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Extranodal lymphoma of the oral and maxillofacial regions: report of our experiences
21st ICOMS 2013 - Abstracts: Oral Papers T24.OR013
T24.OR015
A survey of 183 paediatric patients from Barcelona including 239 supernumerary unerupted teeth
Extranodal lymphoma of the oral and maxillofacial regions: report of our experiences
E. Ferrés-Amat 1,2,∗ , E. Ferrés-Amat 1,2 , J. Prats-Armengol 1,2 , J. Mareque-Bueno 1,2 , E. FerrésPadró 1 1 Department
of Oral and Maxillofacial Surgery, Fundació Hospital De Nens De Barcelona, Spain 2 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain Background and objectives: Unerupted supernumerary teeth, depending on the morphology, number and distribution can give rise to various alterations in the eruption and development of those permanent teeth to which they are related. We aimed to make an epidemiological and descriptive study of the clinical characteristics of patients in Barcelona. Methods: A descriptive study including 239 supernumerary teeth from 183 healthy paediatric patients between 5 and 19 year old, that have been surgically treated in our service during a 5 years period. Results: Male patients (120) were more frequently affected than female (63) patients mainly within the central incisors-mesiodens (55.12%), in which predominates conoid morphology. Surgical treatment was done by palatal/lingual extraction (51.30%), with few surgical complications (only 1 case of post-surgical bleeding). Conclusions: Incidence in supernumerary teeth is higher among male patients (ratio M:F of 1.82:1). They are most frequently located in the maxilla (82%), specifically, in the premaxilla. Most cases presented only one supernumerary tooth and, in multiple cases the premolar region is predominant. The conoid shape is the commonest morphology. Surgical extraction, was done by palatal/lingual in 51.30% of the cases, as opposed to the vestibular approach in 43.61%. Key words: supernumerary teeth; mesiodens; hyperodontia http://dx.doi.org/10.1016/j.ijom.2013.07.491 T24.OR014 Human papillomavirus associated head and neck squamous cell carcinoma: does the expression of cancer stem cell markers influence overall survival?
M. Goto 1,∗ , T. Saito 2 , H. Sato 3 , T. Okubo 3 , N. Kuroyanagi 3 , H. Hachiya 4 , K. Kurita 1 , K. Shimozato 5 1 Department
of Oral and Maxillofacial Surgery, Aichi Gakuin University, Nagoya, Japan Department of Oral and Maxillofacial Surgery, Okazaki Municipal Hospital, Aichi, Japan 3 Department of Oral and Maxillofacial Surgery, Hekinan Municipal Hospital, Aichi, Japan 4 Department of Oral and Maxillofacial Surgery, Tokusyukai Ogaki Hospital, Gifu, Japan 5 Department of Maxillofacial Surgery, Aichi Gakuin University, Nagoya, Japan 2
Background: An extranodal lymphoma in oral cavity represents less than 5% of oral malignant disease, commonly arising in submucosal tissues of gingiva, palate, and tongue. The lymphoma in the jaws is sometimes difficult to be diagnosed because of absence of specific signs and symptoms, as well as their low frequency. Here we present our experiences of the primary extranodal lymphoma which involved some difficult cases to be diagnosed. Methods: This study reports 7 cases of the extranodal lymphoma in oral cavity or maxillofacial regions. All of the patients were proven pathological diagnoses with biopsy specimens. Data investigated were patients’ characteristics, staging, pathological diagnoses, image findings, and treatment courses. Results: Four patients were male and 3 female with a median age of 63 years. Chief complaints were gingival swelling in 5 patients and pain in 2, presented with lower lip paresthesia in 2. Primary sites of disease were bone of maxilla in 1 patient and mandible in 2, upper gingiva in 1, floor of mouth in 1, maxillary sinus in 1, and palatal soft tissue in 1, respectively. Two of those were clinically diagnosed inflammatory diseases at the time of their first present. Histological diagnoses from biopsy specimens showed the diffuse large B-cell lymphoma in 4 cases, the adult T-cell lymphoma/leukemia in 2, and Burkitt’s lymphoma in 1. Staging included stage IAE in 2 patients, IIAE in 3, IVA in 1, and IVB in 1. Four patients were died of the disease during a follow-up period, although 1 of them had a complete response after chemotherapy. Conclusions: A careful examination is necessary to be diagnosed early, which results in a better prognosis. Moreover, maxillofacial surgeons are needed to keep following up the patients to recognize any recurrences after completing their treatments. Key words: lymphoma; oral cavity; jaw
