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Omami G, Yeoh M. Malignant Lesions of the Oral Region. Dent Clin North Am 2024; 68:319-335. [PMID: 38417993 DOI: 10.1016/j.cden.2023.09.006] [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: 03/01/2024]
Abstract
This article focuses on the radiographic presentations of various malignant conditions that affect the oral region and delineates the role of CT, MR imaging, and PET in oral cancer imaging.
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Affiliation(s)
- Galal Omami
- Division of Oral Diagnosis, Oral Medicine, and Oral Radiology, Department of Oral Health Practice, University of Kentucky College of Dentistry, 770 Rose Street, MN320, Lexington, KY 40536, USA.
| | - Melvyn Yeoh
- Division of Oral and Maxillofacial Surgery, University of Kentucky College of Dentistry, 770 Rose Street, D-528, Lexington, KY 40536, USA
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Evangelista K, de Faria Vasconcelos K, Teodoro AB, Cavalcanti MGP, de Mendonça EF, Watanabe S, Silva MAG. Malignant tumours mimicking periapical lesions: A report of three cases and literature review. AUST ENDOD J 2022; 48:515-521. [PMID: 34939718 DOI: 10.1111/aej.12597] [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: 03/12/2021] [Revised: 11/12/2021] [Accepted: 12/05/2021] [Indexed: 12/14/2022]
Abstract
Apical periodontitis shows radiographic signs such as widening of the periodontal ligament and periapical radiolucency, which differ in extent depending on the stage of the lesion. However, other lesions can be associated with or coincidental to the apical region, representing developmental lesions and benign or malignant tumours. This article describes three cases of malignant tumours, a central mucoepidermoid carcinoma (CMEC), a chondroblast osteosarcoma and an osteosarcoma of the jaw (OSJ) that presented as periapical lesions. Endodontists must be aware of unsuccessful treatment, persistent pain, signs of paraesthesia, a rapid growth rate and delayed response to therapy associated with atypical features. Complementary examinations, such as biopsy and computed tomography, can allow the early diagnosis of malignant tumours, leading to a better prognosis and thus increased survival rates and improvement in quality of life.
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Affiliation(s)
- Karine Evangelista
- Division of Orthodontics, Dental School, Federal University of Goiás, Goiás, Brazil
| | - Karla de Faria Vasconcelos
- Department of Imaging and Pathology & Department of Oral Health Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Ana Beatriz Teodoro
- Department of Stomatology, Dental School, Federal University of Goiás, Goiás, Brazil
| | | | | | - Satiro Watanabe
- Department of Oral and Maxillofacial Surgery, Dental School, Federal University of Goiás, Goiás, Brazil
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Aloua R, Kerdoud O, Slimani F. Jaw Osteosarcoma misdiagnosed as a giant aneurysmal cyst in childhood. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2021. [DOI: 10.1016/j.epsc.2021.101786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Pires MD, Martins JNR, Dias GS, Doutel D, Ordinola-Zapata R. Osteosarcoma of the anterior maxilla mimicking a periapical pathology: A case report. AUST ENDOD J 2021; 47:656-663. [PMID: 33604945 DOI: 10.1111/aej.12491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/14/2021] [Accepted: 02/03/2021] [Indexed: 01/24/2023]
Abstract
Osteosarcomas of the jaws (OSJ) are difficult to diagnose, rare malignant lesions, with uncharacteristic radiographic and clinical presentation. Early diagnosis and treatment are essential to improve long-term prognosis. The current report presents a rare case of a primary conventional osteoblastic osteosarcoma of the anterior maxilla in a 25-year-old female. She presented to a private dental clinic after developing pain, facial oedema and palpation tenderness of a mass associated with the upper right lateral incisor. The signs and symptoms mimicked very closely a regular radiolucent and symptomatic periapical pathology, and the definitive diagnosis was only possible through a combination of clinical, radiographic and histopathological findings. The patient was referred to an oncology facility, where she was submitted to radical excision surgery through a hemi-maxillectomy. Although other pathologies are uncommon, the differential diagnosis of lesions compatible with odontogenic periapical pathology should not be neglected.
