Systematic Review and Report of a Case. J Oral Maxillofac Surg 2021; 79:1081.e1-1081.e9. [PMID: 33529609 DOI: 10.1016/j.joms.2020.12.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 12/28/2020] [Accepted: 12/29/2020] [Indexed: 01/27/2023]
Abstract
PURPOSE To assess the prognostic findings of the carcinomatous transformation of odontogenic keratocyst (OKC). METHODS A systematic review of all cases of carcinomatous transformation of OKC was completed, and a case report was included. RESULTS A total of 679 publications were screened, and 37 cases met inclusion criteria. The mean age for patients with malignant transformation of OKC was 45.1 years. Pain (67.5%) and swelling (78.3%) were the most common symptoms. The malignant transformation occurred with increased frequency in the posterior mandible and larger lesions that span greater than 2 subunits of the involved jaw. Resection was the definitive treatment in all cases and 14 cases (46%) utilized adjuvant treatment. CONCLUSIONS Patient outcomes and follow-up was variable in our study such that overall survival was difficult to determine. However, overall survival in malignant transformation of odontogenic cysts of all kinds ranges from 62 to 85% and 30 to 8% for 2 and 5 years, respectively.
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Affiliation(s)
- Hattanas Kumchai
- Resident and PhD Student, Oral & Maxillofacial Surgery Department, Thomas Jefferson University Hospital, Philadelphia, PA.
| | - Allen F Champion
- Assistant Professor, Oral & Maxillofacial Surgery Department, Thomas Jefferson University Hospital, Philadelphia, PA
| | - James C Gates
- Clinical Instructor, Oral & Maxillofacial Surgery Department, Thomas Jefferson University Hospital, Philadelphia, PA
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Titinchi F, Morkel J. Residual cyst of the jaws: A clinico-pathologic study of this seemingly inconspicuous lesion. PLoS One 2020; 15:e0244250. [PMID: 33332452 PMCID: PMC7746164 DOI: 10.1371/journal.pone.0244250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/07/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Residual cysts are relatively rare inflammatory cysts of the jaws. They are essentially radicular cysts without the presence of the offending dentition. These lesions have the ability to destroy bone within the jaws without any symptoms. Moreover, they can mimic more aggressive cysts and tumours on radiographs. The aim of this study was to describe the clinico-pathological features of residual cysts in order to discern them from other cystic lesions as well as analyse their management and recurrence patterns. MATERIALS AND METHODS Sixty-four histopathologically confirmed residual cysts were analysed based on their clinical, radiological and histopathological features. Their management and follow-up were also noted. RESULTS The majority of lesions presented in elderly (46.8%), edentulous patients (60.9%) and were most commonly found in the posterior regions of the mandible (51.6%). Clinico-pathological features that aided in their diagnosis included long-standing history with slow growing swelling and presence of well-defined, unilocular cystic lesion associated with previously extracted dentition. Enucleation was a successful method in the management of residual cysts with very low recurrence rate (1.6%). Two patients (3.1%) developed squamous cell carcinoma from the cyst lining. CONCLUSION Residual cysts should be high on the list of differential diagnosis when elderly, edentulous patients present with cystic lesions in the jaws compared to dentate patients (P<0.01). All lesions should by biopsied and sent for histopathological examination along with radiological correlation as they have the potential to transform into primary intra-osseous squamous cell carcinoma with devastating consequences to the patient.
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Affiliation(s)
- Fadi Titinchi
- Department of Maxillo-Facial and Oral Surgery, Faculty of Dentistry and WHO Collaborating Centre, University of the Western Cape, Tygerberg Oral Health Center, Cape Town, South Africa
- * E-mail:
| | - Jean Morkel
- Department of Maxillo-Facial and Oral Surgery, Faculty of Dentistry and WHO Collaborating Centre, University of the Western Cape, Tygerberg Oral Health Center, Cape Town, South Africa
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Hegde U, Sheshanna SH, Jaishankar HP, Prasad RR. Primary intraosseous squamous cell carcinoma ex-odontogenic cyst. J Cancer Res Ther 2020; 16:683-685. [PMID: 32719292 DOI: 10.4103/jcrt.jcrt_606_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Squamous cell carcinomas of the oral cavity are quite common, but primary intraosseous squamous cell carcinomas (PIOSCCs) are rare. Their origin from lining of different odontogenic cysts has been documented. More than 50% of such cases have been reported to occur in periapical inflammatory cysts, and less than 10 cases are reported to arise from odontogenic keratocyst (OKC). One such rare case of a PIOSCC, which presented as an OKC initially, is being reported.
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Affiliation(s)
- Usha Hegde
- Department of Oral Pathology and Microbiology, JSS Dental College and Hospital, Mysore, Karnataka, India
| | | | - H P Jaishankar
- Department of Oral Medicine and Radiology, JSS Dental College and Hospital, Mysore, Karnataka, India
| | - R Rajendra Prasad
- Department of Oral and Maxillofacial Surgery, JSS Dental College and Hospital, Mysore, Karnataka, India
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Marchal A, Gérard É, Curien R, Bourgeois G. Primary intraosseous carcinoma arising in dentigerous cyst: Case report. Int J Surg Case Rep 2020; 76:530-533. [PMID: 33207425 PMCID: PMC7599364 DOI: 10.1016/j.ijscr.2020.10.059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/13/2020] [Accepted: 10/13/2020] [Indexed: 11/29/2022] Open
Abstract
Primary intraosseous carcinoma arising in a dentigerous cyst is a rare observation. There are no clinical or radiological pathognomonic characteristics and the diagnosis is often made fortuitously. A surgical excision with clear margin is the cornerstone of treatment. A systematic and careful microscopic analysis of any cyst, even if look like benign, should be undertaken.
