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Patel P, Effiom OA, Akinshipo AWO, Akintoye SO. Differential Profile of Primary and Recurrent Ameloblastomas Among Afro-descendants and Non-Afro-descendants-a Systematic Review. J Racial Ethn Health Disparities 2024; 11:92-100. [PMID: 36596981 PMCID: PMC10437082 DOI: 10.1007/s40615-022-01500-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 01/05/2023]
Abstract
Ameloblastoma is an aggressively growing jaw tumor with high recurrent properties. Reports on global and racial distribution of ameloblastoma are variable and inconclusive. The role of race and ethnicity on ameloblastoma growth characteristics, genetic mutational profile, and recurrence is also still unclear. The primary aim of this systematic review was to assess genetic, racial, and ethnic distribution of primary and recurrent ameloblastoma from published literature. The secondary aim was to assess potential correlations between ethnicity, genetic mutation, and disparities in ameloblastoma treatment outcomes in Afro-descendants and non-Afro-descendants. Twenty-three eligible articles were selected based on preferred reporting items for systematic review and meta-analysis (PRISMA), and a total of 169 ameloblastoma cases were evaluated. Data on patient demographics, ameloblastoma growth characteristics, and genetic status were collected for quantitative analysis. Among a total of 169 ameloblastoma cases, Afro-descendant patients had higher primary and recurrent ameloblastomas at 15.5% and 4.7% respectively compared to non-Afro-descendant at 10.7% and 1.8% respectively. Additionally, BRAF V600E was positively associated with 48.8% of all ameloblastomas and strong predilection for Afro-descendants. Despite the paucity of information on genetic profile of ameloblastomas in the Afro-descendant patient cohort, this ethnic group still accounted for 2.95% of all BRAF V600E-positive tumors. These suggest that Afro-descendants are understudied regarding ameloblastoma characteristics, genetic profile, and recurrence profile. Mutational analysis of ameloblastoma tumors in Afro-descendants should be promoted.
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Affiliation(s)
- Parth Patel
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Olajumoke A Effiom
- Department of Oral and Maxillofacial Pathology/Biology Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria
| | - Abdul-Warith O Akinshipo
- Department of Oral and Maxillofacial Pathology/Biology Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria
| | - Sunday O Akintoye
- Department of Oral and Maxillofacial Pathology/Biology Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria.
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, 240 S 40th Street, Philadelphia, PA, USA.
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Khan S, Gautam N, Sharma T, Pooja SD. Ossifying fibroma mimiking jaw tumour: A radiographic dilema. J Cancer Res Ther 2024; 20:441-444. [PMID: 38554359 DOI: 10.4103/jcrt.jcrt_1757_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 09/02/2022] [Indexed: 04/01/2024]
Abstract
Fibro-osseous lesions (FOLs) of the craniomaxillofacial region comprise a group of developmental, dysplastic, and neoplastic alterations. FOLs include ossifying fibromas (OF), cemento-ossifying fibroma (COF), familial gigantiform cementoma (FGC), fibrous dysplasia (FD), and cemento-osseous dysplasia (COD). Evidence suggests that some FOL, especially FD and OF may have a risk of spontaneous malignant transformation. This report documents a rare case of malignant transformation of ossifying fibromas of the jaw and the probable cause for same. Although it is rare, the clinician should have a complete follow up to observe such changes among the patients having FOLs.
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Affiliation(s)
- Saba Khan
- Department of Oral Medicine and Radiology, Darshan Dental College and Hospital, Loyara, Udaipur, Rajasthan, India
- Department of Oral Medicine and Radiology, Sankalchand Patel University, Visnagar, Gujarat, India
| | - Nishita Gautam
- Department of Oral Medicine and Radiology, Darshan Dental College and Hospital, Loyara, Udaipur, Rajasthan, India
| | - Tulika Sharma
- Department of Oral Medicine and Radiology, Darshan Dental College and Hospital, Loyara, Udaipur, Rajasthan, India
| | - S Dhakad Pooja
- Department of Oral Medicine and Radiology, Darshan Dental College and Hospital, Loyara, Udaipur, Rajasthan, India
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3
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Zhang L, Xu Q, Feng Z. Comprehensive clinical, genome and transcriptomic analysis of primary ghost cell odontogenic carcinoma. Oral Oncol 2024; 148:106616. [PMID: 37988836 DOI: 10.1016/j.oraloncology.2023.106616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 10/24/2023] [Accepted: 10/30/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVES There is currently no comprehensive genome-wide description of the primary ghost cell odontogenic carcinoma (GCOC), hindering our understanding of pathogenesis. We herein present a case with comprehensive clinical, genome and transcriptomic analysis. These will serve as the first comprehensive molecular atlas for primary GCOC. A 58-year-old male underwent subtotal resection with prosthetic restoration. Genome sequencing (WGS) detected previously identified CTNNB1 mutation with novel alterations of MAP3K, EP300, and 22q11.21 region. Transcriptome results showed significant involvement of cytokine-cytokine receptor interaction and PI3K-Akt signaling pathway. These results need to be compared with more GCOCs for more accurate clinical guidance.
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Affiliation(s)
- Lirui Zhang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
| | - Qiaoshi Xu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
| | - Zhien Feng
- Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China.
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4
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Zhou Z, Zhang Y, Zhu L, Cui Y, Gao Y, Zhou C. Familial gigantiform cementoma with recurrent ANO5 p.Cys356Tyr mutations: Clinicopathological and genetic study with literature review. Mol Genet Genomic Med 2024; 12:e2277. [PMID: 37649308 PMCID: PMC10767285 DOI: 10.1002/mgg3.2277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 08/17/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Familial gigantiform cementoma (FGC) is a rare tumor characterized by the early onset of multi-quadrant fibro-osseous lesions in the jaws, causing severe maxillofacial deformities. Its clinicopathological features overlap with those of other benign fibro-osseous lesions. FGC eventually exhibits progressively rapid growth, but no suspected causative gene has been identified. METHODS In this study, three patients with FGC were recruited, and genomic DNA from the tumor tissue and peripheral blood was extracted for whole-exome sequencing. RESULTS Results showed that all three patients harbored the heterozygous mutation c.1067G > A (p.Cys356Tyr) in the ANO5 gene. Furthermore, autosomal dominant mutations in ANO5 at this locus have been identified in patients with gnathodiaphyseal dysplasia (GDD) and are considered a potential causative agent, suggesting a genetic association between FGC and GDD. In addition, multifocal fibrous bone lesions with similar clinical presentations were detected, including five cases of florid cemento-osseous dysplasia, five cases of polyostotic fibrous dysplasia, and eight cases of juvenile ossifying fibromas; however, none of them harbored mutations in the ANO5 gene. CONCLUSION Our findings indicate that FGC may be an atypical variant of GDD, providing evidence for the feasibility of ANO5 gene testing as an auxiliary diagnostic method for complex cases with multiple quadrants.
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Affiliation(s)
- Zheng Zhou
- Department of Oral PathologyPeking University School and Hospital of StomatologyBeijingP.R. China
- National Engineering Laboratory for Digital and Material Technology of StomatologyPeking University School and Hospital of StomatologyBeijingP.R. China
| | - Ye Zhang
- Department of Oral PathologyPeking University School and Hospital of StomatologyBeijingP.R. China
- National Engineering Laboratory for Digital and Material Technology of StomatologyPeking University School and Hospital of StomatologyBeijingP.R. China
| | - Lijing Zhu
- Department of Oral PathologyPeking University School and Hospital of StomatologyBeijingP.R. China
- National Engineering Laboratory for Digital and Material Technology of StomatologyPeking University School and Hospital of StomatologyBeijingP.R. China
| | - Yajuan Cui
- Department of Oral PathologyPeking University School and Hospital of StomatologyBeijingP.R. China
- National Engineering Laboratory for Digital and Material Technology of StomatologyPeking University School and Hospital of StomatologyBeijingP.R. China
| | - Yan Gao
- Department of Oral PathologyPeking University School and Hospital of StomatologyBeijingP.R. China
- National Engineering Laboratory for Digital and Material Technology of StomatologyPeking University School and Hospital of StomatologyBeijingP.R. China
| | - Chuan‐Xiang Zhou
- Department of Oral PathologyPeking University School and Hospital of StomatologyBeijingP.R. China
- National Engineering Laboratory for Digital and Material Technology of StomatologyPeking University School and Hospital of StomatologyBeijingP.R. China
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5
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Bolek AM, Smith MM, Taney K, Powers B. Symphyseal-Sparing Mandibulectomy for Canine Acanthomatous Ameloblastoma in Dogs: 35 Cases. J Vet Dent 2024; 41:10-16. [PMID: 37006121 DOI: 10.1177/08987564231163692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
Canine acanthomatous ameloblastoma (CAA) has been reported to be the most prevalent odontogenic tumor in dogs. The most common location of this tumor is the rostral mandible. Symphyseal-sparing mandibulectomy has been shown to be an effective technique to maintain mandibular continuity and promote early return to function. In this retrospective study, 35 dogs with CAA associated with a mandibular canine tooth were evaluated following a symphyseal-sparing rostral mandibulectomy. Dogs with intraoperative transection of the canine tooth root and subsequent root fragment extraction were included. The objective of this study was to evaluate outcome following excision of CAA with mid-root transection. Data retrospectively evaluated in this study included the following: narrowest tumor margin, narrowest tumor margin at the border associated with the transected canine root, tumor size, and prevalence of local recurrence. This study showed that 82.86% of CAA were completely excised with tumor-free margins (N = 29). The median narrowest overall tumor-free margin was 3.5 mm (interquartile range [IQR] 2.0-6.5 mm) and the median tumor-free margin associated with the border of the transected canine root was 5.0 mm (IQR 3.1-7.0 mm). Follow-up data was obtained in 25 cases via phone interviews with referring veterinarians and clients. No local tumor recurrence was reported in cases with incomplete tumor excision (N = 5). All dogs with follow-up data survived at least 1 year following surgery. It was concluded that segmental or rostral mandibulectomy with wide margins to include the entire mandibular canine tooth with subsequent mandibular instability may not be warranted for dogs with CAA associated with this tooth.
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Affiliation(s)
- Ann M Bolek
- Center for Veterinary Dentistry and Oral Surgery, Gaithersburg, MD, USA
| | - Mark M Smith
- Center for Veterinary Dentistry and Oral Surgery, Gaithersburg, MD, USA
| | - Kendall Taney
- Center for Veterinary Dentistry and Oral Surgery, Gaithersburg, MD, USA
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Tora R, Welch J, Sun J, Agarwal SK, Bell DA, Merino M, Weinstein LS, Simonds WF, Jha S. Phenotypic Profiling and Molecular Mechanisms in Hyperparathyroidism-jaw Tumor Syndrome. J Clin Endocrinol Metab 2023; 108:3165-3177. [PMID: 37339334 PMCID: PMC10655532 DOI: 10.1210/clinem/dgad368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/06/2023] [Accepted: 06/15/2023] [Indexed: 06/22/2023]
Abstract
CONTEXT Hyperparathyroidism-jaw tumor (HPT-JT) syndrome is a heritable form of primary hyperparathyroidism caused by germline inactivating mutations in CDC73 encoding parafibromin and is associated with an increased risk of parathyroid cancer. There is little evidence to guide the management of patients with the disease. OBJECTIVE (1) Characterize the natural history of HPT-JT, (2) correlate genotype and histology of parathyroid tumors with parafibromin immunostaining, (3) understand molecular changes downstream to CDC73 loss. DESIGN Retrospective study of patients with HPT-JT syndrome (genetically confirmed or affected first-degree relatives). Independent review of uterine tumor from 2 patients and staining for parafibromin on parathyroid tumors from 19 patients (13 adenomas, 6 carcinomas) was performed. RNA-sequencing was performed in 21 parathyroid samples (8 HPT-JT-related adenomas, 6 HPT-JT-related carcinomas, and 7 sporadic carcinomas with wild-type CDC73). RESULTS We identified 68 patients from 29 kindreds with HPT-JT with median age at last follow-up of 39 [interquartile range, 29-53] years. A total of 55/68 (81%) developed primary hyperparathyroidism; 17/55 (31%) had parathyroid carcinoma. Twelve of 32 (38%) females developed uterine tumors. Of the 11 patients who had surgical resection for uterine tumors, 12/24 (50%) tumors were rare mixed epithelial mesenchymal polypoid lesions. Four of 68 patients (6%) developed solid kidney tumors; 3/4 had a CDC73 variant at p.M1 residue. Parafibromin staining of parathyroid tumors did not correlate with tumor histology or genotype. RNA-sequencing showed a significant association of HPT-JT-related parathyroid tumors with transmembrane receptor protein tyrosine kinase signaling pathway, mesodermal commitment pathway, and cell-cell adhesion. CONCLUSIONS Multiple, recurrent atypical adenomyomatous uterine polyps appear to be enriched in women with HPT-JT and appear characteristic of the disease. Patients with CDC73 variants at p.M1 residue appear predisposed to kidney tumors. CLINICAL TRIAL NUMBER NCT04969926.
