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Hamid R, Gaur A, Gupta S, Garg R. Ewing's sarcoma masquerading as an odontogenic infection. J Cancer Res Ther 2023; 19:S950-S953. [PMID: 38384088 DOI: 10.4103/jcrt.jcrt_1133_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/19/2022] [Indexed: 02/23/2024]
Abstract
ABSTRACT Ewing's sarcoma (ES) is a small, blue, malignant, round cell tumor of unknown origin. ES is the fourth most common malignant bone tumor, whereas among children, it is found to be the second most common primary malignant bone tumor after osteosarcoma. Swelling is usually the first clinical presentation, followed by pain. ES is an aggressive tumor showing rapid growth and metastasis with complex diagnosis. Because mandibular involvement is rare, it can be misdiagnosed as an odontogenic infection/tumor. We report an unusual case of ES in a 13-year-old female treated for an odontogenic infection before a diagnosis of ES was finally made to make the clinicians aware of this rare entity. Emphasis is also given that ES and odontogenic infections/tumors can masquerade each other with delays in diagnosis and the possibility of devastating results.
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Affiliation(s)
- Rizwan Hamid
- Department of Oral Medicine and Radiology, Maulana Azad Institute of Dental Sciences, B.S.Z. Marg, New Delhi, India
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2
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Nakai Y, Nakai F, Matsuki Y, Hanai R, Nakagawa K, Takayama Y, Matsuo C, Higuchi S, Miyazaki R, Sukegawa S, Miyake M. Treatment of mandibular Ewing’s sarcoma in a child: A rare case and literature review. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2022. [DOI: 10.1016/j.ajoms.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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3
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Tseng CH, Wang WC, Chen CY, Hsu HJ, Chen YK. Retrospective analysis of primary intraosseous malignancies in mandible and maxilla in a population of Taiwanese patients. J Formos Med Assoc 2021; 121:787-795. [PMID: 34531103 DOI: 10.1016/j.jfma.2021.08.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND/PURPOSE Due to the rarity and diversity of primary intraosseous malignancies in jawbones, we aimed to evaluate the clinicopathological features and discuss the findings of our collected cases with the literatures. METHODS Twenty-nine patients (2000-2020) diagnosed with primary central malignancies of jawbones were selected from the database of Oral Pathology Department in our institution. Clinical features, radiographic appearance, and histopathological diagnosis of the 29 cases were analyzed. RESULTS Twenty-nine patients aged between 19 and 84 years (average, 57.4 years) with a male to female ratio of 1.2:1 were included. The most frequent site was the mandibular body and ramus, followed by the posterior maxilla and mandibular symphysis. The most common diagnosis was osteogenic sarcoma (n = 13), followed by odontogenic carcinoma (n = 7), hematologic malignancies (n = 5), salivary gland malignancies (n = 2), and neurogenic sarcomas (n = 2). The most frequent symptoms were swelling, pain, paresthesia of lower lip, and mobile tooth. Radiographically, they usually presented as ill-defined osteolytic to osteoblastic lesions depending on the amount of ossification. Wide excision comprising partial maxillectomy and segmental mandibulectomy were the most common therapeutic methods. CONCLUSION Despite the rarity of primary central malignancies in jawbones, the clinical features may mimic infectious process or benign lesions. Detailed history-taking, clinical and imaging examination and awareness of the patient's signs and symptoms combining with the histopathological inspection are important for early diagnosis and improved prognosis. The current data contributes a useful basis for clinical investigation regarding intraosseous malignancies occurring in the jawbones.
