1/87. Odontogenic carcinoma occurring in a dentigerous cyst: case report and clinical management.This case report describes an unusual odontogenic carcinoma, which was detected during routine periodontal examination. The lesion occurred in a dentigerous cyst associated with an impacted third molar in an otherwise asymptomatic 66-year-old male patient. The impacted tooth and lesion were excised based on evidence of radiographic change and clinical findings. An unusual histopathologic presentation is reported. The treatment provided for this tumor and the management of impacted teeth is reviewed.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
2/87. Odontogenic ghost cell carcinoma: a case report with reference to the relation between apoptosis and ghost cells.The neoplastic variant of calcifying odontogenic cyst has various designations, and its malignant counterpart has been reported as aggressive epithelial odontogenic ghost cell tumor or odontogenic ghost cell carcinoma. We present a case of odontogenic ghost cell carcinoma with reference to the relation between the ghost cells and apoptosis. A 33-year-old man complained of a mandibular mass. The mass occupied the entire right side of the mandible with destruction of both buccal and lingual bone. The mass also infiltrated into submandibular and sublingual spaces. Histologically, the mass was composed of a solid proliferation of hyperchromatic and pleomorphic epithelial cells with abnormal mitoses. islands of ghost cells were frequently admixed with nucleated cells, and there were foci of ameloblastic differentiation. Immunohistochemical stains for cytokeratins, involucrin, and apoptosis-related proteins such as Bcl-2, Bcl-X(L), and Bax were done. Terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling (TUNEL) assay was also performed. The nucleated cells adjacent to the ghost cells expressed cytokeratins and involucrin, but the ghost cells had no reaction. Bcl-2 was negative. Both Bcl-X(L) and Bax were demonstrated in the nucleated cells adjacent to the ghost cells. The ghost cells exhibited Bax protein. Some nucleated cells adjacent to the ghost cells were positive with TUNEL assay. The above results indicate that ghost cells undergo abnormal terminal differentiation as an apoptotic process.- - - - - - - - - - ranking = 1.2keywords = carcinoma (Clic here for more details about this article) |
3/87. Ameloblastic carcinoma ex ameloblastoma of the mandible with malignancy-associated hypercalcemia.ameloblastoma is a rare, locally destructive, benign neoplasm of the jawbones, which arises from epithelium derived from the epithelial components of the developing tooth. Ameloblastic carcinoma is the term used to designate any ameloblastoma in which there is histologic evidence of malignancy in the primary tumor, regardless of whether it has metastasized. Most ameloblastic carcinomas are presumed to have arisen de novo, with few cases of malignant transformation of ameloblastoma being apparent. hypercalcemia is the most common metabolic complication of malignancy. Although malignancy-associated hypercalcemia is often reported in association with other malignancies, it is exceedingly unusual in association with ameloblastoma, malignant ameloblastoma, or ameloblastic carcinoma. We describe a patient with multiple recurrences of ameloblastoma, with subsequent malignant transformation presenting with malignancy-associated hypercalcemia.- - - - - - - - - - ranking = 1.4keywords = carcinoma (Clic here for more details about this article) |
4/87. Calcifying epithelial odontogenic (Pindborg) tumor with malignant transformation and metastatic spread.BACKGROUND: Pindborg tumors (calcifying epithelial odontogenic tumors) are uncommon neoplasms of odontogenic origin most often located in the posterior mandible. First described in detail in 1955 by Pindborg, these tumors are considered benign but can be locally aggressive in nature, with recurrence rates of 10% to 15% reported. The malignant form of this tumor is exceedingly rare. methods: We describe the case of a 64-year-old woman initially treated for a painful infected left mandibular third molar. The patient underwent extraction of the tooth and excision of an associated soft tissue component. Subsequent histologic review identified a Pindborg tumor of the left posterior mandible. RESULTS: After initial excision, this tumor recurred twice, with the recurrences exhibiting a progression to a malignant Pindborg tumor (odontogenic carcinoma) with vascular invasion and spread to a cervical lymph node. Further treatment involved radical surgery and adjuvant radiotherapy. At last review 12 months after treatment, the patient was disease free. CONCLUSIONS: This article describes only the second case of odontogenic carcinoma. The transformation from benign to malignant histologic findings has not previously been documented in this tumor. The salient clinical features of this case are presented along with supportive pathologic and radiologic evidence.- - - - - - - - - - ranking = 0.4keywords = carcinoma (Clic here for more details about this article) |
5/87. Clear cell odontogenic carcinoma. Report of two cases and review of the literature.This study reviews the literature and reports on the morphologic and immunophenotypic features of 2 clear cell odontogenic carcinomas occurring in the mandible of elderly women, showing extensive infiltration into adjacent tissues. The tumor cells were large, with clear cytoplasm, and arranged in irregular sheets. Some of the latter demonstrated a peripheral rim of cells with eosinophilic cytoplasm or included duct-like structures. There was no evidence of ameloblastic differentiation. Most cells contained glycogen granules and were immunoreactive for cytokeratins and epithelial membrane antigen. In the differential diagnosis other clear cell odontogenic, salivary gland, and metastatic tumors should be considered. Both cases were treated with surgical excision, and the patients are free of disease after 3 and 5 years, respectively. In the literature, however, variable behavior of these tumors has been reported, including recurrence and metastases. It is recommended that terms such as clear cell ameloblastoma and clear cell odontogenic tumor not be used to describe such tumors.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
