Tumours arising from oral minor salivary glands may exhibit an overlap of clinical and morphological features that may produce diagnostic and therapeutic dilemmas. The aim of this study is to asses ...the value of fine needle aspiration cytology (FNAC) in differentiation of benign and malignant tumours and to render a specific diagnosis.We evaluated the team work of surgeon and cytologist to improve diagnostic accuracy. Two steps are important for accuracy: sampling aspirate that should be done together by surgeon and cytologist and cytological microscopic analysis of the smears that should be performed by an experienced cytologist. The study included 132 patients with intraoral minor salivary gland
tumours between 2002 and 2011. Adequate material was obtained from 121 (91.7%) patients. FNAC was usually performed by cytologist in a team with maxillofacial surgeon at cytology department that is more convenient for preparing the samples and especially for ROSE procedure (rapid-on site evaluation) of smears. In such a way the cytologist checked the adequacy of samples and decided whether some ancillary techniques should be used and therefore repeat FNAC. A total of 82 patients underwent surgery, 40 with malignant and 42 with benign tumours. Preoperative cytological diagnoses were compared with histopathological ones using histopathology as a gold standard. The most common benign tumour
was pleomorphic adenoma and among malignant tumours adenoid cystic carcinoma. The most commonly affected site was the palate. The team work of surgeon and cytologist achieved specificity of 95.1%, sensitivity of 97.6% and diagnostic accuracy of 96.3%. We can conclude that although subclassification of some tumour types of salivary glands remains poor, FNAC is invaluable in patient triage and therefore should be considered in the first line investigations of these lesions by the cytologist and surgeon.
Although civilian populations have been heavily involved in most of the recent wars and conflicts throughout the world, most reports analyzed casualty data of military personnel, often leaving ...civilian casualties excluded or underestimated. A comparison of epidemiologic and medical data for maxillofacial injuries between civilians and servicemen (policemen, soldiers, and United Nations Protection Forces) during the aggression against Croatia is attempted. Of the 220 casualties admitted to the Department of Maxillofacial Surgery in Zagreb between August 1991 and December 1992, almost one-fourth were civilians. A significant difference between civilians and servicemen was noted in age and sex distribution. The incidence and severity of maxillofacial and associated injuries is almost equal, and the pattern of injuries is of the same type for civilian and military personnel.
U suradnji s »Instrumentarijom« iz Zagreba 1987. godine izrađena
je na Klinici za kirurgiju lica, čeljusti i usta vlastita modifikacija seta za osteosintezu kostiju lica minipločicom. Cilj rada jest ...da se ocijeni uspješnost liječenja prijeloma donje čeljusti minipločicom »Instrumentarija« te da se ona usporedi s »klasičnim« metodama
liječenja - intermaksilarnom fiksacijom i osteosintezom žičanom ligaturom. U radu je primijenjena vlastita metoda u ocjeni uspješnosti
liječenja prijeloma donje čeljusti. Metoda se koristi ocjenom liječnika i samoocjenjivanjem. Pet osnovnih parametara za ocjenu uspješnosti liječenja: okluzija, žvakanje, izgled nakon liječenja, trajanje intermaksilarne fiksacije i komplikacije, raščlanjeno je i bodovano, što nam je omogućilo objektivizaciju uspjeha liječenja pojedinom metodom. Obrađeno je 124 bolesnika s prijelomom donje čeljusti koji su zadovoljavali zadane kriterije. Iz rezultata zaključujemo da intraoralni pristup ima prednosti pred ekstraoralnim. Pregledom uspješnosti svih triju metoda zaključujemo da se najbolji uspjeh liječenja kod prijeloma donje čeljusti postiže osteosintezom minipločicom, te je smatramo metodom izbora kod prijeloma koji zahtijevaju osteosintezu, a zbog brze uspostave funkcije i malog broja komplikacija dajemo joj prednost pred konzervativnom terapijom ako nema kontraindikacija za njezinu primjenu.