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Affiliation(s)
- Rana Tora
- Metabolic Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - James Welch
- Metabolic Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Jian Sun
- NIAID Collaborative Bioinformatics Resource (NCBR), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Sunita K Agarwal
- Metabolic Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Debra A Bell
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Maria Merino
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Lee S Weinstein
- Metabolic Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - William F Simonds
- Metabolic Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Smita Jha
- Metabolic Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, USA
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7
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Al-Sammak A, Rezki O, Pennington M, Manosca F, Cuevas-Nunez M, Qaisi M, Greenbaum E, Murphy J. Treatment challenges of persistent ghost cell odontogenic carcinoma: a case report and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:e123-e132. [PMID: 37330392 DOI: 10.1016/j.oooo.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/10/2023] [Accepted: 04/17/2023] [Indexed: 06/19/2023]
Abstract
The aim of this case report is to review and compare the clinical, radiologic, histopathologic, and immunohistochemical features, along with the treatment of a case of ghost cell odontogenic carcinoma. In addition, a report of the existing published literature with an emphasis on treatment will be described to provide information on this rare but aggressive tumor. The family of odontogenic ghost cell tumors comprises a spectrum of lesions characterized by odontogenic epithelium with ghost cell keratinization and calcifications. It appears that early detection is vital in proper treatment due to the high possibility of malignant transformation.
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Affiliation(s)
- Ali Al-Sammak
- Department of Oral and Maxillofacial Surgery, John H Stroger Jr Hospital, Chicago, IL, USA
| | - Othman Rezki
- Department of Oral and Maxillofacial Surgery, John H Stroger Jr Hospital, Chicago, IL, USA
| | - Michael Pennington
- College of Dental Medicine, Midwestern University, Downers Grove, IL, USA
| | - Frances Manosca
- Department of Pathology, John H Stroger Jr Hospital, Chicago, IL, USA
| | - Maria Cuevas-Nunez
- College of Dental Medicine, Midwestern University, Downers Grove, IL, USA
| | - Mohammed Qaisi
- Department of Oral and Maxillofacial Surgery, John H Stroger Jr Hospital, Chicago, IL, USA
| | - Even Greenbaum
- Department of Otolaryngology, Northwestern Medicine, Chicago, IL, USA; Department of Otolaryngology, John H Stroger Jr Hospital, Chicago, IL, USA
| | - James Murphy
- Department of Oral and Maxillofacial Surgery, John H Stroger Jr Hospital, Chicago, IL, USA; Plastic and Reconstructive Surgery, Rush University Medical Center, Chicago, IL, USA.
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8
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Tun KM, Kitkumthorn N, Bumalee D, Arayapisit T, Lapthanasupkul P. Differential expression of PEA3 in odontogenic cysts and tumors. J Oral Pathol Med 2023; 52:777-785. [PMID: 37549030 DOI: 10.1111/jop.13476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/15/2023] [Accepted: 07/21/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND PEA3 transcription factor has been identified as a downstream target of the MAPK and PI3K pathways, and PEA3 overexpression has been observed in a variety of tumor types. We aimed to evaluate PEA3 expression in odontogenic cysts and tumors and compare the expression among odontogenic lesions. In addition, the correlations between PEA3 expression and clinicopathological characteristics of conventional ameloblastoma and unicystic ameloblastoma were investigated. METHODS This study was performed on 165 samples of odontogenic cysts and tumors including 20 dentigerous cysts, 20 odontogenic keratocysts, 16 adenomatoid odontogenic tumors, 5 ameloblastic fibromas, 45 unicystic ameloblastomas, and 59 conventional ameloblastomas. The sections were immunohistochemically stained with mouse monoclonal anti-PEA3 antibody and PEA3 expression was evaluated as the immunoreactive score. RESULTS PEA3 expression was absent in all dentigerous cysts (DCs) and odontogenic keratocysts, while all adenomatoid odontogenic tumors showed either no (75%) or low (25%) expression of PEA3. Most of the ameloblastic fibromas (60%) displayed no PEA3 expression. A high expression of PEA3 was observed in a substantial number of unicystic ameloblastomas (48.9%) and conventional ameloblastomas (49.2%) in our study. PEA3 expression in DCs, odontogenic keratocysts and adenomatoid odontogenic tumors were significantly different from that in conventional ameloblastomas and that in unicystic ameloblastomas (p < 0.05). The expression of PEA3 was significantly different in the age groups of unicystic ameloblastomas and histological subtypes of conventional ameloblastomas (p < 0.05). CONCLUSION PEA3 overexpression is predominant in unicystic ameloblastomas and conventional ameloblastomas compared to other odontogenic lesions, indicating a pivotal role of PEA3 as a downstream effector of MAPK pathway in these two odontogenic lesions.
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Affiliation(s)
- Khin Mya Tun
- Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Nakarin Kitkumthorn
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Dusit Bumalee
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Tawepong Arayapisit
- Department of Anatomy, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Puangwan Lapthanasupkul
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Abstract
BACKGROUND Cystic lesions of the gnathic bones present challenges in differential diagnosis. This category includes a smorgasbord of odontogenic and non-odontogenic entities that may be reactive or neoplastic in nature. While most cystic jaw lesions are benign, variability in biologic behavior makes distinction between these entities absolutely crucial. METHODS Review. RESULTS Two clinical cases are presented in parallel and are followed by an illustrated discussion of the ten most likely differential diagnoses that should be considered when confronted with a cystic jaw lesion. Strong emphasis is placed on the histologic differences between these entities, empowering readers to diagnose them with confidence. Perhaps even more importantly, the more common diagnostic pitfalls in gnathic pathology are discussed, recognizing that a definitive diagnosis cannot be rendered in every situation. The histologic diagnoses for the two clinical cases are finally revealed. CONCLUSION Cystic lesions of the maxilla and mandible may be odontogenic or non-odontogenic. The most common cystic lesions are the reactive periapical cyst, and the dentigerous cyst (which is developmental in nature). It is important to note that cystic neoplasms also occur in the jaws, and that the presence of inflammation may obscure the diagnostic histologic features of lesions like odontogenic keratocyst and unicystic ameloblastoma. Ancillary testing is of limited diagnostic value in most scenarios. However, both clinical and radiographic information (such as the location, size, duration, associated symptoms, and morphology of the lesion in its natural habitat) are significantly useful.
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Affiliation(s)
- Anne C McLean
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
- Clements University Hospital UT Southwestern Medical Center, 6201 Harry Hines Blvd, RM UH04.252, Dallas, TX, 75390, USA.
| | - Pablo A Vargas
- Department of Oral Diagnosis, The State University of Campinas, Piracicaba, São Paulo, Brazil
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Kim SY, Lee JY, Cho YJ, Jo KH, Kim ES, Han JH, Baek KH, Moon SD. USP37 Deubiquitinates CDC73 in HPT-JT Syndrome. Int J Mol Sci 2022; 23:ijms23126364. [PMID: 35742816 PMCID: PMC9224168 DOI: 10.3390/ijms23126364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 05/31/2022] [Accepted: 06/06/2022] [Indexed: 11/30/2022] Open
Abstract
The CDC73/HRPT2 gene, a defect which causes hyperparathyroidism–jaw tumor (HPT-JT) syndrome, encodes CDC73/parafibromin. We aimed to investigate whether CDC73 would be a target for ubiquitin–proteasome degradation. We cloned full-length cDNAs encoding a family of 58 ubiquitin-specific deubiquitinating enzymes (DUBs), also known as ubiquitin-specific proteases (USPs). Use of the yeast two-hybrid system then enabled us to identify USP37 as interacting with CDC73. The biochemical interaction between the USP37 and CDC73 and their reciprocal binding domains were studied. Co-localization of CDC73 and USP37 was observed in cells. CDC73 was found to be polyubiquitinated, and polyubiquitination of CDC73 was prominent in mutants. CDC73 was deubiquitinated via K48-specific ubiquitin chains by USP37, but not by the catalytically inactive USP37C350S mutant. Observation of the binding between deletion mutants of CDC73 and USP37 revealed that the β-catenin binding site of CDC73 and the ubiquitin-interacting motifs 2 and 3 (UIM2 and 3) of USP37 were responsible for the interaction between the two proteins. Moreover, these two enzymes co-existed within the nucleus of COS7 cells. We conclude that USP37 is a DUB for CDC73 and that the two proteins interact through specific domains, suggesting that USP37 is responsible for the stability of CDC73 in HPT-JT syndrome.
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Affiliation(s)
- Su Yeon Kim
- Institute of Biomedical Industry, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (S.Y.K.); (J.-y.L.)
| | - Ji-young Lee
- Institute of Biomedical Industry, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (S.Y.K.); (J.-y.L.)
| | - Yun-jung Cho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Korea; (Y.-j.C.); (K.H.J.); (E.S.K.); (J.H.H.)
| | - Kwan Hoon Jo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Korea; (Y.-j.C.); (K.H.J.); (E.S.K.); (J.H.H.)
| | - Eun Sook Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Korea; (Y.-j.C.); (K.H.J.); (E.S.K.); (J.H.H.)
| | - Je Ho Han
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Korea; (Y.-j.C.); (K.H.J.); (E.S.K.); (J.H.H.)
| | - Kwang-Hyun Baek
- Department of Biomedical Science, CHA University, Seongnam 13488, Korea;
| | - Sung-dae Moon
- Institute of Biomedical Industry, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (S.Y.K.); (J.-y.L.)
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Korea; (Y.-j.C.); (K.H.J.); (E.S.K.); (J.H.H.)
- Correspondence: ; Tel.: +82-32-280-5508
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11
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Yang Y, Song A, Nie M, Jiang Y, Li M, Xia W, Xing X, Wang O, Hu Y. A novel long-range deletion spanning CDC73 and upper-stream genes discovered in a kindred of familial primary hyperparathyroidism. Endocrine 2022; 75:907-915. [PMID: 34729685 DOI: 10.1007/s12020-021-02917-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 10/16/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To confirm the exact break-point of a novel long-range deletion discovered in one female parathyroid carcinoma (PC) patient who has a strong family history suggesting familial hyperparathyroidism, and to investigate the expression of parafibromin in the patient's affected lesion. METHODS Clinical information of one female patient as well as five of her relatives was collected. Their genomic DNA extracted from peripheral blood went through Sanger sequencing and multiplex ligation-dependent probe amplification (MLPA). After completing whole genome sequencing (WGS), clone sequencing was also performed, whose result was aligned with standard human genome database after Sanger sequencing. RESULTS The medical history of recurrent hypercalcemia after parathyroidectomy and histopathological investigation confirmed that the female patient was diagnosed with PC. WGS displayed a novel 130 kb long-range deletion spanning UCHL5 to CDC73 that was later confirmed by clone sequencing. MLPA showed similar results in four of her five relatives, suggesting these people to be carriers of the same long-range deletion, and three among them had a history of primary hyperparathyroidism (PHPT) ahead of the proband's first visit. CONCLUSIONS We discovered a novel 130 kb long-range deletion spanning CDC73 in a family of 5 persons, and the existence of the deletion was related to PHPT and PC. Our discovery validated the role of CDC73 mutation in the occurrence of PHPT and PC, which provided new information to the genetic studies of PC.
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Affiliation(s)
- Yi Yang
- Key Laboratory of Endocrinology of the Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100032, China
| | - An Song
- Key Laboratory of Endocrinology of the Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100032, China
| | - Min Nie
- Key Laboratory of Endocrinology of the Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100032, China
| | - Yan Jiang
- Key Laboratory of Endocrinology of the Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100032, China
| | - Mei Li
- Key Laboratory of Endocrinology of the Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100032, China
| | - Weibo Xia
- Key Laboratory of Endocrinology of the Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100032, China
| | - Xiaoping Xing
- Key Laboratory of Endocrinology of the Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100032, China
| | - Ou Wang
- Key Laboratory of Endocrinology of the Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100032, China.
| | - Ya Hu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100032, China.
