Mandibular Tumor Research Articles

Evaluation of the Inferior Alveolar Canal for Cysts and Tumors of the Mandible—Comparison of Multidetector Computed Tomography and 3-Dimensional Volume Interpolated Breath-Hold Examination Magnetic Resonance Sequence With Curved Multiplanar Reformatted Reconstructions

To evaluate the mandibular canal using volume interpolated breath-hold examination (VIBE) sequencing in patients with cysts and tumors of the mandible. Twenty-five patients with mandibular cysts and tumors were recruited for a study in the authors' institution to compare the role of multidetector row computed tomography with magnetic resonance imaging (MRI) in jaw lesions. Of these 25 patients, VIBE was performed in 12 patients (age range, 16 to 52 yrs; 11 male and 1 female patients) and formed the study group. The status (normal/destroyed/attenuated) and position of the inferior alveolar canal (normal/displaced) on panoramic reconstructed computed tomographic (CT) images and curved multiplanar reformatted (MPR) images reconstructed from VIBE images were analyzed. The contralateral normal mandibular canal was used as the control in these patients. In all 12 patients, the inferior alveolar canal on the normal side was visualized as a hyperintense structure in relation to the hypointense bone on the curved MPR VIBE images. In 9 patients, the inferior alveolar canal was equally well visualized on panoramic CT and curved MPR VIBE images. In 2 patients, the inferior alveolar canal was better visualized on curved MPR VIBE images; in 1 patient, the course of the mandibular canal was better seen on panoramic CT images. MR reconstructions with VIBE sequencing as source images provide images comparable to CT reconstructed images for evaluation of the mandibular canal. Three-dimensional (3D) VIBE sequencing can be added to the MR protocol to visualize the inferior alveolar neurovascular bundle. 3D VIBE sequencing increases the diagnostic capabilities of MRI when used to image mandibular cysts and tumors.

Odontogenic myxoma: A rare case involving maxillary sinus with a brief review of the literature

Myxoma is one of the least common lesions of maxillary bone, representing 3 to 8% of odontogenic tumors and cysts. It apparently rises from the mesenchymal portion of the tooth germ, the dental papilla, the follicle, or the periodontal ligament. Some authors had previously associated its origin with a myxomatous change of an odontogenic fibroma or residual foci of embryonic tissue. In the jaws, the myxoma occurs most often in the mandible, generally in the posterior region. However, many investigators do not agree with these data and report an equal frequency of mandibular and maxillary tumors. When located in the maxilla, the tumor frequently involves the maxillary sinus, though the literature refers to the mandible as the most common location of the tumor. The present paper presents a case of odontogenic myxoma (OM) involving the maxillary sinus, a rare case according to the literature.

Brown tumor in mandible as a first sign of vitamin D deficiency: A rare case report and review

Central giant cell granulomas (CGCGs) are uncommon but the most aggressive benign intraosseous tumors of jaws, with an unpredictable outcome. They account for less than 7% of all benign jaw lesions, with a female to male ratio of about 2:1. The classical “brown tumor” is commonly seen in the long bones, pelvis, and ribs. Facial bone involvement is rare and usually appears as solitary or multilocular soap bubble like radiolucencies. CGCGs are traditionally treated by both surgical and intralesional injection, with a variable recurrence rate. Here, we report a 12-year-old female patient with mandibular brown tumor as a first sign of secondary hyperthyroidism induced due to vitamin D deficiency and hypocalcemia.

下顎関節突起に生じた軟骨芽細胞腫の1例

Chondroblastoma is a rare benign tumor of the head and neck. We report a case of chondroblastoma of the mandibular condyle. A 56-year-old woman was referred to our department for the treatment of a left mandibular condyle tumor, which was detected on computed tomography （CT）. The patient had a 3-month history of intermittent pain in the left pre-auricular area, accompanied by episodic trismus and subjective swelling around the lesion. CT and magnetic resonance imaging （MRI） revealed an osteolytic defect in the anterior portion of the left mandibular condyle and a mass extending anterolaterally. The biopsy diagnosis was a chondroblastoma. We performed an en bloc resection that included part of the mandibular ramus. There has been no sign of recurrence for 26 months postoperatively.

