scholarly journals Treatment Algorithm for Ameloblastoma

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Madhumati Singh ◽  
Anjan Shah ◽  
Auric Bhattacharya ◽  
Ragesh Raman ◽  
Narahari Ranganatha ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Treatment Algorithm ◽  
Radical Resection ◽  
Malignant Potential ◽  
Treatment Modalities ◽  
High Recurrence Rate ◽  
Anatomical Location ◽  
Odontogenic Tumour ◽  
Treatment Algorithms ◽  
Fibula Graft

Ameloblastoma is the second most common benign odontogenic tumour (Shafer et al. 2006) which constitutes 1–3% of all cysts and tumours of jaw, with locally aggressive behaviour, high recurrence rate, and a malignant potential (Chaine et al. 2009). Various treatment algorithms for ameloblastoma have been reported; however, a universally accepted approach remains unsettled and controversial (Chaine et al. 2009). The treatment algorithm to be chosen depends on size (Escande et al. 2009 and Sampson and Pogrel 1999), anatomical location (Feinberg and Steinberg 1996), histologic variant (Philipsen and Reichart 1998), and anatomical involvement (Jackson et al. 1996). In this paper various such treatment modalities which include enucleation and peripheral osteotomy, partial maxillectomy, segmental resection and reconstruction done with fibula graft, and radical resection and reconstruction done with rib graft and their recurrence rate are reviewed with study of five cases.

scholarly journals Keratocystic odontogenic tumour: An experience in the northeast of Brazil

2011 ◽  
Vol 139 (5-6) ◽  
pp. 291-297 ◽  
Author(s):  
Mello Araújo ◽  
Gurgel Araújo ◽  
Gonçalves Ramos ◽  
Souza de ◽  
Brandi Schlaepfer-Sales ◽  
...  
Keyword(s):  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Recurrence Rate ◽  
Basal Cell ◽  
Radiographic Finding ◽  
Brazilian Population ◽  
Anatomical Location ◽  
Odontogenic Tumour ◽  
Odontogenic Tumours ◽  
Keratocystic Odontogenic Tumour

Introduction. Keratocystic odontogenic tumours raise particular interest, because of their high recurrence rate and association with nevoid basal cell carcinoma syndrome. Objective. To analyze the clinical and histopathological features of all cases diagnosed as keratocystic odontogenic tumour in a Brazilian population. Methods. A total of 64 keratocystic odontogenic tumours, arising in forty-six patients, were evaluated using the following parameters: association with nevoid basal cell carcinoma syndrome, gender, age at first diagnosis, race, anatomical location, symptoms, radiographic features, history of recurrence, association with teeth, and treatment. Results. Keratocystic odontogenic tumours were more frequent among women than men (1:0.84). The mean patient age was 31.5 years (SD: ?16.6). Ten tumours (16.4%) involved the maxilla and 51 (83.6%) the mandible. Swelling (n=12; 46.1%), followed by pain and swelling (n=4; 15.3%), were most common clinical manifestations. A unilocular radiotransparency with well-defined margins was the main radiographic finding (n=29; 87.8%). A significant association was observed between the multilocular radiographic pattern and recurrence (p<0.05, Fisher?s Test). Sixty-one (95.3%) tumours were treated by surgical enucleation followed by bone curettage, and the recurrence rate was 13% (n=6). This study showed that the keratocystic odontogenic tumours relapsed within a mean period of 25-36 months. Conclusion. Despite the results of this study being similar to previous reports found in the literature, it provides an important insight about keratocystic odontogenic tumours in a Brazilian population.

Extramammary Paget Disease of the Vulva: A Case Series Examining Treatment, Recurrence, and Malignant Transformation

2018 ◽  
Vol 28 (3) ◽  
pp. 632-638 ◽  
Author(s):  
Roni Nitecki ◽  
Michelle Davis ◽  
Jaclyn C. Watkins ◽  
Yiru E. Wu ◽  
Allison F. Vitonis ◽  
...  
Keyword(s):  
Symptom Control ◽  
Tertiary Care ◽  
Case Series ◽  
Radical Resection ◽  
High Rate ◽  
Treatment Modalities ◽  
High Recurrence Rate ◽  
Paget Disease ◽  
Significant Difference ◽  
Disease Free

