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Osteoblastoma is a benign neoplasm which commonly occurs in the vertebral column and long bones. The tumour grows slowly and rarely recurs after surgery. This report presents the clinicopathological and radiological findings of a case of recurrent osteoblastoma in the maxilla. A 7-year-old male patient visited our department with chief complaints of left facial swelling and pain. A panoramic radiograph showed a homogeneous radio-opaque expansile lesion in the left maxilla. The lesion was thought to be fibrous dysplasia and the patient underwent a surgical excision using the Caldwell-Luc procedure. Histopathological examination of the lesion confirmed it as benign osteoblastoma. The lesion recurred 6 months after the initial surgery. CT images revealed a large mass with multiple internal calcifications. Subsequently, the patient underwent mass excision with subtotal left maxillectomy. Follow-up CT scans at 1 year intervals showed no recurrence for 5 years. [ABSTRACT FROM AUTHOR]

Osteosarcoma (OS) is a malignant mesenchymal tumor, which rarely occurs in the maxilla. Although variable histologic and radiographic features of OS have been reported previously, in the majority of the cases painful swelling of the jaw is mentioned as the first clinical presentation. Furthermore, early diagnosis and wide surgical resection of the tumor are the most important determinant factors of prognosis. Therefore, the unusual clinical presentations of OS should be considered meticulously to expedite the diagnosis process. We describe a case of OS of the maxilla with extremely unusual presentation in a 42-year-old female, that was initially designated as "epulis fissuratum". Here, we highlight the importance of combining the clinical, radiographic and histopathologic examination to obtain a definitive diagnosis and also the significance of early effective surgical intervention in evaluation of pathologic lesions. [ABSTRACT FROM AUTHOR]

The article offers step-by-step instructions for performing the bilateral rostral maxillectomy in a dog.

Desmoplastic ameloblastoma (DA) is a newly recognised, rare odontogenic neoplasm that is a histological variant of ameloblastoma. In this type, the islands of ameloblastoma are surrounded and often compressed by a dense and sometimes hyalinised fibrous connective tissue. Although ameloblastomas are usually located in the mandible, this variant often occurs in the anterior maxilla. In view of the paucity of DA case series and only limited understanding of its biological behaviour and prognosis, proper treatment strategies for DA are not entirely defined so far. The purpose of this paper was to review the literature and to demonstrate a rare case for an improved understanding of the behaviour and prognosis of DA. [ABSTRACT FROM AUTHOR]

Desmoplastic ameloblastoma (DA) is a relatively rare histological variant of ameloblastoma with specific clinical, radiological, and histological features. This tumor is more commonly seen in the anterior region of jaws as a mixed radiopaque-radiolucent lesion resembling benign fibro-osseous lesions. Histologically, DA is characterized by small nests and strands of "compressed" odontogenic epithelium supported by pronounced collagenized stroma. Metaplastic bone formation has been reported in few cases. This report describes a lesion in the left anterior maxilla of a young female patient. [ABSTRACT FROM AUTHOR]

We report a case of recurrent chondrosarcoma of the maxilla in a 29 yr old male patient. The lesion presented as a small diffuse swelling on the left maxillary anterior region which had progressed over a period of one year. On aspiration, a chondromyxoid matrix was noted with cells arranged singly or in groups. Bi and tri-nucleation was noted with a moderate degree of nuclear pleomorphism. A diagnosis of well differentiated chondrosarcoma was made which was confirmed on histopathology. The clinicopathological findings of this case and a review of chondrosarcoma is presented and discussed. [ABSTRACT FROM AUTHOR]

An Aneurysmal bone cyst (ABC) is a rare benign lesion seen as a locally destructive, rapidly expansile, mostly affecting long bones and vertebrae. The association of ABC with Cemento-ossifying fibroma (COF) is extremely rare with only few cases reported so far in maxilla. We are herewith reporting one such case of hybrid lesion in a 15-year old boy, who came with a solitary swelling of right maxilla and showing partial obliteration of buccal vestibular sulcus and paraesthesia over right cheek region. Coronal Computed tomography (CT) of Para nasal sinus (PNS) view revealed large expansile lesion with thinning of cortex in right maxillary sinus involving hard palate and right alveolar process. Histological features were confirmative of the diagnosis of Aneurysmal Bone Cyst of Maxilla secondary to Cemento-ossifying fibroma. Treatment consisted of the enucleation of the lesion with surgical curettage through an intraoral approach under general anaesthesia. [ABSTRACT FROM AUTHOR]