Simultaneous Palatal Pleomorphic Adenoma and Mandibular Keratocystic Odontogenic Tumor in a Pediatric Patient

Neoplasms of the salivary gland account for 3% of all head and neck tumors; most of these occur in the parotid gland and are benign; 80% of them are pleomorphic adenomas. Benign neoplasms of the salivary gland are rare in children compared with adults. Keratocystic odontogenic tumor (KCOT) is considered the second most frequent neoplasm of all odontogenic tumors after the ameloblastoma. In the present report, we introduce the unusual presentation of a child with a simultaneous pleomorphic adenoma of the right hard palate and a KCOT of the left mandibular angle. The case is significant for 2 reasons; according to the literature, there are few reports of pleomorphic adenoma arising from a minor salivary gland of the palate in a patient younger than 18 years. This is to our knowledge the first recorded instance of simultaneous palatal pleomorphic adenoma and mandibular KCOT occurring in a child.

Intraosseous Mandibular Venous Malformation

Intraosseous venous malformations are rare benign lesions that account for approximately 0.5% to 1% of all osseous tumors. Involvement of the facial skeleton is rather uncommon, with the mandible and maxilla most frequently involved. In the current study, we report a case of an intraosseous venous malformation in a 52-year-old male patient with a history of mandibular keratocystic odontogenic tumor. The patient presented with an asymptomatic bony lesion in the mandible. Treatment involved surgical excision. Histopathologic examination of the excised specimen revealed an intraosseous venous malformation. Twelve months postoperatively, there was no evidence of recurrence.

Piezoelectric-assisted removal of a benign fibrous histiocytoma of the mandible: An innovative technique for prevention of dentoalveolar nerve injury

In this article, we present our experience with a piezoelectric-assisted surgical device by resection of a benign fibrous histiocytoma of the mandible.A 41 year-old male was admitted to our hospital because of slowly progressive right buccal swelling. After further radiographic diagnosis surgical removal of the yellowish-white mass was performed. Histologic analysis showed proliferating histiocytic cells with foamy, granular cytoplasm and no signs of malignancy. The tumor was positive for CD68 and vimentin in immunohistochemical staining. Therefore the tumor was diagnosed as primary benign fibrous histiocytoma. This work provides a new treatment device for benign mandibular tumour disease. By using a novel piezoelectric-assisted cutting device, protection of the dentoalveolar nerve could be achieved.

Imaging findings in mandibular primitive neuroectodermal tumour: a report of a rare case and review of the literature

Primitive neuroectodermal tumours (PNETs) are aggressive undifferentiated tumours that occur mainly in the central nervous system (CNS). Reviewing the literature, only six cases of primary PNET of the mandible have been reported. These rare tumours are usually overlooked in clinical practice. An 18-year-old woman who presented with dental caries and left cheek swelling was initially diagnosed with facial cellulitis, but the swelling persisted despite adequate intravenous antibiotic therapy. Subsequent ultrasound and MR examinations revealed a tumour originating from the left mandibular ramus. The ultrasonography-guided percutaneous core needle biopsy confirmed the diagnosis of peripheral PNET. The radiographic features of mandibular PNETs are similar to those of PNETs in other regions, except for haemorrhage, necrosis and calcification. In addition, this is the first reported case with sonographic and MR images of this rare tumour, and the first case that was diagnosed based on the ultrasonography-guided percutaneous core needle biopsy. Using these image characteristics, mandibular PNETs can be diagnosed more accurately.

Decompression and surgical treatment of large mandibular tumor with a satellite focus

Decompression and surgical treatment of large mandibular tumor with a satellite focus

Osteosarcomas de la región de cabeza y cuello

Osteosarcoma of the head and neck area. Analysis of 12 patients Background: Less than 10% of osteosarcomas are located the head and neck region, mainly affecting the mandible and maxillary region. Aim: To analyze the therapeutic modality, types of reconstruction, surgical complications and survival of patients treated for osteosarcoma of the head and neck. Material and Methods: Review of medical records of 12 patients aged 17 to 34 years (6 women) treated for osteosarcoma of the head and neck between september 1998 and may 2009. Results: The localization of the tumor was maxillary in eight, mandibular three and ethmoidal in one patient. According to histologic grade, seven tumors were grade 1, four were grade 2 and one was grade 3. Adjuvant and neoadjuvant chemotherapy were administered to all and seven patients, respectively. The surgical treatment for maxillary tumors was maxillectomy. A reconstruc- tion with rectum abdomini free fl ap was done in four patients and with dermoepidermic graft and an obturator prosthesis in three. In one patient, the defect was covered with a dental prosthesis. Treatment for mandibular tumors was mandibular excision. A reconstruction with peroneal free fl ap was performed in two patients and with an iliac crest graft in one. The ethmoidal tumor was resected and covered with local fl aps. There were four complications. Two patients had a cutaneous fi stula, one patient had a free fl ap partial atrophy and one patient had surgical site infection. Two patients who had positive margins died from local recurrence. Of the 10 patients with negative margins, seven are alive without recurrence, one died due to the disease, one has disseminated disease and one died from another cause. Conclusions: Our results in the treatment of head and neck osteosarcomas are consistent with published data.

