exudates and Mandibular-Neoplasms

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.

Topics: Ameloblastoma; Bicuspid; Biopsy, Needle; Child; Diagnosis, Differential; Follow-Up Studies; Humans; Immunohistochemistry; Malaysia; Male; Mandibular Neoplasms; Odontogenic Cysts; Oral Surgical Procedures; Rare Diseases; Tooth; Tooth Extraction; Treatment Outcome

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.. This is a retrospective study (1993 through 2008) of consecutive ameloblastoma cases accessioned in 2 main oral pathology diagnostic centers: the Unit of Stomatology, Institute for Medical Research and the Department of Oral Pathology, Oral Medicine, and Periodontology, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia. Data on patient demographics, tumor location, symptomology, duration, radiographic appearance, preoperative diagnosis, clinicopathologic subtypes, treatment, and recurrence were analyzed.. Three hundred forty cases of ameloblastoma were reviewed. These were from 197 male patients (57.9%) and 143 female patients (42.1%), with a male-to-female ratio of 1.4:1. A wide age range (7 to 85 years), mean onset age of 30.3 ± 16.3 years, and peak incidence in the second decade of life were recorded. Most were mandibular tumors (n = 311/340, 91.5%). These consisted of 95 (28%) unicystic ameloblastomas, 221 (65%) solid/multicystic ameloblastomas, 22 (6.4%) desmoplastic ameloblastoma, and 2 (0.6%) peripheral ameloblastomas. Unicystic ameloblastoma (41.1%) and solid/multicystic ameloblastoma (52.0%) mostly affected Malays patients, whereas desmoplastic ameloblastoma (59.1%) was prevalent in Chinese patients. Unicystic ameloblastoma (56.8%) and solid/multicystic ameloblastoma (47.1%) occurred predominantly in the body and posterior mandible, whereas desmoplastic ameloblastoma (36.4%) preferentially involved the anterior jaw segment. Most tumors presented as multilocular radiolucencies (36.8%). Enucleation (n = 42/92, 45.7%) was the treatment of choice. About 18 cases (13.3%) presented with recurrence.. Because ameloblastoma subsets differ in their biologic behavior, the present data are significant as baseline references for clinicians and pathologists.

Topics: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Ameloblastoma; Child; Female; Humans; Malaysia; Male; Mandibular Neoplasms; Maxillary Neoplasms; Middle Aged; Retrospective Studies; Sex Distribution; Young Adult

An adult, female Malayan sun bear (Helarctos malayanus) was diagnosed with squamous cell carcinoma of the rostral mandible. Initial treatment included bilateral mandibulectomy rostral to the lingual frenulum followed by intra- and perilesional cisplatin injections. Recovery after the procedure was uneventful and the Malayan sun bear adapted well to a shortened mandible. Histopathology indicated incomplete surgical excision of the tumor; therefore, radiation therapy was instituted weekly for four treatments at 2 Gy in parallel opposed fields (total 4 Gy each treatment) with one additional cisplatin treatment. Two years after initial presentation, the animal showed no recurrence of neoplasia.

Topics: Animals; Antineoplastic Agents; Carcinoma, Squamous Cell; Cisplatin; Female; Malaysia; Mandibular Neoplasms; Treatment Outcome; Ursidae

This report reviews the clinicopathologic characteristics of 104 cases of odontomas diagnosed in the Division of Stomatology, Institute for Medical Research, Kuala Lumpur, over a 29-year period (1967-1995). The results showed no real predilection in terms of sex (M:F ratio, 1:1), race (45.2% Malays, 40.4% Chinese, 10.6% Indians and 3.8% other races) or site (maxilla:mandible ratio, 1: 1.04) distribution. The mean age at presentation was 24.8 years and the age range was 3-74 years. There were 102 intraosseous and 2 extraosseous odontomas. Swelling was the most common presenting complaint. The majority of cases (81.9%) were clinically diagnosed as odontomas. The treatment of choice was surgical enucleation. Compound (43.3%) and complex (35.5%) odontomas were the two most common histological types encountered. The present findings correlate favorably with reported studies from other geographic areas.

Topics: Adolescent; Adult; Age Factors; Aged; Asian People; Child; Child, Preschool; China; Ethnicity; Female; Humans; India; Jaw Neoplasms; Malaysia; Male; Mandibular Neoplasms; Maxillary Neoplasms; Middle Aged; Odontoma; Sex Factors; White People

Seventeen cases are reported of desmoplastic variant of ameloblastoma of the jaws observed during the years 1967-1991. There were 12 females and 5 males, and these consisted of 7 Chinese, 6 Malays, 2 Indians, 1 Sikh and 1 Kadazan. Their ages at diagnosis ranged from 21-60 years with a mean of 36.6 years. There were 10 mandibular and 7 maxillary tumours. Of these, 14 cases involved the anterior segment with extension to the premolar region in 5 cases. 60% of cases were radiologically suggestive of fibro-osseous lesions. The main mode of treatment was resection and 1 case presented with recurrence. The findings of this study were compared with those of previous reports.

Topics: Adult; Ameloblastoma; Collagen; Connective Tissue; Epithelium; Female; Humans; Malaysia; Male; Mandibular Neoplasms; Maxillary Neoplasms; Middle Aged; Neoplasms, Fibrous Tissue

A study was made of the clinical statistics of odontogenic cysts treated at two hospitals in West Malaysia over a 6-year period. The general incidence of the individual cyst-types is similar to that reported in previous studies. A marked difference in the age distribution of radicular cysts emerged and 80% of the residual cysts in the survey occurred amongst the Chinese population. Reasons for the distribution variation are discussed.

Topics: Adolescent; Adult; Age Factors; Aged; Child; Female; Humans; Malaysia; Male; Mandibular Neoplasms; Maxillary Neoplasms; Middle Aged; Odontogenic Cysts; Sex Factors; Statistics as Topic