6/87. Central (intraosseous) adenoid cystic carcinoma of the mandible: report of a case with periapical involvement.Primary intraosseous salivary gland tumors are rare, with mucopidermoid carcinoma being the most frequent histotype. The authors present a case of adenoid cystic carcinoma, located in the mandibular incisor region, associated with pain. Endodontic treatment resulted in increased pain and progressive mandibular expansion. An apicoectomy was conducted, and an intraosseous adenoid cystic carcinoma was diagnosed at histological examination. The patient was treated by wide surgical resection, and is alive and well without recurrences or distant metastases 14 yr after the original diagnosis. The case presented herein calls attention to the preoperative clinical diagnosis of periapical lesions. Radiologically, focal sclerosing osteitis, cementoblastoma, cementifying and ossifying fibroma, periapical cemental dysplasia, complex odontoma, and calcifying epithelial odontogenic tumor should be considered in the differential diagnosis. In addition the unusual occurrence of salivary gland tumors in intraosseous location stresses the importance of systematic histological examination of any tissue sample obtained after endodontic procedures.- - - - - - - - - - ranking = 1.4keywords = carcinoma (Clic here for more details about this article) |
7/87. Primary intraosseous carcinoma of the jaw: pooled analysis of world literature and report of two new cases.Primary intraosseous carcinoma (PIOC) is a rare malignant neoplasm of the jaw. These tumours are believed to arise from the odontogenic epithelium and hence are also referred to as odontogenic carcinoma. A detailed search was made for squamous cell PIOC of the jaw in English literature using medline Cancer CD. The data obtained were transferred onto dBase software. Two detailed case reports of patients treated at Regional Cancer Centre, Trivandrum during 1996 and 1997 were also included. A pooled analysis was carried out. survival analysis was carried out using Kaplan-Meier method and log-rank statistics were used for comparing survival. A total of 35 cases were analysed, of which 33 were from published literature. The mean age of the patients at the time of diagnosis was 52.3 years with male to female ratio being 2.5:1. Posterior mandible was the predominant site. The median follow-up time was 28 months. overall survival at 5 years was 37.8% (95% CI; 14.8-61.0) while the corresponding disease free survival was 29.8% (95% CI; 9.2-54.1). Primary intraosseous carcinoma is a rare tumour of jawbones, characterized by progressive swelling of the jaw, pain and loosening of tooth. The tumour is locally aggressive and metastasizes to regional nodes. The overall and disease free survival is poor with almost 50% patients failing loco-regionally within the first 2 years of follow-up.- - - - - - - - - - ranking = 1.4keywords = carcinoma (Clic here for more details about this article) |
8/87. Pigmented intraosseous odontogenic carcinoma of the maxilla: a pediatric case report and differential diagnosis.We report a pigmented intraosseous odontogenic carcinoma of the maxilla occurring in a 6-year-old Japanese boy. Grossly, the tumor showed solid, gray-yellow, and markedly pigmented appearance. histology showed neoplastic growths of atypical epithelial cells that occasionally contained melanin pigments. melanocytes with dendritic processes were often found in the tumor cell clusters, and solitary or aggregated melanophages were scattered within the dense fibrovascular stroma. The tumor cells were diffusely positive for cytokeratins and epithelial membrane antigen, and focally positive for vimentin, neuron specific enolase, neurofilament protein, carcinoembryonic antigen, and amelogenin. Ultrastructural studies showed well-developed intercellular junctions, mainly desmosomes, and glycogen particles. In addition, some tumor cells contained melanosomes and/or a few neurosecretory granules. We consider that the present tumor suggests a close association of ectoderm, mesenchyma, and neuroectoderm in embryogenesis of the tooth, and can raise a diagnostic confusion with melanotic neuroectodermal tumor.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
9/87. Primary intraosseous carcinoma associated with impacted third molar of the mandible: review of the literature and report of a new case.This study investigated the clincopathologic features of primary intraosseous carcinoma (PIOC) related to the third molar of the mandible. Six cases (5 from the literature and 1 new case; mean patient age 73 years) of PIOC associated with completely impacted lower third molar were analyzed. For comparison, 8 cases of PIOC presenting after extraction of the lower third molar were also evaluated, with a significantly lower mean patient age of 56 years. Most lesions were deceptively similar to those related to the lateral type of dentigerous cyst, and half of the impacted cases revealed an asymptomatic fracture of the mandible. In all patients except for the present case, metastasis had not been recorded. Surprisingly, no patients are known to have died of PIOC. In our experience the prognosis of PIOC associated with a completely impacted third molar is much better than commonly believed, although the number of cases involved is too small to make a general conclusion. However, delay in establishing the correct diagnosis followed by extraction without awareness of the carcinoma is know to adversely affect the prognosis.- - - - - - - - - - ranking = 1.2keywords = carcinoma (Clic here for more details about this article) |
10/87. Clear cell odontogenic carcinoma.Clear cell tumours, in the head and neck region, are usually derived from salivary or odontogenic tissues, or may be metastatic. A few clear cells may be present in odontogenic cysts, while, odontogenic neoplasms composed predominantly of clear cells are quite rare. They include calcifying epithelial odontogenic tumours (CEOT), ameloblastoma and odontogenic carcinoma. Clear cell odontogenic tumour (CCOT) has been classified in the last WHO classification as a benign tumour, but it is now recognized as a more sinister lesion and current opinion is that CCOT should be designated as a carcinoma. These tumours are characterized by aggressive growth, recurrences, and metastatic disease. A recent review of the literature has yielded 30 cases of tumours with similar characteristics. These tumours have a peak incidence in the 5th-7th decades, with a female predilection. The anterior portions of the jaws, especially the mandible, are most frequently affected. The aggressive potential of these neoplasms is well documented by the extensive invasion of adjacent tissues, multiple recurrences and regional or distant metastases.- - - - - - - - - - ranking = 1.2keywords = carcinoma (Clic here for more details about this article) |
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