Cases reported "Maxillary Neoplasms"

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1/56. Fibrodysplasia ossificans progressiva and associated osteochondroma of the coronoid process in a child.

    The article reports the occurrence of osteochondroma in a fibrodysplasia ossificans progressiva patient. A 5-year-old boy presented with limited mouth opening and firm swelling of the right zygomatic complex area. The boy had bilateral hallux valgus of the great toes and heterotopic endochondral ossification of facial and neck regions. Associated osteochondroma of the coronoid process and aggressive heterotopic ossification of masticatory and neck muscles were found in response to traumatic injuries. Natural and clinical histories of fibrodysplasia ossificans progressiva were reviewed. An early diagnosis and avoidance of factors that aggravate ossification are key factors in reducing the expected degree of physical disabilities of patients. An early recognition of congenital skeletal deformities, early detection of abnormal ossification, and awareness of the disease by the involved physicians are important factors in the early diagnosis of the disease and in reducing any unnecessary trauma. Bone scintigrams and CT scans are effective noninvasive tools for an early detection of ossification and for monitoring the progression of the disease. Further investigation of its pathogenesis at a molecular level is important to understand better the nature of the disease and to develop an effective treatment protocol.
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2/56. Malignant ameloblastoma of the maxilla.

    This case illustrates a rare occurrence of an ameloblastoma arising in the maxilla and metastasizing to the neck and lungs within a three-year period following the initial resection. A discussion of the pathology is presented and the necessity for aggressive initial therapy with close follow-up is emphasized.
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3/56. endodermal sinus tumor of the maxillary sinus: a case report.

    endodermal sinus tumor is an uncommon malignant germ cell tumor that occurs in both gonadal and extragonadal tissues. Endodermal sinus tumors of the head and neck, exclusive of the central nervous system, are rare. We report a case of endodermal sinus tumor arising from the maxillary sinus in a 4-year-old boy. Combined treatment with radiation therapy and chemotherapy resulted in complete tumor regression.
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4/56. Reconstruction of the pediatric maxilla and mandible.

    BACKGROUND: The creation of osseous defects in the upper and lower jaws in children is an uncommon occurrence. It is therefore likely that a head and neck reconstructive surgeon will accumulate only limited experience in restoring such defects. We have reviewed 7 pediatric bone-containing microvascular free flap reconstructions in 6 patients for reconstruction of the upper or lower jaws. Three patients were available for long-term follow-up to evaluate the effect of osseous free flap reconstruction on function and growth and development of the donor site. DESIGN: Retrospective review. SETTING: Academic tertiary referral center for otolaryngology. patients AND methods: Six pediatric patients ranging in age from 8 to 16 years underwent 2 fibular, 4 scapular, and 1 iliac free flap procedure for restoration of 2 maxillary and 5 mandibular defects from 1992 to 1997. Three of the 6 patients were available for long-term follow-up to assess the postoperative donor site function in an effort to determine the effect of this surgery on long-term donor site morbidity and development. RESULTS: Two patients were lost to follow-up, and 1 died secondary to complications related to distant metastatic disease. Three of 6 patients were observed for 2 years 6 months, 4 years, and 4 years 2 months, respectively. Two of the 3 patients who were observed long term have undergone full dental rehabilitation and currently maintain a regular diet and deny pain with mastication or deglutition. One patient did not require dental rehabilitation. All 3 patients demonstrate gross facial symmetry and normal dental occlusion. Assessment of the fibular donor site demonstrated normal limb length and circumference. The patients denied pain or restriction to recreational activity. Scapular donor sites demonstrated normal range of motion, strength, and shoulder stability. CONCLUSIONS: Free flap reconstruction of the pediatric maxilla and mandible requires harvesting bone from actively growing donor sites. We have found no evidence of functional deficit after bone harvest from the fibular or scapular donor sites. patients demonstrate normal growth at the donor sites, and symmetry of the mandible and maxilla is preserved.
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5/56. Trans-osseous passage of head and neck brachytherapy tubes.

    brachytherapy following surgical resection of head and neck malignancy is a useful adjunct if full dose external beam radiotherapy has been performed previously. Percutaneous tube placement has been described but accurate placement can be technically difficult in certain areas of the head and neck. A case report is presented of trans-osseous brachytherapy tube placement through the zygoma bone to allow for optimum surgical bed irradiation without kinking of the tubes. It is proposed that the trans-osseous placement is a useful technique when siting of the tubes is difficult.
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6/56. Treatment of giant cell granuloma of the maxilla with intralesional injection of steroids.

