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Tirupathi S, Afnan L. Is trigeminal neuralgia the tip of cancer iceberg: An insight. J Cancer Res Ther 2024; 20:500-501. [PMID: 38554376 DOI: 10.4103/jcrt.jcrt_2488_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 02/06/2023] [Indexed: 04/01/2024]
Affiliation(s)
- Sunnypriytham Tirupathi
- Department of Pediatric and Preventive Dentistry, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Lamea Afnan
- Department of Public Health Dentistry, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
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2
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Amber A, Nawaz H, Bhatti HN, Mushtaq Z. Surface-enhanced Raman spectroscopy for the characterization of different anatomical subtypes of oral cavity cancer. Photodiagnosis Photodyn Ther 2023:103607. [PMID: 37220841 DOI: 10.1016/j.pdpdt.2023.103607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/04/2023] [Accepted: 05/09/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND The prognosis for oral cancer patients is still very poor worldwide. Early detection and treatment therapy remain the key issue to be addressed for improved patient survival. The characteristic Raman spectral features associated with the biochemical changes in the blood serum samples can be used for the diagnosis of diseases, particularly for oral cancer. Surface-enhanced Raman spectroscopy (SERS) is a promising technique for non-invasive and early detection of oral cancer by analyzing molecular changes in body fluids. OBJECTIVES To detect oral cavity anatomical subsites (buccal mucosa, cheek, hard palate, lips, mandible, maxilla, tongue and tonsillar region) cancers by using blood serum samples, SERS with principal component analysis is used. MATERIAL AND METHOD SERS is employed with silver nanoparticles for the analysis and detection of oral cancer serum samples by comparing with healthy serum samples. SERS spectra are recorded by Raman instrument and preprocessed using the statistical tool. Principal component analysis (PCA) and Partial least square discriminant analysis (PLS-DA) are used to discriminate between oral cancer serum samples and control serum samples. RESULTS Some major SERS peaks are observed at 1136 cm-1 (Phospholipids) and 1006 cm-1 (Phenylalanine) remain higher in intensities for oral cancer spectra as compared to healthy spectra. The peak at 1241 cm-1 (amide III) is observed only in oral cancer serum samples while absent in healthy serum samples. Higher protein and DNA contents were detected in SERS mean spectra of oral cancer. Moreover, PCA is used to identify the biochemical differences in the form of SERS features which is used to differentiate between oral cancer and healthy blood serum samples, while PLS-DA is used to build differentiation model of oral cancer serum samples and healthy control serum samples. PLS-DA provides successful differentiation with 94% specificity and 95.5% sensitivity. CONCLUSIONS SERS can be used for the diagnosis of oral cancer and to identify metabolic changes that occur during disease development.
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Affiliation(s)
- Arooj Amber
- Department of Chemistry, University of Agriculture Faisalabad, Faisalabad, (38000), Pakistan
| | - Haq Nawaz
- Department of Chemistry, University of Agriculture Faisalabad, Faisalabad, (38000), Pakistan.
| | - Haq Nawaz Bhatti
- Department of Chemistry, University of Agriculture Faisalabad, Faisalabad, (38000), Pakistan
| | - Zahid Mushtaq
- Department of Biochemistry, University of Agriculture Faisalabad, Faisalabad, (38000), Pakistan
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3
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Gangwani P, Sadda A, Danakas A, Kolokythas A. Metastatic disease to the condyle: A case report and review of literature. ORAL AND MAXILLOFACIAL SURGERY CASES 2022. [DOI: 10.1016/j.omsc.2022.100244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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4
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Ahuja US, Shetty DC, Rathore A, Dhillon M. Occult prostate carcinoma with metastasis to the mandible presenting as numb chin syndrome. J Oral Biol Craniofac Res 2021; 11:393-395. [PMID: 34026480 PMCID: PMC8134737 DOI: 10.1016/j.jobcr.2021.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 04/09/2021] [Accepted: 04/27/2021] [Indexed: 11/28/2022] Open
Abstract
Prostate cancer is one of the leading causes of death due to malignancy in men. Occult malignancy presenting with no primary symptoms could be a challenge to the diagnostician. Metastasis of prostate carcinoma to the mandible is rare and usually presents with non-specific symptoms. Only 1% of oral cancers account for lesions which present as metastasis of other primary malignancies. We report a rare case of prostate carcinoma being diagnosed as metastasis to the mandible with the patient presenting with numb chin syndrome.
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Affiliation(s)
- Upasana Sethi Ahuja
- Department of Oral Medicine and Radiology, I.T.S Dental College, Ghaziabad, UP, India
| | - Devi Charan Shetty
- Department of Oral and Maxillofacial Pathology, I.T.S Dental College, Ghaziabad, UP, India
| | - Akshay Rathore
- Department of Oral Medicine and Radiology, I.T.S Dental College, Ghaziabad, UP, India
| | - Manu Dhillon
- Department of Oral Medicine and Radiology, I.T.S Dental College, Ghaziabad, UP, India
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5
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Metastatic Prostate Adenocarcinoma of the Mandible Diagnosed With Oral Manifestations. J Craniofac Surg 2019; 31:e220-e222. [PMID: 31688259 DOI: 10.1097/scs.0000000000006025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Metastasis from the prostate gland to the mandible is rarely encountered and commonly present with non-specific features like unexplained pain, swelling, and numb chin syndrome. Here we present a case with metastatic prostate adenocarcinoma detected secondary to oral manifestations. Patients present with unexplained facial pain and numbness should alert clinicians to the presence of malignant disease, and appropriate hematological, radiological and or histological investigations should be performed. Thereby, clinicians can prevent the overlook of the first signs of metastasis, accelerate the early diagnosis and positively orientate the prognosis of the disease, especially in a patient without known malignancy.