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Affiliation(s)
- Chih-Huang Tseng
- Division of Oral Pathology & Maxillofacial Radiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Oral & Maxillofacial Imaging Center, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Chen Wang
- Division of Oral Pathology & Maxillofacial Radiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Oral & Maxillofacial Imaging Center, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ching-Yi Chen
- Division of Oral Pathology & Maxillofacial Radiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Oral & Maxillofacial Imaging Center, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Han-Jen Hsu
- Division of Oral & Maxillofacial Surgery, Kaohsiung Medical University Hospital Kaohsiung, Taiwan
| | - Yuk-Kwan Chen
- Division of Oral Pathology & Maxillofacial Radiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Oral & Maxillofacial Imaging Center, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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4
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Ahuja US, Puri N, Gupta D, Singh S, Kumar G. Ewing's Sarcoma of Mandible: A Case Report with Review. Int J Clin Pediatr Dent 2020; 12:470-474. [PMID: 32440057 PMCID: PMC7229355 DOI: 10.5005/jp-journals-10005-1665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim To make dentists and pedodontists aware of a possible outcome of a rapidly growing swelling. Background Ewing's sarcoma is a rare aggressive variant of small round cell tumors and is an uncommon malignancy that occurs usually in childhood. It constitutes 10–15% of all primary malignant tumors and represents the second most common malignant bone tumor occurring in children and young adults. Case description We report a case of Ewing's sarcoma in an 11-year-old male child who reported with a rapidly progressing swelling in the left mandibular posterior region. Panoramic view and computed tomography showed characteristic moth eaten and sun-ray appearance. Fine-needle aspiration cytology revealed a small round cell tumor. Since the exact diagnosis is hard to achieve before biopsy, the condition poses a difficult diagnostic dilemma for the clinician. Histopathology was performed for the accurate diagnosis. Conclusion Dentists and pedodontists should develop a high index of suspicion in diagnosing cases with rapidly enlarging intraoral or extraoral swellings as early and correct diagnosis may improve clinical management and survival for patients with this disease. Clinical significance Our case report is an attempt to help the dental community in developing familiarity with the clinical presentation of Ewing's sarcoma. How to cite this article Ahuja US, Puri N, Gupta D, et al. Ewing's Sarcoma of Mandible: A Case Report with Review. Int J Clin Pediatr Dent 2019;12(5):470–474.
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Affiliation(s)
- Upasana S Ahuja
- Department of Oral Medicine and Radiology, ITS Dental College, Ghaziabad, Uttar Pradesh, India
| | - Nidhi Puri
- Department of Oral Medicine and Radiology, ITS Dental College, Ghaziabad, Uttar Pradesh, India
| | - Deepak Gupta
- Department of Oral Medicine and Radiology, MM College of Dental Sciences and Research, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India
| | - Shivangi Singh
- Department of Oral Medicine and Radiology, ITS Dental College, Ghaziabad, Uttar Pradesh, India
| | - Gyanendra Kumar
- Department of Pediatric and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
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Saleh M, Loison-Robert L, Guillerminet V, Larras P, Berquet A, Ahossi V. The oral surgeon in the front-line of the diagnosis of Ewing sarcoma: a case report. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2018. [DOI: 10.1051/mbcb/2018009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: Ewing's sarcoma is a primary malignant bone tumor that affects children and young adults. In rare cases, it affects the bones of the face. The diagnosis is difficult because signs are non-specific. Positive diagnosis is based on a cytogenetic examination showing a specific translocation of the EWS gene. Treatment involves a sequence including chemotherapy, oncological surgery and radiotherapy. Observation: The case presented is that of a 4-year old girl initially sent for suspicion of dental cellulitis. On clinical examination, she had recent mandibular dental mobility and a gingival mucosa swelling. Signs of bone lysis interesting the mandibular symphysis was observed on the orthopantomogram. She had no pain or symptoms indicating neoplasia. This atypical situation led to a bone biopsy who revealed the diagnostic of mandibular Ewing's sarcoma. A suitable medical care in a specialized unit was able to be started without delay. Discussion: The literature reports other cases also wrongly diagnosed as an infectious pathology of dental origin. Conclusion: This case shows that the diagnosis of mandibular Ewing's sarcoma must be evoked in front of any atypical mandibular lesion of the child, regardless of his age or sex. Physicians and dental surgeons specialized in oral surgery are then in the foreground to help establish early diagnosis and ensure rapid management by limiting the functional and aesthetic sequelae related to localization.
