Cases reported "Jaw Neoplasms"

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1/60. Lesions associated with familial polyposis coli: studies of lesions of lesions of the stomach, duodenum, bones, and teeth.

    The entire gastrointestinal tract and bones were examined systematically in 24 patients (10 pedigrees) in whom familial polyposis coli was diagnosed. Polypoid lesions were observed in the stomach in as high as 68.2% of the cases, and in the duodenum in 90%. Abnormalities were noted in the skeleton in 50% and in the mandible in 81.3%. The authors emphasize the possibility that familial polyposis coli is substantially the same entity as Gardner's syndrome.
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2/60. Squamous odontogenic tumor. Report of six cases of a previously undescribed lesion.

    Six cases of a previously unnamed oral lesion are described and the name squamous odontogenic tumor is applied. The lesion causes radiolucent areas of bone destruction adjacent to the roots of teeth. In one case there were multiple separate lesions. light microscopy revealed numerous islands of benign squamous epithelium with focal areas of keratinization and calcification. Electron microscope examination in one case showed normal squamous epithelial cells with abundant glycogen granules, tonofilaments and myelin bodies. Complete surgical excision seems the best therapy, as only one lesion recurred following treatment.
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3/60. Well-differentiated intraosseous osteosarcoma of the jaws: experience of two cases from the Instituto Nacional de Cancerologia, mexico.

    Osteosarcomas of the jaws represent less than 10% of all osteosarcomas, and most of them are high-grade neoplasms. Prognostic factors in overall survival include tumor size, location and histologic grade. Examples of well-differentiated (low-grade) intraosseous osteosarcomas of the jaws (WDIOJ) have been rarely reported. This article presents two cases of this unusual lesion, one of which was located in the maxilla of a 17-year-old man and the other developed in the mandible of a 37-year-old woman. CT scan was necessary to detect the small foci of penetration into the thinned cortical bone and the reactive periosteal bone formation, which are important findings to establish the correct diagnosis of WDIOJ and help to exclude other benign intraosseous lesions that may be very similar histologically, such as fibrous dysplasia, ossifying and desmoplastic fibromas. In spite of tumor size (mean 5.2 cm), their well-demarcated borders allowed complete removal of both tumors. There is no evidence of tumoral activity in any of our patients after follow-up periods of 15 months and 5 years. Wide excision seems to be the treatment of choice for this subgroup of osteosarcomas.
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4/60. Periosteal osteosarcoma of the jaws: report of 2 cases.

    osteosarcoma (OS) occurs most often in the long bones. OS of the jaws has clinical and biologic aspects different from those of the long bones. They tend to occur at an older mean age, pain and swelling are more typical, and prognosis is more favorable. Nearly all OS shows a very prominent central intramedullary bone component. Only rarely are juxtacortical (peripheral) OS located in the jaws. There are 2 main types of juxtacortical OS, periosteal and parosteal. We present 2 cases of OS of the jaws where the clinical, radiologic, and histologic findings pointed to a diagnosis of periosteal OS. Both patients presented, in fact, with lesions located superficially on the bone surface with no marrow involvement. Both tumors were characterized by the presence of a moderately differentiated chondroblastic tumor with foci of osteoid and bone formation. Periosteal OS should be differentiated microscopically from periosteal chondrosarcoma, intramedullary OS with periosteal extension, high-grade surface OS, and parosteal OS. The clinical differential diagnosis was done, in these cases, for epulis, gingival tumors, peripheral odontogenic fibroma, peripheral ossifying fibroma, pyogenic granuloma, peripheral giant cell granuloma, and mesenchymal malignant tumors.
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5/60. A case of Burkitt's lymphoma that presented initially with resorption of alveolar bone.

    A 16-year-old male was evaluated for a 1-month history of alveolar bone resorption, which had been treated with endodontics by a neighborhood dentist. Intraoral examination showed slight gingival swelling and teeth mobility. However, no tumor mass was seen. The panoramic image showed resorption of alveolar bone and loss of teeth lamina dura. Because he complained of general fatigue, he was introduced to the internist. Biopsies of gingiva and bone marrow aspiration revealed a massive proliferation of lymphoblasts expressing CD10, 19, 20 and hla-dr antigens on the surface. Their karyotypes were abnormal; 46, XY, t (8;14) (q24;q32). Accordingly, he was diagnosed as Burkitt's lymphoma, and received intensive chemotherapy which relieved his symptoms and decreased his tumor. However, his disease soon became refractory to chemotherapy, and he died 11 weeks after the onset.
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6/60. Multiple odontomas in the facial bones. A case report.

    A rare case of multiple compound odontoma involving the facial bones and erupting into the oral cavity of a 15-year-old Nigerian girl is presented. The unacceptable facial appearance and the surgical approach used makes this case worth reporting.
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7/60. osteosarcoma of the jaw. The Chaim Sheba Medical Center experience.

