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Bhattacharjee K, Rehman O, Venkatraman V, Das D, Mohapatra SSD, Gogoi R, Soni D. Blood within the bone: orbital intraosseous venous malformation. Orbit 2024; 43:316-328. [PMID: 38261337 DOI: 10.1080/01676830.2024.2303761] [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: 10/25/2023] [Accepted: 01/06/2024] [Indexed: 01/24/2024]
Abstract
PURPOSE Description of clinical features, radiological characteristics, and management strategies in primary orbital intraosseous venous malformation (OIVM) with pertinent literature review. METHODS A retrospective analysis including clinical, radiologic, operative, and histopathological data of six cases of histopathologically proven OIVM was done. A comprehensive literature review was conducted using online databases and augmented with manual search to identify reported cases of OIVM. RESULTS Study data showed five females and one male in young to middle-age group, with an average age of 30 years (range: 20-48 years). Proptosis was noted in five cases (83.33%), and the duration of symptoms ranged from 6 months to 10 years. Frontal and zygomatic bones were most frequently affected and expansile bony lesion was the most common CT scan finding. Three patients underwent pre-operative embolization of feeders followed by en bloc excision of mass and surgical reconstruction (50%); one patient was managed with partial excision (16.66%) while two were regularly followed-up after incision biopsy (33.33%). Histopathology revealed vascular spaces with endothelial lining, separated by bony trabeculae in all patients. Follow-up periods ranged from 6 to 48 months and no recurrence or progression were noted. CONCLUSIONS OIVM is an exceptionally rare disorder with a gradually progressive benign course. Ophthalmologists need to be mindful of this entity during patient evaluation as it has propensity for large volume blood loss intra-operatively, owing to its vascular nature. Complete excision with reconstruction of resultant defect is the preferred treatment strategy and without known recurrence.
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Affiliation(s)
- Kasturi Bhattacharjee
- Department of Ophthalmic Plastic & Reconstructive Surgery and Oculofacial Aesthetics, Sri Sankaradeva Nethralaya, Guwahati, India
| | - Obaidur Rehman
- Department of Oculoplasty and Ocular Oncology, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Vatsalya Venkatraman
- Department of Oculoplasty, Ocular Oncology and Facial Aesthetics, ASG Eye Hospital, Jodhpur, India
| | - Dipankar Das
- Department of Ocular Pathology, Uveitis and Neuro-Ophthalmology, Sri Sankaradeva Nethralaya, Guwahati, India
| | - Shyam Sundar Das Mohapatra
- Department of Ophthalmic Plastic & Reconstructive Surgery and Oculofacial Aesthetics, Sri Sankaradeva Nethralaya, Guwahati, India
| | - Rahul Gogoi
- Department of Ophthalmic Plastic & Reconstructive Surgery and Oculofacial Aesthetics, Sri Sankaradeva Nethralaya, Guwahati, India
| | - Deepak Soni
- Department of Ophthalmic Plastic & Reconstructive Surgery and Oculofacial Aesthetics, Sri Sankaradeva Nethralaya, Guwahati, India
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Cerqueira É, Correia S, Ramalhosa F, Lopes T, Mendes Abreu J. Challenges and Management of Capillary Intraosseous Hemangioma in the Mandibular Symphysis: A Case Report. Cureus 2024; 16:e58035. [PMID: 38738024 PMCID: PMC11088288 DOI: 10.7759/cureus.58035] [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] [Accepted: 04/11/2024] [Indexed: 05/14/2024] Open
Abstract
Capillary intraosseous hemangioma is a benign vascular neoplasm that affects bone tissue, yet its occurrence in the jaw bones has been seldom reported in the literature. We present a case of a capillary intraosseous hemangioma located in the mandibular symphysis of a 28-year-old male. Initially addressed by the patient's dentist as an infectious lesion of endodontic origin, the sudden worsening of the condition, marked by the development of a rapidly expanding exophytic mandibular lesion and tooth mobility, led to the consideration of various potential diagnoses. Subsequently, an incisional biopsy was performed, triggering multiple episodes of recurrent bleeding, leading to several visits to the emergency department, and prompting an urgent status upgrade for the patient. Upon the histological diagnosis of vascular neoplasm, the patient underwent the excision of the lesion, with a favorable and uneventful evolution, although with expected sequelae. As a result, a temporary prosthetic solution, comprising a Maryland Bridge, was implemented, with plans for guided bone regeneration and implant-supported fixed dental prostheses currently in progress. This case underscores the diagnostic and therapeutic challenges associated with this rare condition. Consequently, achieving the optimal outcome for the patient largely depends on a multidisciplinary approach, emphasizing the critical importance of thorough preoperative assessment, along with a well-devised treatment plan and rapid intervention.
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Affiliation(s)
| | | | - Fátima Ramalhosa
- Pathology, Clinical and Academic Centre of Coimbra, Coimbra, PRT
| | - Teresa Lopes
- Maxillofacial Surgery, ULS Coimbra, Coimbra, PRT
| | - João Mendes Abreu
- Faculty of Medicine, Clinical and Academic Centre of Coimbra, Coimbra, PRT
- Stomatology, Clinical and Academic Centre of Coimbra, Coimbra, PRT
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Masoomian B, Asadigandomani H, Rafizadeh SM, Ghodous S, Nozarian Z. Orbital primary intraosseous hemangioma in a three-month old infant: A case report. Am J Ophthalmol Case Rep 2024; 33:101982. [PMID: 38230391 PMCID: PMC10789994 DOI: 10.1016/j.ajoc.2023.101982] [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: 05/19/2023] [Revised: 09/21/2023] [Accepted: 12/20/2023] [Indexed: 01/18/2024] Open
Abstract
Purpose To report a 3-month-old boy with rapid progressive orbital intraosseous hemangioma which was treated with excisional biopsy and orbital rim reconstruction. Observation A 3-month-old boy was referred with the aggressive growth of a mass on the right orbital region. The mass was noted to develop over 4 weeks. On presentation this firm nontender orbital mass measuring 5 × 5cm mimicked a more ominous malignancy. The spiral computed tomography scan showed a destructive mass with protrusion superiorly and inferiorly toward the orbital cavity and anterior cranial fossa. The patient underwent gross tumor resection and reconstruction of the orbital rim. Histology findings revealed an intraosseous hemangioma. There was no evidence of recurrence after 1-year follow-up. Conclusion and Importance Due to rapid progression, the patient's age, and lesion size, this case is unique. There were additional challenges regarding complete resection, intra-cranial extension, and significant blood loss in an infant. Therefore, in the face of rapidly progressing orbital tumors in infants, despite the very low prevalence of intraosseous hemangioma, this diagnosis should be considered.
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Affiliation(s)
- Babak Masoomian
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Asadigandomani
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohsen Rafizadeh
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahriar Ghodous
- Department of Medical Sciences, Guilan University of Medical Sciences, Rasht, Iran
| | - Zohreh Nozarian
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Ethunandan M. Management of Midfacial and Skull Vault Osseous Vascular Lesions. Oral Maxillofac Surg Clin North Am 2024; 36:61-72. [PMID: 37821289 DOI: 10.1016/j.coms.2023.09.007] [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: 10/13/2023]
Abstract
There continuous to be widespread misuse of nomenclature used to described vascular anomalies, This is even more pronounced in the case of intra-osseous lesions. Bone involvement is more common with vascular malformations and extremely rare in haemangiomas. An accurate diagnosis is mandatory for tailored management and often based on a thorough history, clinical examination, and cross-sectional imaging. Surgery remains the main stay for the management of symptomatic venous malformations. Embolisation with or without surgery is the main stay for arteriovenous malformations. Virtual surgical planning, with surgical guides and patient specific implants help achieve predictably excellent results.
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Affiliation(s)
- Madan Ethunandan
- Oral & Maxillofacial Surgery, University Hospital Southampton, Tremona Road, Southampton, SO16 6YD, UK; Oral & Maxillofacial Surgery, Sri Ramchandra Institute of Higher Education and Research, Prour, Chennai, 600116, India.
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Kochaji N, Ajalyakeen H, Fakir A, Al-Mozaik AAS. Intraosseous hemangioma of the mandible: A rare case report. Int J Surg Case Rep 2023; 109:108496. [PMID: 37473620 PMCID: PMC10372736 DOI: 10.1016/j.ijscr.2023.108496] [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: 05/20/2023] [Revised: 06/22/2023] [Accepted: 06/27/2023] [Indexed: 07/14/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Intraosseous hemangioma is a benign vascular tumour, it is mostly seen in long bones, vertebrae, and rarely on jaw bones, it usually occurs with its cavernous form. Medical literature is lacking a full description of capillary hemangioma of the jaws due to its rareness. CASE PRESENTATION A 68 year old male referred to the dentist for normal checking, without significant medical history nor presuming medications. The panoramic radiograph showed radiolucent lesion in the right mandibular body. Surgery was performed and the excisional biopsy was subjected to a private oral pathology lab for the definite diagnosis, which was capillary hemangioma. CLINICAL DISCUSSION Intraosseous hemangioma rarely occurs in the jaws. Normally it is asymptomatic and discovered accidently on radiographs. Radiological findings for intraosseous hemangiomas are not well documented. Treatment of intraosseous capillary hemangioma differs according to the dimension and size of the lesion. CONCLUSION This paper aims to guide the clinician to start including hemangioma in the differential diagnosis for translucent lesions located in the jawbones, when radiographs show the necessity of that, in order to avoid uncontrollable bleeding and even death during any surgical intervention.
