- Email: [email protected]
Diagnosis and treatment of carcinoma arising from richly stromal pleomorphic adenoma of the parotid gland
Abstracts polarised expression of cytokeratin and involucrin. There was no evidence for BM, either by immunohistochemistry or by electron microscopy, although OSCC are immunohistochemically positive for collagen type IV and laminin in the 2D cell culture. There were no differences in proliferative activity of the gels with and without fibroblasts. Conclusions: Carcinoma cell invasion depends on the presence of Iibroblasts in the gel, indicating the important role of tumour stromal libro-/myotibroblasts during carcinomic invasion. The absence of a BM does not, per se, imply an invasive tumour growth. Moreover, stratification and terminal differentiation of epithelial tumour cells occur independently of a structural BM. Correspondence: Prof. Dr Dr P. Hyckel, Klinik und Gesichtschirurgie/Plastische Operationen, Universitat Jena, D-07740 Jena, Germany.
fur Mund-, KieferFriedrich-schiller-
Possible correlation between odontogenic soft-tissue infection and the thermal effects of the weather. Statistical analysis in 2111 patients. C 0. Keller, H. Feifel, K. Bucher, 7: Reineke, D. Riediger. (Mund Kiefer GesichtsChir 1998; 2: 261-265). A possible correlation between the thermal effects of the weather and the frequency of odontogenic soft-tissue infections was investigated with special regard to the so-called felt temperature (gT). Clinical data of 2111 patients between 1992 and 1996, in whom an incision was made because of an odontogenic soft-tissue infection, were evaluated retrospectively and correlated to meteorological data for Aachen, collected or calculated by the ‘Deutsche Wetterdienst’. In order to describe the thermal exchange between the human organism and the surroundings in a satisfactory way, the gT was chosen. The gT is a complexly calculated meteorological parameter that allows physiologically adequate estimation of the thermic surroundings of humans. Over the whole study time, there was no impressive correlation between course and changing of the gT and the frequency of odontogenic soft-tissue infections. This result agrees with our finding that there was no seasonal accumulation of odontogenic soft-tissue infections over the year in Aachen. Nevertheless, there was a statistically significant negative correlation between values or weighted changes of the gT and the frequency of abscess and/or infiltration in the winter and less in springtime. A similar statistically significant correlation could not be found for summer or autumn. Correspondence: Prof. Dr Dr H. Feifel, Kieferund Plastische Gesichtschirurgie, RWTH Aachen, PauwelsstraBe, D-S2074
Klinik
fur Zahn-, Mund-, Universitatsklinikum, Aachen, Germany.
Diagnosis and treatment of carcinoma arising from richly stromal pleomorphic adenoma of the parotid gland. S. Stojoadinovic, S. Reinert. S. Philippou. (Mund Kiefer GesichtsChir 1998; 2: 266-269). The case is reported of a 27-year-old patient who developed multiple recurrences of a carcinoma arising from richly stromal pleomorphic adenoma of the parotid gland over 13 years. Originally, the tumor was classified as a benign pleomorphic adenoma because there were no cytological characteristics of malignancy. Later on, the diagnosis had to be modified to that of a carcinoma arising from a pleomorphic adenoma because of the infiltrating growth pattern of the tumour. A multicentric local recurrence and metastases on the left side of the neck supported the correct diagnosis. This case demonstrates that, beside the classic cytological criteria of malignancy, invasion and penetration of the capsule can be decisive for the diagnosis of malignant transformed pleomorphic adenoma. Treatment and prognosis of salivary gland tumors assume a clear determination of their dignity. The unusual course in this case of a pleomorphic adenoma originally diagnosed as benign demonstrates the importance of regular follow-up.
from
Mund-,
Kiefer-
und Gesichtschirurpie
417
Correspondence: Dr Dr S. Stojadinovic, Klinik fur Mund-, Kieferund Gesichtschirurgie, Plastische Operationen, Ruhr-Universitlt Bochum, In der Schomau 23-25, D-44892 Bochum, Germany.
