1
|
Bhat A, Smart R, Egbert M, Susarla SM. Benign Non-Odontogenic Pathology in Children. Oral Maxillofac Surg Clin North Am 2024; 36:295-302. [PMID: 38402139 DOI: 10.1016/j.coms.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2024]
Abstract
This article provides a comprehensive overview of benign non-odontogenic pathologies. Bone-derived lesions like osteoma, osteoid osteoma, osteoblastoma, and osteochondroma are discussed in detail, emphasizing their radiographic features, locations, and treatment strategies. Cartilage-derived lesions such as chondroma, chondroblastoma, and chondromyxoid fibroma are also examined, noting their typical presentation and management approaches. The article then delves into fibroconnective tissue lesions. Mesenchymal and vascular lesions are detailed regarding their clinical and radiographic characteristics and treatment options. Lastly, nerve-derived lesions like schwannoma and neurofibroma are covered, providing insights into their association with diseases like neurofibromatosis and preferred management strategies.
Collapse
Affiliation(s)
- Aparna Bhat
- Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, 1959 NE Pacific Street, B-307, Seattle, WA 98195, USA
| | - Ryan Smart
- Department of Surgery, University of North Dakota School of Medicine and Health Sciences, Private clinic 2585 23rd Avenue South, Fargo, ND 58103, USA.
| | - Mark Egbert
- Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, 1959 NE Pacific Street, B-307, Seattle, WA 98195, USA; Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine, 1959 Northeast Pacific Street, B-307, Seattle, WA 98195, USA; Craniofacial Center, Seattle Children's Hospital, 4800 Sand Point Way Northeast, Seattle, WA 98015, USA
| | - Srinivas M Susarla
- Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, 1959 NE Pacific Street, B-307, Seattle, WA 98195, USA; Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine, 1959 Northeast Pacific Street, B-307, Seattle, WA 98195, USA; Craniofacial Center, Seattle Children's Hospital, 4800 Sand Point Way Northeast, Seattle, WA 98015, USA
| |
Collapse
|
2
|
do Nascimento SVB, da Silva WR, Faria CAB, de Souza RKB, do Lago CAP, Sobral APV. Aneurysmal Bone Cyst in the Anterior Region of the Mandible. Head Neck Pathol 2024; 18:50. [PMID: 38884839 PMCID: PMC11183029 DOI: 10.1007/s12105-024-01641-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 03/22/2024] [Indexed: 06/18/2024]
Abstract
Aneurysmal bone cyst is a rare osteolytic lesion of uncertain etiology, commonly observed in the lower limbs, with only 1-2% of reports in gnathic bones. We present the case of a 27-year-old male patient referred to the oral and maxillofacial surgery and traumatology service due to complaints of paresthesia in the mental region and increased mandibular volume. Physical examination revealed midline shift and hard consistency. Imaging examinations demonstrated a radiolucent/hypodense lesion with disruption of the mandibular cortices. The histopathological examination of incisional biopsy material led to the diagnosis of a central giant cell lesion. The patient underwent surgical resection, and the histopathological analysis of the specimen revealed a predominantly solid lesion, characterized by blood-filled spaces of varying size, not covered by epithelium or endothelium, with the presence of spindle cells, multinucleated giant cells, and basophilic osteoid material, concluding the diagnosis of mixed-type aneurysmal bone cyst. Despite being uncommon, aneurysmal bone cysts should be considered in the differential diagnosis of volumetric increase in the gnathic bones of young patients.
Collapse
Affiliation(s)
| | - Weslay Rodrigues da Silva
- Dental College of Pernambuco, Postgraduate Program in Dentistry, University of Pernambuco (UPE), R. Arnóbio Marques, 310, Recife, 50100-130, PE, Brazil.