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Yoshimoto S, Morita H, Okamura K, Hiraki A, Hashimoto S. αTAT1-induced tubulin acetylation promotes ameloblastoma migration and invasion. J Transl Med 2022; 102:80-89. [PMID: 34508164 PMCID: PMC8695380 DOI: 10.1038/s41374-021-00671-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/24/2021] [Accepted: 08/24/2021] [Indexed: 01/18/2023] Open
Abstract
Ameloblastoma (AB) is the most common benign epithelial odontogenic tumor occurring in the jawbone. AB is a slowly growing tumor but sometimes shows a locally invasive and an aggressive growth pattern with a marked bone resorption. In addition, the local recurrence and distant metastasis of AB also sometimes occurs, which resembles one of the typical malignant potentials. From these points of view, to understand better the mechanisms of AB cell migration or invasion is necessary for the better clinical therapy and improvements of the patients' quality of life. Microtubules in eukaryotic cells reveal the shape of hollow cylinders made up of polymerized alpha (α)- and beta (β)-tubulin dimers and form the cytoskeleton together with microfilaments and intermediate filaments. Microtubules play important roles in cell migration by undergoing assembly and disassembly with post-translational modifications. Stability of microtubules caused by their acetylation is involved in cell migration. In this study, we investigated the expression and distribution of acetylated α-tubulin and alpha-tubulin N-acetyltransferase 1 (αTAT1), an enzyme which acetylates Lys-40 in α-tubulin, in AB specimens, and analyzed how tubulin was acetylated by αTAT1 activation in a human AB cell line, AM-1. Finally, we clarified that TGF-β-activated kinase1 (TAK1) was phosphorylated by TGF-β stimulation, then, induced tubulin acetylation via αTAT1 activation, which subsequently activated the migration and invasion of AB cells.
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Affiliation(s)
- Shohei Yoshimoto
- Section of Pathology, Department of Morphological Biology, Division of Biomedical Sciences, Fukuoka Dental College, Fukuoka, 814-0193, Japan
- Oral Medicine Research Center, Fukuoka Dental College, Fukuoka, 814-0193, Japan
| | - Hiromitsu Morita
- The Center for Visiting Dental Service, Department of General Dentistry, Fukuoka Dental College, Fukuoka, 814-0193, Japan
| | - Kazuhiko Okamura
- Section of Pathology, Department of Morphological Biology, Division of Biomedical Sciences, Fukuoka Dental College, Fukuoka, 814-0193, Japan
| | - Akimitsu Hiraki
- Section of Oral Oncology, Department of Oral and Maxillofacial Surgery, Division of Oral and Medical Management, Fukuoka Dental College, Fukuoka, 814-0193, Japan
| | - Shuichi Hashimoto
- Section of Pathology, Department of Morphological Biology, Division of Biomedical Sciences, Fukuoka Dental College, Fukuoka, 814-0193, Japan.
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de Souza Vieira G, de Pinho Montovani P, Rozza-de-Menezes RE, Cunha KSG, Conde DC. Comparative Analysis Between Dentinogenic Ghost Cell Tumor and Ghost Cell Odontogenic Carcinoma: A Systematic Review. Head Neck Pathol 2021; 15:1265-1283. [PMID: 34128137 PMCID: PMC8633206 DOI: 10.1007/s12105-021-01347-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/09/2021] [Indexed: 11/24/2022]
Abstract
Dentinogenic ghost cell tumor (DGCT) and ghost cell odontogenic carcinoma (GCOC) form a spectrum of rare benign and malignant odontogenic neoplasms, respectively. The aim of this study was to perform a comparative systematic review of the clinicopathological, genetic, therapeutic, and prognostic features of DGCT and GCOC. The electronic search was performed until December 2020 on seven electronic databases. Case reports, series, and research studies with enough histopathological criteria for diagnosis and all genomic studies were included. Both DGCT and GCOC showed a male prevalence (p = 0.043), with mandibular and maxillary predilections, respectively (p = 0.008). Peripheral DGCT (DGCTp) affected most elderly people (p < 0.001), and central DGCT (DGCTc) and GCOC occurred mainly in younger individuals. Unilateral enlargement of maxilla or mandible was the most common clinical sign associated with a radiolucent or mixed image. Ameloblastomatous epithelium was often present in both neoplasms. Basaloid and large cells with vesicular nuclei were also frequently seen in GCOC. β-catenin expression and mutations (CTNNB1 gene) were found in DGCT and GCOC. Conservative surgery was mostly used for DGCTp, while radical resection was chosen for DGCTc and GCOC. High recurrence rates were found in DGCTc and GCOC. Metastasis occurred in 16.7% of GCOC cases and the 5-year survival rate was 72.6%. DGCT and GCOC share numerous clinicopathological features and demand a careful histopathological evaluation, considering the overlap features with other odontogenic tumors and the possibility of malignant transformation of DGCT. A strict regular post-operative follow-up is mandatory due to high recurrence rates and metastatic capacity in GCOC.
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Affiliation(s)
- Gustavo de Souza Vieira
- Graduate Program in Pathology, School of Medicine, Federal Fluminense University, Niterói, RJ, Brazil
| | | | - Rafaela Elvira Rozza-de-Menezes
- Department of Pathology, School of Medicine, Hospital Universitário Antônio Pedro, Federal Fluminense University, Av. Marquês do Paraná, 303, 4ºandar, sala 01, Centro, Niterói, RJ, 24033-900, Brazil
| | - Karin Soares Gonçalves Cunha
- Graduate Program in Pathology, School of Medicine, Federal Fluminense University, Niterói, RJ, Brazil
- Department of Pathology, School of Medicine, Hospital Universitário Antônio Pedro, Federal Fluminense University, Av. Marquês do Paraná, 303, 4ºandar, sala 01, Centro, Niterói, RJ, 24033-900, Brazil
| | - Danielle Castex Conde
- Department of Pathology, School of Medicine, Hospital Universitário Antônio Pedro, Federal Fluminense University, Av. Marquês do Paraná, 303, 4ºandar, sala 01, Centro, Niterói, RJ, 24033-900, Brazil.
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Conde DC, Vieira GDS, Montovani PDP, Beserra JPR, Ribeiro MCG, Rozza-de-Menezes RE, Cunha KS. Dentinogenic ghost cell tumor with focal atypical features suggesting ghost cell odontogenic carcinoma: Report of a challenging diagnosis. Oral Oncol 2021; 124:105524. [PMID: 34531146 DOI: 10.1016/j.oraloncology.2021.105524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/06/2021] [Indexed: 11/17/2022]
Abstract
Dentinogenic ghost cell tumor (DGCT) represents a rare benign odontogenic neoplasm that can appear in a central or peripheral form and may rarely undergo malignant transformation to ghost cell odontogenic carcinoma (GCOC). We aim to report a case of a central DGCT with focal cytological malignant aspects. A 24-year-old woman exhibited a painful enlargement and dental mobility in the left posterior maxilla for about one year, which appeared as an expansive well-defined hypodense maxillary image with hyperdense foci invading ipsilateral maxillary sinus. Incisional biopsy showed a predominantly solid hyperchromatic basaloid epithelium presenting cellular pleomorphism and mitotic activity, admixed with abundant ghost cell aggregates and dentinoid material. The lesion was immunopositive for p53 and had 21% of Ki-67 proliferation index (PI). These microscopic features suggested initially a GCOC diagnosis. Partial left maxillectomy was performed without complications. The surgical specimen presented an exuberant variation of the epithelial parenchyma, including ameloblastomatous, fusiform, and cribriform areas, with numerous ghost cells and dentinoid material, lacking any signs of malignancy. The final diagnosis was DGCT. The patient is in a strict regular follow-up for over two years, and there are no signs of recurrence.
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Affiliation(s)
- Danielle Castex Conde
- Department of Pathology, School of Medicine, Federal Fluminense University, Niterói, RJ, Brazil.
| | - Gustavo de Souza Vieira
- Graduate Program in Pathology, School of Medicine, Federal Fluminense University, Niterói, RJ, Brazil
| | | | | | | | | | - Karin Soares Cunha
- Department of Pathology, School of Medicine, Federal Fluminense University, Niterói, RJ, Brazil; Graduate Program in Pathology, School of Medicine, Federal Fluminense University, Niterói, RJ, Brazil
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15
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Hallikeri K, Babu B, Sudhakaran A, Monteiro R. Cell Block and Its Impact in the Diagnosis of Jaw Lesions over Fine Needle Aspiration Cytology. Acta Cytol 2021; 65:361-367. [PMID: 34237724 DOI: 10.1159/000517166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 05/09/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To determine the role and efficacy of fine needle aspiration cytology (FNAC) and cell block in diagnosis of jaw lesions and compare the agreement between FNAC and cell block to predict the diagnosis. METHOD The sample comprised 51 cases, including 12 odontogenic keratocysts (OKCs), 8 ameloblastomas, 22 radicular cysts, 7 dentigerous cysts, and 1 each of intraosseous mucoepidermoid carcinoma (MEC) and adenomatoid odontogenic tumor (AOT). FNAC samples remaining after hematoxylin and eosin (H&E)-stained cytosmear diagnosis were centrifuged at 3,000 rpm for 10 min. The supernatant was discarded and sediment mixed with 2-3 mL alcohol and filtered. To this, 10% formalin was added, filtered, taken for routine processing, and stained with H&E. The result of FNAC smear and cell block was compared with histopathological diagnosis. RESULTS On cytological examination of the smears, 7 OKCs and 22 radicular cysts were diagnosed, whereas ameloblastomas, AOT, intraosseous MEC, and dentigerous cysts were not. This gave an agreement of 56.8% with the biopsy reports. Cell block sections stained with H&E of 12 OKCs, 22 radicular cysts, 1 MEC, and 3 cases of ameloblastoma offered a diagnosis in accordance with the biopsies giving an agreement of 74.5%, while dentigerous cyst and AOT failed to do so. In comparison with FNAC, additionally 5 cases of OKC and 1 of MEC could be detected, and in ameloblastoma, out of 8 cases, only 3 yielded a concordant diagnosis through the cell block technique. CONCLUSION In comparison with FNAC, the architectural pattern and the morphology of the cells were better preserved by the cell block technique. This substantiates that cell block could be used as an ancillary technique to aid in definitive diagnosis of head and neck swellings.
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Affiliation(s)
- Kaveri Hallikeri
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, SDM College of Dental Sciences and Hospital, A Constituent Unit of Shri Dharmasthala Manjunatheshwara University, Dharwad, India
| | - Biji Babu
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, SDM College of Dental Sciences and Hospital, A Constituent Unit of Shri Dharmasthala Manjunatheshwara University, Dharwad, India
| | - Archana Sudhakaran
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, SDM College of Dental Sciences and Hospital, A Constituent Unit of Shri Dharmasthala Manjunatheshwara University, Dharwad, India
| | - Roshni Monteiro
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, SDM College of Dental Sciences and Hospital, A Constituent Unit of Shri Dharmasthala Manjunatheshwara University, Dharwad, India,
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Nazerani Hooshmand T, Pernthaler B, Szurian K, Pau M, Aigner RM. 18F-FDG PET/CT in the Hyperparathyroidism-Jaw-Tumor Syndrome. Clin Nucl Med 2021; 46:497-498. [PMID: 33826572 DOI: 10.1097/rlu.0000000000003625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Hyperparathyroidism-jaw-tumor syndrome (HPT-JTS) is a rare autosomal dominant disorder. A typical manifestation of HPT-JTS is the association of jaw-ossifying fibroma with primary hyperparathyroidism. Due to its rarity and diversity in its manifestations, it is a challenging diagnosis. A 33-year-old woman was referred due to painful swelling of the right maxilla suggestive of malignancy. The clinical presentations were not conclusive until she underwent F18-fluorodeoxyglucose positron emission tomography/computed tomography (F18-FDG PET/CT). F18-FDG PET/CT proved to be a useful tool to assist the clinicians in visualizing the "bigger picture" and, therefore all manifestation as pieces of "one puzzle."
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Affiliation(s)
| | | | | | - Mauro Pau
- Division of Oral-, Maxillofacial Surgery, Department of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
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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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18
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Nieberler M, Stimmer H, Rasthofer D, Nentwig K, Weirich G, Wolff KD. Defining secure surgical bone margins in head and neck squamous cell carcinomas: The diagnostic impact of intraoperative cytological assessment of bone resection margins compared with preoperative imaging. Oral Oncol 2020; 102:104579. [PMID: 32062159 DOI: 10.1016/j.oraloncology.2020.104579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 01/09/2020] [Accepted: 01/20/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Imaging provides crucial staging information for treatment planning of head and neck squamous cell carcinomas (HNSCCs). Despite technical progress in imaging techniques, defining the extent of bone involvement preoperatively remains challenging and requires intraoperative information to control for adequate resection. The intraoperative cytological assessment of the bone resection margins (ICAB) provides information whether bone is infiltrated by carcinoma. The aim of this study was to assess the diagnostic value of preoperative imaging compared with ICAB in order to achieve carcinoma-free bone margins. MATERIALS AND METHODS 108 HNSCC patients underwent preoperative computed tomography (CT), magnetic resonance imaging (MRI) and orthopantomogram (OPG) for staging and surgical planning. Curative resection was planned based on imaging. Intraoperatively, the resection margins were controlled by ICAB. The diagnostic value of preoperative imaging and ICAB was assessed with reference to the histological findings. RESULTS CT showed a sensitivity of 89.7%, specificity of 63.0%, positive predictive value (PPV) of 85.9%, and negative predictive value (NPV) of 70.8%. MRI revealed a sensitivity of 45.5%, specificity of 66.7%, PPV of 71.4% and NPV of 40.0%. OPG-imaging had a sensitivity of 64.7%, specificity of 76.2%, PPV of 81.5%, NPV 57.1%. In comparison, ICAB provided a sensitivity of 78.6%, specificity of 95.7%, PPV 73.3%, and NPV 96.7%. The accuracy was 82.1%, 52.9%, 69.0%, and 93.5% for CT, MRI, OPG, and ICAB, respectively. CONCLUSION Preoperative imaging lacks accuracy in defining adequate bone resection margins, compared with ICAB. ICAB supports preoperative imaging and intraoperative frozen sections to improve bone margin control.
