Suppl.completo reimpag._4b_. 04/10/13 15:55 Pagina 33
Case Report
Primary intraosseus carcinoma of the jaws arising froma odontogenic cyst - a case report V. Zavaglia1, A. Nori2, C. Rubini3, S.R. Berlin4, C. Serafini4 1SOD of Dentistry Surgical and Special AOU “Ospedali Riuniti” Ancona, Italy; 2Oral Surgery SOD of Surgical Dentistry of Special AOU “Ospedali Riuniti”, Ancona, Italy; 3Istitute of Pathological Anatomy, Polytechnic University of Marche, Ancona, Italy; 4SOD of Dentistry and Special Surgery, AOU “Ospedali Riuniti” Ancona, Italy Background. Squamous cell carcinoma of the jaw located purely in the bone is extremely rare. Most of these intraosseous carcinomas, also called odontogenic carcinomas are thought to arise from the epithelial lining of an odontogenic cyst. The diagnosis of the development of carcinoma from the cyst lining can only be established by histopatologic examination. Surgeons should appreciate the elevated aggressiveness of this tumor despite adequate surgical treatment. The authors recommend initial aggressive surgical treatment to decrease the local recurrence rate. Case Report. A primary intraosseous carcinoma arising from an odontogenic cyst in a 58-year-old man is reported. Subjective symptoms were noted by the patient (severe pain and intraoral fistulain the lower jaw). Single-tooth retained with associated presumed cystic lesion was evident in the lower jaw on a routine radiograph. Histology revealed an intraosseous carcinoma after removal of the teeth and “cystectomy”. No metastasis was detected. The patient is free of disease after 3 years. Conclusion. This case report clearly demonstrates the importance of clinician awareness of the malignant potential of apparently innocuous cystic lesion. Although primary intraosseous carcinoma is rare, this case emphasizes the importance of careful histological examination of apparently innocuous odontogenic cysts. In addition, as malignant changes in their epithelial lining are always possible, “cystic” lesions should not only be removed but as completely as possible. References • • •
Swinsin BD, Jerjes W, Thomas GJ. Squamous cell carcinoma arising in a residual odontogenic cyst. J Oral Maxillofac Surg 2005 Aug; 63(8):1231-3. Berens A, Kramer FJ, Kuettner C, Eckhardt A, Kreft A. Klinik für Mund-, Kiefer- und Gesichtschirurgie, Medizinische Hochschule Hannover. Mund Kiefer Gesichtschir 2000 Sep;4(5):330-4. Scheer M, Koch AM, Drebber U, Kuebler AC. Primary intraosseus carcinoma of the jaws arising froma odontogenic cyst-a case report. J Oral Maxillofac Surg 2004 Jun; 32(3):166-9.
Annali di Stomatologia 2013; Suppl. 2: 1-48
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Case Report
Primary intraosseus carcinoma of the jaws arising froma odontogenic cyst - a case report V. Zavaglia1, A. Nori2, C. Rubini3, S.R. Berlin4, C. Serafini4 1SOD of Dentistry Surgical and Special AOU “Ospedali Riuniti” Ancona, Italy; 2Oral Surgery SOD of Surgical Dentistry of Special AOU “Ospedali Riuniti”, Ancona, Italy; 3Istitute of Pathological Anatomy, Polytechnic University of Marche, Ancona, Italy; 4SOD of Dentistry and Special Surgery, AOU “Ospedali Riuniti” Ancona, Italy Background. Squamous cell carcinoma of the jaw located purely in the bone is extremely rare. Most of these intraosseous carcinomas, also called odontogenic carcinomas are thought to arise from the epithelial lining of an odontogenic cyst. The diagnosis of the development of carcinoma from the cyst lining can only be established by histopatologic examination. Surgeons should appreciate the elevated aggressiveness of this tumor despite adequate surgical treatment. The authors recommend initial aggressive surgical treatment to decrease the local recurrence rate. Case Report. A primary intraosseous carcinoma arising from an odontogenic cyst in a 58-year-old man is reported. Subjective symptoms were noted by the patient (severe pain and intraoral fistulain the lower jaw). Single-tooth retained with associated presumed cystic lesion was evident in the lower jaw on a routine radiograph. Histology revealed an intraosseous carcinoma after removal of the teeth and “cystectomy”. No metastasis was detected. The patient is free of disease after 3 years. Conclusion. This case report clearly demonstrates the importance of clinician awareness of the malignant potential of apparently innocuous cystic lesion. Although primary intraosseous carcinoma is rare, this case emphasizes the importance of careful histological examination of apparently innocuous odontogenic cysts. In addition, as malignant changes in their epithelial lining are always possible, “cystic” lesions should not only be removed but as completely as possible. References • • •
Swinsin BD, Jerjes W, Thomas GJ. Squamous cell carcinoma arising in a residual odontogenic cyst. J Oral Maxillofac Surg 2005 Aug; 63(8):1231-3. Berens A, Kramer FJ, Kuettner C, Eckhardt A, Kreft A. Klinik für Mund-, Kiefer- und Gesichtschirurgie, Medizinische Hochschule Hannover. Mund Kiefer Gesichtschir 2000 Sep;4(5):330-4. Scheer M, Koch AM, Drebber U, Kuebler AC. Primary intraosseus carcinoma of the jaws arising froma odontogenic cyst-a case report. J Oral Maxillofac Surg 2004 Jun; 32(3):166-9.
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