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Primary intraosseous carcinoma arising from an odontogenic cyst: A case report.

Adachi M, Inagaki T, Ehara Y, Azuma M, Kurenuma A, Motohashi M, Muramatsu Y - Oncol Lett (2014)

Bottom Line: Radical dissection was subsequently performed, however, histopathological examination of the resected specimen revealed neither invasion into the surrounding tissues penetrating the periosteum nor lymph node metastasis at the right submandibular lesion.Following the pathological diagnosis of primary intraosseous carcinoma (PIOC), the patient received 6,000 Gy radiation as post-operative radiotherapy and chemotherapy with oral administration of tegafur, gimeracil and oteracil potassium.The patient is currently undergoing follow-up examinations.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Asahi University Murakami Memorial Hospital, Gifu 500-8523, Japan.

ABSTRACT
Cyst-like lesions in the mandible rarely develop into malignancies, and the reported incidence is between 0.3 and 2%. The present study describes a rare case of primary intraosseous squamous cell carcinoma of the mandible arising from an odontogenic cyst. A 59-year-old female was referred to Asahi University Murakami Memorial Hospital (Gifu, Japan), with acute pain in the right molars. An initial examination revealed buccal swelling and paresthesia of the mental nerve. Following an intraoral examination, the oral mucosa was confirmed to be normal, however, percussion pain was experienced between the lower right first premolar and second molar. Panoramic radiography revealed a retained lower right wisdom tooth and an irregular radiolucent area between the lower right molar and a mandibular angle with unclear margins. Computed tomography revealed diffuse bone resorption and an extensive loss of cortical bone on the buccal and lingual sides. A biopsy was performed and the pathological diagnosis was of a squamous cell carcinoma arising from the epithelial lining of the odontogenic cyst. Radical dissection was subsequently performed, however, histopathological examination of the resected specimen revealed neither invasion into the surrounding tissues penetrating the periosteum nor lymph node metastasis at the right submandibular lesion. Following the pathological diagnosis of primary intraosseous carcinoma (PIOC), the patient received 6,000 Gy radiation as post-operative radiotherapy and chemotherapy with oral administration of tegafur, gimeracil and oteracil potassium. The patient is currently undergoing follow-up examinations. Although PIOC arising from an odontogenic cyst is rare, it should be considered as a differential diagnosis for radiolucency of the jaw bone, particularly in older patients exhibiting a history of cystic lesions.

No MeSH data available.


Related in: MedlinePlus

Photomicrographs of the lesion obtained from the surgical specimen revealing moderately-differentiated squamous cell carcinoma (framed area), with intact squamous epithelium presented by the arrow, which was observed to be overlying the tumor. Hematoxylin and eosin stain; magnification, (A) ×40 and (B) ×200 (framed area).
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f2-ol-08-03-1265: Photomicrographs of the lesion obtained from the surgical specimen revealing moderately-differentiated squamous cell carcinoma (framed area), with intact squamous epithelium presented by the arrow, which was observed to be overlying the tumor. Hematoxylin and eosin stain; magnification, (A) ×40 and (B) ×200 (framed area).

Mentions: Intraoperative observations revealed that the tumor had extended through the buccal and lingual cortex and invaded the masseter and internal pterygoid muscles. In addition, pathological examination of the surgical specimen revealed squamous cell carcinoma with an intact squamous epithelium, which was observed to be overlying the tumor (Fig. 2). Lymph node metastasis was not observed in the neck lymph nodes. A positive margin was present in the specimen at the end of the inferior alveolar nerve, therefore the patient received post-operative radiotherapy, and chemotherapy. External beam irradiation was performed five times per week at 2 Gy per fraction to a total of 60 Gy, while the doses of the oral administration of tegafur, gimeracil and oteracil potassium were 60 mg/m2/day for two weeks followed by a two week rest for a total of six months. The one-year post-operative follow-up revealed no local recurrence or distant metastasis.


