Background: Ameloblastoma may present a significant treatment challenge in the locally advanced, recurrent and metastatic setting. Comprehensive genomic profiling (CGP) can identify targetable genomic alterations to aid in treatment. Methods: Ameloblastoma samples were sequenced using hybrid-capture based sequencing. A systematic literature review was performed to examine outcomes in studies employing targeted treatment in ameloblastoma.
Results:We reviewed 14 cases of Ameloblastoma using CGP. There were six patients with activating BRAF mutations, five with PIK3CA, five with SMO, four with FGFR2, one with EGFR, and one with ROS1. All cases were MSI stable and the median TMB was 2.5 mutations/Mb. A separate literature review of clinical outcomes in ameloblastoma showed a predominance of at least partial response to targeted treatment (7/12 cases).
Conclusion:CGP is helpful in identifying specific driver mutations in patients with complex ameloblastoma. Targeted treatment has been employed with success in achieving treatment response.
Background
The surgical ciliated cyst of the maxilla was initially reported as a sequela of Caldwell–Luc type open maxillary sinus procedures. Recently, other etiologies have become apparent and cases have been reported outside of the maxilla. They have the potential for local destruction and at times may mimic a locally aggressive tumor or cyst. We aim to elucidate the etiopathogenesis of the surgical ciliated cyst to improve prevention, diagnosis and treatment of these lesions.
Body
A systematic review of the literature using PubMed and Scopus databases was conducted to assess the presentation, treatment, and outcomes of this disease. Surgical ciliated cysts of the maxillofacial region shows a 1.1:1 female-to-male ratio with a protracted time to diagnosis (range: 4–22 years). Typically, radiology shows a unilocular radiolucency (95%) and histology predominantly shows pseudostratified ciliated columnar epithelium (58%). The most common treatment of these lesions involves enucleation and curettage. In rare instances, transfacial approaches, resection, and reconstruction are required. Recurrence ranges from 6 to 20%.
Conclusion
Surgical ciliated cyst should be considered in a patient presenting with an orofacial mass or edema who has a history of maxillofacial injury or surgery. Timely diagnosis will decrease the severity and morbidity associated with this entity. Meticulous surgical technique can aid in the prevention of this lesion.
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