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Affiliation(s)
| | - Jorge N R Martins
- Faculdade de Medicina Dentaria, Universidade de Lisboa, Lisboa, Portugal
| | | | - Delfim Doutel
- Serviço de Anatomia Patológica (SAP), Instituto Português de Oncologia (IPO), Lisboa, Portugal
| | - Ronald Ordinola-Zapata
- Division of Endodontics, University of Minnesota School of Dentistry, Minneapolis, MN, USA
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Affiliation(s)
- Galal Omami
- Division of Oral Medicine, Diagnosis and Radiology, Department of Oral Health Practice, University of Kentucky College of Dentistry, Lexington, KY, USA
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6
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Brierley DJ, Crane H, Hunter KD. Lumps and Bumps of the Gingiva: A Pathological Miscellany. Head Neck Pathol 2019; 13:103-113. [PMID: 30693455 PMCID: PMC6404662 DOI: 10.1007/s12105-019-01000-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 01/02/2019] [Indexed: 11/30/2022]
Abstract
Lesions of the gingivae are amongst the commonest lesions seen in patients and the vast majority are reactive hyperplasias, related to a number of chronic irritant stimuli. However, there are a number of entities that have a predilection for the gingivae, which are much less common in other parts of the oral cavity. The purpose of this paper is to discuss the clinical and histological differential diagnoses when presented with a lump on the gingivae, including the approach to diagnosis and diagnostic pitfalls.
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Affiliation(s)
- Daniel J. Brierley
- Academic Unit of Oral and Maxillofacial Medicine and Pathology, School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, S10 2TA UK
| | - Hannah Crane
- Academic Unit of Oral and Maxillofacial Medicine and Pathology, School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, S10 2TA UK
| | - Keith D. Hunter
- Academic Unit of Oral and Maxillofacial Medicine and Pathology, School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, S10 2TA UK ,Department of Oral Pathology and Biology, University of Pretoria, Pretoria, South Africa
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7
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Early Diagnosis: A Seeming Misfortune for Osteosarcoma of Mandible-Rare Case Report. Indian J Otolaryngol Head Neck Surg 2018; 71:748-751. [PMID: 31742056 DOI: 10.1007/s12070-018-1534-x] [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: 09/15/2018] [Accepted: 11/13/2018] [Indexed: 10/27/2022] Open
Abstract
Osteosarcoma is a mesenchymal malignant tumour of long bones; it is the second most common malignancy of bone after multiple myeloma but it rarely affects jaw, accounting only for 4-8% of all osteosarcomas (Baumhoer et al. in Oral Oncol 50(2):147-153, 2014). The rare occurrence of tumour makes it challenging to diagnose either by radiographic or histopathologic examination. Here we presented a rare case of chondroblastic variant of osteosarcoma of body of mandible in a 54 year old female.
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ElKordy MA, ElBaradie TS, ElSebai HI, KhairAlla SM, Amin AAE. Osteosarcoma of the jaw: Challenges in the diagnosis and treatment. J Egypt Natl Canc Inst 2018; 30:7-11. [PMID: 29490886 DOI: 10.1016/j.jnci.2018.02.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 02/04/2018] [Accepted: 02/07/2018] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Osteosarcomas rarely affect jaw bones. Patients are usually older than those who suffer long bone sarcomas, with a rare incidence of metastasis. This is suggestive of a different pattern of behavior compared with long bone sarcomas. This study aimed to present NCI, Cairo University experience in treating patients diagnosed with osteosarcomas of the jaw, including the diagnostic challenges and treatment outcome. PATIENTS AND METHODS This is a retrospective case series study of all cases of osteosarcomas of mandible and maxilla that were treated at the NCI, in the period between 2006 and 2013. Patients' data, including demographic data, various clinical presentations, results of investigations, treatment modalities performed and outcomes, were collected from hospital records kept in the Biostatistics Department at NCI. RESULTS Records showed 21 cases of osteosarcoma of the jaw. The mandible was affected in 15 cases, the maxilla in six. Two cases had sun-ray periosteal reactions. Erroneous biopsy results were found in 4 cases compared with final pathology reports of surgical resections. All cases underwent surgical resections, with 8 cases having positive margins. The median follow-up period was 19.3 months (range 0.3-98.0 months). The cumulative disease-free survival (DFS) was 27.5% and the median DFS was 72 months. The cumulative overall survival at end of the study was 77.4%. CONCLUSIONS Osteosarcoma of the jaw is challenging both to diagnose and manage. This is due to the high incidence of mistakes in biopsy results, rare specific radiological features and difficulties in proper resection due to proximity to vital structures.
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Affiliation(s)
- Mohamed Atef ElKordy
- Department of Surgical Oncology, National Cancer Institute, Cairo University, Egypt.
