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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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Oh HJ, Shin DW, Yoon HJ, Myoung H, Kim SM. Primary intraosseous carcinoma in the pediatric and adolescent mandible. World J Surg Oncol 2022; 20:25. [PMID: 35086533 PMCID: PMC8793206 DOI: 10.1186/s12957-021-02465-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 11/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Primary intraosseous carcinoma (PIOC) is a rare malignant odontogenic tumor that predominantly occurs in males older than 50 years. PIOC can be misdiagnosed as odontogenic cyst because it occasionally shows a well-defined border on radiography. In this study, related literatures of pediatric and adolescent PIOC cases were analyzed under strict PRISMA guidelines along with an adolescent case who was provisionally misdiagnosed as an odontogenic cyst. METHODS All case reports for PIOC published in English from 1966 to 2021 were collected. Cases under the age of 20 were classified as pediatric and adolescent populations in this study. A total of 12 pediatric and adolescent cases including 11 PIOCs from the literature and one new case of a 14-year-old female were analyzed. Clinical and radiographic features, diagnosis and treatment approaches, and prognosis were investigated. RESULTS Ages ranged from 4 to 18 years. The female to male ratio was 1.4:1. Seven cases occurred in the mandible. Swelling was observed in 11 patients. The radiologic borders were well-defined in six cases and corticated in four cases. Tooth displacement and root resorption were observed in four and six cases, respectively. The provisional diagnosis for seven patients was odontogenic cyst and enucleation was performed in six cases including the new case. During the follow-up period, local recurrence occurred in three patients. The pediatric and adolescent PIOC cases with local recurrence showed poor prognosis. The locally recurred lesion in the new case did not decrease in size despite concurrent chemo-radiation therapy. CONCLUSIONS Three-dimensional imaging modalities and incisional biopsy with multiple specimens are necessary to rule out PIOC in the lesions with atypical radiographic findings. PIOC should be diagnosed differentially from odontogenic cyst even in pediatric and adolescent populations to properly manage the disease with poor prognosis.
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Affiliation(s)
- Hyun Jun Oh
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Dong Whan Shin
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Hye-Jung Yoon
- Department of Oral Pathology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Hoon Myoung
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
| | - Soung Min Kim
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
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N KK, Merwade S, Prabakaran P, C H LP, B S A, C N G. Magnetic resonance imaging versus cone beam computed tomography in diagnosis of periapical pathosis – A systematic review. Saudi Dent J 2021; 33:784-794. [PMID: 34938018 PMCID: PMC8665196 DOI: 10.1016/j.sdentj.2021.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 07/17/2021] [Accepted: 09/05/2021] [Indexed: 11/04/2022] Open
Abstract
Objective The diagnosis of any dental pathology can vary from being simple to challenging. While the use of cone beam computed tomography (CBCT) is well established, magnetic resonance imaging (MRI) remains a proof of concept. This systematic review aims to compare the diagnostic ability of MRI with CBCT in diagnosing periapical pathosis. Materials and Methods This systematic search was performed using the electronic databases of MEDLINE, Cochrane Library, Google Scholar, and Science Direct to identify relevant articles from 2010 to 2020. The search terms used were magnetic resonance imaging, cone beam computed tomography, diagnosis, and periapical diseases. Result In total, 3218 potentially relevant abstracts and titles were identified. After removing duplicates, 1288 articles were reviewed for titles and abstracts, and 29 articles were selected for full-text reading. From those, 19 articles were finally selected that included original research studies, case reports, and case series and were included for systematic review. Most of the studies included in this review suggested that the combined use of CBCT and MRI is needed for a better and more precise diagnosis of complex periapical pathoses. The main advantage of MRI is its ability to image soft tissues usingnonionizing radiation, and the main disadvantage in the case of CBCT is overdiagnosis of the lesion. Conclusion MRI has various advantages over CBCT with similar diagnostic utility. When diagnosing periapical pathogens, both MRI and CBCT are needed for an accurate diagnosis.
