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Practical considerations in the management of malignant bone tumors
Review of the Literature hsociale THOMAS
Editor J. COOK
Corresponding Editors ITALY Alexander G. Nutlay Halifax, Nova Scotia
AUSTRALIA A. . Arnott Sy i!l ey, Australia CENTRAL AMERICA Claudio Funcia Cornell Havana, Cuba
SCANDINAVIA Reidar F. Sognnaes Belmont, Mass.
SOUTH AMERICA Guillermo A. Ries Centeno Buenos Aires! Argentina
SPAIN Jo& Font Valencia, Spain
ENGLAND Paul A. Toller St. Albaus, England
SWITZERLAND AND Erik P. Steinmann Hans Miihlemann Raoul H. Boitel Ziirich, Switzerland
FRANCE AND BELGIUM Jacques Lhlgnac Paris, France
JUNE,
GERMANY
1954
Abstracts of Current ORAL Practical Considerations in the Management J. A. M. A. 152: 297, May, 1953.
Literature SURUERY of Malignant
Bone Tumors.
-II.
R. McCarroll.
It should consist of adequate biopsy, including Pathologic diagnosis is essential. part of the periovteum and any soft tiesue involvement. A classification of bone tumors suitable for practical we is presented below: “ 1. Derived from cartilage: chondrosarcoma. “2. Derived from bone: osteosarcoma. “3. Derived from connective tissue: a. Fibrosarcoma. b. Malignant giant cell tumors. 680
ABSTRACTS
OF CTJRRENT LITERATURE
“4.
Derived from mesenchmal connective thelial system : Ewing sarcoma. “5. Derived from the hematopoetic tissue: a. Multiple myeloma. b. Reticulum cell sarcoma. c. The leukemias. tl. Hodgkin’s disease. ’ ’ Treatment and prognosis are discussed.
TUMORS
tissue,
OF THE
Considerations
About Hard and Dentified Rev. de stomatol. 53: 885, 1953.
or possibly
681 from
the retieuloendit
T. 3. ((.
JAWS
Adamantinoma.
M. Dechaume and B. Xerebef.
A child born in 1942 was operated upon in 1948 for a tumor of the mandible, which had developed progressively and without symptoms. Second and third operations were done in 1950. When seen by the authors in July, 1951, the face of the child, who was in good general condition, was deformed by a mass, the size of a walnut, located at the posterior part of the left horizontal ramus of the mandible. The skin was normal. There were no sensory disturbance and no adenopathy. The intraoral examination revealed an ulceration which circumscribed a hard mass of a gray appearance, suggesting tooth substance rather than bone. It was firmly attached to the jaw. The two lower premolars were missing. The x-ray examination was conclusive. Lateral views showed a mass of irregular outline and density with shadows suggestive of dental roots. The mass was limited by the lower border of the mandible, the first molar, and the tooth bud of the first premolar. An operation was performed in July, 1951. The outer plate was removed to expose the hard mass which was broken into pieces with bone-cutting forceps and removed one piece after another. Conclusion All tumors of that type have not always an identical embryology and are not always Some originate from the outer layer of bearing the same relation to the dental system. the epithelial sheath of the tooth, the formation of which is disturbed. They might 1)~ classified as dysorganoplasias. Some are the result of an abnormal proliferation of a tooth bud. Some are probably due to aberrant epithelial cells. Microscopic examination of the excised tissue showed that all the tissues of the tooth The dentine structure was dystrophic, disturbed were present. The enamel was normal. The pulp tissue and the cementum were with lacunae, “ calcospherites, ’ ’ and dead tracts. normal. The presence of enamel is not as rare as is usually believed. If the dysembryoplasia affects the tissues before they differentiate, the tumor has higher potentialities and may develop into a mono or polycystic type of adamantinoma ol’ affects tissues at the even an ” adamantine epithelioma. ’ ’ But if the dysembryoplasia time of adamantinogenesis, a tumor consisting of enamel, dentine, and, later on, cerneut results. The treatment of cases like the one reported is surgical and, in cases in which it is feared that a fracture of the mandible may occur during removal, a splint should he con.T. I,. structed before surgery.
RESEARCH The Composition The Dental
and Structure Journal
of Human
of Australia
Dental Enamel. 25: 83-95,1953.
H. R. Sullivan,
D.D.Sc. (Syd.).
