Second Decade Of Life Research Articles

Positioning adolescence in the developmental timeline.

Adolescence, the second decade of life, bridges childhood and adulthood, but also represents a host of unique experiences that impact health and well-being. Lifespan theories often emphasize the continuity of individual characteristics and their contexts from childhood to adolescence, underscoring the distal influence of childhood experiences. Yet, adolescence is marked by transitions that may provoke discontinuities, particularly within individuals, their contexts, and their interactions within those contexts. These discontinuities occur at varied times, orders, and intensities for individualyouth, suggesting that adolescence may be a developmental turning point where earlier life experiences may be mediated, reversed, or transformed by proximal events. This perspective piece emphasizes the importance of considering transitions, discontinuities, and developmental turning points in adolescence as well as their potential to explain heterogeneity in adolescent and adult outcomes. We explore one biological and one contextual transition in adolescence and highlight innovative theories and methods for investigating continuity and discontinuity dynamics across development, which could lead to new insights related to the adolescent period and its importance in shaping future life trajectories.

The Pattern of Bacterial Infections Among Chronic Suppurative Otitis Media Cases at a Tertiary Care Centre in North-East India.

Chronic suppurative otitis media (CSOM) is a chronic inflammation of the mucoperiosteal lining of the middle ear cleft, presenting with recurrent ear discharge through a tympanic membrane perforation. The present study aims to assess the spectrum of bacterial infection among CSOM cases and detect the isolated organism's antibiotic sensitivity pattern. The prospective hospital-based observational study was conducted from June 2021 to June 2022 and included 94 CSOM cases. An aural swab of the ear discharge was collected from each patient under aseptic precautions. The swab was utilized for Gram's staining and the aerobic bacterial pathogen culture. The organisms isolated were tested for antibiotic sensitivity using the Kirby-Bauer disc diffusion method. The most affected age group was the second decade of life (27.7%, n=26), with a male-to-female ratio of 1.35:1. The mean duration of ear discharge was 24.0±14.7 months, mostly mucoid ear discharge (39.4%, n=37). Among gram-positive bacteria, methicillin-resistant Staphylococcus aureus was isolated in 16 (17.0%) cases. Pseudomonas aeruginosa was the most isolated gram-negative bacteria strain in 26 (27.7%) cases. Cotrimoxazole (67.7%, n=21) had the highest sensitivity towards gram-positive bacteria isolates. Amongst gram-negative bacteria, amikacin and ciprofloxacin were the most sensitive, with 78.0% (n=39) susceptibility. Evaluating the spectrum of infecting organisms of CSOM and their antibiotic sensitivity may help initiate prompt treatment with the appropriate antibiotic regimen, thereby preventing future complications.

Idiopathic toe walking: What’s New? An Integrative Review

Objective: Consolidate the current knowledge on idiopathic toe walking, provide a critical overview, and identify areas for potential future research. Methods: An electronic search was conducted in the following databases up to June 2023: MEDLINE, EBSCO, Embase, CINAHL Plus, and PubMed. The PICO framework was employed to define search terms. Results: Despite considerable methodological heterogeneity among studies, a stronger inclination was found to investigate etiological and prognostic factors. There is a trend for a higher prevalence in boys with a positive family history. Novel classifications have been proposed to improve differential diagnosis. Among conservative treatment options, there is stronger evidence for gait improvement using serial casting followed by orthoses. Severe cases may benefit from surgical zone III gastrocsoleus lengthening. Conclusion: Further studies with standardized methodologies are required to clarify questions about this condition’s etiology, classification, and treatment. Nonetheless, there is a higher level of evidence supporting conservative treatments with serial casting and orthoses and zone III gastrocsoleus lengthening for severe cases in the second decade of life. Level of evidence II; Diagnostic studies. Keywords: Walking; Equinus Deformity; Foot;

A pediatric and young adult case of unclassified renal cell carcinoma with medullary phenotype (RCCU-MP): Clinical course and treatment

