- Email: [email protected]
P.279 Case report of ghost cell odontogenic carcinoma with review of literature
Posters P.276 Native X-ray examination and ultrasonography of major salivary glands in sialolithiasis J. Szalma1 , Z. Ny´ar´ady1 , M. T´oth2 , L. Olasz1 . 1 Dental Clinic of PTE AOK Medical University, Department of Oral and Maxillofacial Surgery, Hungary; 2 PTE AOK Medical University, Department of Radiology, Hungary Introduction and Objectives: The aim of our study was to evaluate diagnostic role of the native X-ray and ultrasonography in sialolithiasis. Materials and Methods: During a timescale of 30 months, between September 2003 and February 2006, 39 patients were selected for this study. Panoramic and/or occlusal plain radiographs and ultrasonography were taken, following a diagnostic protocol constructed. Further investigations, such as CT, MR were performed to discover when differential diagnostic problem occurs. Invasive investigations such as sialography and sialoendoscopy were not used. Results: The sensitivity of sonography was 75% in the parotis, 56.25% in the submandibular gland and 100% in the sublingual gland. The sensitivity of panoramic X-ray was between 0% and 37.50%. Intraoral occlusal radiograph had a sensitivity of 63– 100%. In 34.38% of the cases sialoliths were found in the proximal third of the duct or inside the gland. The cumulative sensitivity of the examined diagnostic methods was 87.2%. Conclusions: Despite of the high specificity of CT and MRI, ultrasonography and native X-ray keep their priorities as diagnostic methods, due to their cost-effectiveness and wide-availability. CT, MRI, sialography and sialoscopy has their role in hard to diagnose cases. P.277 Thrombosis of cervical vascular malformation in neurofibromatosis type 1 R. Gonz´alez-Garc´ıa, J. Sastre-P´erez, V. Escorial-Hern´andez, P.L. Martos, M. Mancha de la Plata, F.J. Rodr´ıguez-Campo, L. Naval-G´ıas. Department of Oral and Maxillofacial Surgery, University Hospital La Princesa, Madrid, Spain Introduction and Objectives: Extracranial vascular malformations have been rarely reported in relation to the vertebral artery system in neurofibromatosis type 1 (NF1). However, no cases of thrombosis of vascular malformation located in the anterior or anterolateral neck have been previously reported. Material and Methods: We present a case of NF1 which presented a fast-growing large mass in the right side of the face and neck without associated infection. CT and MRI showed a 7.3×5.3 cm-mass located anterior to the sternocleidomastoid muscle. A well-defined tubular-curved structure was also observed. Results: The diagnosis was thrombosis of vascular malformation associated with large plexiform neurofibroma in relation to the jugular vein system. A conservative approach was adopted, with resolution of the thrombotic cervical mass after two months. Since surgical excision of neurofibromas in the head and neck region is desirable in the management of NF1, a close pre-surgical study by means of angiography or angio-MRI is mandatory in order to detect the presence of associated vascular malformations. It will decrease the risk of bleeding during the surgical intervention. Due to its location, compromise of the upper-airway must be considered. Conclusion: Although little experience is available in relation to the management of thrombosis in this kind of vascular malformation, we propose a conservative approach. Spontaneous resolution after a few weeks will allow elective resection of
Oral medicine/Pathology 203 residual neurofibromatous tissue if indicated. In relation to it, pre-operative embolization has been suggested to avoid surgical haemorrhage, although the presence of dilated and tortuous vessels may advocate to failure. P.278 Bilateral sialolithiasis: Case presentations and review of the literature A. Bucur, O. Dinca, T. Nita, D. Slavescu. Department of Oral and Maxillofacial Surgery, UMF “Carol Davila”, Bucharest, Romania Introduction: Sialolithiasis is a medical condition with an increasing incidence over the last few years. The most affected glands are the submaxillary (83%), occuring more seldom in the parotids (16%). No matter the localization, this condition is generally unilateral. Case presentations: The aim of this study is to present two unusual cases of bilateral sialolithiasis. In both cases, the calculi affect the submaxillary glands. The particularity of the cases is that they were not associated with any identifiable causes. Conclusions: There are very few such cases described in the literature, most of them associated with a local or general ethiologic condition. The ethiology of the medical conditions in the presented cases is subject to debate. P.279 Case report of ghost cell odontogenic carcinoma with review of literature M.E. Schenberg1 , S.P. Nazaretian2,3 , I. Simpson2 , P. Slootweg4 . 