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Spindle cell variant of ameloblastic carcinoma of mandible 下颌骨骨髓瘤纺锤形细胞变异癌
IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-05-03 DOI: 10.1016/j.ajoms.2024.04.017
Kiran Jot , Rahul Yadav , Aanchal Kakkar , Deepika Mishra
Ameloblastic carcinoma (AC) is an aggressive odontogenic tumor. Spindle cell variant of AC (SCAC) is a rare entity and only sixteen cases of SCACs have been reported in the literature till date. We reported a case of 42-years-old male presented with swelling in right lower posterior region for 3 years. Radiology revealed multilocular osteolytic with cortical thinning and rarefaction showing internal non-enhancing areas. Histologically, the tumor revealed areas characteristic of ameloblastoma along with hypercellular areas of monomorphic spindle shaped cells merging into the stroma displaying cytological atypia, suggestive of AC with spindle cell variant. The purpose of this case report is to document an unusual case of spindle cell variant of AC, which can mimic other oral spindle cell lesions. Additionally, proliferative marker along with histological parameters like cytological atypia, mitoses and cell morphology is emphasized.
绒毛细胞癌(AC)是一种侵袭性牙源性肿瘤。纺锤形细胞变异型牙髓母细胞癌(SCAC)是一种罕见的肿瘤,迄今为止,文献中仅报道了16例SCAC。我们报告了一例 42 岁男性病例,患者右下后部肿胀 3 年。放射学检查发现肿瘤为多发性溶骨性,皮质变薄、稀疏,内部为非增强区。组织学上,肿瘤显示出釉母细胞瘤的特征区域,以及单形纺锤形细胞与基质融合的高细胞区,显示出细胞学不典型性,提示为具有纺锤细胞变异的 AC。本病例报告的目的是记录一例不寻常的 AC 纺锤形细胞变异病例,该病例可模拟其他口腔纺锤形细胞病变。此外,报告还强调了增殖标志物以及细胞学不典型性、有丝分裂和细胞形态等组织学参数。
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引用次数: 0
Carcinoma ex pleomorphic adenoma primarily composed of squamous cell carcinoma in buccal region – Case report 主要由鳞状细胞癌构成的口腔多形性腺瘤 - 病例报告
IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-05-03 DOI: 10.1016/j.ajoms.2024.04.014
Takako Naruse , Kouji Ohta , Hideo Shigeishi , Toshinori Ando , Takayuki Nakagawa , Nao Yamakado , Yoshiaki Ninomiya , Shinichi Sakamoto , Yoko Ishida , Tomonao Aikawa
Carcinoma ex pleomorphic adenoma (CXPA) is a tumor arising from a pleomorphic adenoma and classified as an independent type in the 2005 WHO classification. These tumors mainly occur in the parotid gland or palate, though rarely in the buccal region. The carcinoma component is most often a salivary duct carcinoma, while findings of a squamous cell carcinoma (SCC) are rare. Here, we report a case of carcinoma of pleomorphic adenoma origin with SCC as the main component occurring in the buccal region. A 77-year-old woman was referred to our department because of swelling in the right buccal mucosa. An elastic hard mass was found in the right buccal subcutaneous region and induration in the right buccal mucosa due to the mass was noted by palpation. Biopsy results from an obtained specimen led to a diagnosis of SCC. The patient underwent excision of a right-sided buccal malignant tumor in combination with skin resection and partial right-sided maxillary resection. Histopathological examination findings of the excised tumor indicated CXPA primarily composed of SCC with lymph node metastasis. Thereafter, multiple sites of distant metastasis were found. The patient died at two years six months after surgery.
多形性腺瘤癌(CXPA)是一种由多形性腺瘤引起的肿瘤,在 2005 年世界卫生组织的分类中被列为一个独立的类型。这类肿瘤主要发生在腮腺或上颚,但很少发生在颊部。癌变部分最常见的是唾液腺导管癌,而鳞状细胞癌(SCC)则很少见。在此,我们报告了一例发生在颊部的以 SCC 为主要成分的多形性腺瘤癌。一名 77 岁的妇女因右口腔粘膜肿胀而被转诊至我科。在右侧颊粘膜皮下区域发现一个弹性硬块,触诊时发现右侧颊粘膜因肿块而出现压痕。从获得的标本中进行的活检结果诊断为 SCC。患者接受了右侧口腔恶性肿瘤切除术、皮肤切除术和右侧上颌骨部分切除术。切除肿瘤的组织病理学检查结果显示,CXPA 主要由 SCC 组成,并伴有淋巴结转移。此后,又发现多处远处转移。患者于术后两年六个月去世。
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引用次数: 0
General anesthesia with remimazolam for tooth extraction in a patient with Noonan syndrome and hypertrophic obstructive cardiomyopathy: A case report 在一名患有努南综合征和肥厚型梗阻性心肌病的患者拔牙时使用雷马唑仑进行全身麻醉:病例报告
IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-05-02 DOI: 10.1016/j.ajoms.2024.04.016
Hisanobu Kamio , Kana Oue , Yasuyuki Asada , Nanako Ito , Serika Imamura , Mitsuru Doi , Yoshitaka Shimizu , Mitsuhiro Yoshida , Souichi Yanamoto , Hiroshi Hanamoto