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Affiliation(s)
- Markus Nieberler
- Department of Oral and Maxillofacial Surgery, Hospital rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81679 Munich, Germany.
| | - Herbert Stimmer
- Department of Radiology, Hospital rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81679 Munich, Germany
| | - Daniela Rasthofer
- Department of Oral and Maxillofacial Surgery, Hospital rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81679 Munich, Germany
| | - Katharina Nentwig
- Department of Oral and Maxillofacial Surgery, Hospital rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81679 Munich, Germany
| | - Gregor Weirich
- Institute of Pathology, Technische Universität München, Trogerstr. 18, 81675 Munich, Germany
| | - Klaus-Dietrich Wolff
- Department of Oral and Maxillofacial Surgery, Hospital rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81679 Munich, Germany
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Abstract
Jaw phosphaturic mesenchymal tumors (PMTs) are a rare neoplasm with uncertain histogenesis. This study aimed to clarify the clinical and pathological features of jaw PMTs.We reviewed the clinical records of 39 patients diagnosed with PMTs in the jaws, and investigated clinical and morphologic characteristics, histologic subtypes, and immunophenotypes of all cases.Microscopic analyses revealed 2 major histologic tumor subtypes: "phosphaturic mesenchymal tumors of mixed epithelial and connective tissue" (PMTMECT), and "phosphaturic mesenchymal tumors of mixed connective tissue" (PMTMCT). PMTMECTs and PMTMCTs accounted for 29 and 10 cases of PMTs, respectively. Most PMTMECT diagnoses were made predominantly in males aged <45 years, and the incidence was similar in both the mandible and maxilla. In contrast, patients with PMTMCTs are predominantly females aged ≥45 years, and all tumors were in the mandible. Histologically, PMTMECT had lower cellularity and a more elongated and spindled mesenchymal component with less elaborate intrinsic microvasculature than PMTMCT. Immunohistochemically, the epithelia of all PMTMECTs was immunoreactive for AE1/AE3. Other immunohistochemical staining of PMTMECTs revealed positive expression of vimentin, SATB2, ERG, CD99, Bcl-2, CD56, S-100, D2-40, CD68, SMA, and CD34 in either one or both components. Immunohistochemical staining of PMTMCTs was diffusely positive for vimentin and a varied ratio of positivity for SATB2, ERG, CD99, Bcl-2, CD56, S-100, D2-40, CD68, SMA, and CD34, but negative for AE1/AE3. Most patients were cured by complete resection, except 2 patients who had repeated recurrences, one of which also had multiple metastasis.Jaw PMT can be divided into 2 major histological subtypes. PMTMECTs are more common than are PMTMCTs, and can transform into malignant PMTMCTs during the progression. PMTMECTs were more commonly observed in males and the incidence was similar in both the maxilla and mandible. PMTMCTs were almost always observed in the mandible of females. Compared with PMTMCTs, PMTMECTs have an admixture of epithelial components with less prominent vasculature and lower cellularity. There were no statistically significant differences in the expression of immunohistochemical markers except AE1/AE3 between PMTMECTs and PMTMCTs. However, immunohistochemical markers have great significance for differentiating other mesenchymal tumors.
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Affiliation(s)
- Dongmei Li
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College,
| | - Ran Zhu
- Department of Pathology, China-Japan Friendship Hospital,
| | - Lian Zhou
- Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Dingrong Zhong
- Department of Pathology, China-Japan Friendship Hospital,
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Yang R, Tang Y, Zhang X, Liu Z, Gokavarapu S, Lin C, Ren Z, Zhou Y, Cao W, Ji T. Recurrence factors in pediatric ameloblastoma: Clinical features and a new classification system. Head Neck 2019; 41:3491-3498. [PMID: 31322781 DOI: 10.1002/hed.25867] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 01/27/2019] [Accepted: 06/18/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Ameloblastomas of jaw in the pediatric population are a rare clinical entity and have not been well addressed in the literatures. The present retrospective study analyzed the risk factors associated with recurrence of pediatric ameloblastomas. METHODS Cases of primary pediatric ameloblastomas seen in a tertiary hospital between 2005 and 2015 were analyzed to identify the clinical factors associated with recurrence. RESULTS There were a total of 104 cases of primary pediatric ameloblastomas. The overall mean maximum tumor diameter was 4.11 ± 1.339 cm. The receiver operating characteristic curve and the Youden Index showed an optimal cutoff point of 4.95 cm to accurately predict recurrence. Bone cortex/soft tissue invasion were associated with tumor recurrence (P < .001). CONCLUSIONS The maximum tumor diameter, root resorption, and bone cortex/soft tissue invasion were risk factors for recurrence of pediatric ameloblastomas. The new classification system may serve as a predictor of recurrence in pediatric ameloblastomas.
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Affiliation(s)
- Rong Yang
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Tang
- Department of Stomatology, Tongren Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xu Zhang
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zheqi Liu
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sandhya Gokavarapu
- Discipline of Oral and Maxillofacial Surgery, University Dental Cluster, National University Health System (NUHS), Singapore
| | - Chengzhong Lin
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhenhu Ren
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yongmei Zhou
- Department of Oral Mucosal Diseases, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Cao
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tong Ji
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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22
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Giovanini AF, Priesnitz TF, Til B, Reisdoerfer G, do Nascimento TCDL, Sobreiro B, de Siqueira AS, Pinheiro JDJV. Immunolocalization of IP3R and V-ATPase in Ameloblastomas. Head Neck Pathol 2019; 14:392-398. [PMID: 31183746 PMCID: PMC7235139 DOI: 10.1007/s12105-019-01044-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 05/27/2019] [Indexed: 11/26/2022]
Abstract
The goal of this study was to investigate the immunolocalization of inositol 1,4,5-trisphosphate receptor (IP3R) and vacuolar ATPase (V-ATPase) in ameloblastomas with special attention to the invasive front. Thirty-seven cases of previously diagnosed formalin-fixed paraffin-embedded (FFPE) human ameloblastoma samples were selected for this study. The samples were grouped according to the predominant histologic pattern and comprised twelve plexiform, eighteen follicular, and seven unicystic ameloblastomas. Of the unicystic variants, six demonstrated purely luminal and intraluminal growth, and one displayed mural extension. One granular cell variant was included in the follicular ameloblastoma group. All specimens were evaluated for IP3R and V-ATPase expression by immunohistochemistry (IHC). IP3R was positive in columnar cells, similar to ameloblasts, and non-peripheral cells in all samples. In the area of tumor protrusion and front of invasion, membranous and cystoplasmic IP3R expression was observed. In contrast, areas adjacent to tumoral protrusion demonstrated only membranous staining patterns. V-ATPase was not expressed in peripheral columnar cells of the unicystic and granular cell variants of ameloblastoma; however, strong staining was present in these cells in plexiform ameloblastomas, follicular ameloblastomas, and areas of mural growth of unicystic ameloblastomas. In areas of tumor protrusion, reactivity for V-ATPase was observed with both membranous and cytoplasmic staining, while other areas showed only membranous V-ATPase. These findings suggest that concomitant immunolocalization of IP3R and V-ATPase, with both cytoplasmic and membranous expression in the peripheral columnar cells, may indicate the invasive potential of ameloblastomas. Furthermore, these results suggest the tumoral spread of ameloblastomas may be correlated with the autophagy process and channelopathy. The expression of these proteins could establish a baseline for future research and provide therapeutic targets for treatment of ameloblastomas.
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Affiliation(s)
- Allan Fernando Giovanini
- Medical School, Positivo University Curitiba, R Pedro Viriato Parigot de Souza, 5300 Campo Comprido, Curitiba, Paraná, 81280-330, Brazil.
| | | | - Bruna Til
- Dentistry School, Positivo University Curitiba, Curitiba, Paraná, Brazil
| | - Gisele Reisdoerfer
- Dentistry School, Positivo University Curitiba, Curitiba, Paraná, Brazil
| | | | - Bernardo Sobreiro
- Medical School, Positivo University Curitiba, R Pedro Viriato Parigot de Souza, 5300 Campo Comprido, Curitiba, Paraná, 81280-330, Brazil
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23
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Abstract
RATIONALE Ameloblastoma is generally characterized as a benign tumor originating in odontogenic epithelium. However, few cases of metastatic malignant ameloblastoma have also been reported. Due to the low incidence of malignant ameloblastoma, there is no established treatment regimen. To explore effective treatment for malignant ameloblastoma, we reported this case study. PATIENTS CONCERNS This report described a case of a 28-year-old malignant ameloblastoma female patient with multiple metastasis (brain and lung). DIAGNOSES The patient presented ameloblastoma of the left mandible in 2012. Three years later, local recurrence and brain metastasis was observed during a follow-up examination. Five years later, malignant ameloblastoma was detected by imaging and immunohistochemistry in the bilateral multiple pulmonary nodules and mediastinal lymph nodes. INTERVENTIONS The patient was initially treated with tumor resection. Three years later after local recurrence and brain metastasis, she was accepted the extensive mandibulectomy supplemented with brain stereotactic body radiotherapy (SBRT). When diagnosed with pulmonary metastasis, the patient received combined chemotherapy regimen of MAID (mesna, adriamycin, ifosfamide and dacarbazine) for 6 cycles. OUTCOMES The efficacy evaluation was partial remission (PR) after the 6 cycles of MAID. The last patient follow-up was July 24th 2018, and no evidence of progression was observed. The progression-free survival (PFS) of the patient was more than 9 months. LESSONS Surgical resection is the optimal treatment for locally recurrent ameloblastoma. SBRT may be an effective treatment for unresectable oligometastasis of malignant ameloblastoma. Finally, combined chemotherapy of MAID showed encouraging effects in the management of metastatic malignant ameloblastoma.
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Affiliation(s)
- Danyang Li
- Department of Medical Oncology of Zhengzhou University Affiliated Cancer Hospital
| | - Shuning Xu
- Department of Medical Oncology of Zhengzhou University Affiliated Cancer Hospital
| | - Miaomiao Sun
- Department of Pathology of Zhengzhou University Affiliated Cancer Hospital
| | - Lei Qiao
- Department of Medical Oncology of Zhengzhou University Affiliated Cancer Hospital
| | - Lifeng Wang
- Department of Imaging of Zhengzhou University Affiliated Cancer Hospital, Henan Cancer Hosptial, Zhengzhou, Henan, China
| | - Ying Liu
- Department of Medical Oncology of Zhengzhou University Affiliated Cancer Hospital
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24
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Abstract
Malignancy of melanocytes, a pigment-producing cell, is referred as malignant melanoma (MM) which occur basically on skin and oral mucous membrane, but as well found in ears, eyes, gastrointestinal tract and genital mucosa. Oral melanomas has propensity to metastasise and invade more voluntarily than other malignant counterparts. Here we present a case of 52-year-old male patient with a chief symptom of blackening of gums in the upper front tooth region. In dental history, the patient revealed history of faulty artificial prosthesis fixed in the same region since 6 months. On the basis of a through clinical assessment, a provisional opinion of oral malignant melanoma, was prepared. On histopathological and immunohistochemical analysis with S-100 and homatropine methylbromide 45 the diagnosis of MM was confirmed.
