Chondrosarcoma of the temporomandibular joint : a case report and review of the literature

Chondrosarcoma is a malignant tumor characterized by the formation of cartilage, but not bone, by tumor cells. Only 5% to 10% of chondrosarcomas occur in the head and neck, representing 0.1% of all head and neck neoplasms, with the larynx and the maxillo-nasal region being the most common sites. This report describes an unusual case of chondrosarcoma in a 54-year-old man who presented with pain and swelling in the left preauricular area. Computed tomography demonstrated a soft tissue mass in the left temporomandibular joint without causing erosion of the adjacent bony structures. The tumor was treated by excision in a single block with perilesional tissues, preserving the facial nerve. Hist…

Diagnóstico diferencial de tumefacciones y tumoraciones submandibulares

Metástasis mandibular por carcinoma hepático: un infrecuente caso con severa hemorragia

El carcinoma hepatocelular (CH) es relativamente infrecuente en Europa y Estados Unidos, a pesar de que en este último país se diagnostican más de 13.000 nuevos casos cada año. Las metástasis mandibulares por CH son inusuales, recogiéndose en la literatura hasta el momento, 50 casos. En el presente trabajo se documenta un nuevo caso, correspondiente a un varón de 54 años que presentó una metástasis por HC en el cuerpo mandibular derecho, al año del tratamiento de su tumor primario. El curetaje-biopsia de la lesión se acompañó de una profusa hemorragia. El paciente falleció a los seis meses de la biopsia, con múltiples metástasis. Se describen las posibles vías de diseminación hematógena de …

Papillary cystadenoma and cystadenocarcinoma of salivary glands : two unusual entities

Cystadenoma and cystadenocarcinoma are rare salivary gland tumours histologically characterized by prominent cystic and frequently papillary growth. We present two cases of cystadenoma of a minor salivary gland (upper lip) and parotid cystadenocarcinoma respectively, captured between 834 salivary gland tumors studied in our hospital from 1980 to 2004. The authors review the clinical, histological, and biological features of these two unusual tumours, and differential diagnosis with other salivary glands neoplasms. Both entities usually reveal papillary proliferation of the epithelial lining and are composed of cells that possess bland cytomorphologic features. Differentiation of tumour type…

Oral bisphosphonates-associated osteonecrosis in rheumatoid arthritis

Adverse effects associated with the use of bisphosphonates are infrequent and consist of pyrexia, renal function impairment, and hypocalcemia. Bisphosphonates-associated osteonecrosis of the jaws is an uncommon but potentially serious complication of intravenous bisphosphonate therapy in cancer patients. The degree of risk for osteonecrosis in patients taking oral bisphosphonates, such as alendronate, is uncertain and warrants careful monitoring. Oral bisphosphonates-associated osteonecrosis can occur in patients with rheumatoid arthritis. We report a case of mandibular osteonecrosis in a patient who received alendronate for 3.8 years. The pathology improved after bisphosphonate therapy dis…

Odontoma intraóseo erupcionado: Una infrecuente patología

Objetivos: Los odontomas que afectan a los tejidos blandos son muy infrecuentes, pudiendo presentarse bajo dos formas clinicas: odontoma periférico y odontoma erupcionado. Se documenta un caso de odontoma erupcionado con el objetivo de discutir entre ambas formas de presentación clínica de esta patología. Diseño del estudio: Estudio de caso. Resultados: Se presenta el caso de un varón con una masa dura localizada en la región posterior del reborde alveolar izquierdo del maxilar superior, de un año de evolución y lento crecimiento. La ortopantomografía mostró la presencia de una tumoración radiodensa en la región posterior del maxilar izquierdo. El estudio histológico de la pieza operatoria …

Current Controversies in Classification, Management, and Prevention of Bisphosphonate-Related Osteonecrosis of the Jaw

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a serious complication associated with oral and intravenous bisphosphonate therapy that adversely affects the quality of life, producing significant morbidity. Since the first description of bone necrosis in patients receiving bisphosphonate therapy in 2003 [1], hundreds of studies were published about this topic and various national and international medical societies have published protocols and guidelines. Nevertheless, there are still many controversies regarding the classification, management, and prevention of BRONJ. Even the definition of BRONJ is still debated and changed with the progress of knowledge and experience. Accord…

Progressive facial hemiatrophy with associated osseous lesions

Progressive facial hemiatrophy (PFH) is a rare condition characterized by the slow, progressive appearance of a unilateral facial atrophy that affects the skin, subcutaneous tissue, muscle and bone. We report the case of a 60-year-old female patient whose cutaneous symptoms commenced in 1987 in the form of a purplish erythema on the left side of her face and neck, which subsequently remitted giving rise to an indurated region in the left maxillary region. Since 1995 until the present day, she has developed facial hemiatrophy on the left side accompanied by progressive osseous reabsorption of the upper maxilla and left mandible with atrophy of soft tissue. The association of the onset of PFH…

Tratamiento de los carcinomas epidermoides orales y orofaringeos mediante láser de CO2

Introducción: El efecto de la amplia longitud de onda del láser de CO2 es la vaporización térmica de los tejidos, consiguiendo una máxima concentración de energía con una mínima penetración en los mismos. En el campo de la cirugía oral generalmente se emplea para el tratamiento de los pequeños tumores mucosos de la cavidad oral y la orofaringe, por la escasa morbilidad que produce y la ausencia de necesidad reconstructiva del defecto creado. Objetivo: Analizar la evolución postoperatoria, en los pacientes tratados por carcinomas epidermoides orales y orofaringeos, tras la resección mediante láser de CO2. Compararla con la de los pacientes tratados mediante métodos quirúrgicos convencionales…

Lemierre’s Syndrome: a serious complication of an odontogenic infection

Necrobacillosis, postanginal septicaemia or Lemierre’s Syndrome is characterised by suppurative thrombophlebitis of the internal jugular vein with embolization to several sites, including the lungs. We report the case of a 38-year-old man who was initially hospitalized because of odontogenic cellulitis. Given the deterioration of his clinical state (septic shock and multiple organ failure), neck computed tomography was performed, revealing both cervical and parotid abscesses, and thrombosis of the right internal jugular vein. Streptococcus salivarius was isolated. The patient was treated with intravenous antibiotics, and surgical drainage and after 6 weeks of treatment, recovered completely…