MyMedR

Desmoplastic fibroma: report of a case with proliferative myositis

Boon LC, Phaik KS, Khanijow V

Ann Dent, 1991;50(2):28-32.

Desmoid tumor of the mandible, or desmoplastic fibroma, is a rare disease with only a few cases reported in the literature. This paper presents the rare case of an elderly male with desmoplastic fibroma of the mandible with an uncommon accompanying proliferative myositis. The case is discussed with emphasis on the clinical presentation, differential diagnosis and treatment of this lesion.

Matched MeSH terms: Mandibular Neoplasms/pathology*

Cemento-ossifying fibroma with mandibular fracture. Case report in a young patient

Ong AH, Siar CH

Aust Dent J, 1998 Aug;43(4):229-33.

PMID: 9775467

The cemento-ossifying fibroma is classified as an osteogenic neoplasm of the jaws. It commonly presents as a progressively growing lesion that can attain an enormous size with resultant deformity if left untreated. A case of a large cemento-ossifying fibroma involving the left mandible is described in a 15 year old male patient. The clinical, radiographic and histological features as well as surgical findings are presented. The treatment of choice of this lesion is also emphasized. Two years after surgery, there was no evidence of recurrence and the transosseous wire used to immobilize the fracture was found to be completely buried in the jaw bone.

Matched MeSH terms: Mandibular Neoplasms/pathology

Transmigration of permanent mandibular canines. Case report

Shanmuhasuntharam P, Boon LC

Aust Dent J, 1991 Jun;36(3):209-13.

PMID: 1877915

Transmigration is the migration of a tooth across the midline of the jaw. This phenomenon is found only in relation to the permanent mandibular canines. Two cases are reported. In both, the cause of this deviation was an odontome found in the site normally occupied by the mandibular canine. The literature on transmigration is reviewed.

Matched MeSH terms: Mandibular Neoplasms/pathology

Fulltext Numb chin syndrome: an ominous sign of mandibular metastasis

Razak A, Goh BS, Rajaran JR, Nazimi AJ

BMJ Case Rep, 2018 May 14;2018.

PMID: 29764822 DOI: 10.1136/bcr-2017-223586

A 51-year-old woman a known case of stage 2 breast carcinoma in 2006 and underwent left mastectomy performed in the same year presented with bilateral lower limb pain suggestive of spinal pathology, and left chin numbness, both of 2 weeks' duration. Examination revealed left mandibular hypoesthesia without any other sign or symptoms. Orthopantomogram was unremarkable apart from mild alveolar bone expansion at tooth 36 area, which was extracted 3 months earlier. Subsequently, a full-body positron emission tomography contrast enhanced computer tomography revealed hypermetabolic lesions of her axial (excluding skull) and appendicular skeleton. In the head and neck region, left mandibular foramen and oropharynx bilaterally showed increased metabolism suggestive of tumour metastasis. The diagnosis was numb chin syndrome secondary to mandibular metastasis. Apart from supportive treatment, she was started on palliative chemotherapy and radiotherapy. At the time of discharge, there were no active complaints other than the aforementioned hypoesthesia.

Matched MeSH terms: Mandibular Neoplasms/pathology

Squamous odontogenic tumor of the mandible: a case report demonstrating immunoexpression of Notch1, 3, 4, Jagged1 and Delta1

Siar CH, Nakano K, Ng KH, Tomida M, Nagatsuka H, Kawakami T

Eur J Med Res, 2010 Apr 08;15(4):180-4.

PMID: 20554499

BACKGROUND: Squamous odontogenic tumor (SOT) is a rare benign odontogenic epithelial neoplasm. A slow-growing painless expansive swelling is the common presenting symptom. Histopathologically, SOT can be easily misdiagnosed as an acanthomatous ameloblastoma. Although Notch receptors and ligands have been shown to play a role in cell fate decisions in ameloblastomas, the role of these cell signaling molecules in SOT is unknown.

CASE REPORT: This paper describes a case of SOT affecting the anterior mandible of a 10-year-old Indian female. The patient was treated by local surgical excision and there has been no follow-up clinical record of recurrence 5 years after primary treatment. Histo?pathological examination revealed a solid, locally-infiltrative neoplasm composed of bland-looking squamatoid islands scattered in a mature fibrous connective tissue stroma and the diagnosis was SOT. Immunohistochemical evaluation showed positive reactivity of varying intensity in the neoplastic epithelial cells for Notch1, Notch3, Notch4, and their ligands Jagged1 and Delta1. Expression patterns showed considerable overlap. No immunoreactivity was detected for Notch2 and Jagged2.