Introduction Carcinomas arising in odontogenic cysts are uncommon. Malignant transformation of a dentigerous cyst is a rare observation. A primary intraosseous carcinoma from a dentigerous cyst in a 69 years old female is presented in this case report. Presentation of case The patient initially consulted for pain in the mandibular left molar region. Primary investigations firstly showed a probably benign lesion but immunochemistry analysis finally revealed a squamous cell carcinoma arising in a dentigerous cyst. An extension assessment was performed and no evidence of lymph node extension or distant metastasis were found. A non-interrupting mandibular bone resection without neck dissection was realized. The patient made a good recovery after surgery without postoperative complication. No clinical symptoms or sign of local recurrence or metastasis was detected after 17 months follow-up. Discussion PIOC arising in a dentigerous cyst is a rare observation. PIOC from odontogenic cysts have an incident rate of 0,3 to 2% and only 16%–51% of them are PIOC from dentigerous cyst. There are no clinical or radiological pathognomonic characteristics. They often look like benign lesion and the diagnosis is often made fortuitously. A surgical excision with clear margin is the cornerstone of treatment. Clinical and radiological follow-up of the patient is recommended. Conclusion This case underlines the importance of a systematic and careful microscopic analysis of any lesion, even benign at first sight. Surgeons and pathologists should be aware of the malignant potential of odontogenic cysts. This can modify the surgical management and the follow-up of the patient.
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Affiliation(s)
- Alix Marchal
- Department of Oral Surgery, Regional Hospital Center of Metz-Thionville, Mercy Hospital, France.
| | - Éric Gérard
- Department of Oral Surgery, Regional Hospital Center of Metz-Thionville, Mercy Hospital, France
| | - Rémi Curien
- Department of Oral Surgery, Regional Hospital Center of Metz-Thionville, Mercy Hospital, France
| | - Geoffrey Bourgeois
- Department of Oral Surgery, Regional Hospital Center of Metz-Thionville, Mercy Hospital, France
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de Morais EF, Carlan LM, de Farias Morais HG, Pinheiro JC, Martins HDD, Barboza CAG, de Almeida Freitas R. Primary Intraosseous Squamous Cell Carcinoma Involving the Jaw Bones: A Systematic Review and Update. Head Neck Pathol 2020; 15:608-616. [PMID: 33044723 PMCID: PMC8134565 DOI: 10.1007/s12105-020-01234-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 10/06/2020] [Indexed: 01/15/2023]
Abstract
Primary intraosseous oral squamous cell carcinoma (PIOSCC) is a rare malignant neoplasm that affects the jaws. Despite its aggressive biological behavior, there are no studies that evaluated the clinicopathological features of this tumor and parameters associated with its prognosis. The objective of the present study was to conduct a systematic review of the available data on oral and maxillofacial PIOSCC in order to determine its clinicopathological characteristics and biological behavior. We conducted a systematic review in May 2020 in multiple databases using a specific search strategy. Cases diagnosed as PIOSCC in the oral cavity and maxillofacial complex that had sufficient histopathological data, absence of ulceration in the oral mucosa, a negative result for a distant primary tumor, and radiographic evidence of an osteolytic lesion that was entirely or mostly surrounded by the jaw bones were included. A total of 109 published articles were included in our systematic review, corresponding to 257 cases. PIOSCC showed a male predilection (69.3%) and a preference for the mandible (7:1), with the posterior region being the most commonly affected site. The mean age at diagnosis was 57.3 years. Cortical expansion, pain, and lip/facial paresthesia were the most common clinical features. Regarding histopathological features, most PIOSCC were well-differentiated and the solid subtype was the most common. Statistical analysis showed that PIOSCC located in the mandible (p = 0.03) and recurrence (p < 0.01) were significantly associated with a higher mortality rate. PIOSCC has a poor prognosis, with high rates of mortality.
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Affiliation(s)
- Everton Freitas de Morais
- Department of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN, CEP 59056-000, Brazil.
| | - Leonardo Magalhães Carlan
- Department of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN, CEP 59056-000, Brazil
| | - Hannah Gil de Farias Morais
- Department of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN, CEP 59056-000, Brazil
| | - Juliana Campos Pinheiro
- Department of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN, CEP 59056-000, Brazil
| | - Hélder Domiciano Dantas Martins
- Department of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN, CEP 59056-000, Brazil
| | - Carlos Augusto Galvão Barboza
- Department of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN, CEP 59056-000, Brazil
| | - Roseana de Almeida Freitas
- Department of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN, CEP 59056-000, Brazil
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TÜKEL HC, YAZICIOĞLU İ. Çocuk hastalarda dentigeröz kistlerle ilişkili gömülü dişlerin sürmesi öngörülebilir mi? CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.732954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Malignant Lesions Mimicking Endodontic Pathoses Lesion: A Systematic Review. J Endod 2020; 47:178-188. [PMID: 32918962 DOI: 10.1016/j.joen.2020.08.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/14/2020] [Accepted: 08/31/2020] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Malignant nonendodontic periapical lesions represent a rare diagnosis, in which few case have been reported about this condition. Due to the low occurrence and little exploration of this subject, serious errors of diagnosis are observed in the oral medicine services. In this sense, the purpose of the present review was to integrate the information on the record published on malignant lesions that mimic endodontic pathoses into a comprehensive analysis of their clinical, radiologic, and histopathologic features. METHODS An online search was made in March 2020 in the following databases: Pubmed, Web of Science, and Scopus. Eligibility criteria included publications having enough clinical, radiologic, and histopathologic information to confirm the diagnosis. Data were assessed descriptively. RESULTS Forty-nine publications from 16 countries comprising 60 cases were included. There is a nearly equal occurrence rate between males and females (male/female ratio is 49.15%/50.84%) with a mean age of 46.56 years. The lesions were more prevalent in the posterior mandibles (40.69%), and, radiographically, they were unilocular radiolucent. Histopathologic analysis showed metastasis (26.67%) as the most prevalent lesion followed by salivary gland malignant disease (25%). CONCLUSIONS The present systematic review revealed several histologic types of malignant periapical lesions that could be mimicking endodontic pathoses. Because these lesions usually do not show clinical or radiologic features of malignant alteration, clinicians should consider these hypotheses in their routine.