Clear cell odontogenic carcinoma and squamous cell carcinoma: case report and literature review. M. Vesper, 7: Wilck, K. Donath, R. Schmelzle. (Mund Kiefer GesichtsChir 1998; 2: 270-274). One case of a newly described, rare odontogenic tumor is reported. A literature review of 19 cases lends support to the odontogenic origin and metastatic capability, both regionally and distantly, of the clear cell odontogenic tumor. We conclude that this tumor is malignant, with a tendency to recur locally after surgery. It requires an aggressive surgical approach and should be referred to as a clear cell odontogenic carcinoma. In our patient, we saw a clear cell odontogenie carcinoma and a squamous cell carcinoma, both with regional lymph node metastasis. The histological differentiation of this type of tumor from other clear cell tumors is difftcult. Correspondence: Dr und Gesichtschirurgie, tinistrape 52, D-20251
Dr
M. Vesper, Klinik Universitltskrankenhaus Hamburg, Germany.
fur
Mund-, Eppendorf,
KieferMar-
Basal cell adenocarcinoma of the minor salivary glands of the palate: case report and review of the literature. 7: Pluth, H. Dnllenbach. (Mund Kiefer GesichtsChir 1998; 2: 275-278). Basal cell adenocarcinoma was first introduced as an entity in the second edition of the WHO’s Histological Typing of Salivary Gland Tumours in 1991. This tumor was first described in 1990 by Ellis and Wiskovitch from the Armed Forces Institute of Pathology (AFIP). Basal cell adenocarcinoma accounts for about 2.9% of all salivary gland malignancies. More than 90% of the tumors are situated in the parotid gland. Intraoral manifestations are known from case reports only. Tumors of the palate have been mentioned in three cases. Histologically, this tumor can easily be confused with basal cell adenoma and the solid basaloid subtype of adenoid cystic carcinoma. The case presented here is a middle-aged white woman with a basal cell adenocarcinoma of the palate. Therapy consisted of surgical extirpation with three-dimensional safety margins and histologically proven clear resection margins. Knowledge at this point indicates that basal cell adenocarcinoma has a rather high probability of local recurrence (up to SO%) and a mostly lymphogenous metastatic potential for as long as 10 years after removal of the primary tumor. Ten-year survival is around 75%. Correspondence: Dr Dr T. Plath, Klinik fur Kieferchirurgie Plastische Gesichtschirurgie, Klinikum Benjamin Franklin, Universitlt Berlin, Hindenburgdamm 30, D-12200 Germany.
Tenosynovial giant-cell invasion of the middle Wildfiirster, G Jundt. 1998”; 2: 279-281).
und Freie Berlin,
tumor of the temporomandibular ioint with cranial fossa. S. S;ojadinovic, S. ieinert, U E. Machtens. (Mund Kiefer GesichtsChir
A 63-year-old man is presented in whom a tenosynovial giant-cell tumor destroyed the right temporomandibular joint and fossa and extensive intracranial growth. Because of uncharacteristic complaints, a symptomatic treatment was performed elsewhere. The lesion was finally resected under endotracheal anesthesia. After 20 months free of recurrence, the patient’s outcome is very satisfying. Differential diagnosis and therapy are discussed. Correspondence: Dr Dr Sasa Stojadinovic, Klinik fur Mund-, Kieferund Gesichtschirurgie-Plastische Operationen, RuhrUniversitlt, In der Schornau 23325, D-44 892 Bochum, Germany.
fur Mund-, KieferFriedrich-schiller-
Possible correlation between odontogenic soft-tissue infection and the thermal effects of the weather. Statistical analysis in 2111 patients. C 0. Keller, H. Feifel, K. Bucher, 7: Reineke, D. Riediger. (Mund Kiefer GesichtsChir 1998; 2: 261-265). A possible correlation between the thermal effects of the weather and the frequency of odontogenic soft-tissue infections was investigated with special regard to the so-called felt temperature (gT). Clinical data of 2111 patients between 1992 and 1996, in whom an incision was made because of an odontogenic soft-tissue infection, were evaluated retrospectively and correlated to meteorological data for Aachen, collected or calculated by the ‘Deutsche Wetterdienst’. In order to describe the thermal exchange between the human organism and the surroundings in a satisfactory way, the gT was chosen. The gT is a complexly calculated meteorological parameter that allows physiologically adequate estimation of the thermic surroundings of humans. Over the whole study time, there was no impressive correlation between course and changing of the gT and the frequency of odontogenic soft-tissue infections. This result agrees with our finding that there was no seasonal accumulation of odontogenic soft-tissue infections over the year in Aachen. Nevertheless, there was a statistically significant negative correlation between values or weighted changes of the gT and the frequency of abscess and/or infiltration in the winter and less in springtime. A similar statistically significant correlation could not be found for summer or autumn. Correspondence: Prof. Dr Dr H. Feifel, Kieferund Plastische Gesichtschirurgie, RWTH Aachen, PauwelsstraBe, D-S2074
Klinik
fur Zahn-, Mund-, Universitatsklinikum, Aachen, Germany.
