Rhabdomyosarcoma of the oral and maxillofacial region in Jordanians: a retrospective analysis

OBJECTIVE: The objective was to study the clinicopathologic features of rhabdomyosarcoma (RMS) of the oral and maxillofacial region in Jordanians. STUDY DESIGN: Data were collected from records of patients treated between 1989 and 2000 at the Maxillofacial Unit of Jordan University of Science and Technology. The main outcome measures were age, gender, location, stage of disease, histopathologic type, treatment received, follow-up period, and eventual outcome. RESULTS: Nine patients with RMS aged 4 to 17 years were found, with a male to female ratio of 2:1. Six (67%) bony sites and 7 (78%) soft tissue sites were involved. The extent of disease was locoregional in 8 (89%) cases, nodal in 3 (33%) cases, and distant metastatic in 2 (22%) cases. The Intergroup Rhabdomyosarcoma Study classification of clinical groups was as follows: 2 (22%) cases in stage II, 5 (56%) cases in stage III, and 2 (22%) cases in stage IV. The histopathologic types found were 6 (67%) embryonal, 2 (22%) alveolar, and 1 (11%) undifferentiated. Triple agent chemotherapy was used in the treatment of 8 cases, singly or in combination with surgery or radiotherapy. Two patients are still alive, and 5 patients have died of disease. CONCLUSIONS: The clinicopathologic features of maxillofacial RMS in this group of Jordanians are different from those of people from other countries. Further studies are needed to have a better understanding of the behavior of RMS in the oral and maxillofacial area.     

Lipoma of the oral and maxillofacial region: Site and subclassification of 125 cases

OBJECTIVE: Lipomas and lipoma variants are common soft tissue tumors, but occur infrequently in the oral and maxillofacial region. In this study, we reviewed 125 lipomas in specific oral and maxillofacial locations. We wanted to examine and compare the clinicopathologic features of these tumors.Study design The records from the Oral and Maxillofacial Pathology Registry of the Armed Forces Institute of Pathology from 1970 to the present were searched for cases coded as "lipoma." This study included 125 cases based on location within the oral and maxillofacial region, benign histology, and available clinical information. Subcutaneous and intraosseous lipomas were excluded. The tumors were classified according to the most recent World Heath Organization classification for soft tissue tumors. RESULTS: Of 125 lipomas, 91 tumors occurred in males, 33 in female patients, and 1 of unknown gender. The mean age was 51.9 years, range 9-92 years. Four tumors occurred in pediatric patients (age <18 years). Specific anatomic sites within the oral and maxillofacial region included the parotid region (n=30); buccal mucosa (n=29); lip (n=21); submandibular region (n=17); tongue (n=15); palate (n=6); floor of mouth (n=5); and vestibule (n=2). The mean size of tumors was 2.2 centimeters, range 0.5 to 8.0 centimeters. The mean duration of the tumors prior to excision was 3.2 years, range 6 weeks to 15 years. Most patients presented with an asymptomatic, circumscribed mass. Grossly, most tumors were described as pink and smooth, occasionally mucoid. Histologically, the tumors were subclassified as classic lipomas (n=62); spindle cell/pleomorphic lipomas (n=59); fibrolipoma (n=2), and chondroid lipoma (n=2). Fourteen tumors exhibited secondary changes, such as fat necrosis, atrophy, and prominent hyalinization; 23 tumors were histologically confirmed to be intramuscular. CONCLUSIONS: Lipomas of the oral and maxillofacial region occur most commonly in adult males in the parotid region, followed closely by the buccal mucosa. These tumors are uncommon in children. Interestingly, spindle cell lipomas are common in this region and comprise the majority of our parotid and lip tumors. Angiolipomas were absent in this anatomic region in this study. Secondary changes and atrophy should not be confused with the malignant histologic features of a liposarcoma.     

Oral pyogenic granuloma in Jordanians: a retrospective analysis of 108 cases.

