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C A Waldron

Publications and source records attributed to C A Waldron.

At least 19 recordsLinked to original sources
PubMed1997

Distinguishing features of focal cemento-osseous dysplasia and cemento-ossifying fibromas. II. A clinical and radiologic spectrum of 316 cases.

The distinguishing histopathologic features of focal cemento-osseous dysplasia (FCOD) (including lesions occurring in both anterior and posterior jaws) and cemento-ossifying fibroma (COF) (ossifying fibroma and cementifying fibroma) were demonstrated in our earlier work. The aim of the current study was to further refine their clinical and radiographic features. We have assessed 18 clinical and radiographic parameters by univariate comparisons (chi-squared and Student t tests), and a multivariate assessment (logistic regression) in 241 cases of FCOD and 75 of COF. These cases were diagnosed from a combination of clinical, radiographic, and histopathologic information. FCOD was seen predominantly in black women, with a peak incidence in the fourth and fifth decades, whereas COF showed no female predilection except in the fourth decade (p < 0.005). COF occurred in patients an average of 10 years younger than patients with FCOD (p < 0.0001). Most patients with FCOD were asymptomatic (62%); the average lesion size was 1.8 cm. More than half of patients with COF displayed jaw expansion and a considerably larger size lesion (mean 3.8 cm, p < 0.001). The mandible was the most frequent site for both FCOD (86%) and COF (70%). Radiographically, a well-defined border was observed in 53% of cases of FCOD and 85% of cases of COF (p < 0.01). Cases of FCOD mostly demonstrated an irregularly mixed radio-opacity (69%), whereas 53% of COFs presented as a radiolucency (p < 0.005). In FCOD, there was a close association with tooth apices (70.6%, p < 0.0001) or with previous extraction sites (21%, p < 0.05); however, the majority of COF cases (86%) showed no relationship with either. Combining the radiographic feature of a periapical location with the pathology of multiple curetted fragments and "ginger root" bony trabeculae, allowed 90% sensitivity and 89% specificity in a logistic regression model to predict the lesion to be an FCOD. These findings provide guidelines not only to distinguish these two entities clinically, but also aid in reaching an accurate diagnosis histopathologically.

Adolescent↗
PubMed1997

Distinguishing features of focal cemento-osseous dysplasias and cemento-ossifying fibromas: I. A pathologic spectrum of 316 cases.

Focally expressed cemento-osseous dysplasia (periapical cemento-osseous dysplasia and focal cemento-osseous dysplasia) and cemento-ossifying fibroma (ossifying fibroma and cementifying fibroma) are two clinically recognized entities that are not easily differentiated histopathologically because of the lack of recognition of specific microscopic features. We have assessed 20 pathologic parameters for their ability to distinguish reliably between the two. Included in this study were 241 cases of focally expressed cemento-osseous dysplasia and 75 cases of cemento-osseous fibroma diagnosed from a combination of clinical, radiographic, and histopathologic information. Results revealed that 92.5% of focally expressed cemento-osseous dysplasia were composed of multiple small fragments of tissue whereas 88.0% of cemento-osseous fibromas showed a large intact specimen. Thick curvilinear trabeculae ("ginger root" pattern) or irregularly shaped cementum-like masses were typically seen in focally expressed cemento-osseous dysplasia, whereas thin isolated trabeculae with prominent osteoblastic rimming were more commonly observed in cemento-osseous fibroma. The stroma of focally expressed cemento-osseous dysplasia often displayed characteristic cavernous-like vascularity that was almost always associated with bony trabeculae. Free hemorrhage was frequently interspersed in the artifactual spaces throughout focally expressed cemento-osseous dysplasia. In contrast, the cases of cemento-osseous fibroma showed more cellularity in the stroma in which a storiform pattern was present in more than half the lesions studied. Giant cells, when present in cemento-osseous fibroma, were clustered in the center of the cellular stroma. The features described here allowed distinction histopathologically in 94% of cases studied. Three progressive stages of focally expressed cemento-osseous dysplasia and subtypes of cemento-osseous fibroma may be recognizable microscopically.

Blood Vessels↗
PubMed1993

Central giant cell lesions of the jaws. A clinical, radiologic, and histopathologic study.