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6
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Casaroto AR, DA Silva Sampieri MB, Soares CT, DA Silva Santos PS, Yaedu RYF, Damante JH, Lara VS. Ewing's Sarcoma Family Tumors in the Jaws: Case Report, Immunohistochemical Analysis and Literature Review. In Vivo 2017; 31:481-491. [PMID: 28438883 PMCID: PMC5461465 DOI: 10.21873/invivo.11087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 03/27/2017] [Accepted: 03/31/2017] [Indexed: 12/26/2022]
Abstract
Due to the low incidence of the Ewing's Sarcoma (ES) family tumors, the available epidemiology is likely to be unreliable, and at present, there are no standard diagnostic or clinical guidelines outlining their management. This report describes a case of peripheral primitive neuroectodermal tumor (ES/pPNET) which initially mimicked cystic lesions, and describes a comparison between ES and ES/pPNET in the jaws by the World Health Organization classification. This review addressed 63 cases published in the English literature between 1950 and 2016. The majority of cases were ES. Both ES and ES/pPNET mimicked other benign entities such as traumatic, cystic and inflammatory lesions. The patients who died of their disease had a history of metastatic tumors, and primary tumor located in the mandible and maxilla for ES and ES/pPNET, respectively. The differentiation of the ES family tumors from other small blue-cell tumors may be difficult and requires familiarity with histological and immunohistochemical features.
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Affiliation(s)
- Ana Regina Casaroto
- Department of Oral Pathology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil
| | | | | | | | | | - José Humberto Damante
- Department of Stomatology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil
| | - Vanessa Soares Lara
- Department of Oral Pathology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil
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7
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Margaix-Muñoz M, Bagán J, Poveda-Roda R. Ewing sarcoma of the oral cavity. A review. J Clin Exp Dent 2017; 9:e294-e301. [PMID: 28210452 PMCID: PMC5303334 DOI: 10.4317/jced.53575] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 12/16/2016] [Indexed: 11/09/2022] Open
Abstract
Objectives A review is made of the clinical, diagnostic, therapeutic and survival characteristics of Ewing sarcoma (ES) of the oral cavity. Material and Methods A systematic literature search was carried out, with restrictions referred to time (1960-2014), language (English and Spanish) and type of study (case reports, letters, datasets, reviews). The following MeSH terms and boolean operators were used: Ewing AND Sarcoma AND [tongue, jaw, maxilla, cheek, condyle OR temporomandibular, floor AND mouth, gum OR gingiva, palate OR palatal, lip, uvula, head AND neck]. Results Seventy-one cases of ES of the oral cavity were documented from 53 articles. The main differences versus ES of other locations were a younger age at manifestation, a shorter time from symptoms onset to diagnosis, and swelling as the most frequent clinical manifestation versus swelling and pain in the rest of disease locations. The way in which ES manifests in the oral cavity is varied and comprises dental displacement (19.7%), dental mobility (7%), root reabsorption (5.6%), destruction of the dental follicle (4.2%), premature exfoliation (4.2%) and paresthesia of the chin (2.8%). Metastatic neck adenopathies appear in 11.3% of the cases. Significant differences in survival are observed between patients with a complete diagnosis of ES (hematoxylin-eosin staining, PAS positivity, CD99 positivity) and those with an incomplete diagnosis. Conclusions Ewing sarcoma of the oral cavity presents a series of specific features that distinguish it from ES of other locations. Key words:Primitive neuroectodermal tumor, PNET, Ewing sarcoma, Ewing tumor, sarcoma, oral cavity.
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Affiliation(s)
- Maria Margaix-Muñoz
- DDS, PhD. Associate Professor of Oral Medicine. Department of Stomatology, University of Valencia. Valencia (Spain)
| | - José Bagán
- MD, DDS, PhD. Charmain of Oral Medicine. Department of Stomatology, University of Valencia. Head of Stomatology and Maxillofacial Surgery Service. General Universitary Hospital of Valencia. Valencia (Spain)
| | - Rafael Poveda-Roda
- MD, DDS, PhD. Staff physician. Stomatology and Maxillofacial Surgery Service. General Universitary Hospital of Valencia. Valencia (Spain)
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Bhardwaj B, Sharma S, Chitlangia P, Agarwal P, Bhamboo A, Rastogi K. Mandibular Dentigerous Cyst in a 10-Year-Old Child. Int J Clin Pediatr Dent 2016; 9:281-284. [PMID: 27843264 PMCID: PMC5086020 DOI: 10.5005/jp-journals-10005-1378] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 03/21/2016] [Indexed: 11/23/2022] Open
Abstract
Dentigerous cyst is the most common odontogenic cyst. It is characterized by a unilocular radiolucent lesion that encloses permanent tooth buds or, under certain circumstances, displaced tooth buds. Buccal bony expansion and a missing tooth is the most common clinical feature. Various treatment modalities have been mentioned in the literature for management of dentigerous cysts. This article presents a left mandibular dentigerous cyst in a 10-year-old boy. Marsupialization was the treatment of choice and a denturelike space maintainer was provided. Long-term follow-up revealed good healing of the bony lesion.
