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Hirbo Guyolla Y, Tesfaye Abebe F, Zewdie K. Spontaneous bilateral supra-and infratentorial chronic subdural hematoma in human immunodeficiency virus-infected patient: A case report and literature review. INTERDISCIPLINARY NEUROSURGERY 2022. [DOI: 10.1016/j.inat.2022.101632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Mandibular Melanotic Neuroectodermal Tumor of Infancy: Interdisciplinary Treatment from 2 Months to 19 Years of Age. J Maxillofac Oral Surg 2022; 21:105-111. [PMID: 35400932 PMCID: PMC8934838 DOI: 10.1007/s12663-021-01571-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 04/10/2021] [Indexed: 10/21/2022] Open
Abstract
Melanotic neuroectodermal tumor of infancy (MNTI) is a clinically distinctive, benign neoplasm of neural crest origin. The tumor develops usually in the anterior maxilla and rarely in the skull and mandible. This is a report of the interdisciplinary treatment of a rare case of MNTI occurring in the mandible. The patient was initially addressed for examination at the age of 2 months with a rapidly growing tumor of the mandible that had increased double in size in a week. A well-defined lesion in the left mandible shown on MRI and high urine vanillylmandelic acid (VMA) level determined the diagnosis. The complete interdisciplinary treatment included four interventions. Surgery with enucleation and curettage, performed as first intervention, at the age of 2 months. The second intervention lasted from age 7 to age 15 and included a first phase of Orthodontic treatment to monitor normal growth, followed by interceptive Orthodontic treatment and Prosthodontic intervention with interim dentures. The third intervention accomplished after competition of growth and included the pre-prosthetic surgery with an augmentation of the height of the edentulous atrophic mandible and placement of 4 implants. In the fourth intervention the permanent prosthodontic restoration supported by implants was applied.
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Clinical and imaging features of melanotic neuro-ectodermal tumor of infancy of the maxillary bone: report of four cases and review of the literature. Oral Radiol 2022; 38:630-637. [PMID: 35876986 PMCID: PMC9474332 DOI: 10.1007/s11282-022-00638-7] [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: 04/05/2022] [Accepted: 06/30/2022] [Indexed: 11/01/2022]
Abstract
Melanotic neuro-ectodermal tumor of infancy (MNTI) is an extremely rare tumor. The purpose of this study was to describe the imaging features of maxillary bone MNTIs and introduce the key points for clinical diagnosis of MNTI. We retrospectively reviewed four patients with histology-proven MNTIs arising from the maxillary bone. All patients underwent ultrasonic inspections, CT and/or MR scanning. Combined with previously literature, the imaging features were comprehensively evaluated and analyzed. All MNTIs showed a firm, non-ulcerated rapidly-growing soft-tissue swelling with pigmented (blue-colored or black-colored or gray-colored) mucosa. The onset ages were younger than 6 month-old. CT images showed osteolytic or expansive bone destruction of the involved maxillae, fragmentary cortical bone, "free-floating" tooth germs, with or without spiculated/sunburst periosteal reaction. The tumor appeared lightly hyper-intense on T2-weighted sequences, while isointense or lightly hypo-intense or lightly hyper-intense signal on T1-weighted sequences. Enhanced images all displayed heterogeneous enhancement. No metastasis features of lymph nodes or abdominal organs were demonstrated by cervical and abdominal ultrasonic inspections. As a conclusion, accurate recognition of the imaging features of MNTI combined with history and clinical manifestations (early infancy, painless, firm, pigmented mucosa, non-ulcerating lesion) can provide clues for diagnosis of this rare entity.
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Zameer MM, Rao S, Chandrashekar V, D'Cruz A. Melanotic Neuroectodermal Tumor of Infancy: Does Enucleation Alone Suffice? J Indian Assoc Pediatr Surg 2021; 26:265-267. [PMID: 34385774 PMCID: PMC8323579 DOI: 10.4103/jiaps.jiaps_135_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 10/20/2020] [Accepted: 11/27/2020] [Indexed: 11/22/2022] Open
Abstract
Melanotic neuroectodermal tumor of infancy (MNTI) is a rare melanin-containing mesenchymal tumor of neural crest origin. We present a case of MNTI in a 1-year-old girl. It was managed successfully with conservative excision (enucleation).