The histology, radiographs, and follow-up information for 142 cases of central giant cell lesions of the jaws were reviewed in an effort to determine which, if any, microscopic features could be correlated with clinical behavior. The majority of these lesions were asymptomatic and relatively innocuous. However, some displayed a more aggressive clinical course characterized by root resorption, pain or paresthesia, and cortical perforation. The over-all recurrence rate in the 142 cases was 16%. Adequate follow-up information (mean, 48 months) was only obtained for 47 patients, and 23 (46%) of these experienced one or more recurrences. Statistically significant histologic differences in distribution of giant cells and frequency of osteoid within the lesions were found in lesions that recurred as opposed to those that did not. The concept that giant cell lesions of the jaws are not totally different entities from giant cell tumors is discussed.

Adolescent↗
PubMed1993

Expression patterns of epithelial differentiation antigens and lectin-binding sites in ameloblastomas: a comparison with basal cell carcinomas.

Whether the peripheral ameloblastoma (PA) and intraoral basal cell carcinoma (BCC) are two different clinical entities or essentially the same lesion still remains unresolved. The immunophenotypes of neoplastic cells of peripheral and intraosseous ameloblastomas, ameloblastic carcinomas, and BCCs were studied using a panel of monoclonal/polyclonal antibodies and lectins. The major cytokeratins (CKs) of neoplastic cells of ameloblastomas were CKs 5 and 14, whereas co-expression of CKs 8, 18, and 19 was observed in the cells of the stellate reticulum-like areas. Metaplastic squamous and keratinizing cells found in follicular and acanthomatous variants of ameloblastomas expressed CKs 1 and 10, involucrin, and binding sites for the lectins Ulex europeaus agglutinin I and Helix pomatia agglutinin. beta 2-Microglobulin was uniformly negative in all cases of ameloblastomas and ameloblastic carcinomas studied. Cutaneous BCCs also demonstrated similar reactive patterns with the above-mentioned antigens. The most striking feature is the presence of a peritumorous band-like peanut agglutinin staining found in both BCCs and PAs but not in intraosseous ameloblastomas. This unique peanut agglutinin staining pattern of PA may be diagnostically useful for its histopathologic distinction from an intraosseous ameloblastoma that has infiltrated the soft tissue. The neoplastic cells of ameloblastomas express markers of less-differentiated epithelial cells. Despite differences in epithelial origins, PAs are tumors analogous to cutaneous BCCs.

Adolescent↗
PubMed1993

Fibro-osseous lesions of the jaws.

In the first volume of the Journal of Oral Surgery, Dr G. Victor Boyko presented a case of osteofibroma of the mandible associated with leontiasis ossea of the skull (Boyko GV: J Oral Surg 1:100, 1943). The patient was a 32-year-old white woman who had complaints of right mandibular enlargement and a prominence of the right frontal and temporal areas of uncertain duration in August 1939. Mandibular radiographs showed an area of reduced radiodensity. Skull films showed a marked increase in density of the inferior part of the right temporal region and of the frontal bone, with evidence of both bone destruction and proliferation in the inferior frontal and orbital regions. A mandibular biopsy was reported as osteofibroma. The patient was kept under observation for 8 months after the biopsy, with little change in her condition. A course of deep x-ray therapy was then delivered to the mandibular lesion. She subsequently developed a pathologic fracture that was treated by maxillomandibular fixation. The fracture stabilized and at the last clinical examination, in June 1942, the patient had a union with good functional occlusion and was reported to be in good mental and physical condition.

Black People↗
PubMed1993

Giant cell lesions of the jaws: evaluation of nucleolar organizer regions in lesions of varying behavior.

To examine whether giant cell lesions of the jaws (GCL) of varying behavior could be separated histologically, a number of GCL were studied using the AgNOR staining technique for nucleolar organizer regions. The mean AgNOR count of mononuclear cells from recurrent lesions (1.73 +/- 0.15) was slightly higher than that of the aggressive lesions (1.54 +/- 0.21) and much higher than that of the non-aggressive/non-recurrent lesions (1.33 +/- 0.14). Similarly, the mean AgNOR count of the multinucleate giant cells of the recurrent lesions (1.52 +/- 0.14) was slightly higher than that of aggressive lesions (1.34 +/- 0.092) and much higher than that of non-aggressive/non-recurrent lesions (1.26 +/- 0.05). Statistical analysis showed a significant difference between the mean number of AgNORS of recurrent lesions and non-recurrent/non-aggressive ones in both the mononuclear and multinuclear population (p < 0.05).