Diagnosis and treatment of carcinoma arising from richly stromal pleomorphic adenoma of the parotid gland. S. Stojoadinovic, S. Reinert. S. Philippou. (Mund Kiefer GesichtsChir 1998; 2: 266-269). The case is reported of a 27-year-old patient who developed multiple recurrences of a carcinoma arising from richly stromal pleomorphic adenoma of the parotid gland over 13 years. Originally, the tumor was classified as a benign pleomorphic adenoma because there were no cytological characteristics of malignancy. Later on, the diagnosis had to be modified to that of a carcinoma arising from a pleomorphic adenoma because of the infiltrating growth pattern of the tumour. A multicentric local recurrence and metastases on the left side of the neck supported the correct diagnosis. This case demonstrates that, beside the classic cytological criteria of malignancy, invasion and penetration of the capsule can be decisive for the diagnosis of malignant transformed pleomorphic adenoma. Treatment and prognosis of salivary gland tumors assume a clear determination of their dignity. The unusual course in this case of a pleomorphic adenoma originally diagnosed as benign demonstrates the importance of regular follow-up.
from
Mund-,
Kiefer-
und Gesichtschirurpie
417
Correspondence: Dr Dr S. Stojadinovic, Klinik fur Mund-, Kieferund Gesichtschirurgie, Plastische Operationen, Ruhr-Universitlt Bochum, In der Schomau 23-25, D-44892 Bochum, Germany.
Clear cell odontogenic carcinoma and squamous cell carcinoma: case report and literature review. M. Vesper, 7: Wilck, K. Donath, R. Schmelzle. (Mund Kiefer GesichtsChir 1998; 2: 270-274). One case of a newly described, rare odontogenic tumor is reported. A literature review of 19 cases lends support to the odontogenic origin and metastatic capability, both regionally and distantly, of the clear cell odontogenic tumor. We conclude that this tumor is malignant, with a tendency to recur locally after surgery. It requires an aggressive surgical approach and should be referred to as a clear cell odontogenic carcinoma. In our patient, we saw a clear cell odontogenie carcinoma and a squamous cell carcinoma, both with regional lymph node metastasis. The histological differentiation of this type of tumor from other clear cell tumors is difftcult. Correspondence: Dr und Gesichtschirurgie, tinistrape 52, D-20251
Dr
M. Vesper, Klinik Universitltskrankenhaus Hamburg, Germany.
fur
Mund-, Eppendorf,
KieferMar-
Basal cell adenocarcinoma of the minor salivary glands of the palate: case report and review of the literature. 7: Pluth, H. Dnllenbach. (Mund Kiefer GesichtsChir 1998; 2: 275-278). Basal cell adenocarcinoma was first introduced as an entity in the second edition of the WHO’s Histological Typing of Salivary Gland Tumours in 1991. This tumor was first described in 1990 by Ellis and Wiskovitch from the Armed Forces Institute of Pathology (AFIP). Basal cell adenocarcinoma accounts for about 2.9% of all salivary gland malignancies. More than 90% of the tumors are situated in the parotid gland. Intraoral manifestations are known from case reports only. Tumors of the palate have been mentioned in three cases. Histologically, this tumor can easily be confused with basal cell adenoma and the solid basaloid subtype of adenoid cystic carcinoma. The case presented here is a middle-aged white woman with a basal cell adenocarcinoma of the palate. Therapy consisted of surgical extirpation with three-dimensional safety margins and histologically proven clear resection margins. Knowledge at this point indicates that basal cell adenocarcinoma has a rather high probability of local recurrence (up to SO%) and a mostly lymphogenous metastatic potential for as long as 10 years after removal of the primary tumor. Ten-year survival is around 75%. Correspondence: Dr Dr T. Plath, Klinik fur Kieferchirurgie Plastische Gesichtschirurgie, Klinikum Benjamin Franklin, Universitlt Berlin, Hindenburgdamm 30, D-12200 Germany.
Tenosynovial giant-cell invasion of the middle Wildfiirster, G Jundt. 1998”; 2: 279-281).
und Freie Berlin,
tumor of the temporomandibular ioint with cranial fossa. S. S;ojadinovic, S. ieinert, U E. Machtens. (Mund Kiefer GesichtsChir
A 63-year-old man is presented in whom a tenosynovial giant-cell tumor destroyed the right temporomandibular joint and fossa and extensive intracranial growth. Because of uncharacteristic complaints, a symptomatic treatment was performed elsewhere. The lesion was finally resected under endotracheal anesthesia. After 20 months free of recurrence, the patient’s outcome is very satisfying. Differential diagnosis and therapy are discussed. Correspondence: Dr Dr Sasa Stojadinovic, Klinik fur Mund-, Kieferund Gesichtschirurgie-Plastische Operationen, RuhrUniversitlt, In der Schornau 23325, D-44 892 Bochum, Germany.