Noonan syndrome (NS) is characterized by various abnormalities and is complicated with cardiac diseases, such as hypertrophic cardiomyopathy, in > 80% of cases. Minimum hemodynamic changes are a crucial factor during general anesthesia in such patients. We report the case of a patient with NS and hypertrophic obstructive cardiomyopathy (HOCM) who underwent general anesthesia using remimazolam, a new ultrashort-acting benzodiazepine anesthetic, which is expected to cause less circulatory depression. A 19-year-old woman with NS complicated with HOCM was scheduled to undergo extraction of the wisdom teeth and second molar under general anesthesia. Preoperative evaluation revealed HOCM with left ventricular outflow tract obstruction and the patient had chronic heart failure. After the placement of an arterial line under moderate sedation with remimazolam, general anesthesia was induced with remimazolam, fentanyl, and rocuronium, followed by anesthesia maintenance with remimazolam and remifentanil. Tracheal intubation was performed using videolaryngoscopy. Local anesthesia and inferior alveolar nerve block were performed using adrenaline-free local anesthetics. Intraoperatively, low-dose phenylephrine was administered continuously to maintain peripheral vascular resistance. At the end of surgery, the endotracheal tube was replaced with an i-gel® supraglottic airway device before emergence from general anesthesia. After full recovery from anesthesia, the i-gel® was removed, and the patient was transferred to the hospital ward. The perioperative blood pressure and heart rate were maintained within normal ranges, and no cardiovascular events occurred during anesthesia. Anesthesia management using remimazolam and low-dose phenylephrine with reduction in perioperative stress may provide an appropriate circulatory condition for noncardiac surgery in patients with HOCM.
努南综合征(NS)以各种异常为特征,80%的病例并发心脏疾病,如肥厚型心肌病。在对这类患者进行全身麻醉时,最小血流动力学变化是一个关键因素。我们报告了一例患有 NS 和肥厚型梗阻性心肌病(HOCM)的患者,她使用了一种新型超短效苯并二氮杂卓麻醉剂雷米马唑仑进行全身麻醉,这种麻醉剂预计会造成较少的循环抑制。一名患有 NS 并发 HOCM 的 19 岁女性计划在全身麻醉下拔除智齿和第二磨牙。术前评估显示,HOCM 伴有左心室流出道梗阻,患者患有慢性心力衰竭。在使用瑞马唑仑进行中度镇静的情况下放置动脉导管后,使用瑞马唑仑、芬太尼和罗库溴铵诱导全身麻醉,然后使用瑞马唑仑和瑞芬太尼维持麻醉。气管插管使用视频喉镜进行。使用不含肾上腺素的局麻药进行了局部麻醉和下肺泡神经阻滞。术中持续注射小剂量苯肾上腺素以维持外周血管阻力。手术结束后,在脱离全身麻醉前用 i-gel® 声门上气道装置替换了气管导管。麻醉完全恢复后,移除 i-gel®,患者被转移到医院病房。围术期血压和心率均保持在正常范围内,麻醉期间未发生心血管事件。使用雷马唑仑和小剂量苯肾上腺素进行麻醉管理并减少围术期应激,可为 HOCM 患者的非心脏手术提供适当的循环条件。
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引用次数: 0
Foreign body in infant hard palate: A report of a rare case and literature review 婴儿硬腭异物:罕见病例报告和文献综述
IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-05-02 DOI: 10.1016/j.ajoms.2024.04.015
Shohei Takaoka , Kenji Yamagata , Satoshi Fukuzawa , Fumihiko Uchida , Naomi Ishibashi-Kanno , Hiroki Bukawa
Infants tend to place anything in their mouths; however, foreign bodies embedded in the hard palate of infants are extremely rare in clinical practice. Infants are often difficult to examine, and foreign bodies in the hard palate are misdiagnosed as neoplastic or inflammatory lesions in some cases. We present a rare case of a foreign body that was not diagnosed until its removal from the hard palate of an infant under general anesthesia. A healthy 12-month-old girl with a protruding foreign body on the hard palate was referred for close investigation. A white-yellow protruding foreign body measuring approximately 10 mm was found on the palate. Computed tomography revealed a radiopaque foreign body at the border. It was decided to examine and performed biopsy under general anesthesia, and the foreign body removed easily was an obviously plastic object with a semicircular shape and a brim around it. The histopathological examination of the abnormal gingiva under the foreign body revealed inflammatory granulation tissue. This report highlights the difficulty in diagnosing an infant with a foreign body in the hard palate and the safety of its removal under general anesthesia. Clinicians must consider the possibility of foreign bodies causing lesions on an infant’s hard palate. Therefore, careful examination and safe removal are necessary to prevent serious aspiration complications.
