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Odontogenic tumours: Analysis of 497 cases from Nigeria
Int. J. Oral Maxillofac. Surg. 2005; 34 (Supplement 1): $ 1 - $ 1 8 1
70 statistically significant (RR less than 0.28). Auricular cartilage (1 study; n=17; mean f/u 3 years): MSR 82.4 percent. CI for pain improvement was statistically significant (RR greater than Dermal graft (1 study; n = 17; mean f/u 5.5 years): MSR was 87.9 percent. CI for pain improvement was statistically significant (RR greater than 4.1). There was insufficient data to extrapolate CI for MIO improvement in all of the studies involving autogenous grafts, but the mean change in MIO was statistically significant based on t-test. TMJ discectomy without graft was favorable compared to alloplasts, in terms of improving joint pain and MIO. It is difficult to draw conclusions on the autogenous grafts given insufficient human clinical trials, but they seem to have success comparable to other disc replacement techniques.
[•]
DIAGNOSTIC PROBLEMS IN TUMOURS OF THE TEMPOROMANDIBULAR JOINT. AN ANALYSIS OF 235 CASES REPORTED IN LITERATURE AND 12 NEW CASES
M. Wenghoefer 1, C. Fischenbeck 1, R. Steffens 1, S. Berg62.
1Department of Oral & Maxillofacial Surgery, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany; 2Department of Oral & Maxillofacial Surgery, University of Nijmegen, Geert Grooteplein-Zuid 14, 6525 GA Nijmegen, the Netherlands Because patients with Tumours of the temporomandibular joint (TMJ) present with similar symptoms as patients with non tumorous TMJlesions, making an exact diagnosis still remains difficult. This study analyzes 235 cases of benign and malignant tumours of the TMJ reported in Literature between 1965 and 2004 and 12 new cases treated at our clinic between 1995 and 2000. From 247 cases were 67 benignant (osteoma or osteochondroma) 25 malignnant (osteosarkoma, synovialcell carcinoma, chondrosarkoma) 38 metastasis (prostate cancer, breast cancer, colon cancer) and 117 tumourlike lesions (synovial chondromatosis). At presentation there was no distinct symptom in patients with neoplastic lesions of the TMJ: All patients showed either pain or swelling or crepitation or a combination of these symptoms. Patients with benignant tumours were between 21 and 50 years. Malignant tumours occurred at every age but became more frequent in elder patients. Altogether 57.55% of the patients in this study were of female gender. Because Patients with benign and malignant TMJ-tumours as well as patients with non tumorous TMJ-lesions show similar clinical symptoms and a radiographic distinction between malignant and benign TMJ-tumours remains difficult, histological samples are mandatory for an exact diagnosis and planning of specific treatments.
[•
TMJ's SYNOVIAL SARCOMA - RARE DISORDER AND POSSIBLE DIFFERENTIAL DIAGNOSIS
B. Hohlweg-Majert, D. Emmerich, J. B6hm, R. Schmelzeisen, D. Schulze.
University Freiburg Hospital, departement of oral and maxillofacial surgery, Freiburg, Germany Neoplasms of the temporal mandibular joint (TMJ) are very rare. They can derive directly from condylar structures, from the surrounding adjacent tissues or as a distant metastatic transformation. Synovial sarcoma of the TMJ is a very unusual disease as well. Only 3% of all synovial sarcomas can be found in the head and neck region. The tumor itself doesn't arise from the synovial membrane. On the contrary the periarticular tissue is the origin, while synovial sarcoma usually presents in teenagers and young adults. We want to demonstrate some distinct cases of TMJ synovial sarcoma and reveal potential differential diagnosis. Four cases of TMJ synovial sarcoma with corresponding CT and CBCT images and histologic slices are presented. The patients demonstrated preauricular swelling, dental midline deviation and limited mouth opening. All of them were referred from dental practitioners. All suspect cases disclosed histologically as synovial sarcoma. Another case with the same clinical symptoms turned out to be a developmental disorder of the tympanic bone. In case of synovial sarcoma of the TMJ diagnosis can only be assured via histologic confirmation. Clincal symptoms are to common and the available imaging modalities only show tumorous destruction, infiltration and/or residual calcified bodies. A rare developmental disorder of the tympanic bone - persistence of foramen of Huschke - has to be differentiated.