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Affiliation(s)
- Bindu Bhardwaj
- Professor, Department of Oral Surgery, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India
| | - Sunil Sharma
- Professor and Head, Department of Oral Surgery, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India
| | - Punit Chitlangia
- Reader, Department of Oral Surgery, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India
| | - Prateek Agarwal
- Senior Lecturer, Department of Oral Surgery, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India
| | - Amit Bhamboo
- Senior Lecturer, Department of Oral Surgery, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India
| | - Komal Rastogi
- Private Consultant, Department of Oral Surgery, Rajasthan India
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9
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Chatzistefanou I, Kabesi S, Paraskevopoulos K, Koliouskas D, Antoniades K. Ewing's Sarcoma of Mandible: An Impressive Case of Spontaneous Mandible Regeneration. Int J Clin Pediatr Dent 2016; 9:273-277. [PMID: 27843262 PMCID: PMC5086018 DOI: 10.5005/jp-journals-10005-1376] [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: 01/08/2016] [Accepted: 02/21/2016] [Indexed: 11/23/2022] Open
Abstract
Ewing's sarcoma (ES) is an uncommon aggressive bone malignancy that mainly affects children and adolescents. Mandible involvement is quite rare and usually represents metastasis from another skeletal site. Combined therapy including wide surgical resection and preoperative and postoperative chemotherapy has been demonstrated as the mainstay of therapeutic approach. As improved therapeutic modalities have significantly increased survival over the last decades, functional and esthetic reconstruction of the postmandibulectomy defect is usually necessary for patient's total rehabilitation. We report a case of ES of the mandible with special consideration to the postresection spontaneous structural and functional regeneration of the mandible. HOW TO CITE THIS ARTICLE Chatzistefanou I, Kabesi S, Paraskevopoulos K, Koliouskas D, Antoniades K. Ewing's Sarcoma of Mandible: An Impressive Case of Spontaneous Mandible Regeneration. Int J Clin Pediatr Dent 2016;9(3):273-277.
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Affiliation(s)
- Ioannis Chatzistefanou
- Resident, Department of Oral and Maxillofacial Surgery, Papanikolaou General Hospital, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Sotiria Kabesi
- Student, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Paraskevopoulos
- Resident, Department of Oral and Maxillofacial Surgery, Papanikolaou General Hospital, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Dimitrios Koliouskas
- Consultant and Chief, Department of Pediatrics, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Antoniades
- Professor, Department of Oral and Maxillofacial Surgery, Papanikolaou General Hospital, Aristotle University of Thessaloniki Thessaloniki, Greece
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10
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Goswami M, Bhushan U, Jangra B. Goldenhar Syndrome: A Case Report with Review. Int J Clin Pediatr Dent 2016; 9:278-280. [PMID: 27843263 PMCID: PMC5086019 DOI: 10.5005/jp-journals-10005-1377] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 02/27/2016] [Indexed: 11/23/2022] Open
Abstract
Goldenhar syndrome is a rare condition which is characterized by a multitude of anomalies involving craniofacial structures, vertebrae, internal organs and usually occurs unilaterally. The etiology of this syndrome is unclear since it varies genetically and is linked to a plethora of reasons. Herein, we report a case of Goldenhar syndrome with hemifacial microsomia and microtia along with systemic involvement which was clinically and radio-graphically assessed. Many classical signs of the syndrome were present in the patient along with few rare ones. The various aspects of this rare disease have been discussed with emphasis on timely diagnosis and multidisciplinary approach to manage it. HOW TO CITE THIS ARTICLE Goswami M, Bhushan U, Jangra B. Goldenhar Syndrome: A Case Report with Review. Int J Clin Pediatr Dent 2016;9(3):278-280.