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9
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Omami G. "Cookie-bite" lesion of the mandible. J Am Dent Assoc 2017; 148:530-534. [PMID: 28545920 DOI: 10.1016/j.adaj.2017.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 04/07/2017] [Accepted: 05/04/2017] [Indexed: 12/14/2022]
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Tudor-Green B, Fonseca FP, Gomez RS, Brennan PA. Current update on the diagnosis and management of head and neck hard tissue sarcomas. J Oral Pathol Med 2017; 46:667-673. [DOI: 10.1111/jop.12573] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2017] [Indexed: 12/29/2022]
Affiliation(s)
- Ben Tudor-Green
- Department of Plastic and Reconstructive Surgery; Royal Devon & Exeter Hospital; Exeter UK
- Department of Oral and Maxillofacial Surgery; Queen Alexandra Hospital; Portsmouth UK
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology; School of Dentistry; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| | - Ricardo S. Gomez
- Department of Oral Surgery and Pathology; School of Dentistry; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| | - Peter A. Brennan
- Department of Oral and Maxillofacial Surgery; Queen Alexandra Hospital; Portsmouth UK
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Mahajan A, Vaish R, Desai S, Arya S, Sable N, K D'cruz A. Gnathic Osteosarcoma: Clinical, Radiologic, and Pathologic Review of Bone Beard Tumor. J Glob Oncol 2016; 3:823-827. [PMID: 29244987 PMCID: PMC5735964 DOI: 10.1200/jgo.2016.006494] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Abhishek Mahajan
- All authors: Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Richa Vaish
- All authors: Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Subhash Desai
- All authors: Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Supreeta Arya
- All authors: Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Nilesh Sable
- All authors: Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Anil K D'cruz
- All authors: Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India
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Chittaranjan B, Tejasvi MA, Babu BB, Geetha P. Intramedullary osteosarcoma of the mandible: a clinicoradiologic perspective. J Clin Imaging Sci 2014; 4:6. [PMID: 25598996 PMCID: PMC4286825 DOI: 10.4103/2156-7514.148273] [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: 11/08/2013] [Accepted: 12/12/2014] [Indexed: 12/03/2022] Open
Abstract
Osteosarcoma is a non-hematopoietic primary malignant tumor of bone or mesenchymal tissue. Although osteosarcoma is not a common malignant bone tumor, accounting for approximately 20% of sarcomas, tumor of the jaw bone is uncommon, representing only about 4% of osteosarcomas of long bones. We report a case of a 72-year-old female with a swelling on the left side of the mandible and intra-oral swelling on the floor of the mouth. Conventional radiograph and advanced imaging modalities such as computed tomography and magnetic resonance imaging revealed an intramedullary osteosarcoma of the mandible. This report highlights importance of imaging modalities in the diagnosis of malignant tumors of the jaws.
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Affiliation(s)
- Bhogisetty Chittaranjan
- Department of Prosthodontics, Kamineni Institute of Dental Sciences, Narketpally, Nalgonda District, Telangana, India
| | - Ml Avinash Tejasvi
- Department of Oral Medicine and Radiology, Kamineni Institute of Dental Sciences, Narketpally, Nalgonda District, Telangana, India
| | - Bangi Balaji Babu
- Department of Oral Medicine and Radiology, Kamineni Institute of Dental Sciences, Narketpally, Nalgonda District, Telangana, India
| | - Paramkusam Geetha
- Department of Oral Medicine and Radiology, Kamineni Institute of Dental Sciences, Narketpally, Nalgonda District, Telangana, India
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Arora P, Rehman F, Girish KL, Kalra M. Osteosarcoma of mandible: Detailed radiographic assessment of a case. Contemp Clin Dent 2013; 4:382-5. [PMID: 24124311 PMCID: PMC3793566 DOI: 10.4103/0976-237x.118355] [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] [Indexed: 12/02/2022] Open
Abstract
Osteosarcoma (OS) is a malignant connective tissue tumor originating from bone and is the most common primary bone malignancy of long bones but seldom arises in jaw bones. Osteosarcoma of jaws is frequently seen arising in the second and third decade as compared to earlier occurrences in other bones and show a slight predilection for body of mandible. It is a highly malignant tumor with varied radiographic features. We present a case with detailed radiographic assessment using intraoral radiograph, computed tomography (CT), 3-D CT, CT angiography techniques and histological evaluation.