037. Tumor Vl
[O3•]
ODONTOGENIC TUMOURS: ANALYSIS OF 497 CASES FROM NIGERIA
J. Arotiba 1, S. Ajike 2, E. Adebayo 2, O. Fasola 1 , V. Akinmoladun 1 .
1Department of Oral & Maxillofacial Surgery, University College Hospital, Ibadan; 2Maxillofacial Surgery Unit Ahmadu Bello Teaching Hospital, Kaduna, Nigeria We retrospectively analyzed 497 patients with histologically diagnosed odontogenic tumours in two referral Hospitals in Nigeria. The aim of the study was to determine the type, relative frequencies,age and sex prevalence, radiological and clinical features,treatment and outcome: Biopsy records, Clinical files, and radiographic reports of all patients histologically diagnosed as odontogenic tumours from the two centres (UCH, Ibadan; 1980-2003 & MFU Kaduna; 1979-1998) were retrieved and analyzed. 497 patients (Males=274 or 55% : Females=233 or 45%) were seen with age range of 6-77 years (Mean + SD = 30.8+14.5 years).Mean duration of tumours was 40 months (±52.6 SD).The lesions were more common in the mandible (399 cases; 80.3%) than the maxillar. The most common tumours were Ameloblastoma (N =344; 69.2%), Fibromyxoma (N=59; 11.8%) and Adenomatoid odontogenic tumour (N =24; 4.8%). Intra-alveolar carcinoma was the most common malignant odontogenic tumor. Tretments given were Enucleation (53), EN Block resection (27), Segmental resection (90), Mandibulectomy (115) and Maxillectomy (12). Recurrence was seen in 5.8% of cases. Ameloblastoma is the most common odontogenic tumors in this envoronment and adequate resection will minimise recurrence. [-0-'3--~ CONTROVERSY ABOUT JAWS ADAMANTINOMA
A. Benedetti, S. Naumovski, V. Popovski, B. Ilievski. Clinic for
Maxillofacial Surgery Vodnjanska 17, Skopje 1000, Macedonia The ameloblastoma has a very long history of recognation and controversy. For the clinician can cause difficulties in diagnosis and treatment because is asymptomatic and remains undiscover until lesional growth produces jaw swelling, tooth eruption and dental occlusion disturbances. Controversy about behaviour continues to evoke wide difference of opinion among authors between benign and Iocaly invasive with strong tendency to recur to variable range of malignant behaviour from lowgrade to high-grade even with not well differentiated metastatic lesions that aggresively invide adjacent and regional tissues as well as bronchopulmonary system,local and distant lymph nodes and distant organs. This study was carried out to examine the clinical behaviour of these lesions,histopathological findings and to present some asults of treatment. This was a retrospective clinical study in a consecutive series of eleven patients during the years 1994-2004 treated at the Clinic for Maxillofacial Surgery in Skopje. All the patients were treated operatively at our clinic. The diagnosis were confirmed with histopathologicaly requairings specialised techniques. Patients have been evaluated clinically and radiographically after surgery. There was significant difference in the age of the patients. The youngest was 8 and the oldiest patient was 85 years old. Nonsignificant differences were found in male to female ratio (6:5). The tumors were located in 9 patients in mandible and in 2 in maxilla. The histopathological study confirmed the diagnosis of adamantinoma. Normal postoperative function and satisfactory esthetic results were found in majority of patients. Recidives of the tumor were found in 3 patients and the operative treatment was necessary again. Based on results of this study with good operative succes we can demonstrate big controversy questions about age of the patients, malignancy of the tumor, operative results. ~
A
CASE OF PEMPHIGUS VULGARIS WITH MULTIPLE PRIMARY ORAL CANCERS ON LONG PERIOD
K. Mori, .K. Ninomiya, I. Mataga. 2nd Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Dentistry at Niigata, Japan Pemphigus vulgaris is a serious chronic skin and mucosal disease characterized by the appearance of bullae and erosion. Recently, relation
70 statistically significant (RR less than 0.28). Auricular cartilage (1 study; n=17; mean f/u 3 years): MSR 82.4 percent. CI for pain improvement was statistically significant (RR greater than Dermal graft (1 study; n = 17; mean f/u 5.5 years): MSR was 87.9 percent. CI for pain improvement was statistically significant (RR greater than 4.1). There was insufficient data to extrapolate CI for MIO improvement in all of the studies involving autogenous grafts, but the mean change in MIO was statistically significant based on t-test. TMJ discectomy without graft was favorable compared to alloplasts, in terms of improving joint pain and MIO. It is difficult to draw conclusions on the autogenous grafts given insufficient human clinical trials, but they seem to have success comparable to other disc replacement techniques.