    OBJECTIVE: The purpose of this article is to present 14 cases of osteosarcoma of the jaw treated at our medical center from 1989 to 1998. These cases are discussed in the light of a comprehensive review of 774 cases reported in the English literature over the past 3 decades. Differences between osteosarcoma of the jaws and osteosarcoma of the long bones are examined. SUBJECTS AND methods: The patients ranged in age from 8 to 78 years, the mean age being 33 years. Each patient had a histopathologically established diagnosis of osteosarcoma of the jaw. Records were reviewed for epidemiologic data, treatment modalities, and survival. RESULTS: Of the 14 patients, 6 (42%) had tumors in the mandible and 8 (58%) had tumors in the maxilla. Of the mandibular tumors, 5 occurred in the body of the mandible; all maxillary tumors originated in the alveolar ridge and involved the maxillary sinus. The chief complaint was an intraoral or extraoral painless swelling. Histopathologic types included chondroblastic, osteoblastic, fibroblastic, and malignant fibrous histiocytoma-like. Pathologic grade was determined to be high (3 or 4) in 13 cases and low (1) in only 1 mandibular case. All patients underwent surgical resection and immediate reconstruction. Adjuvant therapy included postoperative radiation (5 patients), postoperative chemotherapy (2 patients), and preoperative chemotherapy and postoperative radiation (1 patient). CONCLUSIONS: The results of the present study support the literature indicating that osteosarcoma of the jaw differs from osteosarcoma of the long bones in its biological behavior even though they have the same histologic appearance. Because of differences in tumor characteristics, the introduction of chemotherapy did not dramatically alter the prognosis of osteosarcoma of the jaw. early diagnosis and radical surgery are the keys to high survival rates.
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8/60. Unusual presentation of mastoid eosinophilic granuloma in a young patient.

    eosinophilic granuloma is a well-recognized form of Langerhans cell histiocytosis, most commonly involving the skull bones, usually with an excellent prognosis. Recurrent and difficult to recognize osteolytic lesions of the skull are encountered only rarely. A patient with recurrent eosinophilic granuloma of the skull is reported. In spite of appropriate multimodality treatment, there were several recurrences, most recently with involvement of the mastoid process. Imaging studies revealed extensive involvement of surrounding structures with expansion of the tumor into the middle cranial fossa and slight pressure on the antero-medial portion of the temporal lobe of the brain. Despite extensive involvement, the patient had no complaints. Because of the rarity of such silent and unpredictable lesions, a systematic approach with regular CT and MRI follow-up is suggested.
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9/60. Gnathodiaphyseal dysplasia: a syndrome of fibro-osseous lesions of jawbones, bone fragility, and long bone bowing.

    We report an unusual generalized skeletal syndrome characterized by fibro-osseous lesions of the jawbones with a prominent psammomatoid body component, bone fragility, and bowing/sclerosis of tubular bones. The case fits with the emerging profile of a distinct syndrome with similarities to previously reported cases, some with an autosomal dominant inheritance and others sporadic. We suggest that the syndrome be named gnathodiaphyseal dysplasia. The patient had been diagnosed previously with polyostotic fibrous dysplasia (PFD) elsewhere, but further clinical evaluation, histopathological study, and mutation analysis excluded this diagnosis. In addition to providing a novel observation of an as yet poorly characterized syndrome, the case illustrates the need for stringent diagnostic criteria for FD. The jaw lesions showed fibro-osseous features with the histopathological characteristics of cemento-ossifying fibroma, psammomatoid variant. This case emphasizes that the boundaries between genuine GNAS1 mutation-positive FD and other fibro-osseous lesions occurring in the jawbones should be kept sharply defined, contrary to a prevailing tendency in the literature. A detailed pathological study revealed previously unreported features of cemento-ossifying fibroma, including the participation of myofibroblasts and the occurrence of psammomatoid bodies and aberrant mineralization, within the walls of blood vessels. transplantation of stromal cells grown from the lesion into immunocompromised mice resulted in a close mimicry of the native lesion, including the sporadic formation of psammomatoid bodies, suggesting an intrinsic abnormality of bone-forming cells.
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10/60. Preoperative application of limited cone beam computerized tomography as an assessment tool before minor oral surgery.

    We describe the preoperative application of limited cone beam computerized tomography (CT) using a Dental three-dimensional (3D)-CT as an assessment tool before minor oral surgery. The Dental 3D-CT provided 42.7 mm-high and 30 mm-wide rectangular solid images. This size covered the height of the mandible with standing teeth. Dental 3D-CT clearly demonstrated lesions in the maxillary and mandibular bone. Resorption of the bone due to disease expansion was depicted more clearly on the Dental 3D-CT than on conventional radiographs. Information about lesion location and the relationship between the lesions and their adjacent anatomical structures, such as the mandibular canal and maxillary antrum, was useful for minor oral surgery. Due to its high resolution and low radiation dose, Dental 3D-CT was useful for preoperative examination prior to minor oral surgery.
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