Primary Intraosseous Carcinoma Research Articles

Primary intraosseous carcinoma in the parasymphyseal region of mandible: A case report and review

Primary intraosseous carcinoma in the parasymphyseal region of mandible: A case report and review

Primary Intraosseous Carcinoma Arising on Top of Recurrent Kerato-Cystic Odontogenic Tumor in a Young Male Patient

Primary Intraosseous Carcinoma Arising on Top of Recurrent Kerato-Cystic Odontogenic Tumor in a Young Male Patient

Primary De Novo Intra-Osseous Carcinoma of Mandible: A Rare Case Report

Primary intraosseous carcinoma is a rare neoplastic lesion, which occurs in the jaws. We report a new case of unusual tumor, which is discussed with its clinical, histopathological aspects. A 63yr old male patient presented with pain in the lower right back tooth region and swelling, since 3-months. In the present case the clinical, histological and radiological features of intraosseous carcinoma are discussed. Hence the aggressiveness of tumor highlights the present case.

Primary intraosseous carcinoma of the mandible

Primary intraosseous carcinoma (PIOC) is a rare neoplasm occurring in the jaw bones, especially in younger patients which is locally aggressive and has a poor prognosis. It is believed to arise from the odontogenic epithelium. It is called as PIOC because it arises de novo which makes it primary and it develops centrally within the bone hence called as intraosseous. The early lesions are asymptomatic or a painful swelling is seen. To diagnose PIOC, basic criteria have been proposed. (1) Absence of ulcer in the oral mucosa overlying the tumor, (2) Absence of another primary tumor at the time of diagnosis and for at least 6 months during the follow-up, and (3) Histological evidence of squamous cell carcinoma. Till date, around 60 cases of PIOC are reported. Being rare, we would like to discuss the review of literature and a case report on PIOC.

Carcinomes intra-osseux primitifs des mâchoires de novo (type 3)

Primary intraosseous carcinoma (PIOC) of the jaws is a rare epidermoid carcinoma from epithelial origin and initially strictly localized within the bone. Histologically, type 3 PIOC (PIOC3) is a de novo primary intraosseous carcinoma. Because of the rarity of this illness, we propose an analysis of a personal case and a revue of the literature. Two search engines (Pubmed®, Sciencedirect®) were questioned over the period 1976-February 2016 by using following keywords carcinoma, intraosseous, jaws, squamous cell carcinoma. Articles reporting proven PIOC3 and mentioning a precise treatment were selected. Thirty articles concerning 54 patients (sex ratio: 2.4; mean age: 56.8; extreme: 24-78) met the inclusion criterions. The most common symptoms were swelling (53%), pain (44.9%) and infra-alveolar nerve paresthesia (30.6%). The time to diagnosis was 13 weeks. Classification of Zwetyenga et al. showed more than 80% of T2 and T3 stages. The lesions were predominantly mandibular (85.2%) and posterior. Less than a third of patients had lymph node and 10% had distant metastasis. Treatment consisted mostly in a combination of surgery and radiotherapy. With a mean follow-up of 74.8 months, 70.8% were in remission with no evidence of recurrence. We report the case of a 58-year-old patient, with no medical history, complaining since several months about periodontitis with teeth mobility in the right mandibular area. The panoramic X-ray showed a bone lysis at the place of tooth No.46. In the absence of alveolar healing after extraction and antibiotherapy, a biopsy was made that diagnosed a differentiated keratinizing squamous cell carcinoma. CT scan and MRI showed a mandibular cortical bone loss with involvement of adjacent structures and lymphadenopathy in the ipsilateral IB area. The patient was treated with a combination of chemotherapy and surgery. Postoperative chemo- and radiotherapy is still going on. The PIOC3 is a rare tumor, mainly arising in males around 50. Diagnosis should be evoked in the presence of painful swelling and nervous symptoms. The time to diagnosis is long. Tumors are usually seen at late stages. Treatment classically combines surgery and radiotherapy.

Survival and Prognosis for Malignant Tumors of Odontogenic Origin.