婴儿倾向于将任何东西放入口中,但在临床实践中,嵌入婴儿硬腭的异物极为罕见。婴儿通常很难进行检查,硬腭异物有时会被误诊为肿瘤或炎症病变。我们介绍了一例罕见病例,该病例是在全身麻醉下从婴儿硬腭取出异物后才确诊的。一名 12 个月大的健康女孩因硬腭上有异物突出而被转诊接受仔细检查。在腭部发现了一个约 10 毫米的白黄色突出异物。计算机断层扫描显示边界处有一个不透射线的异物。医生决定进行检查,并在全身麻醉的情况下进行了活组织检查,轻松取出的异物是一个明显的塑料制品,呈半圆形,周围有帽檐。对异物下的异常牙龈进行组织病理学检查后发现有炎症性肉芽组织。该报告强调了诊断婴儿硬腭异物的难度以及在全身麻醉下取出异物的安全性。临床医生必须考虑到异物导致婴儿硬腭病变的可能性。因此,必须仔细检查并安全取出异物,以防发生严重的吸入并发症。
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引用次数: 0
Anti-BP230 type mucous membrane pemphigoid with desquamative gingivitis: A case report 抗 BP230 型粘膜丘疹并伴有脱屑性牙龈炎:病例报告
IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-04-27 DOI: 10.1016/j.ajoms.2024.04.013
Seiichiro Oda , Hirofumi Okada , Atsushi Kihara , Norito Ishii , Hiroshi Koga , Yoshiyuki Mori , Tadahide Noguchi
Mucous membrane pemphigoid (MMP) is an autoimmune subepithelial/subepidermal blistering disease characterized by linear deposition of immunoglobulin G (IgG), IgA, and/or C3 in the basement membrane zone (BMZ) and predominant mucosal lesions involving the oral cavity and conjunctivae. Here, we describe a case of a 58-year-old Japanese man with MMP. Intraoral examination revealed desquamative gingivitis in the upper and lower gingivae. No conjunctival or cutaneous lesions were observed. Histopathological examination revealed a subepithelial split with inflammatory cell infiltration of the epithelial and connective tissues. Direct immunofluorescence revealed a linear deposition of C3 in the BMZ. IgG autoantibodies against BP230 were detected using an enzyme-linked immunosorbent assay. Indirect immunofluorescence using 1 mol/L NaCl-split skin sections revealed no reactivity for serum IgG or IgA. Immunoblotting using normal human epidermal extract as a substrate did not detect IgG reactivity against the 230-kDa antigen. Based on the above results, the definitive diagnosis of MMP with anti-BP230 antibody alone was established. Our case was categorized as low-risk MMP. The patient was treated with 0.1% triamcinolone acetonide ointment, oral minocycline, and oral nicotinamide, which improved the oral erosions. However, the mechanism underlying IgG autoantibody production against intracellular BP230 remains unclear. Further research and more such case studies are necessary to elucidate the mechanism of anti-BP230 antibody production and the clinical feature of anti-BP230 type MMP.
粘膜丘疹性类风湿(MMP)是一种自身免疫性上皮下/表皮下大疱性疾病,其特征是免疫球蛋白 G(IgG)、IgA 和/或 C3 在基底膜区(BMZ)线性沉积,主要粘膜病变涉及口腔和结膜。在此,我们描述了一例 58 岁的日本男性 MMP 患者。口腔内部检查发现,上牙龈和下牙龈出现脱屑性牙龈炎。未发现结膜或皮肤病变。组织病理学检查发现上皮下分裂,上皮和结缔组织有炎症细胞浸润。直接免疫荧光显示,C3在BMZ呈线状沉积。使用酶联免疫吸附试验检测到了针对 BP230 的 IgG 自身抗体。使用 1 mol/L NaCl 分层皮肤切片进行间接免疫荧光检测,未发现血清 IgG 或 IgA 反应。使用正常人表皮提取物作为底物进行免疫印迹,未检测到针对 230 kDa 抗原的 IgG 反应。根据上述结果,仅用抗 BP230 抗体就可明确诊断为 MMP。我们的病例被归类为低风险 MMP。患者接受了 0.1% 曲安奈德醋酸氨溴索软膏、口服米诺环素和口服烟酰胺的治疗,口腔糜烂有所改善。然而,针对细胞内 BP230 的 IgG 自身抗体产生的机制仍不清楚。要阐明抗 BP230 抗体产生的机制和抗 BP230 型 MMP 的临床特征,还需要进一步研究和更多此类病例研究。
{"title":"Anti-BP230 type mucous membrane pemphigoid with desquamative gingivitis: A case report","authors":"Seiichiro Oda ,&nbsp;Hirofumi Okada ,&nbsp;Atsushi Kihara ,&nbsp;Norito Ishii ,&nbsp;Hiroshi Koga ,&nbsp;Yoshiyuki Mori ,&nbsp;Tadahide Noguchi","doi":"10.1016/j.ajoms.2024.04.013","DOIUrl":"10.1016/j.ajoms.2024.04.013","url":null,"abstract":"<div><div>Mucous membrane pemphigoid (MMP) is an autoimmune subepithelial/subepidermal blistering disease characterized by linear deposition of immunoglobulin G (IgG), IgA, and/or C3 in the basement membrane zone (BMZ) and predominant mucosal lesions involving the oral cavity and conjunctivae. Here, we describe a case of a 58-year-old Japanese man with MMP. Intraoral examination revealed desquamative gingivitis in the upper and lower gingivae. No conjunctival or cutaneous