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A dentinogenic ghost cell tumor (DGCT) is a rare benign odontogenic tumor that commonly shows characteristics of solid proliferation and has a relatively high risk of recurrence after surgical treatment. We herein report a case of a central DGCT that occurred in the maxilla and resulted in bone expansion. This study highlights new imaging findings (particularly magnetic resonance imaging) along with histopathological observations. In addition, we conducted a review of the existing literature on this rare tumor. A 37-year-old man developed swelling around the right cheek. A benign odontogenic tumor such as ameloblastoma was suspected based on the imaging examination findings (including bone expansion and the internal characteristics of the tumor) on panoramic imaging, computed tomography, and magnetic resonance imaging. The lesion was surgically excised from the right maxilla. Postoperative histopathological examination led to a definitive diagnosis of central DGCT. The tumor comprised epithelial neoplastic islands, resembling ameloblastoma, inside tight fibroconnective tissue; masses of ghost cells and formation of dentin were also observed. We had suspected that the minute high-density region around the molars on the imaging examinations represented alveolar bone change; however, it represented dentin formation. This led to difficulty diagnosing the lesion. Although DGCT may present characteristic findings on imaging examinations, its occurrence is infrequent, and in some cases, the findings may include the presence or absence of an impacted tooth without obvious calcification. The present case suggests that we should consider the possibility of an odontogenic tumor with calcification when high-density structures are observed inside the lesion. [ABSTRACT FROM AUTHOR]

There are several treatment options available to restore function and appearance in patients with combined mid-facial defects. Owing to the size of the defect and the associated size and weight of the prostheses, adequate retention can be challenging to achieve. Retention of a facial prosthesis can be improved using several techniques, such as medical grade adhesives, attachments, or osseo-integrated implants. For patients with a history of radiotherapy, surgical rehabilitation may be less favourable than non-surgical approaches owing to the risk of osteoradionecrosis and a reduced blood supply in the surgical fields. This clinical case report highlights the conservative rehabilitation of a combined mid-facial defect using a magnet-retained intra-oral and extra-oral prosthesis. CPD/Clinical Relevance: A thorough medical and clinical assessment will highlight factors that will influence the treatment planning process when managing a combined mid-facial defect. [ABSTRACT FROM AUTHOR]

Background: Neurofibroma is a common benign tumor of neuronal origin that can occur as a solitary tumor or as a component of the generalized syndrome of neurofibromatosis. Neurofibromas are primarily located in the subcutaneous soft tissues and commonly involve extra-oral sites. Solitary intraosseous neurofibromas of the oral cavity are infrequent, with occurrences in the maxilla being exceedingly rare. Case presentation: A 22-year-old male patient presented with an asymptomatic mass in the maxilla. Cone-beam computed tomography revealed a round, well-outlined, radiolucent lesion with expansive growth. The neoplasm with the complete capsule was completely removed and confirmed as a neurofibroma based on histopathological and immunohistochemical findings. The reported cases of solitary intraosseous neurofibromas located in the maxilla published in the English literature were compiled to assist in the diagnosis of solitary intraosseous neurofibromas of the maxilla. Nine months after the surgery, there were no signs of tumor recurrence or malignant transformation. Conclusions: This report emphasizes that rare locations of neurofibromas, such as solitary intraosseous neurofibromas in the maxilla, typically demonstrate nonspecific clinical and radiological features. Clinicians should consider solitary intraosseous neurofibromas as possible differential diagnoses and recognize the histopathological and immunohistochemical features to confirm the correct diagnosis. A longer follow-up period is required because of the potential for local recurrence and malignant transformation of these tumors. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The study's purpose was to compare the quality of life (QoL) in oncologic patients treated with different rehabilitation protocols following maxillary tumor resections. PATIENTS AND METHODS: The patients were divided into three groups. Group A: 18 patients with maxillary obturator prosthesis. Group B: 17 patients with simultaneous autologous tissue reconstruction. Group C: 12 patients with prosthesis on zygomatic implants. The post-operative QoL was compared using standard questionnaires, investigating items like pain, mood, social relations, and specific functions that could potentially compromise the post-operative QoL. A secondary analysis compared reconstructed vs. non-reconstructed pa-tients. RESULTS: Most questionnaire items did not show significant differences among groups. Statistically significant outcomes were found in two parameters (social contact and sexuality), in which patients treated with zygomatic implants had the best satisfaction, and patients with obturator prostheses showed the lowest satisfaction. Patients belonging to the non-reconstructed group showed better moods than those in the reconstructed group, while taste problem complaints and pain were lower in the reconstructed group. CONCLUSIONS: Although the type of reconstruction procedure depends on the type of maxillectomy to be performed and on the general health situation of each patient, the impact of the rehabilitation protocol on the patients' QoL should be accounted for when planning the treatment. [ABSTRACT FROM AUTHOR]

Brown tumors are rare skeletal manifestations of hyperparathyroidism. It is a form of osteitis fibrosa cystica caused by hyperparathyroidism due to excessive secretion of parathyroid hormone. Then, hypercalcemia results in excessive osteoclastic activity in the bones. Brown tumors are considered a rare complication of hyperparathyroidism, as their reported existence is only about 1.5-4.5%. Herein, we report a rare case of brown tumor arising from the left maxilla due to primary hyperparathyroidism, its challenge in diagnosis with giant cell tumor, and its literature review. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the prognosis and quality of life for primary malignant maxillary sinus tumors. Methods: This was a retrospective analysis. 164 patients diagnosed with primary malignant maxillary sinus tumors between 2005 and 2018 were recruited. Patients were treated according to the pathological type and the lesion range. Prognostic differences of different pathological types, surgical resection methods, repair methods, treatment methods, and different local recurrence sites were analyzed. Survival analysis and prognostic factors analysis were performed. Results: Overall survival (OS) rate was 74.7% at 3 years, 60.5% at 5 years, and 45.8% at 10 years. Disease-free survival (DFS) rate was 67.2% at 3 years, 45.6% at 5 years, and 30.8% at 10 years. There was significant difference in OS rate among different pathological types (χ2 = 14.18, P < 0.05). The order of 5-year OS rate was as follows: malignant transformation of inverted Papilloma (77.7%) > adenoid cystic carcinoma (74.1%) > squamous cell carcinoma (48.4%) > sarcoma (22.1%). The order of disease-free survival was as follows: total maxillary resection > subtotal maxillary resection > endoscopic nasal tumor resection ≥enlarged maxillary resection, the 5-year DFS rate were 68.6%, 53.5%, 46.2%, and 42.9%, respectively. The OS of postoperative radiotherapy was significantly better than that of preoperative radiotherapy (χ2 = 7.16, P < 0.05). There was significant difference in OS between recurrent and non-recurrent patients (χ2 = 68.57, P < 0.05). Conclusions: The pathological type and the timing of radiotherapy are independent prognostic factors for primary malignant tumor of maxillary sinus. In addition, different local surgical resection methods are independent factors affecting the recurrence rate. [ABSTRACT FROM AUTHOR]

