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Yan C, Shentu W, Gu C, Cao Y, Chen Y, Li X, Wang H. Prenatal Diagnosis of Fetal Oral Masses by Ultrasound Combined With Magnetic Resonance Imaging. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:597-604. [PMID: 33904194 DOI: 10.1002/jum.15733] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/19/2021] [Accepted: 04/13/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To analyze the imaging manifestations of common fetal oral masses by ultrasound combined with magnetic resonance imaging (MRI) and to discuss their differential diagnoses. METHODS A retrospective study of 6 fetuses with oral masses was performed at a tertiary referral center. The imaging features of prenatal ultrasonography and MRI in the diagnosis of fetal oral masses were analyzed. RESULTS Histopathological examination and/or postpartum ultrasound revealed lymphangioma malformation in 2 fetuses, and mucosal retention cyst, mature teratoma, immature teratoma, and cranial meningocele in 1 fetus, respectively. The teratoma had a characteristic sonographic appearance. In our study, the 4 cases of cystic masses did not have an abnormal vessel architecture. Supplemental MRI revealed a mass effect at the level of the hypopharynx, and in 2 cases with polyhydramnios, the mass obstructed the fetuses' upper airway. Thus, ex-utero intrapartum therapy surgery was performed to secure the newborn's airway. CONCLUSIONS Oral fetal tumors represent rare congenital malformations. This study shows that a prenatal diagnosis of oral masses is feasible by ultrasound examination. MRI can further confirm the results of ultrasonography and clearly show the relationship between the mass and the hypopharynx. Ultrasonography combined with MRI could, to a large extent, facilitate early detection and appropriate treatment and improve outcome.
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Affiliation(s)
- Can Yan
- Department of Medical Ultrasonic, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Weihui Shentu
- Department of Medical Ultrasonic, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Congmin Gu
- Institute of Pathology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Yaxian Cao
- Department of Radiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Yunyu Chen
- Department of Medical Ultrasonic, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xiaofei Li
- Department of Medical Ultrasonic, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Hongying Wang
- Department of Medical Ultrasonic, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
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Ye Y, Tang R, Liu B, Li Y, Mo Y, Zhang Y. Prenatal diagnosis and multidisciplinary management: a case report of congenital granular cell epulis and literature review. J Int Med Res 2021; 49:3000605211053769. [PMID: 34719988 PMCID: PMC8562647 DOI: 10.1177/03000605211053769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Congenital granular cell epulis (CGCE) is a rare benign soft tissue lesion that usually originates from the neonatal gingiva and can lead to difficulty in breathing and feeding upon birth. This current case report describes a female newborn with a gingival mass that was identified by prenatal fetal ultrasonography. At birth, the oral mass was observed to protrude from the mouth, which adversely affected feeding. The lips could not be closed. The breathing was unaffected. Through a multidisciplinary team approach involving several healthcare professionals, the mass was successfully removed under general anaesthesia during an uncomplicated surgical procedure. Postoperative histopathological examination confirmed that the mass was a CGCE of the newborn. The infant recovered well after the operation.
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Affiliation(s)
- Yujiao Ye
- Children's Health Centre, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, Sichuan Province, China
| | - Ruiqi Tang
- Children's Health Centre, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, Sichuan Province, China
| | - Beibei Liu
- Department of Neonatology, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, Sichuan Province, China
| | - Yi Li
- Department of Head and Neck Tumour Surgery, Hospital of Stomatology Sichuan University, Chengdu, Sichuan Province, China
| | - Yunlu Mo
- Department of Pathology, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, Sichuan Province, China
| | - Yong Zhang
- Department of Neonatology, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, Sichuan Province, China
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Morice A, Neiva C, Fabre M, Spina P, Jouenne F, Galliani E, Vazquez MP, Picard A. Conservative management is effective in unicystic ameloblastoma occurring from the neonatal period: A case report and a literature review. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 129:e234-e242. [PMID: 31562035 DOI: 10.1016/j.oooo.2019.08.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 07/28/2019] [Accepted: 08/26/2019] [Indexed: 12/28/2022]
Abstract
Unicystic ameloblastoma (UA), a benign odontogenic tumor of the jaw, represents less than a third of all ameloblastomas and seems less aggressive than other types of ameloblastoma. We present here the first case of UA that developed prenatally and was successfully managed in the early neonatal period with marsupialization and curettage performed carefully to avoid injury to the tooth germ. BRAF and SMO mutations were not detected. After 2 years of follow-up, complete reossification and normal eruption of deciduous teeth were noted, and there was no recurrence of UA. We recommend conservative treatment of UA in the pediatric population to avoid loss of and/or injury to the tooth germ, provided close follow-up is carried out all through the individual's growth for early detection of potential recurrences, growth impairments, or tooth eruption disorders. The intratumoral somatic mutational status of BRAF, SMO, RAS family, and FGFR2 may help determine personalized targeted treatment, particularly in case of recurrence.