1 Oral and maxillofacial surgeon, Dandenong Hospital, Southern Health, Melbourne, Australia; 2 Department of Anatomical Pathology, Southern Cross Pathology, Monash Medical Centre, Clayton, Vic., Australia; 3 Department of Anatomy and Cell Biology, Faculty of Medicine, Monash University, Clayton, Vic., Australia; 4 Pathology, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands Ghost cell odontogenic carcinoma (GCOC) is the especially rare malignant counterpart of calcifying odontogenic cyst and benign odontogenic ghost cell tumour. We present a case of a middleaged male who presented with a maxillary tumour and underwent maxillectomy. The tumour was slow growing over many years and remained asymptomatic until pain symptoms developed prior to initial presentation. The excised tumour was diagnosed as a GCOC. The diagnosis lies in the identification of malignant cytological features such as small baseloid and large epithelial cells admixed with elements of a calcifying odontogenic cyst or benign odontogenic neoplasm. We recommend further case reports to further our understanding of the epidemiology, clinical features, natural history and management and to confirm histopathological features of this rare malignant odontogenic tumuor. P.280 Native X-ray examination and ultrasonography of major salivary glands in sialolithiasis J. Szalma1 , Z. Nyarady1 , M. Toth2 , L. Olasz1 . 1 Department of Oral and Maxillofacial Surgery, PTE AOK Dental Clinic, P´ecs, Hungary; 2 Department of Radiology PTE AOK Medical Center, P´ecs, Hungary Introduction and Objectives: The aim of our study was to evaluate diagnostic role of the native X-ray and ultrasonography in sialolithiasis. Materials and Methods: During a timescale of 30 months, 39 patients were selected in a study group with lithiasis of the major salivary glands. Panoramic and/or occlusal plain radiographs
Oral medicine/Pathology 203 residual neurofibromatous tissue if indicated. In relation to it, pre-operative embolization has been suggested to avoid surgical haemorrhage, although the presence of dilated and tortuous vessels may advocate to failure. P.278 Bilateral sialolithiasis: Case presentations and review of the literature A. Bucur, O. Dinca, T. Nita, D. Slavescu. Department of Oral and Maxillofacial Surgery, UMF “Carol Davila”, Bucharest, Romania Introduction: Sialolithiasis is a medical condition with an increasing incidence over the last few years. The most affected glands are the submaxillary (83%), occuring more seldom in the parotids (16%). No matter the localization, this condition is generally unilateral. Case presentations: The aim of this study is to present two unusual cases of bilateral sialolithiasis. In both cases, the calculi affect the submaxillary glands. The particularity of the cases is that they were not associated with any identifiable causes. Conclusions: There are very few such cases described in the literature, most of them associated with a local or general ethiologic condition. The ethiology of the medical conditions in the presented cases is subject to debate. P.279 Case report of ghost cell odontogenic carcinoma with review of literature M.E. Schenberg1 , S.P. Nazaretian2,3 , I. Simpson2 , P. Slootweg4 . 1 Oral and maxillofacial surgeon, Dandenong Hospital, Southern Health, Melbourne, Australia; 2 Department of Anatomical Pathology, Southern Cross Pathology, Monash Medical Centre, Clayton, Vic., Australia; 3 Department of Anatomy and Cell Biology, Faculty of Medicine, Monash University, Clayton, Vic., Australia; 4 Pathology, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands Ghost cell odontogenic carcinoma (GCOC) is the especially rare malignant counterpart of calcifying odontogenic cyst and benign odontogenic ghost cell tumour. We present a case of a middleaged male who presented with a maxillary tumour and underwent maxillectomy. The tumour was slow growing over many years and remained asymptomatic until pain symptoms developed prior to initial presentation. The excised tumour was diagnosed as a GCOC. The diagnosis lies in the identification of malignant cytological features such as small baseloid and large epithelial cells admixed with elements of a calcifying odontogenic cyst or benign odontogenic neoplasm. We recommend further case reports to further our understanding of the epidemiology, clinical features, natural history and management and to confirm histopathological features of this rare malignant odontogenic tumuor. P.280 Native X-ray examination and ultrasonography of major salivary glands in sialolithiasis J. Szalma1 , Z. Nyarady1 , M. Toth2 , L. Olasz1 . 1 Department of Oral and Maxillofacial Surgery, PTE AOK Dental Clinic, P´ecs, Hungary; 2 Department of Radiology PTE AOK Medical Center, P´ecs, Hungary Introduction and Objectives: The aim of our study was to evaluate diagnostic role of the native X-ray and ultrasonography in sialolithiasis. Materials and Methods: During a timescale of 30 months, 39 patients were selected in a study group with lithiasis of the major salivary glands. Panoramic and/or occlusal plain radiographs