Background: According to previous research, 2.8% of lesions clinically identified as endodontic pathosis were ultimately diagnosed as non-endodontic periapical lesions via histopathology, and 3.7% of these non-endodontic periapical lesions were malignant neoplasms. Rhabdomyosarcoma, a malignant tumor most commonly observed in children, is uncommon in the oral cavity. Case presentation: This is a report of a rare case of embryonal rhabdomyosarcoma in a 41-year-old female, in which the lesion was in the maxillary gingiva. The biopsy reports confirmed the diagnosis of embryonal rhabdomyosarcoma. The wide excision of the tumor, free flap reconstruction, chemotherapy, and radiotherapy were performed. Clinical, radiological, and histopathological and management aspects of the neoplasm were also discussed. Conclusions: This case report aimed to create awareness that rhabdomyosarcoma is one of the differential diagnoses of periapical lesions. [ABSTRACT FROM AUTHOR]

Purpose: Patients with maxillary defects after a maxillectomy live with a range of functional and social problems. As techniques for functional reconstruction of the maxilla have been applied in a number of these patients, some of them regained confidence in their lives again. Nevertheless, there was still no clear consensus on the connecting and loading patterns of zygomatic implant–supported prosthetics in bilateral maxillary defects. This study aimed to investigate the function of a novel technique using “three-dimensional ring”–supported prosthetics based on zygomatic implants and compared its effects with two other conventional approaches through assessing the quality of the patient’s life. Materials and Methods: Forty-five eligible patients who had different degrees of maxillectomy received treatment of conventional prostheses with a clasp (25 patients, group 1), a regular implant with obturator removal (10 patients, group 2), or a zygomatic implant combined with “three-dimensional ring”–supported prosthetics (10 patients, group 3). A questionnaire that included the indicators of the Obturator Functioning Scale (OFS) and EORTC Head and Neck 35 assessment was employed to evaluate the functional rehabilitation and quality of life (QOL) of patients in the study. The data were then summarized into a worksheet (Excel 2010), and the mean and standard deviation were calculated. The data were processed with SPSS 19.0 for Windows statistical software. Results: The questionnaire analysis showed a statistically significant difference in the OFS, EORTC H&N 35, and QOL scores between group 3 and group 1 or group 2. Importantly, in the assessment of EORTC H&N 35, the proportion of patients in group 3 who lost weight after the functional restoration of maxillary defection was lower than that of the other two groups. In this research, a new connection device mode, which provided a retentive force between the zygomatic implants and prosthetics through a 3D ring–shaped milling bar with golden galvanized frames, was conducted and proved to be a reliable and feasible functional reconstruction therapy through patients’ questionnaire surveys. Conclusion: This research provided an effective reconstruction strategy for patients with maxillary resection that could remarkably improve the life quality of patients. [ABSTRACT FROM AUTHOR]

Tumor-induced osteomalacia (TIO) is a rare, paraneoplastic disorder of hypophosphatemia associated with elevated tumor-produced fibroblast growth factor 23 (FGF23). Maxillofacial tumors are rarely involved in TIO, especially maxillary TIO in children. We present a 14-year-old boy with osteomalacia and high serum levels of FGF23, a hormone associated with decreased phosphate resorption, due to a maxillary tumor. The patient was treated with oral phosphorus and calcitriol, and surgical removal of the tumor was performed. After 21 months follow-up, he was pain free and had returned to full activity. We review the reported pediatric cases of TIO in the maxillofacial and oral region and discuss the management of these patients considering the published evidence. [ABSTRACT FROM AUTHOR]

Objective: To explore and summarize the clinical features, differential diagnosis and treatment of the oral maxillofacial schwandoma. Case presentation: This is a report of a case of a 46-year-old female patients with neurolemmoma in the maxillary gingiva. The clinical features, pathological features, differential diagnosis and treatment were analyzed. Literature review was conducted in search of domestic and overseas journal full-text database from 1986 ~ 2017. 39 reports on the oral and maxillofacial Neurolemmoma from 1986 to 2017 in the database of China hospital knowledge database and the PubMed database, there were 405 patients. There were 23 cases of gingival mucosa, 17 in foreign literature and only 6 in the domestic literature. Conclusions: The incidence of gingival Neurolemmoma is extremely low, the predilection age is similar to other parts, it is middle-aged and young, and there is no obvious gender tendency. About 25–45% of schwannomas are found in the head and neck, and rarely in the mouth (only 1%). The most common internal location of the mouth is the tongue, followed by the floor of the mouth, buccal mucosa, palate, gums, and lips. Schwannomas are slow-growing benign tumors that are rare in the gums. Gingival schwannoma is usually a single occurrence, and the clinical manifestations are mostly painless gum mass, tooth loosening and displacement, without peripheral bone changes and regional lymph node metastasis. It is difficult to diagnose this tumor according to clinical manifestations, and pathological diagnosis is still the basis for the diagnosis of gingival schwannoma. So far, surgical resection is the preferred treatment for this disease, and the prognosis is good. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of telerehabilitation on oral function of oral and maxillofacial tumor patients. Design: Unicentral, single-blind, randomized controlled trial. Setting: Community. Subjects: Patients with primary oral and maxillofacial tumor receiving surgical treatment. Interventions: Telerehabilitation guidance from therapists. Main measures: At the beginning of training (T0) and 1 month (T1), 3 months (T2) and 6 months (T3) after training, patients' masticatory ability (mastication efficiency—masticatory performance evaluating gum, maximum bite force and mouth opening) and swallowing ability (water swallowing test) was measured. Modified Sato questionnaire and MD Anderson dysphagia inventory (MDADI) were used for self-evaluation of masticatory and swallowing ability. Results: A total of 64 participants (intervention: 33; control: 31) were included. The masticatory efficiency scores of the intervention group were significantly better than those of the control group at T2 (intervention: 3.67 (0.48); control: 3.03 (0.85)) and T3 (intervention: 4.20 (0.30); control: 3.50 (0.79)); and maximum mouth opening was better at T2 (intervention: 3.18 (0.59); control: 2.77 (0.54)) and T3 (intervention: 3.54 (0.58); control: 3.09 (0.41)). In water swallowing test, the intervention group had better scores at T2 and T3. The scores of MDADI scale in intervention group were better than those in the control group after 3 months of training. In subgroup analysis, the intervention group of oral cancer patients had better swallowing function at T2 and T3, but no significant difference was found in the subgroup of oropharyngeal cancer. Conclusions: Telerehabilitation could greatly improve the long-term (3–6 months) training effect under the condition of greatly saving medical resources and reducing personnel contact. [ABSTRACT FROM AUTHOR]