We report a case of recurrent Pindborg tumor (calcifying epithelial odontogenic tumor) of the maxilla. The patient was a 34-year-old woman who had been previously diagnosed with Pindborg tumor and treated with curettage. She was subsequently referred to us for evaluation of nasal obstruction. Examination revealed the presence of a mass lesion in the right nasal cavity and right maxilla, which was identified as a recurrence of her earlier Pindborg tumor. The patient was treated with maxillectomy with orbital preservation. Pindborg tumor is a rare odontogenic tumor; when it does occur, it is more often seen in the mandible than in the maxilla. While this tumor is often treated with curettage alone, the aggressive nature of the recurrence in our patient necessitated radical surgery. We report this case to highlight the need to be suitably aggressive in treating these types of tumors in order to avoid recurrence. [ABSTRACT FROM AUTHOR]

Mucoepidermoid carcinoma generally arises from salivary glands, representing 5 to 10% of all salivary tumors. It is rarely seen in the jaws. The purpose of this paper was to report the case of a large mucoepidermoid carcinoma arising in the maxilla of a 15-year-old. [ABSTRACT FROM AUTHOR]

Background: Primary intraosseous squamous cell carcinoma is a rare jaw bone tumor defined as squamous cell carcinoma arising within the jaw, having no initial connection with the oral mucosa and developing from residual odontogenic epithelium or from an odontogenic cyst or tumor. Solid type of this tumor arising in the maxilla is an even rarer presentation, because the majorities derive from cystic lesions and are found in the posterior mandible. Case presentation: A 36-year-old Japanese man was referred to our clinic with a complaint of pain around the anterior maxillary region on the right side. Intraoral examination identified a firm, nonfluctuant mass with no ulceration in the vestibular region of teeth #11-13. Incisional biopsy was performed, leading to histological diagnosis of moderately differentiated squamous cell carcinoma. Contrast-enhanced computed tomography revealed a destructive tumor with no cystic lesion, >50 mm in diameter. There was no evidence of metastatic disease on chest radiography, upper gastric endoscopy or positron emission tomography. Based on these findings, solid type primary intraosseous squamous cell carcinoma was diagnosed. The patient underwent tumor ablative surgery. The surgical defect was reconstructed using a partially double-folded free radial forearm flap and prefabricated denture-based surgical obturator. The postoperative course was quite good. Neither recurrence nor metastasis had been found as of 3 years and 1 month postoperatively. Conclusion: To the best of our knowledge, the present case represents only the 10th case of solid type primary intraosseous squamous cell carcinoma arising in the maxilla to be reported. [ABSTRACT FROM AUTHOR]

Inflammatorymyofibroblastic tumor (IMT) is a rare lesion found mostly in children and young adults and originates fromthe lung, abdominopelvic region, and retroperitoneum. Clinical manifestations of IMT or imaging are nonspecific and diagnosis is based on histopathological and immunohistochemical findings. Minority of all IMTs will metastasize. IMT in the oral cavity is an extreme rarity and this is a first case report of IMT in maxilla causing delayed tooth eruption andmultiple cervical root resorptionwith an 11- year-old child. The IMT reported here was positive for smoothmuscle actin, vimentin, and anaplastic lymphoma kinase (ALK1)with immunohistochemistry. Only three IMTs of the jaws have been reported so far and none of them had delayed root eruption and tooth resorption. This unusual case ofIMTin a child was alsoALK1- positive supporting neoplastic origin of her tumor. The case presented here underscores the importance of histopathological examination of the tissue found in any root resorption especially in the case of multiple resorptions. [ABSTRACT FROM AUTHOR]

After surgical resection of the tumours in the region of maxilla the formation of defects creates many problems for the patients. Defects in the maxillofacial region affect physical, psychological and social status of the patient. As surgery for such conditions is often radical, the prosthodontist is faced not only with the prosthodontic problems which are involved, but also the psychological problem of the patient's rehabilitation. In general, there is reduced capacity for residual teeth and tissue to provide optimal cross arch support, stability and retention. The design must take into account the tooth-tissue support considerations and the impact of the altered environment on prosthesis support, stability and retention. The characterization of the prosthesis plays an important role to improve the aesthetics of the prosthesis and to give the prosthesis a more lifelike appearance. This case report describes a technique for fabrication of a frame designed definitive cast partial obturator prosthesis by doing characterization for a life like appearance of the prosthesis for a maxillectomy patient. [ABSTRACT FROM AUTHOR]

