Surgical treatment of tumours in the anterior mandible and surrounding tissues may result in defects which can be restored by a fibula free flap. The upper airway may change during this process. The ...purpose of this retrospective study was to evaluate upper airway changes after fibula free flap reconstruction. A total of 37 patients who underwent anterior mandibulectomy and fibula free flap reconstruction between 2012 and 2020 were recruited. Patients with benign and malignant tumours involving the anterior mandible were included. Spiral computed tomography was performed 1 week preoperatively, 1 week postoperatively, and at> 1 year (range 12–23 months) after surgery. Cross-sectional areas and volumes of the upper airway were measured. Data were analysed by two-way analysis of variance. The upper airway in the malignant tumour group showed an increasing trend, especially at the soft palate and tongue base levels (P < 0.01). In the benign tumour group, the upper airway showed no significant changes. The location of the minimum cross-sectional area moved downwards in both groups, and the area increased in the malignant tumour group during long-term follow-up. Upper airway obstruction is less likely to occur in the long term after surgical resection of anterior mandible malignancies and fibula free flap reconstruction.
Abstract Background Molecular characterization of ameloblastoma has demonstrated a high frequency of driver mutations in BRAF and SMO . Pre-clinical data suggest that FDA-approved BRAF targeted ...therapies may be immediately relevant for patients with ameloblastoma positive for the BRAF-V600E mutation. Methods A neoadjuvant treatment regime of dabrafenib was given to a patient with recurrent BRAF -mutant mandibular ameloblastoma. The patient subsequently underwent left mandible composite resection of the tumor and pathologic evaluation of treatment response. Results The ameloblastoma demonstrated a slow but dramatic response with over 90% tumor volume reduction. The inner areas of the tumor demonstrated degeneration and squamous differentiation while intact ameloblastoma was present in the outer areas associated with bone. Conclusions Targeted neoadjuvant therapy for ameloblastoma may be useful in certain clinical settings of primary ameloblastoma. These might include tumors of advanced local stage where a neoadjuvant reduction could alter the extent of surgery and instances of local recurrence where surgical options are limited.
An incidental radiolucent lesion involving the angle of the mandible Nör, Felipe; Cuéllar, Juan Pablo Castro; Wongpattaraworakul, Wattawan ...
Oral surgery, oral medicine, oral pathology and oral radiology,
June 2023, 2023-06-00, 20230601, Letnik:
135, Številka:
6
Journal Article
Rhabdomyosarcoma (RMS) with TFCP2 rearrangement has been identified recently. This entity has a distinctive clinicopathologic features: a rapidly aggressive clinical course, a preference for the ...craniofacial bones, a spindle and epithelioid histomorphology, and positive immunohistochemistry for epithelial markers, ALK, and myogenic markers. RMS with TFCP2 rearrangement is rare and may be misdiagnosed as other spindle cell tumors. Here, we report a case of this entity arising in the mandible, which was initially diagnosed as ossifying fibroma in primary tumor in another hospital. A 26-year-old man presented with a recurred mass in the mandible for 1 month after the operation of mandibular tumor. The first excisional specimen was initially diagnosed as ossifying fibroma in another hospital. Histopathologic examination revealed the tumor with a hybrid spindle cell and epithelioid cytomorphology, spindle cells and spindle-to-epithelioid cells with eosinophilic and rich cytoplasm, with high-grade features, prominent nucleoli and some atypical mitosis. Immunohistochemical analysis revealed positivity for desmin, MYOD1, pan-keratin, ALK (5A4), ALK (D5F3). Based on the morphology and immunophenotype, molecular studies were performed, which revealed a FUS::TFCP2 fusion transcript, confirming the diagnosis of Rhabdomyosarcoma with FUS::TFCP2 fusion. Making a correct diagnosis is primarily dependent on awareness by the pathologist of this rare subtype of RMS and careful histopathological evaluation, supported by immunohistochemical and molecular analysis, to avoid potential diagnostic pitfalls.
Background
Although metastatic involvement of bony sites including cranial bones is common in neuroblastoma (NB), mandibular metastases (MM) are uncommon, and specific outcomes have not been reported ...upon in the modern therapeutic era.
Methods
In this retrospective study, medical records on patients with MM from NB were reviewed. Statistical analysis was performed using the Kaplan‐Meier method.
Results
Of 29 patients, nine (31%) had MM at diagnosis, whereas in 20 (69%) MM were first detected at NB relapse at a median time of 26 (6‐89) months from diagnosis. Median maximal diameter of lesions was 3 (range 0.8‐4.9) cm. MM were unilateral in 83% of patients, with ascending ramus (55%) and mandibular body (38%) being the two most common sites. All patients received systemic chemotherapy, and 26 (93%) patients received radiotherapy to MM. At a median follow‐up of 37.3 (24.2‐219.5) months, eight of nine patients with MM at diagnosis did not experience mandibular progressive disease. Eighteen of 20 patients with MM at relapse received therapeutic radiotherapy; objective responses were noted in 78%. Seventy‐two percent (5/18) had not experienced relapse within the radiation field at a median of 12 (2‐276) months postradiotherapy. Dental findings at follow‐up after completion of NB therapy included hypodontia, hypocalcification of enamel, and trismus. Median 3‐year overall survival in patients with relapsed MM was 51 ± 12% months from relapse.
Conclusion
MM when detected at diagnosis is associated with a prognosis similar to that for other skeletal metastases of NB. Radiotherapy is effective for control of MM detected both at diagnosis and relapse. Significant dental abnormalities posttherapy warrant regular dental evaluations and appropriate intervention.
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