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Affiliation(s)
- Nabil Kochaji
- Oral Histology & Pathology Department, Faculty of Dentistry, Damascus University, Damascus, Syria.
| | - Haya Ajalyakeen
- Oral Histology & Pathology Department, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Anas Fakir
- Faculty of Dentistry, Damascus University, Damascus, Syria
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Kim MG, Ryu JH, Lee DM, Park TS, Choi JA, Lee KC, Han SH. Removal of an intraosseous hemangioma of the frontal bone through an anterior hairline incision: a case report. Arch Craniofac Surg 2023; 24:189-192. [PMID: 37654240 PMCID: PMC10475701 DOI: 10.7181/acfs.2023.00150] [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: 03/28/2023] [Revised: 05/01/2023] [Accepted: 06/20/2023] [Indexed: 09/02/2023] Open
Abstract
An intraosseous hemangioma of the frontal bone is typically removed via a coronal incision. This procedure, while effective, can be lengthy and may result in complications such as a prominent scar and hair loss. An alternative approach involves a direct incision in the forehead, which leaves a less noticeable scar and allows a quicker recovery. However, in this specific case, the patient declined both coronal surgery and surgery through a direct forehead incision due to cosmetic concerns. Therefore, we proposed an anterior hairline incision. A 35-year-old woman presented with a firm, non-mobile, palpable mass on her right forehead. Preoperative non-contrast computed tomography revealed a heterogeneous osteolytic lesion. We performed an excisional biopsy through the anterior hairline. Postoperative non-contrast computed tomography was conducted 2 and 6 months after surgery. The wound was clean and free of complications, and there was no local recurrence. Partial resection can reduce scarring for patients who are concerned about cosmetic outcomes. However, the potential for recurrence remains a significant concern. We present this case of an anterior hairline incision for a hemangioma located in the forehead, evaluated using serial computed tomography for both preoperative and postoperative imaging.
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Affiliation(s)
- Myung-Good Kim
- Department of Plastic and Reconstructive Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Jeong-Ho Ryu
- Department of Plastic and Reconstructive Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Dong Min Lee
- Department of Plastic and Reconstructive Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Tae-Seo Park
- Department of Plastic and Reconstructive Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Ji-An Choi
- Department of Plastic and Reconstructive Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Keun-Cheol Lee
- Department of Plastic and Reconstructive Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Song-Hee Han
- Department of Pathology, Dong-A University College of Medicine, Busan, Korea
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Ommerborn MA, John G, Becker J, Preetz J, Gabris S. Forty-five-months follow-up of a minimally invasive, interdisciplinary treated hemangioma of the mandible with a high risk of severe bleeding - a case report. Head Face Med 2023; 19:1. [PMID: 36639813 PMCID: PMC9840336 DOI: 10.1186/s13005-022-00346-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 12/21/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Hemangiomas are benign tumours, mostly seen in the soft tissues. The intraosseous appearance is rare, in particular in the jaws they represent a very seldom malformation. AIM To present a combined endodontic and surgical management report of a clinical case with a rare intraosseous hemangioma diagnosis in the mandible. CASE PRESENTATION This well-documented case report describes the interdisciplinary treatment approach of an intraosseous hemangioma in the left mandible of a 70-year-old male patient. This incidental finding was detected through a routine dental examination. The panoramic radiograph revealed an asymptomatic, apical translucency approximately 15 mm diameter with contact to the mesial root of the tooth 36. The clinical examinations showed no abnormalities. The multifaceted specialized treatments started with the endodontic treatment of the tooth prior to the surgical removal of the lesion and were followed by the histological assessment. As derived from the histologically verified diagnosis, this rare case included the risk of severe bleeding complications during therapy.
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Affiliation(s)
- Michelle Alicia Ommerborn
- grid.411327.20000 0001 2176 9917Department of Operative Dentistry, Periodontology and Endodontology, Faculty of Medicine, Heinrich-Heine-University, Düsseldorf, Germany
| | - Gordon John
- grid.411327.20000 0001 2176 9917Department of Oral Surgery and Central Admittance, Faculty of Medicine, Heinrich-Heine-University, Düsseldorf, Germany
| | - Jürgen Becker
- grid.411327.20000 0001 2176 9917Department of Oral Surgery and Central Admittance, Faculty of Medicine, Heinrich-Heine-University, Düsseldorf, Germany
| | - Julia Preetz
- grid.411327.20000 0001 2176 9917Department of Pathology, Faculty of Medicine, Heinrich-Heine-University and University Hospital, Düsseldorf, Germany
| | - Sondos Gabris
- grid.411327.20000 0001 2176 9917Department of Operative Dentistry, Periodontology and Endodontology, Faculty of Medicine, Heinrich-Heine-University, Düsseldorf, Germany
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8
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Strauss SB, Steinklein JM, Phillips CD, Shatzkes DR. Intraosseous Venous Malformations of the Head and Neck. AJNR Am J Neuroradiol 2022; 43:1090-1098. [PMID: 35863785 PMCID: PMC9575427 DOI: 10.3174/ajnr.a7575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/10/2022] [Indexed: 11/07/2022]
Abstract
Intraosseous venous malformations represent a subtype of venous vascular malformations that arise primarily in bone. In the head and neck, intraosseous venous malformations are most frequently found in the skull, skull base, and facial skeleton, with location at the geniculate ganglion of the facial nerve perhaps the most widely recognized. These non-neoplastic lesions are characterized by dilated venous channels with characteristic internal bony spicules on CT but may present with a more complex appearance on MR imaging and may share features with more aggressive lesions. Further confounding the imaging-based diagnosis of intraosseous venous malformation is the frequent misrepresentation of these lesions as hemangiomas in the radiology and clinical literature, as well as in daily practice. Because most intraosseous venous malformations can be left alone, their correct diagnosis may spare a patient unnecessary concern and intervention.
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Affiliation(s)
- S B Strauss
- From the Department of Radiology (S.B.S., C.D.P.), Weill Cornell Medical Center/Weill Cornell Medical Center, New York, New York
| | - J M Steinklein
- Department of Radiology (J.M.S., D.R.S.), Zucker School of Medicine at Hofstra/Northwell, New York, New York
| | - C D Phillips
- From the Department of Radiology (S.B.S., C.D.P.), Weill Cornell Medical Center/Weill Cornell Medical Center, New York, New York
| | - D R Shatzkes
- Department of Radiology (J.M.S., D.R.S.), Zucker School of Medicine at Hofstra/Northwell, New York, New York
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Bird CE, Traylor JI, Johnson ZD, Kim J, Raisanen J, Welch BG, Abdullah KG. Surgical Management of a Massive Frontal Bone Hemangioma: Case Report. J Neurol Surg Rep 2022; 83:e72-e76. [PMID: 35832685 PMCID: PMC9272017 DOI: 10.1055/s-0042-1750366] [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: 05/18/2021] [Accepted: 03/29/2022] [Indexed: 11/09/2022] Open
Abstract
Intraosseous hemangiomas are rare, benign tumors that can arise from the calvarium. These lesions often invade the outer table of the skull, but typically spare the inner table and intracranial structures. En bloc surgical resection is the standard treatment for intraosseous hemangiomas. However, a piecemeal resection may be required to safely remove the tumor in cases involving the inner table to protect the underlying brain parenchyma and vascular structures. Proper reconstruction is critical to optimize the cosmetic outcome, and a staged procedure allowing implantation of a custom-made implant can be considered for large lesions involving the forehead. We present a case of a patient with a large frontal intraosseous hemangioma with intradural involvement to highlight the surgical nuances of resection and review the existing literature regarding optimal management of these patients.
