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Li J, Jiang EH, Jiang SC, Liu B, Xiong XP, Sun YF, Deng WW. A retrospective study of the malignant change of odontogenic keratocyst. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101466. [PMID: 37030439 DOI: 10.1016/j.jormas.2023.101466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 03/09/2023] [Accepted: 04/05/2023] [Indexed: 04/10/2023]
Abstract
The odontogenic keratocyst (OKC) is a common cystic lesion of the maxilla and mandible. Squamous cell carcinoma (SCC) arising from OKC or dysplasia occurring in OKC is rare. This study aimed to explore the incidence and clinical features of the dysplasia and malignant transformation of OKC. In this study, 544 patients diagnosed with OKC were collected. Among them, 3 patients were diagnosed as SCC arising from OKC, and 12 patients were diagnosed as OKC with dysplasia. The incidence was calculated. Clinical features were analyzed by chi-square test. In addition, a representative case reconstructing mandible with vascularized fibula flap under general anesthesia was reported. And cases reported before were reviewed. The incidence of the dysplasia and malignant transformation of OKC, which are highly associated with the clinical features of swelling and chronic inflammation, is about 2.76%. But the relevance between the dysplasia and malignant transformation and age, gender together with pain is not statistically high. All in all, the clinical features of swelling and chronic inflammation can be considered as characteristics of the dysplasia and malignant transformation of OKC. Although the pain isn't statistically relevant, it may be a dangerous clew. Also, combined with earlier literatures, the dysplasia and malignant transformation of OKC shows unique features of radiographs and histopathology.
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Affiliation(s)
- Ji Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Er-Hui Jiang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Oral Maxillofacial-Head Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Sheng-Chao Jiang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bing Liu
- Department of Oral Maxillofacial-Head Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xue-Peng Xiong
- Department of Oral Maxillofacial-Head Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yan-Fang Sun
- Department of Oral Maxillofacial-Head Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
| | - Wei-Wei Deng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Oral Maxillofacial-Head Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
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Dixit S, Kumar A, Srinivasan K. A Current Review of Machine Learning and Deep Learning Models in Oral Cancer Diagnosis: Recent Technologies, Open Challenges, and Future Research Directions. Diagnostics (Basel) 2023; 13:diagnostics13071353. [PMID: 37046571 PMCID: PMC10093759 DOI: 10.3390/diagnostics13071353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 03/25/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023] Open
Abstract
Cancer is a problematic global health issue with an extremely high fatality rate throughout the world. The application of various machine learning techniques that have appeared in the field of cancer diagnosis in recent years has provided meaningful insights into efficient and precise treatment decision-making. Due to rapid advancements in sequencing technologies, the detection of cancer based on gene expression data has improved over the years. Different types of cancer affect different parts of the body in different ways. Cancer that affects the mouth, lip, and upper throat is known as oral cancer, which is the sixth most prevalent form of cancer worldwide. India, Bangladesh, China, the United States, and Pakistan are the top five countries with the highest rates of oral cavity disease and lip cancer. The major causes of oral cancer are excessive use of tobacco and cigarette smoking. Many people’s lives can be saved if oral cancer (OC) can be detected early. Early identification and diagnosis could assist doctors in providing better patient care and effective treatment. OC screening may advance with the implementation of artificial intelligence (AI) techniques. AI can provide assistance to the oncology sector by accurately analyzing a large dataset from several imaging modalities. This review deals with the implementation of AI during the early stages of cancer for the proper detection and treatment of OC. Furthermore, performance evaluations of several DL and ML models have been carried out to show that the DL model can overcome the difficult challenges associated with early cancerous lesions in the mouth. For this review, we have followed the rules recommended for the extension of scoping reviews and meta-analyses (PRISMA-ScR). Examining the reference lists for the chosen articles helped us gather more details on the subject. Additionally, we discussed AI’s drawbacks and its potential use in research on oral cancer. There are methods for reducing risk factors, such as reducing the use of tobacco and alcohol, as well as immunization against HPV infection to avoid oral cancer, or to lessen the burden of the disease. Additionally, officious methods for preventing oral diseases include training programs for doctors and patients as well as facilitating early diagnosis via screening high-risk populations for the disease.