Renal cell carcinoma (RCC) is the most common kidney tumor in adults. RCC is rare in children, although its incidence increases in the second decade of life. Renal medullary carcinoma (RMC) is a rare and often aggressive RCC subtype characterized by complete loss of SMARCB1/INI1, predominantly diagnosed in patients with sickle cell disease or -trait. Here, we describe a pediatric and a young adult patient with clinicopathological characteristics similar to RMC but without hemoglobinopathies. These tumors are currently classified as “RCC unclassified with medullary phenotype” (RCCU-MP). Both our patients had an infiltrating, rather small kidney tumor with SMARCB1/INI1 deficiency. Remarkably, the aggressiveness and clinical course and treatment differed greatly between these two cases. So far, only nine patients, predominantly adults, have been reported. In a literature overview, most cases were metastatic and progressed or relapsed after varying treatment approaches, with low survival. Whereas the classification of these tumors remains a topic of debate, case reports add to the current knowledge of RMCs without hemoglobinopathies, stressing the importance of sharing experience concerning rare renal neoplasms with often poor outcomes, also concerning younger age categories.

Periosteal Ewing Sarcoma with Distant Metastases: Report of Two Patients and Review of the Literature.

Periosteal Ewing sarcoma (ES) is an exceedingly rare topographic subtype of the ES. To our knowledge, only 60 patients have been reported in the medical English language literature. It predominantly affects men in the second decade of life and arises in the long tubular bone diaphysis. PES rarely develops distant metastases. We report two patients of this rare ES location that were found on the distal tibial shaft and proximal femoral diaphysis of a 21-year-old man and an 8-year-old boy, respectively. Both patients were treated with neoadjuvant chemotherapy, wide resection, and adjuvant chemotherapy. One of our patients had lung metastases at the time of diagnosis and died 5 years later. The other patient presented intramedullary humeral bone metastasis 19 years after diagnosis. There has been no evidence of disease in the 26 years of follow-up. Close follow-up of periosteal ES is recommended because distant metastases may exceptionally occur, even several years after diagnosis.

Hepatic Cirrhosis with Esophageal Varices: A Case Report

Background: In adults, portal hypertension is generally caused by hepatic cirrhosis, whereas in children it is more commonly caused by extrahepatic abnormalities with normal liver function. Portal hypertension causes hemodynamic abnormalities. Gastrointestinal bleeding is the most severe clinical manifestation of portal hypertension in both children and adults. Pathogenetically, increased pressure in the portal vein can be caused by increased vascular resistance and increased portal blood flow. The site of obstruction can be prehepatic (portal vein obstruction), intrahepatic (presinusoidal: eg congenital hepatic fibrosis; para sinusoidal: cirrhosis, hepatotoxic drug therapy, vitamin A hepatotoxicity; post sinusoidal: venocclusive disease) and/or post hepatic (Budd-Chiari syndrome, constrictive pericarditis). Case presentation: The study reports the results of observations of a case of a boy, FAA, aged 12 years and 2 months who came to the emergency room at Dr. M. Djamil General Hospital Padang with the main complaint of hematemesis and splenomegaly from physical examination. Non cirrhotic portal fibrosis is a cause that is not uncommon in the population in the early second decade of life. Some children with non-cirrhotic portal fibrosis as adults can end up with end stage liver disease. Conclusion: Patients with noncirrhotic or cirrhotic portal hypertension can be assessed using the Child Pugh instrument as an instrument that is still used to determine the survival rate if patients with portal hypertension.

Clinico-Epidemiological Profile of Vitiligo Among Patients Attending a Tertiary Care Centre of North-East India.