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de Menezes VCB, Siqueira ECD, Costa SFDS, de Souza FTA, de Souza RP, Gomez RS, Gomes CC. Effects of aging on DNA hydroxymethylation and methylation in human dental follicles. Arch Oral Biol 2020; 118:104856. [PMID: 32763471 DOI: 10.1016/j.archoralbio.2020.104856] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/22/2020] [Accepted: 07/23/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Despite the high frequency of impacted teeth and increased frequency of lesions in dental follicles (DF) with aging, DF age-changes remain unclear. We compared the global methylation and hydroxymethylation profiles in DF in relation to age. DESIGN DF associated with impacted lower third molars were obtained from 59 individuals. Global DNA methylation (5mC content) and hydroxymethylation (5hmC) were evaluated by ELISA. We tested the correlation between 5mC and 5hmC content, and the correlation of each with patients' age. The differences in age, 5mC, and 5hmC in DF from men/women, and location (left/right mandible) was tested. RESULTS The mean age of the 59 individuals was 19.56 ± 3.92, ranging from 13 to 31 years, and most were women (n = 39). 5hmC content and age up to 19 years were inversely correlated (Spearman's correlation coefficient=-0.552, p = 0.0003, n = 38). There was no relationship between 5hmC and 5mC content. There was no difference in the medians of age (p = 0.25), 5hmC (p = 0.33) and 5mC (p = 0.86) between men/women, nor in the medians of age (p = 0.39), 5hmC (p = 0.99) and 5mC (p = 0.22) between the left/right side of the tooth extraction. CONCLUSION An inverse correlation between 5hmC and age was established, with no correlation between 5mC and 5hmC content in DF. The biological meaning of such a decrease of global DNA hydroxymethylation with age in DF remains to be clarified.
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Affiliation(s)
- Vinícius César Barbosa de Menezes
- Department of Oral Surgery and Pathology, Universidade Federal de Minas Gerais (UFMG), Av. Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, CEP: 31270-901, Brazil.
| | - Elisa Carvalho de Siqueira
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Av. Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, CEP: 31270-901, Brazil.
| | - Sara Ferreira Dos Santos Costa
- Department of Oral Surgery and Pathology, Universidade Federal de Minas Gerais (UFMG), Av. Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, CEP: 31270-901, Brazil.
| | - Fabrício Tinôco Alvim de Souza
- Department of Oral Surgery and Pathology, Universidade Federal de Minas Gerais (UFMG), Av. Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, CEP: 31270-901, Brazil.
| | - Renan Pedra de Souza
- Grupo de Pesquisa em Bioestatística e Epidemiologia Molecular, Department of Genetics, Ecology and Evolution,Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Av. Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, CEP: 31270-901, Brazil.
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, Universidade Federal de Minas Gerais (UFMG), Av. Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, CEP: 31270-901, Brazil.
| | - Carolina Cavaliéri Gomes
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Av. Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, CEP: 31270-901, Brazil.
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Hauer L, Seidlová P, Merglová V, Hrusak D, Böhmová H, Posta P, Gencur J, Netolicky J. Complete removal of dentigerous cysts with preservation of associated teeth as an alternative to marsupialization in children and preadolescents. J Craniomaxillofac Surg 2020; 48:808-814. [PMID: 32593630 DOI: 10.1016/j.jcms.2020.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/15/2020] [Accepted: 05/31/2020] [Indexed: 11/25/2022] Open
Abstract
The aim of this study is to evaluate the results of dentigerous cysts enucleation with preservation of cyst-associated teeth as a single procedure in a group of children and preadolescents. A retrospective case series of seven patients with 15 unerupted developing teeth associated with or adjacent to dentigerous cysts was conducted. Patients were treated using the uniform surgical protocol (cystectomy, preservation of cyst-associated teeth, without use of orthodontic traction, primary wound closure). The metric analysis of the cysts and unerupted teeth on CBCT and an evaluation of the state of involved teeth after the treatment was performed. The mean age of patients was 9.0 ± 2.1 years (range 5-12 years, median = 9 years). All teeth erupted spontaneously. No serious postoperative complications or recurrences of lesions were detected. The mean follow-up was 53.1 ± 15.7 months (range 25-71 months, median = 52 months). The cystectomy of dentigerous cysts with preservation of associated teeth may be considered an alternative to marsupialization in children and preadolescents.
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Affiliation(s)
- Lukas Hauer
- Department of Oral and Maxillofacial Surgery (Head of Department: Dr. Daniel Hrusak, Ph.D.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic.
| | - Petra Seidlová
- Department of Dentistry (Head of Department: As. Prof. Dr. Antonin Zicha, CSc.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - Vlasta Merglová
- Department of Dentistry (Head of Department: As. Prof. Dr. Antonin Zicha, CSc.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - Daniel Hrusak
- Department of Oral and Maxillofacial Surgery (Head of Department: Dr. Daniel Hrusak, Ph.D.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - Hana Böhmová
- Department of Dentistry (Head of Department: As. Prof. Dr. Antonin Zicha, CSc.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - Petr Posta
- Department of Oral and Maxillofacial Surgery (Head of Department: Dr. Daniel Hrusak, Ph.D.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - Jiri Gencur
- Department of Oral and Maxillofacial Surgery (Head of Department: Dr. Daniel Hrusak, Ph.D.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - Jan Netolicky
- Department of Dentistry (Head of Department: As. Prof. Dr. Antonin Zicha, CSc.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic
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Luo XJ, Cheng ML, Huang CM, Zhao XP. Reduced delay in diagnosis of odontogenic keratocysts with malignant transformation: A case report. World J Clin Cases 2020; 8:2374-2379. [PMID: 32548170 PMCID: PMC7281059 DOI: 10.12998/wjcc.v8.i11.2374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/22/2020] [Accepted: 04/30/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND In rare cases, odontogenic keratocysts (ODs) transform into squamous cell carcinoma. Intervals between the first attendance of a patient and the diagnosis of OD with malignant transformation vary from weeks to years. In this article, we report a case of malignancy derived from OD with a five-day delay in diagnosis.
