Diode laser on excision of giant peripheral odontogenic myxoma: a rare case report and literature review

It was to report a rare case of peripheral odontogenic myxoma removed with high-power diode laser and to do an extensive review of studies of odontogenic cysts and tumors treated with high-power laser (HPL). This is a rare case of a 63-year-old male patient with a peripheral odontogenic myxoma measuring approximately 10 cm in the attached gingiva region of tooth 16 removed with a high-power diode laser (808 nm, 3 W, in continuous mode, under constant suction, with 400-µm optical fiber). A literature review was also carried out looking for articles that involved the use of HPL in the treatment of odontogenic cysts and tumors, without restriction of year or language. In the present case, there was no need for suturing, no postoperative discomfort, and minimal bleeding during the procedure. In a 12-month follow-up period, there were no signs of recurrence. Only two cases of intra-osseous odontogenic myxomas treated with HPL and 10 cases involving other odontogenic cysts and tumors were found. All studies showing HPL to be effective in treating these lesions. Despite the different types of lasers used and different parameters, it is observed that lasers are effective in the treatment of odontogenic lesions.

Ameloblastic carcinoma: An analysis of 14 cases

OBJECTIVES

To present the classifications of malignant ameloblastomas, provide histopathologic guidelines for the diagnosis of ameloblastic carcinoma, and discuss treatment and long-term follow-up.

STUDY DESIGN

Fourteen archival specimens of ameloblastic carcinoma with detailed treatment and follow-up documentation were identified by the authors.

RESULTS

Traditional methods of microscopic observation form the basis for diagnosis. Histopathologic features of ameloblastic carcinoma include lack of differentiation, hypercellularity, high mitotic index, vascular invasion, and neural invasion.

CONCLUSION

The long-term follow-up findings in this study support the concept that aggressive surgical intervention provides the best chance for survival. Patients treated otherwise had recurrence. The patients with the highest number of recurrences did not survive the disease.

Primary intraosseous odontogenic carcinoma arising in an odontogenic cyst or de novo: A clinicopathologic study of six new cases

The term primary intraosseous odontogenic carcinoma (PIOC) has been primarily used to describe a squamous cell carcinoma within the jaws arising either from a previous odontogenic cyst or de novo. Here, we report 6 new cases of PIOC, affecting 4 female and 2 male patients with a mean age of 56.2 years. Two cases involved the maxilla and 4 cases occurred in the mandible. The typical radiographic presentation was that of a radiolucent lesion with well or ill defined margins. Histopathologically, 4 cases were diagnosed as well differentiated keratinizing PIOC arising from previous odontogenic cysts (2 odontogenic keratocysts and 2 periapical cysts). The remaining 2 cases were poorly differentiated nonkeratinizing PIOC, which appeared to arise de novo. Treatment consisted of surgical removal, with postoperative radiotherapy in 5 cases, and to date neither recurrence nor metastasis have occurred. Knowledge of the clinical, radiographic, and histopathologic features of PIOC allows accurate diagnosis and appropriate treatment of this rare malignancy.

Calcifying epithelial odontogenic (Pindborg) tumor with malignant transformation and metastatic spread

BACKGROUND

Pindborg tumors (calcifying epithelial odontogenic tumors) are uncommon neoplasms of odontogenic origin most often located in the posterior mandible. First described in detail in 1955 by Pindborg, these tumors are considered benign but can be locally aggressive in nature, with recurrence rates of 10% to 15% reported. The malignant form of this tumor is exceedingly rare.

METHODS

We describe the case of a 64-year-old woman initially treated for a painful infected left mandibular third molar. The patient underwent extraction of the tooth and excision of an associated soft tissue component. Subsequent histologic review identified a Pindborg tumor of the left posterior mandible.

RESULTS

After initial excision, this tumor recurred twice, with the recurrences exhibiting a progression to a malignant Pindborg tumor (odontogenic carcinoma) with vascular invasion and spread to a cervical lymph node. Further treatment involved radical surgery and adjuvant radiotherapy. At last review 12 months after treatment, the patient was disease free.

CONCLUSIONS

This article describes only the second case of odontogenic carcinoma. The transformation from benign to malignant histologic findings has not previously been documented in this tumor. The salient clinical features of this case are presented along with supportive pathologic and radiologic evidence.

Radiation therapy for long-term control of odontogenic tumours and epulis in three cats

Orthovoltage radiation was used to treat odontogenic tumours in three cats following incomplete surgical resection. Cats received a total radiation dose of 48-52 Gy over a period of 26-29 days. Acute toxicities were mild, consisting of hair loss within the radiation field in all cats, and mild mucositis in one cat. All cats had long-term (>35 months) control of their tumour, and two cats are still alive without recurrence of tumour 60 and 39 months, respectively, after completing treatment. Radiation therapy should be considered to be an adjuvant to incomplete surgery in cats with odontogenic neoplasms or epulides.

Orthovoltage radiotherapy of acanthomatous epulides in 39 dogs

Acanthomatous epulides in 39 dogs were treated with orthovoltage x-rays. The acanthomatous epulis recurred in only 3 dogs, 2 of which were successfully retreated with x-rays. Malignant tumors other than acanthomatous epulis developed at the site of the irradiated acanthomatous epulis in 7 of the dogs. Five of the tumors were squamous cell carcinoma, one was a fibrosarcoma, and one was an osteosarcoma. The range of survival times (1 to 102 months), mean survival time (38 months), median survival time (37 months), 1-year survival rate (85%), and 2-year survival rate (67%) were encouraging and suggested that the described treatment was satisfactory for acanthomatous epulides. Cause of death in most dogs was not related to the acanthomatous epulis.

X-ray therapy of selected odontogenic neoplasms in the dog

X-ray therapy was used on 14 selected adamantinomas and 2 ameloblastic odontomas, with beneficial results. The recommended x-ray treatment is a minimum total dose of 3,600 rads and a maximum of 4,200 rads, at a half-value layer of 1.5 to 2 mm of Cu. Five to 6 treatments were spread over a 10- to 12-day period.