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Update of odontogenic tumors
S18
Pathology (2014), 46(S2)
PATHOLOGY 2014 ABSTRACT SUPPLEMENT
Laboratory techniques including microsatellite analysis, flow cytometry, in situ hybridization, sequencing, comparative genomic hybridization, and imprinting gene studies have been applied. Vast majority of complete moles are diploid and purely androgenic while most partial moles are triploid having excessive paternal genome with maternal contribution. Adjunct techniques, such as p57kip2 immunohistochemistry as well as ploidy and microsatellite analysis, have become more commonly applied to facilitate diagnosis of GTD. Molecular cytogenetic studies are also useful in distinguishing gestational and non-gestational trophoblastic choriocarcinoma with implication on chemotherapy regimes. However, we should understand clearly the diagnostic pattern and limitation of such tests to avoid misinterpretation. The basic prerequisite of processing adequate or all evacuated material for histopathological evaluation as well as correlation with clinical, radiological and biochemical findings remains the most important diagnostic approach.
for last 10 years but our knowledge of odontogenic tumors continues to evolve. At biennial meetings of International Association of Oral and Maxillofacial pathologists (IAOP), we have started discussions on classification of odontogenic tumors toward the next WHO Classification. I would like to introduce some subjects of discussion including cyst-tumor interface (odontogenic keratocyst vs keratocystic odontogenic tumor, glandular odontogenic cyst vs central mucoepidermoid carcinoma, calcifying odontogenic cyst vs ghost cell lesions); placement of adenomatoid odontogenic tumor (hamartoma vs neoplasia, epithelial tumor vs mixed tumor with dentin formation), clear cell odontogenic carcinoma with dentinoid formation; primary intraosseous squamous cell carcinoma vs sclerosing odontogenic carcinoma; classification based on inductive phenomenon of odontogenesis vs clinical behavior and others. Recent advances in molecular analyses of odontogenic tumors will be presented. I expect to exchange opinions on the new classification of odontogenic tumors.
Head and Neck Pathology: SS13-1 Head and Neck Pathology: LC24-1 AMELOBLASTIC FIBROSARCOMA OF MANDIBLE MOLECULAR DIAGNOSTICS OF HEAD AND NECK TUMORS Alfred King-Yin Lam Griffith Health Institute, Griffith University and Gold Coast University Hospital, Gold Coast, Qld, Australia Research has elucidated the detailed molecular mechanisms of carcinogenesis, tumour progression, and metastasis in different head and neck tumours in the recent decade. These advances have great impacts on pathology practices in areas including oral and head/neck squamous cell carcinoma, papillary thyroid carcinoma, head and neck paraganglioma and salivary gland tumours. (1) In oral and head/neck squamous cell carcinoma, human papilloma virus is an important independent prognostic variable and predictive factor for responsiveness to treatment. The presence of the virus is best reflected by immunohistochemical staining of p16. (2) In papillary thyroid carcinoma, presence of BRAF mutation is predictive of aggressive biological behaviour and could be useful for the diagnosis of papillary thyroid carcinoma. (3) For head/neck paragangliomas, the clinical impact in pathology is the role of pathologist in the detection of SDHB by immunohistochemistry in paraganglioma as SDHB mutations are correlated with presence of metastasis and poor prognosis. (4) In salivary gland tumours, chromosomal translocations as detected by FISH, are useful for diagnosis of tumours like hyalinising clear cell carcinoma and mammary analog secretory carcinoma. In conclusion, awareness of new advances in molecular pathology is essential for proper management of patients with head and neck tumours.
Beverly Y. Wang Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, New York, USA Ameloblastic fibrosarcoma (AFS) of odontogenic origin involving mandible is very rare, which is the malignant counterpart of ameloblastic fibroma with fibrosarcomatous differentiation in mesenchymal stroma admixed with benign ameloblastic epithelium. A 27-year-old white male presented with a rapidly expanding radiolucent mandibular body mass. Extraoral examination revealed a large firm swelling in the region of the left mandibular body. No associated lymphadenopathy or sensory/ motor neurological impairment. Mandibular function and range of motion were normal. Intraoral examination revealed buccal expansion in the body of the left mandible with normal overlying mucosa. There was no abnormal mobility or displacement of the associated dentition. Radiograph demonstrated a radiolucent, multi-locular lesion with ill defined borders. CT scan displayed a bulky, erosive and enhancing lesion of the body and ramus of the mandible. Biopsy was performed and was diagnosed as AFS. The patient was successfully treated with a composite resection of the affected mandible and immediate fibular free flap reconstruction. This case review provides detailed pathological diagnostic features and differentials. Aggressive treatment of AFS, including resection with negative margins is the treatment of choice.
Head and Neck Pathology: SY13-1 HOW TO HANDLE LARYNGEAL SPECIMENS?
Head and Neck Pathology: SC13-1 UPDATE OF ODONTOGENIC TUMORS Takashi Takata Department of Oral and Maxillofacial Pathobiology, Institute of Biomedical and Health Sciences, Hiroshima University, Japan The latest WHO classification of odontogenic tumours was published in 2005. The classification has been used as a global standard
Pieter J. Slootweg Department of Pathology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands Laryngohypopharyngectomies encompass the larynx with a dorsal covering of the mucosa of the hypopharynx subdivided in left and right piriform sinus and the median postcricoid area. Cranially, the specimen may include parts of the base of the tongue and caudally a varying number of tracheal rings.
Copyright © Royal College of pathologists of Australasia. Unauthorized reproduction of this article is prohibited.