CASE SUMMARY A 54-year-old woman was referred to Tongji Hospital in Wuhan, China with complaints of moderate pain, recurrent swelling, and pus discharge around her left maxillary lateral incisor for over 10 years. Physical examination revealed a fistula at the palatine-side mucoperiosteum of the left maxillary lateral incisor and enlarged lymph node in the left neck. Cone beam computed tomography revealed a cystic lesion with massive bone destruction from the left maxillary central incisor to the left secondary maxillary premolar and local bony destruction in the left first mandibular molar. The patient was clinically diagnosed with OD. Enucleation rather than marsupialization was performed given the risk factors of long history, recent aggravated pain, and massive bony destruction. Malignant transformation of OD was confirmed by pathologists 3 d after the operation. Radical surgery was performed, and lymph node metastasis was observed. The patient was subjected to postoperative radiotherapy and synchronous chemotherapy, and no local recurrence or distant metastasis was noted at one-year follow-up.
CONCLUSION Our case suggests that clinicians should be aware of the malignant transformation of OD, especially when patients present with a long history, massive cyst, chronic inflammation, recent persistent infections, aggravated pain, numbness around the cystic lesion, and lymph node enlargement.
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Affiliation(s)
- Xiao-Juan Luo
- Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Ming-Liang Cheng
- Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Chun-Ming Huang
- Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Xiao-Ping Zhao
- Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
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Takahashi H, Takaku Y, Kozakai A, Otsuru H, Murata Y, Myers MW. Primary Intraosseous Squamous Cell Carcinoma Arising from a Dentigerous Cyst of the Maxillary Wisdom Tooth. Case Rep Oncol 2020; 13:611-616. [PMID: 32595471 PMCID: PMC7315222 DOI: 10.1159/000507478] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 03/24/2020] [Indexed: 11/19/2022] Open
Abstract
The World Health Organization defines primary intraosseous squamous cell carcinoma (PIOSCC) as a squamous cell carcinoma (SCC) arising primarily within the jaws and having no connection with the oral mucosa. Here, we report a case of PIOSCC in which it was difficult to differentiate the condition from pericoronitis of an impacted maxillary wisdom tooth. The patient was a 27-year-old pregnant woman with a pain in the right maxillary wisdom tooth. The pain was diagnosed as pericoronitis of the right maxillary wisdom tooth, and the tooth was extracted under local anesthesia. During extraction, soft tissue was observed in the coronal part of the tooth, and it was diagnosed as SCC arising in a dentigerous cyst. Because the tumor may still be present, surgical resection was performed under general anesthesia. There has been no recurrence or metastasis at the 1-year follow-up. This case was histopathologically considered from being a benign odontogenic tumor to a malignant tumor. However, it revealed an extensive aberrant type and invasion equivalent to SCC. Thus, the histopathological diagnosis was PIOSCC arising from a dentigerous cyst. Although advanced cases of PIOSCC have been published, diagnosis of PIOSCC in the early stages is rare. In this case, we diagnosed pericoronitis of an impacted maxillary wisdom tooth and extracted the tooth. Therefore, we discovered it accidentally. In the early stages, diagnosis can be difficult both clinically and histopathologically.
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Affiliation(s)
- Hikaru Takahashi
- Department of Dentistry and Oral Surgery, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan
| | - Yuichiro Takaku
- Department of Dentistry and Oral Surgery, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan
| | - Ayako Kozakai
- Department of Dentistry and Oral Surgery, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan.,Department of Oral and Maxillofacial Surgery, Tokyo Dental College, Tokyo, Japan
| | - Hiroshi Otsuru
- Department of Dentistry and Oral Surgery, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan
| | - Yuya Murata
- Department of Pathology, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan
| | - Michael W Myers
- International Exchange Center, Showa University, Tokyo, Japan
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Primary Intraosseous Squamous Cell Carcinoma of the Anterior Mandible Arising in an Odontogenic Cyst in 34-Year-Old Male. REPORTS 2020. [DOI: 10.3390/reports3020012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Primary intraosseous squamous cell carcinoma (PIOSCC) is a rare and aggressive malignancy arising exclusively within the jaws, without any initial connection with the oral mucosa. The etiology and the epidemiology are unclear due to the rarity of the disease, and there is no current universally accepted staging or treatment protocol. Clinically, the posterior mandible is the most affected site, and common symptoms are swelling and pain. The diagnosis is often difficult either because it requires stringent criteria to be satisfied or because of the absence of a pathognomonic histological pattern. Aggressive surgery is the first-choice treatment, often followed by radiotherapy. The lymph nodal status seems to be the most important factor influencing the prognosis, which is usually poor, with a 5-year survival rate ranging from 30% to 40%. In the present article, we report an unusual case of cystogenic PIOSCC interesting the anterior mandible of a young 34-year-old male, which came to our attention after complaint about recurrent infective episodes affecting a dentigerous cyst (impacted lower canine) discovered ten years before. The age, site, and extension are uncommon. Extensive surgical treatment with fibula free flap reconstruction, adjuvant therapy, and salvage surgery was carried out. The patient was disease-free at a 31-month follow-up.
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Rahman NA, Harun MH, Rahman SA, Mohammad NSA. Floating teeth appearance: A radiographic dilemma. J Taibah Univ Med Sci 2020; 15:160-165. [PMID: 32368214 PMCID: PMC7184205 DOI: 10.1016/j.jtumed.2020.02.005] [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: 12/22/2019] [Revised: 01/31/2020] [Accepted: 02/04/2020] [Indexed: 11/30/2022] Open
Abstract
Gorham disease (GD) is an extremely rare disorder that is characterised by massive osteolysis of the affected bone with unknown aetiology and an unpredictable prognosis. Additionally, no standard treatment is available for GD. This article describes a case report of a 61-year-old Malay woman who was diagnosed with GD of the anterior mandible without a prior history of trauma. She presented with pain and mobility of the dentoalveolar segment for 3 months. The radiographic findings showed “floating teeth” with widening of the periodontal ligament space and localized area of bony destruction. Histopathologically, there was proliferation of numerous dilated endothelial-lined channels within the intertrabecular tissue. Some areas of bone were replaced by fibrous connective tissue giving rise to the appearance of a benign fibroosseous lesion. The patient was managed with simple removal of the affected bone segment under local anaesthesia, followed by prosthodontic rehabilitation. Healing of the surgical site was uneventful, and no recurrence was reported at the 3-year follow-up.