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6
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Sandhu S, Villa A, Treister NS. A mobile molar with furcation involvement. J Am Dent Assoc 2019; 150:972-978. [PMID: 30898305 DOI: 10.1016/j.adaj.2018.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 11/07/2018] [Accepted: 12/07/2018] [Indexed: 11/18/2022]
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7
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Adewale AO, Mofoluwake LA, Olamide OT, Yussuf SA. Two case reports on Mandibular metastases. Ghana Med J 2019; 52:168-172. [PMID: 30602804 DOI: 10.4314/gmj.v52i3.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Metastatic tumours of the oral cavity are not common. The most common site for bone metastases in the head and neck region is the mandible. Metastatic lesion of the mandible most commonly originate from the lungs in men and breast in women, and these lesions (or tumours) usually are carcinomas rather than sarcomas. We report two cases of metastatic lesions in the mandible: (1) A 19year old male with right mandibular swelling and a nodular swelling in the distal two-third of the right tibia. Radiograghs revealed sclerotic lesion with a sunburst appearance in both the jaw and tibia. Histology of the jaw lesion confirmed a metastatic osteosarcoma of the mandible. (2) A 51year old female with a right mandibular swelling with associated swelling in the anterior neck, right shoulder and right parietal region of the skull. Computerised tomography scan (CT) of the jaws showed an osteolytic lesion of the right mandible. CT scan of the brain also showed a large lytic lesion seen in the posterior aspect of the right parietal bone. Histology of the jaw mass confirmed a metastatic follicular carcinoma from the thyroid. Mandibular metastasis may be the first presenting feature of underlying occult malignancy of another primary site. Therefore, clinicians should maintain a high level of suspicion while evaluating patients with a history of cancer presenting with oral lesions.
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Affiliation(s)
- Adesina O Adewale
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Lagos State University College of Medicine, Lagos State, Nigeria
| | - Ladeji A Mofoluwake
- Department of Oral Pathology, Faculty of Dentistry, Lagos State University College of Medicine, Lagos State, Nigeria
| | - Opaleye T Olamide
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Lagos State University College of Medicine, Lagos State, Nigeria
| | - Salami A Yussuf
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Lagos State University College of Medicine, Lagos State, Nigeria
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8
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Shah A, Jahan S, Najar L, Hassan S, Mohammad M. Metastatic clear cell variant of renal cell carcinoma of the mandible: Review and case report. Ann Maxillofac Surg 2016; 6:144-7. [PMID: 27563625 PMCID: PMC4979332 DOI: 10.4103/2231-0746.186121] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
A case of metastatic renal cell carcinoma (RCC) to the mandible is reported. A 22-year-old man consulted us for hypoesthesia of the right lower lip. Panorama X-ray film showed a radiolucent lesion in the right mandibular body. A diagnosis of a metastatic tumor to the mandible from the right kidney was made after evaluation by computed tomography and bone scan with Tc99 methyl diphosphonate which also revealed multiple bone metastases. Histologically diagnosis was clear cell variant of RCC. Patient has been put on radiotherapy for symptomatic treatment and a molecularly targeted drug. The therapy effectively stopped the progressive growth of oral and other metastatic lesions. The quality of life is relatively well maintained with tolerable adverse effects. The patient is still on our follow-up with an improved quality of life.
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Affiliation(s)
- Ajaz Shah
- Department of Oral and Maxillofacial Surgery, Government Dental College, Srinagar, Jammu and Kashmir, India
| | - Shahi Jahan
- Department of Oral and Maxillofacial Surgery, Government Dental College, Srinagar, Jammu and Kashmir, India
| | - Latief Najar
- Department of Oral and Maxillofacial Surgery, Government Dental College, Srinagar, Jammu and Kashmir, India
| | - Shahid Hassan
- Department of Oral and Maxillofacial Surgery, Government Dental College, Srinagar, Jammu and Kashmir, India
| | - Manzoor Mohammad
- Department of Oral and Maxillofacial Surgery, Government Dental College, Srinagar, Jammu and Kashmir, India
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9
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Sathasivam H, Loh YM, Saw CL, Khalid N. Metastatic follicular thyroid carcinoma: a case report. Gerodontology 2016; 34:276-279. [PMID: 27384017 DOI: 10.1111/ger.12240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE A case of oral metastatic follicular thyroid carcinoma is presented. BACKGROUND Metastatic tumours are more frequent in older individuals and can be the only sign/symptom of an undiagnosed primary malignancy. CASE REPORT A 69-year-old lady presented with an enlarging mandibular swelling. Incisional biopsy and imaging studies were suggestive of metastatic follicular thyroid carcinoma. CONCLUSION Metastatic tumours should be considered in the differential diagnosis of mandibular swellings especially in older individuals.
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Affiliation(s)
- Hans Sathasivam
- Department of Oral Surgery, Oral Medicine & Oral Pathology, Hospital Sultan Ismail, Johor Bharu, Malaysia.,Ministry of Health, Penang, Malaysia.,Department of Pathology, Hospital Sultanah Aminah, Johor Bahru, Malaysia
| | - Yi M Loh
- Department of Oral Surgery, Oral Medicine & Oral Pathology, Hospital Sultan Ismail, Johor Bharu, Malaysia
| | | | - Noraida Khalid
- Department of Pathology, Hospital Sultanah Aminah, Johor Bahru, Malaysia
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10
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Çakmak Ö, Tarhan H, Küçük Ü, İlbey YÖ. Prostatic adenocarcinoma with initial metastatic spread to the mandible. Turk J Urol 2015; 41:149-51. [PMID: 26516599 DOI: 10.5152/tud.2015.36043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Prostate cancer is one of the commonest types of malignancy in males. Although prostate cancer has a propensity to metastasize to the bone, metastasis to the mandible is rare. Because of their uncommon incidence, the diagnosis of mandibular metastasis, especially those originating from the prostate, may represent a challenge both for urologists and dentists. Here we present a case of prostatic adenocarcinoma with initial metastatic spread to the mandible.