Keratocystic odontogenic tumours are known for their peculiar behaviour, varied origin, debated development, unique tendency to recur and disputed treatment modalities. Thus, it has been the subject of much research over the last 40 years. It was formerly known as odontogenic keratocyst (OKC). OKC received its new title as keratocystic odontogenic tumour (KCOT) by the WHO (2005) in order to suggest its aggressive and recurrent nature. KCOT is a benign intraosseous neoplasm of the jaw. Involvement of the maxillary sinus is an unusual presentation. We present the case of an 11-year-old child with extensive KCOT and an impacted canine in the right maxillary sinus. The cyst was initially misdiagnosed to be a dentigerous cyst based on the clinical and radiographic features though a differential diagnosis of KCOT and adenomatoid odontogenic tumour was made. The histological examination of the specimen finally confirmed it to be a KCOT. The clinical, radiological and histological features of this tumour along with its surgical management have been discussed. [ABSTRACT FROM AUTHOR]

Ameloblastoma is a benign neoplasm of epitelial odontogenic origin, slowly growing, locally invasive and it is the most common odontogenic tumor in the Jaws. The purpose of the present study was to report a ameloblastoma case which is rare location, emphasing the clinic,operation and histopathological aspects that are relevant for the diagnosis and treatment of this pathology. This case was seen in a male child who was seven years old. Some diagnostic methods such as introoral and external examinations, radiographic and CT imaging systems were used to diagnose this case. The lesion in the case was removed totally with inside and outside maxiller sinus. It was determined a mass which is exopyhitic and sesil implantation and was measured as 2.5 cm. No complication was observed during and after surgery. This case was diagnosed as ameloblastoma after histopathological examination. The patient was monitored during 48 months after surgery and no signs were observed in relation to recurrence during monitoring. [ABSTRACT FROM AUTHOR]

Aim: Anatomical gingival fibromatosis is an uncommon process involving the palatal gingival and maxillary tuberosity generally in a bilateral and symmetrical manner. Treatment varies from basic periodontal care to surgical removal when the condition causes difficulties with oral hygiene, is associated with secondary periodontal diseases or interferes with prosthesis stability. The authors present a plastic reduction technique modified for tooth-bearing areas and discuss its application. Material and methods: The proposed technique was accomplished in three patients presenting with anatomical gingival fibromatosis. Surgery consisted of a three-step technique that aimed at the reduction of the fibromatosis and the reconstruction of the palatal gingiva. Results: None of the patients present post-operative complications during a follow-up period that varied from 6 to 12 months. After surgery all patients improved their ability to provide proper hygiene for the affected area as well as their periodontal condition. Conclusions: The present surgical technique is a treatment option with a good result while maintaining periodontal health. [ABSTRACT FROM AUTHOR]

Plasma cell neoplasia is a lymphoid neoplastic proliferation of B cells and has been classified as multiple myeloma, solitary plasmacytoma, and extramedullary plasmacytoma. Extramedullary plasmacytoma is defined as neoplastic proliferation of plasma cells in the soft tissue. Extramedullary plasmacytoma of the head and neck is very uncommon tumors, representing approximately 0.4% of all head and neck malignancies; amongst them, plasmacytoma of the maxilla is extremely rare. We present a case of a 70-year-old male with swelling on the right middle third of the face, mimicking an abscess, but proven to be extramedullary plasmacytoma. This report discusses the clinical, radiographic, histological, and immunohistochemical features of extramedullary plasmacytoma. [ABSTRACT FROM AUTHOR]

Abstract: The melanotic neuroectodermal tumour of infancy (MNTI) is an uncommon, usually benign neoplasm which is most commonly found in the maxilla. We describe the case of a 6-month-old boy who was referred with a swiftly increasing swelling of the left cheek. After imaging and biopsy, MNTI was confirmed, and surgical resection was performed. Literature demonstrates that most MNTIs occur in the head and neck area and most of those occur in the maxilla. Although most cases are benign, 6.5% are malignant with metastatic disease. Treatment and outcome are discussed in detail. The case highlights the importance of making the diagnosis MNTI early on in order to achieve an optimal outcome. [Copyright &y& Elsevier]

Pindborg tumor, the eponymous counterpart of calcifying epithelial odontogenic tumor (CEOT), is a rare benign odontogenic neoplasm that was first described by a Dutch pathologist Jens Jorgen Pindborg in 1955 and accounts for approximately 1% of all odontogenic tumors. Its origin as well as its malignant potential is controversial. This neoplasm is possibly of stratum intermedium origin and occurring predominantly in the mandible of adults. We hereby report a case of Pindborg tumor arising in the premaxilla which is seldom (9 out of 200 cases) documented in the scientific literature. [ABSTRACT FROM AUTHOR]