PURPOSE: The purpose of the present study was to retrospectively analyze the clinicopathologic features and treatment of oral pyogenic granuloma in Jordanian patients. PATIENTS AND METHODS: Information regarding 108 cases of pyogenic granuloma of the oral cavity that underwent biopsy were retrieved from the records of patients seen at the maxillofacial and periodontology units of the Faculty of Dentistry, Jordan University of Science and Technology, during an 11-year period from 1991 to 2001. Data were reviewed and analyzed for age, gender, site, treatment, and clinical and histopathologic features. RESULTS: Patient ages ranged from 3 to 85 years (mean, 30 years), with the greatest degree of occurrence (26.8%) in the second decade. The male-to-female ratio was 1:1.7. The mean age for females age was higher than that for males. The most frequently involved site was the gingiva (44.4%); other sites were the lips, tongue, buccal mucosa, and palate. Gingival pyogenic granulomas were more prevalent in the maxilla than in the mandible, with the anterior region of both jaws being more commonly affected. The labiobuccal gingiva of both jaws was more commonly affected. The main complaint was bleeding (59.3%), and almost half of the lesions had a pedunculated base, with surface ulceration in 9.2% of cases. The mean greatest granuloma diameter was 10 mm. All lesions were surgically excised, with 5.8% of cases known to have recurred. CONCLUSIONS: The clinicopathologic features of oral pyogenic granuloma in Jordanians are similar to those of other whites. In this series, we found that with surgical excision of pyogenic granuloma, there was a low recurrence rate.     

内镜辅助下切除颌面部良性肿瘤的效果评价

目的 ：探讨内镜辅助下颌面部良性肿瘤切除的可靠性。方法 ：18例颌面部良性肿瘤患者,男7例,女11例;年龄5～34岁,平均16.8岁。前额部纤维瘤3例、脂肪瘤4例;颧部脂肪瘤2例、肌内静脉畸形3例、皮样囊肿6例。肿物大小1.7 cm×2.2 cm～2.0 cm×3.2 cm。全部病例在内镜辅助下耳屏前或发际切口切除。结果 ：全部肿瘤完整切除,手术时间45～75 min,平均54 min。术中出血量6～15 mL,平均8.5 mL。手术过程顺利,切口一期愈合。随访2～8个月,肿瘤无复发,瘢痕隐蔽,美容效果好。结论 ：内镜辅助下耳屏前或额部单通道小切口切除颌面部良性肿瘤安全、可靠,瘢痕隐蔽,美容效果好。     

颌面部骨嗜酸性肉芽肿18例临床分析

目的:分析颌面部骨嗜酸性肉芽肿的临床及X线特点。方法:对18例颌面部骨嗜酸性肉芽肿资料,分别从患者性别、发病年龄、临床表现、发病部位、X线表现、误诊情况、治疗等方面进行回顾性分析。结果:18例颌面部骨嗜酸性肉芽肿患者,男11例,女7例;平均发病年龄16.62岁,平均病程5.5个月;11例为单发,7例为多发,共计29个部位,其中累计下颌骨21处(72.8%),上颌骨4处(13.8%),颅骨3处(10.3%),颧骨1处。主要临床表现为牙齿松动,牙龈肿胀、溃烂、疼痛、面部肿胀伴压痛。X线表现为颌骨中央不规则、溶解样破坏,破坏区呈地图状、网状、虫蚀样改变,骨破坏边缘不清晰。易误诊为骨肉瘤(3例),牙源性粘液瘤(2例),恶性淋巴瘤(1例),浆细胞骨髓瘤(1例),低分化癌(1例),其他恶性肿瘤(4例)。治疗方法6例采取单纯手术,7例采取手术+放疗,3例采取手术+化疗,1例采取手术+放疗+化疗。平均随访5年,14例无复发。结论:该病变特点显著,应正确诊断和治疗。     