SUMMARY “There permeability
are still many points to be clarified concerning the structure, composition and of enamel. It would seem to be true to ssy that it is a highly inorganic
Editor J. COOK
Corresponding Editors ITALY Alexander G. Nutlay Halifax, Nova Scotia
AUSTRALIA A. . Arnott Sy i!l ey, Australia CENTRAL AMERICA Claudio Funcia Cornell Havana, Cuba
SCANDINAVIA Reidar F. Sognnaes Belmont, Mass.
SOUTH AMERICA Guillermo A. Ries Centeno Buenos Aires! Argentina
SPAIN Jo& Font Valencia, Spain
ENGLAND Paul A. Toller St. Albaus, England
SWITZERLAND AND Erik P. Steinmann Hans Miihlemann Raoul H. Boitel Ziirich, Switzerland
FRANCE AND BELGIUM Jacques Lhlgnac Paris, France
JUNE,
GERMANY
1954
Abstracts of Current ORAL Practical Considerations in the Management J. A. M. A. 152: 297, May, 1953.
Literature SURUERY of Malignant
Bone Tumors.
-II.
R. McCarroll.
It should consist of adequate biopsy, including Pathologic diagnosis is essential. part of the periovteum and any soft tiesue involvement. A classification of bone tumors suitable for practical we is presented below: “ 1. Derived from cartilage: chondrosarcoma. “2. Derived from bone: osteosarcoma. “3. Derived from connective tissue: a. Fibrosarcoma. b. Malignant giant cell tumors. 680
ABSTRACTS
OF CTJRRENT LITERATURE
“4.
Derived from mesenchmal connective thelial system : Ewing sarcoma. “5. Derived from the hematopoetic tissue: a. Multiple myeloma. b. Reticulum cell sarcoma. c. The leukemias. tl. Hodgkin’s disease. ’ ’ Treatment and prognosis are discussed.
TUMORS
tissue,
OF THE
Considerations
About Hard and Dentified Rev. de stomatol. 53: 885, 1953.
or possibly
681 from
the retieuloendit
T. 3. ((.
JAWS
Adamantinoma.
M. Dechaume and B. Xerebef.
A child born in 1942 was operated upon in 1948 for a tumor of the mandible, which had developed progressively and without symptoms. Second and third operations were done in 1950. When seen by the authors in July, 1951, the face of the child, who was in good general condition, was deformed by a mass, the size of a walnut, located at the posterior part of the left horizontal ramus of the mandible. The skin was normal. There were no sensory disturbance and no adenopathy. The intraoral examination revealed an ulceration which circumscribed a hard mass of a gray appearance, suggesting tooth substance rather than bone. It was firmly attached to the jaw. The two lower premolars were missing. The x-ray examination was conclusive. Lateral views showed a mass of irregular outline and density with shadows suggestive of dental roots. The mass was limited by the lower border of the mandible, the first molar, and the tooth bud of the first premolar. An operation was performed in July, 1951. The outer plate was removed to expose the hard mass which was broken into pieces with bone-cutting forceps and removed one piece after another. Conclusion All tumors of that type have not always an identical embryology and are not always Some originate from the outer layer of bearing the same relation to the dental system. the epithelial sheath of the tooth, the formation of which is disturbed. They might 1)~ classified as dysorganoplasias. Some are the result of an abnormal proliferation of a tooth bud. Some are probably due to aberrant epithelial cells. Microscopic examination of the excised tissue showed that all the tissues of the tooth The dentine structure was dystrophic, disturbed were present. The enamel was normal. The pulp tissue and the cementum were with lacunae, “ calcospherites, ’ ’ and dead tracts. normal. The presence of enamel is not as rare as is usually believed. If the dysembryoplasia affects the tissues before they differentiate, the tumor has higher potentialities and may develop into a mono or polycystic type of adamantinoma ol’ affects tissues at the even an ” adamantine epithelioma. ’ ’ But if the dysembryoplasia time of adamantinogenesis, a tumor consisting of enamel, dentine, and, later on, cerneut results. The treatment of cases like the one reported is surgical and, in cases in which it is feared that a fracture of the mandible may occur during removal, a splint should he con.T. I,. structed before surgery.
RESEARCH The Composition The Dental
and Structure Journal
of Human
of Australia
Dental Enamel. 25: 83-95,1953.
H. R. Sullivan,
D.D.Sc. (Syd.).
SUMMARY “There permeability
are still many points to be clarified concerning the structure, composition and of enamel. It would seem to be true to ssy that it is a highly inorganic