C. Goetz 1,∗ , E. Drecoll 2 , M. Straub 2 , M. Kesting 1 , K.D. Wolff 1 , A. Kolk 1
http://dx.doi.org/10.1016/j.ijom.2013.07.493
1 Department
T24.OR016
2
of Oral and Maxillofacial Surgery, Technical University Munich, Germany Institute of Pathology, Technical University Munich, Germany
Introduction: 5-Year-overall survival is quoted to be significant better in human papillomavirus (hpv) associated head and neck squamous cell carcinomas (hnscc) than in hnscc related to alcohol and tobacco consumption. An explanation for these results could be that adjuvant chemotherapy and radiation are resulting in higher response rates to hnscc with hpv positive carcinogenesis. On the other hand the hallmarks of cancer, including the cancer stem cell (csc) theory could be different in hpv associated hnscc. In the past only few investigations were done in this field of molecular oncology and were set into correlation to the clinical outcome of the patients. To the detection of hpv infection it is mentioned that staining of p16 shows higher signals than other hpv correlated proteins are doing. Methods: We analysed the expression of the csc markers CD 44, CD 133, CD 49 f, YB-1 and Twist with methods of ICH on a TMA. We did Western Blot on tissues, which were extracted of hpv positive and negative hnscc cell lines. Furthermore we compared the results to hpv negative hnscc cell lines. We set the laboratory results into correlation with the overall survival of the 550 patients, on which the TMA is based. Furthermore we detected hpv in IHC with two different molecular patterns, E7 and p16. Results: The results showed significant difference between the expression oft the latter mentioned csc markers in hpv positive and negative hnscc. A reduced expression of these markers was found through ICH and WB in hpv positive hnscc. We used Spearman rank correlation and set the p-value on <0.05. Conclusion: According to the significant different results between hpv positive and negative hnscc we are showing that there is a need to do further research on this subject and to discuss the treatment of hpv postitive hnscc. http://dx.doi.org/10.1016/j.ijom.2013.07.492
1315
Bone replacement in patients with segmental mandibular defects secondary to aseptic bone necrosis J.F. Granados Colocho 1,∗ , L. Zamudio Sanchez 1 , F. Ruiz Delgado 2 , I. Ya˜nez Vilas 2 , L. Bermudo A˜nino 2 1 2
Resident of Maxillofacial Surgery at Hospital Regional Carlos Haya, Málaga, Spain Graduated Surgeon of Maxillofacial Surgery at Hospital Regional Carlos Haya, Málaga, Spain
Background: Head and neck tumours represent 5–10% of all malignant tumours, often diagnosed at advanced stages, with the patient submitted to gross surgery, radio and chemotherapy, resulting in bone radio necrosis in up to 90% of cases which underwent thru this adjuvant therapy. Recently bisphosphonates appears as another cause of therapy associated bone necrosis. Due to the uprising number of patients with tumours that needs radiotherapy or bisphosphonates, there is an increase in jaw necrosis. Nowadays these defects are managed with biocompatible materials such as ceramics, or bone graft from patient’s fibula. We present a clinical study design for correcting these bone defects using a titanium and albumin scaffold with bone marrow stem cells obtained from hip’s bone medulla. Objectives: Establish a clinical design to develop a new therapeutic option for bone necrosis. Accomplish a new procedure for bone rehabilitation surgery, integrating previously known treatments for bone induction and conduction. Methods: A literature research among current treatment modalities on bone necrosis, and a comparative on newly developed therapeutic options for osteogenesis and bone induction that are approved to be used on human for different pathologies. Results: Currently studied scaffolds are bone inductors, including bio-ceramics, however albumin has been recently used as scaffold, with bone induction capacity and osteogenesis properties. Bone marrow stem cells, are currently approved as a regenerative option in several diseases; these cells can be differentiated to osteoblasts with the advantage of the patient being the donor himself. Conclusions: We propose a clinical study design involving currently approved technics on humans, that are suitable to be use as bone regeneration therapies, and that had never been used together before as repair therapies for gross bone defect pathologies on jaw such as bone necrosis. Key words: bone regeneration; radiotherapy; osteonecrosis; jaw http://dx.doi.org/10.1016/j.ijom.2013.07.494