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Affiliation(s)
- Anne Morice
- Department of Maxillofacial and Plastic Surgery, Rare Diseases Reference Center Coordinator for Clefts and Facial Malformations, Hôpital Universitaire Necker-Enfants Malades, Paris, France; Université Paris Descartes-Sorbonne Paris Cité, Paris, France.
| | - Cecilia Neiva
- Department of Maxillofacial and Plastic Surgery, Rare Diseases Reference Center Coordinator for Clefts and Facial Malformations, Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Monique Fabre
- Department of Pathology, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, and Université Paris Descartes, Paris, France
| | - Paolo Spina
- Cantonal Institute of Pathology, Locarno, Switzerland; Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
| | - Fanélie Jouenne
- Genomic of Solid Tumors Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris; Université Paris-Diderot, Sorbonne Paris Cité, Paris, France
| | - Eva Galliani
- Department of Maxillofacial and Plastic Surgery, Rare Diseases Reference Center Coordinator for Clefts and Facial Malformations, Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Marie-Paule Vazquez
- Department of Maxillofacial and Plastic Surgery, Rare Diseases Reference Center Coordinator for Clefts and Facial Malformations, Hôpital Universitaire Necker-Enfants Malades, Paris, France; Université Paris Descartes-Sorbonne Paris Cité, Paris, France
| | - Arnaud Picard
- Department of Maxillofacial and Plastic Surgery, Rare Diseases Reference Center Coordinator for Clefts and Facial Malformations, Hôpital Universitaire Necker-Enfants Malades, Paris, France; Université Paris Descartes-Sorbonne Paris Cité, Paris, France
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Fievet A, Blondiaux E, Dohna M, Neiva-Vaz C, Ducou le Pointe H, Garel C. Prenatal diagnosis of unicystic ameloblastoma. Diagn Interv Imaging 2017; 99:119-120. [PMID: 29108911 DOI: 10.1016/j.diii.2017.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 09/19/2017] [Accepted: 09/23/2017] [Indexed: 11/24/2022]
Affiliation(s)
- A Fievet
- Service d'imagerie pédiatrique, hôpital Armand-Trousseau, AP-HP, Paris, France.
| | - E Blondiaux
- Service d'imagerie pédiatrique, hôpital Armand-Trousseau, AP-HP, Paris, France; Université Pierre-et-Marie-Curie-Paris VI, Paris, France
| | - M Dohna
- Service d'imagerie pédiatrique, hôpital Armand-Trousseau, AP-HP, Paris, France
| | - C Neiva-Vaz
- Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 75015 Paris, France; Centre de référence des malformations de la face et de la cavité buccale, Paris, France
| | - H Ducou le Pointe
- Service d'imagerie pédiatrique, hôpital Armand-Trousseau, AP-HP, Paris, France
| | - C Garel
- Service d'imagerie pédiatrique, hôpital Armand-Trousseau, AP-HP, Paris, France
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Tonni G, Granese R, Martins Santana EF, Parise Filho JP, Bottura I, Borges Peixoto A, Giacobbe A, Azzerboni A, Araujo Júnior E. Prenatally diagnosed fetal tumors of the head and neck: a systematic review with antenatal and postnatal outcomes over the past 20 years. J Perinat Med 2017; 45:149-165. [PMID: 27508950 DOI: 10.1515/jpm-2016-0074] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 06/19/2016] [Indexed: 12/19/2022]
Abstract
AIM The aim of this study was to review prenatally diagnosed tumors of the head and neck in the fetus and to report antenatal and postnatal outcomes. METHODS PubMed/Medline, EMBASE/SCOPUS, Cochrane database and Google Scholar were reviewed over the last 20 years. No language or article type restriction was used. RESULTS A total of 1940 record were retrieved. Of the 713 records screened, 566 full-text articles were assessed for eligibility. After 445 articles were excluded for specified reasons, 111 studies met the research criteria and were included for qualitative analysis. Overall, 306 cases of fetal tumors of the head and neck were reviewed. Maternal age was an independent factor. The mean maternal age was 28.2 years and gestational age at prenatal diagnosis was 27.1 weeks. Conventional 2D ultrasound was the standard diagnostic procedure in 27.9% of