Adolescent↗
PubMed1993

Imaging of the skin with 20-MHz US.

PURPOSE: The authors clinically evaluated a new high-frequency ultrasound (US) scanner to determine the value of US for dermatologic applications. MATERIALS AND METHODS: A 20-MHz US scanner was used to visualize normal skin at eight sites in 10 healthy volunteers and to evaluate 200 skin lesions (45 malignant, 155 benign). RESULTS: In normal skin, the dermis was markedly echogenic and sharply demarcated from hypoechoic subcutaneous fat. The epidermis was not resolved except on the palm and sole. Only three superficial lesions were not identified with US; evaluation of another three was limited by shadowing. Thickness of the lesions visualized was 0.2-26.0 mm (mean, 1.9 mm +/- 2.6). Most lesions (77%) were hypoechoic, 9% were anechoic, 12% had mixed echogenicity, and 2% were isoechoic or hyperechoic. CONCLUSION: The diagnostic role of high-frequency US appears limited. It did not help differentiate benign from malignant lesions, but it did enable accurate delineation of deep margins of lesions and allowed noninvasive measurement of thickness. These features may help in the preoperative evaluation of skin tumors and in monitoring the response to therapy for certain inflammatory conditions.

Adolescent↗
PubMed1992

Solitary infantile myofibromatosis of the mandible. Report of three cases.

Infantile myofibromatosis (IMF) is a benign localized (solitary) or generalized (multicentric) proliferation of fibroblastic tissue occurring exclusively in infants and children. Three cases of solitary IMF involving the posterior region of the mandible of young children are reported. These lesions manifested clinically as asymptomatic bony expansion and roentgenographically as circumscribed lytic areas. Microscopically these tumors showed a distinct zoning phenomenon of curving bundles or intertwining fascicles of plump, spindle-shaped cells at the periphery and solid sheets of less differentiated round cells in the center. Positive immunostaining for vimentin and actin, with the lack of desmin and S-100 protein reactivity, confirmed their myofibroblastic nature of these cells and supported the diagnosis of IMF. All three lesions were treated by curettage and the follow-up showed no incidence of recurrence or any other complications. As we demonstrate in these case reports, IMF should be included in the differential diagnosis of spindle cell neoplastic processes in children.

Actins↗
PubMed1991

Primary intraosseous squamous carcinoma. Report of two cases.

Two cases of primary intraosseous squamous carcinoma (PIOSC) are reported. One PIOSC is in the mandible of a 24-year-old man and appears to be a keratinizing PIOSC arising de novo. The other PIOSC presented in the edentulous maxilla of a 56-year-old man and was diagnosed as a PIOSC arising from an odontogenic cyst. The 2nd tumor subsequently metastasized to a cervical lymph node. Previous reports have noted a favorable prognosis for PIOC arising in odontogenic cysts, and only 3 other instances of metastases of a PIOSC in an odontogenic cyst have been documented.

Adult↗
PubMed1989

Primary intraosseous carcinoma of the mandible with probable origin in an odontogenic cyst.

Primary intraosseous carcinoma of the jaws (PIOC) is an uncommon lesion, but may not be as rare as commonly believed. Since the putative source of the epithelium giving rise to an intraosseous carcinoma is the epithelium involved in odontogenesis, these lesions are often designated as odontogenic carcinomas. These tumors may theoretically arise (1) from the lining of odontogenic cysts, (2) from other epithelial odontogenic tumors, or (3) de novo from presumed odontogenic rests. While not included in most classifications of PIOC, it appears logical to also include intraosseous mucoepidermoid carcinomas as a fourth type of PIOC. A case of primary intraosseous squamous cell carcinoma of the mandible, with evidence of origin in an odontogenic cyst, is presented. The recent literature on carcinomas arising in jaw cysts is reviewed.

Carcinoma, Squamous Cell↗
PubMed1989

Salivary gland tumors.