Brief Background Tumours arising in the region of the maxilla are currently treated surgically with or without radiotherapy. It leads to defects in the maxillofacial region affecting physical, psychological and social status of the patient. This case report describes a technique for fabrication of a frame designed definitive cast partial hollow bulb obturator prosthesis for successful rehabilitation of a maxillectomy patient. Materials and Methods Defects in the maxillofacial region affect physical, psychological and social status of the patient. As surgery for such conditions is often radical, the prosthodontist is faced not only with the prosthodontic problems which are involved, but also the psychological problem of the patient's rehabilitation. Discussion The design of the cast partial framework plays an important role in the retention and stability of the prosthesis. As the maxillary portion has been resected the design of the major connector is the important factor for stability of the prosthesis. Summary and Conclusions Prosthetic rehabilitation of the dentate maxillectomy patient is a lengthy and time involved process. A well-planned prosthetic treatment will result in satisfactory function and esthetics, alleviating deformities. [ABSTRACT FROM AUTHOR]

Primary oral melanoma is a rare neoplasm of melanocytic origin, accounting for 0.5% of all oral malignancies. The "chameleonic" presentation of a mainly asymptomatic condition, rarity of this lesion, poor prognosis, and the necessity of a highly specialized treatment are factors that should be seriously considered by the involved health provider. Here is a case report presenting a malignant melanoma of oral mucosa in 48-year-old male patient on maxillary gingiva. The lesion was removed by partial maxillectomy and patient is disease free after 11 months of regular followup. This case provides an example of how dental clinicians play a major role in the identification of pigmented lesions of oral cavity and also emphasize on the fact that any pigmented lesion detected in the oral cavity may exhibit potential growth and should be submitted to biopsy to exclude malignancy. [ABSTRACT FROM AUTHOR]

Hemangiomatous ameloblastoma (HA), which is a rare ameloblastic variant, is presented in a 15-year-old boy in the maxillary right molar region associated with unerupted canine and premolars. Radiologic and computed tomographic analysis was suggestive of cystic lesion. An histology picture confirmed the diagnosis of HA. There are less than eight cases documented in the literature and mostly are in the middle age with mandibular location. This is first ever reported case of HA in a 15-year-old boy with maxillary location. Due to less number of documented cases and no long-term follow-ups, clinical behavior and prognosis of this lesion are uncertain. In this case report, the clinical, histological, and radiographic features of HA are presented. [ABSTRACT FROM AUTHOR]

Calcifying epithelial odontogenic tumor (CEOT) is a rare benign, but locally infiltrating odontogenic neoplasm. It accounts for less than 1% of all odontogenic tumors. This is a case report of recurrent CEOT in the maxilla. A 35-year-old patient reported after three years of surgical excision of the lesion, with a recurrence. It is of particular concern because of its anatomic location in the maxilla. Maxillary tumors tend to be more aggressive and rapidly spreading and may involve the surrounding vital structures. Adequate resection of the lesion with disease-free surgical margins and long-term follow-up is recommended. [ABSTRACT FROM AUTHOR]

Melanotic Neuroectodermal Tumor of Infancy (MNTI) is a rare neoplasm occurring in infants before one year of age. It is a neoplasm of fast growth that affects maxilla. In most of the cases it is benign. We reported two cases attended at the Instituto Nacional de Enfermedades Neoplásicas. The patients were two infants, of 4 and 7 months old, in the mandible and maxilla respectively. In both cases the treatment was surgical excision. The diagnosis is corroborated with Inmunohistochemestry markers, S-100, Sinaptofisin and Pankeratin. The evolution was favorable and both patients are alive. Kiru 2012;9(1): 65-70). [ABSTRACT FROM AUTHOR]

Fibrosarcoma is a malignant mesenchymal neoplasm of fibroblasts that rarely affects the oral cavity and can cause local recurrences or metastasis. Fibrosarcomas account for 15% of all soft tissue sarcomas, which represent only 1% of all malignant tumors of the head and neck region. The clinical behavior of the fibrosarcoma is characterized by a high local recurrence rate, and low incidence of loco regional lymph node and/or distant hematogenous metastasis. The etiology for fibrosarcoma has no definite cause but is thought to occur from preexisting lesions or in previously irradiated areas of bone lesions. Immunosuppression associated with HIV infection and acquired immune deficiency syndrome (AIDS) has been consistently linked to various cancers, including Kaposi's sarcoma, non-Hodgkin's lymphoma, and invasive cervical cancer. Rare neoplasms like Hodgkin's disease, anal cancer, leukemia, basal cell carcinoma, and squamous cell carcinoma have also been demonstrated. This paper presents one such a rare incidence of an intraosseous fibrosarcoma occurring in an HIV-positive patient. [ABSTRACT FROM AUTHOR]