T24.OR015
A survey of 183 paediatric patients from Barcelona including 239 supernumerary unerupted teeth
Extranodal lymphoma of the oral and maxillofacial regions: report of our experiences
E. Ferrés-Amat 1,2,∗ , E. Ferrés-Amat 1,2 , J. Prats-Armengol 1,2 , J. Mareque-Bueno 1,2 , E. FerrésPadró 1 1 Department
of Oral and Maxillofacial Surgery, Fundació Hospital De Nens De Barcelona, Spain 2 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain Background and objectives: Unerupted supernumerary teeth, depending on the morphology, number and distribution can give rise to various alterations in the eruption and development of those permanent teeth to which they are related. We aimed to make an epidemiological and descriptive study of the clinical characteristics of patients in Barcelona. Methods: A descriptive study including 239 supernumerary teeth from 183 healthy paediatric patients between 5 and 19 year old, that have been surgically treated in our service during a 5 years period. Results: Male patients (120) were more frequently affected than female (63) patients mainly within the central incisors-mesiodens (55.12%), in which predominates conoid morphology. Surgical treatment was done by palatal/lingual extraction (51.30%), with few surgical complications (only 1 case of post-surgical bleeding). Conclusions: Incidence in supernumerary teeth is higher among male patients (ratio M:F of 1.82:1). They are most frequently located in the maxilla (82%), specifically, in the premaxilla. Most cases presented only one supernumerary tooth and, in multiple cases the premolar region is predominant. The conoid shape is the commonest morphology. Surgical extraction, was done by palatal/lingual in 51.30% of the cases, as opposed to the vestibular approach in 43.61%. Key words: supernumerary teeth; mesiodens; hyperodontia http://dx.doi.org/10.1016/j.ijom.2013.07.491 T24.OR014 Human papillomavirus associated head and neck squamous cell carcinoma: does the expression of cancer stem cell markers influence overall survival?
M. Goto 1,∗ , T. Saito 2 , H. Sato 3 , T. Okubo 3 , N. Kuroyanagi 3 , H. Hachiya 4 , K. Kurita 1 , K. Shimozato 5 1 Department
of Oral and Maxillofacial Surgery, Aichi Gakuin University, Nagoya, Japan Department of Oral and Maxillofacial Surgery, Okazaki Municipal Hospital, Aichi, Japan 3 Department of Oral and Maxillofacial Surgery, Hekinan Municipal Hospital, Aichi, Japan 4 Department of Oral and Maxillofacial Surgery, Tokusyukai Ogaki Hospital, Gifu, Japan 5 Department of Maxillofacial Surgery, Aichi Gakuin University, Nagoya, Japan 2
Background: An extranodal lymphoma in oral cavity represents less than 5% of oral malignant disease, commonly arising in submucosal tissues of gingiva, palate, and tongue. The lymphoma in the jaws is sometimes difficult to be diagnosed because of absence of specific signs and symptoms, as well as their low frequency. Here we present our experiences of the primary extranodal lymphoma which involved some difficult cases to be diagnosed. Methods: This study reports 7 cases of the extranodal lymphoma in oral cavity or maxillofacial regions. All of the patients were proven pathological diagnoses with biopsy specimens. Data investigated were patients’ characteristics, staging, pathological diagnoses, image findings, and treatment courses. Results: Four patients were male and 3 female with a median age of 63 years. Chief complaints were gingival swelling in 5 patients and pain in 2, presented with lower lip paresthesia in 2. Primary sites of disease were bone of maxilla in 1 patient and mandible in 2, upper gingiva in 1, floor of mouth in 1, maxillary sinus in 1, and palatal soft tissue in 1, respectively. Two of those were clinically diagnosed inflammatory diseases at the time of their first present. Histological diagnoses from biopsy specimens showed the diffuse large B-cell lymphoma in 4 cases, the adult T-cell lymphoma/leukemia in 2, and Burkitt’s lymphoma in 1. Staging included stage IAE in 2 patients, IIAE in 3, IVA in 1, and IVB in 1. Four patients were died of the disease during a follow-up period, although 1 of them had a complete response after chemotherapy. Conclusions: A careful examination is necessary to be diagnosed early, which results in a better prognosis. Moreover, maxillofacial surgeons are needed to keep following up the patients to recognize any recurrences after completing their treatments. Key words: lymphoma; oral cavity; jaw