Pathology (2014), 46(S2)
PATHOLOGY 2014 ABSTRACT SUPPLEMENT
Laboratory techniques including microsatellite analysis, flow cytometry, in situ hybridization, sequencing, comparative genomic hybridization, and imprinting gene studies have been applied. Vast majority of complete moles are diploid and purely androgenic while most partial moles are triploid having excessive paternal genome with maternal contribution. Adjunct techniques, such as p57kip2 immunohistochemistry as well as ploidy and microsatellite analysis, have become more commonly applied to facilitate diagnosis of GTD. Molecular cytogenetic studies are also useful in distinguishing gestational and non-gestational trophoblastic choriocarcinoma with implication on chemotherapy regimes. However, we should understand clearly the diagnostic pattern and limitation of such tests to avoid misinterpretation. The basic prerequisite of processing adequate or all evacuated material for histopathological evaluation as well as correlation with clinical, radiological and biochemical findings remains the most important diagnostic approach.
for last 10 years but our knowledge of odontogenic tumors continues to evolve. At biennial meetings of International Association of Oral and Maxillofacial pathologists (IAOP), we have started discussions on classification of odontogenic tumors toward the next WHO Classification. I would like to introduce some subjects of discussion including cyst-tumor interface (odontogenic keratocyst vs keratocystic odontogenic tumor, glandular odontogenic cyst vs central mucoepidermoid carcinoma, calcifying odontogenic cyst vs ghost cell lesions); placement of adenomatoid odontogenic tumor (hamartoma vs neoplasia, epithelial tumor vs mixed tumor with dentin formation), clear cell odontogenic carcinoma with dentinoid formation; primary intraosseous squamous cell carcinoma vs sclerosing odontogenic carcinoma; classification based on inductive phenomenon of odontogenesis vs clinical behavior and others. Recent advances in molecular analyses of odontogenic tumors will be presented. I expect to exchange opinions on the new classification of odontogenic tumors.
Head and Neck Pathology: SS13-1 Head and Neck Pathology: LC24-1 AMELOBLASTIC FIBROSARCOMA OF MANDIBLE MOLECULAR DIAGNOSTICS OF HEAD AND NECK TUMORS Alfred King-Yin Lam Griffith Health Institute, Griffith University and Gold Coast University Hospital, Gold Coast, Qld, Australia Research has elucidated the detailed molecular mechanisms of carcinogenesis, tumour progression, and metastasis in different head and neck tumours in the recent decade. These advances have great impacts on pathology practices in areas including oral and head/neck squamous cell carcinoma, papillary thyroid carcinoma, head and neck paraganglioma and salivary gland tumours. (1) In oral and head/neck squamous cell carcinoma, human papilloma virus is an important independent prognostic variable and predictive factor for responsiveness to treatment. The presence of the virus is best reflected by immunohistochemical staining of p16. (2) In papillary thyroid carcinoma, presence of BRAF mutation is predictive of aggressive biological behaviour and could be useful for the diagnosis of papillary thyroid carcinoma. (3) For head/neck paragangliomas, the clinical impact in pathology is the role of pathologist in the detection of SDHB by immunohistochemistry in paraganglioma as SDHB mutations are correlated with presence of metastasis and poor prognosis. (4) In salivary gland tumours, chromosomal translocations as detected by FISH, are useful for diagnosis of tumours like hyalinising clear cell carcinoma and mammary analog secretory carcinoma. In conclusion, awareness of new advances in molecular pathology is essential for proper management of patients with head and neck tumours.
Beverly Y. Wang Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, New York, USA Ameloblastic fibrosarcoma (AFS) of odontogenic origin involving mandible is very rare, which is the malignant counterpart of ameloblastic fibroma with fibrosarcomatous differentiation in mesenchymal stroma admixed with benign ameloblastic epithelium. A 27-year-old white male presented with a rapidly expanding radiolucent mandibular body mass. Extraoral examination revealed a large firm swelling in the region of the left mandibular body. No associated lymphadenopathy or sensory/ motor neurological impairment. Mandibular function and range of motion were normal. Intraoral examination revealed buccal expansion in the body of the left mandible with normal overlying mucosa. There was no abnormal mobility or displacement of the associated dentition. Radiograph demonstrated a radiolucent, multi-locular lesion with ill defined borders. CT scan displayed a bulky, erosive and enhancing lesion of the body and ramus of the mandible. Biopsy was performed and was diagnosed as AFS. The patient was successfully treated with a composite resection of the affected mandible and immediate fibular free flap reconstruction. This case review provides detailed pathological diagnostic features and differentials. Aggressive treatment of AFS, including resection with negative margins is the treatment of choice.
Head and Neck Pathology: SY13-1 HOW TO HANDLE LARYNGEAL SPECIMENS?
Head and Neck Pathology: SC13-1 UPDATE OF ODONTOGENIC TUMORS Takashi Takata Department of Oral and Maxillofacial Pathobiology, Institute of Biomedical and Health Sciences, Hiroshima University, Japan The latest WHO classification of odontogenic tumours was published in 2005. The classification has been used as a global standard
Pieter J. Slootweg Department of Pathology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands Laryngohypopharyngectomies encompass the larynx with a dorsal covering of the mucosa of the hypopharynx subdivided in left and right piriform sinus and the median postcricoid area. Cranially, the specimen may include parts of the base of the tongue and caudally a varying number of tracheal rings.
Copyright © Royal College of pathologists of Australasia. Unauthorized reproduction of this article is prohibited.