Chondroid syringoma (CS) is a rare, benign, appendageal tumor with diagnostic feature of myxochondroid stroma supporting eccrine and apocrine epithelial structures. The usual presentation is a ...painless, slowly growing mass, typically located in the head and neck region. It usually affects middle-aged and older male patients. Because of its unremarkable clinical presentation it is often overlooked. It should be included in the differential diagnosis of cutaneous head and neck tumors, especially in middle-aged men. Optimal treatment of CS is total surgical excision. We present a 63 year-old man with a small nodule on the neck with 5 years of duration. The diagnosis was made initially on fine needle aspiration cytology that was performed by ultrasound guidance and confirmed subsequently by histology. FNA cytology may be very useful to determine diagnosis before excision.
Sluznica usne šupljine prekrivena višeslojnim pločastim epitelom izvorište je benignih i malignih promjena, od jednostavnog fibroma pa do karcinoma usne šupljine. Doktori stomatologije mogu, s ...obzirom na dostupnost patoloških promjena rutinskom kliničkom pregledu, bez dodatnih dijagnostičkih metoda postaviti dijagnozu i uputiti bolesnika oralnom ili maksilofacijalnom kirurgu. U ranom otkrivanju i liječenju različitih tvorbi najvažnije je bolesnika uputiti pravodobno, kako bi se i manjim kirurškim zahvatima mogao izliječiti.
Na sluznici se manifestiraju i patološki procesi dubljih slojeva. U malim žlijezdama slinovnicama svih dijelova usne šupljine mogu se razviti mukozne ciste, benigni i maligni tumori. Tumori žlijezda slinovnica čine oko 3% svih tumora u tijelu, dakle razmjerno su rijetki. No važno je znati da 10 do 20% svih navedenih tumora nastaje u malim žlijezdama, najčešće na nepcu. Jednako tako važan je podatak da razmjerna čestoća malignih tumora raste kako se veličina žlijezda u kojima se pojavljuje smanjuje.
Prikaz slučaja
Bolesnik u dobi od 21 godine dolazi na pregled zbog bezbolne izrasline na tvrdome nepcu u visini kutnjaka, promjera 2 cm, široke baze, egzulcerirane površine i zadebljalih rubova. Iz anamneze saznajemo da bez subjektivnih tegoba traje oko 2 godine. Prije šest mjeseci tvorba je egzulcerirala i osjetio je da iz nje izlazi tekućina. Učinjena biopsija pokazala je da je riječ o mukoepidermoidnom karcinomu, o malignoj neoplazmi male žlijezde slinovnice koja nastaje u svakoj životnoj dobi, no ipak je najčešća u djece. Tumor je odstranjen elektroskalpelom, a patohistološki nalaz potvrdio je dijagnozu te pokazao da je riječ o prvome stupnju malignosti (G-1). Takve vrste tumora rjeđe recidiviraju i metastaziraju, a prema podatcima iz literature stupanj izliječenja unutar 5 godina iznosi 90%.
Malignome malih žlijezda slinovnica često je teško klinički međusobno razlikovati, a mogu sličiti i benignom pleomorfnom adenomu. Pravodoban dolazak bolesnika na pregled, pravodobno upućivanje specijalistu te pravodobna biopsija i kirurški zahvat povećavaju izglede za izlječenje.
Role of various cytokines have been implicated in the development and perpetuation
of Sjögren's syndrome (SS), but no specific cytokine could be determined as a major contributor
to the SS. Salivary ...and serum interleukin 6 (IL-6) levels have been studied previously
in patients with SS, but data upon salivary and serum basic fibroblast growth
factor (bFGF) in SS are lacking. The aim of this study was to evaluate levels of salivary
and serum IL-6 and bFGF in 18 patients with SS, age range 32–79, mean 54.05 years.
Control group consisted of 23 healthy participants, mean age 25 years. Serum IL-6 and
bFGF levels were not significantly different between patients with SS and healthy controls.
Elevated levels of salivary IL-6 and bFGF in patients with SS when compared to
the healthy controls were found (p<0.001). We might speculate that higher levels of salivary
IL-6 and bFGF in patients with SS might originate from local production probably
having source in the salivary glands.