lesions were observed. Histopathological examination revealed a subepithelial split with inflammatory cell infiltration of the epithelial and connective tissues. Direct immunofluorescence revealed a linear deposition of C3 in the BMZ. IgG autoantibodies against BP230 were detected using an enzyme-linked immunosorbent assay. Indirect immunofluorescence using 1 mol/L NaCl-split skin sections revealed no reactivity for serum IgG or IgA. Immunoblotting using normal human epidermal extract as a substrate did not detect IgG reactivity against the 230-kDa antigen. Based on the above results, the definitive diagnosis of MMP with anti-BP230 antibody alone was established. Our case was categorized as low-risk MMP. The patient was treated with 0.1% triamcinolone acetonide ointment, oral minocycline, and oral nicotinamide, which improved the oral erosions. However, the mechanism underlying IgG autoantibody production against intracellular BP230 remains unclear. Further research and more such case studies are necessary to elucidate the mechanism of anti-BP230 antibody production and the clinical feature of anti-BP230 type MMP.</div></div>","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":"37 1","pages":"Pages 210-214"},"PeriodicalIF":0.4,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142660547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of the changes in trabecular bone density of angle and condyle regions of the mandible before and after COVID-19 contraction using fractal analysis 利用分形分析评估 COVID-19 收缩前后下颌角和髁状突区域骨小梁密度的变化
IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-04-24 DOI: 10.1016/j.ajoms.2024.04.011
Farzad Esmaeili , Narges Bayat , Amir Ebrahimpour Tolouei , Mohammad Azimzadeh , Mehrdad Nateghi , Kasra Rahimipour
This study aimed to investigate the impact of COVID-19 on the trabecular bone thickness in the mandible using fractal analysis. The researchers selected 82 healthy patients who had previously been infected with COVID-19 and had dental panoramic radiographs (DPRs) prior to contracting the virus. DPRs were obtained again after infection, and the trabecular thickness was analyzed before and after COVID-19 using statistical tests. The results revealed that the average trabecular thickness of the mandible at the angle and condyle regions decreased significantly after contracting COVID-19. The mean thickness before infection was 1.479 ± 0.128 at the angle point and 1.469 ± 0.124 at the condylar region, while after infection, it decreased to 1.200 ± 0.123 and 1.159 ± 0.114, respectively. The reduction in trabecular thickness was found to be statistically significant. This study underscores the importance of monitoring bone density in COVID-19 patients. The findings suggest that COVID-19 can have extrapulmonary effects on skeletal health, specifically the mandibular bone. The results highlight the need for preventive interventions to mitigate pathological bone loss in individuals affected by COVID-19. Overall, this research emphasizes the significance of considering skeletal manifestations and implementing appropriate measures for COVID-19 patients to safeguard their bone health.
这项研究旨在利用分形分析法研究 COVID-19 对下颌骨骨小梁厚度的影响。研究人员选取了 82 名健康患者,这些患者曾感染过 COVID-19,并在感染病毒前拍摄了牙科全景X光片(DPR)。感染后再次拍摄了牙科全景X光片,并使用统计检验分析了COVID-19感染前后的小梁厚度。结果显示,感染 COVID-19 病毒后,下颌角和髁状突区域的平均骨小梁厚度明显下降。感染前,角点的平均厚度为 1.479 ± 0.128,髁状突区域的平均厚度为 1.469 ± 0.124,而感染后则分别降至 1.200 ± 0.123 和 1.159 ± 0.114。小梁厚度的减少具有统计学意义。这项研究强调了监测 COVID-19 患者骨密度的重要性。研究结果表明,COVID-19 会对骨骼健康(尤其是下颌骨)产生肺外影响。研究结果强调,有必要采取预防性干预措施,以减轻 COVID-19 患者的病理性骨质流失。总之,这项研究强调了考虑骨骼表现并采取适当措施保护 COVID-19 患者骨骼健康的重要性。
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引用次数: 0
Maroteaux-lamy syndrome (mucopolysaccharidosis VI) with abnormal coronoid and condylar processes of the mandible: Report of a case with surgical intervention 马罗托-拉米综合征(粘多糖病 VI)伴下颌骨冠状突和髁状突异常:一例手术干预病例的报告
IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-04-23 DOI: 10.1016/j.ajoms.2024.04.012

