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Squamous odontogenic tumor: a case report
ICOMS 2011—Abstracts: Oral Papers Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.151
151 Bisphosphonate-related osteonecrosis of the jaws—an initial case series report of treatment combining marginal bone resection and autologous platelet-rich plasma M. Curi ∗ , C.L. Cardoso, D.H. Koga, C. Zardetto Oncology, Hospital Santa Catarina, São Paulo, Brazil
Purpose: Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is a well recognized pathologic entity which is challenging and difficult to manage. Recent literature contains several articles with most recommending a conservative management. In this study, we report a treatment modality for advanced cases of BRONJ which involves marginal bone resection and autologous platelet-rich plasma (PRP). Patients and methods: This case series comprised 25 patients with BRONJ lesions and a history of intravenous bisphosphonate therapy for metastatic bone diseases which did not respond to conservative treatment. All patients were surgically managed by a standardized protocol combining marginal bone resection and PRP topically. Results: Of the 25 patients, 20 (80%) showed a complete wound healing during the follow-up. Median follow-up was 36 months. Microscopic examination revealed actinomyces in 15 specimens. Conclusion: BRONJ has been shown to be refractory to a conservative management. Treatment of refractory BRONJ with a combination of marginal bone resection and PRP has shown to be an effective therapy in most of patients and should be considered an alternative treatment modality for management of advanced cases. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.152
152 Squamous odontogenic tumor: a case report C.A. Voisin ∗ , D. Ifrim, Y. Van Hemelrijck, R. Glineur, M. Vilbi Oral and Maxillofacial Surgery, ULB University, Brussels, Belgium
Squamous odontogenic tumor is a rare, benign, locally infiltrative neoplasm of the jaws originally described in 1975 by Pullon et al. To date, less than 50 cases have been reported in the literature. We present a case of a fifteen years old boy reporting painful swelling of the left mandible evolving over the previous five months. Histological analysis first led to an initial diagnosis of squamous cell carcinoma but did not match with the very slow clinical evolution of the lesion. After new curettage and histological examinations, the diagnosis of a squamous odontogenic tumor was made. The histopathological features and our treatment strategy are discussed followed by a brief review of the literature. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.153
153 Oral cancers in patients with submucous fibrosis are clinico-pathologically different from those without submucous fibrosis P. Chaturvedi ∗ , S.S. Vaishampayan, S. Nair, D. Nair Head and Neck Oncosurgery, Tata Memorial Hospital, Mumbai, India
Introduction: Indian subcontinent has a unique problem of oral submucous fibrosis (OSMF), which is related to areca nut chewing usually along with smokeless tobacco. Our astute observation indicated that the oral squamous cell carcinomas (OSCC) arising in the background of OSMF are clinically different from those without OSMF. Methodology: Consecutive 371 diagnosed OSCC patients undergoing surgery, from June 2010 to April 2011 were included. The diagnosis of OSMF was based on the established clinical criteria. All underwent standard surgery as per their disease status. We analyzed their histopathology reports for certain known prognostic parameters. The data was analyzed by the SPSS software. Results: One hundred and twelve patients (30.2%) had OSCC arising in the background of OSMF (OC-SMF) and 220 oral cancer patients (69.8%) did not have
1071
OSMF (OC). The male female ratio for OC-SMF was 1:10 while for OC it was 1: 3 (p = 0.001). OC-SMF patients were in younger age (p = 0.003) and early stages (T1 and T2) (p = 0.001). Incidences of nodal metastasis and extra-capsular spread were significantly less (p = 0.0001) and (p = 0.0002) in OC-SMF group. The mean tumor thickness was significantly low (p = 0.0001) and tumors were less likely poorly differentiated (p = 0.001) with primary site as tongue in OC-SMF group (p = 0.003) (odd’s ratio 2.06). Discussion: Based on our results we propose that oral cancer patients with SMF are clinico-pathologically different from those without SMF. Since the study is of short duration, we cannot comment on the differential oncologic outcomes of these 2 groups of patients following treatment Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.154
154 The management of oral malignant melanoma: the Shanghai experience W. Guo ∗ , G. Ren, C. Li, C. Zhang Dept. of Oral and Maxillofacial Surgery, 9th People’s Hospital Shanghai Jiaotong University, Shanghai, China
Objective: To analyze and evaluate the effect of multidisciplinary sequential treatment in dealing with oral mucosal malignant melanoma. In order to establish the routine of treatment with this disease. Clinical data: From January 1994 to January 2008, the data of 106 patients undergoing treatments (cryosurgery, surgery, chemotherapy, and immunotherapy) for oral mucosal malignant melanoma were retrospected. The follow-up time was 2–14 years. Results: There were 57 males and 49 females. The most common site was the palate. The second location was the gingiva, followed by the floor of mouth and tongue. The peak age of the disease in both sexes was 40–60 years. The rate of regional nodal and distant metastasis was about 70% and 40% respectively. The middle survival length of the patients was 4.5 years and the 5-year cumulative survival rate was 31%. The reason of death was distant metastases. Conclusion: No single management strategy can be considered the standard of care. It is suggested that multidisciplinary sequential treatment should be the routine regimen of oral mucosal malignant melanoma.