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Affiliation(s)
- Mridula Goswami
- Professor and Head, Department of Pedodontics and Preventive Dentistry Maulana Azad Institute of Dental Sciences, Delhi, India
| | - Urvashi Bhushan
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry Maulana Azad Institute of Dental Sciences, Delhi, India
| | - Babita Jangra
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry Maulana Azad Institute of Dental Sciences, Delhi, India
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11
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Ewing's Sarcoma Localized in the Mandible: A Case Report. W INDIAN MED J 2015; 64:444-6. [PMID: 26624604 DOI: 10.7727/wimj.2014.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 04/23/2014] [Indexed: 11/18/2022]
Abstract
Ewing's sarcoma is one of the most aggressive primary bone tumours. Ewing's sarcoma arising from the bones of the head and neck region is extremely rare; only 4-9% of all Ewing's sarcoma originate in this region. We report a case of Ewing's sarcoma localized in the mandible because of its unusual presentation.
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12
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Owosho AA, Ko E, Rosenberg HI, Yom SK, Antonescu CR, Huryn JM, Estilo CL. Primary Ewing Family of Tumors of the Jaw Has a Better Prognosis Compared to Tumors of Extragnathic Sites. J Oral Maxillofac Surg 2015; 74:973-81. [PMID: 26679553 DOI: 10.1016/j.joms.2015.10.029] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 10/22/2015] [Accepted: 10/24/2015] [Indexed: 12/23/2022]
Abstract
PURPOSE Primary Ewing sarcoma of the jaw is rare. The aim of this study was to describe new cases of primary Ewing sarcoma of the jaw and investigate reported prognostic factors of Ewing sarcoma in this series and treatment outcome. MATERIALS AND METHODS Six patients with primary Ewing sarcoma of the jaw were treated at the Memorial Sloan Kettering Cancer Center (MSKCC) from 1992 through 2013. Clinical data, pathology reports, treatment prescribed, treatment regimens, outcome, and follow-up information were reviewed. RESULTS Five of 6 patients were female and 5 cases were in the mandible. No patient presented with metastatic disease at diagnosis. All cases were positive for CD99, and 3 patients with genetic confirmation were positive for EWS-FLI1 fusion or EWSR1 gene rearrangement. All patients received induction multiagent chemotherapy and surgical resection and 2 patients received adjuvant radiotherapy. Total (grade IV) or nearly total (grade III) tumor necrosis in 3 of 5 patients (60%) assessed for histologic response to chemotherapy indicated intense sensitivity. All patients were alive and free of disease, with no history of local recurrence, at a median follow-up period of 6.5 years. CONCLUSION Patients with primary Ewing sarcoma of the jaw have a good prognosis and metastasis is an uncommon occurrence at initial presentation.
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Affiliation(s)
- Adepitan A Owosho
- Dental Oncology Research Fellow, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Eugene Ko
- Former Research Fellow, Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY; Clinical Assistant Professor, School of Dentistry, University of Michigan, Ann Arbor, MI
| | - Haley I Rosenberg
- Research Study Assistant, Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - SaeHee K Yom
- Assistant Attending, Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Cristina R Antonescu
- Attending, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Joseph M Huryn
- Chief, Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Cherry L Estilo
- Attending, Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
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Abstract
Ewing sarcoma (ES) is a primary bone malignant neoplasm and is the second most common primary malignancy of the bone found in childhood and adolescence after osteosarcoma. ES has an annual frequency in the population younger than 20 years of approximately 2.9 per million. ES occurs most frequently in the long bones of the extremities and pelvis and very rarely in the jaw. Recently, it was revealed that chromosomal translocation t(11;22)(q24;q12), which fuses the EWS gene on chromosome 22 and the FLI-1 gene on chromosome 11, occurs in most cases of ES. We report here a rare case of mandibular ES in a 10-year-old child with chromosomal translocation t(21;22)(q22;q12) in which the EWS gene is fused with the ERG gene on chromosome 21.