Determine survival and factors affecting survival for patients with malignant tumors of odontogenic origin. Retrospective analysis of the National Cancer Institute's SEER database (Surveillance, Epidemiology, and End Results). Tertiary medical center. All cases of malignant tumors of odontogenic origin were extracted from the SEER database for the period of 1973 to 2011. Demographic, tumor-specific, and survival data were tabulated and Kaplan-Meier survival analysis conducted according to histopathologic results. Cox regression analysis stratified for histopathology was conducted to determine factors that influenced survival. A total of 308 cases of malignant tumors with odontogenic origin were analyzed. Malignant ameloblastoma accounted for 59.7% of cases, followed by malignant odontogenic tumor (35.4%; including odontogenic carcinoma, odontogenic sarcoma, primary intraosseous carcinoma, and ameloblastic carcinoma) and ameloblastic fibrosarcoma (2.9%). The overall mean and median were 229 and 227 months, respectively, while the 5-year survival rate was 81% for the entire cohort. Malignant ameloblastoma exhibited the best mean survival (237 months), whereas malignant odontogenic tumor (139 months) and ameloblastic fibrosarcoma (42 months) had lower mean survival rates. Younger age, surgery with adjuvant radiation, and smaller tumor size were found to improve survival. Significantly different survival can be expected depending on individual tumor histopathology, tumor size, age at diagnosis, and treatment modality.

Intraosseous mucoepidermoid carcinoma of the mandible – a rare case report

Mucoepidermoid carcinoma (MEC) is the most common salivary gland malignancy. The majority of these tumors arises in the parotid and minor salivary glands but may rarely develop intraosseously. Primary intraosseous mucoepidermoid carcinoma (PIOC) of the jaw bones is an extremely rare malignant salivary gland tumor. Very few cases have been reported in the literature to date. Case report: The current manuscript highlights clinical and radiographic features of a rare case of PIOC in a 32 year old Indian female patient. Conclusion: All the dental practitioners should be aware of the protean features of central MEC. These lesions should be included in the differential diagnosis of unilocular and multilocular radiolucent lesions of the jaws. An early and accurate diagnosis is important so that the neoplastic transformation must be identified and treated effectively.

Primary Intraosseous Carcinoma in Anterior Region of the Mandible: A Case Report

Primary Intraosseous Carcinoma in Anterior Region of the Mandible: A Case Report

Primary Intraosseous Carcinoma of Mandible: A Case Report

Primary Intraosseous Carcinoma of Mandible: A Case Report

Primary intraosseous carcinoma of jaw – A diagnostic dilemma

Primary intraosseous carcinoma (PIOC) is a relatively uncommon group of malignant tumors. The definite diagnosis of PIOC is often difficult, as the lesion must be distinguished from alveolar carcinoma that may invade the bone from the overlying soft tissues or from the tumors that may have metastasized to the jaw from a distant site and from the tumors of maxillary sinus origin. Since the most common symptom of PIOC is swelling and persistent pain in the mandible, the diagnosis becomes difficult, and an infectious etiology is commonly considered. Furthermore, as the diagnostic criteria of PIOC are obscure, the cases, which have been reported as PIOC in the English literature are very few. The author presents a case report with the review of the literature and also tries to solve the dilemma in the diagnosis of PIOC.

Massive mandibular destruction and alveolar nerve infiltration without lower lip paresthesia in primary intraosseous carcinoma: report of two cases and critical appraisal of diagnostic criteria.

To report two cases of solid type primary intraosseous carcinoma (PIOC) with a critical appraisal of one of the WHO diagnostic criteria. Both patients had radiographic and histopathologic findings showing massive mandibular destruction as well as the involvement of the inferior alveolar nerve, without lip or chin paresthesia. Patients were treated through hemimandibulectomy followed by reconstruction through fibula free flap and forearm flap. Lip and/ or chin paresthesia are rather frequent in metastatic and salivary gland tumors but not in primary tumors of the jaws. Reasons for such a discrepancy are mostly unknown. A few hypotheses are put forward here. It is the opinion of the authors that most of the diagnostic criteria for solid type PIOC are acceptable. However, the criterion "absence of ulcer formation on the overlying mucosa" mainly depends on the dimension of the tumor at diagnosis.