CONCLUSIONS: Present findings suggest that Notch receptors and their ligands play differential roles in the cytodifferentiation of SOT.

Matched MeSH terms: Mandibular Neoplasms/pathology

An unsuspected ameloblastoma in the subpontic region of the mandible with consideration of pathogenesis from the radiographic course

Siar CH, Nakano K, Chelvanayagam PI, Ng KH, Nagatsuka H, Kawakami T

Eur J Med Res, 2010 Mar 30;15(3):135-8.

PMID: 20452900

The purpose of this report is to document a case of unsuspected ameloblastoma involving the right man dibular subpontic region in a 38-year-old Cambodian female patient. This lesion was purportedly preceded by multiple radiolucencies which were diagnosed as radicular cysts and treated a few times in the past years by enucleation followed by endodontic therapy of the affected teeth. Bridgework restoration of the partially edentulous area was performed. This case report demonstrates radiographic changes that occurred in the periods before and after the diagnosis of ameloblastoma. The case may represent an example of radicular cysts and ameloblastoma occurring as a collision phenomenon, or the ameloblastoma may have arisen as a result of neoplastic transformation of the lining epithelium in an inflammatory odontogenic epithelial cyst.

Matched MeSH terms: Mandibular Neoplasms/pathology*

Desmoplastic ameloblastoma in Indians: report of five cases and review of literature

Sivapathasundharam B, Einstein A, Syed RI

Indian J Dent Res, 2007 10 17;18(4):218-21.

PMID: 17938502

In the recent World Health Organization classification of odontogenic tumours, desmoplastic ameloblastoma has been characterized as a variant of ameloblastoma, with specific clinical, radiographical, and histological features. Till date, 145 cases have been reported in Japanese, Chinese, Malaysian, Western, and African populations, with very few cases described in Indians. Here, we report five cases in the Indian population. The male to female ratio was 3:2. The mean age at diagnosis was 33.2 years. Four of the tumours were located in the maxilla, in the anterior premolar region. The lone mandibular tumour was located anteriorly, crossing the midline. Three of the tumours had a mixed radiologic appearance with poorly defined borders. Unilocular change was seen in one of them. Two tumours presented as unilocular radiolucencies with specks of radiopacities and well-circumscribed borders. Histologically, irregular odontogenic islands, with a stretched-out 'kite-tail' appearance, were seen in a dense desmoplastic stroma. The peripheral layer of the epithelial islands was made up of flattened cells and the inner core was made up of spindle-shaped and, in some instances, squamous-shaped cells. In two cases, odontogenic epithelium in the form of follicles, typical of solid/multicystic ameloblastoma, was seen and these were typed as 'hybrid' variants. All the cases were treated by resection.

Matched MeSH terms: Mandibular Neoplasms/pathology

Mandibulotomy: an analysis of its morbidities

Nabil S, Nazimi AJ, Nordin R, Hariri F, Mohamad Yunus MR, Zulkiflee AB

Int J Oral Maxillofac Surg, 2018 Dec;47(12):1511-1518.

PMID: 30837061 DOI: 10.1016/j.ijom.2018.05.020

The mandibulotomy is a procedure that was developed to improve access in tumour resection. This study aimed to investigate the complications associated with mandibulotomy and analyze factors that could affect the risks of developing these complications. The hospital records of all patients who underwent a mandibulotomy as part of their tumour ablative surgery at two major centres in Malaysia were reviewed retrospectively. Demographic, clinical, and complications data were recorded and analyzed. Early postoperative complications occurred in 46.5% of the patients and post-radiation therapy complications in 16.1%. Wound dehiscence (27.9%) and inferior alveolar nerve injury (25.6%) were the common early postoperative complications. Dental injuries (9.7%) and plate exposure/infection (9.7%) were the common post-radiation therapy complications. Furthermore, inferior alveolar nerve injury and early abscess formation were significantly associated with the site of the mandibulotomy. The T-stage of a tumour but not the site of mandibulotomy was significantly associated with tumour margin clearance. Mandibulotomy does pose an added risk of complications for a patient undergoing tumour surgery. The benefits of mandibulotomy in terms of gaining margin clearance could not be proven in this study. The site of mandibulotomy appears to increase the risk of developing an inferior alveolar nerve injury.

Matched MeSH terms: Mandibular Neoplasms/pathology

Chondrosarcoma of the mandible: a case report

Saini R, Abd Razak NH, Ab Rahman S, Samsudin AR

J Can Dent Assoc, 2007 Mar;73(2):175-8.

