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1/2. Primary intraosseous carcinoma and odontogenic cyst. Three new cases and review of the literature.

    INTRODUCTION: The Odontogenic Primary Intraosseous carcinoma (PIOC) are a rare group of malignant tumours with strict clinic and anatomy pathological diagnosis criteria. The different classification suggested for these tumours and the small amount of cases described in literature makes it hard to know exactly how many of the cases published until now are real. MATERIAL AND methods: We present three new cases of PIOC originated from a previous cystic lesion that where treated in our Hospital. Two of them in the posterior jaw region where is more frequent, and the third in the upper jaw. We explain the procedure we used in each case and the aesthetic-functional reconstruction used witches are two fibula osteomyocutaneous free flaps and a bone graft of iliac crest and further placing of implants. The classification, the clinical and radiological diagnosis, the treatment and its survival are discussed. RESULTS: In all three cases we were able to see in the anatomy pathological study an epithelial, exclusively without surrounding oral mucosa affectation or tissues near the lesion as well as the lack of tumorous pathology in other parts of the body. One of the patients died because of premature massive cervical recidiva while the other two patients are currently free form illness, for ten years one of them and fifteen months the other. CONCLUSIONS: The anatomy pathological study of all of the lesions of cystic characteristics at jaw level is very important because of the risk of coexisting with carcinomatous cells. The treatment of these tumours consists in practising aggressive surgery and, in some cases, radio and/or chemotherapy post intervention. ( info)

2/2. Primary intraosseous carcinomas of the jaws arising within an odontogenic cyst, ameloblastoma, and de novo: report of new cases with reconstruction considerations.

    Primary intraosseous carcinoma (PIOC) of the jaws has been rarely reported. The authors report 3 new cases of PIOC arising within an odontogenic cyst, ameloblastoma, and de novo origin, respectively. Surgeons should appreciate the elevated aggressiveness of this tumor despite adequate surgical treatment. The authors recommend initial aggressive surgical treatment to decrease the local recurrence rate. ( info)

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