Maroteaux-Lamy syndrome (mucopolysaccharidoses VI) is a rare genetic disease results in functional deficiency of arylsulfatase B and accumulation of dermatan sulfate within lysosomes in various tissues. Here we present an 8-year-old male who was referred for treatment of limited mouth opening. The patient had been diagnosed with mucopolysaccharidoses VI at age of 6 months. He had received bone marrow transplantation at age of 3.5 years, developed graft-versus-host disease and subsequent vitiligo-like changes. The patient presented with short stature, and some skeletal anomalies. In radiographic images bilateral hyperplasia of the coronoid process, underdeveloped condyles, and dentigerous cyst-like follicles in the jaws were noted. Bilateral coronoidectomy was performed to improve the maximum opening of the mouth. Post-op follow-up examinations in 5 years showed moderate improvement. Abnormal coronoid and condylar processes are unusual in MPS VI. Proper management is needed to improve patients’ oral and general health for the remainder of their lives.

Maroteaux-Lamy 综合征(粘多糖病 VI)是一种罕见的遗传性疾病,会导致芳基硫酸酯酶 B 功能性缺乏,并在各种组织的溶酶体中积累硫酸皮质酯。我们在此介绍一名因张口受限而转诊治疗的 8 岁男性患者。患者在 6 个月大时被诊断出患有粘多糖病 VI。他在 3.5 岁时接受了骨髓移植,后来患上了移植物抗宿主病,并出现了白癜风样改变。患者表现为身材矮小和一些骨骼异常。放射影像显示,患者双侧冠状突增生,髁状突发育不全,下颌有齿状囊肿样滤泡。为了改善口腔的最大张开度,医生对他进行了双侧冠状突切除术。术后5年的随访检查显示病情有适度改善。冠状突和髁突异常在 MPS VI 中并不常见。需要进行适当的治疗,以改善患者余生的口腔和全身健康状况。
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引用次数: 0
Artificial intelligence in dentistry — A scoping review 人工智能在牙科中的应用--范围审查
IF 0.4 Q3 Dentistry Pub Date : 2024-04-21 DOI: 10.1016/j.ajoms.2024.04.009
Ruchi Vashisht , Aaina Sharma , Tanvi Kiran , Satnam Singh Jolly , Prabhleen Kaur Brar , Jay Veer Puri