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Affiliation(s)
- Özgür Çakmak
- Clinic of Urology, Tepecik, Training and Research, Hospital, İzmir, Turkey
| | - Hüseyin Tarhan
- Clinic of Urology, Tepecik, Training and Research, Hospital, İzmir, Turkey
| | - Ülkü Küçük
- Clinic of Pathology, Tepecik, Training and Research, Hospital, İzmir, Turkey
| | - Yusuf Özlem İlbey
- Clinic of Urology, Tepecik, Training and Research, Hospital, İzmir, Turkey
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11
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Turner-Iannacci A, Mozaffari E, Stoopler ET. Mental nerve neuropathy: case report and review. CAN J EMERG MED 2015; 5:259-62. [PMID: 17472769 DOI: 10.1017/s1481803500008460] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
ABSTRACT
Mental nerve neuropathy (MNN) or “numb chin syndrome” is a rare neurologic symptom most often associated with malignancy. Patients typically develop paresthesia or numbness localized to the chin and lower lip and will often seek care at their local emergency department. Pain and expansion of the lower jaw may also be present. We report a case of MNN associated with a metastatic lesion in the mandible. The purpose of this article is to highlight the importance of recognizing MNN, a potentially life-threatening symptom of metastatic carcinoma, and enable clinicians to properly diagnose MNN, which may mimic other conditions that affect the mandible.
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Affiliation(s)
- Amy Turner-Iannacci
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, U.S.A
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12
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Aksoy S, Orhan K, Kursun S, Kolsuz ME, Celikten B. Metastasis of prostate carcinoma in the mandible manifesting as numb chin syndrome. World J Surg Oncol 2014; 12:401. [PMID: 25547947 PMCID: PMC4326431 DOI: 10.1186/1477-7819-12-401] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 12/05/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Numb chin syndrome is an uncommon but well-recognized symptom in medical oncology. This condition can be related to metastatic neurological manifestation of malignancy, often with no clinically visible pathology. About 1% of oral cancers, which are located in the soft tissues and jaws, are metastases of primary tumors located elsewhere in the body. The posterior mandible is the most common site of metastasis of the oral region because of its rich blood supply in active areas of hematopoiesis. This article describes prostate carcinoma metastasis located in the mandible and temporomandibular joint of a 78-year-old male. CASE PRESENTATION A 78-year-old male patient presented to our outpatient clinic with a complaint of numbness and pain on the left site of the mandible. The patient stated that he had been suffering from this numbness for 1 to 2 months. In the medical anamnesis, it was discovered that patient had prostate carcinoma (CA) 5 years previous, and since then, he had visited his doctor periodically for an annual examination. In these examinations and on the basis of tests carried out at the hospital 1 year previous, it was stated that no CA relapse traces were detected. The patient had visited his dentist 2 months previous for pain and numbness of the left molar region. CONCLUSIONS We report numb chin syndrome, which is an uncommon neurological manifestation of metastatic malignancy. The clinical course and rapid deterioration after the initial presentation of this syndrome is discussed. This clinical situation illustrates the importance of good medical history review prior to all procedures by the medical professions dealing with oncology patients. An awareness of this condition is crucial, especially in symptoms with unexplained facial pain and numbness.
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Affiliation(s)
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Besevler 06500, Ankara, Turkey.
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13
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Misir AF, Mercan U, Günhan O. Metastasis of lung adenocarcinoma to the mandible: Report of a case. J Oral Maxillofac Pathol 2013; 17:253-6. [PMID: 24250088 PMCID: PMC3830236 DOI: 10.4103/0973-029x.119745] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Adenocarcinoma of the lung that metastasizes to the mandible is uncommon. There are only a few cases described in the English-language literature regarding metastasis to mandible from adenocarcinoma of the lung. This article shows a metastasis from adenocarcinoma of the lung affecting the mandible of a 55-year-old male patient where the metastatic lesion was detected before primary tumor. This article emphasizes the importance of detailed dentoalveolar examination and early diagnosis for finding the primary focus of metastatic lesions.
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Affiliation(s)
- Ahmet Ferhat Misir
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bulent Ecevit University, Zonguldak, Turkey
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14
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Metastatic pancreatic adenocarcinoma to the mandibular condyle: a rare clinical presentation. J Oral Maxillofac Surg 2013; 72:83-8. [PMID: 23911149 DOI: 10.1016/j.joms.2013.06.207] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 06/12/2013] [Accepted: 06/13/2013] [Indexed: 11/24/2022]
Abstract
Metastatic disease to the oral cavity is rare, representing only 1-8% of oral malignancies, and involvement of the mandibular condyle is even less prevalent. In a recent literature review of 796 cases of metastatic disease to the oral cavity, only 39 (13.8%) involved the condyle. This report is a unique case of metastatic pancreatic adenocarcinoma to the condyle. There are only 5 documented cases of metastatic pancreatic adenocarcinoma to the oral cavity, one of which metastasized to the condyle. This is an important case because metastatic lesions to the condyle may mimic temporomandibular joint disorders making clinical diagnosis and decision-making extremely challenging for the oral and maxillofacial surgeon. The requirement for arrival at an appropriate and prompt diagnosis is crucial for determining the most appropriate treatment regimens and improved outcomes. Additionally, in approximately 33% of cases, the oral metastatic lesion may be the first indication of an undiscovered distant primary tumor, making timely evaluation and treatment critical from an oncologic perspective.