Primary Intraosseous Adenoid Cystic Carcinoma in Mandible: Case Report

Primary Intraosseous Adenoid Cystic Carcinoma in Mandible: Case Report

Keratocystic odontogenic tumor: A case report and review of literature

Keratocystic odontogenic tumor (KCOT) has been identified as a tumor after observation of its biological behavior and genetic abnormalities consistent with neoplastic progression. In 2005, the World Health Organization (WHO) working group considered odontogenic keratocyst (OKC) to be a tumor and recommended the term KCOT, distinguishing the lesion from the orthokeratinizing variant, which is now considered an OKC or orthokeratinized odontogenic cyst. Very rarely, KCOTs can transform into more aggressive lesions such as ameloblastoma and primary intraosseous carcinoma (PIOSCC). In this paper, we present a case of KCOT involving the angle and ramus of the mandible, with histopathologic evidence of ameloblastomatous changes. We also discuss about the evolution of this lesion from a cyst to a tumor along with the latest updates of the entity.

Primary intraosseous carcinoma arising from an odontogenic cyst: A case report.

Cyst-like lesions in the mandible rarely develop into malignancies, and the reported incidence is between 0.3 and 2%. The present study describes a rare case of primary intraosseous squamous cell carcinoma of the mandible arising from an odontogenic cyst. A 59-year-old female was referred to Asahi University Murakami Memorial Hospital (Gifu, Japan), with acute pain in the right molars. An initial examination revealed buccal swelling and paresthesia of the mental nerve. Following an intraoral examination, the oral mucosa was confirmed to be normal, however, percussion pain was experienced between the lower right first premolar and second molar. Panoramic radiography revealed a retained lower right wisdom tooth and an irregular radiolucent area between the lower right molar and a mandibular angle with unclear margins. Computed tomography revealed diffuse bone resorption and an extensive loss of cortical bone on the buccal and lingual sides. A biopsy was performed and the pathological diagnosis was of a squamous cell carcinoma arising from the epithelial lining of the odontogenic cyst. Radical dissection was subsequently performed, however, histopathological examination of the resected specimen revealed neither invasion into the surrounding tissues penetrating the periosteum nor lymph node metastasis at the right submandibular lesion. Following the pathological diagnosis of primary intraosseous carcinoma (PIOC), the patient received 6,000 Gy radiation as post-operative radiotherapy and chemotherapy with oral administration of tegafur, gimeracil and oteracil potassium. The patient is currently undergoing follow-up examinations. Although PIOC arising from an odontogenic cyst is rare, it should be considered as a differential diagnosis for radiolucency of the jaw bone, particularly in older patients exhibiting a history of cystic lesions.

Primary de novo intraosseous carcinoma of the mandible: A rare case report

Primary intraosseous carcinoma (PIOC) is a very rare, but well-recognized entity, which is locally aggressive with quite poor prognosis. It may arise within the jaws either from a previous odontogenic cyst or de novo, rather than from a pre-existing epithelial lesion. A case of PIOC arising in the mandible of a 63-year-old male patient is reported in this article, with the clinical, radiological, and histological features described. This rare lesion must be considered in any differential diagnosis of jaw radiolucency.

Intraosseous mucoepidermoid carcinoma of the maxilla: A silent invader

Intraosseous mucoepidermoid carcinoma of the jaw bones is an extremely rare malignant salivary gland tumor of unknown etiology. Mucoepidermoid carcinoma is usually associated with salivary glands and comprises 5-10% of all salivary gland tumors. Its occurrence in the maxilla is even rarer. It is commonly seen in the posterior part of the mandible; the palate is the most common site for minor salivary gland involvement, accounting for 41.1% of intraoral lesions. The World Health Organization defines primary intra-osseous carcinoma arising de novo within the jaws (PIOC) as `a squamous cell carcinoma within the jaw, having no initial connection with the oral mucosa and presumably developing from residues of the odontogenic epithelium'. The early lesion (PIOC) shows asymptomatic nature often leading to delay of diagnosis or treatment. Despite its rarity and deceptive resemblance to odontogenic cyst and tumors, PIOC should be considered in the differential diagnosis of radiolucent jaw lesions. This article discusses in detail its clinical relevance with literature updates.

