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Use of molecular diagnostics to distinguish glandular odontogenic cyst and mucoepidermoid carcinoma
Int. J. Oral Maxillofac. Surg. 2015; 44S: e183–e317 available online at http://www.sciencedirect.com
E-Poster Presentation Use of molecular diagnostics to distinguish glandular odontogenic cyst and mucoepidermoid carcinoma A. Abdullakutty 1,∗ , A.W. Barrett 1 , D.M. Coombes 1 , B.S. Bisase 1 , M. Faulkner 1 , A. Skálová 2 1
Queen Victoria Hospital, East Grinstead, UK Department of Pathology, Charles University, Faculty of Medicine Plzen, Czech Republic
2
Glandular odontogenic cyst (sialo-odontogenic cyst) is an uncommon developmental odontogenic cyst, the clinical significance of which lies in its tendency to recur, and histopathological features which mimic those of mucoepidermoid carcinoma. This report describes three cystic lesions of the jaws with similar histopathological features. One occurred in the mandibular premolar area of a 49-year-old woman and was diagnosed as glandular odontogenic cyst. The second developed in the maxilla of a man aged 39 in association with an impacted second premolar tooth. This was initially diagnosed as dentigerous cyst, but after recurrence six years later the diagnosis was revised to glandular odontogenic cyst. The third occurred in a 30-year-old woman five years after the extraction of a mandibular third molar in the same site as the lesion; a diagnosis of glandular odontogenic cyst was initially favoured, but a third biopsy (taken over a year later) showed unequivocal, invasive mucoepidermoid carcinoma which had infiltrated nerves and bone. Glandular odontogenic cyst and mucoepidermoid carcinoma may be inseparable on the basis of histopathological features, but the presence of a rearrangement of the MAML2 gene, as detected by FISH, distinguishes the two and offers the potential for prompt diagnosis and appropriate treatment. http://dx.doi.org/10.1016/j.ijom.2015.08.002 Unusual case of medication related osteonecrosis (MRONJ): pathological fracture of coronoid process A. Abdullakutty 1,∗ , A. Jowett 2 , B. Bailey 2 1 2
Queen Victoria Hospital, East Grinstead, UK Royal Surrey County Hospital, Guildford, UK
There are increasing numbers of cases of bisphosphonate related osteonecrosis of bones within the head and neck, and in rare circumstances this has led to pathological fracture of bones such as the maxilla and mandible. We report the first case to our knowledge of pathological fracture of the coronoid process of the mandible resulting from long term use of alendronic acid. 0901-5027/000183+317 $36.00/0
The patient presented with increasing trismus and some swelling over the right mandible. Radiographic examination revealed extensive area of necrosis at the right body and ramus of the mandible spreading to involve the right coronoid process with pathological fracture. This demonstrates the unpredictable nature of medication related osteonecrosis and how the disease can progress rapidly to cause significant morbidity. This case illustrates the extent of the damage that can be caused when straightforward dental procedures are carried out on patients taking oral bisphosphonates. It seems a matter of great importance that guidelines are published on the dental treatment of patients taking bisphosphonates, and that further information regarding the possible consequences of bisphosphonate use is given to General Medical Practitioners. http://dx.doi.org/10.1016/j.ijom.2015.08.003 A Prognostic Nutritional Index for patients with end-stage oral cancer A. Abe 1,∗ , Y. Ito 1 , T. Ito 1 , S. Kunii 1 , M. Takemoto 1 , Y. Katayama 2 , M. Adachi 3 1
Department of Oral and Maxillofacial Surgery, Nagoya Ekisai Hospital, Nagoya, Japan 2 Department of Oral and Maxillofacial Surgery, Sakura General Hospital, Komaki, Japan 3 Department of Oral and Maxillofacial Surgery, Shizuoka General Hospital, Shizuoka, Japan Background: Estimation of the prognosis of the patients with end-stage oral cancer is important. However, clinicians do not estimate survival time accurately. The Prognostic Nutritional Index (PNI) is calculated based on objective factors by using the formula PNI = [serum albumin level × 10] + [0.005 × total peripheral lymphocyte count]. We reviewed the usefulness of PNI as a predictor of prognosis in patients with end-stage oral cancer. Methods: We retrospectively evaluated primary disease, follow-up duration, and change in PNI value in 15 patients who died of oral cancer between 2005 and 2014. Results: The mean follow-up period was 133 days. The PNI values were 38.5, 36.5, 27.2, and 24.8 at 3 months, 2 months, 1 months and 1 week before death, showing a gradual decrease over time. Conclusions: When oral cancer patients enter the end stage of the disease, they lose their mastication and deglutition functions, and their dietary intake decreases. This affects their nutritional status, rapidly worsening their overall status, which eventually