Objectives Vitiligo is a widespread cutaneous disorder. The present study aims to evaluate the epidemiologic profile of vitiligo and investigate its different clinical forms, disease activity, hereditary associations, triggering factors, and probable association with other diseases. Methods This prospective observational study was conducted over one year, from 2019 to 2020, and included 120 cases demonstrating definite clinical evidence of vitiligo. All selected patients underwent a detailed medical history interview. Specific enquiries were made regarding precipitating factors, clinical features of the disease, histories of other autoimmune diseases, and family histories. Thorough clinical, laboratory, and cutaneous examinations were performed on all patients. Descriptive statistical methods and diagrams were used to summarise the data. Results The age at presentation (31 patients, 25.8%) and the onset of the disease (32 patients, 26.6%) was predominantly in the second decade of life. The condition was usually progressive, with vitiligo vulgaris being the most prevalent type (56 cases, 46.7%). Disease onset (37 individuals, 30.8%) and the prevalence of lesions were higher in the lower leg. Body surface area involvement was ≤1% in 72 (60.0%) patients. Itching and trauma were the typical initiating factors. Leukotrichia in 38 (31.7%) cases, Koebner's phenomena in 23 (19.1%) cases, and a positive family history in 26 (21.7%) cases were observed. Thyroid dysfunction, hypertension, and various skin conditions are associated with the disease. Conclusion Vitiligo is more common in the young population. The condition is often progressive, with vitiligo vulgaris being the most common type. Itching and trauma are frequent initiating factors. Monitoring patients for associated diseases may be crucial for diagnosis and treatment outcomes.

Epidemiology, Seasonal Variability, and Factors Associated with Increased Mortality in Patients with Acute Appendicitis in Thailand: A Study Using Data from the National Health Security Office

Objective: The study aimed to study the spatiotemporal distribution of acute appendicitis in Thailand, using a reimbursement dataset from the National Health Security Office, and also analyze for mortality and factors associated with mortality after an appendectomy.Material and Methods: The study used data mining to analyze a reimbursement data set from the Thailand National Health Security Office (NHSO), focusing on the diagnosis of acute appendicitis (K35.2-K35.9). The analysis looked for the incidence trend and seasonal variation of the incidence. The study also analyzed mortality and factors associated with the mortality. A prediction model for mortality was constructed using a decision tree. Results: During the 4 fiscal years of the study period, from October 2016 - September 2020, a total of 287,449 individuals were diagnosed with acute appendicitis, and 272,850 appendectomies were performed, which gave an annual incidence (AI) of 10.8/10,000 person-years. The peak age incidence was in the second decade of life, which had an age-specific AI of 28.4/10,000 person-years. Using a multiplicative model of time series detrending and a decomposition model and a seasonal variation of acute appendicitis, with the highest incidence from May to October, linear regression showed a significant correlation between the incidence of appendicitis and precipitation (r2=0.28, p-value<0.001). The AI of appendicitis was declining and showed an especially large decline in the year 2020, when the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic began. The overall mortality was 2.3%. A significantly higher mortality rate was found in cases with extreme age (pediatric or geriatric), those with co-morbidities (diabetes, hypertension, dyslipidemia, chronic pulmonary disease, chronic kidney disease), and those with complications, especially generalized peritonitis, sepsis, and acute kidney injury. A decision-tree prediction model suggested that sepsis and renal complication were key nodes determining mortality risk in pediatric and geriatric appendicitis. Conclusion: A mortality risk from appendicitis remains in Thai patients, especially the elderly with co-morbidities and those with generalized peritonitis, sepsis, or renal complications. Early diagnosis and improvement in perioperative care in the extreme age groups might improve the mortality figure.

SYNE1 gene mutation: A recessive ataxic syndrome presenting with weakness and muscle atrophy. A case report

BackgroundAutosomal recessive spinocerebellar ataxia type 8 (SCAR8) is a rare neurodegenerative disease that can be manifest in a wide spectrum from ataxias and motoneuron syndromes. ObjectiveTo report a case of mutation in the SYNE1 gene with predominant motoneuron disease signs. MethodsIndex case medical report and literature review. ResultsA 32-year-old woman onset with pyramidal and lower motoneuron signs and symptoms during the second decade of life, with marked dysarthria showing associated cerebellar pattern. Clinical investigation with electroneuromyography showed chronic preganglionic disease and brain MRI showed cerebellar atrophy. Genetic testing confirmed pathogenic mutation in homozygosity in the SYNE1 gene. ConclusionsRare neurological condition that may be associated with signs of impairment of the pyramidal pathway and second motoneuron (amyotrophic lateral sclerosis-like syndrome), in addition to cerebellar ataxia in insidious course.