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Affiliation(s)
- Cylaina E Bird
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Jeffrey I Traylor
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Zachary D Johnson
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Jun Kim
- Department of Neurosurgery, Westmead Hospital, Westmead, Sydney, Australia
| | - Jack Raisanen
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Babu G Welch
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Kalil G Abdullah
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
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Antúnez-Conde R, Navarro Cuéllar C, Salmerón Escobar JI, Díez-Montiel A, Navarro Cuéllar I, Dell’Aversana Orabona G, del Castillo Pardo de Vera JL, Navarro Vila C, Cebrián Carretero JL. Intraosseous Venous Malformation of the Zygomatic Bone: Comparison between Virtual Surgical Planning and Standard Surgery with Review of the Literature. J Clin Med 2021; 10:jcm10194565. [PMID: 34640581 PMCID: PMC8509390 DOI: 10.3390/jcm10194565] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/22/2021] [Accepted: 09/22/2021] [Indexed: 01/02/2023] Open
Abstract
Intraosseous venous malformations affecting the zygomatic bone are infrequent. Primary reconstruction is usually accomplished with calvarial grafts, although the use of virtual surgical planning, cutting guides and patient-specific implants (PSI) have had a major development in recent years. A retrospective study was designed and implemented in patients diagnosed with intraosseous venous malformation during 2006–2021, and a review of the scientific literature was also performed to clarify diagnostic terms. Eight patients were treated, differentiating two groups according to the technique: four patients were treated through standard surgery with resection and primary reconstruction of the defect with calvarial graft, and four patients underwent resection and primary reconstruction through virtual surgical planning (VSP), cutting guides, STL models developed with CAD-CAM technology and PSI (titanium or Polyether-ether-ketone). In the group treated with standard surgery, 75% of the patients developed sequelae or morbidity associated with this technique. The operation time ranged from 175 min to 210 min (average 188.7 min), the length of hospital ranged from 4 days to 6 days (average 4.75 days) and the postoperative CT scan showed a defect surface coverage of 79.75%. The aesthetic results were “excellent” in 25% of the patients, “good” in 50% and “poor” in 25%. In the VSP group, 25% presented sequelae associated with surgical treatment. The operation time ranged from 99 min to 143 min (average 121 min), the length of hospital stay ranged from 1 to 2 days (average of 1.75 days) and 75% of the patients reported “excellent” results. Postoperative CT scan showed 100% coverage of the defect surface in the VSP group. The multi-stage implementation of virtual surgical planning with cutting guides, STL models and patient-specific implants increases the reconstructive accuracy in the treatment of patients diagnosed with intraosseous venous malformation of the zygomatic bone, reducing sequelae, operation time and average hospital stay, providing a better cover of the defect, and improving the precision of the reconstruction and the aesthetic results compared to standard technique.
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Affiliation(s)
- Raúl Antúnez-Conde
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain; (R.A.-C.); (J.I.S.E.); (A.D.-M.); (I.N.C.); (C.N.V.)
| | - Carlos Navarro Cuéllar
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain; (R.A.-C.); (J.I.S.E.); (A.D.-M.); (I.N.C.); (C.N.V.)
- Correspondence:
| | - José Ignacio Salmerón Escobar
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain; (R.A.-C.); (J.I.S.E.); (A.D.-M.); (I.N.C.); (C.N.V.)
| | - Alberto Díez-Montiel
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain; (R.A.-C.); (J.I.S.E.); (A.D.-M.); (I.N.C.); (C.N.V.)
| | - Ignacio Navarro Cuéllar
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain; (R.A.-C.); (J.I.S.E.); (A.D.-M.); (I.N.C.); (C.N.V.)
| | | | | | - Carlos Navarro Vila
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain; (R.A.-C.); (J.I.S.E.); (A.D.-M.); (I.N.C.); (C.N.V.)
| | - José Luis Cebrián Carretero
- Maxilofacial Surgery Department, Hospital Universitario La Paz, 28046 Madrid, Spain; (J.L.d.C.P.d.V.); (J.L.C.C.)
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11
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Intraosseous Venous Malformation of the Zygomatic Bone: Virtual Surgical Planning and Reconstruction With Customized CAD-CAM Titanium Implant. J Craniofac Surg 2021; 32:e757-e759. [PMID: 34191769 DOI: 10.1097/scs.0000000000007751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
ABSTRACT Zygomatic intraosseous vascular anomalies are uncommon. Most cases have been reported without a precise diagnosis. The prevalence is 3:1 women during the fourth decade of life. The study of these lesions includes clinical findings, radiological studies, such as computed tomography and magnetic resonance imaging scans, and a postoperative histological study of the specimen. Biopsy is not recommended because of the risk of bleeding. Complete surgical resection remains the gold standard elective treatment.The case of a patient with an intraosseous venous malformation of the zygomatic bone is presented, detailing the clinical, histological, and radiological characteristics and the surgical treatment with a primary reconstruction through Computer-Aided Design/Computer-Aided Manufacturing customized titanium implant guided by virtual surgical planning with a reduction of surgical time and morbidity in the donor area with optimal functional and aesthetic results.
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12
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Salemi F, Foroozandeh M, Mirzaee M, Farhadian M, Makateb P, Mostafapour M. Appearance of Mandibular Para-radicular Third Molar Radiolucencies on Cone-Beam Computed Tomography. Contemp Clin Dent 2021; 12:128-132. [PMID: 34220151 PMCID: PMC8237813 DOI: 10.4103/ccd.ccd_156_20] [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: 04/05/2020] [Revised: 06/07/2020] [Accepted: 07/02/2020] [Indexed: 11/30/2022] Open
Abstract
Aims: Mandibular para-radicular third molar radiolucencies (MPRs) may be mistaken for pathological lesions, leading to misdiagnosis and mistreatment. This study sought to assess the appearance of MPRs on cone-beam computed tomography (CBCT). Settings and Design: This was a descriptive, cross-sectional study. Materials and Methods: This study evaluated 770 CBCT of patients presenting to the dental school of Hamadan University of Medical Sciences. Demographic information, unilateral or bilateral presence, shape and prevalence of MPRs observed on axial and sagittal sections, their density, thinning of cortical margin, internal trabeculation, bony expansion, and mean height and width of MPRs were all evaluated. Statistical Analysis Used: Data were analyzed using SPSS version 22.0 and descriptive statistics. Chi-square test was used. Results: Seventy (9.1%) patients had a total of 82 MPRs, including 51 (72.86%) females. The prevalence of MPRs in females was more than males (P = 0.011). The majority of MPRs were unilateral 58 (70.73%), mostly round in shape 48 (58.54%), and were mostly associated with third molars with distoangular impaction 47 (57.31%); this difference was statistically significant (P < 0.001). Furthermore, in 47 (57.32%) patients, MPRs had less density than the surrounding bone. MPRs were not associated with expansion or root resorption in any patient. Conclusion: Differentiation of MPRs from the pathological lesions is important to make a decision about further imaging or referral for surgical treatment. MPRs are often considered normal since they do not cause root resorption or bone expansion and do not affect the lamina dura. MPRs are more commonly found adjacent to third molars with distoangular impaction.
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Affiliation(s)
- Fatemeh Salemi
- Department of Oral and Maxillofacial Radiology, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Foroozandeh
- Department of Oral and Maxillofacial Radiology, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Mirzaee
- Department of Oral and Maxillofacial Radiology, Dental School, Guilan University of Medical Sciences, Rasht, Iran
| | - Maryam Farhadian
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Paria Makateb
- Department of Oral and Maxillofacial Radiology, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Marjan Mostafapour
- Department of Oral and Maxillofacial Radiology, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
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Alamri A, Pauchet D, Balaton A, Oriez C, Dupuy O, Ben Hamou A. Severe Graves' disease-associated orbitopathy: A rare case of frontal bone hemangioma. Clin Case Rep 2021; 9:787-789. [PMID: 33598245 PMCID: PMC7869314 DOI: 10.1002/ccr3.3638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/10/2020] [Accepted: 11/23/2020] [Indexed: 11/09/2022] Open
Abstract
Graves' orbitopathy might be severe, requiring treatment with high-dose glucocorticoids. A lytic bone lesion, malignant lesions, and diseases resulting from bone remodeling processes (eg, Paget's disease) must be excluded by markers and imagery. Outcomes of high-dose glucocorticoids and thyrotoxicosis must be screened and prevented.
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Affiliation(s)
- Ahmad Alamri
- Paris Saint Joseph Hospital GroupParisFrance
- Diabetology, Endocrinology and NutritionParisFrance
| | - Daphné Pauchet
- Paris Saint Joseph Hospital GroupParisFrance
- Diabetology, Endocrinology and NutritionParisFrance
| | - André Balaton
- Paris Saint Joseph Hospital GroupParisFrance
- Diabetology, Endocrinology and NutritionParisFrance
| | - Constance Oriez
- Paris Saint Joseph Hospital GroupParisFrance
- Diabetology, Endocrinology and NutritionParisFrance
| | - Olivier Dupuy
- Paris Saint Joseph Hospital GroupParisFrance
- Diabetology, Endocrinology and NutritionParisFrance
| | - Adrien Ben Hamou
- Paris Saint Joseph Hospital GroupParisFrance
- Diabetology, Endocrinology and NutritionParisFrance
- Thyroid Unit, American Hospital of ParisNeuilly‐sur‐SeineFrance
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Kim HS, Kim WS, Kim HK, Bae TH. Removal of intraosseous hemangioma in frontal bone under direct vision through a small incision. Arch Craniofac Surg 2021; 22:52-55. [PMID: 33714253 PMCID: PMC7968979 DOI: 10.7181/acfs.2020.00661] [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: 11/17/2020] [Revised: 01/03/2021] [Accepted: 02/05/2021] [Indexed: 11/11/2022] Open
Abstract
Complete surgical excision within a margin of normal healthy bone is the treatment of choice for intraosseous hemangioma. A 56-year-old man visited with complaints of a firm, mildly tender, immovable, and palpable mass on the right forehead (size: 1.5× 1.5 cm). Non-contrast brain computed tomography performed preoperatively revealed a 1.5 cm heterogenous osteolytic lesion with suspected internal trabeculation in the right frontal bone. Under general anesthesia, a 2 cm transverse incision was made on the forehead skin rather than bicoronal incision. Full-thickness en bloc resection of the frontal bone including the mass was performed. The frontal bone was removed with care taken not to damage the frontal sinus mucosa. The frontal sinus was sealed with a collagen patch (Tachocomb) and a cranioplasty was performed using bone cement. At 6 months postoperative, a clean wound was confirmed without any complications, and there was no local recurrence. Surgical excision of intraosseous hemangioma in the frontal sinus bone can be performed via direct incision or the bicoronal approach. In this case, the direct incision approach was used to achieve smaller scars and faster recovery than the bicoronal approach.