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Affiliation(s)
- Shriniket Dixit
- School of Computer Science and Engineering, Vellore Institute of Technology, Vellore 632014, India
| | - Anant Kumar
- School of Bioscience and Technology, Vellore Institute of Technology, Vellore 632014, India
| | - Kathiravan Srinivasan
- School of Computer Science and Engineering, Vellore Institute of Technology, Vellore 632014, India
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Oh HJ, Shin DW, Yoon HJ, Myoung H, Kim SM. Primary intraosseous carcinoma in the pediatric and adolescent mandible. World J Surg Oncol 2022; 20:25. [PMID: 35086533 PMCID: PMC8793206 DOI: 10.1186/s12957-021-02465-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 11/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Primary intraosseous carcinoma (PIOC) is a rare malignant odontogenic tumor that predominantly occurs in males older than 50 years. PIOC can be misdiagnosed as odontogenic cyst because it occasionally shows a well-defined border on radiography. In this study, related literatures of pediatric and adolescent PIOC cases were analyzed under strict PRISMA guidelines along with an adolescent case who was provisionally misdiagnosed as an odontogenic cyst. METHODS All case reports for PIOC published in English from 1966 to 2021 were collected. Cases under the age of 20 were classified as pediatric and adolescent populations in this study. A total of 12 pediatric and adolescent cases including 11 PIOCs from the literature and one new case of a 14-year-old female were analyzed. Clinical and radiographic features, diagnosis and treatment approaches, and prognosis were investigated. RESULTS Ages ranged from 4 to 18 years. The female to male ratio was 1.4:1. Seven cases occurred in the mandible. Swelling was observed in 11 patients. The radiologic borders were well-defined in six cases and corticated in four cases. Tooth displacement and root resorption were observed in four and six cases, respectively. The provisional diagnosis for seven patients was odontogenic cyst and enucleation was performed in six cases including the new case. During the follow-up period, local recurrence occurred in three patients. The pediatric and adolescent PIOC cases with local recurrence showed poor prognosis. The locally recurred lesion in the new case did not decrease in size despite concurrent chemo-radiation therapy. CONCLUSIONS Three-dimensional imaging modalities and incisional biopsy with multiple specimens are necessary to rule out PIOC in the lesions with atypical radiographic findings. PIOC should be diagnosed differentially from odontogenic cyst even in pediatric and adolescent populations to properly manage the disease with poor prognosis.
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Affiliation(s)
- Hyun Jun Oh
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Dong Whan Shin
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Hye-Jung Yoon
- Department of Oral Pathology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Hoon Myoung
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
| | - Soung Min Kim
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
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Ye P, Wei T, Gao Y, Zhang W, Peng X. Primary intraosseous squamous cell carcinoma arising from an odontogenic keratocyst: case series and literature review. Med Oral Patol Oral Cir Bucal 2021; 26:e49-e55. [PMID: 33037806 PMCID: PMC7806341 DOI: 10.4317/medoral.23947] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 09/17/2020] [Indexed: 11/25/2022] Open
Abstract
Background The aim of this study was to investigate the clinicopathologic features of primary intraosseous squamous cell carcinoma arising from an odontogenic keratocyst (PIOSCC ex OKC) and comprehensively improve the understanding of this disease.
Material and Methods We retrospectively investigated five cases of PIOSCC ex OKC at Peking University School and Hospital of Stomatology. We also conducted a systematic review of studies on PIOSCC ex OKC by using online databases from their inception until February 2020.
Results In our series of five cases, all lesions were located in the mandible. Three cases (60%) showed recurrent OKCs and two cases (40%) showed primary OKCs. During the follow-up period, one patient died of local relapse. No patients developed metastasis. On the basis of our literature survey, we selected 22 articles reporting 29 patients with PIOSCC ex OKC. Seven of these patients (24.1%) showed local recurrence, three patients (10.3%) developed cervical metastasis, three patients (10.3%) developed distant metastasis (in the pleura in one case and in the lung in two cases), and seven patients died from the disease during the follow-up period. The disease-specific 5-year survival rate in the study group was 53.2%. Through univariate and multivariate analysis, local recurrence was identified as the only significant independent prognostic factor for survival (P < 0.05).
Conclusions The results suggest that PIOSCC ex OKC is a rare intermediate-grade malignancy. Although elective neck dissection is typically unnecessary, adequate therapy should be applied to achieve the lowest local recurrence rate possible to ensure a favorable survival rate. Key words:Primary intraosseous squamous cell carcinoma, odontogenic keratocyst, prognosis.
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Affiliation(s)
- P Ye
- Peking University School and Hospital of Stomatology 22 Zhongguancun Nandajie, Haidian District Beijing 100081, People's Republic of China
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Kumchai H, Champion AF, Gates JC. Carcinomatous Transformation of Odontogenic Keratocyst and Primary Intraosseous Carcinoma: A Systematic Review and Report of a Case. J Oral Maxillofac Surg 2021; 79:1081.e1-1081.e9. [PMID: 33529609 DOI: 10.1016/j.joms.2020.12.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 12/28/2020] [Accepted: 12/29/2020] [Indexed: 01/27/2023]
Abstract
PURPOSE To assess the prognostic findings of the carcinomatous transformation of odontogenic keratocyst (OKC). METHODS A systematic review of all cases of carcinomatous transformation of OKC was completed, and a case report was included. RESULTS A total of 679 publications were screened, and 37 cases met inclusion criteria. The mean age for patients with malignant transformation of OKC was 45.1 years. Pain (67.5%) and swelling (78.3%) were the most common symptoms. The malignant transformation occurred with increased frequency in the posterior mandible and larger lesions that span greater than 2 subunits of the involved jaw. Resection was the definitive treatment in all cases and 14 cases (46%) utilized adjuvant treatment. CONCLUSIONS Patient outcomes and follow-up was variable in our study such that overall survival was difficult to determine. However, overall survival in malignant transformation of odontogenic cysts of all kinds ranges from 62 to 85% and 30 to 8% for 2 and 5 years, respectively.