Chiasm gliomas in pediatric patients. Part 1. Сlinical manifestations

Chiasm gliomas are very important heterogeneous group of tumors manifesting in the first and second decades of life and is the second leading cause of blindness in children with neurosurgical pathology. It is a benign, slow-growing piloid astrocytoma, accounting for 1–5% of intracranial gliomas in children. The incidence of neurofibromatosis type 1 among patients with chiasm glioma ranges from 7 to 60%. The location of the tumor is determined based on ophthalmological symptoms, neuroimaging data (MRI), and surgical findings. The initial growth of the tumor occurs in the anterior visual pathway structures (optic nerves, chiasm, optic tracts) and leads to ophthalmological symptoms, which are dominant in the clinical manifestations of the disease. Chiasm damage may occur in one or both optic nerves, in one or both optic tracts. Damage to the chiasm manifests as bitemporal heteronymous hemianopsia. Moreover, the spread of the tumor to the optic nerves is accompanied by decreased visual acuity. Damage to the optic tract is manifested by homonymous hemianopia and normal visual acuity. However, isolated damage to the optic tract is uncommon and usually occurs with chiasm and optic nerve lesions; hence, visual disturbances are more complex. Lesions in the optic nerve fibers in the chiasm and optic nerves/tracts lead to primary descending atrophy of the optic nerves. Papilledema with optic nerve atrophy indicates occlusive hydrocephalus. Delayed diagnosis of the disease affects treatment results.

Abstract 6148: Multiple new Ewing sarcoma susceptibility loci expand knowledge of germline genetic etiology and nominate mechanisms of risk

Abstract Ewing sarcoma (EwS) is a rare and aggressive pediatric cancer with peak incidence in the second decade of life. EwS occurs primarily in children of European ancestry suggesting a genetic component to susceptibility. Prior investigations identified six susceptibility loci associated with EwS, with evidence for additional signals not reaching the commonly accepted threshold for genome-wide significance (i.e., p<5×10−8). At least two of these loci demonstrate evidence of tagging variation in length of nearby GGAA microsatellites, which alter binding of the pathognomonic EWSR1::FLI1 fusion resulting in downstream dysregulation of target genes promoting sarcomagenesis. To identify additional susceptibility loci, we performed the largest genome-wide association study (GWAS) to date consisting of 1,640 EwS cases and 8,457 cancer-free individuals of European ancestry from 8 studies and matched by principal components. Genotype imputation was carried out by study/array using TOPMed data as the reference and each set was analyzed using PLINK 1.9 adjusting for significant principal components. Variants were included in each study if minor allele count was greater than five in each set of cases. Individual study results were combined using fixed effects meta-analysis in Metasoft with variants demonstrating evidence for heterogeneity excluded.For previously reported EwS loci (i.e., 1p36.22, 6p25.1, 10q21.3, 15q15.1, 20p11.22 and 20p11.23), odds ratios (OR) remained high for GWAS (OR=1.5-2.4) and the -log10 p-values grew by several orders of magnitude, providing strong evidence for replication in the additional 907 EwS cases and 7,111 cancer-free controls. Our analysis identified five novel loci reaching genome-wide significance (P-valuemeta< 5×10−8) at 5q32, 7q32.3, 8q24.2, 13q32.3, and 17q23.2. Risk allele frequency of newly identified loci ranged from 0.001 to 0.75with estimated ORs ranging from 1.31-4.30. eQTL analyses nominated nearby biologically plausible candidate genes for future functional investigation including LARS1, a gene implicated in osteosarcoma and skeletal muscle dysgenesis, at the 5q32 locus and COX5BP6, a gene implicated in age at menarche and testosterone levels, at 13q32.3.Our results add to evidence supporting a strong inherited genetic component to EwS risk and particularly a genetic architecture harboring a substantial number of common variants with moderate effect. Ongoing work is focusing on enrichment analyses of GGAA microsatellite repeat sequences in identified risk loci to search for evidence for germline-somatic interactions with EWSR1::FLI1. Citation Format: Aubrey K. Hubbard, Weiyin Zhou, Carrie Boyce, Javed Khan, Melissa M. Hudson, Kirsten K. Ness, Zhaoming Wang, Katherine A. Janeway, Philip J. Lupo, Lindsay M. Morton, Stephen J. Chanock, Thomas G. Grünewald, Olivier Delattre, Mitchell J. Machiela, Ewing Sarcoma Germline Genetics Group. Multiple new Ewing sarcoma susceptibility loci expand knowledge of germline genetic etiology and nominate mechanisms of risk [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6148.