E-Poster Presentation Use of molecular diagnostics to distinguish glandular odontogenic cyst and mucoepidermoid carcinoma A. Abdullakutty 1,∗ , A.W. Barrett 1 , D.M. Coombes 1 , B.S. Bisase 1 , M. Faulkner 1 , A. Skálová 2 1
Queen Victoria Hospital, East Grinstead, UK Department of Pathology, Charles University, Faculty of Medicine Plzen, Czech Republic
2
Glandular odontogenic cyst (sialo-odontogenic cyst) is an uncommon developmental odontogenic cyst, the clinical significance of which lies in its tendency to recur, and histopathological features which mimic those of mucoepidermoid carcinoma. This report describes three cystic lesions of the jaws with similar histopathological features. One occurred in the mandibular premolar area of a 49-year-old woman and was diagnosed as glandular odontogenic cyst. The second developed in the maxilla of a man aged 39 in association with an impacted second premolar tooth. This was initially diagnosed as dentigerous cyst, but after recurrence six years later the diagnosis was revised to glandular odontogenic cyst. The third occurred in a 30-year-old woman five years after the extraction of a mandibular third molar in the same site as the lesion; a diagnosis of glandular odontogenic cyst was initially favoured, but a third biopsy (taken over a year later) showed unequivocal, invasive mucoepidermoid carcinoma which had infiltrated nerves and bone. Glandular odontogenic cyst and mucoepidermoid carcinoma may be inseparable on the basis of histopathological features, but the presence of a rearrangement of the MAML2 gene, as detected by FISH, distinguishes the two and offers the potential for prompt diagnosis and appropriate treatment. http://dx.doi.org/10.1016/j.ijom.2015.08.002 Unusual case of medication related osteonecrosis (MRONJ): pathological fracture of coronoid process A. Abdullakutty 1,∗ , A. Jowett 2 , B. Bailey 2 1 2
Queen Victoria Hospital, East Grinstead, UK Royal Surrey County Hospital, Guildford, UK
There are increasing numbers of cases of bisphosphonate related osteonecrosis of bones within the head and neck, and in rare circumstances this has led to pathological fracture of bones such as the maxilla and mandible. We report the first case to our knowledge of pathological fracture of the coronoid process of the mandible resulting from long term use of alendronic acid. 0901-5027/000183+317 $36.00/0
The patient presented with increasing trismus and some swelling over the right mandible. Radiographic examination revealed extensive area of necrosis at the right body and ramus of the mandible spreading to involve the right coronoid process with pathological fracture. This demonstrates the unpredictable nature of medication related osteonecrosis and how the disease can progress rapidly to cause significant morbidity. This case illustrates the extent of the damage that can be caused when straightforward dental procedures are carried out on patients taking oral bisphosphonates. It seems a matter of great importance that guidelines are published on the dental treatment of patients taking bisphosphonates, and that further information regarding the possible consequences of bisphosphonate use is given to General Medical Practitioners. http://dx.doi.org/10.1016/j.ijom.2015.08.003 A Prognostic Nutritional Index for patients with end-stage oral cancer A. Abe 1,∗ , Y. Ito 1 , T. Ito 1 , S. Kunii 1 , M. Takemoto 1 , Y. Katayama 2 , M. Adachi 3 1
Department of Oral and Maxillofacial Surgery, Nagoya Ekisai Hospital, Nagoya, Japan 2 Department of Oral and Maxillofacial Surgery, Sakura General Hospital, Komaki, Japan 3 Department of Oral and Maxillofacial Surgery, Shizuoka General Hospital, Shizuoka, Japan Background: Estimation of the prognosis of the patients with end-stage oral cancer is important. However, clinicians do not estimate survival time accurately. The Prognostic Nutritional Index (PNI) is calculated based on objective factors by using the formula PNI = [serum albumin level × 10] + [0.005 × total peripheral lymphocyte count]. We reviewed the usefulness of PNI as a predictor of prognosis in patients with end-stage oral cancer. Methods: We retrospectively evaluated primary disease, follow-up duration, and change in PNI value in 15 patients who died of oral cancer between 2005 and 2014. Results: The mean follow-up period was 133 days. The PNI values were 38.5, 36.5, 27.2, and 24.8 at 3 months, 2 months, 1 months and 1 week before death, showing a gradual decrease over time. Conclusions: When oral cancer patients enter the end stage of the disease, they lose their mastication and deglutition functions, and their dietary intake decreases. This affects their nutritional status, rapidly worsening their overall status, which eventually