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Affiliation(s)
- Madhusudan Astekar
- Department of Oral and Maxillofacial Pathology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Rajkumar R Choubey
- Department of Oral and Maxillofacial Pathology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | | | - Santosh Gupta
- Oral and Maxillofacial Pathology, Jaipur Dental College, Jaipur, Rajasthan, India
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25
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Ciuffi S, Cianferotti L, Nesi G, Luzi E, Marini F, Giusti F, Zonefrati R, Gronchi G, Perigli G, Brandi ML. Characterization of a novel CDC73 gene mutation in a hyperparathyrodism-jaw tumor patient affected by parathyroid carcinoma in the absence of somatic loss of heterozygosity. Endocr J 2019; 66:319-327. [PMID: 30799315 DOI: 10.1507/endocrj.ej18-0387] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Hyperparathyrodism-jaw tumor (HPT-JT) syndrome is an autosomal dominant disorder. Loss of function of the cell division cycle protein 73 homolog (CDC73) gene is responsible for the syndrome. This gene encodes an ubiquitously expressed 531 amino acid protein, parafibromin, that acts as a tumor suppressor. Loss of heterozygosity (LOH) of the CDC73 locus in many HPT-JT associated parathyroid tumors from patients with germline mutation is in accordance with Knudson's "two-hit" model for hereditary cancer. A 41-year-old man with mandible ossifying fibroma suffered from severe hypercalcemia due to parathyroid carcinoma (PC). Genetic analysis was performed to evaluate germinal and somatic CDC73 gene mutation as well as real-time qRT-PCR to quantify CDC73 mRNA, miR-155 and miR-664 expression levels. Immunohistochemistry and Western blotting (WB) assay were carried out to evaluate parafibromin protein expression. A novel heterozygous nonsense mutation, c.191-192 delT, was identified in the CDC73 gene. No CDC73 LOH was found in PC tissue, nor any differences in expression levels for CDC73 gene, miR-155 and miR-664 between PC and parathyroid adenoma control tissues. On the contrary, both immunohistochemistry and WB assay showed an approximate 90% reduction of parafibromin protein expression in PC. In conclusion, this study describes a novel germinal mutation, c.191-192 delT, in the CDC73 gene. Despite normal CDC73 gene expression, we found a significant decrease in parafibromin. We hypothesize that a gene silencing mechanism, possibly induced by microRNA, could play a role in determining somatic post-transcriptional inactivation of the wild type CDC73 allele.
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Affiliation(s)
- Simone Ciuffi
- Department of Surgery and Translational Medicine, University of Florence, Florence 50139, Italy
| | - Luisella Cianferotti
- Department of Surgery and Translational Medicine, University of Florence, Unit of Bone and Mineral Diseases, University Hospital of Florence, Florence 50139, Italy
| | - Gabriella Nesi
- Department of Surgery and Translational Medicine, University of Florence, Section of Pathological Anatomy, University Hospital of Florence, Florence 50139, Italy
| | - Ettore Luzi
- Department of Surgery and Translational Medicine, University of Florence, Florence 50139, Italy
| | - Francesca Marini
- Department of Surgery and Translational Medicine, University of Florence, Florence 50139, Italy
| | - Francesca Giusti
- Department of Surgery and Translational Medicine, University of Florence, Unit of Bone and Mineral Diseases, University Hospital of Florence, Florence 50139, Italy
| | - Roberto Zonefrati
- Department of Surgery and Translational Medicine, University of Florence, Florence 50139, Italy
| | - Giorgio Gronchi
- Department of Surgery and Translational Medicine, University of Florence, Florence 50139, Italy
| | - Giuliano Perigli
- Department of Surgery and Translational Medicine, University of Florence, Unit of General Surgery, University Hospital of Florence, Florence 50139, Italy
| | - Maria Luisa Brandi
- Department of Surgery and Translational Medicine, University of Florence, Unit of Bone and Mineral Diseases, University Hospital of Florence, Florence 50139, Italy
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Chrcanovic BR, Gomez RS. Melanotic neuroectodermal tumour of infancy of the jaws: an analysis of diagnostic features and treatment. Int J Oral Maxillofac Surg 2018; 48:1-8. [PMID: 30170777 DOI: 10.1016/j.ijom.2018.08.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 06/26/2018] [Accepted: 08/09/2018] [Indexed: 12/12/2022]
Abstract
The purpose of this study was to integrate the available published data on melanotic neuroectodermal tumour of infancy (MNTI) of the jaws into a comprehensive analysis of its clinical/radiological features, with emphasis on the predictive factors associated with recurrence. Eligibility criteria included publications with sufficient clinical/radiological/histological information to confirm the diagnosis. A total of 288 publications reporting 429 MNTI cases were included. MNTIs were slightly more prevalent in males and markedly more prevalent in the maxilla. Most of the lesions were asymptomatic, presenting cortical bone perforation and tooth displacement. Nine lesions were malignant, with metastasis in five cases. Enucleation was the predominant treatment (67.2%), followed by marginal (18.4%) and segmental resection (6.1%). Eighty-one of 356 lesions (22.8%) recurred. Recurrence rates were 61.5% for curettage, 25.3% for enucleation alone, 16.2% for enucleation+curettage, 20.0% for enucleation+peripheral osteotomy, 11.3% for marginal resection, 10.0% for segmental resection, 30.0% for chemotherapy, and 33.3% for radiotherapy. Enucleation and resection presented significantly lower recurrence rates in comparison to curettage. Curettage appears not to be the best form of treatment, due to its high recurrence rate. As resection (either marginal or segmental) is associated with higher morbidity, enucleation with or without complementary treatment (curettage or peripheral osteotomy) would appear to be the most indicated therapy.
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Affiliation(s)
- B R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
| | - R S Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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27
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Vogels R, Baumhoer D, van Gorp J, Eijkelenboom A, Verdijk M, van Cleef P, Bloemena E, Slootweg PJ, Lohman B, Debiec-Rychter M, Flucke U. Clear Cell Odontogenic Carcinoma: Occurrence of EWSR1-CREB1 as Alternative Fusion Gene to EWSR1-ATF1. Head Neck Pathol 2018; 13:225-230. [PMID: 30047065 PMCID: PMC6514205 DOI: 10.1007/s12105-018-0953-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 07/18/2018] [Indexed: 01/08/2023]
Abstract
Clear cell odontogenic carcinoma (CCOC) is a rare, low-grade malignant epithelial neoplasm, occurring in the jawbones, mainly affecting the mandible of elderly patients. In addition to hyalinizing clear cell carcinoma of the salivary gland, it is one of the epithelial neoplasms known to harbor an EWSR1-ATF1 fusion. Therefore, a link between these tumors seems plausible. We describe six cases of CCOC showing EWSR1 rearrangements, with two cases being positive for the ATF1 partner gene using FISH analysis. In one case, an EWSR1-CREB1 fusion was identified using RT-PCR, which we report for the first time in this tumor type. The other three cases investigated by FISH were negative for ATF1, CREB1 and CREB3L2. In conclusion, our data show that EWSR1-CREB1 is an alternative fusion gene to EWSR1-ATF1 in CCOC.
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Affiliation(s)
- Rob Vogels
- Department of Pathology, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
- Department of Pathology, Stichting PAMM, Eindhoven, The Netherlands
| | - Daniel Baumhoer
- Bone Tumour Reference Centre and DOESAK Reference Registry, Institute of Pathology, University Hospital and University of Basel, Basel, Switzerland
| | - Joost van Gorp
- Department of Pathology, Diakonessenhuis Utrecht, Utrecht, The Netherlands
| | - Astrid Eijkelenboom
- Department of Pathology, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Marian Verdijk
- Department of Pathology, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Patricia van Cleef
- Department of Pathology, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Elisabeth Bloemena
- Department of Pathology, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
- Department of Pathology, VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Pieter J Slootweg
- Department of Pathology, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Bjorn Lohman
- Department of Pathology, Laurentius Hospital Roermond, Roermond, The Netherlands
| | - Maria Debiec-Rychter
- Department of Human Genetics, KU Leuven and University Hospitals Leuven, Leuven, Belgium
| | - Uta Flucke
- Department of Pathology, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
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28
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Gómez-Herrera Z, Molina-Frechero N, Damián-Matsumura P, González-González R, Farfán-Morales JE, Bologna-Molina R. Expression of proteoglycans in two types of ameloblastoma: novel Immunohistochemical findings. J BIOL REG HOMEOS AG 2018; 32:479-487. [PMID: 29921372 DOI: pmid/29921372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Alterations in cellular and extracellular matrix components play an important role during tumorigenesis; proteoglycans are included among these components. Ameloblastomas are odontogenic tumors distinguished as invasive and infiltrative neoplasms and are divided into different histological types, the most common of which are the unicystic ameloblastoma and the conventional ameloblastoma. The aim of this study was to identify the presence of two proteoglycans, perlecan and biglycan, in different types of ameloblastoma. Using immunohistochemistry, we determined the presence of both proteins in 28 unicystic ameloblastomas and 23 conventional ameloblastomas. We identified the cytoplasmic and nuclear presence of perlecan and the cytoplasmic presence of biglycan in both types of ameloblastoma. The mean values of immunoexpression were higher in the conventional type compared to the unicystic type. Neither the presence of biglycan in ameloblastomas nor the nuclear presence of perlecan in any odontogenic tumor has previously been reported. The differential immunoexpression of perlecan and biglycan in these types of ameloblastomas suggests their participation in the developmental process of these tumors.
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Affiliation(s)
- Z Gómez-Herrera
- Biological and Health Sciences Ph.D. Program, Metropolitan Autonomous University (Universidad Autónoma Metropolitana) Mexico City, Mexico
| | - N Molina-Frechero
- Health and Care Department, Metropolitan Autonomous University (Universidad Autónoma Metropolitana- Iztapalapa) Mexico City, Mexico
| | - P Damián-Matsumura
- Department of Biology of Reproduction, Metropolitan Autonomous University (Universidad Autónoma Metropolitana-Xochimilco) Mexico City, Mexico
| | - R González-González
- Research Department, Juarez University of the Durango State, Durango, Mexico
| | - J E Farfán-Morales
- Molecular Pathology Laboratory, National Institute of Pediatrics, Mexico City, Mexico
| | - R Bologna-Molina
- Molecular Pathology Area, School of Dentistry, University of the Republic (UDELAR), Montevideo, Uruguay
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29
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Abstract
A case is presented of a male patient affected by a giant cell lesion of the jaw, which had two recurrences in 8 years. Histologically, the lesion appeared to be composed of giant cells and mononuclear cells. Histoenzymatic study demonstrated acid phosphatase in both types of cells, and beta-glucuronidase in giant cells only. In some nuclei of giant cells, ultrastructural investigation showed filaments or microtubular structures of variable length, with irregular transverse periodicity, in addition to other expected findings. These characteristic features, found in giant cells of some giant cell tumors of the long bones, have never before been reported in a giant cell lesion of the jaw. The results are considered in order to assess the diagnosis, and the pathologic profiles of giant cell reparative granuloma, and of giant cell tumor are critically discussed.
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Affiliation(s)
- R Bondi
- Istituto di Anatomia e Istologia Patologica, Università di Firenze, Italia
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30
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van der Tuin K, Tops CMJ, Adank MA, Cobben JM, Hamdy NAT, Jongmans MC, Menko FH, van Nesselrooij BPM, Netea-Maier RT, Oosterwijk JC, Valk GD, Wolffenbuttel BHR, Hes FJ, Morreau H. CDC73-Related Disorders: Clinical Manifestations and Case Detection in Primary Hyperparathyroidism. J Clin Endocrinol Metab 2017; 102:4534-4540. [PMID: 29040582 DOI: 10.1210/jc.2017-01249] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 10/09/2017] [Indexed: 11/19/2022]
Abstract
CONTEXT Heterozygous pathogenic germline variants in CDC73 predispose to the development of primary hyperparathyroidism (pHPT) and, less frequently, ossifying fibroma of the jaw and renal and uterine tumors. Clinical information on CDC73-related disorders has so far been limited to small case series. OBJECTIVE To assess the clinical manifestations and penetrance in CDC73-related disorders and to improve case detection in pHPT. DESIGN Nationwide retrospective Dutch cohort study. SETTING Tertiary referral center. PATIENTS We studied 89 patients with pHPT referred for germline CDC73 analysis and 43 subsequently tested relatives who proved to be mutation carriers. INVESTIGATION Germline CDC73 mutation analysis. MEAN OUTCOME CDC73 mutation detection yield, referral rate, and CDC73-related disease penetrance. RESULTS Pathogenic germline CDC73 variants were identified in 11 of the 89 referred pHPT patients (12.4%), with (suspected) hyperparathyroidism-jaw tumor (HPT-JT) syndrome (n = 3), familial isolated pHPT (n = 5), apparently sporadic parathyroid carcinoma (n = 2), and apparently sporadic parathyroid adenoma (n = 1). The estimated penetrance of CDC73-related disorders was 65% at age 50 years (95% confidence interval, 48% to 82%) in 43 nonindex mutation carriers. CONCLUSIONS Germline CDC73 analysis is recommended in individuals with (suspected) HPT-JT syndrome, familial isolated pHPT, atypical or malignant parathyroid histology, and young individuals with pHPT. These criteria would increase germline CDC73 mutation detection, enabling optimal clinical management of pHPT as well as genetic counseling and surveillance for family members at risk for developing CDC73-related disorders.