Primary intraosseous carcinoma arising from an odontogenic cyst: A case report.

Adachi M, Inagaki T, Ehara Y, Azuma M, Kurenuma A, Motohashi M, Muramatsu Y - Oncol Lett (2014)

Photomicrographs of the lesion obtained from the surgical specimen revealing moderately-differentiated squamous cell carcinoma (framed area), with intact squamous epithelium presented by the arrow, which was observed to be overlying the tumor. Hematoxylin and eosin stain; magnification, (A) ×40 and (B) ×200 (framed area).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4114598&req=5

f2-ol-08-03-1265: Photomicrographs of the lesion obtained from the surgical specimen revealing moderately-differentiated squamous cell carcinoma (framed area), with intact squamous epithelium presented by the arrow, which was observed to be overlying the tumor. Hematoxylin and eosin stain; magnification, (A) ×40 and (B) ×200 (framed area).
Mentions: Intraoperative observations revealed that the tumor had extended through the buccal and lingual cortex and invaded the masseter and internal pterygoid muscles. In addition, pathological examination of the surgical specimen revealed squamous cell carcinoma with an intact squamous epithelium, which was observed to be overlying the tumor (Fig. 2). Lymph node metastasis was not observed in the neck lymph nodes. A positive margin was present in the specimen at the end of the inferior alveolar nerve, therefore the patient received post-operative radiotherapy, and chemotherapy. External beam irradiation was performed five times per week at 2 Gy per fraction to a total of 60 Gy, while the doses of the oral administration of tegafur, gimeracil and oteracil potassium were 60 mg/m2/day for two weeks followed by a two week rest for a total of six months. The one-year post-operative follow-up revealed no local recurrence or distant metastasis.

Bottom Line: Radical dissection was subsequently performed, however, histopathological examination of the resected specimen revealed neither invasion into the surrounding tissues penetrating the periosteum nor lymph node metastasis at the right submandibular lesion.Following the pathological diagnosis of primary intraosseous carcinoma (PIOC), the patient received 6,000 Gy radiation as post-operative radiotherapy and chemotherapy with oral administration of tegafur, gimeracil and oteracil potassium.The patient is currently undergoing follow-up examinations.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Asahi University Murakami Memorial Hospital, Gifu 500-8523, Japan.

ABSTRACT
Cyst-like lesions in the mandible rarely develop into malignancies, and the reported incidence is between 0.3 and 2%. The present study describes a rare case of primary intraosseous squamous cell carcinoma of the mandible arising from an odontogenic cyst. A 59-year-old female was referred to Asahi University Murakami Memorial Hospital (Gifu, Japan), with acute pain in the right molars. An initial examination revealed buccal swelling and paresthesia of the mental nerve. Following an intraoral examination, the oral mucosa was confirmed to be normal, however, percussion pain was experienced between the lower right first premolar and second molar. Panoramic radiography revealed a retained lower right wisdom tooth and an irregular radiolucent area between the lower right molar and a mandibular angle with unclear margins. Computed tomography revealed diffuse bone resorption and an extensive loss of cortical bone on the buccal and lingual sides. A biopsy was performed and the pathological diagnosis was of a squamous cell carcinoma arising from the epithelial lining of the odontogenic cyst. Radical dissection was subsequently performed, however, histopathological examination of the resected specimen revealed neither invasion into the surrounding tissues penetrating the periosteum nor lymph node metastasis at the right submandibular lesion. Following the pathological diagnosis of primary intraosseous carcinoma (PIOC), the patient received 6,000 Gy radiation as post-operative radiotherapy and chemotherapy with oral administration of tegafur, gimeracil and oteracil potassium. The patient is currently undergoing follow-up examinations. Although PIOC arising from an odontogenic cyst is rare, it should be considered as a differential diagnosis for radiolucency of the jaw bone, particularly in older patients exhibiting a history of cystic lesions.

No MeSH data available.


Related in: MedlinePlus