Clinical Characteristics And Success Of Ptosis Surgery At Indonesia National Eye Center Cicendo Eye Hospital During January 2016 – December 2020

ABSTRACT Ptosis is defined as drooping of the upper eyelid. Unilateral or bilateral ptosis can affect appearance and visual function, both of which can negatively impact quality of life. It may be congenital or acquired, determined by the timing of onset. To describe clinical characteristics and surgical outcomse in ptosis correction surgery at Indonesia National Eye Centre, Cicendo Eye Hospital. This is a descriptive-retrospective study, medical records of patients who was admitted to Indonesia National Eye Centre, Cicendo Eye Hospital, from January 2016 to December 2020 with diagnosis of eyelid ptosis were included in this study. From total of 189 patients (209 eyes) in this study, there were 41,8% male and 58,2% female patients with median age 22 years at the first time of visit. Most of the patients had unilateral ptosis (89,5%), and 10,5% had unilateral ptosis. According to the etiology of ptosis, 34,2% eyes were neurogenic ptosis. Degree of ptosis were severe in 70,9% eyes and most patients had fair levator function. Success rate were more than 95% in ptosis patient who underwent surgery. Majority of ptosis patient in Indonesia National Eye Centre, Cicendo Eye Hospital were caused by neurogenic followed by mechanical, traumatic, aponeurotic, myogenic, and pseudoptosis. Female patients were more common than male patients and median age at the first time visit were during second decade of life. Surgical outcome in ptosis tend to have high clinical success rates. Keywords: Characteristic, Outcome, Ptosis, Surgery

A rare case of fibrous dysplasia in the mandible: a case report

Background: Fibrous dysplasia (FD) is a benign fibro-osseous lesion of the bone which can be monostotic FD and the polyostotic form. Polyostotic FD with café-au-lait spots of the skin and hormonal imbalances is called McCune–Albright syndrome. Besides, Mazabraud syndrome is characterized by polyostotic FD and intramuscular myxomas. FD has its onset during childhood or early adolescence and usually occurs within the first or second decade of life.
 The mode of presentation of the FD of the jaw ranges from asymptomatic to dental anomalies, pain, and facial asymmetry. Given the clinical history and radiological assessment, cystic lesions have some important differential diagnoses which range from cystic ameloblastoma, fibrous dysplasia, aneurysmal bone cyst, and odontogenic keratocyst.
 Case report: This presents a 19-year-old female who presented to the maxillofacial surgeons’ clinic with a referral from a peripheral hospital. Her major complaint was right-sided facial swelling which was noticed 4 years before the presentation. A plain radiograph revealed an expansile lesion of the mid-right mandible appearing as a well-outlined, fairly oval multiloculated cystic radiolucent mass with multiple internal septations. A preliminary diagnosis of a complex cystic right jaw mass with benign features was made with possible differential diagnoses such as ameloblastoma, fibrous dysplasia, aneurysmal bone cyst, and odontogenic keratocyst were suggested as possible differential diagnoses. Finally, she had an excision biopsy with a histological diagnosis of fibrous dysplasia. The outcome of the surgery was satisfactory at one year review.
 

Poorly differentiated papillary thyroid carcinoma in a 5-year-old girl: a case report

BackgroundThe incidence of thyroid cancer has been increasing among the population less than 20 years of age, especially during the second decade of life. Differentiated papillary thyroid cancer is the most common pathology in children. It usually presents with thyroid nodules with or without cervical lymphadenopathy. Thyroid nodules carry a considerable risk of malignancy in children.Case presentationWe herein report a 5-year-old girl with poorly differentiated papillary thyroid cancer which is an extremely rare finding at this age. The patient underwent right thyroid lobectomy followed by left hemi thyroidectomy and right central and lateral neck dissection. Pathologic examination revealed a poorly differentiated papillary thyroid carcinoma with nodal deposits.ConclusionIt is essential to raise awareness of proper evaluation and management of thyroid nodules at such an age.