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Affiliation(s)
- Karin van der Tuin
- Department of Clinical Genetics, Leiden University Medical Center, the Netherlands
| | - Carli M J Tops
- Department of Clinical Genetics, Laboratory for Diagnostic Genetic Analysis, Leiden University Medical Center, the Netherlands
| | - Muriel A Adank
- Department of Clinical Genetics, VU Medical Center, the Netherlands
| | | | - Neveen A T Hamdy
- Center for Endocrine Tumors Leiden, Division of Endocrinology, Department of Medicine, Leiden University Medical Center, the Netherlands
| | - Marjolijn C Jongmans
- Department of Clinical Genetics, Radboud University Medical Center, the Netherlands
- Department of Medical Genetics, Utrecht University Medical Center, the Netherlands
- Princess Maxima Center for Pediatric Oncology, the Netherlands
| | - Fred H Menko
- Family Cancer Clinic, Netherlands Cancer Institute, the Netherlands
| | | | - Romana T Netea-Maier
- Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Center, the Netherlands
| | - Jan C Oosterwijk
- Department of Genetics, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Gerlof D Valk
- Department of Endocrine Oncology, University Medical Center Utrecht, the Netherlands
| | | | - Frederik J Hes
- Department of Clinical Genetics, Leiden University Medical Center, the Netherlands
| | - Hans Morreau
- Department of Pathology, Leiden University Medical Center, the Netherlands
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31
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Hsu SY, Cheng HT, Manrique O, Hsu YC. Anterograde injection of low-dose urokinase salvages free anterolateral thigh flap: A case report of safe and effective treatment. Medicine (Baltimore) 2017; 96:e7932. [PMID: 29019875 PMCID: PMC5662298 DOI: 10.1097/md.0000000000007932] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
RATIONALE A 54-year-old Taiwanese male came to our hospital presented with right retromolar mucoepidermoid carcinoma. Composite resection and right modified radical neck dissection were performed. We then use free anteral lateral thigh flap to reconstruct the defect. However, venous congestion was found 32 h after the surgery. PATIENT CONCERNS The main concerns of the patient is complete salvage of the free flap, and avoiding the secondary free flap harvesting and reconstruction surgeries. DIAGNOSES Right retromolar mucoepidermoid carcinoma. INTERVENTIONS We report the case of a patient with an anterolateral thigh flap with venous perianastomosis thrombosis and intraflap microvascular thrombosis successfully salvaged using anterograde intra-arterial injection of low-dose urokinase (60,000 U), without administering intravenous anticoagulation heparin during the postoperative period. OUTCOMES The flap was completely salvaged 3 days after treatment. No other flap-associated or bleeding complications were noted. The intra-oral wounds around the flap completely healed without any post-ischemic complications. LESSONS SUBSECTIONS Although the ideal urokinase doses and delivery procedures for free flap salvage have not been developed thus far, our method maximizes the urokinase gradient in the flap, minimizes the total dose required for flap salvage, and ensures no systemic spread. Thus, compared with other thrombolytic agents, urokinase may be more effective and safe for free flap salvage. With more experience, a standardized dosage and procedure can be developed.
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32
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Baig MZ, Sahibzada HA, Siddiqi KM. Calcifying Cystic Odontogenic Tumor. J Coll Physicians Surg Pak 2017; 27:588-589. [PMID: 29017682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 07/01/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Muhammad Zeeshan Baig
- Department of Oral and Maxillofacial Surgery, Islamabad Medical and Dental College, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad
| | - Haafsa Arshad Sahibzada
- Department of Oral and Maxillofacial Surgery, Islamabad Medical and Dental College, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad
| | - Khalid Mahmood Siddiqi
- Department of Oral and Maxillofacial Surgery, Islamabad Medical and Dental College, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad
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Abstract
AIM This study aimed at evaluating histological features of 52 cases of calcifying odontogenic cyst (COC), which is an uncommon benign odontogenic lesion. The World Health Organization (WHO) classified COC as a neoplasm and used the term calcifying cystic odontogenic tumor (CCOT) for benign cystic type and the dentinogenic ghost cell tumor (DGCT) for the benign solid-type lesions. There is no agreement regarding COC classification. MATERIALS AND METHODS A total of 52 cases of COC were selected and reviewed from the archive of the Pathology Department of Taleghani Educational Hospital, Tehran, Iran. To better understand the pathogenesis of COC, the cases were classified. RESULTS There were 52 cases (31 males and 21 females). The lesion was found in all age groups, and patients' age from 8 to 61 years. Nineteen cases affected the maxilla, and 33 cases affected the mandible. Except two cases, all were intraosseous lesions. Radiographically, 30 cases showed a unilocular radiolucent area, and 22 cases showed a mixed radiolucent/ radiopaque region. Histopathologically, 43 cases were cystic type and 9 cases were neoplastic. CONCLUSION There are two different histopathological entities. In view of these findings, it is very difficult to determine every lesion that has a cystic architecture is truly cystic or is a neoplastic one in nature. It is believed that the solid variants may be neoplastic. CLINICAL SIGNIFICANCE A better understanding of the histological type of the lesion can provide a classification across patients. This can help in treatment planning to improve patient outcomes.
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Affiliation(s)
- Soussan Irani
- Department of Oral Pathology, Dental Faculty, Dental Research Centre, Research Centre for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran, Phone: +988138354250, e-mail:
| | - Forough Foroughi
- Department of Pathology, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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34
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Troiano G, Dioguardi M, Cocco A, Laino L, Cervino G, Cicciu M, Ciavarella D, Lo Muzio L. Conservative vs Radical Approach for the Treatment of Solid/Multicystic Ameloblastoma: A Systematic Review and Meta-analysis of the Last Decade. Oral Health Prev Dent 2017; 15:421-426. [PMID: 28748232 DOI: 10.3290/j.ohpd.a38732] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To examine whether a difference exists in the relapse rate between the conservative and radical approaches after the treatment of solid/multicystic ameloblastoma (SMA), a systematic review of the literature based on evidence of the last decade was performed. MATERIALS AND METHODS The search strategy incorporated examinations of electronic databases, supplemented by hand searches. A search of four electronic databases, including Ovid MEDLINE, PubMed, EMBASE and Web of Science, was carried out for relevant studies published in the English language from January 2005 to September 2015. Cross referencing and hand research was used to identify further articles. Relative Risk (RR) as effect estimates was calculated in both fixed and random effects models. RESULTS Of 4234 abstracts screened, only 26 articles met the inclusion criteria and were screened in full text. Of these, only 4 were included in the final meta-analysis. CONCLUSION The inverse of variance test revealed a statistical difference in the relapse rate for SMA treatment with the conservative vs radical approach. The higher recurrence rate after a conservative approach compared to the surgical approach is significant. However, this review cannot give any recommendation due to the lack of clinical evidence.
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Gilon Y, Thonnart F. [Unicystic ameloblastoma presenting in Delleman's syndrome]. Rev Med Liege 2017; 72:344-348. [PMID: 28795546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Ameloblastoma is an odontogenic tumour that represents 1 % of oral tumours but 10 % of odontogenic tumours. Ameloblastoma is characterized by low and noiseless growth, that explains a lot of advanced forms. The tumour is known as benign with local malignity due to its locally invasive behaviour and its recurrence. The treatment choice remains complicated because of recurring nature and large resection in vital anatomical areas. The therapeutic approach will be based on size, anatomical localisation, histologic variants and anatomical complications. The treatment options should be discussed with the patient because of possible important morphological and functional sequelae.
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Affiliation(s)
- Y Gilon
- Service de Chirurgie Maxillo-faciale, CHU de Liège, site Sart Tilman, Liège, Belgique
| | - F Thonnart
- Service de Chirurgie Orale et Maxillo-faciale, CHU de Liège, site Sart Tilman, Liège, Belgique
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Yukimori A, Oikawa Y, Morita KI, Nguyen CTK, Harada H, Yamaguchi S, Kayamori K, Yamaguchi A, Ikeda T, Sakamoto K. Genetic basis of calcifying cystic odontogenic tumors. PLoS One 2017; 12:e0180224. [PMID: 28658279 PMCID: PMC5489209 DOI: 10.1371/journal.pone.0180224] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 06/12/2017] [Indexed: 11/20/2022] Open
Abstract
Calcifying cystic odontogenic tumors (CCOTs) are benign cystic tumors that form abnormally keratinized ghost cells. Mutations in CTNNB1, which encodes beta-catenin, have been implicated in the development of these tumors, but a causal relationship has not been definitively established. Thus, mutational hot spots in 50 cancer genes were examined by targeted next-generation sequencing in 11 samples of CCOT. Mutations in CTNNB1, but not in other genes, were observed in 10 of 11 cases. These mutations constitutively activate beta-catenin signaling by abolishing the phosphorylation sites Asp32, Ser33, or Ser37, and are similar to those reported in pilomatrixoma and adamantinomatous craniopharyngioma. In contrast, BRAF or NRAS mutations were observed in 12 and two control samples of ameloblastoma, respectively. In HEK293 cells, overexpression of mutated CTNNB1 also upregulated hair keratin, a marker of ghost cells. Furthermore, ghost cells were present in two cases of ameloblastoma with BRAF and CTNNB1 mutations, indicating that ghost cells form due to mutations in CTNNB1. The data suggest that mutations in CTNNB1 are the major driver mutations of CCOT, and that CCOT is the genetic analog of pilomatrixoma and adamantinomatous craniopharyngioma in odontogenic tissue.
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Affiliation(s)
- Akane Yukimori
- Department of Oral Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yu Oikawa
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kei-ichi Morita
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Bioresource Research Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - Chi Thi Kim Nguyen
- Department of Oral Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroyuki Harada
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Satoshi Yamaguchi
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kou Kayamori
- Department of Oral Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Akira Yamaguchi
- Department of Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | - Tohru Ikeda
- Department of Oral Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kei Sakamoto
- Department of Oral Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Costa Arantes DA, Gonçalves AS, Jham BC, Duarte ECB, de Paula ÉC, de Paula HM, Mendonça EF, Batista AC. Evaluation of HLA-G, HLA-E, and PD-L1 proteins in oral osteosarcomas. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:e188-e196. [PMID: 28159587 DOI: 10.1016/j.oooo.2016.12.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 11/26/2016] [Accepted: 12/01/2016] [Indexed: 01/16/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the expression of human leukocyte antigens (HLAs) G and E and programmed death-ligand 1 (PD-L1) in oral osteosarcoma (OO) (n = 13). The relationship between the expression of these molecules and histologic grading and metastasis was also evaluated. STUDY DESIGN HLA-G, HLA-E, and PD-L1 were identified by immunohistochemistry. Samples of normal bone tissue (n = 6) were used as controls. The sections were evaluated using a semiquantitative scoring system with an immunoreactive score, where a score of 0 was considered absent, ≤2 was low, and >2 was high expression. RESULTS We identified high expression of HLA-G, HLA-E, and PD-L1 by malignant osteoblastic cells in 69.2% of OO cases, which was statistically higher than that in controls (P < .05). Overexpression of these proteins was identified in 8 of 11 samples of high-grade and 1 of 2 samples of low-grade OO. Additionally, 66.6% of patients with metastases (n = 4) and 71.4% of patients without metastases (n = 5) had high expression of HLA-G, HLA-E, and PD-L1 in tumor samples (P > .05). CONCLUSION OO had high expression of HLA-G, HLA-E, and PD-L1 irrespective of clinicopathologic parameters, including histologic grading and metastasis.
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Affiliation(s)
| | - Andréia Souza Gonçalves
- Department of Stomatology (Oral Pathology), Dental School, Federal University of Goiás, Goiânia, Brazil
| | - Bruno Correia Jham
- College of Dental Medicine-Illinois, Midwestern University, Downers Grove, IL, USA
| | | | - Élbio Candido de Paula
- Division of Anatomic Pathology, Araújo Jorge Hospital, Association of Cancer Combat of Goiás, Goiânia, Brazil
| | - Henrique Moura de Paula
- Division of Anatomic Pathology, Araújo Jorge Hospital, Association of Cancer Combat of Goiás, Goiânia, Brazil; Department of Pathology and Medicine Laboratory, Medicine School, Federal University of Goiás, Goiânia, Brazil
| | - Elismauro Francisco Mendonça
- Department of Stomatology (Oral Pathology), Dental School, Federal University of Goiás, Goiânia, Brazil; Head and Neck Division, Araújo Jorge Hospital, Association of Cancer Combat of Goiás, Goiânia, Brazil
| | - Aline Carvalho Batista
- Department of Stomatology (Oral Pathology), Dental School, Federal University of Goiás, Goiânia, Brazil.