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Affiliation(s)
- Nurhayu A Rahman
- Oral Medicine and Oral Pathology Unit, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian Kelantan, Malaysia
| | - Masitah H Harun
- Oral Medicine and Oral Pathology Unit, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian Kelantan, Malaysia
| | - Shaifulizan A Rahman
- Oral and Maxillofacial Surgery Unit, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Nurul S A Mohammad
- Outpatient Dental Clinic, Hospital USM, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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36
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PIC developing from odontogenic cysts: Clinical and radiological considerations on a series of 6 cases. ORAL AND MAXILLOFACIAL SURGERY CASES 2020. [DOI: 10.1016/j.omsc.2019.100139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Abdelkarim AZ, Elzayat AM, Syed AZ, Lozanoff S. Delayed diagnosis of a primary intraosseous squamous cell carcinoma: A case report. Imaging Sci Dent 2019; 49:71-77. [PMID: 30941291 PMCID: PMC6444010 DOI: 10.5624/isd.2019.49.1.71] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 10/18/2018] [Accepted: 11/18/2018] [Indexed: 02/06/2023] Open
Abstract
Primary intraosseous squamous cell carcinoma is a rare malignant central jaw tumor derived from odontogenic epithelial remnants. Predominantly, it affects mandible, although both jaw bones may be involved. This report describes a 60-year-old man who was initially misdiagnosed with a periapical infection related to the right lower wisdom tooth. After four months, the patient presented to a private dental clinic with a massive swelling at the right side of the mandible. Panoramic radiographs and advanced imaging revealed a lesion with complete erosion of the right ramus, which extended to the orbital floor. A biopsy from the mandibular angle revealed large pleomorphic atypical squamous cells, which is the primary microscopic feature of a poorly differentiated squamous cell carcinoma.
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Affiliation(s)
- Ahmed Z Abdelkarim
- Department of Anatomy, Biochemistry and Physiology, University of Hawai'i School of Medicine, Honolulu, HI, USA
| | - Ahmed M Elzayat
- Department of Oral and Maxillofacial Surgery, Insurance Hospital, Suez, Egypt
| | - Ali Z Syed
- Oral and Maxillofacial Medicine and Diagnostics Science, CWRU School of Dental Medicine, Cleveland, OH, USA
| | - Scott Lozanoff
- Department of Anatomy, Biochemistry and Physiology, University of Hawai'i School of Medicine, Honolulu, HI, USA
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Li K, Yang L, Qiao YJ, Liang YJ, Wang X, Liao GQ. Risk factors and prognosis for the primary intraosseous carcinoma of the jaw. Int J Oral Maxillofac Surg 2019; 48:157-162. [DOI: 10.1016/j.ijom.2018.07.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 06/15/2018] [Accepted: 07/30/2018] [Indexed: 10/28/2022]
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Kimura M, Shiraki Y, Ishibashi K, Umemura M. Remarkable Short-Term Regression of a Posterior Mediastinum Metastasis From Primary Intraosseous Carcinoma Treated With Nivolumab: A Case Report. J Oral Maxillofac Surg 2018; 77:555.e1-555.e6. [PMID: 30576676 DOI: 10.1016/j.joms.2018.11.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 11/07/2018] [Accepted: 11/14/2018] [Indexed: 11/29/2022]
Abstract
Primary intraosseous carcinoma (PIOC; not otherwise specified) is a rare odontogenic malignancy that is believed to arise from the odontogenic epithelium. In addition, some cases arise in odontogenic cysts or other benign precursors. There are no established treatment protocols for PIOC because of its rarity. In particular, no standard therapy has been established for patients with recurrent or metastatic PIOC. This report describes a case in which the use of nivolumab showed a marked treatment response in metastatic PIOC. The patient was a 71-year-old man with PIOC. The patient underwent segmental mandibulectomy with modified radical neck dissection after neoadjuvant chemotherapy, including 2 cycles of paclitaxel, cetuximab, and carboplatin and 1 cycle of docetaxel, cisplatin, and 5-fluorouracil. The lesion rapidly enlarged during neoadjuvant chemotherapy, and surgical specimens showed no histologic therapeutic effects of chemotherapy. Three months after the surgery, contrast-enhanced computed tomograms showed posterior mediastinal lymph node metastasis. Treatment with nivolumab was initiated, and notable clinical improvement was noted after 2 cycles. Although it was a short-term treatment, remarkable effects were observed and no adverse events were noted during and after nivolumab treatment. Nivolumab could be an attractive treatment option for metastatic PIOC that is resistant to traditional chemotherapy and target therapy, including cetuximab. Further investigation of this treatment is warranted.
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Affiliation(s)
- Masashi Kimura
- Chief Surgeon, Department of Oral and Maxillofacial Surgery, Ogaki Municipal Hospital, Ogaki, Japan.
| | - Yukihiro Shiraki
- Assistant Professor, Department of Pathology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenichiro Ishibashi
- Chief Surgeon, Department of Oral and Maxillofacial Surgery, Ogaki Municipal Hospital, Ogaki, Japan
| | - Masahiro Umemura
- Director, Department of Oral and Maxillofacial Surgery, Ogaki Municipal Hospital, Ogaki, Japan
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Slootweg PJ, Odell EW, Baumhoer D, Carlos R, Hunter KD, Taylor AM, Richardson MS, Slater L, Speight PM, Wright J, Thompson LDR. Data Set for the Reporting of Malignant Odontogenic Tumors: Explanations and Recommendations of the Guidelines From the International Collaboration on Cancer Reporting. Arch Pathol Lab Med 2018; 143:587-592. [PMID: 30500289 DOI: 10.5858/arpa.2018-0417-sa] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A data set has been developed for the reporting of excisional biopsies and resection specimens for malignant odontogenic tumors by members of an expert panel working on behalf of the International Collaboration on Cancer Reporting, an international organization established to unify and standardize reporting of cancers. Odontogenic tumors are rare, which limits evidence-based support for designing a scientifically sound data set for reporting them. Thus, the selection of reportable elements within the data set and considering them as either core or noncore is principally based on evidence from malignancies affecting other organ systems, limited case series, expert opinions, and/or anecdotal reports. Nevertheless, this data set serves as the initial step toward standardized reporting on malignant odontogenic tumors that should evolve over time as more evidence becomes available and functions as a prompt for further research to provide such evidence.