cases and was implemented in 27.3% of cases by 3D ultrasound and fetal magnetic resonance imaging (MRI). Diagnostic evaluation of intracranial spreading and high-airway obstructions was greatly enhanced by fetal MRI. The more common type of fetal tumor was hemangioma/lymphangioms (42.1%), followed by teratomas (29.7%), tumors of the gingiva (10.1%) and lymphatic venous malformations (9.1%), respectively. Fetal karyotyping was performed only in 9.8% of cases; within fetuses undergoing karyotype, chromosomal abnormalities accounted for 20% of cases. The most common pregnancy complication was polyhydramnios (26.3%). Ex utero intrapartum treatment (EXIT) procedure was performed in 30.1% of cases while surgical excision was used in 22.9% during postnatal life. The survival rate was 35.35%. CONCLUSION Fetal tumors of the head and neck are rare congenital malformations. Two-dimensional ultrasound is diagnostic in almost all cases; however, MRI may be an important diagnostic adjunct in targeted cases and help patient selection for immediate intubation at the time of delivery. EXIT procedure and surgical removal of the tumor was associated with good prognosis.
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Multiple congenital granular cell epulis: case report and immunohistochemical profile with emphasis on vascularization. Case Rep Dent 2015; 2015:878192. [PMID: 25722896 PMCID: PMC4334617 DOI: 10.1155/2015/878192] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 01/24/2015] [Indexed: 01/25/2023] Open
Abstract
Congenital granular cell epulis is a rare benign soft tissue lesion arising from the alveolar ridge in neonates. A rare case of multiple congenital granular cell epulis is reported, alongside a description of its vascular immunohistochemical profile. A female newborn presented with two exophytic pedunculated red nodules located on the alveolar ridge between the future eruption sites of the incisors and canines of the mandible and maxilla. A conservative surgical excision was performed on the second day of life. Histology revealed proliferation of round granular cells containing an abundant eosinophilic cytoplasm with basophilic nuclei, ranging from round to oval in shape. Numerous blood vessels were also seen. Immunohistochemical analysis of the granular cells revealed positivity for CD68, D2-40, Ki67, VEGF, and FGF and negativity for S100, CD34, and CD105. Immunostaining for CD34, CD105, and D2-40 confirmed the presence of a large number of blood and lymphatic vessels. Although rare, an understanding of this lesion is paramount for correct diagnosis and appropriate treatment. In the present report, the immunohistochemical profile confirmed increased vascularization, proving that these lesions are composed of not only new and preexisting blood vessels, but also lymphatic vessels.
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Abstract
Congenital granular cell epulis is a rarely reported lesion of unknown histogenesis with a strong predilection for the maxillary alveolar ridge of newborn girls. Microscopically, it demonstrates nests of polygonal cells with granular cytoplasm, a prominent capillary network, and attenuated overlying squamous epithelium. The lesion lacks immunoreactivity for S-100, laminin, chromogranin, and most other markers except neuron-specific enolase and vimentin. Through careful observation of its unique clinical, histopathologic, and immunohistochemical features, this lesion can be distinguished from the more common adult granular cell tumor as well as other differential diagnoses.
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Affiliation(s)
- Rachel Conrad
- From the Department of Pathology and Laboratory Medicine, Loma Linda University Medical Center, Loma Linda, California
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Frisova V, Prosova B, Mahdian N, Kyncl M, Vlk R, Rocek M. Prenatal Diagnosis of Congenital Epulis by 2D/3D Ultrasound and Magnetic Resonance. Fetal Diagn Ther 2013; 33:272-6. [DOI: 10.1159/000346811] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Accepted: 12/24/2012] [Indexed: 11/19/2022]
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