U literaturi postoje podatci o ulozi interleukina 6 (IL-6) i bazičnoga čimbenika rasta fibroblasta (bFGF) u bolesnika s oralnim karcinomima, ali nema podataka o salivarnom IL-6 i bFGF u tih ...bolesnika.
Svrha ovoga ispitivanja bila je odrediti vrijednosti salivarnog i serumskog IL-6 i bFGF u 35 bolesnika s planocelularnim karcinomom usne šupljine, dobi od 40-73 godine, prosječne dobi 54 godine. Kontrolna se je skupina sastojala od 23 zdrava sudionika, u dobi od 25 godina. Dobiveni podatci analizirani su Mann-Whitney U testom i vrijednosti manje od 0,001 smatrale su se statistički znatnima. Serumske vrijednosti IL-6 i bFGF nisu se znatno razlikovale između ispitne i kontrolne skupine. Povišene vrijednosti salivarnog IL-6 i bFGF ustanovljene su u oboljelih od planocelularnoga karcinoma u usporedbi s kontrolnom skupinom (p<0,001). Možemo zaključiti da povišene vrijednosti salivarnog IL-6 i bFGF u oboljelih od planocelularnoga karcinoma potječu od lokalne proizvodnje.
Are the new staging rules better for T4 oral cancer? Virag, Misˇo; Uglesˇić, Vedran; Aljinović, Narandzˇa ...
The American journal of surgery,
11/1995, Letnik:
170, Številka:
5
Journal Article, Conference Proceeding
Recenzirano
Background: In order to find whether the changes in primary tumor definition influence the distribution of T (tumor extent) stages and prognoses, a retrospective study was undertaken.
Patients and ...methods: There were 1,040 patients with adequate data for staging and 868 of those patients underwent surgical treatment. Among the surgically treated patients, 187 fulfilled the new (American Joint Committee on Cancer AJCC/International Union Against Cancer 1988) and 77 fulfilled the old (AJCC 1977) criteria for T4 tumors. The distribution of all patients, rate of patients initially treated with surgery, incidence of metastases, and survival were analyzed.
Results: The neck was clinically positive (N+) in 50% of T4 patients staged according to the new rules and 69% of patients staged according to the old rules. The 5-year overall survival rate for T4-staged patients irrespective of therapy was 29% using the new rules and 13% using the old rules. The 5-year disease-free survival rate for T4-operated patients was 60% using the new rules and 45% using the old rules.
Conclusions: The previous AJCC rules for the T4 tumors were a better indicator of poor prognosis.
Rizik maligne transformacije oralnoga lichena planusa predmetom je mnogih rasprava i oprečnih stajališta u literaturi. Kronicitet oralnih lezija lichena nosi manji rizik za nastanak oralnoga ...karcinoma, a rizik za njegov nastanak veći je na već upaljenim, atrofičnim i erozivnim površinama oralnoga lichena. procjenjuje se da OLP maligno alterira
u 0,4 - 2,5% slučajeva, pretežito onih s već prije dokazanom lichenoidnom displazijom. Novije molekularno genetičke studije pokazuju minimalne genetičke promjene u lezijama oralnoga lichena, a veće su promjene zabilježene u epitelnoj displaziji i malignim lezijama.
Ovim radom želimo prikazati dva dobro dokumentirana slučaja oralnoga karcinoma koji se je razvio na bukalnoj sluznici u osoba s dugotrajnim oralnim lichenom.
Prikazani slučajevi dokumentiraju i upozoravaju na prirodnu sklonost oralnoga lichena planusa malignoj alternaciji i ističu nužnost redovitih biopsija: inicijalne biopsije kod prvoga pregleda radi postavljanja dijagnoze i češćih kontrolnih biopsija tijekom kliničkoga praćenja lezija kako bi se pravodobno otkrile promjene koje upozoravaju na
displaziju. S obzirom na to da OLP predstavlja rizičnu leziju, potrebne su i genetičke raščlambe određenim markerima.