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Affiliation(s)
- Pieter J Slootweg
- From the Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands (Dr Slootweg); Head and Neck Pathology, King's College London, United Kingdom (Dr Odell); Institute of Pathology, University Hospital Basel, Basel, Switzerland (Dr Baumhoer); Centro Clínico de Cabeza y Cuello, Pathology Division, Guatemala City, Guatemala (Dr Carlos); Oral and Maxillofacial Medicine, Surgery and Pathology (Dr Hunter) and the Department of Oral Pathology (Dr Speight), University of Sheffield, Sheffield, United Kingdom; Health Care Department, Universidad Autonoma Metropolitana Xochimilco, Mexico City, Mexico (Dr Mosqueda Taylor); the Department of Pathology & Laboratory Medicine, Medical University of South Carolina, Charleston (Dr Richardson); Scripps Oral Pathology Service, San Diego, California (Dr Slater); the Department of Diagnostic Sciences, Texas A&M College of Dentistry, Dallas (Dr Wright); and the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills (Dr Thompson)
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Kang S, Leem DH. Verrucous carcinoma arising from a previous cystic lesion: a case report. Maxillofac Plast Reconstr Surg 2018; 40:31. [PMID: 30397593 PMCID: PMC6200831 DOI: 10.1186/s40902-018-0169-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 08/31/2018] [Indexed: 11/11/2022] Open
Abstract
Background Verrucous carcinoma (VC) accounts for 1–10% of cases of squamous cell carcinoma (SCC) in the oral cavity, and 75% of VC occur in the oral cavity. Only 3% of primary intraosseous squamous cell carcinomas (PIOSCC), which means SCC occurring primarily in the bone, are VC. Verrucous carcinoma arising from odontogenic cysts (OC) is very rare, with only seven cases reported to date. Case presentation This study reported a case of a patient who underwent partial maxillectomy and neck dissection for VC that occurred in the right anterior maxilla. The patient was admitted to the emergency department at our institution 8 years ago and showed cystic lesions in the anterior maxilla on facial computed tomography (CT) images. Treatment through other departments including assessment of laceration in the mental region and only suture was performed. This report highlights a very rare case of VC in the right anterior maxilla arising from a previous cystic lesion. Conclusions Since PIOSCC can arise from OC, appropriate treatment of intraosseous cysts and regular radiologic evaluation are necesssary. Surgical exicision of the primary lesion without neck dissection can lead to good prognosis for patients with primary intraosseous verrucous carcinoma.
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Affiliation(s)
- Sunghyun Kang
- 1Department of Oral and Maxillofacial Surgery, Chonbuk National University Hospital, 20 Geonjiro, Deokjin-gu, Jeonju-si, Jeollabuk-do 54907 South Korea
| | - Dae Ho Leem
- 2Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju-si, Jeollabuk-do 54896 South Korea
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Nokovitch L, Bodard AG, Corradini N, Crozes C, Guyennon A, Deneuve S. Pediatric case of squamous cell carcinoma arising from a keratocystic odontogenic tumor. Int J Pediatr Otorhinolaryngol 2018; 112:121-125. [PMID: 30055720 DOI: 10.1016/j.ijporl.2018.06.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 06/19/2018] [Accepted: 06/21/2018] [Indexed: 01/24/2023]
Abstract
Keratocystic odontogenic tumors (KCOT) are exceptional in children and adolescents as they usually occur in the third decade. The present study reports the case of a 15 years old girl who was diagnosed with a KCOT that underwent malignant transformation. KCOT diagnostic was based on clinical, radiological, histopathological and immunohistochemical findings. A conservative treatment by enucleation was performed. Histopathological analysis of the surgical specimen concluded to a KCOT, with an infra-centimetric focus of well-differentiated squamous cell carcinoma. Owing to the well-differentiated character of the squamous cell carcinoma, a single clinical and MRI surveillance every 3 months was decided, without complementary treatment.
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Affiliation(s)
- Lara Nokovitch
- Oncologic Surgery Department, Centre Léon Bérard, Lyon, France
| | | | | | - Carole Crozes
- Pathology Laboratory Department, Centre Léon Bérard, Lyon, France
| | | | - Sophie Deneuve
- Oncologic Surgery Department, Centre Léon Bérard, Lyon, France.
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Barbosa EB, Pedroso Mota MC, Vieira WR, Chone CT, Pfeilsticker LN. WITHDRAWN: Primary intraosseous carcinoma of the mandible presenting with facial palsy: report of a case and review of literature. ORAL AND MAXILLOFACIAL SURGERY CASES 2018. [DOI: 10.1016/j.omsc.2018.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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44
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Vera-Sirera B, Rubio-Martínez L, Forner-Navarro L, Vera-Sempere F. Orthokeratinized odontogenic cysts: a Spanish tertiary care centre study based on HPV DNA detection. Head Face Med 2018; 14:10. [PMID: 30005670 PMCID: PMC6043989 DOI: 10.1186/s13005-018-0167-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 06/29/2018] [Indexed: 11/17/2022] Open
Abstract
Background The role of human papillomavirus (HPV) in orthokeratinized odontogenic cysts (OOCs) has rarely been studied. The objective is to describe the clinicopathological findings in a series of OOCs from a Spanish population that were investigated in relation to the possible presence of HPV. Methods A clinicopathological retrospective analysis followed by a molecular analysis of 28 high- and low-risk HPV genotypes was performed in OOC samples of patients seen during the last 15-years in a Spanish tertiary care center. Results Of 115 odontogenic cysts with keratinization, 16 cases of OOCs were confirmed and evaluated. OOCs occurred predominantly in the mandible of males (mean age 36.06 ± 13.16 years). Swelling of the jaw followed by pain were the most common clinical symptoms, and 56.5% of the OOC cases were associated with an unerupted tooth. After a mean post-cystectomy follow-up of 3.8 years, only one recurrent case was observed, resulting in a verrucous cystic lesion that was considered premalignant after immunohistological examination. DNA extraction was successful from 14 of the 16 OOC cases. None of the primary OCCs or the single recurrent OOC were positive for HPV in the molecular analysis. Conclusions OOCs show a very limited potential for recurrence. Our results suggest that neither high- or low-risk HPV subtypes are likely to play a role in the etiology or neoplastic transformation of OOC, at least in the Spanish population.