- Integrated Anatomic Pathology Center, Oswaldo Cruz University Hospital (OCUH), Recife, PE, Brazil.
| | - Caroline Augusta Belo Faria
- Dental College of Pernambuco, Postgraduate Program in Dentistry, University of Pernambuco (UPE), R. Arnóbio Marques, 310, Recife, 50100-130, PE, Brazil
- Integrated Anatomic Pathology Center, Oswaldo Cruz University Hospital (OCUH), Recife, PE, Brazil
| | | | | | - Ana Paula Veras Sobral
- Dental College of Pernambuco, Postgraduate Program in Dentistry, University of Pernambuco (UPE), R. Arnóbio Marques, 310, Recife, 50100-130, PE, Brazil
- Integrated Anatomic Pathology Center, Oswaldo Cruz University Hospital (OCUH), Recife, PE, Brazil
| |
Collapse
|
3
|
Siddiqui HK, Khan SA, Aijaz A, Qureshi MB. Unraveling the challenges in the diagnosis and management of desmoplastic fibroma of the mandible-a case report. BMC Oral Health 2024; 24:256. [PMID: 38378640 PMCID: PMC10877879 DOI: 10.1186/s12903-024-04018-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/12/2024] [Indexed: 02/22/2024] Open
Abstract
Desmoplastic fibroma (DF) is an uncommon bone tumor that originates from the mesenchymal tissue and despite being benign, exhibits aggressive behavior locally. The following report describes the case of a 7-year-old boy with a rapidly enlarging swelling on the right side of the mandible. After a thorough clinical examination, radiographic imaging, and histopathological analysis, the diagnosis of DF was confirmed. Treatment planning was formulated considering both the tumor's tendency for local recurrence and the patient's well-being. Due to the patient's young age, segmental resection was not deemed appropriate, and an aggressive curettage and enucleation of the lesion followed by the bone graft was performed instead. The patient was kept under close follow-up for the first month of post-surgery and later reviewed after 3, 6, 9, and 12 months, respectively. Good bone healing was observed on radiographs. The patient did not show any signs of recurrence based on clinical or radiographic assessments and did not exhibit any neurosensory deficits as well.
Collapse
Affiliation(s)
- Humayun Kaleem Siddiqui
- Oral & Maxillofacial Surgery, Dental Section, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Shahrukh Ali Khan
- Dental Section, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
| | - Anum Aijaz
- Oral & Maxillofacial Surgery, Dental Section, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Madiha Bilal Qureshi
- Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| |
Collapse
|
4
|
Albagieh H, Aldosari M, Alkhathlan A, Alfawaz N, Almutairi M. Radiolucent lesions that may resemble inflammatory periapical lesions: A review article. Saudi Dent J 2023; 35:916-919. [PMID: 38107039 PMCID: PMC10724350 DOI: 10.1016/j.sdentj.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/02/2023] [Accepted: 11/02/2023] [Indexed: 12/19/2023] Open
Abstract
Non-endodontic lesions (NEL) closely resemble lesions of endodontic origin. Its etiology can be odontogenic, non-odontogenic, neoplastic, or anatomic variations that can resemble inflammatory periapical lesions in the periapical area. Inflammatory periapical lesions are caused by pulpal pathoses and require endodontic treatment. Since numerous NEL may resemble inflammatory periapical lesions, they can lead to misdiagnosis and inappropriate management. Thus, a detailed review of the patients' medical and dental histories with clinical examination, including radiographic findings, is essential for the proper assessment of periapical lesions. Numerous cases of misdiagnoses of NEL have been reported in literature. Thus, this review aimed to strengthen the awareness of clinicians on periapical radiolucency, which may resemble inflammatory periapical lesions.
Collapse
Affiliation(s)
- Hamad Albagieh
- Oral Medicine and Diagnostic Sciences Department, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Nawaf Alfawaz
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | |
Collapse
|
5
|
Sharma AE, Kerr DA, Cipriani NA. Small biopsies in the head and neck: Bone and soft tissue. Semin Diagn Pathol 2023; 40:353-370. [PMID: 37453847 DOI: 10.1053/j.semdp.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 04/30/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023]
Abstract
Bone and soft tissue lesions in the head and neck encompass not only a broad morphologic spectrum but also significant inherent clinicopathologic overlap. Epidemiology, radiology, and location - similar to the diagnostic assessment in other sites - are especially important considerations in the context of an established mesenchymal proliferation. Herein, the approach towards diagnosis is stratified by morphology (spindle, sarcomatoid, epithelioid, round cell), cellular lineage (fibroblastic, nerve sheath, rhabdomyogenic), and tumor grade (benign, low- to high-grade malignant) as the basis of further immunohistochemical or molecular investigation.
