Maintaining a high level of suspicion for recurrent malignant disease: report of a case with periapical involvement

Dewan, Khushboo; Owens, Jonathan M.; Silvester, K.C.

doi:10.1111/j.1365-2591.2007.01281.x

Cited by 8 publications

(4 citation statements)

References 21 publications

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“…In case 1, the patient had been receiving root canal treatment for 2 years; an earlier biopsy could have led to a better prognosis. In this study, the treatment protocol was surgery, chemotherapy and radiotherapy, which was associated with the low-grade histological type of tumour, corroborated with successful treatment and favourable prognosis (10,14,15).…”

Section: Discussionsupporting

confidence: 58%

“…Other reported cases had a long period of evolution (4) with up to five years of symptoms. In our case, the first symptoms were Table 1 Cases reported on the literature involving osteosarcoma (22,26,27,28,29) and central mucoepidermoide carcinoma (11,12,25), and other malignant tumors (2,5,8,14,30,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46) reported two years before the patient was evaluated by a stomatologist. The cases involving OSJ other symptoms that were useful for suspecting a malignant lesion, such as swelling, persistent pain and paraesthesia.…”

Section: Discussionmentioning

confidence: 72%

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Malignant tumours mimicking periapical lesions: A report of three cases and literature review

et al. 2021

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Apical periodontitis shows radiographic signs such as widening of the periodontal ligament and periapical radiolucency, which differ in extent depending on the stage of the lesion. However, other lesions can be associated with or coincidental to the apical region, representing developmental lesions and benign or malignant tumours. This article describes three cases of malignant tumours, a central mucoepidermoid carcinoma (CMEC), a chondroblast osteosarcoma and an osteosarcoma of the jaw (OSJ) that presented as periapical lesions. Endodontists must be aware of unsuccessful treatment, persistent pain, signs of paraesthesia, a rapid growth rate and delayed response to therapy associated with atypical features. Complementary examinations, such as biopsy and computed tomography, can allow the early diagnosis of malignant tumours, leading to a better prognosis and thus increased survival rates and improvement in quality of life.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 72%

Malignant tumours mimicking periapical lesions: A report of three cases and literature review

et al. 2021

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“…In some instances, patients with Ca ex PA were reported to present with skin ulceration, tumour fungation, skin fixation, palpable lymphadenopathy and dysphagia [2,7]. In addition, they may have swollen jaw (due to bone invasion), dental pain, and sudden loss of vitality [15]. The cancer has also been seen as a lacrimal sac mass, extending into the canaliculi and nasolacrimal duct, with or without chronic epiphora and recurrent dacryocystitis [11].…”

Section: Clinical Featuresmentioning

confidence: 99%

Carcinoma ex Pleomorphic Adenoma: A Comprehensive Review of Clinical, Pathological and Molecular Data

Antony

Gopalan

Smith

et al. 2011

Head and Neck Pathol

214

243

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Carcinoma ex pleomorphic adenoma (Ca ex PA) is a carcinoma arising from a primary or recurrent benign pleomorphic adenoma. It often poses a diagnostic challenge to clinicians and pathologists. This study intends to review the literature and highlight the current clinical and molecular perspectives about this entity. The most common clinical presentation of CA ex PA is of a firm mass in the parotid gland. The proportion of adenoma and carcinoma components determines the macroscopic features of this neoplasm. The entity is difficult to diagnose pre-operatively. Pathologic assessment is the gold standard for making the diagnosis. Treatment for Ca ex PA often involves an ablative surgical procedure which may be followed by radiotherapy. Overall, patients with Ca ex PA have a poor prognosis. Accurate diagnosis and aggressive surgical management of patients presenting with Ca ex PA can increase their survival rates. Molecular studies have revealed that the development of Ca ex PA follows a multistep model of carcinogenesis, with the progressive loss of heterozygosity at chromosomal arms 8q, then 12q and finally 17p. There are specific candidate genes in these regions that are associated with particular stages in the progression of Ca ex PA. In addition, many genes which regulate tumour suppression, cell cycle control, growth factors and cell-cell adhesion play a role in the development and progression of Ca ex PA. It is hopeful that these molecular data can give clues for the diagnosis and management of the disease.

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“…The late onset pain usually results from local invasion of adjacent tissues [10]. In some cases, patients may complaint of skin alterations, lymphadenopathy, dysphagia and dental pain [2,11]. Rarely, some CEPAs can carry a slow grow for over decades of years, making diffi cult a timely diagnosis [2].…”

Section: Discussion/conclusionmentioning

confidence: 99%

Carcinoma Ex Pleomorphic Adenoma of the Uvula - Case Report

Costa¹,

Gonçalves²,

Carção³

et al. 2021

J Biomed Res Environ Sci

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Introduction: Carcinoma Ex Pleomorphic Adenoma (CEPA) results from the malignant transformation of a benign tumor of the Salivary Glands (SG), the Pleomorphic Adenoma (PA). PA is considered the most common salivary tumor with a 5% risk of malignant transformation and its excision is recommended. CEPA is a rare tumor, corresponding to 3.6% of all salivary tumors and 11.6% of all GS carcinomas. About 18% of CEPAs affect minor SG, with the palate being the most common location. The present work serves to describe a case of a CEPA of the Uvula Minor SG (UMSG). Case Report: We present a case report of a 57-year-old patient, with no relevant medical history, referred to the ENT consultation due to the appearance and progressive growth of a painless uvula lesion. The objective ENT examination showed a 15 mm ulcerative-vegetating lesion with apparent origin on the posterior face of the uvula. The lesion was biopsied and histopathological examination identified the presence of a neoplasm of the minor SG, probably NOS adenocarcinoma. The patient underwent Computed Tomography (CT) scan that showed an irregularity of the uvula, with no signs of invasion of the remaining soft palate, without other significant pharyngo-laryngeal changes. The patient underwent partial pharyngectomy and bilateral selective cervical ganglion dissection, and the histopathology of the surgical specimen confirmed that it was an invasive CEPA, the malignant component of the tumor corresponding to a NOS adenocarcinoma of the UMSG. The patient has been followed up in the ENT consultation, with no signs so far of loco-regional recurrence. Discussion/Conclusion: In the presented case, the patient probably developed an undiagnosed PA that had become malignant over time. Given that it is a poor prognosis neoplasm, it’s essential that the ENT specialists are aware of this disease, in order to facilitate and anticipate the diagnosis and treatment as much as possible.

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Maintaining a high level of suspicion for recurrent malignant disease: report of a case with periapical involvement

Cited by 8 publications

References 21 publications

Malignant tumours mimicking periapical lesions: A report of three cases and literature review

Malignant tumours mimicking periapical lesions: A report of three cases and literature review

Carcinoma ex Pleomorphic Adenoma: A Comprehensive Review of Clinical, Pathological and Molecular Data

Carcinoma Ex Pleomorphic Adenoma of the Uvula - Case Report

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