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Affiliation(s)
- Hyeon Seok Kim
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, Seoul, Korea
| | - Woo Seob Kim
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, Seoul, Korea
| | - Han Koo Kim
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, Seoul, Korea
| | - Tae Hui Bae
- Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, Seoul, Korea
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15
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Intraosseous Hemangioma of Nasal Bone: Unusual Cause of Epiphora. J Craniofac Surg 2021; 31:e722-e723. [PMID: 32604276 DOI: 10.1097/scs.0000000000006710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Intraosseous hemangioma is very rare, accounting for <1% of bone tumors. Nasal bone origin of it is even rarer. A 63-year-old female patient visited our clinic with a complaint of epiphora. On physical examination, about 2-cm-sized nontender and fixed mass was palpated along the left nasomaxillary suture area. Preoperative magnetic resonance imaging findings were consistent with intraosseous hemangioma originating from the nasal bone. Epiphora was thought to be developed due to the mass effect and a marginal resection of the mass was performed. The defect was reconstructed with a septal cartilage and porous polyethylene implant (Synpor). Postoperatively, epiphora subsided and there has been no sign of recurrence or facial deformity during 6 months of follow-up.
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Madiraju GS. Pediatric intraosseous hemangioma of the anterior mandible. Oral Oncol 2020; 108:104951. [PMID: 32792210 DOI: 10.1016/j.oraloncology.2020.104951] [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: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 10/23/2022]
Abstract
Intraosseous hemangioma is a benign vascular neoplasm and seldom affects the mandible. The diagnosis is challenging owing to its unspecific clinical and radiographic findings. Treatment options in children should be elective based on their age, symptoms, and facial deformity. Herein a rare case of intraosseous hemangioma of the mandible in a 14-year-old female is presented.
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Affiliation(s)
- Guna Shekhar Madiraju
- Faculty of Pediatric Dentistry, Department of Preventive Dental Sciences, King Faisal University, Al Ahsa, Saudi Arabia.
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17
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Temerek AT, Ali S, Shehab MF. Computer guided resection and reconstruction of intra-osseous zygomatic hemangioma: Case report and systematic review of literature. Int J Surg Case Rep 2019; 66:240-256. [PMID: 31874384 PMCID: PMC6931065 DOI: 10.1016/j.ijscr.2019.12.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 11/30/2019] [Accepted: 12/10/2019] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVES to systemically integrate the available data on various published treatment strategies for intraosseous hemangioma of the zygoma in an updated comprehensive systematic review, and to present a new case of treated resection and immediate reconstruction using computer guided patient specific composite graft. CASE PRESENTATION A 29 years old female patient with intraosseos zygomatic hemangioma treated using computer guided resection and immediate reconstruction. The resection was performed using a resection template constructed based on preoperative 3D planning. The reconstruction was performed using ramus bone graft and titanium mesh. The patient was followed up for 3 years with no complications. METHODS An electronic search was performed on 3 data bases; additional hand search of bibliographies of selected articles was performed. Eligibility criteria include human studies presenting intraosseous zygomatico-orbital hemangioma with clearly reported therapeutic strategies. RESULTS 53 articles with 73 cases were included. The lesion was highly prevalent in females compared to males (2.28:1). Fifth decade represents the highest prevalence with mean age of 44.1 ± 1.8 years. The main patient concern was swelling and facial deformity. Total tumor resection can assure no recurrence, while partial resection and curettage are associated with high recurrence rate.
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Affiliation(s)
- Ahmed Talaat Temerek
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, South Valley University, Qena, Egypt.
| | - Sherif Ali
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.
| | - Mohamed Farid Shehab
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.
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18
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Sáenz AA, Porto NF, Sánchez MP. Intraosseous cavernous hemangioma: presentation of a clinical case. EGYPTIAN JOURNAL OF NEUROSURGERY 2018. [DOI: 10.1186/s41984-018-0018-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Seo BF, Kang KJ, Jung SN, Byeon JH. Skeletal cavernous hemangiomas of the frontal bone with orbital roof and rim involvement. Arch Craniofac Surg 2018; 19:214-217. [PMID: 30282433 PMCID: PMC6177681 DOI: 10.7181/acfs.2018.01921] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 08/27/2018] [Indexed: 11/11/2022] Open
Abstract
Skeletal cavernous hemangiomas are rare, benign tumors that may involve the supraorbital rim and orbital roof. However, such involvement is extremely rare. We report a case of skeletal cavernous hemangioma of the frontal bone involving the orbital roof and rim. En bloc excision and reconstruction, using a calvarial bone graft for the orbital roof and rim defect, was performed. It is important not only to perform total excision of skeletal cavernous hemangiomas, but to properly reconstruct the defects after the total excision since several complications can arise from an orbital roof and rim defect.
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Affiliation(s)
- Bommie Florence Seo
- Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Kyo Joon Kang
- Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Sung-No Jung
- Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Jun Hee Byeon
- Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
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An Algorithm for Managing Intraosseous Vascular Anomalies of the Craniofacial Skeleton. J Craniofac Surg 2018; 29:622-627. [PMID: 29068964 DOI: 10.1097/scs.0000000000004014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Intraosseous vascular anomalies (IOVA) are rare in the craniofacial skeleton and present a diagnostic and therapeutic challenge. This study aims to describe the clinical management based on a large case series. METHODS A retrospective chart review was performed and 9 IOVA were identified over a 15-year period. Data on demographics, diagnostic features, clinical management, and outcomes were reviewed. RESULTS Five frontal bone IOVA and 4 orbital IOVA were identified. The postoperative follow-up ranged from 4 months to 4 years. All 9 lesions were diagnosed with computed tomography (CT) imaging. Magnetic resonance imaging (MRI) was used to delineate soft tissue involvement in 2 patients presenting with oculo-orbital dystopia and ophthalmoplegia. En bloc excision was performed in all patients. Preoperative interventional embolization was critical in the successful resection of an orbital IOVA following 2 previously failed attempts that were aborted secondary to hemorrhage. Intraoperative 3-dimensional stereotactic navigation was used for the accurate en bloc excision of a frontal IOVA to prevent injury to the frontal sinus. Reconstruction of esthetic and functional deformities was successfully accomplished. CONCLUSION The diagnosis of IOVA relies primarily on clinical assessment and CT imaging. Further interpretation of the involvement of periorbital, facial, and intracranial soft tissue is best defined by MRI. Multidisciplinary care with interventional radiology and neurosurgery must be considered for ensuring the safe and adequate en bloc excision of craniofacial IOVA.
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21
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Fábián Z, Szabó G, Petrovan C, Horváth KU, Babicsák B, Hüttl K, Németh Z, Bogdán S. Intraosseous venous malformation of the zygomatico-orbital complex. Case report and literature review with focus on confusions in vascular lesion terms. Oral Maxillofac Surg 2018; 22:241-247. [PMID: 29651653 DOI: 10.1007/s10006-018-0691-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 03/27/2018] [Indexed: 11/30/2022]
Abstract
Intraosseous vascular malformations (VascM) of the facial skeleton are rare entities, raising difficulties even today in their treatment. We present a case for zygomatic intraosseous venous malformation of traumatic etiology with growth dynamics presentation and a multidisciplinary treatment approach, with intravascular embolization surgical ablation and primary reconstructruction using a titanium patient-specific implant (PSI), and a review of the literature for intraosseous vascular lesions of the facial skeleton focusing on the diagnostic syntagms used by the involved medical personnel, to shed light on the confusions over these terms.
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Affiliation(s)
- Zoltán Fábián
- University of Medicine and Pharmacy, Târgu Mureș, Romania
| | - György Szabó
- Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária st. 52, Budapest, 1085, Hungary
| | - Cecilia Petrovan
- Department of Oral and Maxillofacial Surgery, County Clinical Emergency Hospital, 1 decembrie 1918 Blvd. 26-28, 540011, Târgu Mureș, Romania
| | - Karin Ursula Horváth
- Department of Ophthalmology, Mureș County Clinical Hospital, Márton Áron st. 26, 540058, Târgu Mureș, Romania
| | - Botond Babicsák
- Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária st. 52, Budapest, 1085, Hungary
| | - Kálmán Hüttl
- Heart and Vascular Center, Semmelweis University, Városmajor st. 68, Budapest, 1122, Hungary
| | - Zsolt Németh
- Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária st. 52, Budapest, 1085, Hungary
| | - Sándor Bogdán
- Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária st. 52, Budapest, 1085, Hungary.
