Cases reported "Mandibular Neoplasms"

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1/362. Central neurilemmoma of the jaws. review of literature and case report.

    Neurilemmomas presenting as primary central bone tumors are extremely rare. Only 21 cases have been reported to have arisen in the jaws; all except for one have occurred in the mandible. The majority of these have been associated with the inferior dental nerve. A case of a central neurilemmoma arising in the anterior mandible is reported. Its probable origin is from one of the alveolar branches of the incisive nerve--an unusual site in the mandible. The radiographic features include expansion of cortical bone, resorption of roots of teeth, the presence of lace-like bony septa and a spotty calcification within the tumor. The treatment and the prognosis are briefly discussed.
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2/362. A unique case of desmoplastic ameloblastoma of the mandible: report of a case and brief review of the English language literature.

    A unique case of desmoplastic ameloblastoma is reported from the clinical, radiographic, and histologic viewpoints. The patient was a 56-year-old man who complained of a painless swelling on the buccal aspect of the left mandible. Periapical and panoramic radiographs revealed a rounded, slightly radiolucent area with blurred osteosclerotic margins. Occlusal radiograph and computed tomography images disclosed buccal bone expansion outlined by thinned cortices. Computed tomography images exhibited an enhanced area in the anterior portion of the lesion. Interestingly, the coronal computed tomography images revealed a close relationship between the periodontal membrane of the left mandibular second premolar and the enhanced area. biopsy specimens from the anterior portion of the lesion displayed typical histologic features of the desmoplastic variant of ameloblastoma. However, those from the posterior portion disclosed a large cystic formation. Oxytalan fibers were identified in the stromal tissue of the tumor, which suggested that the tumor arose from the epithelial rests of Malassez in the periodontal membrane of the related tooth. We also reviewed previously reported 41 cases. In 36 of 38 cases in which the location was specified, the tumor was found in the anterior to premolar region of the maxilla or mandible. A radiographic description was given in only 29 previous cases, 28 of which involved multilocular lesions. No cyst as large as the one in the present case was found among the previously reported desmoplastic ameloblastomas. Although the present case deviates from the usual desmoplastic variant of ameloblastoma in terms of locus, radiologic appearance, and cyst formation, it still meets the histologic criteria for this variant in both the stromal and epithelial components.
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3/362. Metastasis of thyroid carcinoma to the mandible. Case report.

    Metastatic tumours to the jaw bones are uncommon. The incidence of jaw bone metastasis is difficult to assess accurately since the usual method to determine the distribution of a metastatic tumour has been by a radiographic skeletal survey in which the jaws are rarely included. At times, metastatic lesions of the orofacial region may be the first evidence of dissemination of a known tumour from its primary site. A case of metastatic follicular carcinoma of the thyroid to the mandible is presented. The present case emphasizes the importance of considering metastasis in the differential diagnosis of a radiolucent lesion in the mandible in a patient with a history of any malignant disease.
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4/362. Burkitt's lymphoma presenting as lower lip paraesthesia in a 24 year old Nigerian. Case report.

    An unusual case of stage D Burkitt's lymphoma in a 24 year old Nigerian female undergraduate is reported. There was a four month history of left lower lip paraesthesia followed three months later by a slowly progressive 'pimple-sized' nodular mandibular swelling arising from the mental foramen region. A full-blown, rapidly developing abdominal mass manifested only three weeks after a biopsy of the mandibular swelling. Aspiration of the latter and a histologic report of the mandibular mass confirmed Burkitt's lymphoma. The patient responded very well to appropriate chemotherapy. Clinicians should not overlook insidious jaw swellings in any adult residing in the endemic zone of Burkitt's lymphoma, in view of the fact that successful therapy is dependent on early diagnosis. Mental nerve paraesthesia is very rarely seen in Burkitt's lymphoma.
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5/362. Follicular carcinoma in ectopic thyroid gland. A case report.