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15
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Benoit MM, Vargas SO, Bhattacharyya N, McGill TA, Robson CD, Ferraro N, Didas AE, Labow BI, Upton J, Taghinia A, Meara JG, Marcus KJ, Mack J, Rodriguez-Galindo C, Rahbar R. The presentation and management of mandibular tumors in the pediatric population. Laryngoscope 2013; 123:2035-42. [DOI: 10.1002/lary.24020] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Revised: 11/29/2012] [Accepted: 01/07/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Margo McKenna Benoit
- Department of Otolaryngology; Strong Memorial Hospital, University of Rochester Medical Center; Rochester; New York
| | - Sara O. Vargas
- Department of Pathology; Harvard Medical School; Boston; Massachusetts; U.S.A
| | - Neil Bhattacharyya
- Department of Otolaryngology; Brigham and Women's Hospital; Boston; Massachusetts
| | - Trevor A. McGill
- Department of Otolaryngology; Harvard Medical School; Boston; Massachusetts; U.S.A
| | - Caroline D. Robson
- Division of Neuroradiology; Harvard Medical School; Boston; Massachusetts; U.S.A
| | - Nalton Ferraro
- Children's Hospital Boston; Harvard Medical School; Boston; Massachusetts; U.S.A
| | - Amanda E. Didas
- Department of Otolaryngology; Harvard Medical School; Boston; Massachusetts; U.S.A
| | - Brian I. Labow
- Department of Plastic Surgery; Harvard Medical School; Boston; Massachusetts; U.S.A
| | - Joseph Upton
- Department of Plastic Surgery; Harvard Medical School; Boston; Massachusetts; U.S.A
| | - Amir Taghinia
- Department of Plastic Surgery; Harvard Medical School; Boston; Massachusetts; U.S.A
| | - John G. Meara
- Department of Plastic Surgery; Harvard Medical School; Boston; Massachusetts; U.S.A
| | - Karen J. Marcus
- Division of Radiation Oncology; Harvard Medical School; Boston; Massachusetts; U.S.A
| | - Jennifer Mack
- Department of Hematology and Oncology; Harvard Medical School; Boston; Massachusetts; U.S.A
| | | | - Reza Rahbar
- Department of Otolaryngology; Harvard Medical School; Boston; Massachusetts; U.S.A
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Bhadage CJ, Vaishampayan S, Umarji H. Mandibular metastasis in a patient with follicular carcinoma of thyroid. Contemp Clin Dent 2012; 3:212-4. [PMID: 22919227 PMCID: PMC3425110 DOI: 10.4103/0976-237x.96835] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Mandibular metastasis due to thyroid carcinoma is not very frequent and the cases described in the literature are few. Due to its bloodstream dissemination, most of them are a consequence of the follicular variant of thyroid carcinomas. We are presenting a case in which the metastatic lesion of mandible was detected before diagnosis of primary malignancy.
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Affiliation(s)
- Chetan J. Bhadage
- Department of Oral Medicine and Radiology, MGV's KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Sagar Vaishampayan
- Department of Head and Neck Oncology, TATA Memorial Hospital, Mumbai, Maharashtra, India
| | - Hemant Umarji
- Department of Oral Medicine and Radiology, Government Dental College and Hospital, Mumbai, Maharashtra, India
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17
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Peterson P, Templeton R, Kademani D. Poster 60: Metastatic Adenocarcinoma of the TMJ: A Report of 2 Cases and Review of the Literature. J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.joms.2011.06.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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18
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Numb Chin Syndrome as a Manifestation of Possible Breast Cancer Metastasis Around Dental Implants. J Craniofac Surg 2011; 22:942-5. [DOI: 10.1097/scs.0b013e31820fe1af] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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19
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Freudlsperger C, Kurth R, Werner MK, Hoffmann J, Reinert S. Condylar metastasis from prostatic carcinoma mimicking temporomandibular disorder: a case report. Oral Maxillofac Surg 2010; 16:79-82. [PMID: 21125304 DOI: 10.1007/s10006-010-0256-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Accepted: 11/16/2010] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although metastatic carcinoma is the most common malignant tumor of the bone, less than 1% of all metastatic bone lesions are presented in the maxillofacial area. As the mandibular body is the most frequent localization, metastasis to the mandibular condyle is extremely rare. CASE REPORT This report describes a rare case of prostate carcinoma metastatic to the mandibular condyle in a 75-year old man, who was referred because of persistent pain in the temporomandibular joint (TMJ) region and a limitation of opening, initially misdiagnosed and treated as temporomandibular disorder (TMD). Histopathological examination confirmed the suspected metastasis of prostate carcinoma and local radiation therapy was performed. DISCUSSION TMD represent a diagnostic challenge and sometimes an interdisciplinary approach is required to prevent a delay of the correct treatment. Metastatic cancer should be included in the differential diagnosis of TMD, especially in patients with a malignant disease.
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Affiliation(s)
- Christian Freudlsperger
- Department of Oral and Maxillofacial Surgery, University Hospital Tuebingen, Osianderstrasse 2-8, 72076 Tuebingen, Germany.