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Brandner JS, Rawal YB, Kim LJ, Dillon JK. Intraosseous Hemangioma of the Frontal Bone. Report of a Case and Review of the Literature. J Oral Maxillofac Surg 2018; 76:799-805. [DOI: 10.1016/j.joms.2017.09.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 09/17/2017] [Accepted: 09/18/2017] [Indexed: 10/18/2022]
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23
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Choi JS, Bae YC, Kang GB, Choi KU. Intraosseous hemangioma of the orbit. Arch Craniofac Surg 2018; 19:68-71. [PMID: 29609437 PMCID: PMC5894550 DOI: 10.7181/acfs.2018.19.1.68] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 03/01/2018] [Accepted: 03/09/2018] [Indexed: 11/11/2022] Open
Abstract
Intraosseous hemangioma is an extremely rare tumor that accounts for 1% or fewer of all osseous tumors. The most common sites of its occurrence are the vertebral column and calvaria. Occurrence in a facial bone is very rare. The authors aim to report a case of the surgical treatment of intraosseous hemangioma occurring in the periorbital region, which is a very rare site of occurrence and to introduce our own experiences with the diagnosis and treatment of this condition along with a literature review. A 73-year-old male patient visited our hospital with the chief complaint of a mass touching the left orbital rim. A biopsy was performed by applying a direct incision after local anesthesia. Eventually, intraosseous hemangioma was diagnosed histologically. To fully resect the mass, the orbital floor and zygoma were exposed through a subciliary incision under general anesthesia, and then the tumor was completely eliminated. Bony defect was reconstructed by performing a seventh rib bone graft. Follow-up observation has so far been conducted for 10 months after surgery without recurrence or symptoms.
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Affiliation(s)
- June Seok Choi
- Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea
| | - Yong Chan Bae
- Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Gyu Bin Kang
- Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea
| | - Kyung-Un Choi
- Department of Pathology, Pusan National University School of Medicine, Busan, Korea
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Chandra SR, Chen E, Cousin T, Oda D. A case series of intraosseous hemangioma of the jaws: Various presentations of a rare entity. J Clin Exp Dent 2018; 9:e1366-e1370. [PMID: 29302291 PMCID: PMC5741852 DOI: 10.4317/jced.54285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 10/09/2017] [Indexed: 11/05/2022] Open
Abstract
Background Hemangiomas of the soft tissue are common in the head and neck area, especially in the tongue and in children under ten years of age. Intraosseous hemangiomas of the mandible and maxilla (IHM), on the other hand, are exceedingly rare and are not well characterized. This study presents six IHM cases focusing on the clinical, radiographic, and histologic characteristics. Material and Methods Six cases of IHM were retrieved from the archives of the Biopsy Services at the University of Washington. Clinical, radiologic, and histologic findings are described. Results A total of six cases of IHM were reviewed. The patient age range was 16 to 65; the group comprised three females and three males. All six cases presented as swellings, two caused tooth resorption, and one was associated with pain and numbness. Three of the six IHM were present in the body of the mandible, two in the area of the extracted right mandibular third molar, and one in the anterior maxilla between the right canine and lateral incisor. Radiographically, five were radiolucent and one was radiopaque. Of the five radiolucent, two were unilocular and three multilocular. The one radiopaque case was exophytic, simulating a large osteoma. Histologic features ranged from cavernous to a mix of venous and arterial types. Follow-up is available for all six cases ranging between one to seven years; only one case recurred within the first year post-surgery. Conclusions IHM are exceedingly rare; IHM do not present in a consistent manner both clinically and radiographically. It is therefore important to recognize the wide spectrum of IHM's clinical, radiographic, and histological presentations. Key words:Hemangioma, Vascular Malformation, mandible, maxilla.
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Affiliation(s)
- Srinivasa R Chandra
- MD, DDS, Clinical Assistant Professor, 1959 NE Pacific St, Department of Oral & Maxillofacial Surgery, University of Washington School of Dentistry, Seattle, Washington 98195-7133, USA
| | - Eleanor Chen
- MD, PhD, Assistant Professor, Department of Pathology, University of Washington Medical Center , 1959 NE Pacific St Box 357705
| | - Timothee Cousin
- DDS, Candidate, Class of 2017, 1959 NE Pacific St, Room D322, University of Washington School of Dentistry, Seattle, Washington 98195, USA
| | - Dolphine Oda
- BDS MSc, Professor, 1959 NE Pacific St, Department of Oral & Maxillofacial Surgery, University of Washington School of Dentistry, Seattle, Washington 98195-7133, USA
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25
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Bocchialini G, Castellani A, Bozzola A, Rossi A. A Hemangioma of the Zygomatic Bone: Management Ensuring Good Reconstructive and Aesthetic Results. Craniomaxillofac Trauma Reconstr 2017; 10:332-336. [PMID: 29109848 DOI: 10.1055/s-0036-1594274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 08/27/2016] [Indexed: 12/30/2022] Open
Abstract
Hemangiomas are benign tumors representing only 0.7 to 1% of all bone tumors; those that arise in the zygomatic region are rarely described in the literature. Here, we describe the case of a 55-year-old woman with a mass in the right orbitozygomatic region. She was diagnosed on the basis of preoperative clinical manifestations, data from an earlier histopathological examination, and computed tomography (CT). The CT scan revealed a lesion in the right zygomatic region at the level of the cancellous component. This caused thinning and remodeling of the deformed cortex both medially and laterally. Surgery was performed. We describe the clinical characteristics of our case with an emphasis on surgical management of the lesion using a titanium grid prepared by reference to a stereolithographic model.
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Affiliation(s)
- Gabriele Bocchialini
- Unit of Maxillo-Facial Surgery, Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Lombardia, Italy
| | - Andrea Castellani
- Unit of Maxillo-Facial Surgery, Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Lombardia, Italy
| | - Anna Bozzola
- Department of Molecular and Translational Medicine, Section of Pathology, University Spedali Civili of Brescia, Brescia, Italy
| | - Alessandro Rossi
- Unit of Maxillo-Facial Surgery, Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Lombardia, Italy
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Powers DB, Fisher E, Erdmann D. Zygomatic Intraosseous Hemangioma: Case Report and Literature Review. Craniomaxillofac Trauma Reconstr 2016; 10:1-10. [PMID: 28210401 DOI: 10.1055/s-0036-1592087] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 04/10/2016] [Indexed: 10/20/2022] Open
Abstract
Intraosseous hemangiomas are uncommon intrabony lesions, representing approximately 0.5 to 1% of all intraosseous tumors. Their description varies from "benign vasoformative neoplasms" to true hamartomatous proliferations of endothelial cells forming a vascular network with intermixed fibrous connective tissue stroma. These commonly present as a firm, painless swelling. Intraosseous hemangiomas present more commonly in females than in males and most likely occur in the fourth decade of life. The most common etiology of intraosseous hemangioma is believed to be prior trauma to the area. They have a tendency to bleed briskly upon removal or biopsy, making preoperative detection of the vascular nature of the lesion of significant importance. There are four variants: (1) capillary type, (2) cavernous type, (3) mixed variant, and (4) scirrhous type. Generally most common in the vertebral skeleton, they can also present in the calvarium and facial bones. In the head, the most common site is the parietal bone, followed by the mandible, and then malar and zygomatic regions. Intraosseous hemangiomas of the zygoma are rare entities with the first case reported in 1950 by Schoenfield. In this article, we review 49 case reports of intraosseous hemangioma of the zygoma, and also present a new case treated with excision followed by polyether-ether ketone implant placement for primary reconstruction.
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Affiliation(s)
- David B Powers
- Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Elda Fisher
- Department of Oral and Maxillofacial Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Detlev Erdmann
- Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
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27
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Correction of Facial Deformity in Sturge-Weber Syndrome. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 4:e843. [PMID: 27622111 PMCID: PMC5010334 DOI: 10.1097/gox.0000000000000843] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 04/29/2016] [Indexed: 01/06/2023]
Abstract
Background: Although previous studies have reported soft-tissue management in surgical treatment of Sturge–Weber syndrome (SWS), there are few reports describing facial bone surgery in this patient group. The purpose of this study is to examine the validity of our multidisciplinary algorithm for correcting facial deformities associated with SWS. To the best of our knowledge, this is the first study on orthognathic surgery for SWS patients. Methods: A retrospective chart review included 2 SWS patients who completed the surgical treatment algorithm. Radiographic and clinical data were recorded, and a treatment algorithm was derived. Results: According to the Roach classification, the first patient was classified as type I presenting with both facial and leptomeningeal vascular anomalies without glaucoma and the second patient as type II presenting only with a hemifacial capillary malformation. Considering positive findings in seizure history and intracranial vascular anomalies in the first case, the anesthetic management was modified to omit hypotensive anesthesia because of the potential risk of intracranial pressure elevation. Primarily, both patients underwent 2-jaw orthognathic surgery and facial bone contouring including genioplasty, zygomatic reduction, buccal fat pad removal, and masseter reduction without major complications. In the second step, the volume and distribution of facial soft tissues were altered by surgical resection and reposition. Both patients were satisfied with the surgical result. Conclusions: Our multidisciplinary algorithm can systematically detect potential risk factors. Correction of the asymmetric face by successive bone and soft-tissue surgery enables the patients to reduce their psychosocial burden and increase their quality of life.