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14
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Sorin T, Mansuy L, Colson T, Minetti C, Brix M, Simon E. [Ewing's sarcoma of the mandible in children: reconstruction by induced membrane]. ACTA ACUST UNITED AC 2014; 115:318-22. [PMID: 25001547 DOI: 10.1016/j.revsto.2014.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 03/24/2014] [Accepted: 05/14/2014] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Ewing's sarcoma (ES) is a malignant bone neoplasm that develops during the first two decades of life, and affects male more than female patients (sex ratio 1.6/1). ES head and neck bone localization is extremely uncommon (2 to 4%). We report a rapid induced membrane reconstruction without primary bone autograft. OBSERVATION A 7-year-old boy presented with a 50mm mandibular ES centered on the horizontal branch of the right mandible. This patient was treated by a combination of neo-adjuvant chemotherapy, surgery, and adjuvant radio-chemotherapy, according to the Euro-Ewing 99 protocol. The right horizontal mandibular branch was resected, following induction chemotherapy. A macroplate and a cement spacer were used for the reconstruction, while expecting anatomopathological results. Seventeen days later, we removed the spacer because of scar disunion. The radiographic controls revealed a spontaneous osteogenesis along the macroplate despite the early cement spacer removal. This spontaneously bone growth allowed avoiding a free vascularized bone transfer for the reconstruction. The tissue regeneration potential of this young boy and the cement spacer induced membrane could explain this spontaneous osteogenesis phenomenon. DISCUSSION Induced membrane can be added to the therapeutic options for pediatric oncologic mandibular bone loss. It avoids using of a free vascularized bone transfer.
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Affiliation(s)
- T Sorin
- Service de chirurgie plastique et maxillo faciale, hôpital Central, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France.
| | - L Mansuy
- Service d'hématologie et oncologie pédiatrique, hôpitaux de Brabois, CHU de Nancy, 5, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - T Colson
- Service de chirurgie plastique et maxillo faciale, hôpital Central, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France
| | - C Minetti
- Service de chirurgie plastique et maxillo faciale, hôpital Central, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France
| | - M Brix
- Service de chirurgie plastique et maxillo faciale, hôpital Central, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Université de Lorraine, 34, cours Léopold, 54052 Nancy, France
| | - E Simon
- Service de chirurgie plastique et maxillo faciale, hôpital Central, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Université de Lorraine, 34, cours Léopold, 54052 Nancy, France
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15
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Keshani F, Jahanshahi G, Attar BM, Kalantari M, Razavi SM, Hashemzade Z, Tavakoli P. Ewing's sarcoma in mandibular similar to dental abscess. Adv Biomed Res 2014; 3:62. [PMID: 24627870 PMCID: PMC3950843 DOI: 10.4103/2277-9175.125841] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Accepted: 01/15/2013] [Indexed: 11/22/2022] Open
Abstract
Ewing's sarcoma is a rare malignant neoplasm that comprises approximately 4-6% of primary bone tumors. In most cases, femur and pelvis are affected, and less commonly the head and neck areas (in the jaws, usually the mandible). These tumors have been reported more frequently in males, mostly aged 5-20 years old. Systemic symptoms and signs such as fever, weight loss, anemia, leukocytosis, and elevated erythrocyte sedimentation rate (ESR) may be the first signs in oral Ewing's sarcoma. Such signs and symptoms are also seen in odontogenic infections and abscess. In one case, the patient went to a dentist with pain, swelling, and abscess similar to odontogenic infection and patient's tooth was pulled due to misdiagnosis. This tumor has an aggressive clinical behavior and is identified with rapid growth and high probability of metastasis at diagnosis. Thus, it is necessary to differentiate it from a dental abscess. As for the treatment of Ewing's sarcoma, first the tumor must undergo chemotherapy to reduce its size and, eventually, it undergoes extensive surgery. This case report deals with a 16-year-old patient wrongly diagnosed with odontogenic infection and abscess, and hospitalized. As the symptoms did not remit, biopsy was carried out and the patient was operated on with Ewing's sarcoma diagnosis.