Although the incidence of salivary gland tumors in the general population is relatively low, these neoplasms account for a significant proportion of tumors of the oral and perioral regions and are therefore of considerable interest to the dentist. Malignant salivary gland tumors comprise the second most common type of oral cancer, although squamous cell carcinomas arising from the surface mucosa are nine times more common. Salivary gland tumors occur in both the major (parotid, submandibular, and sublingual) and minor (accessory) salivary glands of the oropharynx. This article will discuss various types of salivary gland tumors and treatment options.

Adenocarcinoma↗
PubMed1988

Tumors of the intraoral minor salivary glands: a demographic and histologic study of 426 cases.

In a demographic and histologic study of 426 oral minor salivary gland tumors, 57.5% were classified as benign and 42.5% were classified as malignant or potentially malignant. There was an overall female preponderance (1.59/1). The mean age for females was 53.1 years and for males was 50.6 years. The mean age for patients with malignant tumors was 5.4 years greater than for patients with benign tumors and was statistically significant. The palate was the most common site for oral minor salivary gland tumors followed by the upper lip and the buccal mucosa. These three sites accounted for 76.1% of all cases. Pleomorphic adenoma was the most common benign tumor (41% of all cases and 71% of benign tumors) followed by monomorphic adenoma of the canalicular and basal cell subtypes (10% of all tumors and 18.9% of benign lesions). Mucoepidermoid carcinoma was the most commonly encountered malignant tumor, accounting for 15.2% of all tumors and 35.9% of malignant lesions. Low-grade (terminal duct, lobular, polymorphous) adenocarcinoma was the most second most common type, making up 11% of all tumors and 26.4% of all malignant tumors. The results of this study are compared with other recent studies.

Adenocarcinoma↗
PubMed1987

A histopathologic study of 116 ameloblastomas with special reference to the desmoplastic variant.

The histopathologic features of 116 ameloblastomas were reviewed with special reference to the incidence of the recently described desmoplastic variant. The series included 110 intraosseous lesions and 6 extraosseous ameloblastomas. Ninety-six (88%) of the intraosseous tumors were found in the mandible, and 61% involved the molar-ascending ramus area. Fourteen examples of the desmoplastic variant were identified, representing 13% of the intraosseous tumors. The lesions showed distinctive histologic features characterized by an extensive collagenized stroma containing small islands of tumor epithelium with scant tendency to form cystic structures. This histologic variant has a marked tendency to involve the anterior portions of the jaws with 7 of the 14 examples being located in the maxilla. These desmoplastic lesions also showed unusual radiographic findings, often more suggestive of a benign fibro-osseous lesion than of ameloblastoma.

Adolescent↗
PubMed1985

Clear cell ameloblastoma--an odontogenic carcinoma.

Two cases of aggressive intraosseous epithelial tumor of the jaws are presented. Both tumors demonstrated an unusual biphasic pattern with areas of acceptable follicular ameloblastoma together with a conspicuous clear-cell component. The clinical course indicates these lesions should be considered as low grade odontogenic carcinomas. Further subclassification according to the World Health Organization classification and the recently proposed modification by Elzay is discussed.

Aged↗
PubMed1985

Fibro-osseous lesions of the jaws.

During the 15 years since the author's 1970 paper on fibro-osseous lesions of the jaws, the subject has continued to interest the clinician and pathologist. Several new entities have been delineated during this period, and new concepts and controversies regarding the diagnosis and management of these lesions have arisen. A classification of fibro-osseous jaw lesions that the author has found to be workable is presented, and criteria for their diagnosis and management based on the authors' experience is discussed.

Adolescent↗
PubMed1981

Verrucous carcinoma of the oral cavity. A review of forty-nine cases.

Verrucous carcinoma is a distinctive, extremely well-differentiated, slow-growing variant of the squamous cell carcinoma. Forty-nine cases of this neoplasm were gathered from the Oral Pathology Service at the Emory University School of Dentistry from 1965 to 1979. The most common site of occurrence was the buccal mucosa, followed by the mandibular alveolar ridge and gingiva. The majority of our patients were between the ages of 50 and 80 years, and most of them were Caucasians. Although most other series of oral verrucous carcinoma show a male predominance, almost 60 percent of our cases occurred in females. The role of radiation therapy in treatment of oral verrucous carcinoma is controversial, and adequate surgical excision appears to be the treatment of choice.

Adult↗