Background: The development of synchronous multiple primary cancers is one of the major causes of death in patients with head and neck cancer. Herein, we report a case of synchronous intraductal papillary mucinous carcinoma (IPMC), invasive in a patient with maxillary gingival carcinoma. Case presentation: A 73-year-old female visited our hospital complaining of a mass on the left side of the maxillary gingiva. Intraorally, an exophytic tumor, 50 × 25 mm in size, was found on the gingiva of the left maxillary posterior, and a diagnosis of squamous cell carcinoma was revealed by cytology. Emission tomography/ computed tomography with 18 Fluorodeoxyglucose-Positron (18FDG- PET/ CT) showed increased accumulation in the left maxillary gingiva, the left side of cervical lymph nodes, and the main pancreatic duct. The pancreatic ductal tumor was performed the biopsy at esophagogastroduodenoscopy (EGD) and resulted in a pathological diagnosis of IPMC, invasive. The patient was diagnosed as synchronous double primary cancers consisting of maxillary gingival carcinoma cT4aN2bM0 and IPMC, invasive cT3N0M0. She refused radical treatment, and died 11 months later. Conclusion: 18FDG- PET/ CT, EGD and multidisciplinary approach is required for the detection and determining the treatment strategy of synchronous double primary cancers. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the possible risk factors for mastoid cellulitis after treatment in patients with oral cancer. Methods: Patients with oral cancer who underwent preoperative and postoperative contrast-enhanced computed tomography (CECT) between January 2017 and March 2020 were retrospectively evaluated. Using an image reporting system, cases with reports containing the keyword "mastoid cellulitis" were registered in the mastoid cellulitis group. Fifty patients with oral cancer who did not develop mastoid cellulitis were randomly selected as the control group. Information concerning age, sex, location, and histopathological type of the primary tumor, presence or absence of cervical lymph node metastasis, and treatment methods were obtained from the hospital's electronic medical records to investigate the association between these factors and the occurrence of mastoid cellulitis. Results: Statistically significant differences were observed in the following factors: age (p = 0.004), primary tumor site (p < 0.001), histopathological type (p = 0.032), radiotherapy (p < 0.001), and chemotherapy (p < 0.001). Logistic regression analysis revealed that maxillary tumors (p < 0.001), histopathological type (p = 0.047), and radiotherapy (p = 0.0301) were significantly associated with the occurrence of mastoid cellulitis. Conclusions: In oral cancer, the risk of postoperative mastoid cellulitis was higher in patients with a maxillary tumor, histopathology other than squamous cell carcinoma, and history of radiotherapy. [ABSTRACT FROM AUTHOR]

Objectives: An error in the diagnosis of an oral or maxillofacial lesion could potentially be detrimental to a patient's prognosis and management. Major discrepancies between the initial and subsequent diagnoses of head and neck pathologies range from 7 to 53%. This study determined the rate of discrepancies found in the diagnoses of oral and maxillofacial lesions after a second opinion in Saudi Arabia. Methods: A retrospective single-center study was conducted by oral and maxillofacial pathology consultants to review all cases referred for a second opinion to the oral and maxillofacial pathology laboratory between January 2015 and December 2020. If the second-opinion diagnosis matched the original diagnosis, this was described as "agreement." If the second-opinion diagnosis did not match the original diagnosis but would not change the management or prognosis of a patient, this was classified as a "minor disagreement." If the second-opinion diagnosis resulted in the changing of a patient's management or prognosis, this was categorized as a "major disagreement." Chi-square test and Fisher's exact test were used to compare data between original and second-opinion diagnoses. A p-value of less than 0.05 was considered significant. Results: Of 138 cases, 59 (43%) had an initial diagnosis and a second-opinion diagnosis that were in major disagreement. The most common tumor for which there was a major disagreement was squamous cell carcinoma. No single factor influenced the occurrence of major disagreements. Conclusions: Our evaluation reiterates the importance of obtaining a second opinion from a specialist in oral and maxillofacial pathology to improve the diagnostic accuracy for lesions. A formal system for this step, in addition to the obtaining of adequate clinical and radiographic information about a patient, is mandatory for the review of difficult cases. [ABSTRACT FROM AUTHOR]

Background: Odontogenic fibroma (OF) is a rare benign odontogenic tumor of ectomesenchymal origin, mostly affecting the tooth-bearing portions of the jaws in middle-aged patients. Whilst small lesions tend to be clinically asymptomatic, varying unspecific clinical symptoms occur with an increase in size and may mimic odontogenic or other maxillofacial bone tumors, cysts, or fibro-osseous lesions of the jaws. Case presentation: A 31-year-old female patient presented with a hard, non-fluctuating protrusion in the vestibule of the upper right maxilla. It was visualized on cone beam computed tomography (CBCT) as space-occupying osteolysis with the displacement of the floor and facial wall of the maxillary sinus, mimicking a cyst-like lesion. The tissue was surgically removed and identified as an OF in the histopathological examination. One year after the surgery, restitution of regular sinus anatomy and physiological intraoral findings were observed. Conclusions: This case report emphasizes that rare entities, like the maxillary OF presented, often demonstrate nonspecific clinical and radiological findings. Nevertheless, clinicians need to consider rare entities as possible differential diagnoses and plan the treatment accordingly. Histopathological examination is essential to conclude the diagnosis. OF rarely recur after proper enucleation. [ABSTRACT FROM AUTHOR]

Oral and maxillofacial tumors (OMTs), such as oral squamous cell carcinoma (SCC), pleomorphic adenoma, and ameloblastoma, are common head and neck tumors. Lipopolysaccharide‐binding protein (LBP) is a type I acute reactive protein, which participates in body inflammatory response modulation through lipopolysaccharide (LPS)‐induced signaling pathway by targeting macrophages (expressing cluster of differentiation 204 [CD204]). Although it is well established that LBP is associated with the development of multiple types of cancer, little is known about the role of LBP in OMTs. This study aims to explore the expression of LBP in OMTs. Here, immunohistochemical (IHC) double staining of LBP and CD204 and enzyme‐linked immunosorbent assay (ELISA) were conducted to explore the LBP expression in OMTs. The findings demonstrated that the LBP expression in OMTs was significantly elevated (p < 0.001). In addition, the LBP expression was associated with the clinical stage (p < 0.001), T classification (p < 0.001), and lymph node metastasis (p < 0.001, except ELISA) but independent of histological grade of SCC, gender, and age in patients with SCC. The optional cutoff of the LBP serum level is 0.721 μg/ml. To conclude, LBP contributes to the development of OMTs and could be a biomarker in the screening and predicting metastasis in patients with OMTs. [ABSTRACT FROM AUTHOR]