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20
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Bouslama S, Omezzine M, Khochtali H. Métastases mandibulaires : présentation de 8 cas. ACTA ACUST UNITED AC 2010. [DOI: 10.1051/mbcb/2010035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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21
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Liapis K, Apostolidis I, Karmiris T, Harhalakis N. Numb chin syndrome as the initial manifestation of acute megakaryoblastic leukemia. Leuk Lymphoma 2010; 51:2310-1. [DOI: 10.3109/10428194.2010.520776] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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22
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Katsnelson A, Tartakovsky JV, Miloro M. Review of the literature for mandibular metastasis illustrated by a case of lung metastasis to the temporomandibular joint in an HIV-positive patient. J Oral Maxillofac Surg 2010; 68:1960-4. [PMID: 20381938 DOI: 10.1016/j.joms.2009.07.075] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2009] [Revised: 07/20/2009] [Accepted: 07/25/2009] [Indexed: 10/19/2022]
Affiliation(s)
- Alexander Katsnelson
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA 02114, USA.
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23
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Panossian M, Gady J, Natarajan E, Eisenberg E. Breast Cancer Metastatic to the Mandible Misdiagnosed as Parotitis: Report of a Case. J Oral Maxillofac Surg 2009; 67:1333-7. [PMID: 19446228 DOI: 10.1016/j.joms.2008.09.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2008] [Accepted: 09/20/2008] [Indexed: 11/26/2022]
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24
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Vega LG, Dipasquale J, Gutta R. Head and neck manifestations of distant carcinomas. Oral Maxillofac Surg Clin North Am 2009; 20:609-23. [PMID: 18940627 DOI: 10.1016/j.coms.2008.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Metastatic tumors to the head and neck from distant carcinomas are rare lesions that epitomize the "zebras." They represent a diagnostic and therapeutic challenge for clinicians and health providers. These lesions usually rank low in the differential diagnosis list, but a history of cancer should prompt clinicians about the possibility of a metastatic lesion from a distant carcinoma. The presence of these lesions usually represents a poor prognosis. The surgeon's role in treating these lesions is to improve or maintain the patient's quality of life, taking into consideration the overall prognosis.
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Affiliation(s)
- Luis G Vega
- Division of Oral & Maxillofacial Surgery, Department of Surgery, University of Florida, Health Science Center, 653-1 West 8th Street, Jacksonville, FL 32209, USA.
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Garas G, Stacey-Clear A, Whitaker S, Collyer J. An atypical presentation of breast cancer metastasis. BMJ Case Rep 2009; 2009:bcr10.2008.1061. [PMID: 21686476 DOI: 10.1136/bcr.10.2008.1061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 78-year-old woman heard a crack in her left mandible while eating a biscuit and reported to her dentist, who urgently referred her to the oral and maxillofacial surgery department. On examination she had a lesion in the body of her left mandible, which had eroded through the lower border and caused a pathological fracture. Her past medical history included a left mastectomy and level II axillary lymph node dissection for a 27 mm grade III invasive ductal carcinoma of the left breast 9 months prior to her mandibular fracture. A transoral incisional biopsy was performed which confirmed the mandibular lesion to be an osteolytic metastasis from the breast. The metastasis was subsequently surgically removed and the remaining mandible repaired with a reconstruction plate followed by postoperative radiotherapy. The patient regained full function of her mandible and is now eating normally. She is being closely followed-up in the oncology outpatient department.
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Affiliation(s)
- George Garas
- East Surrey Hospital, Breast and Endocrine Surgery, Canada Avenue, Redhill, Surrey, RH1 5RH, UK
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Sándor GKB, McGuire TP, Ylikontiola LP, Serlo WS, Pirttiniemi PM. Management of facial asymmetry. Oral Maxillofac Surg Clin North Am 2008; 19:395-422, vi. [PMID: 18088893 DOI: 10.1016/j.coms.2007.05.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Asymmetries of the craniofacial region encompass a multitude of diverse and potentially complex abnormalities that may be the result of numerous causes. The expression and degree of asymmetry for a given condition, although a highly variable process, is the ultimate determinant of the nature of its treatment. This article highlights some of the key features and treatment strategies for various common facial asymmetries.
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Affiliation(s)
- George K B Sándor
- Graduate Program in Oral and Maxillofacial Surgery and Anesthesia, University of Toronto, Toronto, Ontario, Canada.
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Kraigher-Krainer E, Lackner H, Sovinz P, Schwinger W, Benesch M, Urban C. Numb chin syndrome as initial manifestation in a child with acute lymphoblastic leukemia. Pediatr Blood Cancer 2008; 51:426-8. [PMID: 18506757 DOI: 10.1002/pbc.21627] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Numb chin syndrome (NCS) describes the affection of the inferior alveolar nerve and is a purely sensory neuropathy. Its symptoms include numbness of the skin of the chin, the lip and the gingival mucosa. Mostly seen in adults, it has rarely been described in children. We report on an 11-year-old male who presented with NCS as initial manifestation of acute lymphoblastic leukemia of B-cell type.