Objective: To report the frequency of the types of maxillary tumours and the resulting post-surgical defects based on Aramany classification. Study design, duration and setting: This descriptive study was done during the period of 5 years (2005-11) at the Otorhinolaryngology & Head and Neck Surgery Unit, Khyber Teaching Hospital Peshawar. Methodology: A pre-structured proforma was used for data collection. Data recorded included patients' age, gender, type of maxillary tumour, type of maxillectomy and approach for resection, Post-surgical defect based on Aramany classification for acquired maxillary defects, neck dissection, radiotherapy, and prosthetic rehabilitation. Data were computed for descriptive statistics including frequencies, percentages and mean values. Results: Patients (n=53) had a male to female ratio of 1.7. Some 26.4% patients belonged to the age group of 31-40 years. Maxillectomy was done for inverted papilloma, a benign tumour in 1.9% patients as compared to malignant squamous cell carcinoma in 66% patients. Maxillary resection for fibrous dysplasia was done in 3.8% patients who were relatively younger. Maxillectomy in all cases was performed using Weber-Fergusson incision approach. Surgical resection resulted in Armanay class I defect in 73.58% patients. In 92.5% patients a surgical obturator was provided to patients at the time of maxillectomy. Conclusion: Maxillectomy was mainly performed for resecting malignant tumours using Weber-Fergusson incision with the fitting of immediate surgical obturator. The resulting defect was mainly Aramany Class I defects. [ABSTRACT FROM AUTHOR]

Conventional ameloblastomas are rare, benign, epithelial odontogenic tumors that tend to grow slowly in the mandible or maxilla, but are locally invasive and can be highly destructive of the surrounding dental anatomy. Aggressive resection is the most effective method of eliminating the tumors, but treatment can further contribute to patient deformity and malfunction. Ameloblastomas also have a high rate of recurrence, which significantly diminishes 8 years after resection, but still requires vigilant clinical monitoring. This case report describes the complete oral rehabilitation of a postresection ameloblastoma patient with a mandibular reconstruction plate and partial edentulism. An autogenous graft was taken from the patient's iliac crest, shaped to fit the defect, and attached with bone screws. After graft incorporation, dental implants were successfully placed into the augmented ridge and restored with a fixed partial denture. There was no evidence of tumor recurrence during the 10 months of treatment or 8 years of subsequent clinical monitoring. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The purpose of this study was to present our experience with definitive surgical management of infants with Melanotic neuroectodermal tumor of infant (MNTI) and epithelioid hemangioendothelioma (EHE). Patients and methods: This study included four male infants with histologically proven MNTI (three infants) and EHE (one infant). CT scan and MRI were for taken for the patients preoperatively. Surgical intervention was used in all infants. Results: This study is a retrospective study that reflects our experience in the last 20 years in maxillectomy in infants. All infants were male with mean age 6 months (2–9 months). Complete resection of the tumor was achieved all infants with no residual or recurrence. Neither chemotherapy nor radiation was used in this study. Conclusions: MNTI and EHE are rare tumor of infant. They present as a slow painless hard swelling of the maxilla. Imaging is an essential before surgical treatment. Complete excision is curative. [Copyright &y& Elsevier]

The article presents a case study of an 11-year-old girl who was evaluated by a maxillofacial and oral surgeon for an expansile lesion of the left posterior maxilla and a clinically absent left maxillary second molar. It says that histologic examination of the lesion showed mineralized dental hard tissue particularly enamel matrix, cementum, and dentin. It discusses ameloblastic fibro-odontoma, a rare odontogenic usually identified in a young person which can be treated with surgical excision.

Background. After resection of maxillofacial tumors, severe functional problems related to mastication, deglutition, and speech are observed in addition to the changes in appearance and psychosocial functioning. Although speech outcome is recovered with prosthetic treatments, patients sometimes complain of continued dissatisfaction with their speech. The purpose of this study was to evaluate the potential dissatisfaction of patients with maxillectomy defects during speech. Methods. Sixteen patients with maxillary obturator were compared with a matched control group. Functional improvement by the maxillofacial prosthesis was confirmed using a speech intelligibility test, a chewing function score, and visual analogue scale on subjective satisfaction. Cortisol and chromogranin A (CgA) were evaluated after prescribed speech tasks. Results. CgA in patients with maxillectomy defects was significantly higher than that in the control group (p < .05), even after the functional improvement by maxillofacial prosthesis. Conclusion. It was revealed that patients with maxillectomy defects have significant psychological stresses during speech, even when their maxillofacial prosthesis resulted in successful functional improvement. [ABSTRACT FROM AUTHOR]