Managing Iris Cysts with Surgical Excision: A Case Series

Introduction : Iris cysts are uncommon iris tumors. Primary iris cysts are congenital and usually not detected until late into the first or second decade of life. Secondary iris cysts have history of trauma or intraocular surgery. Small and asymptomatic iris cysts should be monitored, whereas larger cysts require treatment as they cause complications.
 Case Illustration : Case 1 a 17-year-old teenager had blurred vision without prior intraocular trauma or surgery. Anterior segment examination of the left eye revealed an oval, light brown, and semi-translucent cyst. Case 2 a 15-year-old girl had blurred vision and enlarging white spot in right eye with history of penetrating ocular trauma. Patient had undergone immediate penetrating repair followed by combination of pupilloplasty and cataract surgery. Anterior segment examination of the right eye showed corneal scar and cystic lesion. Both cysts extended to corneal endothelium and were managed surgically.
 Discussion : Larger cysts, especially with complications, require cyst aspiration, laser therapy, injections of antiproliferative agents, or surgery. We decided to surgically aspirate and excised iris walls to remove both iris cysts which were vital to achieve good result. Post-operative periods were uneventful with no significant inflammatory reactions associated with the procedure.
 Conclusion : Different modalities, with varying degrees of success, have been reported for the treatment of iris cysts. Surgical intervention remains the last option which can give a good functional outcome with minimal inflammatory complications, especially when less invasive options do not seem feasible due to the extensive nature of the cyst.

22. MINIMALLY INVASIVE TREATMENT OF PILONIDAL SINUS: A SINGLE-CENTER COHORT STUDY ON SHORT-TERM OUTCOMES

Abstract Introduction Pilonidal sinus is a benign condition that causes infections and abscesses in the intergluteal area, but its physiological explanation is still unclear. There are various surgical techniques to treat it, such as excision with marsupialization, primary closure, and endoscopic pilonidal sinus treatment (EPSiT). Methods Forty-six patients between 13 and 23 years of age, who underwent surgery for pilonidal sinus between 01/01/2020 and 31/12/2022, were analyzed. Three techniques were performed: marsupialization, primary closure, and EPSiT by different surgeons in the same hospital complex. A p-value of <0.05 was considered significant. Results Significant differences were observed in terms of gender, with a predominance of males, and in the number of interventions performed. Regarding postoperative results, significant differences were found in bleeding and hematoma formation. Bleeding was greater in the EPSiT group, although hematoma was significantly lower. Furthermore, differences were found in the patient's follow-up time and attendance at healthcare centers for dressing changes. No significant differences were found in other analyzed variables. Conclusion The peak incidence of pilonidal sinus is typically estimated during the second decade of life, with a predominant occurrence in males. The maximum recurrence occurs within the first three years after the intervention. This study suggests that EPSiT offers significant advantages by reducing the risk of hematoma and, therefore, wound infection compared to classical techniques. However, we rely on retrospective data from a new technique, with a learning curve and limited follow-up. Additionally, the sample size is limited. Further research with longer follow-up is needed.

Goal-directed learning in adolescence: neurocognitive development and contextual influences.

Adolescence is a time during which we transition to independence, explore new activities and begin pursuit of major life goals. Goal-directed learning, in which we learn to perform actions that enable us to obtain desired outcomes, is central to many of these processes. Currently, our understanding of goal-directed learning in adolescence is itself in a state of transition, with the scientific community grappling with inconsistent results. When we examine metrics of goal-directed learning through the second decade of life, we find that many studies agree there are steady gains in performance in the teenage years, but others report that adolescent goal-directed learning is already adult-like, and some find adolescents can outperform adults. To explain the current variability in results, sophisticated experimental designs are being applied to test learning in different contexts. There is also increasing recognition that individuals of different ages and in different states will draw on different neurocognitive systems to support goal-directed learning. Through adoption of more nuanced approaches, we can be better prepared to recognize and harness adolescent strengths and to decipher the purpose (or goals) of adolescence itself.