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Affiliation(s)
- Piyush Arora
- Department of Oral Pathology, Jodhpur Dental College, Jodhpur, Rajasthan, India
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14
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Kalburge JV, Sahuji SK, Kalburge V, Kini Y. Osteosarcoma of mandible. J Clin Diagn Res 2013; 6:1597-9. [PMID: 23285471 DOI: 10.7860/jcdr/2012/3922.2574] [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: 01/05/2012] [Accepted: 06/06/2012] [Indexed: 11/24/2022]
Abstract
Osteosarcomas are malignant neoplasms of the bone which commonly affect the long bones. The involvement of the jaws are rarely noticed. These neoplasms often shows a typical clinical behaviour as well as varied radiological appearances. Similarly, their histological growth pattern can be quite diverse. Confirmation of the final diagnosis of an osteosarcoma often requires a histopathological examination of the multiple biopsy specimens and vigorous discussion amongst the experts. All these clinical features, radiographic appearances and histological diagnostic difficulties were encountered in a case of osteosarcoma of the mandible in a 29-year old female.
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Affiliation(s)
- Jitendra V Kalburge
- Professor, Department of Oral & Maxillofacial Pathology, Rural Dental College, Pravara Institute of Medical Sciences , Loni, India
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15
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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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Thariat J, Julieron M, Brouchet A, Italiano A, Schouman T, Marcy PY, Odin G, Lacout A, Dassonville O, Peyrottes-Birstwisles I, Miller R, Thyss A, Isambert N. Osteosarcomas of the mandible: are they different from other tumor sites? Crit Rev Oncol Hematol 2011; 82:280-95. [PMID: 21868246 DOI: 10.1016/j.critrevonc.2011.07.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Revised: 07/03/2011] [Accepted: 07/29/2011] [Indexed: 10/17/2022] Open
Abstract
BACKGROUND Osteosarcomas of the mandible (MOS) affect 1/10 million persons/year, mostly the young adult. Due to lack of specific data, the treatment of MOS is extrapolated from that of extragnathic OS but varies widely between institutions. MATERIALS AND METHODS We aimed at providing a focused description of MOS histologies and grades through the English literature, at determining the evidence-based role of chemotherapy, of adjuvant radiation therapy and the potential of reconstructive surgery tailored through modern pre-operative multi-modal imaging. RESULTS The estimated proportion of high grade MOS was 58%. However, low-grade MOS may be underestimated as they are mostly reported as case reports. The intermediate grade was hardly found in the literature. Estimated weighted-mean proportions of chondroblastic and osteoblastic MOS were 37% and 46%, respectively. Multimodal imaging modalities including MRI has a great potential for accurate pre-operative assessment of tumor extensions into bone and soft tissues. Surgery is the mainstay of treatment and margins the most important factor. The role of neoadjuvant chemotherapy in treating occult systemic metastases and in increasing the probability of clear margins is controversial, as well as the histology-dependent response to chemotherapy. The role of adjuvant radiotherapy (mostly proposed for positive margins) and/or adjuvant chemotherapy is still controversial. Crude survival is around 77% and local control around 67%. Local failure is the main cause of death in MOS compared to extragnathic sites.
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Affiliation(s)
- Juliette Thariat
- Department of Radiation Oncology/IBDC CNRS UMR 6543, Cancer Center Antoine-Lacassagne - Institut Universitaire de la Face et du Cou, University Nice Sophia-Antipolis, 33 Av. Valombrose, 06189 NICE Cedex 2 France.
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Accuracy of Tooth Development Stage, Tooth Size and Dental Arch width in Multi-Detector Row Computed Tomography of Human Skulls. ACTA ACUST UNITED AC 2010. [DOI: 10.5466/ijoms.9.108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Cozza R, Devito R, De Ioris MA, Zama M, Boldrini R, Fidani P, Donfrancesco A. Epithelioid osteosarcoma of the jaw. Pediatr Blood Cancer 2009; 52:877-9. [PMID: 19202567 DOI: 10.1002/pbc.21894] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Epithelioid osteosarcoma (OS) is a rare sub-type of OS with an aggressive behavior. An epithelioid OS was diagnosed in an 8-year-old female with painful swelling of the left jaw. After two courses of chemotherapy (cisplatin/methotrexate/doxorubicin), the patient presented a progressive disease. After hemimandibulectomy, 13 courses of post-operative chemotherapy (cisplatin/methotrexate/doxorubicin/ifosfamide) were performed. Histological and ultra-structural examination showed a high grade neoplasm consisting of sheets of epithelioid cells with focal osteoid formation. The patient is alive and in complete remission 42 months from diagnosis.