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Affiliation(s)
- Forouz Keshani
- Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Isfahan, Iran
| | | | | | - Mahsa Kalantari
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Isfahan, Iran
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Krishna KB, Thomas V, Kattoor J, Kusumakumari P. A Radiological Review of Ewing's Sarcoma of Mandible: A Case Report with One Year Follow-up. Int J Clin Pediatr Dent 2013; 6:109-14. [PMID: 25206203 PMCID: PMC4086594 DOI: 10.5005/jp-journals-10005-1200] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 06/25/2013] [Indexed: 11/23/2022] Open
Abstract
Ewing's sarcoma (ES) is an uncommon round cell tumor with an aggressive course affecting mainly children and young adults. Only 1% of cases is reported with jaw involvement and have mandibular predilection. Radiographic finding in ES reflect many destructive nature of the lesion, like osteolysis, cortical erosion, periostitis and soft tissue mass. A case of ES of the mandible is reported with special consideration to the radiological appearance. How to cite this article: Krishna KBB, Thomas V, Kattoor J, Kusumakumari P. A Radiological Review of Ewing's Sarcoma of Mandible: A Case Report with One Year Follow-up. Int J Clin Pediatr Dent 2013;6(2):109-114.
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Affiliation(s)
- Kb Bimal Krishna
- Postgraduate Student, Department of Oral Medicine and Radiology Government Dental College, Thiruvananthapuram, Kerala, India e-mail:
| | - Valsa Thomas
- Professor and Head, Department of Oral Medicine and Radiology Government Dental College, Thiruvananthapuram, Kerala, India
| | - Jayasree Kattoor
- Professor and Head, Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - P Kusumakumari
- Professor and Head, Division of Pediatric Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
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Abstract
Ewing's sarcoma is a malignant tumor of bones that primarily affects children and young adults. The true origin of this small round cell lesion still remains controversial. It was originally described by James Ewing in 1921 as arising from undifferentiated osseous mesenchymal cells; however, recent studies suggest that Ewing's tumor might be neuroectodermally derived from various degrees of differentiation of the primitive neural tissues. This paper reports a rare case of ES of the mandible in an 11-year-old girl, which had been previously misdiagnosed and treated as a dental abscess. In the clinical examination, a hard immobile expansive mass of 2 cm diameter was observed on the left side of the mandible. Radiographic examination revealed a diffuse radiolucent lesion with ill-defined borders and wide vestibular bone plate destruction. Microscopically, the tumor was composed by monotonous small round cells that exhibited immunoreactivity for CD99, vimentin and desmin. Surgical resection of mandible followed by mandibular reconstruction was adopted. The patient was subjected to multiagent chemotherapy with Vincristine [VC], Dactinomycin [AC], Cyclophosphamide [CP] and Doxorubicin [AD]).
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Affiliation(s)
- B H Sripathi Rao
- Department of Oral and Maxillofacial Surgery, Yenepoya Dental College, Mangalore, India
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Wang Z, Huang G, Yan Q, Wang L, Zhu J, Lu Y, Li P, Cheng H, Ma MJ, Walker BF, Allen PW. Inflammatory monomorphic undifferentiated sarcoma with distinct clinical and pathological features: a 'new' entity? Pathology 2011; 43:48-53. [PMID: 21240065 DOI: 10.1097/pat.0b013e328340c1f4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIM To describe two patients with a highly aggressive, apparently 'new' and rare soft tissue and bone malignancy of childhood and early adult life that we have named inflammatory monomorphic undifferentiated sarcoma. METHODS AND RESULTS Two histologically identical tumours located in the proximal humerus and the anterior chest wall of males aged 6 and 31 presented as solitary, painful, tender, necrotising, masses, associated with fever, leukocytosis and negative microbiological cultures. The extensively necrotic resected tumours consisted of large, monomorphic epithelioid cells with vesicular nuclei, prominent eosinophilic nucleoli, and abundant eosinophilic cytoplasm surrounded by numerous neutrophils and eosinophils which formed sterile microabscesses. Immunohistochemical and ultrastructural studies revealed no specific differentiation. Both tumours were very aggressive, with early local recurrence, metastasis to regional and distant lymph nodes and viscera, and no response to several different chemotherapeutic regimens. CONCLUSION A careful review of the literature led us to believe that inflammatory monomorphic undifferentiated sarcoma may represent a rare and distinct clinicopathological entity that does not appear to have been previously described.
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Affiliation(s)
- Zhe Wang
- Department of Pathology, State Key Laboratory of Cancer Biology, Xijing Hospital and School of Basic Medicine, Fourth Military Medical University, Xi'an, PR China.
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