Primary liposarcoma in oral and maxillofacial region

Liposarcoma as one of the most common soft-tissue sarcomas in adults rarely occurs in oral and maxillofacial region. Its rarity makes a systematic and in-depth understanding of these uncommon entities extremely difficult. Here we aimed to characterize and analyze the epidemiology, clinicopathologic characteristics, treatment and prognosis of primary oral and maxillofacial liposarcomas by presenting our experience from a Chinese tertiary referral hospital and literature review. All relevant information was manually collected from medical records from the authors' department (1993-2009) and literature retrieval (Jan.1940-Sep.2009). A total number of 150 patients were identified and included with mean age 49.1 years old and a slight male preponderance. These lesions mostly occurred in tongue (32.0%) followed by buccal region (28.7%) and were diagnosed as atypical lipmatous tumor/well-differentiated (58.45%) and myxoid liposarcomas (27.5%) by pathologic re-evaluation and re-categorization based on 2002 WHO classification scheme. Complete surgical excision with negative margins was the primary treatment modality, while therapeutic utilities of adjuvant radiotherapy/chemotherapy remained controversial. Our data reinforced histopathologic subtype as one of key prognostic factors irrespective of gender, age and primary sites for this malignancy. More importantly, our analysis further revealed that tumor size (especially when larger than 3.6 cm) served as another important prognostic factor suggesting higher rates of disease-related death. Taken together, these findings might for the first time provide comprehensive information regarding the epidemiology, clinicopathologic features, treatment and prognosis of oral and maxillofacial liposarcoma.     

面颈部皮肤钙化上皮瘤临床及病理研究

目的：面颈部皮肤钙化上皮瘤为一类较少见的真性肿瘤,本文总结并讨论其临床及病理特点.方法：收集南京口腔医院颌面外科及病理科1991～2005年已经确诊并经手术治疗的钙化上皮瘤共9例临床病案进行回顾性分析.结果：本病患者以青少年俱多,其中～19岁组占42%,P＜0.05,性别趋向女性,男女之比为1∶2.本病临床上极易误诊,本文资料中9例其误诊率达66%.组织病理观察,表现为影细胞及嗜硷性细胞片状排列为特征.本病经外科手术切除后未见复发.结论：皮肤钙化上皮瘤好发于青少年,且女性占多数.钙化上皮瘤临床易发生误诊,利用影像学手段可提高诊断率.手术切除彻底可以预防复发.     

口腔颌面部异位脑膜瘤的临床特点:附23例病例分析

目的:分析异位脑膜瘤在口腔颌面部发病的临床特点及治疗原则.方法:回顾分析1990-2008年口腔颌面外科收治的23例异位脑膜瘤患者的临床资料,总结其临床表现、影像学特点、手术方法及随访情况.结果:①本组病例中位年龄37岁,总体性别差异不明显,但40岁以后女性多于男性.②好发部位依次为咽旁间隙(13例),颞下窝,翼腭窝(5例),颞部(3例);眶部、颊部各1例.③影像学表现与颅内脑膜瘤相同.④23例均行手术治疗,彻底切除17例,部分残留6例.⑤随访12例,复发3例;出现相应神经损伤症状8例.结论:口腔颌面部异位脑膜瘤多见于中青年患者及老年女性;好发于颌面深部间隙,多与颈鞘及后组颅神经关系密切;术前影像学检查有助于诊断;彻底手术是主要的治疗方法,术后并发症主要是相邻的神经损伤.     

Congenital neck masses: a descriptive retrospective study of 252 cases.

PURPOSE: This retrospective study was conducted to analyze congenital neck masses in Jordanians compared with international findings. PATIENTS AND METHODS: The records of patients with congenital neck masses between 1991 and 2002 were retrieved from the Department of Pathology, Jordan University of Science and Technology, and analyzed for age, gender, location, clinical features, and treatment. RESULTS: Within the 12-year period of the study, a total of 2,063 neck mass lesions were found; of these, 252 (12%) were congenital masses. These cases were distributed into 166 (66%) midline, 55 (22%) lateral, and 31 (12%) entire neck masses. The most frequent mass was thyroglossal duct cyst (fistulas) (53%), followed by cysts (fistulas) of the branchial apparatus (22%), dermoid cysts (11%), hemangiomas (7%), and 1ymphangiomas (6%). The majority of branchial arch anomalies (85%) were of the second arch. The mean age of patients was 16 years, with the greatest number of cases (38%) in the first decade. The male-to-female ratio was 1:1.2, with most lesions affecting females. The majority of lesions presented with painless neck swelling, and all lesions were surgically excised. CONCLUSIONS: The overall frequency and age distribution of congenital neck masses in northern Jordanians are similar to international findings. However, the gender distribution and relative frequency of individual types of neck masses are somewhat different from those in other countries. These differences may be attributed to genetic and geographic differences.     