ObjectivesExtramammary Paget disease (EMPD) of the vulva is a rare lesion with a high recurrence rate ranging from 12% to 61%. The rate of underlying adenocarcinoma varies, but in the largest series was reported at 4%. Given the rarity of the disease there is a paucity of data to optimize treatment. This study aims to describe the management and recurrence patterns in a tertiary care setting and to offer suggestions for management in a modern-day setting.MethodsPatients with pathologically confirmed EMPD treated from 2000 to 2015 were retrospectively identified using an IRB approved database. Clinical data were abstracted from the electronic medical record. Pathology underwent central review.ResultsForty-four patients met criteria and underwent central pathology review. Forty-two patients were treated with surgical excision. Alternative treatment modalities included Mohs surgery in 3 patients and medical therapy in 20 patients. The median number of surgical procedures was 1 and the number of procedures ranged from 1 to 16. Twenty-five patients (56.8%) had recurrent disease with a median of 2 (1-6) recurrences per patient. The median disease-free interval was 28.7 months with a median follow up of 45.8 months (1.2-178.9 months). Three patients (7%) had invasive cancer and 7 patients (16%) were diagnosed with a separate malignancy at or following diagnosis of EMPD. Despite radical resection, the majority of patients had positive margins and there was no significant difference in disease recurrence between simple and radical resection (P = 0.69).ConclusionsPatients with EMPD in this series have a high rate of recurrence. Many undergo multi-modal therapy often with multiple providers. However, patients experience relatively long disease-free intervals with a low rate of associated malignancy. We propose an algorithm for management that focuses on symptom control and minimizing morbidity of treatment intervention once invasive disease has been excluded.

Symptomatic Periungual Fibroma of the Hand

2020 ◽  
Author(s):  
Camelia Qian Ying Tang ◽  
Audrey Qi Xin Chia ◽  
Sreedharan Sechachalam
Keyword(s):  
Literature Review ◽  
Clinical Outcome ◽  
Tuberous Sclerosis ◽  
Recurrence Rate ◽  
Treatment Modalities ◽  
High Recurrence Rate ◽  
Benign Nodules

AbstractPeriungual fibromas are benign nodules commonly found on acral digital areas that are commonly associated with tuberous sclerosis. They vary in size and are challenging to treat, with a high recurrence rate. We present a case of a patient with a periungual fibroma, which by virtue of its size, was of functional concern. The intraoperative findings and their implications on the clinical outcome, together with a literature review on other treatment modalities, are also presented.

scholarly journals Treatment Modalities of Odontogenic Keratocyst of Maxilla and Mandible: Our Experience

2015 ◽  
Vol 6 (4) ◽  
pp. 208-212 ◽  
Author(s):  
Parveen Akhter Lone ◽  
Mohan Singh ◽  
Harpreet Singh Johar
Keyword(s):  
Recurrence Rate ◽  
Maxillofacial Surgery ◽  
Surgical Excision ◽  
Odontogenic Keratocyst ◽  
Treatment Modalities ◽  
High Recurrence Rate ◽  
Oral And Maxillofacial Surgery ◽  
Anterior Maxilla ◽  
Radiographic Appearance ◽  
Maxilla And Mandible

ABSTRACT Background Odontogenic keratocyst (OKC) is known for its most aggressive behavior, high recurrence rate and is most common odontogenic cyst of the jaws. After completion of odontogenesis, some remnants of dental epithelium remain in oral cavity and variety of cysts and tumor can develop from this odontogenic epithelium the most common being odontogenic keratocyst. The most common site of occurrence of OKC reported is mandibular body and ramus region. Objectives The aim of this study is to report the other frequent site of occurrence, different size of OKC in mandible and maxilla and different treatment modalities depending on size, age, and extent of the lesion. Materials and methods Ten patients were selected among the patients referred to the department of oral and maxillofacial surgery with cystic lesions on mandible and maxilla. After making diagnosis treatment planning was done depending upon the age, radiographic appearance and size of the lesion. Results Odontogenic keratocyst was found more in males than females, was found more in mandible than maxilla. Majority of the cases were in mandible angle ramus region followed by anterior maxilla. Seventy-six percent cases were multilocular radiolucencies, whereas 24% unilocular. Multilocular radiolucencies were treated by wide surgical excision, hemimandibulectomy, whereas unilocular radiolucencies were treated by enucleation. Conclusion It is concluded that treatment of OKC depends upon age, radiographic and clinical extent of lesion, unilocular or multilocular appearance, presence of daughter cysts, recurrence rate. How to cite this article Lone PA, Singh M, Johar HS. Treatment Modalities of Odontogenic Keratocyst of Maxilla and Mandible: Our Experience. World J Dent 2015;6(4):208-212.

Cystic Bone Lesions in Horses and Humans: A Comparative Review

1998 ◽  
Vol 11 (01) ◽  
pp. 08-18 ◽  
Author(s):  
C. W. McIlwraith ◽  
J. A. Auer ◽  
Brigitte von Rechenberg
Keyword(s):  
Recurrence Rate ◽  
Subchondral Bone ◽  
Fibrous Tissue ◽  
Clinical Signs ◽  
Bone Lesions ◽  
Anatomical Location ◽  
Cystic Lesions ◽  
Bone Cysts ◽  
Biological Behaviour ◽  
Comparative Review

