Cases reported "Mandibular Neoplasms"

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1/10. Dentinogenic ghost cell tumor: histologic aspects, immunohistochemistry, lectin binding profiles, and biophysical studies.

    Dentinogenic ghost cell tumor accompanied with calcifying odontogenic cyst (COC) was described in terms of its clinical, histological, immunohistochemical, lectin binding and biophysical properties. The case was a 38-year-old Japanese female, in whom the tumor had arisen in the right mandibular premolar and molar region. Material obtained by partial mandibulectomy was used. Decalcified paraffin sections were used to detect keratins, involucrin, and lectin binding; and non-decalcified thin sections were used for biophysical analysis. The lesion comprising dentinogenic ghost cell tumor and COC contained odontogenic epithelium with ghost cells, eosinophilic amorphous materials and osteodentin. Some of the eosinophilic material had undergone transformation into osteodentin. keratins in odontogenic epithelia showed positive PKK1 staining in peripheral tumor cells, and stainings with KL1 and involucrin were positive in centrally located cells. Lectin binding in the amorphous materials was comparatively strong for PNA, and SBA, moderate for WGA, RCA-1, and UEA-1, and slight for DBA and ConA. Lectin binding affinities were higher in the amorphous materials than in the osteodentin. Elemental analysis with an electron probe X-ray microanalysis of the amorphous materials and osteodentin showed a pattern similar to that found in the normal dentin. The biologic properties of the eosinophilic amorphous materials suggested the material to be poorly calcified osteodentin, which gradually transformed into the well-calcified type.
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2/10. Central haemangioma: variance in radiographic appearance.

    Central haemangioma, a "great mimicker" which, fortunately, is a relatively rare condition, may pose a lethal risk for the patient. The diagnosis may become apparent only during biopsy or tooth extraction, which poses a risk of lethal exsanguination; therefore a correct diagnosis is desirable before any biopsy is undertaken. The clinician may not anticipate the severe haemorrhage because of vague clinical history, physical findings and ambiguous radiographic characteristics of the lesion. We report a case of central haemangioma of the mandible whose clinical and radiographic features were equivocal. In addition, an attempt is made to discuss all possible radiographic presentations of central haemangioma and consider differential diagnosis. This case is significant for the reason that it had diverse radiographic appearances in various areas of the lesion in different projections.
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3/10. adamantinoma of the spine: case report.

    OBJECTIVE: We report a patient with a cervicothoracic spinal and a mandibular adamantinoma. adamantinoma is a rare malignant neoplasm of bone and, to our knowledge, there have been only five cases of spinal adamantinoma reported. The pathogenesis of the adamantinoma, as well as the management of this extremely rare spinal tumor, is reviewed. CLINICAL PRESENTATION: A 55-year-old man was admitted to our service with cervical pain and signs of C8 and T1 radiculopathy. On physical examination, cervical spine deformity, swelling in the left mandible region, and signs of C8 and T1 radiculopathy were observed. Neuroradiology examinations showed an osteolytic mass of the C6, C7, and T1 vertebral bodies, extending into the lateral masses and transverse processes. After surgical procedures, the patient had clinical improvement. INTERVENTION: Corpectomy of C6, C7, and T1 was performed through a cervicothoracic anterior approach. Anterior stabilization of the spine was obtained using an autologous iliac crest graft and osteosynthesis with an anterior plate. On a second procedure, posterior tumor resection and spinal stabilization were performed. After the 1-year follow-up examination, a new anterior procedure was performed because of tumor recidivity and spine instability. CONCLUSION: adamantinoma, an extremely rare lesion, is a locally aggressive tumor with slow growth and the potential to metastasize. Although it is an extremely rare occurrence in the spine, adamantinoma should be considered on the diagnosis of tumors of the vertebrae. Neuroradiological examinations are not specific in the differentiation of this tumor from other conditions. This fact, coupled with the limited experience that most physicians in general have in dealing with this tumor, makes the diagnosis and treatment of adamantinoma challenging.
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4/10. Complex wound management: a case study.