PMID: 17355810

Chondrosarcomas are malignant tumours of cartilaginous origin. They range from a well-differentiated growth resembling a benign cartilage tumour to a high-grade malignancy with aggressive local behaviour and the potential to metastasize. Only 5% to 10% of chondrosarcomas are known to occur in the head and neck region. A case of chondrosarcoma of the anterior region of the mandible is presented, along with a review of the relevant literature.

Matched MeSH terms: Mandibular Neoplasms/pathology*

Ameloblastoma of the jaws: a retrospective analysis of 340 cases in a Malaysian population

Siar CH, Lau SH, Ng KH

J Oral Maxillofac Surg, 2012 Mar;70(3):608-15.

PMID: 21723654 DOI: 10.1016/j.joms.2011.02.039

Ameloblastoma of the human jaw is an uncommon but clinically significant odontogenic epithelial neoplasm. The aim was to analyze the clinicopathologic characteristics of ameloblastoma in a Malaysian population.

Matched MeSH terms: Mandibular Neoplasms/pathology

Podoplanin, E-cadherin, β-catenin, and CD44v6 in recurrent ameloblastoma: their distribution patterns and relevance

Siar CH, Ishak I, Ng KH

J Oral Pathol Med, 2015 Jan;44(1):51-8.

PMID: 25059841 DOI: 10.1111/jop.12203

Ameloblastoma is a benign but locally infiltrative odontogenic epithelial neoplasm with a high risk for recurrence. Podoplanin, a lymphatic endothelium marker, putatively promotes collective cell migration and invasiveness in this neoplasm. However, its role in the recurrent ameloblastoma (RA) remains unclear. As morphological, signaling, and genetic differences may exist between primary and recurrent tumors, clarification of their distribution patterns is of relevance.

Matched MeSH terms: Mandibular Neoplasms/pathology

Differential expression of Notch receptors and their ligands in desmoplastic ameloblastoma

Siar CH, Nakano K, Han PP, Nagatsuka H, Ng KH, Kawakami T

J Oral Pathol Med, 2010 Aug 1;39(7):552-8.

PMID: 20337864 DOI: 10.1111/j.1600-0714.2009.00871.x

In mammals, the Notch gene family encodes four receptors (Notch1-4), and all of them are important for cell fate decisions. Notch signaling pathway plays an essential role in tooth development. The ameloblastoma, a benign odontogenic epithelial neoplasm, histologically recapitulates the enamel organ at bell stage. Notch has been detected in the plexiform and follicular ameloblastoma. Its activity in the desmoplastic ameloblastoma is unknown.

Matched MeSH terms: Mandibular Neoplasms/pathology

Osteosarcoma presenting as an aggressive nodular mass in the region of the mandible

Ong ST, Shim CK, Ng KH, Siar CH

J Oral Sci, 2004 Mar;46(1):55-9.

PMID: 15141725

Osteosarcomas are highly malignant neoplasms of bone that are challenging to diagnose. These neoplasms often show atypical behavior. In the initial phase they may present as nondescript bony swellings with an indolent growth rate, only to become overtly aggressive and malignant towards the later phase of the disease. Similarly, the histological growth pattern of this neoplasm can be quite diverse, presenting with areas that mimic benign myofibroblastic tumors, giant cell granulomatous conditions and partial encapsulation. The final diagnosis of an osteosarcoma is often reached after thorough sampling and examination of multiple biopsy specimens. All these clinical features and histological diagnostic difficulties were encountered in a case of osteosarcoma affecting the right mandible of a 62-year-old Chinese woman described here. The diagnostic lessons accrued from this case are discussed.

Matched MeSH terms: Mandibular Neoplasms/pathology*

Osteoma of the condyle as the cause of limited-mouth opening: a case report

Siar CH, Jalil AA, Ram S, Ng KH

J Oral Sci, 2004 Mar;46(1):51-3.

PMID: 15141724

Osteoma is a benign tumour consisting of mature bone tissue. It is an uncommon lesion that occurs mainly in the bones of the craniofacial complex. Only a few cases involving the condylar process have been reported. An osteoma of the left condyle causing limited mouth-opening in a 32-year-old Malaysian Chinese female is reported here to alert the practitioner to consider this lesion as a diagnostic possibility in instances of trismus or limited-mouth opening.

Matched MeSH terms: Mandibular Neoplasms/pathology

Unicystic Ameloblastoma: A Perception for the Cautious Interpretation of Radiographic and Histological Findings

Arora S

J Coll Physicians Surg Pak, 2015 Oct;25(10):761764-764.