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Malignant Lesions Mimicking Endodontic Pathoses Lesion: A Systematic Review. J Endod 2020; 47:178-188. [PMID: 32918962 DOI: 10.1016/j.joen.2020.08.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/14/2020] [Accepted: 08/31/2020] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Malignant nonendodontic periapical lesions represent a rare diagnosis, in which few case have been reported about this condition. Due to the low occurrence and little exploration of this subject, serious errors of diagnosis are observed in the oral medicine services. In this sense, the purpose of the present review was to integrate the information on the record published on malignant lesions that mimic endodontic pathoses into a comprehensive analysis of their clinical, radiologic, and histopathologic features. METHODS An online search was made in March 2020 in the following databases: Pubmed, Web of Science, and Scopus. Eligibility criteria included publications having enough clinical, radiologic, and histopathologic information to confirm the diagnosis. Data were assessed descriptively. RESULTS Forty-nine publications from 16 countries comprising 60 cases were included. There is a nearly equal occurrence rate between males and females (male/female ratio is 49.15%/50.84%) with a mean age of 46.56 years. The lesions were more prevalent in the posterior mandibles (40.69%), and, radiographically, they were unilocular radiolucent. Histopathologic analysis showed metastasis (26.67%) as the most prevalent lesion followed by salivary gland malignant disease (25%). CONCLUSIONS The present systematic review revealed several histologic types of malignant periapical lesions that could be mimicking endodontic pathoses. Because these lesions usually do not show clinical or radiologic features of malignant alteration, clinicians should consider these hypotheses in their routine.
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Pavlin D, Dolenšek T, Švara T, Nemec A. Solid type primary intraosseous squamous cell carcinoma in a cat. BMC Vet Res 2018; 14:23. [PMID: 29357860 PMCID: PMC5778816 DOI: 10.1186/s12917-018-1344-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 01/11/2018] [Indexed: 11/11/2022] Open
Abstract
Background Squamous cell carcinoma (SCC) is the most common nonodontogenic oral tumor in cats. In the jaw, it usually presents as an ulceroproliferative lesion associated with enlargement of the affected bone. Case presentation This report describes the case of a cat in which clinical and radiographic findings of a mandibular swelling were suggestive of an aggressive process, but the oral mucosa was unaffected. The results of histopathological and immunohistochemical examination of the samples obtained from the intraosseous lesion were consistent with SCC. The animal was euthanized 5 months after initial presentation as a result of the severe progression of the disease, and no other primary tumors were identified at necropsy. Conclusions Based on the clinicopathological, microscopic, and immunohistochemical staining features, as well as the absence of a primary tumor at a distant site, we propose that the term, solid type primary intraosseous SCC (PIOSCC), be used to describe this neoplasia, as it shares similar features with human PIOSCC.
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Affiliation(s)
- Darja Pavlin
- University of Ljubljana, Veterinary faculty, Small Animal Clinic, Gerbičeva, 60, Ljubljana, Slovenia.
| | - Tamara Dolenšek
- University of Ljubljana, Veterinary faculty, Institute of Pathology, Wild Animals, Fish and Bees, Gerbičeva, 60, Ljubljana, Slovenia
| | - Tanja Švara
- University of Ljubljana, Veterinary faculty, Institute of Pathology, Wild Animals, Fish and Bees, Gerbičeva, 60, Ljubljana, Slovenia
| | - Ana Nemec
- University of Ljubljana, Veterinary faculty, Small Animal Clinic, Gerbičeva, 60, Ljubljana, Slovenia
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Naruse T, Yanamoto S, Sakamoto Y, Ikeda T, Yamada SI, Umeda M. Clinicopathological Study of Primary Intraosseous Squamous Cell Carcinoma of the Jaw and a Review of the Literature. J Oral Maxillofac Surg 2016; 74:2420-2427. [DOI: 10.1016/j.joms.2016.05.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 04/30/2016] [Accepted: 05/06/2016] [Indexed: 11/16/2022]
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Sullivan M, Gallagher G, Noonan V. The root of the problem: Occurrence of typical and atypical periapical pathoses. J Am Dent Assoc 2016; 147:646-9. [PMID: 27046538 DOI: 10.1016/j.adaj.2016.02.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 02/24/2016] [Accepted: 02/25/2016] [Indexed: 01/07/2023]
Abstract
BACKGROUND A preponderance of periapical radiolucencies are of inflammatory etiology (radicular cysts or periapical granulomas) secondary to pulpal disease. In some instances, however, a suspected periapical inflammatory lesion is not a consequence of pulpal disease but instead represents a lesion of noninflammatory origin. The differential diagnosis for such lesions is broad, ranging from odontogenic cysts and tumors to metastatic disease. As the biological behavior of such lesions is varied, the distinction between inflammatory odontogenic periapical lesions and lesions of noninflammatory origin in a periapical location is critical. METHODS A retrospective study of 5,993 archival periapical biopsies over a span of 15 years from the database of the Oral Pathology Biopsy Service in the Henry M. Goldman School of Dental Medicine at Boston University recorded the incidence of various lesions in a periapical location. RESULTS Of the cases studied, 97.2% represented lesions of inflammatory origin with histopathologic diagnoses as follows: periapical granuloma (60.0%), radicular cyst (36.7%), periapical fibrous scar (0.27 %), and periapical abscess (0.23 %). The remaining 2.8% cases were lesions of noninflammatory origin with histopathologic diagnoses of odontogenic keratocyst (also known as keratocystic odontogenic tumor), benign fibro-osseous lesions, and ameloblastoma. One patient had Langerhans cell disease, and 1 had central giant cell granuloma. CONCLUSIONS Although most periapical specimens biopsied represented expected inflammatory periapical lesions, the biological behavior of underdiagnosed lesions may have considerable consequences for both the patient and the clinician. PRACTICAL IMPLICATIONS This article serves to inform clinicians regarding the diversity of lesions arising in the periapical region of the jaws, to assist in the formulation of differential diagnoses, and to highlight the importance of submission of lesional tissue for histopathologic evaluation and definitive diagnosis when biopsy is clinically indicated.