    BACKGROUND: Giant cell granuloma is rare in the head and neck region and most commonly affects the maxilla and mandible. Although it is a benign disease process, it may be locally destructive. Surgery is the treatment currently recommended. Because of the location of the disease, surgery may be disfiguring. Because it is a benign process, less radical nonsurgical treatment alternatives are desirable. methods: A case report of a giant cell granuloma treated with steroid injections. RESULTS: After six weekly intralesional steroid injections, a giant cell granuloma of the maxilla became calcified and smaller. After a follow-up period of 2 years, there was no evidence of regrowth, and the bony osteolytic lesion had filled with bone. A review of the literature revealed two case reports of successful steroid injections with similar response. CONCLUSIONS: Steroid injections are a viable alternative in the treatment of giant cell granuloma, which may avoid surgery.
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7/56. The operating microscope in the management of melanotic neuroectodermal tumor of infancy.

    Melanotic neuroectodermal tumor of infancy is a rare condition that is most commonly found within the head and neck regions. We present a 4-month-old boy with a melanotic neuroectodermal tumor of infancy of his maxilla. Because of the fairly high recurrence rate, the operating microscope was used after surgical excision to remove unseen remnants of the pigmented lesion. The patient has been followed for 4 years without signs of recurrence.
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8/56. Inheritance of Hippel-Lindau disease: a rare case of maxillary bone metastasis.

    A rare case of familial Hippel-Lindau disease, which is an autosomal dominant disorder with inherited susceptibility to various forms of cancer, is reported in a 46-year-old father and his sons. The father complained of a malignant hypernephroma, which metastasized in the upper jaw 6 months later. As in this patient, renal cell carcinomas are fatal and are exhibited at an early age. Consequentially, patients with familial von hippel-lindau disease exhibiting cases of renal cell carcinoma should be examined very carefully in the head and neck region to detect and treat metastases as early as possible.
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9/56. dermoid cyst of the maxillary sinus.

    Dermoid cysts are rare developmental teratomatous lesions composed of ectodermally derived stratified squamous epithelium and mesodermally derived skin adnexal structures. As part of the teratomatous lesion group, dermoid cysts are related to teratoid cysts, true teratomas, and epignathi. Although several theories have been postulated, the pathogenesis of dermoid cysts, and teratomatous lesions in general, is unclear. Most commonly affecting sites within the head and neck, dermoid cysts may be found in the frontotemporal/lateral brow area, central nasal area, oral cavity, lateral neck, and other sites. We present what is believed to be the first reported case arising within the maxillary sinus and briefly discuss the possible pathogenesis.
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10/56. Radiographic evaluation of malignant fibrous histiocytoma affecting maxillary alveolar bone: a report of 2 cases.

    OBJECTIVE: The purpose of this study was to evaluate the radiographic findings of malignant fibrous histiocytoma (MFH) and to discuss the contribution of these findings to a differentiation of MFH from other malignant tumors of the head and neck. STUDY DESIGN: Two cases of MFH of the maxillary sinus affecting the alveolar bone were evaluated radiographically and scintigraphically. RESULTS: We reported the following findings, which have only seldom been described: the presence of fairly well-demarcated bone destruction in the intraoral radiograph; the relatively smooth surface, uniform density, or no necrotic area of the tumor; in computed tomograph images showing the clear separation of the tumor from surrounding soft tissues; bone scintigraphs reflecting the periosteal reaction to tumor invasion; and lymphoscintigraphy of the metastatic lymph nodes. CONCLUSION: We evaluated the radiographic findings from 2 cases of MFH and describe findings that may aid in the differentiation of MFH. These radiographic features may help dentists differentiate MFH from other malignant tumors in the head and neck, although MFH is a rare disease and there are no radiographic findings that would indicate a specific diagnosis of MFH.
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