Management of Mandibular tumors in the pediatric patient

Management of Mandibular tumors in the pediatric patient

Squamous cell carcinoma (Marjolin's ulcer) in an orocutaneous fistula of a large mandibular ameloblastoma: a case report

IntroductionAmeloblastomas are rare lesions constituting 1% of all jaw tumors. Oral squamous cell carcinomas are common lesions; these constitute about 90% of all oral cancers. Concurrent tumors consisting of ameloblastoma and squamous cell carcinoma are extremely rare.Case presentationThis case report describes a 35-year-old African man who presented with a large mandibular tumor with an orocutaneous fistula that was found to be an ameloblastoma on histopathological examination, with concurrent squamous cell carcinoma histology within the fistula. This presentation was consistent with a Marjolin's ulcer within an ameloblastoma.ConclusionAmeloblastomas and Marjolin's ulcers require different management strategies. Careful histopathological examination of surgical specimens is key to patient outcome, as treatment of these patients depends on an accurate diagnosis.

Ameloblastoma of the Jaws: A Retrospective Analysis of 340 Cases in a Malaysian Population

Ameloblastoma of the human jaw is an uncommon but clinically significant odontogenic epithelial neoplasm. The aim was to analyze the clinicopathologic characteristics of ameloblastoma in a Malaysian population. This is a retrospective study (1993 through 2008) of consecutive ameloblastoma cases accessioned in 2 main oral pathology diagnostic centers: the Unit of Stomatology, Institute for Medical Research and the Department of Oral Pathology, Oral Medicine, and Periodontology, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia. Data on patient demographics, tumor location, symptomology, duration, radiographic appearance, preoperative diagnosis, clinicopathologic subtypes, treatment, and recurrence were analyzed. Three hundred forty cases of ameloblastoma were reviewed. These were from 197 male patients (57.9%) and 143 female patients (42.1%), with a male-to-female ratio of 1.4:1. A wide age range (7 to 85 years), mean onset age of 30.3 ± 16.3 years, and peak incidence in the second decade of life were recorded. Most were mandibular tumors (n = 311/340, 91.5%). These consisted of 95 (28%) unicystic ameloblastomas, 221 (65%) solid/multicystic ameloblastomas, 22 (6.4%) desmoplastic ameloblastoma, and 2 (0.6%) peripheral ameloblastomas. Unicystic ameloblastoma (41.1%) and solid/multicystic ameloblastoma (52.0%) mostly affected Malays patients, whereas desmoplastic ameloblastoma (59.1%) was prevalent in Chinese patients. Unicystic ameloblastoma (56.8%) and solid/multicystic ameloblastoma (47.1%) occurred predominantly in the body and posterior mandible, whereas desmoplastic ameloblastoma (36.4%) preferentially involved the anterior jaw segment. Most tumors presented as multilocular radiolucencies (36.8%). Enucleation (n = 42/92, 45.7%) was the treatment of choice. About 18 cases (13.3%) presented with recurrence. Because ameloblastoma subsets differ in their biologic behavior, the present data are significant as baseline references for clinicians and pathologists.

Benign mandibular tumours: Two case studies from the Maya lowland site of Tikal, Guatemala

AbstractThis study presents a differential diagnosis of benign mandibular tumours identified in two adult burials from the precontact Maya city of Tikal, Guatemala. Both individuals were recovered from domestic structures that date to the Late Classic Period (AD 550–850). The osseous growths were interpreted as probable benign tumours based on evidence of localised growth, a circumscribed border, a dense texture and a lack of osteolytic activity or spiculate bone formation.Burial PTP‐026A is a middle adult (35–50 years) of indeterminate sex with evidence of a small dense, circular mass extending laterally from the right mandibular corpus. Macroscopic and radiographic assessment of this lesion provided a diagnosis of osteoma, a true neoplasm, or alternately, hyperplasia (e.g. exostosis) or hamartoma, which are not true neoplasms.Burial PTP‐017 is a probable young adult female (20–35 years) with a large osteoblastic lesion on the right anterior mandibular corpus. This dense, bony mass extends from the anterior margin of the mental canal, and shows a distinct boundary from the adjacent trabecular and cortical bone. The growth of the osseous mass displaced the right first premolar anteriorly. Radiographic assessment showed the presence of dense, radiopaque material, indicating significant calcification. This suggested a likely fibro‐osseous origin for this lesion, with a probable diagnosis of ossifying fibroma, or possibly osseous dysplasia. Although not definitive, our differential diagnosis was able to exclude a number of neoplastic and non‐neoplastic conditions that affect the jaws. This study provides the first reported cases of possible benign mandibular tumours in the ancient Maya. Copyright © 2009 John Wiley & Sons, Ltd.