Introduction

In dentistry, AI technologies are revolutionizing diagnosis, treatment planning, and patient care. From image analysis for detecting cavities and fractures to personalized treatment recommendations based on patient data, AI is enhancing efficiency and accuracy in dental practices, leading to improved outcomes and patient satisfaction.

Objectives

This scoping review was done to assess the use of artificial intelligence in various fields of dentistry.

Methods

The electronic databases were searched for scientific research articles in electronic search engines like PubMed, Scopus, Web of science etc. and 87 articles fulfilled the eligibility criteria. Various artificial intelligence, machine learning and deep learning tools and techniques used in various fields of dentistry were studied and their accuracy and precision were noted.

Results

We have various artificial intelligence models being used in various fields of dentistry with high accuracy, sensitivity and specificity.

Conclusion

This data would be helpful for dental practitioners in reducing their workload and improve precision and accuracy in various treatments.

导言在牙科领域,人工智能技术正在彻底改变诊断、治疗计划和患者护理。从检测龋齿和骨折的图像分析到基于患者数据的个性化治疗建议,人工智能正在提高牙科临床实践的效率和准确性,从而改善治疗效果,提高患者满意度。方法在电子数据库中搜索PubMed、Scopus、Web of science等电子搜索引擎中的科学研究文章,共有87篇文章符合资格标准。研究了牙科各领域使用的各种人工智能、机器学习和深度学习工具和技术,并记录了它们的准确性和精确性。结果我们发现牙科各领域使用的各种人工智能模型具有很高的准确性、灵敏度和特异性。
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引用次数: 0
Non-calcifying/Langerhans cell-rich variant of calcifying epithelial odontogenic tumor: A case report and review 非钙化/富含朗格汉斯细胞的钙化上皮性牙本质肿瘤变体:病例报告和综述
IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-04-17 DOI: 10.1016/j.ajoms.2024.04.010
Reo Fukushima , Dai Nakashima , Shusaku Yoshimura , Yutaro Kase , Ryunosuke Nozaki , Tomoaki Saito , Atsushi Kasamatsu , Katsuhiro Uzawa
A calcifying epithelial odontogenic tumor (CEOT) is a rare benign epithelial odontogenic tumor. Histologically, CEOTs are commonly composed of polygonal epithelial cells, eosinophilic amyloid deposits, and calcifications. The non-calcifying/Langerhans cell-rich variant, one of the three variants of CEOTs according to the 2022 World Health Organization classification of head and neck tumors, is rare with few cases reported to date. We present an additional case of a non-calcifying/Langerhans cell-rich CEOT. A 76-year-old woman was referred to our department for painless swelling of the mandibular incisor. Computed tomography showed a 33 × 10 × 18 mm well-defined bone resorption lesion without distention, radiopaque spots, or unerupted teeth in the mandible. Tissue biopsy showed that the tumor was composed of atypical cells with oval nuclei and eosinophilic cytoplasm and many amorphous eosinophilic amyloid-like deposits, which led to the diagnosis of CEOT. Marginal mandibulectomy was performed under general anesthesia from the right mandibular first premolar to the left mandibular canine. The tumor was composed of small nests and strands of odontogenic epithelial cells and many amorphous eosinophilic amyloid-like deposits; however, there was no area of calcification in any tissue section. Immunohistochemical examination showed that the tumor epithelial cells were positive for S-100 protein. Based on these histopathological and immunohistochemical findings, the tumor was diagnosed as a non-calcifying/Langerhans cell-rich CEOT. No local recurrence was detected over the 4 years of follow up.
钙化上皮性牙本质肿瘤(CEOT)是一种罕见的良性上皮性牙本质肿瘤。组织学上,CEOT 通常由多角形上皮细胞、嗜酸性淀粉样沉积和钙化组成。非钙化/朗格汉斯细胞丰富变异型是 2022 年世界卫生组织头颈部肿瘤分类中 CEOT 的三种变异型之一,但迄今为止鲜有报道。我们又发现了一例非钙化/朗格汉斯细胞丰富型CEOT。一名 76 岁的妇女因下颌切牙无痛性肿胀而被转诊至我科。计算机断层扫描显示,下颌骨内有一个 33 × 10 × 18 毫米的骨吸收病灶,界限清楚,没有膨胀、不透射线的斑点或未萌出的牙齿。组织活检显示,肿瘤由非典型性细胞组成,细胞核呈椭圆形,细胞质嗜酸性,并有许多无定形的嗜酸性淀粉样沉积物,因此诊断为 CEOT。在全身麻醉的情况下,对右侧下颌第一前磨牙至左侧下颌犬齿进行了下颌骨边缘切除术。肿瘤由细小的牙源性上皮细胞巢和股以及许多无定形的嗜酸性淀粉样沉积物组成,但任何组织切片中都没有钙化区域。免疫组化检查显示,肿瘤上皮细胞的 S-100 蛋白呈阳性。根据这些组织病理学和免疫组化检查结果,该肿瘤被诊断为非钙化/朗格汉斯细胞丰富的 CEOT。4 年的随访未发现局部复发。
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引用次数: 0
A case of treatment-related myelodysplastic syndrome in the early stage after radiotherapy in a patient with cancer of the oral floor 一例口腔底癌患者放疗后早期出现的与治疗相关的骨髓增生异常综合征
IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-04-13 DOI: 10.1016/j.ajoms.2024.04.004