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Bai MR, Shen T, Chen YU, Geng N. Primary intraosseous squamous cell carcinoma in pre-existing keratocystic odontogenic tumor: A case report and literature review. Mol Clin Oncol 2015; 4:187-190. [PMID: 26893858 DOI: 10.3892/mco.2015.678] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 10/29/2015] [Indexed: 02/05/2023] Open
Abstract
Primary intraosseous squamous cell carcinoma (PIOSCC) is a rare type of odontogenic carcinoma that arises within the jaws. PIOSCC has no initial connection with oral mucosa and possibly develops from the residues of the odontogenic epithelium or from an odontogenic cyst or tumor. The diagnosis of PIOSCC can be difficult as it must be differentiated from other odontogenic carcinomas, such as malignant ameloblastoma, from SCCs arising from the overlying oral mucosa, from the primary tumors of the maxillary sinus or nasal mucosa, and from the tumors that have metastasized to the jaws from other primary sites. The present study reported a rare case of a 59-year-old male patient with a course of keratocystic odontogenic tumor for 25 years, between 1988 and 2013, which eventually transformed into PIOSCC after at least five recurrences and corresponding treatments. The mandible excision and titanium plate reconstruction was performed. Follow-up examinations have revealed no sign of recurrence thus far. The present study discussed this case from three aspects of clinical history, radiological examination and pathological features.
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Affiliation(s)
- Ming-Ru Bai
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Ting Shen
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China; Department of Oral Pathology, West China College of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Y U Chen
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China; Department of Oral Pathology, West China College of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Ning Geng
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China; Department of Oral Pathology, West China College of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
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Lukandu OM, Micha CS. Primary intraosseous squamous cell carcinoma arising from keratocystic odontogenic tumor. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:e204-9. [DOI: 10.1016/j.oooo.2015.03.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 02/10/2015] [Accepted: 03/16/2015] [Indexed: 10/23/2022]
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Sirotheau Corrêa Pontes F, Paiva Fonseca F, Souza de Jesus A, Garcia Alves AC, Marques Araújo L, Silva do Nascimento L, Rebelo Pontes HA. Nonendodontic Lesions Misdiagnosed as Apical Periodontitis Lesions: Series of Case Reports and Review of Literature. J Endod 2014; 40:16-27. [DOI: 10.1016/j.joen.2013.08.021] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 08/14/2013] [Accepted: 08/14/2013] [Indexed: 12/12/2022]
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Santos JN, Carneiro Júnior B, Alves Malaquias PDTI, Henriques ACG, Cury PR, Rebello IMCR. Keratocystic odontogenic tumour arising as a periapical lesion. Int Endod J 2013; 47:802-9. [PMID: 24283267 DOI: 10.1111/iej.12220] [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: 08/12/2013] [Accepted: 11/25/2013] [Indexed: 11/29/2022]
Abstract
AIM To document a case of a keratocystic odontogenic tumour (KOT) involving the apical region in the maxilla mimicking a periapical lesion of endodontic origin. SUMMARY Benign and malignant tumours, including odontogenic lesions, can be erroneously diagnosed as periapical radiolucencies. KOTs mimicking periapical lesions of endodontic origin are uncommon, especially when the lesions involve the maxilla. This article describes a 55-year-old man with a well-delimited, oval-shaped, radiolucent lesion, occupying the middle and apical third of teeth 22 and 23. After 30 days, the clinical and radiographic findings remained unchanged and the patient was referred for surgical removal of the lesion. Clinical, radiographic and histopathological features are also discussed and compared with current literature.
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Affiliation(s)
- J N Santos
- Laboratory of Oral Surgical Pathology, School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
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