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Bologna-Molina R, Mikami T, Pereira-Prado V, Pires FR, Carlos-Bregni R, Mosqueda-Taylor A. Primordial odontogenic tumor: An immunohistochemical profile. Med Oral Patol Oral Cir Bucal 2017; 22:e314-e323. [PMID: 28390134 PMCID: PMC5432080 DOI: 10.4317/medoral.21859] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 03/13/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Primordial Odontogenic Tumor (POT) is a recently described odontogenic tumor characterized by a variably cellular loose fibrous tissue with areas similar to the dental papilla, covered by cuboidal to columnar epithelium that resembles the internal epithelium of the enamel organ, surrounded at least partly by a delicate fibrous capsule. The purpose of this study was to investigate the possible histogenesis and biological behavior of this rare tumor by means of a wide immunohistochemical analysis of its epithelial and mesenchymal components. MATERIAL AND METHODS The immunoexpression of twenty-three different antibodies were evaluated in four cases of POT. RESULTS The epithelial cells that cover the periphery of the tumor showed immunopositivity for Cytokeratins 14 and 19, while Amelogenin, Glut-1, MOC-31, Caveolin-1. Galectin-3, PITX2, p53, Bax, Bcl-2, Survivin and PTEN were variably expressed in focal areas. The mesenchymal component of the tumor was positive for Vimentin, Syndecan-1, PITX2, Endoglin (CD105), CD 34, Cyclin D1, Bax, Bcl-2, Survivin and p53. PTEN and CD 90 showed a moderate positivity. BRAF V600E and Calretinin were negative in all samples. Cell proliferation markers (Ki-67, MCM-7) were expressed in <5% of the tumor cells. CONCLUSIONS According to these immunohistochemical findings, we may conclude that POT is a benign odontogenic tumor in which there is both epithelial and mesenchymal activity during its histogenesis, as there is expression of certain components in particular zones in both tissues that suggests this tumor develops during the immature (primordial) stage of tooth development, leading to its inclusion within the group of benign mixed epithelial and mesenchymal odontogenic tumours in the current World Health Organization classification of these lesions.
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Affiliation(s)
- R Bologna-Molina
- Health Care Department, Universidad Autónoma Metropolitana Xochimilco, Calzada del Hueso 1100, Villa Quietud, Mexico City 04960,
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Trento GDS, Gorla LFDO, Navarro CM, Filho VAP. The relevance of dental surgeon on Gorlin-Goltz syndrome. Stomatologija 2017; 19:130-132. [PMID: 29806651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Multiple odontogenic keratocysts could be linked to different conditions. Then, to achieve the correct diagnosis whether their presence is associated to a syndrome, some criteria must be followed. The present study aims to report a case of a 21 years-old male patient whose was referred with several radiolucent lesion on the maxilla-mandibular complex. The lesions were biopsied and the diagnosis of the histological exam hypothesized as odontogenic keratocyst. After complete evaluation, others abnormalities were also found such as calcification of falx cerebri, palmar and plantar pits, and multiple basal cell on feet. The patient was diagnosed with Gorlin-Goltz syndrome and was referred to other medical specialties to adequate follow-up. Dental surgeon represents an important role on correct diagnosis of the Gorlin-Goltz syndrome and could avoid further complications.
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Affiliation(s)
- Guilherme Dos Santos Trento
- Dental School at Araraquara - Unesp - Brazil, 1680th Humaitá Street, Araraquara, São Paulo, ZIP: 14801-903, Brazil.
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Sarmast A, Nayil-M K, Makhdoomi R, Butto A, Ramzan A. Metastatic Ameloblastoma to Brain: A Rare Entity. Gulf J Oncolog 2016; 1:69-71. [PMID: 28191811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2016] [Indexed: 06/06/2023]
Abstract
Ameloblastoma is a rare odontogenic tumor of the jaw. It is a benign neoplasm but local recurrence is common. Metastasis from this tumor is all the more rare. The commonest site for metastasis is lung. Brain is a very uncommon site of involvement. Overall prognosis is good. We hereby discuss ameloblastoma of lower jaw in a young adult which had metastasized to brain. Patient was operated for the metastatic lesion of brain and is doing well on follow-up.
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Affiliation(s)
- Arif Sarmast
- Dept. of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Kashmir, India
| | - Khursheed Nayil-M
- Dept. of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Kashmir, India
| | - Rumana Makhdoomi
- Dept. of Pathology, Sheri-Kashmir Institute of Medical Sciences, Kashmir, India
| | - Azhar Butto
- Dept. of Surgical Oncology, Sheri-Kashmir Institute of Medical Sciences, Kashmir, India
| | - Altaf Ramzan
- Dept. of Neurosurgery, Sheri-Kashmir Institute of Medical Sciences, Kashmir, India
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Ray AC, Foletti JM, Graillon N, Guyot L, Chossegros C. [De novo (type 3) primary intraosseous carcinoma of the jaws]. ACTA ACUST UNITED AC 2016; 117:411-420. [PMID: 27527660 DOI: 10.1016/j.revsto.2016.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 07/07/2016] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Primary intraosseous carcinoma (PIOC) of the jaws is a rare epidermoid carcinoma from epithelial origin and initially strictly localized within the bone. Histologically, type 3 PIOC (PIOC3) is a de novo primary intraosseous carcinoma. Because of the rarity of this illness, we propose an analysis of a personal case and a revue of the literature. MATERIAL AND METHODS Two search engines (Pubmed®, Sciencedirect®) were questioned over the period 1976-February 2016 by using following keywords carcinoma, intraosseous, jaws, squamous cell carcinoma. Articles reporting proven PIOC3 and mentioning a precise treatment were selected. RESULTS Thirty articles concerning 54 patients (sex ratio: 2.4; mean age: 56.8; extreme: 24-78) met the inclusion criterions. The most common symptoms were swelling (53%), pain (44.9%) and infra-alveolar nerve paresthesia (30.6%). The time to diagnosis was 13 weeks. Classification of Zwetyenga et al. showed more than 80% of T2 and T3 stages. The lesions were predominantly mandibular (85.2%) and posterior. Less than a third of patients had lymph node and 10% had distant metastasis. Treatment consisted mostly in a combination of surgery and radiotherapy. With a mean follow-up of 74.8 months, 70.8% were in remission with no evidence of recurrence. We report the case of a 58-year-old patient, with no medical history, complaining since several months about periodontitis with teeth mobility in the right mandibular area. The panoramic X-ray showed a bone lysis at the place of tooth No. 46. In the absence of alveolar healing after extraction and antibiotherapy, a biopsy was made that diagnosed a differentiated keratinizing squamous cell carcinoma. CT scan and MRI showed a mandibular cortical bone loss with involvement of adjacent structures and lymphadenopathy in the ipsilateral IB area. The patient was treated with a combination of chemotherapy and surgery. Postoperative chemo- and radiotherapy is still going on. DISCUSSION The PIOC3 is a rare tumor, mainly arising in males around 50. Diagnosis should be evoked in the presence of painful swelling and nervous symptoms. The time to diagnosis is long. Tumors are usually seen at late stages. Treatment classically combines surgery and radiotherapy.
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Affiliation(s)
- A C Ray
- Service de chirurgie maxillo-faciale, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille, France; Aix-Marseille université, jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; UMR 6057, laboratoire parole et langage (LPL), 13604 Aix-en-Provence, France.
| | - J M Foletti
- Service de chirurgie maxillo-faciale, hôpital Nord, chemin des Bourrely, 13015 Marseille, France; Aix-Marseille université, jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; Aix-Marseille université, IFSTTAR, LBA UMR_T 24, 13916 Marseille, France
| | - N Graillon
- Service de chirurgie maxillo-faciale, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille, France; Aix-Marseille université, jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France
| | - L Guyot
- Service de chirurgie maxillo-faciale, hôpital Nord, chemin des Bourrely, 13015 Marseille, France; Aix-Marseille université, jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France
| | - C Chossegros
- Service de chirurgie maxillo-faciale, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille, France; Aix-Marseille université, jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; UMR 6057, laboratoire parole et langage (LPL), 13604 Aix-en-Provence, France
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Sánchez-Romero C, Bologna-Molina R, Mosqueda-Taylor A, Paes de Almeida O. Immunohistochemical Expression of GLUT-1 and HIF-1α in Tooth Germ, Ameloblastoma, and Ameloblastic Carcinoma. Int J Surg Pathol 2016; 24:410-8. [PMID: 27020375 DOI: 10.1177/1066896916640359] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Hypoxia-inducible factor-1α (HIF-1α) promotes proteins that enable cell survival during hypoxia, such as glucose transporter 1 (GLUT-1). Their coexpression has been associated with aggressiveness in malignancies and has not been studied in odontogenic tumors. Immunohistochemical expression of HIF-1α and GLUT-1 was analyzed in 13 tooth germs (TGs), 55 ameloblastomas (AMs), and 3 ameloblastic carcinomas (ACs). HIF-1α was negative in all TGs, and just 1 case of AM and 1 of AC had nuclear positivity. GLUT-1 expressed in ameloblastic cells of all TGs, AMs, and ACs, with an increasing intensity, respectively, and was significantly higher in solid AM than in unicystic AM (P = .041). Absence of nuclear HIF-1α in TGs and most AMs suggest that GLUT-1 may be induced by alternative pathways to hypoxia. However, in ACs, HIF-1α may be activated; however, to confirm this, additional cases are needed. GLUT-1 overexpression could be related to aggressiveness in AMs and ACs and must represent a normal metabolite in TGs.
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Abstract
Ameloblastoma is a rare, locally aggressive odontogenic neoplasm, accounting for fewer than 1 % of head and neck tumors. Recent literature suggests that the initial surgical approach and histologic growth patterns are the most important prognostic determinants in ameloblastoma. The aim of this study was to compare the clinical presentation, management, and outcomes of patients with ameloblastoma with data reported in the literature; the study spanned 2 decades at a single institution. The institution's database was searched for all patients with pathologically confirmed ameloblastoma, diagnosed between 1990 and 2015. The data collected included sex, age, clinical and imaging findings, management, histologic pattern, clearance of surgical margins, length of follow-up, time to recurrence, and disease-related mortality. The potential risk factors of recurrence were evaluated using log-rank test, proportional hazard model, and Fisher exact test. Review of the database yielded 54 patients with pathologically confirmed ameloblastoma and follow-up. Recurrence was noted in 13 (24 %) patients. Surgical approach was associated with the risk of recurrence (6.1 % following radical resection vs. 52 % following limited surgery, p = 0.002). There were trends toward higher recurrence rate in the group with pathologically documented positive margins (p = 0.054) and in follicular ameloblastoma (p = 0.35). Transformation into ameloblastic carcinoma was identified in two patients. There was no disease-related mortality. Our study confirms the recent data regarding the importance of radical surgical resection in management of ameloblastoma. Surgical approach appears to be the strongest predictor of tumor clearance.
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Affiliation(s)
- Tatyana Milman
- Departments of Pathology and Laboratory Medicine, Perelman School of Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Gui-Shuang Ying
- Department of Ophthalmology, Center for Preventive Ophthalmology and Biostatistics, Scheie Eye Institute, Perelman School of Medicine, Philadelphia, PA, USA
| | - Wei Pan
- Department of Ophthalmology, Center for Preventive Ophthalmology and Biostatistics, Scheie Eye Institute, Perelman School of Medicine, Philadelphia, PA, USA
| | - Virginia LiVolsi
- Departments of Pathology and Laboratory Medicine, Perelman School of Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
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Sullivan M, Gallagher G, Noonan V. The root of the problem: Occurrence of typical and atypical periapical pathoses. J Am Dent Assoc 2016; 147:646-9. [PMID: 27046538 DOI: 10.1016/j.adaj.2016.02.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 02/24/2016] [Accepted: 02/25/2016] [Indexed: 01/07/2023]
Abstract
BACKGROUND A preponderance of periapical radiolucencies are of inflammatory etiology (radicular cysts or periapical granulomas) secondary to pulpal disease. In some instances, however, a suspected periapical inflammatory lesion is not a consequence of pulpal disease but instead represents a lesion of noninflammatory origin. The differential diagnosis for such lesions is broad, ranging from odontogenic cysts and tumors to metastatic disease. As the biological behavior of such lesions is varied, the distinction between inflammatory odontogenic periapical lesions and lesions of noninflammatory origin in a periapical location is critical. METHODS A retrospective study of 5,993 archival periapical biopsies over a span of 15 years from the database of the Oral Pathology Biopsy Service in the Henry M. Goldman School of Dental Medicine at Boston University recorded the incidence of various lesions in a periapical location. RESULTS Of the cases studied, 97.2% represented lesions of inflammatory origin with histopathologic diagnoses as follows: periapical granuloma (60.0%), radicular cyst (36.7%), periapical fibrous scar (0.27 %), and periapical abscess (0.23 %). The remaining 2.8% cases were lesions of noninflammatory origin with histopathologic diagnoses of odontogenic keratocyst (also known as keratocystic odontogenic tumor), benign fibro-osseous lesions, and ameloblastoma. One patient had Langerhans cell disease, and 1 had central giant cell granuloma. CONCLUSIONS Although most periapical specimens biopsied represented expected inflammatory periapical lesions, the biological behavior of underdiagnosed lesions may have considerable consequences for both the patient and the clinician. PRACTICAL IMPLICATIONS This article serves to inform clinicians regarding the diversity of lesions arising in the periapical region of the jaws, to assist in the formulation of differential diagnoses, and to highlight the importance of submission of lesional tissue for histopathologic evaluation and definitive diagnosis when biopsy is clinically indicated.