颏下皮瓣在修复口腔颌面部软组织缺损中的应用

目的:评价颏下皮瓣在口腔颌面部软组织缺损修复中的应用。方法 :采用颏下皮瓣修复口腔颌面部软组织缺损26例,年龄35～80岁;男性18例,女性8例;恶性肿瘤21例,均排除淋巴结转移,良性病变3例,外伤致软组织缺损2例;均用颏下皮瓣修复,皮瓣大小为(3.5 cm×8.0 cm)～(4.0 cm×10.0 cm)。结果:25例皮瓣一期愈合,有1例皮瓣创口裂开,延期愈合。受区外形及功能恢复良好,术后随诊4～20个月,皮瓣在术后2～3个月有10%～15%的缩小。结论:颏下皮瓣制备简单、安全,修复口腔颌面部中小型软组织缺损效果良好。     

Distribution pattern of the adenomatoid odontogenic tumor: a retrospective study from the files of a government teaching hospital,Tamil Nadu,Chennai, India

Aim: To determine the distribution and clinicopathologic characteristics of adenomatoid odontogenic tumors from Tamil Nadu, India, to provide meaningful data for comparison among different population groups, mainly in the Asian context. Methods: Forty‐three adenomatoid odontogenic tumors were reviewed from 493 odontogenic tumors recorded between 1970 and 2008. The data pertaining to age, sex, anatomic site, associated impacted teeth and radiographic details, provisional diagnoses, and macroscopic and microscopic details of the 43 odontogenic tumors were reviewed. Results: The relative frequency of adenomatoid tumors comprised 8.72% of the total odontogenic tumors. The age range was 9–30 years, with a mean age of 16.88 years for combined adenomatoid odontogenic tumors. The mean age for other variants of adenomatoid odontogenic tumors assessed in this study differed slightly between sexes. Forty occurred within the bone and three peripherally. In general, the maxilla was the predominant site of involvement (72.5%), and the anterior region of jaw was affected in 92.5%. For combined adenomatoid odontogenic tumors, the male‐to‐female ratio was 1:1.26, and the maxilla‐to‐mandible ratio was 2.9:1. Microscopically, cystic lesions comprised 37.5% and occurred more often in males with a lower mean age. Conclusion: The present study shows variations in the distribution of adenomatoid odontogenic tumors within the population assessed, but no definite conclusion emerged with regard to regional or ethnic effect.     

颌面部骨肉瘤61例临床病理研究

目的 探讨颌面部骨肉瘤的临床病理特征。方法 对61例颌面部骨肉瘤进行临床资料分析、组织学观察及随访，并进行统计学分析。结果 患者男女之比1．26：1，平均年龄39．8岁，上颌骨占32．8％，下颌骨占57．4％。成骨细胞型占55．7％，成软骨细胞型占16．4％，成纤维细胞型占21．3％。各型骨肉瘤的共同组织学特点为恶性肿瘤细胞直接成骨。肿瘤复发率39．1％，肺转移率8．7％。结论 颌面部骨肉瘤最常见于下颌骨，性别无明显差异，好发年龄段较长骨骨肉瘤提高10余岁。组织学分型上以成骨细胞型为主。肿瘤复发率较高，远处转移率较低，生物学行为较长骨骨肉瘤为好。     

Value of gallium-67 scanning in differentiation of malignant tumors from benign tumors or inflammatory disease in the oral and maxillofacial region