    Mr. G.'s situation was challenging, because it did not readily conform to the management techniques currently available and required consideration of psychosocial and other physical factors. To meet individual patient needs, nurses must be creative in finding solutions to unusual problems. By focusing on the short-term goals for wound management and the goals for family-centered home care as a guide to interventions, adaptations were made to fit this patient's needs.
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5/10. Malignant melanoma metastatic to the mandible.

    Metastatic malignant melanoma to the jaws is uncommon and is usually accompanied by generalized involvement. Hematogenous dissemination with deposition and growth in areas of hematopoietic marrow (that is, the mandibular molar region) is the accepted mechanism for involvement of the jaw. Clinical and radiographic findings are nonspecific. Comprehensive history, physical examination, and tissue microscopy are essential to accurate diagnosis and management of the patient. radiotherapy for palliation is the accepted mode of therapy for symptomatic metastatic melanoma. prognosis in cases with secondary jaw involvement is grave. A case of malignant melanoma with metastases to the mandible is presented and the literature is reviewed.
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6/10. Clinical application of the functional matrix: mandibular reconstruction and monobloc functional therapy.

    A 13-year-old black girl with an extensive ameloblastoma of the mandible required subtotal mandibular resection and immediate reconstruction with use of an autogenous, ipsilateral, corticocancellous graft from the iliac crest and monobic functional therapy. Twenty-seven months later, clinical evaluation showed normal mandibular function and no facial asymmetry. Bony architectural changes after 27 months included reformation of the coronoid process, angular process, and external oblique ridge; preservation of mandibular length and thickness; and maintenance of the alveolar ridge height. The reformation of the coronoid process suggests the importance of the functional matrix (temporalis muscle) in skeletal tissue growth. The monobloc appliance in conjunction with bone grafting is an effective means for transmission of biophysical stimuli and for maintenance of appropriate stress for remodeling of bone in the mandible.
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7/10. Mandibular tumor-induced muscular weakness and osteomalacia.

    The case presented is that of a 26-year-old man who suffered from muscular weakness and aching pains 2 years prior to hospitalization. During that period, a tumor in the mandible was diagnosed. During the neurologic work-up to find the cause of the muscular weakness, the possibility of a metabolic bone disease was raised on the basis of oral findings. The giant-cell nature of the mandibular tumor, with destruction of the periodontium, suggested hyperparathyroidism. The giant-cell nature of the mandibular tumor, with destruction of the periodontium, suggested hyperparathyroidism. However, biochemical findings ruled out this diagnosis and led to the final diagnosis of "tumor-induced osteomalacia." Removal of the mandibular tumor caused substantial improvement in the patient's physical condition and in the biochemical picture, which confirmed the diagnosis.
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8/10. Pediatric fibromatosis requiring mandibular resection and reconstruction.

    Fibromatosis is the nonmalignant proliferation of fibroblasts that aggressively invade adjacent tissues. The cause of this abundant growth is unknown. When fibromatosis develops in the mandible or adjoining tissues, its aggressive growth can compress the trachea and cause death. Resection is the treatment of choice. mandibular reconstruction is performed to prevent displacement of the remaining mandibular segment or segments and consequent difficulties in eating and speaking. Perioperative nurses who care for children with oral or paraoral fibromatoses must understand the special physical and psychological needs of these patients to effectively plan their care.
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9/10. Synovial cell sarcoma of the temporomandibular joint.

    Synovial cell sarcoma is a relatively rare tumor that occurs infrequently in the head and neck. Despite the low incidence, synovial cell sarcoma should be a part of the differential diagnosis when evaluating masses in the head and neck region. The primary mode of treatment is wide en bloc excision. The decision to perform lymph node dissections should be based on physical findings or imaging studies that suggest lymphadenopathy. Post-operative radiation therapy is believed to be of value, but only in large doses of 65 Gy or more. The role of chemotherapy remains unclear. Despite recent advances, the prognosis for this disease remains poor. This report describes the fourth reported case of synovial cell sarcoma involving the temporomandibular joint. The case report details the principles of wide excision and adjuvant radiation therapy in the treatment of synovial cell sarcoma.
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10/10. Solitary, central neurofibroma of the mandible: a case report.

    A case of Solitary Central neurofibroma in a 53 years old female is reported. This is an apparently single primary lesion, in which physical and Radiological examination failed to reveal other bony lesions or the stigmata of multiple neurofribomatosis.
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