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Jimi E, Fukushima H. [NF-κB signaling pathways and the future perspectives of bone disease therapy using selective inhibitors of NF-κB]. Clin Calcium 2016; 26:298-304. [PMID: 26813510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The transcriptional factor nuclear factor κB(NF-κB)regulates the expression of a wide variety of genes that are involved in immune and inflammatory responses, proliferation, and tumorigenesis. NF-κB consists of five members, such as p65(RelA), RelB, c-Rel, p50/p105(NF-κB1), and p52/p100(NF-κB2). There are two distinct NF-κB activation pathways, termed the classical and alternative NF-κB signaling pathways. Since mice lacking both p50 and p52 subunits developed typical osteopetrosis, due to total lack of osteoclasts, NF-κB is also important osteoclast differentiation. A selective NF-κB inhibitor blocked receptor activator of NF-κB ligand(RANKL)-induced osteoclastogenesis both in vitro and in vivo. Recent findings have shown that inactivation of NF-κB enhances osteoblast differentiation in vitro and bone formation in vivo. NF-κB is constitutively activated in many cancers including oral squamous cell carcinoma(OSCC), and is involved in the invasive characteristics of OSCC. A selective NF-κB inhibitor also prevented jaw bone destruction by OSCC by reduced osteoclast numbers in animal model. Thus the inhibition of NF-κB might useful for the treatment of bone diseases, such as arthritis, osteoporosis, periodontitis, and bone invasion by OSCC by inhibiting bone resorption and by stimulating bone formation.
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Affiliation(s)
- Eijiro Jimi
- Division of Molecular Signaling and Biochemistry, Department of Health Promotion, Kyushu Dental University, Japan
| | - Hidefumi Fukushima
- Center for Advanced Stem Cell and Regenerative Research, Tohoku University Graduate School of Dentistry, Japan
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Andisheh-Tadbir A, Fakharian M. HSP70 expression in dentigerous cyst, odontogenic keratocyst, and ameloblastoma. Oral Maxillofac Surg 2015; 19:287-291. [PMID: 25854321 DOI: 10.1007/s10006-015-0492-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Accepted: 03/25/2015] [Indexed: 06/04/2023]
Abstract
Heat shock proteins (HSPs) work as molecular chaperones that can assist cells to deal with stressful situations. Members of the HSP70 family can regulate cell growth and transformation and are involved in the maintenance of cellular homeostasis. In view of the distinct clinical behavior of odontogenic lesions, the objective of the present study was to investigate the immunohistochemical expression of HSP70 in these lesions. In this study, 70 formalin-fixed paraffin-embedded tissue blocks of odontogenic lesion-16 unicystic ameloblastomas (UAs), 17 solid ameloblastomas (SAs), 18 odontogenic keratocysts (OKCs), and 19 dentigerous cysts (DCs)-were reviewed by immunohistochemistry for HSP70 staining. In this study, HSP70 immunostaining was evident in all groups of the specimen. Mean percentage of HSP70 staining in SAs (84.2 ± 11.3) and OKCs (83.4 ± 6.8) were significantly higher than UAs (64.4 ± 9.8) and DCs (12.6 ± 10.2) (p = 0.00). But, there was no statistically significant difference between HSP70 expression in SAs and OKCs. The result of this study proposes that high expression rate of HSP70 has a role in the pathogenesis of ameloblastoma and OKC and is one of the reasons for the aggressive behavior of ameloblastoma and high recurrence role of OKC, reinforcing the classification of OKC as an odontogenic tumor.
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Affiliation(s)
- Azadeh Andisheh-Tadbir
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran,
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García-Muñoz A, Rodríguez MA, Licéaga-Escalera C, Licéaga-Reyes R, Carreón-Burciaga RG, González-González R, Bologna-Molina R. Expression of the transcription factor PITX2 in ameloblastic carcinoma. Arch Oral Biol 2015; 60:799-803. [PMID: 25791324 DOI: 10.1016/j.archoralbio.2015.02.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Revised: 10/06/2014] [Accepted: 02/20/2015] [Indexed: 02/07/2023]
Abstract
Ameloblastic carcinoma is a rare odontogenic tumour that combines the histological features of ameloblastoma with cytological atypia. Until 2005, the incidence of ameloblastic carcinoma was unknown, and since then, fewer than 60 cases have been reported. These tumours may originate from pre-existing tumours or cysts, or they arise de novo from the activation or transformation of embryological cells. PITX2 is a transcription factor that is a product and regulator of the WNT cell signalling pathway, which has been involved in development of several tumours. To analyse whether PITX2 could be involved in the biological behaviour of ameloblastic carcinoma, we analysed the expression of this transcription factor in a sample of this tumour and nine benign ameloblastomas to compare. The results of Western blotting and RT-PCR analyses were positive, and considering the hundreds of genes that PITX2 regulates, we believe that its expression could be intimately linked to the behaviour of ameloblastic carcinoma and possibly other odontogenic lesions.
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Affiliation(s)
- Alejandro García-Muñoz
- School of Dentistry, Universidad Juárez del Estado de Durango, Durango, Mexico; Department of Infectomics and Molecular Pathogenesis, CINVESTAV-IPN, México, D.F., Mexico
| | - Mario A Rodríguez
- Department of Infectomics and Molecular Pathogenesis, CINVESTAV-IPN, México, D.F., Mexico
| | | | | | | | | | - Ronell Bologna-Molina
- School of Dentistry, Universidad Juárez del Estado de Durango, Durango, Mexico; Molecular Pathology, School of Dentistry, Universidad de la República (UDELAR), Montevideo, Uruguay.
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Andisheh-Tadbir A, Pardis S, Ranjbaran P. Twist expression in dentigerous cyst, odontogenic keratocyst, and ameloblastoma. Oral Maxillofac Surg 2015; 19:103-107. [PMID: 25088731 DOI: 10.1007/s10006-014-0459-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 07/25/2014] [Indexed: 06/03/2023]
Abstract
Epithelial-mesenchymal transition (EMT) is a process which is associated with a loss of intercellular adhesion, acquired mesenchymal shape, and increased motility by epithelial cells. Twist is one of the key regulators of EMT.In view of the distinct clinical behavior of odontogenic lesions, the objective of the present study was to investigate the immunohistochemical expression of Twist in these lesions. In this study, 70 formalin-fixed, paraffin-embedded tissue blocks of odontogenic lesion consisting of 16 unicystic ameloblastomas (UA), 17 solid ameloblastomas (SA), 18 odontogenic keratocysts (OKC), and 19 dentigerous cysts (DC) were reviewed using immunohistochemistry for Twist staining. In this study, Twist immunostaining was evident in all groups of the specimens except the dentigerous cyst group. Twist expression was seen in 58.8 % (10/17) of SA, 50 % (8/16) of UA, and 44.4 % (8/18) of OKCs. 23.5 % of SA, 18.8 % of UA, and 16.7 % of OKCs showed Twist expression in more than 50 % of cells. Statistical analysis showed that Twist expression levels were significantly higher in ameloblastomas (SA and UA) and OKCs than dentigerous cysts (P = 0.002). There were no significant differences between Twist expression in SAs, UAs, and OKCs (P > 0.05). The results of this study propose that the high expression rate of Twist plays a role in the pathogenesis of ameloblastomas and OKCs and might be one of the reasons for the aggressive behavior of ameloblastomas and high recurrence of OKCs and could reinforce the classification of OKC as an odontogenic tumor.
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Affiliation(s)
- Azadeh Andisheh-Tadbir
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran,
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Chae MP, Smoll NR, Hunter-Smith DJ, Rozen WM. Establishing the natural history and growth rate of ameloblastoma with implications for management: systematic review and meta-analysis. PLoS One 2015; 10:e0117241. [PMID: 25706407 PMCID: PMC4338260 DOI: 10.1371/journal.pone.0117241] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 12/22/2014] [Indexed: 12/14/2022] Open
Abstract
Background Ameloblastoma is the second most common odontogenic tumor, known to be slow-growing, persistent, and locally aggressive. Recent data suggests that ameloblastoma is best treated with wide resection and adequate margins. Following primary excision, bony reconstruction is often necessary for a functional and aesthetically satisfactory outcome, making early diagnosis paramount. Despite earlier diagnosis potentially limiting the extent of resection and reconstruction, an understanding of the growth rate and natural history of ameloblastoma has been notably lacking from the literature. Method A systematic review of the literature was conducted by reviewing relevant articles from PubMed and Web of Science databases. Each article’s level of evidence was formally appraised according to the Centre of Evidence Based Medicine (CEBM), with data from each utilized in a meta-analysis of growth rates for ameloblastoma. Results Literature regarding the natural history of ameloblastoma is limited since the tumor is immediately acted upon at its initial detection, unless the patient voluntarily refuses a surgical intervention. From the limited data, it is derived that the highest estimated growth rate is associated with solid, multicystic type and the lowest rate with peripheral ameloblastomas. After meta-analysis, the calculated mean specific grow rate is 87.84% per year. Conclusion The growth rate of ameloblastoma has been demonstrated, offering prognostic and management information, particularly in cases where a delay in management is envisaged.
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Affiliation(s)
- Michael P. Chae
- Department of Plastic and Reconstructive Surgery, Frankston Hospital, Peninsula Health, Frankston, Victoria, Australia
- Department of Surgery, Monash University, Clayton, Victoria, Australia
- Monash University Plastic and Reconstructive Surgery Unit, Peninsula Clinical School, Frankston, Victoria, Australia
- * E-mail:
| | - Nicolas R. Smoll
- Department of Plastic and Reconstructive Surgery, Frankston Hospital, Peninsula Health, Frankston, Victoria, Australia
- Department of Surgery, Monash University, Clayton, Victoria, Australia
- Monash University Plastic and Reconstructive Surgery Unit, Peninsula Clinical School, Frankston, Victoria, Australia
| | - David J. Hunter-Smith
- Department of Plastic and Reconstructive Surgery, Frankston Hospital, Peninsula Health, Frankston, Victoria, Australia
- Department of Surgery, Monash University, Clayton, Victoria, Australia
- Monash University Plastic and Reconstructive Surgery Unit, Peninsula Clinical School, Frankston, Victoria, Australia
| | - Warren Matthew Rozen
- Department of Plastic and Reconstructive Surgery, Frankston Hospital, Peninsula Health, Frankston, Victoria, Australia
- Department of Surgery, Monash University, Clayton, Victoria, Australia
- Monash University Plastic and Reconstructive Surgery Unit, Peninsula Clinical School, Frankston, Victoria, Australia
- Department of Surgery, James Cook University Clinical School, Townsville, Queensland, Australia
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Czerninski R, Zadik Y, Vered M, Becker T, Yahalom R, Derazne E, Aframian DJ, Almoznino G. Demographic and clinical factors associated with referrals and compliance to biopsy of oral and maxillofacial lesions. J Oral Pathol Med 2015; 43:364-70. [PMID: 24877225 DOI: 10.1111/jop.12139] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The gold standard for diagnosing oral disease is tissue biopsy. Data regarding compliance with advised oral and maxillofacial (OMF) biopsy are scarce. PURPOSE To quantify compliance and evaluate the demographics and clinical factors associated with referrals and compliance with OMF biopsy procedures. METHODS Medical records of military personnel referred for a biopsy (RB; N = 669) of OMF lesions over a 4-year period were studied retrospectively. These patients were divided into performed the biopsy (PB; N = 386) and not perform biopsy (NPB; N = 283) groups. Demographic and clinical features were analyzed, and demographics were compared to a control group of general military personnel (N > 100,000). RESULTS The RB group differed from the control group regarding age >21 (OR = 1.681, P < 0.001) and education >12 years of schooling (OR = 1.545, P < 0.001). Differences between the PB and NPB groups related to the clinical features of the lesion but not to demographic parameters. Exophytic and suspected potentially malignant/malignant lesions were positively associated with higher compliance to biopsy (OR = 1.75, P = 0.004 and OR = 2.18, P = 0.017, respectively). CONCLUSION Referrals to biopsy of OMF lesions are significantly influenced by age and education, whereas compliance is influenced by clinical features or suspected malignancy. Clinicians and health authorities should be aware of non-compliance, enhance awareness to biopsy as the gold standard in the diagnostic workup of OMF lesions, and closely monitor compliance patterns of patients with clinical and demographic risk factors.
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