A case of squamous cell carcinoma of the gingiva (GSCC) in the left anterior maxilla in a 64-year-old woman that was treated for almost 5 years as suspected periodontal lesion prior to establishing the final diagnosis of oral cancer is presented in this case report. GSCCs have a variable clinical appearance, ranging from an exophytic mass to ulcerative lesions. They have been reported to pose a diagnostic challenge and are not infrequently initially misdiagnosed as periodontal disease. A delay in diagnosis and extraction of teeth in the vicinity of GSCCs has been demonstrated to increase the risk for lymph node metastasis and thus result in a lower 5-year survival rate. To avoid misdiagnosis and delay of the appropriate treatment, a proper histopathologic evaluation is mandatory whenever an incisional biopsy is performed. Furthermore, referral to a specialist in oral medicine or oral and maxillofacial surgery is indicated when a gingival lesion is nonresponsive to treatment, recurring, or rapidly growing in size. [ABSTRACT FROM AUTHOR]

Background: Ensuring high accuracy in multimodal image fusion for oral and maxillofacial tumors is crucial before further application. The aim of this study was to explore the factors influencing the accuracy of multimodal image fusion for oral and maxillofacial tumors. Methods: Pairs of single-modality images were obtained from oral and maxillofacial tumor patients, and were fused using a proprietary navigation system by using three algorithms (automatic fusion, manual fusion, and registration point-based fusion). Fusion accuracy was evaluated including two aspects—overall fusion accuracy and tumor volume fusion accuracy—and were indicated by mean deviation and fusion index, respectively. Image modality, fusion algorithm, and other characteristics of multimodal images that may have potential influence on fusion accuracy were recorded. Univariate and multivariate analysis were used to identify relevant affecting factors. Results: Ninety-three multimodal images were generated by fusing 31 pairs of single-modality images. The interaction effect of image modality and fusion algorithm (P = 0.02, P = 0.003) and thinner slice thickness (P = 0.006) were shown to significantly influence the overall fusion accuracy. The tumor volume (P < 0.001), tumor location (P = 0.007), and image modality (P = 0.01) were significant influencing factors for tumor volume fusion accuracy. Conclusions: To ensure high overall fusion accuracy, manual fusion was not preferred in CT/MRI image fusion, and neither was automatic fusion in image fusion containing PET modality. Using image sets with thinner slice thickness could increase overall fusion accuracy. CT/MRI fusion yielded higher tumor volume fusion accuracy than fusion containing PET modality. The tumor volume fusion accuracy should be taken into consideration during image fusion when the tumor volume is small and the tumor is located in the mandible. [ABSTRACT FROM AUTHOR]

Melanotic neuro-ectodermal tumor of infancy (MNTI) is an extremely rare tumor. The purpose of this study was to describe the imaging features of maxillary bone MNTIs and introduce the key points for clinical diagnosis of MNTI. We retrospectively reviewed four patients with histology-proven MNTIs arising from the maxillary bone. All patients underwent ultrasonic inspections, CT and/or MR scanning. Combined with previously literature, the imaging features were comprehensively evaluated and analyzed. All MNTIs showed a firm, non-ulcerated rapidly-growing soft-tissue swelling with pigmented (blue-colored or black-colored or gray-colored) mucosa. The onset ages were younger than 6 month-old. CT images showed osteolytic or expansive bone destruction of the involved maxillae, fragmentary cortical bone, "free-floating" tooth germs, with or without spiculated/sunburst periosteal reaction. The tumor appeared lightly hyper-intense on T2-weighted sequences, while isointense or lightly hypo-intense or lightly hyper-intense signal on T1-weighted sequences. Enhanced images all displayed heterogeneous enhancement. No metastasis features of lymph nodes or abdominal organs were demonstrated by cervical and abdominal ultrasonic inspections. As a conclusion, accurate recognition of the imaging features of MNTI combined with history and clinical manifestations (early infancy, painless, firm, pigmented mucosa, non-ulcerating lesion) can provide clues for diagnosis of this rare entity. [ABSTRACT FROM AUTHOR]

Statement of the Problem: The prevalence of oral and maxillofacial lesions differs in various populations and is an important concern for health care providers. Purpose: The present study aimed to evaluate the relative frequency and distribution of oral and maxillofacial lesions in patients referred to the Department of Oral and Maxillofacial Pathology, Kerman Faculty of Dentistry in southeast Iran. Materials and Method: In the present retrospective study, the collected data consisted of age, gender, lesion location, and the clinical and histopathological diagnoses of all the biopsy samples diagnosed in 23 years (1997–2020). The data were analyzed with SPSS 22, using the chi-squared test and ANOVA (p< 0.05). Results: From 2092 lesions with a definite diagnosis, 1202 (57.5%) and 890 (42.5%) cases belonged to female and male patients, respectively. The mean age of the subjects was 39.06±17.71 years, and the most frequent location of the lesions was the buccal mucosa (25.2%). The frequencies and number of non-neoplastic lesions, neoplasms, and premalignant lesions were 84% (n=1758), 13.3% (n=278), and 2.7% (n=56), respectively. Reactive lesions were the most common cases, with 34.6% (n=724), and lichen planus was the most frequent lesion with 18.1% (n=379). Squamous cell carcinoma was the most frequent lesion in patients >70 years of age (27.6 %). Conclusion: The present study provided useful data on the frequency and distribution of oral lesions over 23 years and made it possible to compare its results with those of studies carried out in other countries. Non-neoplastic lesions were the most common category, and lichen planus, pyogenic granuloma, and irritation fibroma were the most frequent lesions in descending order. [ABSTRACT FROM AUTHOR]

Background: We established a MSBOS for flap reconstruction in oral and maxillofacial cancer patients. Method: We enrolled 2080 cases of oral and maxillofacial flap reconstruction from January 1, 2010 to December 31, 2021. Patient data were collected, including age, sex, BMI, preoperative Hb levels, ASA grade, T stage, flap type, tumor location, and bone flap. Scoring criteria were established based on a multivariate model of independent risk variables and their odds ratios. Two flap-type groups were divided into low-risk, intermediate-risk and high-risk groups by the scoring criteria, and analyzed using univariate and multivariate logistic regression. Perioperative transfusion analysis identified independent risk factors at various Hb levels. The cumulative percentage of patients requiring perioperative blood transfusion for each surgical procedure was calculated to establish the MSBOS. Results: (1) Regression analysis showed that BMI, tumor T staging, ASA grade, preoperative Hb level (male: Hb < 130 g/L, female: Hb < 120 g/L), and bone flap were independent risk factors for perioperative blood transfusion. (2) Regression analysis showed that independent risk factors for perioperative transfusion included the following: BMI, tumor T3–T4 stage, ASA III, IV grade, and free flap/pediculated flap/bone flap in patients with different Hb levels; T3–T4 stage, ASA grade III–IV in mildly anemic patients; and ASA grade III–IV in moderately anemic patients. (3) A MSBOS was established for flap reconstruction in head and neck cancer patients. Conclusion: A MSBOS for head and neck cancer procedures was reduced by approximately 30% perioperative blood preparation while ensuring that clinical blood use standards were met. It help optimize blood inventory, and save blood resources. [ABSTRACT FROM AUTHOR]