C. Goetz 1,∗ , E. Drecoll 2 , M. Straub 2 , M. Kesting 1 , K.D. Wolff 1 , A. Kolk 1
http://dx.doi.org/10.1016/j.ijom.2013.07.493
1 Department
T24.OR016
2
of Oral and Maxillofacial Surgery, Technical University Munich, Germany Institute of Pathology, Technical University Munich, Germany
Introduction: 5-Year-overall survival is quoted to be significant better in human papillomavirus (hpv) associated head and neck squamous cell carcinomas (hnscc) than in hnscc related to alcohol and tobacco consumption. An explanation for these results could be that adjuvant chemotherapy and radiation are resulting in higher response rates to hnscc with hpv positive carcinogenesis. On the other hand the hallmarks of cancer, including the cancer stem cell (csc) theory could be different in hpv associated hnscc. In the past only few investigations were done in this field of molecular oncology and were set into correlation to the clinical outcome of the patients. To the detection of hpv infection it is mentioned that staining of p16 shows higher signals than other hpv correlated proteins are doing. Methods: We analysed the expression of the csc markers CD 44, CD 133, CD 49 f, YB-1 and Twist with methods of ICH on a TMA. We did Western Blot on tissues, which were extracted of hpv positive and negative hnscc cell lines. Furthermore we compared the results to hpv negative hnscc cell lines. We set the laboratory results into correlation with the overall survival of the 550 patients, on which the TMA is based. Furthermore we detected hpv in IHC with two different molecular patterns, E7 and p16. Results: The results showed significant difference between the expression oft the latter mentioned csc markers in hpv positive and negative hnscc. A reduced expression of these markers was found through ICH and WB in hpv positive hnscc. We used Spearman rank correlation and set the p-value on <0.05. Conclusion: According to the significant different results between hpv positive and negative hnscc we are showing that there is a need to do further research on this subject and to discuss the treatment of hpv postitive hnscc. http://dx.doi.org/10.1016/j.ijom.2013.07.492
1315
Bone replacement in patients with segmental mandibular defects secondary to aseptic bone necrosis J.F. Granados Colocho 1,∗ , L. Zamudio Sanchez 1 , F. Ruiz Delgado 2 , I. Ya˜nez Vilas 2 , L. Bermudo A˜nino 2 1 2
Resident of Maxillofacial Surgery at Hospital Regional Carlos Haya, Málaga, Spain Graduated Surgeon of Maxillofacial Surgery at Hospital Regional Carlos Haya, Málaga, Spain
Background: Head and neck tumours represent 5–10% of all malignant tumours, often diagnosed at advanced stages, with the patient submitted to gross surgery, radio and chemotherapy, resulting in bone radio necrosis in up to 90% of cases which underwent thru this adjuvant therapy. Recently bisphosphonates appears as another cause of therapy associated bone necrosis. Due to the uprising number of patients with tumours that needs radiotherapy or bisphosphonates, there is an increase in jaw necrosis. Nowadays these defects are managed with biocompatible materials such as ceramics, or bone graft from patient’s fibula. We present a clinical study design for correcting these bone defects using a titanium and albumin scaffold with bone marrow stem cells obtained from hip’s bone medulla. Objectives: Establish a clinical design to develop a new therapeutic option for bone necrosis. Accomplish a new procedure for bone rehabilitation surgery, integrating previously known treatments for bone induction and conduction. Methods: A literature research among current treatment modalities on bone necrosis, and a comparative on newly developed therapeutic options for osteogenesis and bone induction that are approved to be used on human for different pathologies. Results: Currently studied scaffolds are bone inductors, including bio-ceramics, however albumin has been recently used as scaffold, with bone induction capacity and osteogenesis properties. Bone marrow stem cells, are currently approved as a regenerative option in several diseases; these cells can be differentiated to osteoblasts with the advantage of the patient being the donor himself. Conclusions: We propose a clinical study design involving currently approved technics on humans, that are suitable to be use as bone regeneration therapies, and that had never been used together before as repair therapies for gross bone defect pathologies on jaw such as bone necrosis. Key words: bone regeneration; radiotherapy; osteonecrosis; jaw http://dx.doi.org/10.1016/j.ijom.2013.07.494