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28
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Dhiman NK, Jaiswara C, Kumar N, Patne SCU, Pandey A, Verma V. Central cavernous hemangioma of mandible: Case report and review of literature. Natl J Maxillofac Surg 2016; 6:209-13. [PMID: 27390499 PMCID: PMC4922235 DOI: 10.4103/0975-5950.183866] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Intraosseous hemangiomas are one of the rarest lesion of jaw bones (0.5-1%) occurring most commonly in vertebral column, skull bone, and rarely in mandible. Mainly occurs in the second decade of life with female: male predilection (2:1). Origin of hemangiomas is still debatable. World Health Organization considers it as a true benign neoplasm of vascular origin, and many authors believe it to be a hamartoma. It is very difficult to diagnose due to variable clinical and radiological features. A biopsy is not done on a routine basis due to a higher risk of hemorrhage. Management is very difficult because of massive vascular network in that region. Here, we are presenting a case report of a 14-year-old boy with intraosseous hemangioma of right body of mandible, which was treated with en bloc surgical resection of mandible and followed by reconstruction.
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Affiliation(s)
- Neeraj Kumar Dhiman
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Chandresh Jaiswara
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Naresh Kumar
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Shashikant C U Patne
- Department of Pathology, Faculty of Modern Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Arun Pandey
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Vishal Verma
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Tanio S, Okamoto A, Majbauddin A, Sonoda M, Kodani I, Doi R, Ryoke K. Intravascular papillary endothelial hyperplasia associated with hemangioma of the mandible: A rare case report. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY MEDICINE AND PATHOLOGY 2016. [DOI: 10.1016/j.ajoms.2015.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Virtual Resection and Subsequent Design of a Patient-Specific Alloplastic Implant in the Preoperative Planning and Surgical Treatment of a Venous Malformation of the Zygoma. J Craniofac Surg 2015; 26:e641-3. [PMID: 26468850 DOI: 10.1097/scs.0000000000002042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
The authors present here the case of a 63-year-old female who developed a venous malformation of the left zygoma. These lesions are typically managed with nonoperative treatment, until or unless overt complicating symptoms require more aggressive surgical intervention. Reconstruction of the zygoma represents a challenge for the operating surgeon, considering its complex three-dimensional anatomy. Traditionally, the surgeon would estimate the appropriate margins of resection intraoperatively, and then design a construct to fit the defect using autologous bone grafts, allografts, or one of the various available alloplastic materials; however, for this patient preoperative virtual surgical planning was used. Using reconstructed three-dimensional images from the patient's maxillofacial computed tomography scan, the margins of the excision were virtually defined and the lesion "excised" during a preoperative planning session based on the specifications of the reconstructive surgeon. This process then allowed the design and production of custom osteotomy guides, and a patient-specific polyetheretherketone (PEEK) implant to match the resulting defect. The authors believe this methodology allows for a more efficient and precise overall procedural experience and reconstructive result, and has innumerable potential applications in the surgical treatment of craniofacial abnormality.
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Abstract
Intraosseous hemangioma is a benign vascular neoplasm, which is mostly seen in vertebrae, maxillofacial bones, and long bones. Intraosseous hemangioma is rarely seen on jaw bones compared to other skeletal bones and usually occurs in the cavernous form. Capillary intraosseous hemangioma of jaws is an uncommon form of intraosseous hemangioma and has not been thoroughly described so far. In this study, a case of capillary intraosseous hemangioma of the mandible was presented with relevant literature review.
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Affiliation(s)
- Omur Dereci
- Department of Oral and Maxillofacial Surgery, Eskişehir Osmangazi University, Eskişehir, Turkiye
| | | | - Sinan Ay
- Department of Oral and Maxillofacial Surgery, Eskişehir Osmangazi University, Eskişehir, Turkiye
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Theologie-Lygidakis N, Schoinohoriti O, Tzermpos F, Christopoulos P, Iatrou I. Management of Intraosseous Vascular Malformations of the Jaws in Children and Adolescents: Report of 6 Cases and Literature Review. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2015; 6:e5. [PMID: 26229584 PMCID: PMC4516857 DOI: 10.5037/jomr.2015.6205] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 02/06/2015] [Indexed: 11/16/2022]
Abstract
Background Intraosseous vascular malformations represent a rare clinical entity of the facial skeleton. The purpose of the current study was to present our experience in a Greek paediatric population and propose guidelines for the treatment of these jaws anomalies in children and adolescents. Methods A retrospective study (from 2009 to 2014) was performed to investigate the features and management of the intraosseous vascular anomalies in a Greek paediatric population. Results Six patients aged between 6 and 14 years were treated for intraosseous vascular malformations (4 venous and 2 arteriovenous) of the jaws. Five lesions were located in the mandible and one in the maxilla. In four lesions with pronounced vascularity superselective angiography, followed by embolization was performed. Individualized surgical treatment, depending on the size and vascularity of the lesions was applied in 4 patients. Conclusions The intraosseous vascular malformations of the jaws may escape diagnosis in paediatric patients. A multidisciplinary approach is important for their safe and efficient treatment. Embolization is recommended for extended high-flow lesions, either preoperatively or as a first-line treatment, when surgery is not feasible without significant morbidity.
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Affiliation(s)
- Nadia Theologie-Lygidakis
- Department of Oral and Maxillofacial Surgery, "P. & A. Kyriakou" Children's Hospital, University of Athens Greece
| | - Ourania Schoinohoriti
- Department of Oral and Maxillofacial Surgery, "P. & A. Kyriakou" Children's Hospital, University of Athens Greece
| | - Fotios Tzermpos
- Department of Oral and Maxillofacial Surgery, "P. & A. Kyriakou" Children's Hospital, University of Athens Greece
| | - Panos Christopoulos
- Department of Oral and Maxillofacial Surgery, "P. & A. Kyriakou" Children's Hospital, University of Athens Greece
| | - Ioannis Iatrou
- Department of Oral and Maxillofacial Surgery, "P. & A. Kyriakou" Children's Hospital, University of Athens Greece
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Abstract
A 59-year-old man presented with a slowly enlarging mass in the lateral orbital rim of the left eye for 1 year. He also reported a history of crania defect in the left front bone (6 years earlier) which was confirmed on the former computed tomographic (CT) scan. On examination, the solid mass lesion located in the left frontal extends to the lateral orbital rim of the left eye. CT scan showed a mass with poorly defined margins, which invaded the neighboring tissue and nearly damaged the bone, and located on the exact site of the preceding crania defect. Complete resection was performed, and the clinical diagnosis of cavernous hemangioma was confirmed on histopathologic examination. Skull cavernous hemangiomas are rare tumors for which the origin is not yet clear. We report a case in which the intraosseous hemangiomas developed at the same site of the preceding crania defect.
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Matsumiya T, Nemoto H, Kasai Y, Maruyama N, Sumiya N. Intraosseous venous malformation of the zygoma: A case report and literature review. Int J Surg Case Rep 2015; 12:132-6. [PMID: 26072005 PMCID: PMC4485688 DOI: 10.1016/j.ijscr.2015.04.032] [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] [Received: 02/18/2015] [Revised: 03/20/2015] [Accepted: 04/26/2015] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Venous malformations of the zygoma are rare. Historically, venous malformations have been misrepresented as "hemangiomas". The International Society for the Study of Vascular Anomaly (ISSVA) classification is a reasonable classification that leads to appropriate clinical diagnosis and treatment strategies. Collaboration between surgeons, radiologists, and pathologists is necessary for accurate diagnosis and management. PRESENTATION OF CASE We present here a case of an IOVM in a 59-year-old woman who was treated with a multidisciplinary approach. Superselective arteriography and embolization were effective for diagnosis as well as for prevention of large hemorrhage during surgery. En-bloc resection of the zygoma was performed within hours after embolization and autologous calvarial bone graft was used for primary reconstruction. DISCUSSION We performed a literature review consisting of reviewing 52 cases of IOVM of the zygoma discussing optimal material for reconstruction of the defect for intraosseous venous malformation of the zygoma nationally and internationally. CONCLUSION The combination of surgery and preoperative angiography makes it possible to prevent high risk of hemorrhage. For primary reconstruction of the zygoma, use of autologous calvarial bone can maintain the volume and reconstruct the natural malar contour.