Malignant transformation of an odontogenic cyst in a period of 10 years.

Primary intraosseous carcinoma of the jaws (PIOSCC) might arise from odontogenic epithelium, more commonly from a previous odontogenic cyst. The aim of this case is to illustrate that the clinician should consider that an apparent benign dentigerous cyst can suffer malignant transformation and that all material removed from a patient must be evaluated histologically. A 44-year-old man presented in a routine periapical X-ray an impacted lower left third molar with radiolucency over its crown. Ten years later, the patient complained of pain in the same region and the tooth was extracted. After one month, the patient still complained of pain and suffered a fracture of the mandible. A biopsy was performed and carcinoma was diagnosed. The patient was treated surgically with adjuvant radio- and chemotherapy and after 8 years, he is well without signs of recurrences. This report describes a central mandibular carcinoma probably developed from a previous dentigerous cyst.

Sclerosing odontogenic carcinoma in the maxilla: a rare primary intraosseous carcinoma

Sclerosing Odontogenic Carcinoma (SOC) was first described by Koutlas etal. in 2008. SOC is a low-grade odontogenic carcinoma, which presents as an expansile radiolucency that causes tooth displacement and root resorption. It is locally aggressive but reports suggest a very low probability of regional or distant metastasis. SOC contains small nests and thin cords of small cuboidal or polygonal epithelial cells with cytoplasmic clearing. Pleomorphism and mitoses are not prominent. Skeletal muscle and perineural infiltration with stromal sclerosis is characteristic. Immunohistochemically, SOC stains for cytokeratins (CK) 5/6 and 19, and e-cadherin. Nuclear staining with p63 is also positive. CK20, carcinoembryonic antigen and CAM 5.2 are negative. We report a rare entity of primary intraosseous carcinoma of the maxilla which has the clinical and histological markers of SOC. Occurrence in the maxilla has been reported only once before in the literature.

The Value of 99mTc-MDP SPECT/CT Fusion Imaging in Evaluating the Extent of Mandibular Invasion by Squamous Cell Carcinoma of Oral Cavity

Objective: Comparing the Accuracy of computed tomography (CT) and 99mTc-methylene-diphosphonate (MDP) SPECT/CT fusion imaging in determining the extent of mandibular invasion by squamous cell carcinoma of the oral cavity, to study the clinical value of SPECT/CT fusion imaging in evaluating the extent of mandibular invasion by squamous cell carcinoma of oral cavity. Material and Methods: Fifty-one patients were revealed mandibular invasion by moderately differentiated squamous cell carcinoma of the oral cavity underwent CT and SPECT/CT. The patients were divided into two groups: A group (oral mucosal squamous cell carcinoma) and B group (primary intra-osseous carcinoma). Two radiologists assessed the CT images and two nuclear medicine physicians separately assessed the SPECT/CT images in consensus and without knowledge of the results of other imaging tests. The extent of bone involvement suggested with an imaging modality was compared with pathological findings in the surgical specimen. Results: The pathological findings as the reference standard ,group A:the extent of mandibular invasion by moderately differentiated squamous cell carcinoma underwent SPECT/CT was 1.02±0.20cm lager than the pathological examination identified, and the extent of mandibular invasion underwent CT was Advances in Cancer: Research & Treatment 2 1.42±0.35cm smaller than the pathological examination identified. There were statistically significant differences among the three methods, p<0.01. Group B: the extent of mandibular invasion by moderately differentiated squamous cell carcinoma underwent SPECT/CT was 1.3±0.39cm larger than that underwent pathological examination. The extent of mandibular invasion underwent CT was 2.55±1.44cm smaller than the pathological examination identified. There were statistically significant difference among the three methods (p<0.01), too. Conclusion: SPECT/CT fusion imaging in identifying the extent of squamous cell carcinoma of the oral cavity on mandibular invasion has important clinical value. The extent of mandibular invasion underwent SPECT/CT was the extent which surgeon to reach the clear margins to the limits of resection.

Primary intraosseous carcinoma of the mandible: report of a cases.

Primary intraosseous carcinoma of the mandible: report of a cases.