[•]
DIAGNOSTIC PROBLEMS IN TUMOURS OF THE TEMPOROMANDIBULAR JOINT. AN ANALYSIS OF 235 CASES REPORTED IN LITERATURE AND 12 NEW CASES
M. Wenghoefer 1, C. Fischenbeck 1, R. Steffens 1, S. Berg62.
1Department of Oral & Maxillofacial Surgery, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany; 2Department of Oral & Maxillofacial Surgery, University of Nijmegen, Geert Grooteplein-Zuid 14, 6525 GA Nijmegen, the Netherlands Because patients with Tumours of the temporomandibular joint (TMJ) present with similar symptoms as patients with non tumorous TMJlesions, making an exact diagnosis still remains difficult. This study analyzes 235 cases of benign and malignant tumours of the TMJ reported in Literature between 1965 and 2004 and 12 new cases treated at our clinic between 1995 and 2000. From 247 cases were 67 benignant (osteoma or osteochondroma) 25 malignnant (osteosarkoma, synovialcell carcinoma, chondrosarkoma) 38 metastasis (prostate cancer, breast cancer, colon cancer) and 117 tumourlike lesions (synovial chondromatosis). At presentation there was no distinct symptom in patients with neoplastic lesions of the TMJ: All patients showed either pain or swelling or crepitation or a combination of these symptoms. Patients with benignant tumours were between 21 and 50 years. Malignant tumours occurred at every age but became more frequent in elder patients. Altogether 57.55% of the patients in this study were of female gender. Because Patients with benign and malignant TMJ-tumours as well as patients with non tumorous TMJ-lesions show similar clinical symptoms and a radiographic distinction between malignant and benign TMJ-tumours remains difficult, histological samples are mandatory for an exact diagnosis and planning of specific treatments.
[•
TMJ's SYNOVIAL SARCOMA - RARE DISORDER AND POSSIBLE DIFFERENTIAL DIAGNOSIS
B. Hohlweg-Majert, D. Emmerich, J. B6hm, R. Schmelzeisen, D. Schulze.
University Freiburg Hospital, departement of oral and maxillofacial surgery, Freiburg, Germany Neoplasms of the temporal mandibular joint (TMJ) are very rare. They can derive directly from condylar structures, from the surrounding adjacent tissues or as a distant metastatic transformation. Synovial sarcoma of the TMJ is a very unusual disease as well. Only 3% of all synovial sarcomas can be found in the head and neck region. The tumor itself doesn't arise from the synovial membrane. On the contrary the periarticular tissue is the origin, while synovial sarcoma usually presents in teenagers and young adults. We want to demonstrate some distinct cases of TMJ synovial sarcoma and reveal potential differential diagnosis. Four cases of TMJ synovial sarcoma with corresponding CT and CBCT images and histologic slices are presented. The patients demonstrated preauricular swelling, dental midline deviation and limited mouth opening. All of them were referred from dental practitioners. All suspect cases disclosed histologically as synovial sarcoma. Another case with the same clinical symptoms turned out to be a developmental disorder of the tympanic bone. In case of synovial sarcoma of the TMJ diagnosis can only be assured via histologic confirmation. Clincal symptoms are to common and the available imaging modalities only show tumorous destruction, infiltration and/or residual calcified bodies. A rare developmental disorder of the tympanic bone - persistence of foramen of Huschke - has to be differentiated.