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Affiliation(s)
- Toshie Matsumiya
- Department of Plastic and Reconstructive Surgery of Fujigaoka Hospital of Showa University, 1-30 Fujigaoka, Aobaku, Yokohamashi, Kanagawa 227-8501, Japan.
| | - Hitoshi Nemoto
- Department of Plastic and Reconstructive Surgery of Fujigaoka Hospital of Showa University, 1-30 Fujigaoka, Aobaku, Yokohamashi, Kanagawa 227-8501, Japan
| | - Yoshiaki Kasai
- Department of Plastic and Reconstructive Surgery of Fujigaoka Hospital of Showa University, 1-30 Fujigaoka, Aobaku, Yokohamashi, Kanagawa 227-8501, Japan
| | - Naoki Maruyama
- Department of Plastic and Reconstructive Surgery of Fujigaoka Hospital of Showa University, 1-30 Fujigaoka, Aobaku, Yokohamashi, Kanagawa 227-8501, Japan
| | - Noriyoshi Sumiya
- Department of Plastic and Reconstructive Surgery of Fujigaoka Hospital of Showa University, 1-30 Fujigaoka, Aobaku, Yokohamashi, Kanagawa 227-8501, Japan
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V P, Puppala N, Deshmukh SN, B J, S A. Cavernous hemangioma of tongue: management of two cases. J Clin Diagn Res 2014; 8:ZD15-7. [PMID: 25478463 DOI: 10.7860/jcdr/2014/10216.5005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 08/27/2014] [Indexed: 11/24/2022]
Abstract
Hemangiomas are benign tumours of infancy and childhood, most commonly located in the head and neck region and occur more frequently in the lips, tongue and palate. The treatment depends upon lesion location, size and evolution stage and the patient's age. This paper describes the management of cavernous hemangioma in a 2 -year -old child and 14 -year -old child using different approaches.
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Affiliation(s)
- Pranitha V
- Professor, Department of Pediatric Dentistry, Mamata Dental College , Khammam, Telangana, India
| | - Niharika Puppala
- Senior Lecturer, Department of Pediatric Dentistry, Mamata Dental College , Khammam, Telangana, India
| | - Sudhanwa N Deshmukh
- Senior Lecturer, Department of Pediatric Dentistry, Sharad Pawar Dental College , Wardha, Maharashtra, India
| | - Jagadesh B
- Post Graduate Student, Department of Pediatric Dentistry, Mamata Dental College , Khammam, Telangana, India
| | - Anuradha S
- Post Graduate Student, Department of Pediatric Dentistry, Mamata Dental College , Khammam, Telangana, India
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Werdich XQ, Jakobiec FA, Curtin HD, Fay A. A clinical, radiologic, and immunopathologic study of five periorbital intraosseous cavernous vascular malformations. Am J Ophthalmol 2014; 158:816-826.e1. [PMID: 25034115 DOI: 10.1016/j.ajo.2014.07.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 07/01/2014] [Accepted: 07/03/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE To correlate the clinical, radiographic, histopathologic, and immunohistochemical features of 5 primary periorbital intraosseous cavernous vascular malformations. DESIGN Retrospective interventional case series. METHODS Clinical and operative records and radiographic images were reviewed. Histopathologic slides were evaluated with hematoxylin-eosin, trichrome, and elastin stains. Immunohistochemical studies were performed with a spectrum of monoclonal antibodies directed at antigens of vascular cells. RESULTS Three men and 2 women ranged in age from 36 to 64 years. Vision was unaffected and there was no proptosis or globe displacement. The slow-growing lesions measured 13-25 mm in greatest diameter (mean 16.4 mm). Computed tomographic studies revealed that 2 lesions were situated in the maxillary bone, 2 in the frontal, and 1 in the zygoma, all anteriorly and with circumscribed, lucent, honeycombed, or sunburst characteristics. Histopathologically the lesions were composed of cavernous or telangiectatic channels; 1 showed advanced fibrotic vascular involution. Immunohistochemistry demonstrated CD31/34 positivity for vascular endothelium and D2-40 negativity for lymphatic endothelium. A typically thin mural myofibroblastic cuff was smooth muscle actin positive, weakly calponin positive, and desmin negative. Glucose transporter-1 and Ki-67 were negative in the endothelium. CONCLUSIONS Intraosseous vascular lesions resemble orbital cavernous venous malformations (not true hemangiomas), except that their vascular walls are thinner owing to the constraints imposed by neighboring bone spicules, which limit the amount of interstitium from which mural myofibroblasts can be recruited. The bony trabeculae conferred the honeycomb or sunburst appearances observed radiographically. En bloc excision of these lesions was successful and avoided complications (mean follow-up, 46 months).
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Affiliation(s)
- Xiang Q Werdich
- David G. Cogan Laboratory of Ophthalmic Pathology, Boston, Massachusetts; Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Frederick A Jakobiec
- David G. Cogan Laboratory of Ophthalmic Pathology, Boston, Massachusetts; Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
| | - Hugh D Curtin
- Department of Radiology, Boston, Massachusetts; Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Aaron Fay
- Ophthalmic Plastic Surgery, Boston, Massachusetts; Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
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Hwang SW, Lee JH, Ryu JA, Choi JM, Lee SK, Kim HS, Kim TS, Kim TH, Lee HS, Bang SY. Diffuse Skeletal Hemangiomatosis Mimicking Sacroiliitis. JOURNAL OF RHEUMATIC DISEASES 2014. [DOI: 10.4078/jrd.2014.21.4.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Soon Woo Hwang
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Jung Hoon Lee
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Jeong Ah Ryu
- Department of Radiology, Hanyang University College of Medicine, Seoul, Korea
| | - Jong Min Choi
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Sang Ki Lee
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hyun Sung Kim
- Department of Pathology, Hanyang University College of Medicine, Seoul, Korea
| | - Tai-Seung Kim
- Department of Orthopedic Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Tae-Hwan Kim
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hye-Soon Lee
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - So-Young Bang
- Division of Rheumatology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
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Cranio-orbital primary intraosseous haemangioma. Eye (Lond) 2013; 27:1320-3. [PMID: 23989119 DOI: 10.1038/eye.2013.162] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 06/19/2013] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Primary intraosseous haemangioma (IOH) is a rare benign neoplasm presenting in the fourth and fifth decades of life. The spine and skull are the most commonly involved, orbital involvement is extremely rare. We describe six patients with cranio-orbital IOH, the largest case series to date. PATIENTS AND METHODS Retrospective review of six patients with histologically confirmed primary IOH involving the orbit. Clinical characteristics, imaging features, approach to management, and histopathological findings are described. RESULTS Five patients were male with a median age of 56. Pain and diplopia were the most common presenting features. A characteristic 'honeycomb' pattern on CT imaging was demonstrated in three of the cases. Complete surgical excision was performed in all cases with presurgical embolisation carried out in one case. In all the cases, histological studies identified cavernous vascular spaces within the bony tissue. These channels were lined by single layer of cytologically normal endothelial cells. DISCUSSION IOCH of the cranio-orbital region is rare; in the absence of typical imaging features, the differential diagnosis includes chondroma, chondrosarcoma, bony metastasis, and lymphoma. Surgical excision may be necessary to exclude more sinister pathology. Intraoperative haemorrhage can be severe and may be reduced by preoperative embolisation.
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Primary intraosseous hemangioma in the frontal bone. Arch Plast Surg 2013; 40:283-5. [PMID: 23730614 PMCID: PMC3665882 DOI: 10.5999/aps.2013.40.3.283] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 03/07/2013] [Accepted: 03/14/2013] [Indexed: 11/08/2022] Open
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Kalsi H, Scannell J. Unusual presentation of an intraosseous hemangioma of the maxilla and displaced canine. Int J Clin Pediatr Dent 2013; 6:124-6. [PMID: 25206206 PMCID: PMC4086593 DOI: 10.5005/jp-journals-10005-1203] [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] [Received: 03/14/2013] [Accepted: 06/25/2013] [Indexed: 11/23/2022] Open
Abstract
Intraosseous hemangiomas are benign vascular malformations which are extremely rare in the maxilla, but have been reported in the mandible, zygoma and orbital region. A 12 years old female presented to the oral and maxillofacial department with an ectopically positioned upper left canine in her zygomatic bone and buccal alveolar expansion between the upper left lateral incisor and upper left first premolar. This case shows the unusual presentation of an intraosseous hemangioma associated with an ectopically migrated upper left canine tooth. It is possible that this lesion caused migration of the tooth. The clinician should be aware of the possibility of this lesion for bony expansile lesions and the importance of radiographic examination in patients who present with delayed eruption of canine teeth. How to cite this article: Kalsi H, Scannell J. Unusual Presentation of an Intraosseous Hemangioma of the Maxilla and Displaced Canine. Int J Clin Pediatr Dent 2013;6(2):124-126.
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Affiliation(s)
- Harpreet Kalsi
- Department of Oral and Maxillofacial Surgery, Queen's Hospital United Kingdom, e-mail:
| | - Jolie Scannell
- Consultant, Department of Oral and Maxillofacial Surgery, Queen's Hospital, United Kingdom
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Haeren RHL, Dings J, Hoeberigs MC, Riedl RG, Rijkers K. Posttraumatic skull hemangioma: case report. J Neurosurg 2012; 117:1082-8. [PMID: 22998057 DOI: 10.3171/2012.8.jns112141] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Intraosseous cavernous hemangiomas of the skull are rare lesions for which the origin is unclear. The authors present a case in which there was a radiologically documented history of trauma preceding the development of a hemangioma in the frontal bone. In a review of the literature the authors found 83 cases of skull hemangiomas, and 43% of the lesions were located in the frontal bone. In 25% of these lesions, previous trauma was reported anamnestically. The present case and radiological findings related to it suggest a causal relationship between trauma and the development of intraosseous hemangioma.