Background: The mandibular second molars demonstrate variations on root and canal morphology. The aim of this study was to investigate all the root canal morphology of mandibular second molars and analyze the morphological variations in patients by gender and age in a Chinese population use CBCT imaging. Methods: Cone-beam computed tomographic images of 1200 bilateral mandibular second molars were obtained from 600 patients (300 females and 300 males) who required a preoperative assessment for implant surgery, surgical removal of impacted teeth, orthodontic treatment, surgery of maxillofacial tumour and cysts or LeFort I osteotomy. CBCT images were divided into 5 groups according to age: "15–24 years", "25–34 years", "35–44 years", "45–54 years" and "≥ 55 years"; and 2 groups by gender: "females" and "males". The following information were recorded: the number of roots and canals and their morphology, the frequency and configuration of C-shaped canals by gender, age and position (left and right). The chi-square test was used to analyse differences between groups. P value of < 0.05 was considered statistically significant. Results: Of the 1200 teeth, 61% had two separate roots located mesiodistally, 35.6% had one C-shaped root. The 45.3% teeth had three canals in two-rooted mandibular second molars. The mesial root showed a Vertucci type II configuration in 28.9% cases followed by type IV(24.4%). While the distal root showed a significant higher prevalence of type I configuration in 95.6%. In the examined 1200 teeth, 430 teeth (35.8%) had C-shaped root canals. The prevalence of C-shaped root canal systems was significantly higher in females (42.5%) than in males (29.1%) (P = 0.000), and did not differ with age (P = 0.126). The 80.4% C-shaped canals were bilateral (P = 0.000) and did not differ with side (left and right) (P = 0.758). Conclusions: The most commonly observed root morphology for the mandibular second molars was 2 separate roots with three canals.The prevalence of C-shaped root canal is 35.8% and is more higher in females than in males. [ABSTRACT FROM AUTHOR]

Leiomyosarcoma is a malignant tumor arising from smooth muscle cells accounting for 10-20% of soft tissue sarcomas and less than 2% are located in head and neck region. We report a case of leiomyosarcoma of maxilla in a 26-year-old female patient referred to Shahid-Beheshti University of Medical Sciences, Faculty of Dentistry. Patient complained of swelling of left side of the face from 5 months ago without a history of significant illness. Clinical examination showed asymmetric swelling of left side of the face with tenderness. The lesion in the left buccal vestibule was tender to the touch and contained erythematous mucosa with a firm tissue. Results of the neck computed tomography (CT) scan indicated mucosal thickening in the left maxillary sinus. In the preoperative magnetic resonance imaging (MRI), a mass with an estimated size of 4.7×3.1×3.0cm was found, extending from the posterior wall to the posterolateral wall of the left maxillary sinus, causing impression and remodeling of the sinus wall. Incisional biopsy was preformed and immunohistochemistry suggested leiomyosarcoma. Partial maxillectomy of the posterior maxillary walls was performed, using an intraoral incision and dissection from the maxillary vestibule up to the mandibular vestibule. The tumor was excised using frozen section. Pathological examination reported the lesion compatible with leiomyosarcoma, with all surgical margins free of tumor. Post-operative MRI showed no definite mass in the region. In conclusion, according to the present results, the clinical features of leiomyosarcoma of the maxilla are clear, and diagnosis is feasible. [ABSTRACT FROM AUTHOR]

We report on a 69-year-old man with locally-advanced left maxillary sinus cancer who underwent treatment with intra-arterial chemoradiotherapy. Angiography showed that the main feeding arteries were the left maxillary artery and the ophthalmic artery, arising from the internal carotid artery. Due to acute branching of the ophthalmic artery, conventional microcatheters could not be inserted. Using a steerable microcatheter, we were able to repeatedly administer chemoradiotherapy via the ophthalmic artery. The tumor has mostly disappeared after intra-arterial chemoradiotherapy, and the patient is still alive two years after treatment. A steerable microcatheter is very useful for acute-angled vascular branches. [ABSTRACT FROM AUTHOR]

The central granular cell odontogenic tumor (CGCOT) is a rare, benign, slowly growing, odontogenic neoplasm. CGCOT was not considered as a distinct entity in the WHO classification reported on 2017. This study reports a rare case of CGCOT involving the right side of maxillary anterior region of a 39-year-old white woman. In addition, to better delineate the clinical, radiographic, histopathologic and immunohistochemical characteristics of CGCOT, a literature review of all published cases (in PubMed/ Google Scholar/ MEDLINE/Scopus) of CGCOT is provided. CGCOT is a very uncommon tumor, with only 51 reported cases in the literature. The present case is interesting regarding to its rarity for being in the maxillary anterior region, which has not been previously reported in Asia. The immunohistochemical findings of the current case and other cases in the literature review, verified the mesenchymal origin of granular cells and odontogenic nature of the epithelium islands, which can be a possible promise for placing this lesion in the future WHO odontogenic tumor classification. [ABSTRACT FROM AUTHOR]

Maxillofacial metastases are rare but represent advanced disease progression and a poor prognosis. The primary purpose of this article is to describe a patient with previously diagnosed and treated invasive ductal breast carcinoma who developed a metastatic lesion in the maxillary gingiva. In addition, this article presents a brief literature review of case reports on metastatic breast cancer manifestations in the gingiva. In the present case, a 68-year-old woman had been diagnosed and treated for invasive ductal breast carcinoma. At the 6-month follow-up after treatment for breast cancer, she complained of pain in the right leg and spine, swelling in the right arm associated with redness, and a nodular growth in the maxillary gingiva that was painful, friable, and associated with tooth mobility. Imaging examinations and microscopic analysis of an oral biopsy specimen revealed disease progression to the oral cavity, femur, lung, and brain. Because of the advanced disease, the patient died within a few weeks. The literature review identified 6 articles that reported varied clinical presentations of metastatic breast cancer in the gingiva. Invasive ductal carcinoma was the most common histologic type. Routine dental follow-up of patients with cancer is essential for the identification and diagnosis of oral lesions to ensure early intervention for lesions that may be distant metastases mimicking benign lesions. [ABSTRACT FROM AUTHOR]

