Ameloblastoma is the most common among all oral cavity neoplasms. It is benign and happens because of a genetic malfunction of the cells responsible for the enamel, called ameloblasts. These tumors ...may occur in any place of the oral cavity, and often present quick growth. Surgery is the main course of treatment, seeking full tumor excision. Surgery may be associated with chemotherapy or radiation. This paper aims to report a case of bilateral total mandibulectomy of a patient with ameloblastoma. The patient had no previous medical history and had a large jaw tumor that caused sialorrhea with blood streaks, cachexia, problems with mouth occlusion, pain and anemia. Left total mandibulectomy was the first-choice treatment, but a right partial mandibulectomy was needed afterwards. However, 2 other reinterventions were necessary, which led to total bilateral mandibulectomy. In conclusion the chosen procedure was effective in bringing quality of life and well-being to the patient.
Dentre as neoplasias de cavidade oral a mais frequente é o ameloblastoma, uma neoplasia benigna de origem odontogênica, derivada da disfunção genética de células responsáveis pela síntese do esmalte dentário, os ameloblastos. Estes tumores podem ocorrer nas mais diversas localidades da cavidade oral e, habitualmente, possuem características de evolução rápida. O principal tratamento baseia-se na exérese tumoral cirúrgica associada ou não a tratamentos adjuvantes como a radioterapia ou quimioterapia. Este trabalho tem como objetivo relatar um caso de mandibulectomia total bilateral com diagnóstico de ameloblastoma. O paciente chegou sem histórico anterior com massa mandibular de grandes proporções e apresentando sialorreia com estrias de sangue, caquexia, dor, dificuldade em ocluir a cavidade oral e anemia. Inicialmente foi realizada mandibulectomia total esquerda e parcial direita, em seguida necessitou de duas reintervenções culminando em mandibulectomia total bilateral, concluiu-se que o procedimento estabelecido foi eficaz como tratamento, trazendo melhor qualidade de vida, conforto e bem-estar ao paciente.
Nasopharyngeal angiofibroma is a histologic benign but locally aggressive vascular tumor described in humans. The description of this disease in dogs is limited. A mixed-breed female dog was ...presented with a history of epistaxis and nasal discharge. Rhinoscopy and computed tomography revealed a soft-tissue mass obstructing the entire nasal cavity, choana, maxillary recess, and right frontal sinus, but there was no bone or lymph node involvement. Histopathologic evaluation revealed irregular groups of blood vessels within a stroma of connective tissue, with secondary inflammation. Immunohistochemistry showed strong vimentin staining, mild factor VIII-related antigen staining, and negative staining for S100. The patient underwent tumor resection with fenestration surgery through the right maxillary bone, and there was tumor recurrence one year after surgery. This case report describes new findings regarding the immunohistochemical evaluation of nasopharyngeal angiofibroma in a dog. The laboratory and imaging findings, associated with a long-term follow-up, reinforce similar features between human and canine angiofibroma and may serve as a basis for immunohistochemical evaluation of this tumor in dogs.
Background: Large skin defects are caused by tumor excision, making appropriate reconstruction and complete healing of the lesion a challenge for surgeons. There are some difficulties in reaching ...these goals, especially in cases of surgical wound in the limbs, due to the scarce amount of skin and its reduced elasticity, which limit the possibility of flaps when compared to the head, neck, and trunk. This study reports a case of wound closure on the lateral skin in the femoral region of a dog’s pelvic limb via island skin graft associated with the implantation of a nonadherent cellulose acetate mesh and intensive postoperative care.Case: An 8-year-old Rottweiler female dog was attended at Pontifical Catholic University of Paraná’s Veterinary Clinic (CVE), in Curitiba, Paraná, presenting a tumor located laterocaudally to the right stifle joint. After preoperative examinations, the patient underwent tumor surgery; however, two more surgical procedures were required due to suture dehiscence in the region, which resulted in increased wound size. At first, the wound was treated for granulation tissue to be formed. Subsequently, the island skin grafting technique was chosen to close the wound, associated with the implantation of a nonadherent cellulose acetate mesh imbibed with petrolatum emulsion to keep the grafted fragments in place. The mesh was fixed in a simple interrupted suture pattern using 2-0 nylon thread. The lateral regions of the chest and abdomen were chosen as donor skin beds due to their large dimensions, skin elasticity, and ease in defect reconstruction. The fragments were obtained using a 10-mm biopsy punch and scalpel, and the defects were sutured in a simple interrupted pattern using 2-0 nylon thread. The patient remained hospitalized for movement restriction and postoperative monitoring for 72 h, and the bandage remained untouched during this time interval. Thereafter, the patient was discharged and it was recommended to clean the wound with jets of 0.9% saline using a 40 × 12 needle attached to a 20 mL syringe, from a distance of 10 cm from the wound. The dressings were changed every 48 h to maintain minimum contact with the wound; however, still keeping it clean to optimize healing. Fourteen days postoperatively, the sutures as well as the non adherent mesh were removed from the donor beds. The dressing was changed and the lesion was cleaned every 24 h because the fixation between the receptor bed and the implanted tissue was considered good. After approximately 80 days, complete epithelialization of the wound was observed.Discussion: Closing of large skin defects in the limbs is challenging due to the impossibility of using other reconstructive surgery techniques, which have limited use because of the extension of the lesion. However, island skin grafting can be considered despite its slower skin healing process than that of skin flaps. Specific management is required for the successful execution of this technique, and in the present case, the application of the non adherent mesh after island skin grafting helped in the immobilization and better adhesion of the fragments to the receiving bed. Thus, it was demonstrated that in-depth knowledge of reconstructive surgery and the surgeon’s expertise favor the emergence of ideas and more effective techniques that ensure success of the surgical procedure by avoiding complications and improving the patients’ quality of life.
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