Melanotic Neuroectodermal Tumor of Infancy

Crockett, Dennis M.; McGill, Trevor J.; Healy, Gerald B.; Friedman, Ellen M.

doi:10.1177/019459988709600214

Cited by 16 publications

(5 citation statements)

References 4 publications

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“…Concerning the treatment of MNTIs, some authors have suggested that wide surgical margins may not be necessary because tumour islets may regress spontaneously after incomplete excision. Numerous clinicians have advocated allowing residual portions of the tumour to remain when radical excision would be mutilating [15][16][17][18] . Shafer and Frissell reported that at the time of the operation it was impossible to tell whether the tumour had been completely excised, and their case was followed up for 66 months with no recurrence 19 .…”

Section: Discussionmentioning

confidence: 99%

Melanotic neuroectodermal tumour of infancy of the jaws: an analysis of diagnostic features and treatment

Gomez

2019

International Journal of Oral and Maxillofacial Surgery

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The purpose of this study was to integrate the available published data on melanotic neuroectodermal tumour of infancy (MNTI) of the jaws into a comprehensive analysis of its clinical/radiological features, with emphasis on the predictive factors associated with recurrence. Eligibility criteria included publications with sufficient clinical/radiological/histological information to confirm the diagnosis. A total of 288 publications reporting 429 MNTI cases were included. MNTIs were slightly more prevalent in males and markedly more prevalent in the maxilla. Most of the lesions were asymptomatic, presenting cortical bone perforation and tooth displacement. Nine lesions were malignant, with metastasis in five cases. Enucleation was the predominant treatment (67.2%), followed by marginal (18.4%) and segmental resection (6.1%). Eighty-one of 356 lesions (22.8%) recurred. Recurrence rates were 61.5% for curettage, 25.3% for enucleation alone, 16.2% for enucleation+curettage, 20.0% for enucleation+peripheral osteotomy, 11.3% for marginal resection, 10.0% for segmental resection, 30.0% for chemotherapy, and 33.3% for radiotherapy. Enucleation and resection presented significantly lower recurrence rates in comparison to curettage. Curettage appears not to be the best form of treatment, due to its high recurrence rate. As resection (either marginal or segmental) is associated with higher morbidity, enucleation with or without complementary treatment (curettage or peripheral osteotomy) would appear to be the most indicated therapy.

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Section: Discussionmentioning

confidence: 99%

Melanotic neuroectodermal tumour of infancy of the jaws: an analysis of diagnostic features and treatment

Gomez

2019

International Journal of Oral and Maxillofacial Surgery

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“…Recurrence rates have previously been reported varying between 10-15% [3][4][5][6][7][8] . However, a recent French multi-centre review reported a recurrence rate of 27% 2 , which is more in keeping with our series where exactly that percentage of cases recurred.…”

Section: Discussionmentioning

confidence: 99%

“…There is a slight male preponderance with a 6:4 male:female ratio presenting at a median age of 4.5 months old 1 . Surgery is the first line of treatment but there is no clear consensus on intraoperative margins and a relatively high rate of recurrence estimated between 10-27% in spite of their predominantly benign nature [2][3][4][5][6][7][8] .…”

Section: Introductionmentioning

confidence: 99%

Melanotic neuroectodermal tumour of infancy: Refining the surgical approach

Rickart

Drummond-Hay

Suchak

et al. 2019

International Journal of Oral and Maxillofacial Surgery

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Melanotic Neuroectodermal Tumour of Infancy (MNTI) are particularly rare and although predominantly benign, are infiltrative and locally aggressive. Presenting in the first year of life, prompt diagnosis and effective management are critical in minimising morbidity and the risk of recurrence. A retrospective review of eleven MNTI managed at Great Ormond Street Hospital (GOSH) from 2000 to 2017 was undertaken. Eight tumours presented in the maxilla, two in the skull and one in the mandible. The primary modality of treatment was surgery in ten cases with one patient receiving neoadjuvant chemotherapy. In spite of microscopically incomplete resection in seven cases, only three recurred. Overall, there was a local recurrence rate of 27% with no distant metastases noted. Disease free survival was 100% with a follow up ranging from 0.75-17 years (median 5). Taking our results in conjunction with the available literature, there is a role for conservative initial surgery of MNTI and this should be coupled with delayed reconstruction and intensive short term follow up. We propose an adapted treatment algorithm that aims to balance the risk of recurrence and malignant change with surgical morbidity in an infant population.

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“…The treatment of choice consists of complete surgical excision with margins and curettage of the underlying bone via a gingivo-buccal sulcus incision or a lateral rhinotomy approach in the case of a large and locally invasive tumour mass (Crocket et al, 1987). An early diagnosis and treatment are important to avoid invasion of important surrounding structures as the optic nerve, and to minimize the extent of bone and soft tissue destruction.…”

Section: Discussionmentioning

confidence: 99%

Fine needle aspiration in the pre-operative diagnosis of melanotic neuroectodermal tumour of infancy

et al. 1999

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A case of melanotic neuroectodermal tumour of infancy is decribed. The pre-operative diagnosis was made on cytological material obtained by fine needle aspiration. The patient was a three-month-old male infant with a rapidly growing maxillary tumour mass that also involved the pterygomaxillary fossae and the floor of the orbit. In addition to the typical clinical presentation, the cytology is also distinctive showing a dual population of small neuroblastic cells and large melanin-containing epithelial cells. Histological, immunohistochemical and electron microscopic examination of the excised mass confirmed the initial diagnosis. The pre-operative distinction of this tumour from other small round cell tumours of infancy (rhabdomyosarcoma, neuroblastoma, melanoma and lymphoma), is essential in order to plan the most complete resection therefore reducing the possibilities of tumour recurrence. This tumour belongs to a field of pathology with which many otolaryngologists may not be familiar.

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Melanotic Neuroectodermal Tumor of Infancy

Cited by 16 publications

References 4 publications

Melanotic neuroectodermal tumour of infancy of the jaws: an analysis of diagnostic features and treatment

Melanotic neuroectodermal tumour of infancy of the jaws: an analysis of diagnostic features and treatment

Melanotic neuroectodermal tumour of infancy: Refining the surgical approach

Fine needle aspiration in the pre-operative diagnosis of melanotic neuroectodermal tumour of infancy

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