[Possibilities of systemic chemotherapy with methotrexate in the treatment of neglected forms of malignant neoplasms of the head and neck].
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The ameloblastoma is a benign, but locally invasively growing tumor with different radiographic structures. These structures may well be explained by typical development of the tumor. Occasionally differential diagnosis appears difficult. Various roentgenographic techniques do facilitate surgical planning if the diagnosis is confirmed microscopically.
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A patient, a 46-year-old female, with a malignant thymoma spreading to the extrathoracic region is described. She underwent a thoracotomy and received radiation therapy, but the myasthenic symptoms did not disappear. A metastatic thymoma of the right mandibula was removed 9 months after thoracotomy. Further examination revealed metastatic thymomas of the bone and liver. After the operation the patient received combination chemotherapy (vincristine, cyclophosphamide, 6-mercaptopurine, prednisone) and remained asymptomatic for 31 months. She was found to have a metastatic thymoma in the occipital lobe of the brain 3.5 years after thoracotomy, and died from infection of the lung. Distant metastases and chemotherapy in malignant thymoma are reviewed.
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This paper deals with a one-stage cosmetically modified operative procedure for resection and simultaneous reconstruction of oral malignancies restricted to the lower 1/3 of the face, in a group of patients falling into stratification staging 2-6, with a moderately well-differentiated squamous cell histological picture. Primary osseous defects have been restored in autogenous full thickness iliac crest bone graft which is split and slid, not only to gain adequate length but also to prepare matching steps for complete osseous compression. It is easy to contour and gives an excellent cosmetic result. Bioacceptable stainless steel implants have also been tried in earlier cases. This one-stage approach supersedes the previously complicated procedures of delayed multi-stage reconstruction and had an 80% success rate in the selected groups with a 4-year follow-up.
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