037. Tumor Vl
[O3•]
ODONTOGENIC TUMOURS: ANALYSIS OF 497 CASES FROM NIGERIA
J. Arotiba 1, S. Ajike 2, E. Adebayo 2, O. Fasola 1 , V. Akinmoladun 1 .
1Department of Oral & Maxillofacial Surgery, University College Hospital, Ibadan; 2Maxillofacial Surgery Unit Ahmadu Bello Teaching Hospital, Kaduna, Nigeria We retrospectively analyzed 497 patients with histologically diagnosed odontogenic tumours in two referral Hospitals in Nigeria. The aim of the study was to determine the type, relative frequencies,age and sex prevalence, radiological and clinical features,treatment and outcome: Biopsy records, Clinical files, and radiographic reports of all patients histologically diagnosed as odontogenic tumours from the two centres (UCH, Ibadan; 1980-2003 & MFU Kaduna; 1979-1998) were retrieved and analyzed. 497 patients (Males=274 or 55% : Females=233 or 45%) were seen with age range of 6-77 years (Mean + SD = 30.8+14.5 years).Mean duration of tumours was 40 months (±52.6 SD).The lesions were more common in the mandible (399 cases; 80.3%) than the maxillar. The most common tumours were Ameloblastoma (N =344; 69.2%), Fibromyxoma (N=59; 11.8%) and Adenomatoid odontogenic tumour (N =24; 4.8%). Intra-alveolar carcinoma was the most common malignant odontogenic tumor. Tretments given were Enucleation (53), EN Block resection (27), Segmental resection (90), Mandibulectomy (115) and Maxillectomy (12). Recurrence was seen in 5.8% of cases. Ameloblastoma is the most common odontogenic tumors in this envoronment and adequate resection will minimise recurrence. [-0-'3--~ CONTROVERSY ABOUT JAWS ADAMANTINOMA
A. Benedetti, S. Naumovski, V. Popovski, B. Ilievski. Clinic for
Maxillofacial Surgery Vodnjanska 17, Skopje 1000, Macedonia The ameloblastoma has a very long history of recognation and controversy. For the clinician can cause difficulties in diagnosis and treatment because is asymptomatic and remains undiscover until lesional growth produces jaw swelling, tooth eruption and dental occlusion disturbances. Controversy about behaviour continues to evoke wide difference of opinion among authors between benign and Iocaly invasive with strong tendency to recur to variable range of malignant behaviour from lowgrade to high-grade even with not well differentiated metastatic lesions that aggresively invide adjacent and regional tissues as well as bronchopulmonary system,local and distant lymph nodes and distant organs. This study was carried out to examine the clinical behaviour of these lesions,histopathological findings and to present some asults of treatment. This was a retrospective clinical study in a consecutive series of eleven patients during the years 1994-2004 treated at the Clinic for Maxillofacial Surgery in Skopje. All the patients were treated operatively at our clinic. The diagnosis were confirmed with histopathologicaly requairings specialised techniques. Patients have been evaluated clinically and radiographically after surgery. There was significant difference in the age of the patients. The youngest was 8 and the oldiest patient was 85 years old. Nonsignificant differences were found in male to female ratio (6:5). The tumors were located in 9 patients in mandible and in 2 in maxilla. The histopathological study confirmed the diagnosis of adamantinoma. Normal postoperative function and satisfactory esthetic results were found in majority of patients. Recidives of the tumor were found in 3 patients and the operative treatment was necessary again. Based on results of this study with good operative succes we can demonstrate big controversy questions about age of the patients, malignancy of the tumor, operative results. ~
A
CASE OF PEMPHIGUS VULGARIS WITH MULTIPLE PRIMARY ORAL CANCERS ON LONG PERIOD
K. Mori, .K. Ninomiya, I. Mataga. 2nd Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Dentistry at Niigata, Japan Pemphigus vulgaris is a serious chronic skin and mucosal disease characterized by the appearance of bullae and erosion. Recently, relation