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Affiliation(s)
- Beatriz Vera-Sirera
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Comunidad Valenciana, Spain
| | - Luis Rubio-Martínez
- Molecular Pathology Unit, Department of Pathology, La Fe University Hospital, University of Valencia, Valencia, Comunidad Valenciana, Spain
| | - Leopoldo Forner-Navarro
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Comunidad Valenciana, Spain
| | - Francisco Vera-Sempere
- Department of Pathology, Faculty of Medicine and Dentistry, La Fe University Hospital, University of Valencia, Torre A, 2° planta, Avda. Fernando Abril Martorell 106, 46026, Valencia, Comunidad Valenciana, Spain.
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45
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Initial-Stage Primary Intraosseous Squamous Cell Carcinoma Derived from Odontogenic Keratocyst with Unusual Keratoameloblastomatous Change of the Maxilla: A Case Report and Literature Discussion. Case Rep Otolaryngol 2018; 2018:7959230. [PMID: 29850338 PMCID: PMC5933066 DOI: 10.1155/2018/7959230] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/08/2018] [Indexed: 02/07/2023] Open
Abstract
Primary intraosseous squamous cell carcinoma (PIOSCC) is a rare malignant neoplasm derived from odontogenic epithelial remnants in the central jaw bone. Most PIOSCCs originate from odontogenic cysts with a nonkeratinized epithelial lining, especially from radicular/residual and dentigerous cysts. There have been few reports of PIOSCCs derived from the odontogenic keratocyst (OKC), particularly those describing pathological features at the initial stage. The diagnosis of PIOSCC is difficult and based on exclusion of other carcinomas, including metastatic tumors from other primary sites. Here, we report an extremely rare case of initial-stage PIOSCC derived from the OKC with unusual keratoameloblastomatous change of the maxilla.
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46
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Pavlin D, Dolenšek T, Švara T, Nemec A. Solid type primary intraosseous squamous cell carcinoma in a cat. BMC Vet Res 2018; 14:23. [PMID: 29357860 PMCID: PMC5778816 DOI: 10.1186/s12917-018-1344-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 01/11/2018] [Indexed: 11/11/2022] Open
Abstract
Background Squamous cell carcinoma (SCC) is the most common nonodontogenic oral tumor in cats. In the jaw, it usually presents as an ulceroproliferative lesion associated with enlargement of the affected bone. Case presentation This report describes the case of a cat in which clinical and radiographic findings of a mandibular swelling were suggestive of an aggressive process, but the oral mucosa was unaffected. The results of histopathological and immunohistochemical examination of the samples obtained from the intraosseous lesion were consistent with SCC. The animal was euthanized 5 months after initial presentation as a result of the severe progression of the disease, and no other primary tumors were identified at necropsy. Conclusions Based on the clinicopathological, microscopic, and immunohistochemical staining features, as well as the absence of a primary tumor at a distant site, we propose that the term, solid type primary intraosseous SCC (PIOSCC), be used to describe this neoplasia, as it shares similar features with human PIOSCC.
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Affiliation(s)
- Darja Pavlin
- University of Ljubljana, Veterinary faculty, Small Animal Clinic, Gerbičeva, 60, Ljubljana, Slovenia.
| | - Tamara Dolenšek
- University of Ljubljana, Veterinary faculty, Institute of Pathology, Wild Animals, Fish and Bees, Gerbičeva, 60, Ljubljana, Slovenia
| | - Tanja Švara
- University of Ljubljana, Veterinary faculty, Institute of Pathology, Wild Animals, Fish and Bees, Gerbičeva, 60, Ljubljana, Slovenia
| | - Ana Nemec
- University of Ljubljana, Veterinary faculty, Small Animal Clinic, Gerbičeva, 60, Ljubljana, Slovenia
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47
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Shen Q, Chen Y, Gokavarapu S, Cao W, Ji T. Primary intraosseous squamous cell carcinoma of the mandible: locoregional control and survival is significantly reduced if the tumour is more than 4cm in size. Br J Oral Maxillofac Surg 2018; 56:48-53. [PMID: 29229291 DOI: 10.1016/j.bjoms.2017.11.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 11/14/2017] [Indexed: 02/08/2023]
Abstract
To establish the prognostic factors for primary intraosseous squamous cell carcinoma we designed a retrospective study of patients treated in the head and neck department of a tertiary referral centre in China from 2010-2015. We collected clinical, radiological, and histopathological data from 36 patients treated during the given time period, among which 34 were followed up. There were 22 male and 12 female patients, 13 of whom gave a history of smoking tobacco and four who drank alcohol. All 34 patients were treated by segmental mandibulectomy and neck dissection. Nine had cervical lymph node metastases on histopathological examination, and none had invaded surgical margins. Twenty-eight were treated with radiotherapy postoperatively. During follow up nine died of locoregional recurrence or metastases. Specific factors such as cervical lymph node metastases were related to a greater likelihood of locoregional recurrence. Patients who drank alcohol were also more likely to develop metastases postoperatively. Tumours more than 4cm in size were significantly associated with reductions in locoregional control and survival.
