J Med Case Rep.
Mandibular intraosseous pseudocarcinomatous hyperplasia: a case report.
Fuchs A1, Hartmann S2, Ernestus K3, Mutzbauer G3, Linz C2, Brands RC2, Kübler AC2, Müller-Richter UD2.
Author information
1
Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany. fuchs_a2@ukw.de.
2
Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany.
3
Institute of Pathology and Comprehensive Cancer Center, University Würzburg, Josef-Schneider-Straße 2, 97080, Würzburg, Germany.
Abstract
BACKGROUND:
Mandibular pseudocarcinomatous hyperplasia is a rare and generally benign pathology. We report on one of these rare cases.
CASE PRESENTATION:
The case history of a 73-year-old white man stated that he had a carcinoma of the oropharynx, which was primarily treated with radiotherapy and chemotherapy 4 years prior. As a result of radiotherapy he developed an osteoradionecrosis of his mandible and a consecutive pathological fracture of his left mandibular angle. Subsequent osteosynthesis was performed with a reconstruction plate. When we first saw him, his reconstruction plate was partially exposed with intraoral and extraoral fistulation. The resected bone of his defect-bordering jaw showed the typical pathohistological findings of an intraosseous mandibular pseudocarcinomatous hyperplasia. After a first reconstruction attempt with an iliac crest graft failed, definitive reconstruction of his mandible with a microvascular anastomosed fibula graft was achieved.
CONCLUSIONS:
Intraosseous pseudocarcinomatous hyperplasia of the mandible is a rare differential diagnosis in maxillofacial surgery. Besides other benign epithelial neoplasms, such as calcifying epithelial odontogenic tumor, squamous odontogenic tumor, or different forms of ameloblastoma, the far more frequent invasive squamous cell carcinoma needs to be excluded. A misinterpretation of pseudocarcinomatous hyperplasia as squamous cell carcinoma must be avoided because it can lead to a massive overtreatment.
KEYWORDS:
Case report; Intraosseous; Mandible; Pseudocarcinomatous hyperplasia
PMID: 27680099 PMCID: PMC5041521 DOI: 10.1186/s13256-016-1052-y
Histopathology.
Mandibular pseudocarcinomatous hyperplasia.
Warter A1, Walter P, Meyer C, Barrière P, Galatir L, Wilk A.
Author information
1
Institute of Pathological Anatomy and Department of Maxillo Facial and Plastic Surgery, University Hospitals, Strasbourg, France.
Abstract
AIMS:
Three unusual cases of pseudocarcinomatous (pseudoepitheliomatous) hyperplasia (PH) affecting chronic osteomyelitic mandibular sequestra are reported to highlight the differences with the various squamous neoplasms which occur in that site.
METHODS AND RESULTS:
In two patients carrying a mandibular graft following the excision of an ameloblastoma, mucosal ulcers resulted in chronic osteomyelitis. In a third patient, an apical dental infection was associated with fistulated osteomyelitis. Histology of the three sequestra showed an intraosseous squamous proliferation. It was characterized by a peripheral involvement of medullary spaces, the more mature epithelial layer covering the bone trabeculae without intervening stroma, and the basal type epithelial layer surrounding a central fibrovascular core. There were no histological or cytological signs of malignancy.
CONCLUSION:
PH shows an inverted pattern when compared with the centro-medullary tumoural islands seen in the various oral or odontogenic squamous neoplasms which occur in the jaws. The lack of signs of malignancy distinguish PH from common squamous cell carcinomas. A short clinical course is an important feature in the distinction of PH from the well differentiated squamous cell carcinomas which may develop in fistulated chronic osteomyelitis.
PMID: 10931233
[Indexed for MEDLINE]
Mandibular intraosseous pseudocarcinomatous hyperplasia: a case report.
Fuchs A1, Hartmann S2, Ernestus K3, Mutzbauer G3, Linz C2, Brands RC2, Kübler AC2, Müller-Richter UD2.
Author information
1
Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany. fuchs_a2@ukw.de.
2
Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany.
3
Institute of Pathology and Comprehensive Cancer Center, University Würzburg, Josef-Schneider-Straße 2, 97080, Würzburg, Germany.
Abstract
BACKGROUND:
Mandibular pseudocarcinomatous hyperplasia is a rare and generally benign pathology. We report on one of these rare cases.
CASE PRESENTATION:
The case history of a 73-year-old white man stated that he had a carcinoma of the oropharynx, which was primarily treated with radiotherapy and chemotherapy 4 years prior. As a result of radiotherapy he developed an osteoradionecrosis of his mandible and a consecutive pathological fracture of his left mandibular angle. Subsequent osteosynthesis was performed with a reconstruction plate. When we first saw him, his reconstruction plate was partially exposed with intraoral and extraoral fistulation. The resected bone of his defect-bordering jaw showed the typical pathohistological findings of an intraosseous mandibular pseudocarcinomatous hyperplasia. After a first reconstruction attempt with an iliac crest graft failed, definitive reconstruction of his mandible with a microvascular anastomosed fibula graft was achieved.
CONCLUSIONS:
Intraosseous pseudocarcinomatous hyperplasia of the mandible is a rare differential diagnosis in maxillofacial surgery. Besides other benign epithelial neoplasms, such as calcifying epithelial odontogenic tumor, squamous odontogenic tumor, or different forms of ameloblastoma, the far more frequent invasive squamous cell carcinoma needs to be excluded. A misinterpretation of pseudocarcinomatous hyperplasia as squamous cell carcinoma must be avoided because it can lead to a massive overtreatment.
KEYWORDS:
Case report; Intraosseous; Mandible; Pseudocarcinomatous hyperplasia
PMID: 27680099 PMCID: PMC5041521 DOI: 10.1186/s13256-016-1052-y
Histopathology.
Mandibular pseudocarcinomatous hyperplasia.
Warter A1, Walter P, Meyer C, Barrière P, Galatir L, Wilk A.
Author information
1
Institute of Pathological Anatomy and Department of Maxillo Facial and Plastic Surgery, University Hospitals, Strasbourg, France.
Abstract
AIMS:
Three unusual cases of pseudocarcinomatous (pseudoepitheliomatous) hyperplasia (PH) affecting chronic osteomyelitic mandibular sequestra are reported to highlight the differences with the various squamous neoplasms which occur in that site.
METHODS AND RESULTS:
In two patients carrying a mandibular graft following the excision of an ameloblastoma, mucosal ulcers resulted in chronic osteomyelitis. In a third patient, an apical dental infection was associated with fistulated osteomyelitis. Histology of the three sequestra showed an intraosseous squamous proliferation. It was characterized by a peripheral involvement of medullary spaces, the more mature epithelial layer covering the bone trabeculae without intervening stroma, and the basal type epithelial layer surrounding a central fibrovascular core. There were no histological or cytological signs of malignancy.
CONCLUSION:
PH shows an inverted pattern when compared with the centro-medullary tumoural islands seen in the various oral or odontogenic squamous neoplasms which occur in the jaws. The lack of signs of malignancy distinguish PH from common squamous cell carcinomas. A short clinical course is an important feature in the distinction of PH from the well differentiated squamous cell carcinomas which may develop in fistulated chronic osteomyelitis.
PMID: 10931233
[Indexed for MEDLINE]
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