PMID: 26454399 DOI: 10.2015/JCPSP.761764

The term Unicystic Ameloblastoma (UA) refers to those cystic lesions that show clinical and radiological characteristics of an odontogenic cyst but on histological examination show a typical ameloblastomatous epithelium lining part of the cyst cavity, with or without luminal and/or mural tumor growth. Till date, lot of controversies exist among oral surgeons and oral pathologists regarding this entity. An attempt is being made here to discuss all the diagnostic dilemmas associated with UA.

Matched MeSH terms: Mandibular Neoplasms/pathology

Premolar Cystic Ameloblastoma in a Child

Pathak S, Sonalika WG, Hs V, Tegginammani AS

J Coll Physicians Surg Pak, 2017 Jan;27(1):47-48.

PMID: 28292369 DOI: 2521

Mandibular swellings may occur as a result of many benign lesions of odontogenic or non-odontogenic origin. Ameloblastomas are benign tumours of odontogenic origin, whose importance lies in its potential to grow into enormous size with resulting bone deformity, it is a slow-growing, persistent, and locally aggressive neoplasm. The unicystic ameloblastoma (UA) represents an ameloblastoma variant, presenting as a cyst clinically and radiographically, but showing typical ameloblastomatous epithelium lining histologically. It commonly occurs in second and third decades of life and is rare in children under 12 years of age, and better response to conservative treatment. It shares many clinical and radiographic features with odontogenic cysts/tumours and/or periapical disease of endodontic origin. Reported here is an unusual case of unicystic ameloblastoma involving the crown of an unerupted mandibular first premolar in a 9-year boy in an uncommon location, which was misdiagnosed as periapical lesion of inflammatory origin clinically, and as a dentigerous cyst radiographically. This highlights the importance to routinely submit the removed surgical specimen for histopathological examination.

Matched MeSH terms: Mandibular Neoplasms/pathology*

Peripheral ameloblastoma with clear cell differentiation

Ng KH, Siar CH

Oral Surg. Oral Med. Oral Pathol., 1990 Aug;70(2):210-3.

PMID: 2290651

This report details a case of mandibular peripheral ameloblastoma having a clear cell component. The latter consisted of ovoid cells with vacuolated or clear cytoplasm and vesicular or pyknotic nuclei that may be disposed as discrete clusters or show direct transition from typical acanthomatous areas. Comparison of this lesion with other odontogenic and nonodontogenic tumors that contain clear cells is discussed in the context of the differential diagnosis.

Matched MeSH terms: Mandibular Neoplasms/pathology*

Plexiform granular cell odontogenic tumor: unicystic variant

Siar CH, Ng KH, Jalil NA

Oral Surg. Oral Med. Oral Pathol., 1991 Jul;72(1):82-5.

PMID: 1891247

Plexiform granular cell odontogenic tumor of the mandible has recently been described. The cardinal histopathologic feature, as its name suggests, is a monophasic plexiform pattern of granular cells; the principal tumor in the differential diagnosis is granular cell ameloblastoma. Unlike the two previously reported cases of plexiform granular cell odontogenic tumor, which occurred as solid tumors in elderly men, the lesion reported here is a unicystic variant occurring in a middle-aged woman.

Matched MeSH terms: Mandibular Neoplasms/pathology*

RANK, RANKL, and OPG in recurrent solid/multicystic ameloblastoma: their distribution patterns and biologic significance

Siar CH, Tsujigiwa H, Ishak I, Hussin NM, Nagatsuka H, Ng KH

Oral Surg Oral Med Oral Pathol Oral Radiol, 2015 Jan;119(1):83-91.

PMID: 25446507 DOI: 10.1016/j.oooo.2014.09.017

To determine the distribution patterns of bone resorption regulators, receptor activator of nuclear factor κ-B (RANK), RANK ligand (RANKL), and osteoprotegerin (OPG) in recurrent ameloblastoma (RAs) and to clarify their impact on the biologic behavior of these neoplasms.

Matched MeSH terms: Mandibular Neoplasms/pathology*

Notch4 overexpression in ameloblastoma correlates with the solid/multicystic phenotype

Siar CH, Nagatsuka H, Chuah KS, Rivera RS, Nakano K, Ng KH, et al.

Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2010 Aug;110(2):224-33.

PMID: 20659700 DOI: 10.1016/j.tripleo.2010.03.009

Notch signaling has been implicated in cell fate decisions during odontogenesis and tumorigenesis of some odontogenic neoplasms; however, its role in solid/multicystic (SA), unicystic (UA), and recurrent (RA) ameloblastoma remains unclear. The aim of this study was to determine Notch receptor and ligand expressions in these subtypes and to speculate on their significance.

Matched MeSH terms: Mandibular Neoplasms/pathology

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