Background. Clinical and pathologic features of oral and maxillofacial malignant lesions are very important and useful in diagnostic and therapeutic planning. The aim of this study was to determine and compare the clinicopathologic features of different types of oral and maxillofacial cancers in Cancer Registry System at Isfahan-Iran. Methods. In this cross-sectional descriptive analytic study, required data (tumor type, tumor location, age, sex, and grade of malignancy) of 1081 patients from Isfahan Cancer Registry collected. Results. In this study, the mean age of the patients was 59.9±18.5years old. Most of the patients were male (56.43%). In this study, squamous cell carcinoma was the most common malignancy (61.9%) followed by non-Hodgkin's lymphoma (7%). The most common site was tongue (38.7%) and then the nasopharynx (13%). Also nasopharynx tumors in men were more common than women (P <0.001). Conclusion. Squamous cell carcinoma, as the most common oral and maxillofacial cancer, requires considerable attention and rapid and appropriate diagnosis and treatment. Knowing the clinical and pathological features of this cancer and risk factors can improve the prognosis of patients. [ABSTRACT FROM AUTHOR]

Background: Diffuse large B-cell lymphoma (DLBCL) is the most common type of lymphatic tumor; however, extranodal DLBCLs that exhibit initial symptoms in the maxilla and mandible are rare. Moreover, DLBCL is clinically classified as a moderate to highly malignant lymphatic tumor that can progress rapidly; therefore, early diagnosis is crucial. However, diagnosis is difficult as the disease causes a diverse range of clinical symptoms with no characteristic imaging findings. We conducted a clinical investigation to clarify the clinical characteristics of DLBCL that exhibits initial manifestation in the maxilla and mandible. Methods: Of the 2748 patients with malignant tumors of the oral and maxillofacial region examined at our hospital during a period of 11 years between January 2006 and December 2016, 27 primary cases diagnosed with DLBCL based on the chief complaint of symptoms in the gingiva and bone of the maxilla and mandible were enrolled in this study. Evaluations were based on sex, age, whether treatment was provided by a previous physician, symptoms, duration of disease until treatment was sought, clinical diagnosis, laboratory findings, and imaging results. Results: There were 15 cases that involved the maxilla and 12 that involved the mandible. The median duration of disease until treatment was sought was 60 d (3–450 d). All cases exhibited a tumor or a mass, and hypoesthesia of the chin was confirmed in eight cases wherein the mandible was involved. The clinical stages were stage I in eight cases, stage II in ten cases, and stage IV in nine cases. Serum lactate dehydrogenase (LDH) levels were elevated in 13 of 22 patients. The overall survival rate was 63%. Conclusions: Symptoms associated with nontender swelling and numbness of the lip or chin in the absence of other findings such as dental infections should raise suspicions about DLBCL. Patients should be provided appropriate imaging and accurate biopsy assessments to improve prognosis. [ABSTRACT FROM AUTHOR]

This case report describes the clinical application of a real-time surgical navigation system to guide zygomatic implants on their placement. With the assistance of this novel navigation system, constant visualization of the drilling trajectory and exact control of the drilling direction can be achieved, which could minimize the risk of penetration into critical anatomical structures. Moreover, implants might be accurately placed in accordance to the preoperative planned position. In this patient, who had previously undergone a hemimaxillectomy, three zygomatic implants were placed on the unilateral zygoma, and two conventional implants were placed on the unresected maxilla. Measurement of distributive deviation of implants between preoperative planning and the postoperative result showed the mean linear deviations at the entrance and apical point of the implant were 1.07 ± 0.15 mm (range: 0.9 to 1.1 mm) and 1.20 ± 0.46 mm (range: 0.7 to 1.6 mm), respectively. The mean angle deviation between the axes of the planned and the actual implant was 1.37 ± 0.21 degrees (range: 1.2 to 1.3 degrees). Therefore, this surgical navigation system represents a reliable approach to guide the placement of zygomatic implants. [ABSTRACT FROM AUTHOR]

Odontomas are benign tumors of jaws with mixed tissue, which are the result of proliferation of odontogenic epithelium and mesenchymal cells. They occur almost centrally and seldom peripherally. There is no report of such a lesion externally while attaching a tooth crown. In this case, we present a lesion on the buccal surface of the right maxillary central incisor crown, which is misconstrued with a dental overgrowth. Such cases may confuse diagnosis during clinical examination. Radiographically, such odontomas may be mistaken for various other lesions. Ultimate diagnosis should be relied upon microscopic evaluation and histopathological results. [ABSTRACT FROM AUTHOR]

Background: Calcifying epithelial odontogenic tumor (CEOT) is a benign but locally aggressive epithelial odontogenic tumor that most commonly occurs in the mandible. Although the maxillary CEOT is rare, its biological behavior is indolent. Aim: A comprehensive immunohistochemical study was performed concerning the local aggressive behavior of this tumor. Patients and methods: In this study, 12 cases of patients who were attended in the outpatient clinic of the Oral and Maxillofacial Department, Faculty of Dentistry, Tanta University were included in this study after confirmed incisional biopsy of CEOT. The patients were examined clinically preoperative and aspiration test was done. After finishing the tumor resection, closure of the maxillary defect was done by double layer repair of the defect. Biopsy of this tumor was stained by the following markers p63, Ki67, type IV collagen, smooth muscle actin (SMA), CK19, CK5/6, S100 to study the biological behavior of the tumor. Results: The neoplastic cells were diffusely cytoplasmic immunoreactive for CK19 and CK5/6. Also, the tumor cells showed mild to moderate staining to SMA. Weak intensity of collagen type IV was detected. The amyloid-like deposit was immunonegative for both SMA and type IV collagen. p63 was expressed in all studied cases. Strong to moderate nuclear staining to p63 was detected in the tumor cells. The Ki67 showed high proliferation activity of tumor cells differing from the benign tumor nature. Conclusion: Maxillary CEOT tends to grow more rapidly and not be circumscribed, suggesting that more aggressive surgery is required in these specific cases. [ABSTRACT FROM AUTHOR]

Metastatic involvement of oral osseous and soft tissues constitutes nearly 1% of all oral malignancies. However, maxillary involvement is uncommon and this phenomenon is even less likely when the primary source is thyroid. A rare case of papillary thyroid carcinoma metastatic to maxillary right posterior alveolar process and sinus in a 43-year-old woman is described and the spectrum of metastatic oral disease is reviewed. The importance of including metastasis in the differential diagnosis of jaw lesions is also emphasized. [ABSTRACT FROM AUTHOR]