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Affiliation(s)
- Elisabeth Kraigher-Krainer
- Division of Pediatric Hematology/Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
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Dib LL, Soares AL, Sandoval RL, Nannmark U. Breast metastasis around dental implants: a case report. Clin Implant Dent Relat Res 2007; 9:112-5. [PMID: 17535335 DOI: 10.1111/j.1708-8208.2007.00033.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Metastases to the oral cavity and to the jaws are rare; hence, the clinical manifestations of the oral metastasis lesion could frequently be simulating general pathologic entities, making the diagnosis a challenging process to the dental team. Local factors, such as trauma, have been observed to facilitate the growth of blood-borne tumors. To this end, surgical procedures such as fixture placement might cause cancer cells to spread. PURPOSE Careful clinical examination is a valuable help in diagnosing oral lesions, which can improve the quality of life of patients and reduce the risks of oral complications. MATERIALS AND METHODS A female patient was referred to the clinic with symptoms of irritation, swelling, and pain associated with implants in the mandible and the maxilla. RESULTS Clinical examination, x-ray, and histopathology revealed that the patients suffered from a metastatic lesion, primary tumor being an adenocarcinoma of the breast diagnosed at the same time. CONCLUSION Optimal clinical examination in conjunction with radiography and histopathology is a necessity in order to discover malignant lesions in time. Routine dental check-ups must comprise more thorough soft-tissue examination.
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Yasar F, Oz G, Dolanmaz D, Akgünlü F. Mandibular metastasis in a patient with pulmonary adenocarcinoma. Dentomaxillofac Radiol 2006; 35:383-5. [PMID: 16940489 DOI: 10.1259/dmfr/26083958] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Metastatic tumour spread to the mandible is quite rare. We report a case of distant metastasis of pulmonary adenocarcinoma in the mandibular bone. The patient had pain in his left mandibular premolar-molar area caused by a mandibular metastasis from a previously undiagnosed pulmonary adenocarcinoma.
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Affiliation(s)
- F Yasar
- Oral Diagnosis and Radiology Department, Selcuk University Dentistry Faculty, Konya Turkey.
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Kuttan NAA, Flemming DK, Dane JN, Ang DB. Metastatic lesion of the anterior mandible with an occult primary: a case report. SPECIAL CARE IN DENTISTRY 2006; 26:76-80. [PMID: 16681243 DOI: 10.1111/j.1754-4505.2006.tb01514.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Metastatic tumors to the oral cavity are relatively uncommon and account for about 1% of all oral cancers. Distant metastases to the jawbone are associated with a poor prognosis and a survival rate that is usually less than one year. The leading common primary sites for these lesions are the breast in females and the lung in males followed by the adrenals, kidneys, prostate, thyroid and colon. In 30% of all cancers, a metastatic lesion could be the first sign of a primary tumor elsewhere in the body. Metastatic lesions to the jaws are known to simulate periodontal and pulpal disease and other radiolucent lesions that can occur in the jaws. Microscopic evaluation with concurrent radiographic skeletal survey is warranted in patients where a metastatic lesion is suspected.
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Affiliation(s)
- Nithyanand A A Kuttan
- Oral Medicine Residents, University of Missouri-Kansas City School of Dentistry, Kansas City, Missouri 64139, USA
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31
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Shankland WE, Bouquot JE. Focal osteoporotic marrow defect: report of 100 new cases with ultrasonography scans. Cranio 2004; 22:314-9. [PMID: 15532316 DOI: 10.1179/crn.2004.039] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Focal osteoporotic marrow defect (FOMD) may be the earliest detectable form of the ischemic marrow disorders. The exact cause is unknown, but three theories have been proposed in the literature. A fourth is presented in this paper. In this study, 100 biopsies were examined histologically and were diagnosed as FOMD, based upon consistent histological characteristics. Until recently, the only diagnostic criteria were radiographic evaluation and incisional biopsy. In February 2002, a through-transmission alveolar ultrasonic test (Cavitat 4000, Cavitat Medical Technologies, Inc., Aurora, CO) was approved by the US Food and Drug Administration and by Health Canada for detection of low bone density and bone desiccation, both features of FOMD and chronic ischemic bone disease. Within this article, the diagnostic criteria and pathological findings of FOMD will be presented. The three current theories concerning its etiology will be briefly presented and a fourth theory will be proposed.
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Déquanter D, Lothaire P, Andry G, Gil T. [Metastatic prostate carcinoma mimicking a parotid tumor: a case report]. ACTA ACUST UNITED AC 2004; 105:182-4. [PMID: 15211218 DOI: 10.1016/s0035-1768(04)72300-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We report a case of prostate carcinoma metastatic to the mandible that had been initially suspected as being a primary tumor of the parotid. The initial symptom was hard swelling in the left parotid region. No pathologic fracture was diagnosed. The metastatic lesion was diagnosed 4 years after diagnosis of the carcinoma of the prostate. This is a very interesting event because of its unusual localization.
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Affiliation(s)
- D Déquanter
- Département de chirurgie, Institut Bordet, Centre des Tumeurs de l'Université Libre de Bruxelles, 1, rue Héger-Bordet 1000 Bruxelles, Belgique
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McDermott RS, Anderson PR, Greenberg RE, Milestone BN, Hudes GR. Cranial nerve deficits in patients with metastatic prostate carcinoma. Cancer 2004; 101:1639-43. [PMID: 15468187 DOI: 10.1002/cncr.20553] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Cranial nerve lesions due to metastases from prostate carcinoma to the skull base are an uncommon yet clinically significant finding. METHODS The authors report the clinical features, treatment, and outcomes for 15 patients who presented with cranial nerve palsies complicating metastatic prostate carcinoma. Patient charts identified from a Fox Chase Cancer Center treatment data base were reviewed. RESULTS All patients had hormone-refractory disease at the time of symptom onset. Twelve of 15 patients had received prior chemotherapy, and 13 of 15 patients had received prior radiation therapy to areas of bony pain. Symptoms varied from recognized clinical syndromes involving multiple cranial nerves to isolated cranial nerve lesions. All patients had lesions at the skull base that were visualized on computed tomography scans or magnetic resonance images. All patients were treated with palliative radiation therapy to either the whole brain or the skull base. Fourteen of 15 patients had a clinical (either partial or complete) response to radiation therapy. All responding patients subsequently died of prostate carcinoma without worsening of residual or development of new cranial nerve symptoms. Ten of 15 patients (67%) died within 3 months of developing symptoms, and the remaining 5 patients lived between 9 months and 31 months from onset of symptoms. CONCLUSIONS The authors concluded that palliative radiation therapy should be considered in this heterogeneous group of patients given the potential for significant symptom improvement.