OBJECTIVE: The purpose of this study was to evaluate the efficacy of gallium-67 ((67)Ga) scanning in the differentiation of malignant tumors from benign tumors or inflammatory disease in the oral and maxillofacial region.Study design Fifty-two patients with tumors or inflammation in the oral and maxillofacial region underwent (67)Ga scanning. The results were compared with the final pathologic diagnosis. RESULTS: The gallium-67 scanning images for 20 of 21 patients who had malignant tumors were positive (95.23%); images for 3 out of 20 patients who had benign tumors also were positive (15%). There was a significant difference between malignant and benign tumors (P <.001). Images for 2 of 11 patients with chronic inflammatory lesions were positive (18.2%), but, unlike the images of malignant tumors, the image outlines of the inflammatory lesions were indistinct and larger than the actual lesions. CONCLUSION: (67)Ga scanning is a useful adjunct tool for differentiation of malignant tumors from benign tumors or inflammatory disease in the oral and maxillofacial region.     

口腔颌面部创伤111例患者的伤情分析

目的:总结和探讨"7·23"重特大动车事故发生后一线医院收治的口腔颌面部创伤患者的伤情特点。方法 :对温州市11家医院收治的111例动车事故中口腔颌面部创伤患者的病例资料进行统计和分析。结果:111例口腔颌面部创伤患者中男女比例为1.27∶1;21～30岁(33.3%)为受伤高峰年龄段。在颌面部创伤中,颌面部软组织伤占81.1%,颌面部骨折占11.7%,牙外伤(牙槽突创伤)患者占7.2%。3例下颌骨骨折患者共发生5处骨折,占骨折的29.4%,发生率最高。合并损伤多发,以四肢损伤和胸部损伤最为多见,分别占31.1%和25.7%。结论:动车事故中口腔颌面部创伤多发,但以软组织伤最为常见,颌骨骨折中下颌骨骨折居多;复合伤多,最常见的是四肢和胸部的损伤。     

颌骨骨母细胞瘤5例报道及文献复习

目的:探讨颌骨骨母细胞瘤的临床和病理特点。方法:结合我院近20年收治的5例颌骨骨母细胞瘤病例,回顾国内有详细记载的54例颌骨骨母细胞瘤病例报告,对其年龄分布、发病部位等临床发病情况和病理特征进行分析。结果:颌骨骨母细胞瘤以10～30岁发病最多,部位以磨牙区最多,局部膨隆与钝性疼痛为主要临床症状。主要病理学特征是不同程度钙化的骨样组织和骨质形成,大量增殖的骨母细胞混杂在富含血管的间质中。结论:全面了解颌骨骨母细胞瘤的发病情况及病理特点,对其诊疗具有一定的临床价值。     

改良梭形切口在颌面部皮肤良性肿瘤切除中的应用

目的 设计一种改良梭形切口,用于切除颌面部皮肤良性肿瘤。方法 经尸体实验。方法 经尸体实验、计算,证实此改良切口具有多方面优点后,用于切除24例颌面部皮肤良性肿瘤。结果 按肿瘤半径为0.5cm、1.0cm、1.5cm计算,改良梭形切口节省切除皮肤面积分别为17．22％、15．42％、16．98％;缝合切口时无张力（或张力小）,切口对合线平整,隐于皱纹线中,无“猫耳”。经1－7a随访,切口瘢痕愈合良好。结论 此改良切口优于传统松形切口,可推广应用于切除颌面部皮肤良性肿瘤。     

Clinical evaluation of thermography in the diagnosis of malignant tumors in the oral and maxillo-facial region

Thermographic images of 48 cases of malignant tumors were analyzed and compared with those of other lesions: 93 cases of acute inflammation, 48 cases of chronic inflammation, 48 cases of benign tumors and 28 cases of cystic lesions. The majority of the cases with malignant tumors showed higher skin temperature over the affected area, but usually not so remarkable such as those of the cases with acute inflammation. The border of the thermal pattern of the tumors showed the tendency to be unclear. Both malignant tumors and acute inflammation appeared to cause an increase in skin temperature of the common carotid artery region on the affected side as compared with the opposite side. Malignant tumors showed the tendency that the temperature of the common carotid artery region of the affected side is equal or lower than the affected region in many cases. It is suggested that with further sophistication of the system suitable for the maxillofacial region, thermography may serve a role in the clinical diagnosis of malignant tumors.