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Affiliation(s)
- Raffaele Cozza
- Division of Oncology, Ospedale Pediatrico Bambino Gesù, Rome, Italy
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20
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Behere R, Lele S. Synchronous osteosarcoma of mandible. ACTA ACUST UNITED AC 2009; 107:e45-9. [PMID: 19426906 DOI: 10.1016/j.tripleo.2009.01.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2009] [Accepted: 01/20/2009] [Indexed: 11/16/2022]
Abstract
Osteosarcoma is the most common primary malignant bone tumor, but only 5% of lesions occur in the jaws. The incidence of synchronous osteosarcomas (1% to 3%) is even less. A combination of synchronous osteosarcoma, with one of the lesions occurring in the jaws, is a very rare combination. A case of synchronous osteosarcoma with involvement of the mandible in a 16-year-old girl is reported. In addition to the mandible, lesions were identified in the left femur, sixth thoracic vertebra, and possibly in the lungs. Imaging and histopathological features are described.
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Affiliation(s)
- Rohit Behere
- Oral Medicine and Radiology, Bharati Vidyapeeth University Dental College and Hospital, Pune, India.
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Hashimoto K, Kawashima S, Kameoka S, Akiyama Y, Honjoya T, Ejima K, Sawada K. Comparison of image validity between cone beam computed tomography for dental use and multidetector row helical computed tomography. Dentomaxillofac Radiol 2008; 36:465-71. [PMID: 18033942 DOI: 10.1259/dmfr/22818643] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To evaluate and compare the image validity of a cone beam CT machine for dental use (3DX) and the latest medical CT system, multidetector row helical CT (MDCT). METHODS A dried right maxilla of an Asian adult was used as a phantom. It was cut from the zygomatic process towards the midline, parallel to the midline plane, into eight slices of 2 mm thickness. This phantom was imaged with the 3DX and MDCT machines. Images were evaluated by comparing them with one selected bone slice from the phantom. In this comparison, two types of MDCT images were used: one with the window level (WL) and window width (WW) suitable for observing teeth (MDCT tooth image), and the other appropriate for observing bone (MDCT bone image). Three dentists and one radiographer then used our reported subjective five-level scale to evaluate and compare images generated by the two systems in terms of validity. Cancellous bone as well as enamel, dentin, pulp cavity, periodontal ligament space, lamina dura and overall impression were evaluated. RESULTS Statistically significant differences (P<0.05) were found for almost all observation items. Our subjective evaluation clarified that 3DX was superior to MDCT in terms of image validity. Few significant intra- or interevaluator errors were found. CONCLUSIONS Our subjective evaluation of image validity clarified 3DX as being superior to MDCT. Taken together with the low skin dose we previously reported for 3DX, the results demonstrate 3DX to be beneficial for imaging diagnosis of hard tissues in the maxillofacial region.
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Affiliation(s)
- K Hashimoto
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry, 1-8-13, Kanda Surugadai, Tokyo 101-8310, Japan.
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Hashimoto K, Kawashima S, Araki M, Iwai K, Sawada K, Akiyama Y. Comparison of image performance between cone-beam computed tomography for dental use and four-row multidetector helical CT. J Oral Sci 2006; 48:27-34. [PMID: 16617198 DOI: 10.2334/josnusd.48.27] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The authors evaluated the imaging performance of cone-beam computed tomography (CBCT) for dental use using 3DX multi-image micro-CT (Morita Co., Kyoto, Japan) and four-row multi-detector helical computed tomography (MDCT) using an Asteion (Toshiba, Tokyo, Japan). A dried right maxillary bone was cut into eight slices 2 mm thick toward the zygomatico-palate and used as a phantom. Images of the phantom were then taken using 3DX and MDCT. The images of two bone slices were evaluated by five dentists for image quality and reproducibility of cancellous bone, as well as enamel, dentin, pulp cavity, periodontal ligament space, lamina dura and the overall image. Using the MDCT images as the standard, the 3DX images were evaluated with a subjective 5-level scale: 3 for an image equal to the MDCT image, 4 or greater for better, and 2 or lower for worse. The scores for all parameters exceeded 4 points. Maximum mean score was 4.8 for the lamina dura. Statistically significant differences were found for all items (P < 0.01). Our subjective evaluation of imaging performance clarified that 3DX was superior to MDCT. The results of this study suggest that 3DX is useful for imaging in the dental field.
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Affiliation(s)
- Koji Hashimoto
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry, Tokyo, Japan.
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