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Affiliation(s)
- Raymond S McDermott
- Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111, USA
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Nishimura T, Iizuka T. Evaluation of the pathophysiology of odontogenic maxillary sinusitis using bone scintigraphy. Int J Oral Maxillofac Surg 2002; 31:389-96. [PMID: 12361072 DOI: 10.1054/ijom.2001.0198] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The inflammatory changes in the maxillary sinus mucosa and wall (mucosal and bony lesions) were evaluated to identify the pathophysiology of odontogenic maxillary sinusitis. Out of 80 patients who underwent CT, 32 patients were examined using single photon emission computerized tomography (SPECT) bone scintigraphy (bone SPECT) with 99mTc-hydroxymethylene-diphosphonate. Mucosal and bony lesions were evaluated morphologically on both images. SPECT data were used to assess the bone activity by calculating the count ratios of the causative alveolar process over the cervical vertebrae. The relationships with clinical symptoms, mucosal changes around the maxillary ostium (ostial lesions), and radiolucencies around the causal teeth (periapical lesions) were assessed. Bone SPECT showing the causal site was valuable for aiding a definitive diagnosis. Mucosal lesions tended to exceed bony lesions horizontally and vertically. Bony lesions tended to extend posteriorly and then anteriorly. The vertical extent of mucosal lesions and the horizontal and vertical extent of bony lesions were correlated with the presence of facial symptoms, ostial lesions, and periapical lesions. Bone activity was significantly correlated with the horizontal and vertical extent of mucosal lesions, horizontal extent of bony lesions, and presence of infraorbital symptoms, ostial lesions, and periapical lesions. Bone activity caused by alveolitis affects the pathophysiology of this disease.
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Affiliation(s)
- T Nishimura
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Japan.
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Ogütcen-Toller M, Metin M, Yildiz L. Metastatic breast carcinoma mimicking periodontal disease on radiographs. J Clin Periodontol 2002; 29:269-71. [PMID: 11940148 DOI: 10.1034/j.1600-051x.2002.290314.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Tumors can metastasize to the jaws, oral soft tissues, or salivary glands. Metastasis from distant organs and tissues to the jaws or oral cavity is considered rare. RESULTS The mandible is the most common site of metastasis of the oral and maxillofacial region. Radiographically, there is usually an area of radiolucency with hazy outline. Such lesions are manifested as radiopaque or sclerotic areas. CONCLUSIONS Radiographic view of a tumor in the present case mimicked a periodontal lesion with an osteolytic area around the roots.
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Affiliation(s)
- M Ogütcen-Toller
- Department of Oral and Maxillofacial Surgery, Dental Faculty of Ondokuz Mayis University, Samsun, Turkey
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Abstract
INTRODUCTION The use of bone scintigraphy (bone scan) in the diagnosis of temporomandibular joint (TMJ) disease has been infrequent, as compared with traditional radiographic techniques. Bone scans have the potential to detect active bone remodeling whereas corresponding radiographs may be normal or document past structural change in the joint. Traditional radiographic findings and relevant clinical signs and symptoms correlated with bone scans may aid in the diagnosis of TMJ disease and possibly affect treatment and prognosis of individual cases. The use of bone scans as an additional tool in diagnosing TMJ disease was assessed in this series of patients. METHODS Thirty consecutive subjects with TMJ tenderness were selected for bone scintigraphy using technetium diphosphonate 99 mTc and single photon emission computerized tomography. These subjects received bone scans as well as other selected imaging modalities for diagnostic purposes. RESULTS AND DISCUSSION The findings on bone scan were evaluated and a change in preliminary clinical diagnosis or treatment was made in 60% of cases because of the findings on bone scintigraphy. Bone scintigraphy may be valuable to assess progress of TMJ inflammation or remodeling, and may affect diagnosis and treatment of patients with TMJ tenderness.
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Affiliation(s)
- J B Epstein
- Department of Dentistry, Vancouver Hospital & Health Sciences Centre, Faculty of Dentistry, University of British Columbia, Vancouver, Canada.
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Copeland B, Clark JM, Sura A, Kilpatrick SE, Shockley W, Meredith S. Prostate carcinoma metastatic to the cervical lymph nodes: report of two cases and review of the literature. Am J Otolaryngol 2001; 22:420-3. [PMID: 11713729 DOI: 10.1053/ajot.2001.28066] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The cervical lymph nodes are a common site of metastasis for cancers originating in the upper aerodigestive tract. Rarely, cancers originating from sites other than the head and neck can metastasize to the cervical lymph node chain. We report on 2 recent patients with metastatic prostate cancer to the cervical lymph nodes.