Background: To research the first-order features of apparent diffusion coefficient (ADC) values on diffusion-weighted magnetic resonance imaging (DWI) in maxillofacial malignant mesenchymal tumours. Methods: The clinical data of 12 patients with rare malignant mesenchymal tumours of the maxillofacial region (6 cases of sarcoma and 6 cases of lymphoma) treated in the hospital from May 2018 to June 2020 and were confirmed by postoperative pathology were retrospectively analyzed. The patients were all examined by 1.5T magnetic resonance imaging. PyRadiomics were used to extract radiomics imaging first-order features. Group differences in quantitative variables were examined using independent-samples t-tests. Results: The voxels number of ADCmean and ADCmedian of sarcoma tissues were 44.9124 and 44.2064, respectively, significantly higher than those in lymphoma tissues (ADCmean (− 68.8379) and ADCmedian (− 74.0045)), the difference considered statistically significant, so do the ADCkurt and ADCskew. Conclusions: The statistical difference of ADCmean and ADCmedian is significant, it is consistent with the outcome of the manual measurement of the ADC mean value of the most significant cross-section of twelve cases of lymphoma. Development of tumour volume based on the ADC parameter map of DWI demonstrates that the first-order ADC radiomics features analysis can provide new imaging markers for the differentiation of maxillofacial sarcoma and lymphoma. Therefore, first-order ADC features of ADCkurt combined ADCskew may improve the diagnosis level. [ABSTRACT FROM AUTHOR]

Objectives: The study was aimed to analyze the clinicopathological and molecular pathological features of diffuse large B‐cell lymphoma (DLBCL) in the oropharyngeal and maxillofacial region. Subjects and methods: A retrospective review was performed with 36 patients who were diagnosed with primary DLBCL of the oropharyngeal and maxillofacial region from 2009 to 2017 in the Department of Pathology at the Hospital of Stomatology, Wuhan University. Immunohistochemistry and fluorescence in situ hybridization were performed. Results: Gene rearrangements of BCL2, BCL6, and MYC were observed in 5.6%, 33.3%, and 22.2%, respectively, including two double‐hit and one triple‐hit DLBCL (8.3%). There was a significant correlation between MYC protein expression and gene translocation (rs = 0.679, p <.001). However, 25% of cases with MYC rearrangement showed low MYC protein expression. In univariate analysis, MYC protein expression, BCL2 rearrangement, MYC rearrangement, and double/triple‐hit DLBCL were associated with shorter overall survival, whereas only MYC protein expression was an independent prognostic value in multivariate model. Conclusions: MYC protein expression was an essential prognostic marker of DLBCL in the oropharyngeal and maxillofacial region. Notably, immunohistochemical staining of MYC, BCL2, and BCL6 could not predict their gene rearrangements, although MYC protein expression was correlated with gene translocation. [ABSTRACT FROM AUTHOR]

Fordyce granules of the oral mucosa are often discovered during routine dental examinations. They are considered anatomic variations and are typically seen on the labial and buccal mucosa in adults. The present case report describes for the first time in the literature an atypical location of an enlarged Fordyce granule with local bone destruction. The diagnostic process, surgical treatment, and follow-up are presented and discussed. [ABSTRACT FROM AUTHOR]

Anaesthesia for otorhinolaryngological procedures has always been challenging in view of a shared and often difficult airway. A 55-year-old male, a known case of carcinoma right maxilla, presented to us following right total maxillectomy, bilateral anterior and posterior ethmoidectomy, sphenoidectomy and right supraomohyoid neck dissection. He needed a revision maxillectomy in view of a residual lesion predominantly in the right superior nasal cavity and maxillary sinus. Mouth opening was restricted to 1.5 cm making direct laryngoscopy impossible. The mass in the right nasal cavity had eroded and caused deviation of the nasal septum completely towards the left, making nasal fibrescopy also difficult. We successfully managed the airway using the technique of asleep oral fibreoptic-guided intubation. [ABSTRACT FROM AUTHOR]

Objectives: This literature review reports the current evidence for the use of zygomatic implants in head and neck oncology patients for the prosthetic rehabilitation of defects of the mid‐face and maxilla. Methods: MEDLINE, Embase and Cochrane databases were searched using strict search terms. Two independent reviewers reviewed the articles and applied inclusion and exclusion criteria. Results: Literature search revealed 437 articles, and following application of the inclusion criteria, 32 articles were included for analysis. Overall survival rates of 77%–100% were reported with few complications, although only four centres presented data on 20 or more patients. Primary implant placement at time of resective surgery has been shown to be an effective means of accelerating rehabilitation along with early loading protocols. The role of radiotherapy in implant failure has not been fully elucidated, and it is clear that zygomatic implants can be successfully used in the irradiated patient. Providing support for maxillary obturators was the most common use reported with both splinted and unsplinted implants. Conclusions: Zygomatic implants provide remote anchorage for a variety of oral and facial prostheses that contribute to the improved function and quality of life for patients being treated for maxillary and mid‐facial tumours. [ABSTRACT FROM AUTHOR]

Keratoameloblastoma is a rare variant and histologically heterogenous group of ameloblastomas, which have areas of ameloblastic epithelium and extensive keratin formation. Other subtypes of ameloblastoma which exhibit keratinisation in their parenchyma include acanthomatousameloblastoma, and papilliferouskeratoameloblastoma. Previously it was thought to be a variant of acanthomatousameloblastoma with focal areas of keratinisation. Extensive keratin deposition in the connective tissue isolates keratoameloblastoma as a separate entity from acanthomatousameloblastoma. The tumour presents itself as a destructive and an enlarging mass, mostly involving the posterior region of the mandible, with men being more commonly affected in the ratio of 3:1. This case report presents two cases of keratoameloblastoma, one in the posterior mandible and the other in the anterior maxillary region. [ABSTRACT FROM AUTHOR]

Introduction: A generous exposure of the midface region is essential for a comprehensive and thorough execution of midface surgical procedures, especially bilateral procedures. Traditional approaches to the midface the midface like the lateral rhinotomy and Weber–Fergusson/Dieffenbach incision with their modifications leave a visible scar, and they are limited in their unilateral exposure. The midface degloving approach with its exclusive intranasal and intraoral incisions leaves no external scars and lends excellent bilateral exposure of the maxilla, zygoma, paranasal areas and infraorbital margins from one side to the other. The midface degloving approach is mainly used to expose pathologies of the maxilla, nasal cavities, paranasal sinuses, nasopharynx, and the central compartment of the anterior and middle cranial base. This approach can also be used to treat midface trauma and perform high-level osteotomies. Materials and Methods: We describe the midface degloving procedure for nine cases operated in the Department of Oral and Maxillofacial Surgery over a period of 7 years (2012–2018): seven maxillary tumors and two maxillary cysts. Results: We obtained excellent exposure for all the cases using this approach. Complications included mild distortion of the lower lateral nasal cartilages and oro-nasal communication. Conclusion: The midface degloving approach lends excellent surgical access to the midfacial skeleton including the maxilla, the paranasal areas, the maxillary sinus, the zygoma, and infraorbital rims. The advantages of this approach besides its generous exposure, is the excellent cosmesis it provides leaving no external scars. [ABSTRACT FROM AUTHOR]