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Affiliation(s)
- M M Zameer
- Department of Pediatric Surgery, Narayana Health, Bengaluru, Karnataka, India
| | - Sanjay Rao
- Department of Pediatric Surgery, Narayana Health, Bengaluru, Karnataka, India
| | - Vinay Chandrashekar
- Department of Pediatric Surgery, Narayana Health, Bengaluru, Karnataka, India
| | - Ashley D'Cruz
- Department of Pediatric Surgery, Narayana Health, Bengaluru, Karnataka, India
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Melanotic neuroectodermal tumor of infancy to the skull: case-based review. Childs Nerv Syst 2020; 36:679-688. [PMID: 31953575 DOI: 10.1007/s00381-020-04509-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 01/10/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Melanotic neuroectodermal tumor of infancy (MNTI) is a rare tumor, which usually occurs in infants under the age of one. Early diagnosis and radical surgery seem to be critical for long-term cure. CASE PRESENTATION We describe a case of a 4-month-old boy with a MNTI to the skull. The mass was first noticed at 4 month of age and grew very rapidly over a time of 2 weeks. Initially, a fine needle biopsy ruled out a sarcoma and led to the diagnosis. The tumor originated from the sphenoid wing and infiltrated the frontotemporal bone, the lateral wall of the right orbit, and the underlying dura mater. A total excision of the tumor, including the adjacent bone and dura, was achieved. Reconstruction of the bone was performed using absorbable plates and Tutobone. Histology confirmed the initial diagnosis, while molecular diagnosis showed high conformity of the MNTI with medulloblastoma group 3. The patient recovered well, while the reconstruction led to a good cosmetic result. A local recurrence occurred leading to a single-dose chemotherapy with Vincristine and a second surgery after 15 weeks. Thereafter, the patient developed recurrent large pseudomeningocele, which was treated by multiple shunt procedures and finally reconstruction of the bone using Palacos. Radiological follow-up 3 months after the second resection showed no tumor recurrence. CONCLUSION Radical surgery for MNTI is to date the gold standard since it seems to minimize recurrence rates. Because of the rapid and destructive growth within the bone, reconstruction is necessary, which can be very challenging in infants.
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Mengide JP, Jaimovich SG, Lubieniecki FJ, Rugilo C, Lamas G, Mantese B. Melanotic neuroectodermal tumor of infancy arising from the skull: report of an unusual case, review of the literature, and a diagnostic approach. Childs Nerv Syst 2020; 36:469-475. [PMID: 31897638 DOI: 10.1007/s00381-019-04476-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 12/10/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Melanotic neuroectodermal tumor of infancy is a rare neoplasm mainly seen in children under 1 year of life. The most common location of the tumor is the maxilla followed by the cranial vault. Surgery is the treatment of choice and outcome mainly depends on extent of resection. OBJECTIVES To report an atypical case of an 8-year-old patient with a melanotic neuroectodermal tumor of infancy, to review the cases with melanotic neuroectodermal tumor of infancy arising from the skull published over the last 13 years, and to provide a diagnostic approach that may allow recognition of a pattern in these rare neoplastic lesions. METHODS A case is reported with a description of the clinical, radiological, surgical, and histopathological features. Additionally, the literature was reviewed to identify reports of patients with melanotic neuroectodermal tumor of infancy arising from the cranial vault and all cases published in PubMed over the last 13 years were included. Only studies that evaluated clinical, radiological, surgical, and histopathological findings were included. CONCLUSION Melanotic neuroectodermal tumor of infancy is a rare entity that may present with unusual features, but nevertheless has an identifiable pattern that allows the tumor to be considered in the differential diagnosis of intracranial space-occupying lesions in children.