151 Bisphosphonate-related osteonecrosis of the jaws—an initial case series report of treatment combining marginal bone resection and autologous platelet-rich plasma M. Curi ∗ , C.L. Cardoso, D.H. Koga, C. Zardetto Oncology, Hospital Santa Catarina, São Paulo, Brazil
Purpose: Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is a well recognized pathologic entity which is challenging and difficult to manage. Recent literature contains several articles with most recommending a conservative management. In this study, we report a treatment modality for advanced cases of BRONJ which involves marginal bone resection and autologous platelet-rich plasma (PRP). Patients and methods: This case series comprised 25 patients with BRONJ lesions and a history of intravenous bisphosphonate therapy for metastatic bone diseases which did not respond to conservative treatment. All patients were surgically managed by a standardized protocol combining marginal bone resection and PRP topically. Results: Of the 25 patients, 20 (80%) showed a complete wound healing during the follow-up. Median follow-up was 36 months. Microscopic examination revealed actinomyces in 15 specimens. Conclusion: BRONJ has been shown to be refractory to a conservative management. Treatment of refractory BRONJ with a combination of marginal bone resection and PRP has shown to be an effective therapy in most of patients and should be considered an alternative treatment modality for management of advanced cases. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.152
152 Squamous odontogenic tumor: a case report C.A. Voisin ∗ , D. Ifrim, Y. Van Hemelrijck, R. Glineur, M. Vilbi Oral and Maxillofacial Surgery, ULB University, Brussels, Belgium
Squamous odontogenic tumor is a rare, benign, locally infiltrative neoplasm of the jaws originally described in 1975 by Pullon et al. To date, less than 50 cases have been reported in the literature. We present a case of a fifteen years old boy reporting painful swelling of the left mandible evolving over the previous five months. Histological analysis first led to an initial diagnosis of squamous cell carcinoma but did not match with the very slow clinical evolution of the lesion. After new curettage and histological examinations, the diagnosis of a squamous odontogenic tumor was made. The histopathological features and our treatment strategy are discussed followed by a brief review of the literature. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.153
153 Oral cancers in patients with submucous fibrosis are clinico-pathologically different from those without submucous fibrosis P. Chaturvedi ∗ , S.S. Vaishampayan, S. Nair, D. Nair Head and Neck Oncosurgery, Tata Memorial Hospital, Mumbai, India
Introduction: Indian subcontinent has a unique problem of oral submucous fibrosis (OSMF), which is related to areca nut chewing usually along with smokeless tobacco. Our astute observation indicated that the oral squamous cell carcinomas (OSCC) arising in the background of OSMF are clinically different from those without OSMF. Methodology: Consecutive 371 diagnosed OSCC patients undergoing surgery, from June 2010 to April 2011 were included. The diagnosis of OSMF was based on the established clinical criteria. All underwent standard surgery as per their disease status. We analyzed their histopathology reports for certain known prognostic parameters. The data was analyzed by the SPSS software. Results: One hundred and twelve patients (30.2%) had OSCC arising in the background of OSMF (OC-SMF) and 220 oral cancer patients (69.8%) did not have
1071
OSMF (OC). The male female ratio for OC-SMF was 1:10 while for OC it was 1: 3 (p = 0.001). OC-SMF patients were in younger age (p = 0.003) and early stages (T1 and T2) (p = 0.001). Incidences of nodal metastasis and extra-capsular spread were significantly less (p = 0.0001) and (p = 0.0002) in OC-SMF group. The mean tumor thickness was significantly low (p = 0.0001) and tumors were less likely poorly differentiated (p = 0.001) with primary site as tongue in OC-SMF group (p = 0.003) (odd’s ratio 2.06). Discussion: Based on our results we propose that oral cancer patients with SMF are clinico-pathologically different from those without SMF. Since the study is of short duration, we cannot comment on the differential oncologic outcomes of these 2 groups of patients following treatment Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.154
154 The management of oral malignant melanoma: the Shanghai experience W. Guo ∗ , G. Ren, C. Li, C. Zhang Dept. of Oral and Maxillofacial Surgery, 9th People’s Hospital Shanghai Jiaotong University, Shanghai, China
Objective: To analyze and evaluate the effect of multidisciplinary sequential treatment in dealing with oral mucosal malignant melanoma. In order to establish the routine of treatment with this disease. Clinical data: From January 1994 to January 2008, the data of 106 patients undergoing treatments (cryosurgery, surgery, chemotherapy, and immunotherapy) for oral mucosal malignant melanoma were retrospected. The follow-up time was 2–14 years. Results: There were 57 males and 49 females. The most common site was the palate. The second location was the gingiva, followed by the floor of mouth and tongue. The peak age of the disease in both sexes was 40–60 years. The rate of regional nodal and distant metastasis was about 70% and 40% respectively. The middle survival length of the patients was 4.5 years and the 5-year cumulative survival rate was 31%. The reason of death was distant metastases. Conclusion: No single management strategy can be considered the standard of care. It is suggested that multidisciplinary sequential treatment should be the routine regimen of oral mucosal malignant melanoma.