A 14-Year-Old Boy with Mandibular Tumor, Spontaneous Spinal Fractures

A 14-Year-Old Boy with Mandibular Tumor, Spontaneous Spinal Fractures

The Use of an Ultrasonic Bone Curette in the Surgery of Jaw Tumors Involving the Inferior Alveolar Nerve

Preservation of lip sensation is crucial in ablative surgery of mandibular tumors. When tumor control does not necessitate sacrifice of the inferior alveolar nerve (IAN), as in some cases of benign tumors of the lower jaw, attempts may be made to spare the nerve. The authors present and discuss their experience with an ultrasonic device in the treatment of benign tumors of the jaw in correspondence of the IAN. Five patients with tumoral lesions involving the IAN underwent surgery with an ultrasonic surgical device (Sonopet Omni Surgical System; Stryker, Kalamazoo, MI). Fine, delicate movements allowed the surgeon to remove bone without damage to surrounding tissue. Three of 5 patients did not present intraoperative or postoperative complications that could be attributed to the Sonopet. Two cases were partial failures. In 1 case, postoperative dysesthesia was encountered, and in the other case, intraoperative transection of the nerve occurred. The Sonopet ultrasonic bone curette proved to be highly useful in surgical procedures close to the IAN because it does not produce heat or cause mechanical injury to the neurovascular bundle. Application of this instrument may provide improved ability to preserve sensibility of the chin and lower lip in patients affected by lesions in proximity to the IAN.

Mandibular adenomatoid odontogenic tumor: A report of an unusual case

Adenomatoid odontogenic tumor (AOT) is a slow-growing, benign tumor that appears in the anterior portion of the jaws and more frequently, the anterior maxilla usually in association with the crowns of unerupted teeth. Most of the tumors are diagnosed in second decade of life. A rare case report of AOT associated with an impacted right mandibular first premolar in a 24-year-old female is reported.

Mandibular brown tumor as the first manifestation of primary hyperparathyroidism: A case report

Patients with primary hyperparathyroidism (brown tumor) are usually asymptomatic and clinical presentation of the tumor in the jaws is rarely the first sign of the disease. We report a 45-year-old female patient who presented with a mandibular swelling as the first sign of the disease.

Intraosseus Plexiform Schwannoma of the Mandible

Schwannomas and neurofibromas are the most common benign tumors derived from peripheral nerves, and whereas the head and neck region is the most common location for the occurrence of benign neural sheath neoplasms, origin within the oral cavity is uncommon, and occurrence centrally in the jaws is most unusual. Plexiform (multinodular) schwannoma is an anatomically unique variant of schwannoma characterized grossly and/or microscopically by intraneural plexiform and often multinodular growth. In current report, we present the first reported case of intraosseous plexiform schwannoma of the mandible, an extremely rare benign neurogenic tumor, diagnosed by optical and immunohistochemical procedures, showing the importance of differential diagnosis of these unusual intraosseous mandibular tumors.

Nephrotic syndrome in Kimura's disease: apropos a case of the glomerular tip lesion in an African-Caribbean male.

Kimura’s disease is characterized by benign subcutaneous masses located in the head and neck region, often accompanied by regional lymphadenopathy and salivary gland involvement. It is a rare disease that predominantly occurs in young Asian males. Histological analysis shows follicular hyperplasia with eosinophilic infiltration; blood examination usually reveals eosinophilia and elevated concentrations of immunoglobulin E (IgE). The aetiology is still unclear; autoimmune diseases, chronic infections and delayed hypersensitivity reactions are considered as possible causes. Renal involvement including nephrotic syndrome is common [1]. We report an African-Caribbean male who developed nephrotic syndrome due to glomerular tip lesions following uncomplicated surgery for a relapsing left-sided mandibular tumour that was diagnosed as Kimura’s disease.