Primary neoplasms of the skeleton are rare, accounting for 0.2% of overall human tumor burden. Osteosarcoma (OS) accounts for 15-35% of all primary bone tumors, while gnathic osteosarcomas (GOS) represent 4-8% of all osteosarcomas. GOS shows a predilection for men, a peak incidence of 33 years, and affects the mandible more than the maxilla. We review the scientiic literature for a better understanding of the clinical, radiographic, and histopathological features of GOS, along with its etiology, staging, treatment protocol, prognosis, and survival. Evidence from molecular research suggests that it is a differentiation disease that disrupts osteoblasts differentiation from mesenchymal stem cells. The classical radiographic finding of a "sunburst" appearance is appreciated only in 50% of GOS. The universally accepted staging system is not commonly used due to the rarity with which they metastasize to the regional lymph nodes. A number of distinct histopathological subtypes have been described, of which osteoblastic GOS are most common. The treatment protocol is multimodal consisting of preoperative chemotherapy followed by surgery and postoperative chemotherapy, and has a 60-70% five-year survival rate. We present two case reports of osteosarcoma involving the maxillary that were initially misdiagnosed as peripheral giant cell granuloma and osteoma of the maxilla, respectively. These case reports demonstrate the diverse clinical, radiographic, and histopathological features that can be encountered in GOS. [ABSTRACT FROM AUTHOR]

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Neurofibromatosis is one of the phakomatosis (neurodermatoses) which are genetically determined hamartomatous or neoplastic diseases of the skin and nervous system. It is not a single entity, but a group of heterogeneous multisystemic neurocutaneous disorders involving both neuroectodermal and mesenchymal derivatives. Plexiform neurofibroma, a histopathologic variant of neurofibroma, is a hallmark of neurofibromatosis type I (NF-I). It is pathognomonic of NF-I and may be the first sign of neurofibromatosis. It often appears within the first 2 years of life or before adolescence and occurs in only 5% of NF-I cases. We present a case of intraosseous plexiform neurofibroma of the maxilla in a 2-year old female, which is rare, along with the oral manifestations and clinicopathological characteristics. Because NF-I is one of the most common genetic disorders and oral manifestations are common, knowledge of the variability of presentation in children is necessary for prompt diagnosis. [ABSTRACT FROM AUTHOR]

Brown tumors are erosive bony lesions caused by rapid osteoclastic activity and peritrabecular fibrosis due to hyperparathyroidism, resulting in a local destructive phenomenon. The classical "brown tumor" is commonly seen in ends of long bones, the pelvis and ribs. Facial involvement is rare and, when present, usually involves the mandible. We report a case of 60-yearold male with a rare initial presentation of primary hyperparathyroidism with bilateral maxillary brown tumors. The present case represents the third report of the bilateral maxillary brown tumors in a patient with primary hyperparathyroidism. Differential diagnosis is important for the right treatment choice. It should exclude other giant cell lesions that affect the maxillae. [ABSTRACT FROM AUTHOR]

Despite the fact that cemento-ossifying fibromas of the maxilla may be quite large and locally aggressive, en-bloc excision is achieved by gentle blunt dissection, with the whole tumour mass peeled out from the adjacent structures. Until recently different fibro-osseous tumours that contained cementum were classified together as ''cementomas''. In 1992 The World Health Organization adopted a new classification that included these fibromas as benign osseous tumours. While such tumours of the mandible are common, those of the maxilla are rare. They are growth products of periodontal membrane remnant. The triggering mechanism in the formation of cementum outside the periodontal membrane remains unclear. We present a 35-year-old woman who had a giant expanding lobular mass in the right maxilla of 5 years duration. She had visual disturbances and nasal obstruction, and was treated successfully by surgical en-bloc resection of the tumour through an infraorbital transverse incision. The differential diagnosis included fibrous dysplasia, osteoid osteoma, osteoblastoma, chronic sclerosing osteomyelitis, ameloblastoma, squamous cell carcinoma of the maxillary sinus, calcifying epithelial odontogenic tumour (Pindborg tumour) and calcifying odontogenic cyst (Gorlin cyst). Histopathological examination confirmed a cemento-ossifying fibroma. [ABSTRACT FROM AUTHOR]

Abstract: A dog with a spontaneous maxillary tumour was given 40Gy of fractionated radiotherapy. At five out of 10 fractions cone-beam CT (CBCT) imaging before and after administration of an iodinated contrast agent were performed. Contrast enhancement maps were overlaid on the pre-contrast CBCT images. The tumour was clearly visualized in the images thus produced. [Copyright &y& Elsevier]