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Affiliation(s)
- Roel H L Haeren
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands.
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Gonçalves FG, Rojas JPO, Hanagandi PB, Valente R, Torres CI, Chankwosky J, Delcardio-O'Donovan R. Case report: Periorbital intraosseous hemangiomas. Indian J Radiol Imaging 2012; 21:287-90. [PMID: 22223942 PMCID: PMC3249945 DOI: 10.4103/0971-3026.90691] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Hemangiomas are hamartomatous proliferation of vessels. Intraosseous hemangiomas of the facial bones are rare and most commonly involve the zygoma, maxilla, mandible, and the nasal bones. A “sunburst” pattern is a typical appearance on CT scan and MRI and therefore a biopsy is not always necessary. Surgery is usually performed in symptomatic cases. The authors describe five typical periorbital intraosseous hemangiomas with a brief review of literature.
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Marcinow AM, Provenzano MJ, Gurgel RK, Chang KE. Primary Intraosseous Cavernous hemangioma of the Zygoma: A Case Report and Literature Review. EAR, NOSE & THROAT JOURNAL 2012; 91:210, 212, 214-5. [DOI: 10.1177/014556131209100512] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Intraosseous hemangiomas are rare. We report the case of a 47-year-old man who presented with a gradually enlarging left zygomatic mass that had caused pain, deformity, and superficial soft-tissue swelling. Computed tomography revealed a well-circumscribed 2.0 × 2.5-cm mass with a ground-glass matrix in the left zygoma. Following surgical excision, the patient's symptoms resolved. Findings on pathologic examination of the excised tissue were consistent with an intraosseous cavernous hemangioma. We describe the features of this rare case, we discuss the pertinent radiologic features and pathophysiology of intraosseous hemangiomas, and we review the available literature.
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Affiliation(s)
- Anna M. Marcinow
- Department of Otolaryngology–Head and Neck Surgery The Ohio State University School of Medicine, Columbus
| | - Matthew J. Provenzano
- Division of Pediatric Otolaryngology–Head and Neck Surgery Cincinnati Children's Hospital Medical Center
| | - Richard K. Gurgel
- Department of Otolaryngology (Head and Neck Surgery), Stanford University Medical Center, Stanford, Calif
| | - Kristi E. Chang
- Department of Otolaryngology–Head and Neck Surgery, University of Iowa College of Medicine, Iowa City
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Kondylidou-Sidira A, Dietrich EM, Koloutsos G, Sakkas L, Antoniades K. Intraosseous vascular malformation of the mandibular condyle: presentation of a case and differential diagnosis. Oral Radiol 2012. [DOI: 10.1007/s11282-012-0090-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Zhu C, Zhu HG, Zhang ZY, Wang LZ, Zheng JW, Ye WM, He Y, Wang YA. Intraosseous Venous Malformations of the Facial Bone: A Retrospective Study in 11 Patients. Phlebology 2012; 28:257-63. [DOI: 10.1258/phleb.2011.011115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objectives: To investigate the clinical symptoms, computed tomography (CT) features and treatments of intraosseous venous malformations (IVM) that occur in the facial bone. Methods and Results: Eleven patients with facial IVM were treated with two surgical techniques, excision ( n = 4) or curettage ( n = 7). No recurrence was encountered at follow-up (45.8 ± 16.0 months). Postoperative deformities were left in two paediatric patients who were treated with excision. Conclusions: The diagnosis of IVM can be difficult and is mainly based on clinical symptoms and CT features. IVM should be differentiated from other lesions, including ameloblastoma, odontogenic cysts, osteosarcoma, aneurysmal bone cysts and arteriovenous malformations, among others. Conventional block biopsy should be replaced by fine needle aspiration cytology for further diagnosis. Curettage is a more appropriate method for IVM compared with excessive en-bloc osteotomy, while transosseous embolo-sclerotherapy may be a promising alternative method. Finally, the terminological confusion between ‘intraosseous haemangioma’ and ‘intraosseous venous malformation’ should be avoided according to the binary classification.
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Affiliation(s)
- C Zhu
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Research Institute of Stomatology and Shanghai Key Laboratory of Stomatology
| | - H G Zhu
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Research Institute of Stomatology and Shanghai Key Laboratory of Stomatology
| | - Z Y Zhang
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Research Institute of Stomatology and Shanghai Key Laboratory of Stomatology
| | - L Z Wang
- Department of Oral Pathology, College of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - J W Zheng
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Research Institute of Stomatology and Shanghai Key Laboratory of Stomatology
| | - W M Ye
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Research Institute of Stomatology and Shanghai Key Laboratory of Stomatology
| | - Y He
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Research Institute of Stomatology and Shanghai Key Laboratory of Stomatology
| | - Y A Wang
- Department of Oral and Maxillofacial Surgery, College of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Research Institute of Stomatology and Shanghai Key Laboratory of Stomatology
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Jois HS, Kumar K P M, Kumar MS, Waghrey S. A mixed neoplasm of intraosseous hemangioma with an ameloblastoma: a case of collision tumor or a rare variant? Clin Pract 2012; 2:e5. [PMID: 24765404 PMCID: PMC3981335 DOI: 10.4081/cp.2012.e5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Revised: 11/23/2011] [Accepted: 12/05/2011] [Indexed: 11/23/2022] Open
Abstract
Hemangiomas of the head and neck are considered to be benign tumors of infancy that are characterized by a rapid growth phase with endothelial cell proliferation, followed by gradual involution. Central hemangiomas are a rare occurrence and even rarer are the hybrid tumors of central hemangiomas with odontogenic tumors such as ameloblastomas. This paper reports a case of one such hybrid tumor in a middle aged adult clinical presenting as a mandibular swelling with indistinct mixed radiographic presentation and histopathologically comprising of intimately associated hemangiomatous vascular channels and typical ameloblastic areas. To the authors' knowledge this is the sixth case of such a hemangiomatous ameloblastoma which has been reported till date.
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Multilocular radiolucency of the mandibular condyle in a 19-year-old woman. ACTA ACUST UNITED AC 2011; 112:6-10. [DOI: 10.1016/j.tripleo.2011.02.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2010] [Revised: 02/15/2011] [Accepted: 02/15/2011] [Indexed: 01/12/2023]
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49
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Wu JH, Du JK, Lu PC, Chen CM. Interdisciplinary management of mandibular intraosseous haemagioma. Br J Oral Maxillofac Surg 2011; 49:e55-7. [PMID: 21398000 DOI: 10.1016/j.bjoms.2011.01.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2010] [Accepted: 01/26/2011] [Indexed: 11/19/2022]
Abstract
Intraosseous haemagiomas usually occur in the vertebral column, and are rare in the facial bones. Mandibular intraosseous haemangioma makes up less than 1% of all intraosseous tumours. We describe here the presentation, diagnosis, treatment, and outcome in a 15-year-old boy who presented with a mandibular intraosseous haemangioma. He was treated by embolisation, en bloc resection, and immediate replacement of the mandibular segment. We also harvested the proximal tibia bone grafts and inserted four dental implants. He is well 3 years later.
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Affiliation(s)
- Ju-Hui Wu
- Department of Family Dentistry, College of Dental Science, Kaohsiung Medical University Hospital, No. 100, Shih-chuan 1st Road, Kaohsiung 807, Taiwan
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Dalton J, Mahoney M, Savage N. Computed tomography appearance of mandibular para-radicular third molar radiolucencies. Dentomaxillofac Radiol 2011; 40:47-52. [PMID: 21159915 DOI: 10.1259/dmfr/16606307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Mandibular para-radicular third molar radiolucencies (MPRs) were first described in 2004 by Bohay et al (Bohay RN, Mara TW, Sawula KW, Lapointe HJ. A preliminary radiographic study of mandibular para-radicular third molar radiolucencies. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 98: 97-101) as a well-defined oval radiolucency surrounded by a thin sclerotic border located immediately distal to the mandibular third molar roots. Bohay et al's analysis was undertaken using panoramic radiographs. The purpose of this study was to confirm Bohay et al's findings on panoramic radiographs and to identify and document the appearance of MPRs on cross-sectional CT. METHODS Panoramic films and CT images of the lower third molar regions from 143 patients were reviewed. RESULTS MPR was identified on panoramic film in 12 patients with a total of 14 MPRs. A number of factors were recorded from panoramic films and CT. CONCLUSIONS This study confirmed the findings of Bohay et al and concluded that the relative lucent appearance on panoramic radiographs can be explained by the presence of one or a combination of factors: (i) an area of decreased density in trabecular bone, (ii) thinning of the inner surface of the buccal cortex, (iii) thinning of the inner surface of the lingual cortex or (iv) a depression in the external surface of the lingual cortex.
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Affiliation(s)
- J Dalton
- The University of Queensland, School of Dentistry, and Queensland Diagnostic Imaging, Brisbane Private Hospital, Queensland, Australia.
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