    Ectopic thyroid rest can be seen anywhere along the path of descent of the gland. The most ectopic thyroid tissue is a thyroglossal duct cyst associated with normal thyroid gland. Sublingual location is less common than a lingual ectopia. True malignant transformation in ectopic thyroid tissue is extremely rare. Such a malignancy is virtually always diagnosed only after surgical excision of the lesion at pathological examination. This report discusses a case of ectopic thyroid follicular carcinoma in the right submandibular region in the absence of orthotopic thyroid, discovered by chance after the surgical excision performed for a preoperative ultrasonically and cytologically misdiagnosed submandibular gland adenocystic carcinoma. The possible aetiology of such an unusual anatomical relationship is discussed as well as the importance of thyroid scanning, ultrasound and/or CT in neck lumps.
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6/362. Primary leiomyosarcoma of the mandible in a 7-year-old girl: report of a case and review of the literature.

    leiomyosarcoma is a malignant neoplasm of smooth muscle origin that manifests itself uncommonly in the oral cavity because of the paucity of smooth muscle in that location. To the best of our knowledge, only 10 cases of leiomyosarcoma primary to the jawbones have been reported in the English language literature. We report the first pediatric case of leiomyosarcoma arising from the mandible. facial asymmetry and swelling were accompanied by a rapidly growing exophytic soft tissue mass that caused buccal displacement of the mandibular left permanent first molar. The lesion, observed radiographically as an extensive ill-defined area of osteolytic alveolar destruction, perforated the lingual cortex, displaced the inferior alveolar nerve canal inferiorly, and produced a "floating-in-air" appearance of the first molar. Diagnosis of leiomyosarcoma was made after initial incisional biopsy of the lesion. A 5-cm segmental mandibulectomy and supraomohyoid neck dissection were followed by reconstruction with a dynamic mandibular reconstruction plate and placement of a multidimensional mandibular distraction device in a transport rectangle of bone to promote bifocal distraction osteogenesis. Forty millimeters of distraction (the technical limit of the device) were performed; this was followed by terminal iliac crest bone grafting. Seventeen months after the definitive surgical procedure, the patient remains free of disease.
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7/362. Granular cell ameloblastoma of jaw. A report of rare case and brief review of literature.

    ameloblastoma is an epithelial odontogenic tumour of the jaw and exhibits diverse microscopic patterns which occurs either singly or in combination with other patterns. The rare granular cell variant is seen in combination usually with follicular or plexiform subtypes. The reported case reveals the microscopic patterns characteristic of granular cell variant only, which is uncommon. The tumour was excised and no recurrence has been observed after nineteen months of surgery.
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8/362. Intraosseous neurofibroma of the jaws.

    Two cases of intraosseous neurofibromas of the mandible are presented. Only 25 cases of this tumor have been published previously. Of the present two cases, one was located at the upper border of the mandible, in the left second molar area where the tooth had been extracted 2 years previously. In the second case, the tumor presented itself as a 10 x 2 cm large destruction, mainly following the course of the alveolar nerve from the mandibular foramen to the mental foramen in the right side of the jaw. The mandibular first right molar was missing but the relationship between the extraction of the tooth and the development of the tumor could not be demonstrated. Histologically, the two tumors differed in the way that case 1 showed a conspicuous amount of delicate, wavy fibrils, some of which showed concentric lamellations resembling the pacinian corpuscle but without neurites containing nerve fiber bundles and also demonstrated a slight pleomorphism.
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9/362. Lymphosarcoma of the mandible associated with macroglobulinemia of Waldenstrom.

    waldenstrom macroglobulinemia is a rare progressive immunoproliferative disorder involving lymphocytes and occasionally plasma cells. Unlike the multiple myeloma, this disease has minimal osseous lesions. Lesions in the jaws are very rare. This paper presents a case of lymphosarcoma in the mandible in a 68-year-old woman, who was diagnosed as suffering from waldenstrom macroglobulinemia. The possibility of immunosuppression by Leukeran as an aetiologic factor causing the bone lesions is suggested.
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10/362. Odontogenic ghost cell carcinoma: report of four new cases and review of the literature.

    Only 12 odontogenic ghost cell carcinomas (OGCC) have been reported in the English language literature to date. This article reports four additional cases of this rare odontogenic tumour and examines them in relation to those previously described. Judging from the number of published cases, the OGCC is more prevalent in Asians than other racial groups, occurs more often in the maxilla than the mandible, and is slightly more common in males than females. Histologically, elements of a benign calcifying odontogenic cyst (COC) can be identified in all the malignant variants, either separated or admixed with the malignant epithelial component. The latter can consist of either small basaloid cells or large epithelial cells. Despite the differing histological presentations, the biological behavior of the tumour is unpredictable, with some cases characterized by relatively indolent growth and others by a locally aggressive and potentially fatal course. The tumour apparently arises most often from malignant transformation of a preexisting benign COC, although it may also develop from other odontogenic tumours.
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