Odontogenic myxoma is a locally invasive benign mesodermal tumour found exclusively in the jaws comprising 3-6% of all odontogenic tumors. It usually occurs in the second and third decade of life commonly involving the mandible as compared to maxilla. Its variable clinical and radiological appearance makes the diagnosis difficult. Here we present a case report of a 30 year old female with a swelling in the left maxilla. The clinical findings made us suspect a case of radicular cyst with the carious molar. However, the radiological and subsequent histopathological examination established a final diagnosis of odontogenic fibromyxoma. [ABSTRACT FROM AUTHOR]

We report a rare case of a 27-year-old Asian female presenting with simultaneous brown tumours in the maxilla and mandible secondary to vitamin D deficiency which was a result of dietary deficiency and lack of exposure to sunlight. [ABSTRACT FROM AUTHOR]

Cone beam CT (CBCT) imaging has become an integral part of radiation therapy, with images typically used for offline or online patient setup corrections based on bony anatomy co-registration. Ideally, the co-registration should be based on tumor localization. However, soft tissue contrast in CBCT images may be limited. In the present work, contrast enhanced CBCT (CECBCT) images were used for tumor visualization and treatment adaptation. Material and methods. A spontaneous canine maxillary tumor was subjected to repeated cone beam CT imaging during fractionated radiotherapy (10 fractions in total). At five of the treatment fractions, CECBCT images, employing an iodinated contrast agent, were acquired, as well as pre-contrast CBCT images. The tumor was clearly visible in post-contrast minus pre-contrast subtraction images, and these contrast images were used to delineate gross tumor volumes. IMRT dose plans were subsequently generated. Four different strategies were explored: 1) fully adapted planning based on each CECBCT image series, 2) planning based on images acquired at the first treatment fraction and patient repositioning following bony anatomy co-registration, 3) as for 2), but with patient repositioning based on co-registering contrast images, and 4) a strategy with no patient repositioning or treatment adaptation. The equivalent uniform dose (EUD) and tumor control probability (TCP) calculations to estimate treatment outcome for each strategy. Results. Similar translation vectors were found when bony anatomy and contrast enhancement co-registration were compared. Strategy 1 gave EUDs closest to the prescription dose and the highest TCP. Strategies 2 and 3 gave EUDs and TCPs close to that of strategy 1, with strategy 3 being slightly better than strategy 2. Even greater benefits from strategies 1 and 3 are expected with increasing tumor movement or deformation during treatment. The non-adaptive strategy 4 was clearly inferior to all three adaptive strategies. Conclusion. CECBCT may prove useful for adaptive radiotherapy. [ABSTRACT FROM AUTHOR]

A desmoplastic small round cell tumor (DSRCT) is an uncommon tumor characterized by polyphenotypic expression and a specific reciprocal translocation t (11; 22) (p13; q12). It has been rarely identified in the head and neck region. Herein, we describe a DSRCT in the maxilla of a young man, who was initially diagnosed with a primitive neuroectodermal tumor (PNET), based on histopathological appearance of a round cell tumor, with MIC2 and —FLI-1 positivity, on immunohistochemistry (IHC). Diagnosis of a DSRCT was confirmed on molecular analysis with positive —RT-PCR and sequencing results for EWS-WT1 transcript and negativity for EWS-FL1. The case is presented to highlight the value of molecular diagnosis in round cell sarcomas at uncommon sites, especially when similar IHC markers can be expressed in a PNET and a DSRCT. An exact diagnosis of a round cell sarcoma has a therapeutic relevance. [ABSTRACT FROM AUTHOR]

Background: Ameloblastic fibrosarcoma (AFS) is a rare odontogenic neoplasm of the jaw that usually arises de novo or through a malignant change in the mesenchymal component of a preexisting or recurrent benign fibroma. The majority of AFS cases reported in the literature arise in the mandible. Case Report: A 35-year-old male presented with an asymptomatic left maxillary mass that on imaging was found to be effacing most of his maxillary sinus. He underwent a left maxillectomy with free-flap reconstruction and adjuvant radiotherapy to the tumor bed. Conclusion: Wide local excision remains the treatment of choice for AFS, given the poor survival rates of patients with recurrent disease. However, long-term studies and follow-up are needed to elucidate the role of adjuvant therapies in the primary treatment of AFS. [ABSTRACT FROM AUTHOR]

Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor which occurs mostly in the mandible. It is primarily seen in fifth to seventh decades with a female predilection. We report a case of CCOC in the maxillary arch of a 66-year-old woman. Morphologic examination along with histochemical and immunohistochemical markers led to the establishment of the diagnosis. It is important to diagnose this entity and differentiate it from other clear cell tumors in the head and neck region as it is a locally aggressive tumor with a propensity for regional, nodal, and distant metastasis. [ABSTRACT FROM AUTHOR]