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Affiliation(s)
- B Copeland
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina Hospitals, Chapel Hill, NC, USA
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Nishimura T, Iizuka T. Diagnostic value of spect bone scintigraphy for odontogenic maxillary sinusitis. Clin Nucl Med 2001; 26:509-14. [PMID: 11353297 DOI: 10.1097/00003072-200106000-00006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE The aim of this study was to assess the diagnostic value of bone SPECT for odontogenic maxillary sinusitis and bone activity in the alveolar process to clarify the pathophysiologic nature of the disease. MATERIALS AND METHODS Computed tomography and bone SPECT with Tc-99m HMDP were performed in 28 patients with odontogenic maxillary sinusitis. Based on the findings of the computed tomographic images, the inflammatory changes in the maxillary sinus mucosa (mucosal lesions) were evaluated horizontally and vertically. For the initial diagnosis, visualization of the causative site by bone SPECT was compared with conventional radiographic and planar findings. SPECT data were used to assess bone activity by calculating the mean count ratios of the alveolar process over the cervical vertebrae. The relation of bone activity to the structure of the mucosal lesions, the presence of clinical symptoms, mucosal changes around the maxillary ostium (ostial lesions), and conventional radiolucent images around the causative teeth (periapical lesions) were assessed. RESULTS Identification of the causative site was sufficiently specific in bone SPECT images. Bone activity was significantly correlated with the structure of the mucosal lesions, both horizontally and vertically, and with the presence of infraorbital symptoms, ostial lesions, and periapical lesions. CONCLUSIONS It is important to view odontogenic maxillary sinusitis as a bone disease in which the bone activity associated with alveolar osteitis affects the pathophysiologic nature of the disease. Bone SPECT is valuable to make a more precise diagnosis, thereby allowing more appropriate treatment of the disease.
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Affiliation(s)
- T Nishimura
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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Imola MJ, Gapany M, Grund F, Djalilian H, Fehling S, Adams G. Technetium 99m single positron emission computed tomography scanning for assessing mandible invasion in oral cavity cancer. Laryngoscope 2001; 111:373-81. [PMID: 11224764 DOI: 10.1097/00005537-200103000-00003] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To study the accuracy of single positron emission computed tomography (SPECT) scanning and compare its results to clinical examination, Panorex, and computed tomography (CT) scanning with respect to determining mandibular invasion by oral cavity and oropharyngeal cancer, and to define the role of SPECT scanning in the preoperative assessment of oromandibular cancer. STUDY DESIGN Prospective study of 38 patients who underwent technetium 99m SPECT scanning as part of their preoperative clinical assessment for cancer at risk of invading the mandible. All patients underwent partial or segmental mandibulectomy as part of their surgical management. METHODS A data protocol was used to tabulate patient demographics, tumor characteristics and results of preoperative tests as patients were enrolled into the study. Following surgical treatment, these data were correlated with histopathological findings. Detailed analysis was performed to assess the tabulated data. RESULTS The SPECT scanning demonstrated an 87% overall accuracy in predicting bone invasion compared with 71% for clinical examination, CT scanning, and Panorex x-rays. The SPECT scanning was significantly more sensitive (95%) than either CT scans (55%) or Panorex x-rays (50%). Notably SPECT scanning demonstrated a considerable improvement in specificity (72%) compared with conventional radionuclide scanning. Although not as specific as CT scanning or plain films, SPECT scanning was significantly more effective in ruling out disease than was clinical examination. CONCLUSIONS Preoperative SPECT scanning used in combination with clinical examination, CT scanning, and Panorex x-rays to assess patients at risk for mandible involvement by oral cavity cancer can improve the accuracy of predicting bone invasion and help in appropriate treatment planning so as to safely reduce the proportion of disease-free jaws resected.
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Affiliation(s)
- M J Imola
- Center for Craniofacial-Skull Base Surgery, 1601 East 19th Avenue, Suite 3100, Denver, CO 80218, USA
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Sarikaya I, Sarikaya A, Holder LE. The role of single photon emission computed tomography in bone imaging. Semin Nucl Med 2001; 31:3-16. [PMID: 11200204 DOI: 10.1053/snuc.2001.18736] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Single photon emission computed tomography (SPECT) of the bone is the second most frequently performed SPECT examination in routine nuclear medicine practice, with cardiac SPECT being the most frequent. Compared with planar scintigraphy, SPECT increases image contrast and improves lesion detection and localization. Studies have documented the unique diagnostic information provided by SPECT, particularly for avascular necrosis of the femoral head, in patients with back pain, for the differential diagnosis between malignant and benign spinal lesions, in the detection of metastatic cancer in the spine, for the diagnosis of temporomandibular joint internal derangement, and for the evaluation of acute and chronic knee pain. Although less rigorously documented, SPECT is being increasingly used in all types of situations that demand more precise anatomic localization of abnormal tracer uptake. The effectiveness of bone SPECT increases with the selection of the proper collimator, which allows one to acquire adequate counts and minimize the patient-to-detector distance. Low-energy, ultrahigh-resolution or high-resolution collimation is preferred over all-purpose collimators. Multihead gamma cameras can increase the counts obtained or shorten acquisition time, making SPECT acquisitions more practical in busy departments and also increasing image quality compared with single-head cameras. Iterative reconstruction, with the use of ordered subsets estimation maximization, provides better quality images than classical filtered back projection algorithms. Three-dimensional image analysis often aids lesion localization.
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Affiliation(s)
- I Sarikaya
- University of Maryland Medical System, Department of Radiology, Baltimore 21201, USA
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Thompson A, Pearce I, Walton G, Payne SR. Numb-chin syndrome: an unusual presentation of metastatic prostate cancer. BJU Int 2000; 85:377-8. [PMID: 10671900 DOI: 10.1046/j.1464-410x.2000.00494.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- A Thompson
- Department of Urology, Manchester Royal Infirmary, University of Manchester, Department of Maxillo-Facial Surgery, Manchester, UK
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