Therapy-related myelodysplastic syndrome (t-MDS) is a rare but potentially fatal adverse event caused by chemotherapy or radiotherapy. We report a case of t-MDS diagnosed 8 months after radiotherapy for recurrent carcinoma of the floor of the mouth and cervical lymph node metastases after surgical treatment. A 74-year-old man visited our department with the chief complaint of pain in the lower part of the tongue. Tumor resection and right radical neck dissection (RND) were performed based on the diagnosis of carcinoma of the floor of the mouth (cT1N2bM0). A computed tomography scan at 10 months postoperatively showed metastatic lymph nodes in the left neck, right hyoid bone, right parotid subpolar, and anterior trachea. Therefore, the patient underwent left RND and excision of the right hyoid bone, subpolar right parotid and anterior tracheal metastatic lymph nodes. Postoperative radiation therapy (70 Gy) was administered to the neck bilaterally. An upper gastrointestinal examination revealed a carcinoma in situ in the lower esophagus, and endoscopic submucosal dissection of the esophagus was performed. He had pancytopenia preoperatively, which progressed postoperatively; therefore, a bone marrow examination was performed to rule out a hematological malignancy. Bone marrow smear and flow cytometric analyses indicated the development of t-MDS. He received supportive transfusion therapy but died 8 months after the diagnosis of t-MDS. During post-treatment follow-up, clinicians should be aware of t-MSD, in addition to cancer recurrence and metastasis.

治疗相关骨髓增生异常综合征(t-MDS)是化疗或放疗引起的一种罕见但可能致命的不良反应。我们报告了一例因口腔底癌复发和手术治疗后颈淋巴结转移而接受放疗8个月后确诊的t-MDS病例。一名 74 岁的男性来我科就诊,主诉为舌头下部疼痛。根据口底癌(cT1N2bM0)的诊断,医生为其进行了肿瘤切除和右侧颈部根治性切除术(RND)。术后 10 个月的计算机断层扫描显示,左颈部、右舌骨、右腮腺下极和气管前部出现转移淋巴结。因此,患者接受了左侧 RND 和右舌骨、右腮腺下极和气管前转移淋巴结切除术。术后对双侧颈部进行了放疗(70 Gy)。上消化道检查发现食道下段有原位癌,于是进行了内镜下食道黏膜下剥离术。他术前有全血细胞减少,术后病情恶化,因此进行了骨髓检查以排除血液恶性肿瘤。骨髓涂片和流式细胞分析表明他患上了 t-MDS。他接受了输血支持治疗,但在确诊为 t-MDS 8 个月后死亡。在治疗后的随访中,除了癌症复发和转移外,临床医生还应注意 t-MDS。
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Journal of Oral and Maxillofacial Surgery Medicine and Pathology
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