Collapse
Affiliation(s)
- Aarti E Sharma
- Hospital for Special Surgery, New York, NY, United States
| | - Darcy A Kerr
- Dartmouth Hitchcock Medical Center, Lebanon, NH, United States
| | | |
Collapse
|
6
|
Abstract
PURPOSE OF REVIEW Aneurysmal bone cysts are rare, locally aggressive bone tumors. Optimal treatment of ABCs is still matter of debate as therapies including sclerotherapy, selective arterial embolization and systemic treatment with denosumab are increasingly utilized, in addition to or instead of traditional curettage. The purpose of this review is to discuss current concepts and difficulties in diagnosing and treating primary ABCs, based on latest available literature. RECENT FINDINGS In diagnostics, multiple new fusion partners of USP-6 have been described on next-generation sequencing specifically for primary ABCs. In a recent systematic review, failure rates of percutaneous injections and surgery were comparable. In a literature review, the use of denosumab seemed effective but resulted in multiple cases of severe hypercalcemia in children. SUMMARY Accurately diagnosing primary ABC is crucial for treatment decisions. Curettage remains a valid treatment option, especially with adjuvant burring, autogenous bone grafting and phenolization. Percutaneous sclerotherapy represents a solid alternative to surgery, with polidocanol showing good results in larger studies. Systematic therapy with denosumab exhibits favorable results but should be reserved in the pediatric population for unresectable lesions, as it may result in severe hypercalcemia in children. When selecting a treatment option, localization, stability and safety should be considered.
Collapse
|
7
|
Channawar RA, Deshpande SV, Shrivastav S, Date SV, Wamborikar H. Aneurysmal Bone Cyst of the Head of the Fibula: An Unusual Presentation. Cureus 2022; 14:e30376. [DOI: 10.7759/cureus.30376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 10/17/2022] [Indexed: 11/07/2022] Open
|
8
|
Xiao L, Cheng J, Li L. FDG PET/CT Image of Soft Tissue Aneurysmal Bone Cyst. Clin Nucl Med 2022; 47:e632-e634. [PMID: 35426845 DOI: 10.1097/rlu.0000000000004229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Soft tissue aneurysmal bone cyst is very rare. Herein, we report FDG PET/CT findings of aneurysmal bone cyst in a 19-year-old man. On conventional image, it presented as a paravertebral soft tissue mass with heterogeneous enhancement and rim eggshell-like calcification. On PET/CT, this solitary lesion had intense FDG uptake with an SUV max of 10.33. The final pathology supported a diagnosis of aneurysmal bone cyst. Our case suggests that soft tissue aneurysmal bone cyst should be regarded as a differential diagnosis of solitary paravertebral mass with intense FDG uptake.
Collapse
Affiliation(s)
- Liu Xiao
- From the Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | | | | |
Collapse
|
9
|
Smit C, Robinson L, Roman Tager E, Oliveira Corrêa Roza AL, Rocha AC, Santos Silva AR, Vargas PA, Romañach MJ, Fonseca FP, Carlos R, van Heerden WF. Clinicoradiological spectrum of primary aneurysmal bone cysts of the maxillofacial region: A series of 31 cases. Dentomaxillofac Radiol 2022; 51:20220071. [PMID: 35522705 PMCID: PMC10043610 DOI: 10.1259/dmfr.20220071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of the current study was to analyse the demographic, clinical and radiological features of primary aneurysmal bone cysts (ABCs) involving the maxillofacial region. METHODS Histologically confirmed cases affecting the maxillofacial region were retrospectively reviewed over a 21 year period (2000-2021). Cases were collected from the archives of five Oral Pathology laboratories from three countries: South Africa, Guatemala and Brazil. The information was analysed, with emphasis on the clinical and radiological spectrum. RESULTS Following the inclusion criteria, a total of 31 cases of primary ABCs were included in the study. A nearly equal male-to-female distribution was seen, with ABCs occurring in males at an earlier age compared to females. Localised swelling was the main clinical presentation. ABCs had a mandibular predominance, particularly in the posterior regions. All ABCs presented as blow-out expansile well-demarcated radiolucent lesions with the majority having a multilocular appearance. Cortical expansion was seen in 91% of cases with loss of cortical integrity being common (78%). CONCLUSION Primary ABCs involving the maxillofacial region are extremely rare with the majority of current published literature consisting of isolated case reports. The current study is the first large series detailing the radiological features.