Late recurrence of calcifying odontogenic cyst: Report of a rare case and review of the literature

AbstractCalcifying odontogenic cyst (COC) is a relatively uncommon cyst of odontogenic origin, occurring in the second decade of life, with no jaw predilection. Radiographically, it typically appears as a well‐defined unilocular radiolucency containing irregular calcifications of varying size and opacity. Treatment consists of conservative surgical excisions with low recurrence rates. The purpose of this paper is to report a rare case of late COC recurrence and review the pertinent literature. A 42‐year‐old female patient presented for evaluation of a painless swelling in the palate, which had been present for 5 years with a gradual, slow increase in dimensions. Twenty years before, a lesion at the same site was surgically excised with a diagnosis of COC. Clinical examination revealed a hard‐in‐consistency swelling in the anterior segment of the hard palate. Radiographically, a radiopaque lesion with an irregular outline was noticed in the left palate adjacent to the left maxillary canine and first premolar, along with a well‐defined radiolucent lesion between the maxillary central incisors. Both lesions were surgically excised, and histopathological examination revealed that the main lesion in the left palate was consistent with recurrent COC, while the lesion between the central incisors was compatible with a nasopalatine duct cyst. Even though the recurrence rate of COC is low, estimated at 3.4% based on our review of the relevant English‐language literature, the current case highlights the possibility of a late recurrence, even several years after the initial diagnosis and treatment, and therefore the need for long‐term follow‐up.

Visual acuity improvement in children with albinism beyond the first decade of life.

To determine if visual maturation continues beyond the first decade of life in children with albinism and whether this is related to albinism type, presence of nystagmus, eye muscle surgery or refractive errors. Case series based on retrospective study of children with confirmed genetic diagnosis of albinism. Clinical data were obtained from medical files of children examined during school years, including albinism type, visual acuity, eye muscle surgery, nystagmus, and others on different visits (Visit 1: ages 7-9; Visit 2: ages: 10-12; Visit 3: ages 13-16; Visit 4: ages >16). Seventy-five children with albinism were included in the study. Patients were divided into different groups according to the albinism type including OCA1A: 17; OCA1B: 28; OCA2: 26; HPS: 3; OCA4: 1. Follow-up ranged from 3-13 years. Progressive visual acuity improvement was seen in all three main groups. T-test paired samples showed a statistically significant improvement when comparing vision from Visit 1 and Visit 3 in both OCA1A and OCA2 groups, with a mean vision improvement of 2 lines. There was no correlation between visual improvement and refractive error, eye muscle surgery or nystagmus. An improved visual performance was seen in a large percentage of children with albinism during the second decade of life. The reason for this late improvement in vision is not clear but may be related to late foveal maturation or improvement in nystagmus with time. This information is useful for clinicians of these patients and when counseling parents.

Adenomatoid odontogenic tumor. Presentation of a clinical case

Adenomatoid odontogenic tumor (ATO) is a rare benign tumor that represents 3% of odontogenic tumors. Originated from remains of the dental lamina or odontogenic epithelium, it occurs in three variants: follicular (73%), extracystic (24%) and intraosseous (3%). The follicular variant is the most common and is usually associated with the crown of an unerupted tooth, typically a maxillary canine. It mainly affects young people in their second decade of life and presents as a painless and slow-growing increase in volume in the anterior maxillary region. In this study, the case of a 16-year-old patient with a follicular variant unicystic TOA in the right mandibular region is presented. A complete enucleation of the lesion, which measured 4 cm, was performed, observing expansion of the external cortex, a close relationship with the included tooth 4.3 and root resorption in adjacent teeth. The diagnosis was confirmed by histopathology, and one year later, the patient showed a favorable evolution, with bone repair and no significant complications. Despite its low incidence, it is crucial to report clinical cases of TOA to improve the understanding of its clinical characteristics, surgical management, and postoperative evolution. In addition, they provide information on the prognosis and possible long-term complications of this odontogenic neoplasm