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Affiliation(s)
- Juan Pablo Mengide
- Neurosurgery Department, Pediatric Hospital "Prof. Dr. Juan P. Garrahan", Buenos Aires, Argentina.
| | - Sebastián G Jaimovich
- Neurosurgery Department, Pediatric Hospital "Prof. Dr. Juan P. Garrahan", Buenos Aires, Argentina
| | - Fabiana J Lubieniecki
- Pathology Department, Pediatric Hospital "Prof. Dr. Juan P. Garrahan", Buenos Aires, Argentina
| | - Carlos Rugilo
- Radiology Department, Pediatric Hospital "Prof. Dr. Juan P. Garrahan", Buenos Aires, Argentina
| | - Gabriela Lamas
- Pathology Department, Pediatric Hospital "Prof. Dr. Juan P. Garrahan", Buenos Aires, Argentina
| | - Beatriz Mantese
- Neurosurgery Department, Pediatric Hospital "Prof. Dr. Juan P. Garrahan", Buenos Aires, Argentina
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Soles BS, Wilson A, Lucas DR, Heider A. Melanotic Neuroectodermal Tumor of Infancy. Arch Pathol Lab Med 2018; 142:1358-1363. [DOI: 10.5858/arpa.2018-0241-ra] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—
Melanotic neuroectodermal tumor of infancy, albeit rare and generally regarded as benign, is an important tumor to recognize because of its rapid growth, potential for local recurrence, and small round blue cell morphology, which can lead to misdiagnosis of a malignant neoplasm.
Objective.—
To review its clinical presentation and immunomorphologic findings, and discuss common entities in the differential diagnosis.
Data Sources.—
The study involved PubMed searches, including multiple review articles, case studies, retrospective studies, selected book chapters, and University of Michigan cases.
Conclusions.—
Melanotic neuroectodermal tumor of infancy most commonly occurs in the bones of the head and neck region during the first year of life, but it can also present in other locations, including the central nervous system, testes, ovaries, and subcutaneous soft tissues. Histologically, it is composed of a biphasic population of cells, consisting of epithelioid melanin-producing cells and primitive neurogenic cells in a fibrocollagenous stroma. These microscopic findings, especially in small biopsies, can lead to a broad differential diagnosis that includes malignant small round blue cell tumors and malignant melanoma. Melanotic neuroectodermal tumor of infancy commonly has an infiltrative growth pattern, and anatomic constraints often lead to incomplete resection and local recurrence, requiring multiple surgical operations. Because melanotic neuroectodermal tumor of infancy can mimic a more aggressive and aggressively treated malignancy, recognition of this rare tumor is very crucial for pathologists.
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Affiliation(s)
| | | | | | - Amer Heider
- From the Divisions of Anatomic and Clinical Pathology (Dr Soles) and Anatomic Pathology (Drs Wilson and Lucas), Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor
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Fakuade BO, Adeoye JB. Melanotic neuroectodermal tumor of infancy: a rare presentation of an extremely rare neoplasm and diagnostic implications in Gombe, Nigeria. Pan Afr Med J 2017; 28:5. [PMID: 29138651 PMCID: PMC5681010 DOI: 10.11604/pamj.2017.28.5.9394] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 08/13/2017] [Indexed: 12/05/2022] Open
Abstract
Melanotic neuro-ectodermal tumor of infancy is very rare. A unique neoplasm of the formative years, it typically involves the face or cranium; possesses rapid, expansile growth; presents as a firm swelling and displays a high rate of recurrence. Its rarity and unique features make diagnosis and management quite challenging. This challenge is increased in resource-limited settings like ours and with atypical presentation, such as was seen at our center, where patient presented with a bony hard swelling.
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Albuquerque AFM, Cunha JF, Avelar RL, Juca E, Costa FWG, Macedo MS. Extensive Melanotic Neuroectodermal Tumor of Infancy. Head Neck Pathol 2015; 10:349-53. [PMID: 26581397 PMCID: PMC4972745 DOI: 10.1007/s12105-015-0671-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 11/11/2015] [Indexed: 10/22/2022]
Abstract
The melanotic neuroectodermal tumor of infancy (MNTI) is a rare childhood neoplasm with an alarming but classical clinical presentation. We present the case of a 2-month-old male infant treated with surgery for an aggressive MNTI on the alveolar process of the maxilla. Radiographic examination showed a diffuse osteolytic radiolucent lesion in the right maxilla, and displacement and dysmorphic changes in the developing primary tooth buds. The patient remained well without evidence of recurrence for 6 months after surgery. We discussed clinicopathological features, management alternatives, and outcome.