SummaryCases of cystic bone lesions in horses and humans were reviewed in the literature. These lesions are radiolucent areas of bone, recognized as subchondral cystic lesions in the horse (SCL), intra-osseous ganglia (IOG), subchondral bone cysts secondary to osteoarthrosis (OAC), and unicameral bone cysts (UCB) in humans. Their morphology is quite similar, consisting of lesions with a distinct cyst wall, and a cavity filled with fibrous tissue and yellowish mucoid fluid. The lesions are surrounded by sclerotic bone and can be easily diagnosed radiographically. SCL, IOG and OAC occur in the subchondral bone close to the adjacent joint, whereas UCB occur in the metaphysis of long bones. Their aetiology and pathogenesis is still unknown, although primary damage to the subchondral bone, cartilage or local blood supply and growth disturbances are discussed. In this review 703 lesions of SCL in horses, 289 lesions of IOG and 1460 lesions of UCB in humans were compared in their anatomical location and clinical signs. SCL and OAC resembled each other with respect to anatomical location. A correlation of affected bones could not be found for all four groups. Clinical presentation concerning age was most similar for SCL and UCB with both lesions mainly occurring in young individuals. Gender predominance of males was present in SCL, IOG and UCB. Clinical diagnosis was either incidental, or connected with intermittent pain in all lesions except for OAC. Additionally, the lesions were also found in conjunction with degenerative joint disease (SCL, OAC) or pathological fractures (UCB). Cystic bone lesions were either treated conservatively, surgically with curettage alone, curettage in combination with grafting procedures, or intra-lesional application of corticosteroids. SCL and UCB were similar in their biological behaviour concerning their slow response to the therapy and relatively high recurrence rate. None of the cystic bone lesions were comparable, and a common aetiology and pathogenesis could not be found.In a literature review cases of cystic bone lesions in horses and humans were compared with the goal to find a common aetiology and pathogenesis. Cystic bone lesions occur in horses as subchondral cystic lesions (SCL), and in humans as either intra-osseous ganglia (IOG), subchondral cystic lesions secondary to osteoarthrosis (OAC) or unicameral bone cysts (UCB). IOG and OAC compare with SCL mainly in the anatomical location. IOG and SCL resemble each other in size, clinical signs and histology, whereas UCB and SCL show a similar biological behaviour regarding their therapeutic response and recurrence rate. None of the cystic bone lesions in humans were comparable to the SCL in horses in all aspects. A common aetiology and pathogenesis could not be established.

Modern molecular and biological aspects of endometriosis-associated infertility

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (5) ◽  
pp. 12-15
Author(s):  
Anastasiia S Safronova ◽  
Mikhail Yu Vysokikh ◽  
Vladimir D Chuprynin ◽  
Natalia A Buralkina
Keyword(s):  
Signaling Pathways ◽  
Recurrence Rate ◽  
High Recurrence Rate ◽  
Modern Drug ◽  
Surgical Methods ◽  
Prevention And Treatment ◽  
Biological Aspects ◽  
Methods Of Treatment ◽  
New Strategies

There is currently no consensus on the etiopathogenetic nature of endometriosis. The causes of aggressive, progressive, infiltrative growth of endometrioid tissue also remain unclear. An important problem remains the high recurrence rate of endometriosis, despite the availability of modern drug and surgical methods of treatment. The study of the central signaling pathways and the search for new key molecules is of paramount importance for a better understanding of the pathogenesis of the disease, and is also an important step in the development of new strategies for the diagnosis, prevention and treatment of endometriosis.

scholarly journals Simplified treatment algorithm for the management of trauma-induced hemorrhage without viscoelastic testing

2021 ◽  
Vol 6 (1) ◽  
pp. e000779
Author(s):  
Sebastian Casu
Keyword(s):  
Major Trauma ◽  
Point Of Care ◽  
Treatment Algorithm ◽  
Standard Of Care ◽  
Trauma Team ◽  
Trauma Patients ◽  
Treatment Protocols ◽  
Treatment Algorithms ◽  
Number Of Treatment ◽  
Uncontrolled Bleeding

Uncontrolled bleeding after major trauma remains a significant cause of death, with up to a third of trauma patients presenting with signs of coagulopathy at hospital admission. Rapid correction of coagulopathy is therefore vital to improve mortality rates and patient outcomes in this population. Early and repeated monitoring of coagulation parameters followed by clear protocols to correct hemostasis is the recommended standard of care for bleeding trauma patients. However, although a number of treatment algorithms are available, these are frequently complex and can rely on the use of viscoelastic testing, which is not available in all treatment centers. We therefore set out to develop a concise and pragmatic algorithm to guide treatment of bleeding trauma patients without the use of point-of-care viscoelastic testing. The algorithm we present here is based on published guidelines and research, includes recommendations regarding treatment and dosing, and is simple and clear enough for even an inexperienced physician to follow. In this way, we have demonstrated that treatment protocols can be developed and adapted to the resources available, to offer clear and relevant guidance to the entire trauma team.

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