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Affiliation(s)
- Hattanas Kumchai
- Resident and PhD Student, Oral & Maxillofacial Surgery Department, Thomas Jefferson University Hospital, Philadelphia, PA.
| | - Allen F Champion
- Assistant Professor, Oral & Maxillofacial Surgery Department, Thomas Jefferson University Hospital, Philadelphia, PA
| | - James C Gates
- Clinical Instructor, Oral & Maxillofacial Surgery Department, Thomas Jefferson University Hospital, Philadelphia, PA
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Hauer L, Seidlová P, Merglová V, Hrusak D, Böhmová H, Posta P, Gencur J, Netolicky J. Complete removal of dentigerous cysts with preservation of associated teeth as an alternative to marsupialization in children and preadolescents. J Craniomaxillofac Surg 2020; 48:808-814. [PMID: 32593630 DOI: 10.1016/j.jcms.2020.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/15/2020] [Accepted: 05/31/2020] [Indexed: 11/25/2022] Open
Abstract
The aim of this study is to evaluate the results of dentigerous cysts enucleation with preservation of cyst-associated teeth as a single procedure in a group of children and preadolescents. A retrospective case series of seven patients with 15 unerupted developing teeth associated with or adjacent to dentigerous cysts was conducted. Patients were treated using the uniform surgical protocol (cystectomy, preservation of cyst-associated teeth, without use of orthodontic traction, primary wound closure). The metric analysis of the cysts and unerupted teeth on CBCT and an evaluation of the state of involved teeth after the treatment was performed. The mean age of patients was 9.0 ± 2.1 years (range 5-12 years, median = 9 years). All teeth erupted spontaneously. No serious postoperative complications or recurrences of lesions were detected. The mean follow-up was 53.1 ± 15.7 months (range 25-71 months, median = 52 months). The cystectomy of dentigerous cysts with preservation of associated teeth may be considered an alternative to marsupialization in children and preadolescents.
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Affiliation(s)
- Lukas Hauer
- Department of Oral and Maxillofacial Surgery (Head of Department: Dr. Daniel Hrusak, Ph.D.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic.
| | - Petra Seidlová
- Department of Dentistry (Head of Department: As. Prof. Dr. Antonin Zicha, CSc.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - Vlasta Merglová
- Department of Dentistry (Head of Department: As. Prof. Dr. Antonin Zicha, CSc.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - Daniel Hrusak
- Department of Oral and Maxillofacial Surgery (Head of Department: Dr. Daniel Hrusak, Ph.D.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - Hana Böhmová
- Department of Dentistry (Head of Department: As. Prof. Dr. Antonin Zicha, CSc.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - Petr Posta
- Department of Oral and Maxillofacial Surgery (Head of Department: Dr. Daniel Hrusak, Ph.D.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - Jiri Gencur
- Department of Oral and Maxillofacial Surgery (Head of Department: Dr. Daniel Hrusak, Ph.D.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - Jan Netolicky
- Department of Dentistry (Head of Department: As. Prof. Dr. Antonin Zicha, CSc.), University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60, Pilsen, Czech Republic
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Luo XJ, Cheng ML, Huang CM, Zhao XP. Reduced delay in diagnosis of odontogenic keratocysts with malignant transformation: A case report. World J Clin Cases 2020; 8:2374-2379. [PMID: 32548170 PMCID: PMC7281059 DOI: 10.12998/wjcc.v8.i11.2374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/22/2020] [Accepted: 04/30/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND In rare cases, odontogenic keratocysts (ODs) transform into squamous cell carcinoma. Intervals between the first attendance of a patient and the diagnosis of OD with malignant transformation vary from weeks to years. In this article, we report a case of malignancy derived from OD with a five-day delay in diagnosis.
CASE SUMMARY A 54-year-old woman was referred to Tongji Hospital in Wuhan, China with complaints of moderate pain, recurrent swelling, and pus discharge around her left maxillary lateral incisor for over 10 years. Physical examination revealed a fistula at the palatine-side mucoperiosteum of the left maxillary lateral incisor and enlarged lymph node in the left neck. Cone beam computed tomography revealed a cystic lesion with massive bone destruction from the left maxillary central incisor to the left secondary maxillary premolar and local bony destruction in the left first mandibular molar. The patient was clinically diagnosed with OD. Enucleation rather than marsupialization was performed given the risk factors of long history, recent aggravated pain, and massive bony destruction. Malignant transformation of OD was confirmed by pathologists 3 d after the operation. Radical surgery was performed, and lymph node metastasis was observed. The patient was subjected to postoperative radiotherapy and synchronous chemotherapy, and no local recurrence or distant metastasis was noted at one-year follow-up.
CONCLUSION Our case suggests that clinicians should be aware of the malignant transformation of OD, especially when patients present with a long history, massive cyst, chronic inflammation, recent persistent infections, aggravated pain, numbness around the cystic lesion, and lymph node enlargement.
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Affiliation(s)
- Xiao-Juan Luo
- Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Ming-Liang Cheng
- Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Chun-Ming Huang
- Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Xiao-Ping Zhao
- Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
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