Collapse
Affiliation(s)
- Chané Smit
- Department of Oral Pathology and Oral Biology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Liam Robinson
- Department of Oral Pathology and Oral Biology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Elena Roman Tager
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
| | | | - Andre Caroli Rocha
- Medical School, Clinics Hospital, University of São Paulo (USP), São Paulo, Brazil
| | - Alan Roger Santos Silva
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
| | - Pablo Austin Vargas
- Department of Oral Pathology and Oral Biology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
| | - Mario José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Pathology and Oral Biology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Román Carlos
- Pathology Section, Centro Clínico de Cabeza y Cuello/Hospital Herrera Llerandi, Guatemala City, Guatemala
| | - Willie Fp van Heerden
- Department of Oral Pathology and Oral Biology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| |
Collapse
|
10
|
Pelkey LJ, Canty BJ, Ferris SP, Mistry DT, Figueroa BE. Aneurysmal Bone Cyst of the Sphenoid Body Mimicking Craniopharyngioma: A Case Report. Cureus 2022; 14:e23128. [PMID: 35308188 PMCID: PMC8918117 DOI: 10.7759/cureus.23128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2022] [Indexed: 11/06/2022] Open
Abstract
An aneurysmal bone cyst is a locally destructive benign lesion that predominately affects the long bones. Sphenoid body involvement is rare. To date, only 19 primary aneurysmal bone cysts of the sphenoid body have been reported. We describe the case of an 18-year-old male with a one-week history of severe right eye pain and lacrimation, right-sided diplopia, right-sided headache, photophobia, nausea, and vomiting. Magnetic resonance imaging (MRI) demonstrated a lobulated lesion centered in the sphenoid body with expansion into the cavernous sinus, sellar region, and clivus. The lesion had a homogenous hyperintense T2 signal with enhancing sidewalls and minimal septations. Computed tomography (CT) angiography revealed a hypoattenuating lesion containing a substance of nine Hounsfield units, compatible with water density. The clinicoradiologic findings were consistent with a craniopharyngioma. Intraoperatively, the lesion was confirmed to contain clear fluid and have prominent arterial feeding vessels. The extradural tumor was then excised with intralesional curettage. The histopathologic analysis resulted in a diagnosis of an aneurysmal bone cyst. This case highlights the potentially non-specific and variable appearance of aneurysmal bone cysts and the need to consider it in the differential diagnosis of sphenoid bone lesions.
Collapse
|
11
|
Liu Y, Zhou J, Shi J. Clinicopathology and Recurrence Analysis of 44 Jaw Aneurysmal Bone Cyst Cases: A Literature Review. Front Surg 2021; 8:678696. [PMID: 34250007 PMCID: PMC8260671 DOI: 10.3389/fsurg.2021.678696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/19/2021] [Indexed: 11/13/2022] Open
Abstract
In the past half-century, considerable attention has been paid to oral and maxillofacial skeletal cyst, however, aneurysmal bone cyst (ABC), unlike other common bone diseases, still contours numerous unanswered questions in terms of classification, etiology and pathological mechanism. The purpose of this article was to evaluate the proportion of primary ABC and secondary ABC, and to assess the recurrence of ABC and related factors. A methodical search of Embase, MEDLINE, Cochrane Library, Web of Science was conducted for well-documented jaw aneurysmal bone cyst (JABC) cases. One hundred thirty-one articles were identified after database searching and 31 of them were included in our study for further research with 44 JABC cases. All the articles were analyzed by two separate authors. About 25% of the reported jaw aneurysmal bone cyst was secondary. Both the pathological classification and surgical treatment had a significant influence on recurrence rate (P = 0.0082, P = 0.0022), while patients' age or radiographic features rarely affected prognosis. Jaw aneurysmal bone cysts can present variable clinical and histological presentations. Recurrence may be attributed to omittance of underlying potential blood supply or conservative surgical protocol.
Collapse
Affiliation(s)
- Yu Liu
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, School of Stomatology, The Affiliated Hospital of Stomatology, Zhejiang University School of Medicine, Hangzhou, China
| | - Jinhan Zhou
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, School of Stomatology, The Affiliated Hospital of Stomatology, Zhejiang University School of Medicine, Hangzhou, China
| | - Jue Shi
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, School of Stomatology, The Affiliated Hospital of Stomatology, Zhejiang University School of Medicine, Hangzhou, China
| |
Collapse
|