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Affiliation(s)
| | - José Ferreira Cunha
- Department of Oral and Maxillofacial, Albert Sabin Hospital, Fortaleza, Ceará Brazil
| | - Rafael Linard Avelar
- Department of Oral and Maxillofacial, University Center of Christus (Unichristus), Fortaleza, Brazil ,University Center Christus, João Adolfo Gurgel Street, 133, Fortaleza, CEP 140120 Brazil
| | - Eduardo Juca
- Department of Neurosurgery, Albert Sabin Hospital of Fortaleza, Fortaleza, Ceará Brazil
| | | | - Mario Sérgio Macedo
- Department of Head and Neck Surgery, Albert Sabin Hospital of Fortaleza, Fortaleza, Ceará Brazil
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Melanotic Neuroectodermal Tumor of Infancy: A Systematic Review. J Oral Maxillofac Surg 2015; 73:1946-56. [DOI: 10.1016/j.joms.2015.03.061] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 03/10/2015] [Accepted: 03/28/2015] [Indexed: 11/22/2022]
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Les tumeurs neuroectodermiques mélanotiques infantiles : état actuel des connaissances. Bull Cancer 2014; 101:626-36. [DOI: 10.1684/bdc.2014.1985] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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12
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Pinheiro TPDS, Carneiro JT, de Melo Alves S, de Jesus Viana Pinheiro J, Tuji FM. Melanotic neuroectodermal tumor of infancy in an African-indigenous patient from the Amazon: a case report. Head Face Med 2013; 9:35. [PMID: 24274360 PMCID: PMC4222608 DOI: 10.1186/1746-160x-9-35] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 11/06/2013] [Indexed: 11/10/2022] Open
Abstract
Melanotic neuroectodermal tumor of infancy (MNTI) is a rare condition that occurs normally in the anterior maxilla of infants aged <1 year. The use of clinical and imaging tools for MNTI is extremely important to prevent problems with function as well as the aesthetic features in a breastfeeding child. Brazil is a multiethnic country with a poor epidemiological policy and little data to track the incidence of certain diseases, including MNTI. It is important to study this pathology with ethnicity as a factor to improve the current epidemiological programs and establish better post-treatment management. This paper describes a case of a 2-month-old male of African-indigenous descent and Brazilian Amazon residency, who presented to our unit in 2009 with a history of an expanding mass involving the anterior maxilla. Clinical and computerized tomography scans were used to diagnose the mass as MNTI, which was removed by total excision. A biopsy later confirmed the MNTI diagnosis.
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Zweifel DF, Kroiss-Benninger S, Kellenberger C, Bredell MG. Unilateral facial swelling in an infant. J Pediatr Surg 2012; 47:1445-8. [PMID: 22813812 DOI: 10.1016/j.jpedsurg.2012.03.081] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Revised: 03/20/2012] [Accepted: 03/24/2012] [Indexed: 11/18/2022]
Abstract
The melanotic neuroectodermal tumour of infancy (MNTI) is an uncommon, usually benign neoplasm which is most commonly found in the maxilla. We describe the case of a 6-month-old boy who was referred with a swiftly increasing swelling of the left cheek. After imaging and biopsy, MNTI was confirmed, and surgical resection was performed. Literature demonstrates that most MNTIs occur in the head and neck area and most of those occur in the maxilla. Although most cases are benign, 6.5% are malignant with metastatic disease. Treatment and outcome are discussed in detail. The case highlights the importance of making the diagnosis MNTI early on in order to achieve an optimal outcome.
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Affiliation(s)
- Daniel Fritz Zweifel
- Department of Maxilla-Facial Surgery, Centre hospitalier universitaire vaudois, Bâtiment hospitalier, Rue du Bugnon 46, 1011 Lausanne, Switzerland.