Introduction: Plasma cell tumors are monoclonal neoplastic proliferation of plasma cells which are divided into three groups: solitary bone plasmacytoma (SBP) and extramedullary plasmacytoma (EMP) which are localized forms, and multiplemyeloma(MM) which is the disseminated form. Skull, long bones, and vertebrae are common sites for SBP and its presence in maxillofacial area is rare. There is a possibility that SBP converts toMMand some authors believe that it can be the early stage of MM. Case Presentation: Here, we present a 59-year old male patient with a mass in maxillary bone enlarging after tooth extraction. Cone beam computed tomography (CBCT) confirmed the existence of a poorly defined lesion in the left maxilla. The microscopic evaluation and immunohistochemical studies confirmed the diffuse and monoclonal population of cells, indicating the diagnosis of plasma cell tumor. There was also no evidence of bone marrow involvement in the aspiration. Conclusions: Early and precise diagnosis of SBP is a crucial element to rule out the possibility of MM. It must be kept in mind that there is possibility of recurrence or progression toMMafter treatment which can completely change the course of disease, and this emphasizes the importance of regular follow up. [ABSTRACT FROM AUTHOR]

Parosteal osteosarcoma of craniofacial location was first described in 1961 and since then, less than 20 cases have been reported in the English literature. This rare tumour of the jaws most commonly affects middle aged men, is considered a low grade, well‐differentiated neoplasm, characterised by spindle cell stroma with minimal atypia and rare mitotic figures, separating irregular well‐developed trabeculae of woven bone. It is considered to have a favourable prognosis and low metastatic potential if treated by radical excision, compared to conventional and periosteal osteosarcomas. Clinically and radiographically it can be mistaken for a benign lesion, therefore high clinical suspicion is advised. Herein we report a case of parosteal osteosarcoma located at the posterior maxilla in a 14‐year‐old male and review of the literature with respect to clinical, radiographical and histopathological features of these lesions. [ABSTRACT FROM AUTHOR]

Introduction: A definitive maxillary obturator prosthesis can be used to rehabilitate a maxillary defect with the aim of improving speech, deglutition, and elimination of oronasal regurgitation. The aims of this study were (1) to determine the time required to fabricate a definitive maxillary obturator prosthesis and (2) to compare the fabrication and follow-up times between a patient's first and second definitive maxillary obturator prosthesis.Materials and Methods: A retrospective review was completed of patients that had maxillary definitive obturators fabricated following head and neck surgery from 2002 to 2018 (n = 173). Demographics, clinical data, date of surgery, start date of fabrication, follow-up dates, and prosthesis follow-up data were collected.Results: The median time to delivery of the patient's first definitive maxillary obturator prosthesis from the date of surgery was 7.7 months for nonradiated patients and 9.6 months for radiated patients (P ≤ .05). Additionally, there was a significant difference in the median number of appointments to fabricate the 1st definitive maxillary obturator prosthesis as compared to the 2nd prosthesis (6 vs 5; P ≤ .05).Conclusion: Fabrication timelines differed based on history of radiotherapy and patient experience. This data is helpful to set expectations for patients and practitioners regarding the process for prosthesis fabrication and follow-up. [ABSTRACT FROM AUTHOR]

Adolescent and young adult (AYA) oral maxillofacial tumors are rare and account for ∼12% of all AYA cancers. Due to the low incidence of these malignancies, diagnostic considerations, therapeutic approaches, and factors affecting prognosis have been difficult to characterize. Given the anatomic structures located within the head and neck, patients are at risk for treatment-related morbidity that may adversely impact their quality of life. We present a single-institution case series of AYA patients with oral maxillofacial tumors treated at the University of Illinois at Chicago. A multidisciplinary treatment approach, including collaboration with the Oral Maxillofacial Surgery, Dentistry, and the Ear, Nose, and Throat teams along with the utilization of Children's Oncology Group treatment protocols, can serve as a model to address the challenges in the management of these complex cases. [ABSTRACT FROM AUTHOR]

Background and Aim: Adenomatoid Odontogenic Tumor (AOT) accounts for less than 3% of all odontogenic tumors. It commonly occurs in anterior region of maxilla associated with an impacted tooth. Multifocal odontogenic lesions are uncommon and have only been observed in conditions associated with known genetic mutations. To the best of our knowledge, only three cases of multifocal adenomatoid odontogenic tumors (AOT) have previously been reported in the literature. Case presentation: In this study, we report the second case of a bilateral, separate AOT in the maxilla in the midline in a 13-years old male. The patient presented with bilateral masses in the maxilla on either side of the midline which had been developed in 1 month. Conclusion: It seems, bilateral occurance of AOT in anterior region of maxilla can be correlated with faster growth and genetic susebtibility. [ABSTRACT FROM AUTHOR]

Melanotic neuroectodermal tumor of infancy is a rare, rapidly growing, painless, pigmented neoplasm with neural crest derivation. It usually occurs during the first year of life and there is a prominent predilection for the maxilla. The purpose of the present report is to describe additional case of melanotic neuroectodermal tumor of infancy of maxilla in a 6- month-old infant male. The treatment included surgical excision with safe margins. No attempt was made for immediate grafting of the surgery site due to high proliferation rate of tissues and self-renewal during infancy. The facial growth was normal and the surgical cleft was tightly closed. Due to the rarity of tumor, essential knowledge on characteristics of this lesion would contribute to a proper diagnosis and benefit treatment planning. [ABSTRACT FROM AUTHOR]

Chondrosarcomas are malignant mesenchymal tumors characterized by the differentiation of pure hyaline cartilage, and they are relatively uncommon in jawbones. Chondrosarcoma of the jaws usually presents as a painless mass or swelling associated with loosening of the associated teeth. This report describes an unusual case of chondrosarcoma that mimicked pulp disease on initial presentation in the maxilla of a 22-yearold man. The relevant literature is reviewed regarding clinicopathologic features and therapeutic management of chondrosarcomas. [ABSTRACT FROM AUTHOR]

Adenoid cystic carcinoma (ACC) is a rare tumor, with a documented annual incidence ranging from 3 to 4.5 cases per million. It constitutes approximately 1% of all head and neck malignancies and around 10% of salivary gland tumors. It is imperative to adopt a multidisciplinary approach to ensure the most appropriate therapeutic outcome. Treatment strategies usually involve a multidisciplinary approach and may include surgery, radiotherapy, chemotherapy, or various combinations of these. In this context, we present a clinical case of ACC originating in the palate of a woman. Throughout this article, we will detail the diagnostic challenges and multidisciplinary treatment strategies implemented, emphasizing the importance of a comprehensive approach in cases of palatal ACC. In addition, we will discuss the rehabilitation process and the outcomes observed during the follow-up of this case., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.