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Affiliation(s)
- Q Shen
- Department of Medical Records and Statistic Service Management, Shanghai Stomatology Key Laboratory, Ninth People's Hospital Affiliated School of Medicine, Shanghai Jiao Tong University, 639 Zhizaoju Road, Shanghai 200011, China.
| | - Y Chen
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Stomatology Key Laboratory, Ninth People's Hospital Affiliated School of Medicine, Shanghai Jiao Tong University, 639 Zhizaoju Road, Shanghai 200011, China.
| | - S Gokavarapu
- Department of Head and Neck Surgery, Krishna Institute of Medical Science, Hyderabad, Telangana 500003, India.
| | - W Cao
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Stomatology Key Laboratory, Ninth People's Hospital Affiliated School of Medicine, Shanghai Jiao Tong University, 639 Zhizaoju Road, Shanghai 200011, China.
| | - T Ji
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Stomatology Key Laboratory, Ninth People's Hospital Affiliated School of Medicine, Shanghai Jiao Tong University, 639 Zhizaoju Road, Shanghai 200011, China.
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48
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Wright JM, Soluk Tekkesin M. Odontogenic tumors: where are we in 2017 ? J Istanb Univ Fac Dent 2017; 51:S10-S30. [PMID: 29354306 PMCID: PMC5750825 DOI: 10.17096/jiufd.52886] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 08/04/2017] [Indexed: 11/30/2022] Open
Abstract
Odontogenic tumors are a heterogeneous group of
lesions of diverse clinical behavior and histopathologic
types, ranging from hamartomatous lesions to malignancy.
Because odontogenic tumors arise from the tissues which
make our teeth, they are unique to the jaws, and by extension
almost unique to dentistry. Odontogenic tumors, as in normal
odontogenesis, are capable of inductive interactions between
odontogenic ectomesenchyme and epithelium, and the
classification of odontogenic tumors is essentially based
on this interaction. The last update of these tumors was
published in early 2017. According to this classification,
benign odontogenic tumors are classified as follows:
Epithelial, mesenchymal (ectomesenchymal), or mixed
depending on which component of the tooth germ gives
rise to the neoplasm. Malignant odontogenic tumors are
quite rare and named similarly according to whether the
epithelial or mesenchymal or both components is malignant.
The goal of this review is to discuss the updated changes to
odontogenic tumors and to review the more common types
with clinical and radiological illustrations.
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Affiliation(s)
- John M Wright
- Department of Diagnostic Sciences, School of Dentistry, Texas A&M University, Dallas, TX USA
| | - Merva Soluk Tekkesin
- Department of Tumor Pathology, Institute of Oncology, Istanbul University, Istanbul Turkey
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Medawela RMSHB, Jayasuriya NSS, Ratnayake DRDL, Attygalla AM, Siriwardena BSMS. Squamous cell carcinoma arising from a keratocystic odontogenic tumor: a case report. J Med Case Rep 2017; 11:335. [PMID: 29191248 PMCID: PMC5710129 DOI: 10.1186/s13256-017-1486-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 09/19/2017] [Indexed: 11/27/2022] Open
Abstract
Background The term “primary intraosseous squamous cell carcinoma” was introduced in 2005 by the World Health Organization with three subcategories. Squamous cell carcinoma arising from the lining of an odontogenic cyst is one important rare subcategory of such lesions with an incidence of 0.01 to 0.02%. Furthermore, the appearance of such malignancy in an odontogenic tumor such as keratocystic odontogenic tumor is considered extremely rare. Case presentation In this case report we report a case of a 50-year-old Sri Lankan woman who complained of pain and increase in the size of a swelling at the anterior mandible, which had been present for over 1 year. The increase was significant for 1 month with accompanying numbness of the left half of her lip. Cone beam computed tomography results revealed an irregular radiolucent lesion involving most of her mandible and, except in the anterior part, very little buccolingual expansion was seen that suggested a keratocystic odontogenic tumor. An excision biopsy of the cyst lining confirmed a squamous cell carcinoma arising from a preexisting keratocystic odontogenic tumor. Conclusions Even though primary intraosseous squamous cell carcinoma arising from a keratocystic odontogenic tumor is considered to be very rare, the present case is comparable to most of the aspects cited in the literature. The current case emphasizes the importance of careful investigation of swellings present in the mandible. Clinicians as well as patients should be aware and detect these changes to avoid being clinically negligent.
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Affiliation(s)
| | | | | | - Ajith Manjula Attygalla
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
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50
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Jalali E, Ferneini EM, Rengasamy K, Tadinada A. Squamous cell carcinoma arising within a maxillary odontogenic keratocyst: A rare occurrence. Imaging Sci Dent 2017; 47:135-140. [PMID: 28680851 PMCID: PMC5489670 DOI: 10.5624/isd.2017.47.2.135] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 03/07/2017] [Accepted: 03/24/2017] [Indexed: 01/17/2023] Open
Abstract
Squamous cell carcinoma (SCC) arising within the lining of an odontogenic keratocyst (OKC) is a rare occurrence. Although potentially locally destructive, OKC is a benign odontogenic process that typically presents with clinical and radiographic features characteristic of a benign intraosseous neoplasm. We present the clinical and radiographic features of a maxillary mass that demonstrated SCC arising from the lining of an OKC. Although the initial clinical and radiographic presentation suggested an infection or malignant neoplasm, biopsies revealed an infiltrative well-differentiated SCC contiguous with and arising from the focus of a pre-existing OKC. The patient subsequently underwent a type II hemi-maxillectomy with neoadjuvant chemoradiation. This report discusses the clinical and radiographic features associated with intraosseous malignancies, especially those arising from an otherwise benign odontogenic lesion. While the majority of OKCs are benign, the current report illustrates the potential for carcinomatous transformation within the lining of an OKC.
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Affiliation(s)
- Elnaz Jalali
- Eliray Oral and Maxillofacial Radiology Consulting Services, Miami, FL, USA
| | - Elie M Ferneini
- Department of Craniofacial Sciences, Division of Oral and Maxillofacial Surgery, University of Connecticut, School of Dental Medicine, Farmington, CT, USA
| | - Kandasamy Rengasamy
- Section of Oral and Maxillofacial Radiology, University of Connecticut, School of Dental Medicine, Farmington, CT, USA
| | - Aditya Tadinada
- Section of Oral and Maxillofacial Radiology, University of Connecticut, School of Dental Medicine, Farmington, CT, USA
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