Benign osseous tumors of the maxillaries have similar characteristics among themselves, such as the slow, asymptomatic growth and being able to cause expansion of the adjacent cortical bone. Amongst these, the cemento-ossifying fibroma has a rare incidence, with predilection for females and more frequent localization in the mandible. This case-report aims to describe the clinical behavior and the therapeutic conduct for this type of tumor. [ABSTRACT FROM AUTHOR]

Summary: Loss of the maxilla due to tumor ablation has both functional and aesthetic consequences. Even small defects become obvious because of missing bone and soft tissue. Reconstruction of the maxilla and midface in these patients presents a challenge to the surgeon although several possibilities are available for this purpose. The long term benefit to patients of the different modalities remains unclear due to wide individual variation. One hundred and twenty-one patients with maxillary oral squamous cell carcinoma were treated with curative intent. One hundred and five patients were surgically reconstructed using local or free microsurgical flaps. All parameters were collected from case records. Kaplan–Meier plots and univariate log-rank test and multivariate Cox proportional hazards regression models were used to determine the association between possible predictor variables and survival time of patients suffering from oral squamous cell carcinomas. After controlling for age, resection margins, nodal stage, and surgical management, which were independent and dependent predictors of survival, the type of reconstruction and involvement of surgical margins were associated with survival (HR=0.50, p =0.044, 95% CI, 0.25–0.98 and HR=3.16, p =0.007, 95% CI, 1.38–7.25). Various types of maxillary defects can be reconstructed successfully using different reconstructive techniques. The size and complexity of defects does not correlate with prognosis in oral squamous cell carcinoma patients. The criteria for reconstruction with a free flap were based on extensive defects in which local flaps were insufficient, on medical co-morbidities, and previous treatment. [Copyright &y& Elsevier]

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Background: Ameloblastoma is a locally aggressive odontogenic tumour of the mandible and maxilla that, if neglected, can cause severe facial disfigurement and functional impairment. A thorough understanding of its clinicopathological behaviour is essential to avoid recurrence associated with inadequately treated disease. Currently, wide resection and immediate reconstruction is the treatment of choice in most cases of mandibular ameloblastoma. We present our experience in the management of this disease and review the current status of the literature. Method: Retrospective review of all patients between 1996 and 2006 with histologically confirmed ameloblastoma. A literature review on the current understanding of this disease and its management is then presented. Results: Six patients were identified, ranging between 23 and 54 years old. All were females. Two tumours involved the angle and posterior body of the mandible, one the angle and ramus, one the body and two the anterior mandibular. Four patients underwent mandibular reconstruction with free tissue transfer and two by non-vascularized bone grafts. All procedures were successful. One patient developed deep vein thrombosis requiring anticoagulation. Another developed a collection at the mandibular surgical site requiring drainage. Satisfactory union was achieved in all cases with no evidence of recurrence. All patients had adequate cosmesis, masticatory efforts and speech. Conclusion: Management of ameloblastoma remains a challenge and requires a thorough understanding of the behaviour of its different clinicopathological variants. We have found segmental mandibulectomy and immediate reconstruction to be an excellent treatment option in our series of patients. [ABSTRACT FROM AUTHOR]

Hyperparathyroidism is nowadays diagnosed early and asymptomatically with the improvements in routine biochemical tests and radiological procedures. The late bony complications of the disease have therefore started to decline rapidly. Brown tumours are one of the bony complications of hyperparathyroidism. The mandible is the predominantly affected site in the maxillofacial area. Maxillary involvement is rare. Here, an extremely rare case of a 19-year-old male patient with brown tumours in his maxilla and mandible associated with tertiary hyperparathyroidism is presented. A thorough diagnostic work-up was carried out and treatment options for both hyperparathyroidism and brown tumours were discussed. The importance of different radiological evaluation methods and the consultation between the oral and maxillofacial surgeons, general practitioner dentists, endocrinologists and radiologists are emphasised. [ABSTRACT FROM AUTHOR]

We present a very unique case of a premaxillary chondrosarcoma arising in a relatively 'younger' female with apparently much 'better' disease free 7-year survival. The literature has been reviewed and a meaningful discussion regarding diagnosis and treatment is highlighted. [ABSTRACT FROM AUTHOR]

Primitive neuroectodermal tumor (PNET) of the maxilla is a soft tissue sarcoma classically described under small round blue cell tumors. This tumor is commonly seen in the chest, pelvis, abdomen, and extremities; and rarely in dura, ovaries, cervix, etc. These tumors are rare in the head and neck area. We report a case of a 3-year-old girl presenting with a PNET of the maxilla. [ABSTRACT FROM AUTHOR]