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Melanotic Neuroectodermal Tumor of Infancy: Report of 2 Cases. J Oral Maxillofac Surg 2010; 68:2341-6. [DOI: 10.1016/j.joms.2009.03.059] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Revised: 01/20/2009] [Accepted: 03/25/2009] [Indexed: 11/20/2022]
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Lambropoulos V, Neofytou A, Sfougaris D, Mouravas V, Petropoulos A. Melanotic neuroectodermal tumor of infancy (MNT1) arising in the skull. Short review of two cases. Acta Neurochir (Wien) 2010; 152:869-75. [PMID: 19669690 DOI: 10.1007/s00701-009-0472-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2009] [Accepted: 07/15/2009] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Melanotic neuroectodermal tumor of infancy (MNT1) is a rare congenital pigmented neoplasm of neural crest origin, locally aggressive, and rapidly growing that develops during the first year of life. It most commonly arises from the maxilla, the cranial vault, and the mandible. Early diagnosis and radical surgery are critical for a long-term outcome. METHODS A literature search through PUBMED revealed 43 cases of MNT1 arising in the skull. We reviewed the available literature and studied the presenting symptoms, diagnostic procedures, treatment, rates of recurrences, malignancy, and data of follow-up. We report two further cases of infants aged 4 and 10 months, respectively, with MNT1 arising from the cranial vault who underwent radical excision of the lesion. CONCLUSION Melanotic neuroectodermal tumor of infancy should be included in the differential diagnosis of skull lesions in infants. Radical surgery must be considered as the treatment of choice and close follow-up for at least 2 years is necessary.
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Jain P, Garg RK, Kapoor A. Melanotic neuroectodermal tumor of infancy in oral cavity at unusual age. Fetal Pediatr Pathol 2010; 29:344-52. [PMID: 20704481 DOI: 10.3109/15513815.2010.494702] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The melanotic neuroectodermal tumor of infancy is an extremely rare, fast-growing but benign lesion, commonly occurring in the maxilla of children within the first year of life. Only about 380 cases of this particular tumor have been documented in the medical literature and very few of them have been reported to have occurred in late childhood. We describe here a relatively uncommon presentation of melanotic neuroectodermal tumor of infancy of maxilla arising from palatal gingiva of a 10 year-old female, its course and management by surgical excision with safe margins.
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Affiliation(s)
- Pramod Jain
- Department of Periodontology & Implant Dentistry, Government Dental College & Hospital, Jaipur, India
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Nazira B, Gupta H, Chaturvedi AK, Rao SA, Jena A. Melanotic neuroectodermal tumor of infancy: discussion of a case and a review of the imaging findings. Cancer Imaging 2009; 9:121-5. [PMID: 20080455 PMCID: PMC2821590 DOI: 10.1102/1470-7330.2009.0019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Melanotic neuroectodermal tumor of infancy (MNTI) is an uncommon melanin-containing mesenchymal tumor of neural crest origin. What make this tumor unique and interesting is its characteristic predilection for anterior maxilla (premaxilla) and the presence of pigment melanin which gives the tumor distinct clinicopathological, immunohistochemical, ultrastructural and imaging features. Although first described almost a century ago, to the authors’ knowledge, only a few hundred cases of MNTI have been reported worldwide in the English medical literature. The pool of documented radiological findings is even more sparse as not more than a dozen cases could be abstracted from an Internet search of the radiology literature. We document a case of MNTI and describe the imaging findings with intent to contribute to its small but accruing radiological data.
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Affiliation(s)
- B Nazira
- Departments of Radiology, Rajiv Gandhi Cancer Institute and Research Center, New Delhi, India.
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Selim H, Shaheen S, Barakat K, Selim AA. Melanotic neuroectodermal tumor of infancy: review of literature and case report. J Pediatr Surg 2008; 43:E25-9. [PMID: 18558161 DOI: 10.1016/j.jpedsurg.2008.02.068] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2007] [Revised: 02/20/2008] [Accepted: 02/22/2008] [Indexed: 10/21/2022]
Abstract
Melanotic neuroectodermal tumor of infancy (MNTI) is an uncommon, fast-growing, pigmented neoplasm of neural crest origin. It primarily affects the maxilla of the infants during the first year of life. Approximately, a few hundred of these tumors have been reported in medical literature. We present a case of a newborn with MNTI involving the anterior maxillary region. The treatment included surgical excision of the lesion with safe margins, using an intraoral approach and removal of associated developing tooth buds. We made no attempt at immediate bone grafting. The patient had no recurrence at 1 year postoperatively. The diagnostic features and management alternatives of MNTI are discussed.
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Affiliation(s)
- Heba Selim
- Department of Oral and Maxillofacial Surgery, Ain Shams University School of Dentistry, Cairo 11381, Egypt
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