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Oral and maxillofacial tumours in north Jordanian children and adolescents: a retrospective analysis over 10 years.

This study evaluates the types and distribution of oral and maxillofacial tumours in north Jordanian children and adolescents. The records of the Department of Pathology at Jordan University of Science & Technology, during the period 1991-2000, were reviewed for patients younger than 19 years with oral and maxillofacial tumours. The tumours were analysed for age, sex, site and type. Out of all maxillofacial tumours, 23% occurred in children and adolescents, of these 10% were malignant and 90% were benign. 73% of the latter were soft tissue tumours and 17% were jaw tumours (58% odontogenic and 42% non-odontogenic). The most common benign soft tissue and jaw tumours were haemangioma and odontoma, respectively. 58% of malignant tumours were sarcomas and 42% were carcinomas. The mean age was 11 years with a female to male ratio of 1:1.2. The intraoral and extraoral sites most commonly affected by benign soft tissue tumours were the lower lip and face, respectively. While the total number of benign jaw tumours was slightly larger in the maxilla than the mandible, odontogenic tumours were more in the maxilla, and nonodontogenic tumours were more in the mandible. Differences found in this study between Jordanian children and adolescents and those from other countries may be attributable to genetic and geographic differences. The majority of benign tumours in the young are probably developmental rather than true neoplasms.

Adolescent↗

Versatility of temporalis myofascial flap in maxillofacial reconstruction--analysis of 30 cases.

Temporalis myofascial flap holds great promise for the reconstruction of various defects of the maxillofacial region-either congenital or surgical. The dependable blood supply through the middle and deep temporal arteries, proximity to the maxillofacial region, possibility to mobilize it to the oral cavity through the under surface of zygomatic arch and its fanned out nature permits the surgeon to use this flap for the reconstruction of various maxillofacial defects and even as an interposing tissue. In this series of 30 cases, we have used the temporalis myofascial flap for the reconstruction of different types of maxillofacial defects and as an interposing material in TMJ surgeries. We found that this flap is very valuable in maxillofacial reconstruction.

Ankylosis↗

[Follow-up in patients with head and neck tumors: evaluation of CT criteria for local tumor recurrence].

BACKGROUND: Aim of this study was to evaluate morphologic criteria for diagnosis of locally recurrent head and neck tumors in helical CT. METHODS: Retrospective study, 44 examinations with radiologically abnormal findings were re-read by two radiologists; findings were analysed and correlated with histological diagnosis and clinical findings. RESULTS: 25 cases of local tumor recurrence were confirmed histologically. The accuracy of helical-CT in our preselected examinations for a local tumor recurrence was 93.5 %, the specificity 83.3 %. But 13/44 cases showed radiologically equivocal findings, among them 6 tumor recurrences. The most common characteristics of the 25 proven tumor recurrences were: contrast medium enhancement (96 %), increased volume in comparison to previous examination (92 %), inhomogenity (72 %); however contrast medium-enhancement and increasing volume were also seen in 68.4 % and 63.1 % of the benign changes. CONCLUSION: Contrast medium enhancement and increasing volume are criteria with a high sensitivity but low specifity in predicting a local tumor recurrence in head and neck cancer.

Carcinoma, Squamous Cell↗

[Reproducibility of nonradioactive DDRT-PCR method for detection of gene expression in squamous epithelial carcinoma cells of the upper aerodigestive tract].

BACKGROUND: The analysis of the gene spectrum in tumor and normal cells may provide information about genes involved in the differentiation or in the genesis of tumors. Differential Display Reverse Transcriptase Polymerase Chain Reaction (DDRT-PCR) is an innovative method that enables quick analysis of almost all mRNA molecules expressed in the cells. METHODS: In the trials, the mRNAs of keratinocytes and tumor cells were amplified by a number of oligonucleotide pairs after reverse transcription and resolved on polyacrylamide gel. A modified protocol for the amplification of cDNA probes was devised for detecting PCR products with silver nitrate. RESULTS: After reverse transcription of mRNAs, all cDNA samples were successfully amplified using the protocol devised for the silver nitrate DDRT-PCR, and the differentially expressed fragments were reproducibly demonstrated. CONCLUSIONS: The high reproducibility and feasibility of silver nitrate DDRT-PCR expand the alternatives for analyzing gene expression and detecting selectively expressed genes in different kinds of cells.

Carcinoma, Squamous Cell↗

[Site and incidence of multiple cancers in patients with squamous cell carcinomas of the upper aerodigestive tract].

The etiology of multiple primary cancers has not been clearly elucidated, although some pathogenic factors are known. The studies reported here include 796 patients who, between January 1970 and March 1989, presented with a carcinoma of the upper aerodigestive system. The charts of 687 patients were analyzed retrospectively; 109 patients were studied prospectively by systematic pretherapeutic panendoscopy. Multiple primary cancers were found in 76 cases (9.5%), 33 patients had synchronous cancers, and 43 had metachronous cancers. In the prospective study, the incidence of multiple cancers was higher (13.7%) than in the retrospective group (8.8%). Synchronous primaries were more frequent in the prospective study (8.2%) than in the retrospective analysis (3.4%). Second primaries were mostly found in the esophagus, the hypopharynx, the buccal cavity, and the lung. The authors also examined whether the anatomic location of the second primary cancer can be related to the site of the first. The five-year survival rate among patients with synchronous cancers (18%) was lower than among patients with metachronous cancers (41%). The prognosis for synchronous cancers deteriorates if the planned treatment has to be modified following the discovery of a second primary. Systematic pretherapeutic panendoscopy should be used to help detect early asymptomatic second primaries which might be missed during clinical examination.

Carcinoma, Squamous Cell↗

[1st report on indirect lymphography using iotasul in the head and neck region].

The early results in 29 patients with tumours in the head and neck are described, on whom indirect lymphography with the water-soluble contrast medium Iotasul had been carried out (experimental contrast medium, Schering AG). After careful sub-epidermal injection of about 12 ml contrast, either lateral to the eye or in the region of the chin, lymph vessels were seen in 25 patients and lymph nodes in 20. These were demonstrated by conventional radiography or by xero-radiography. There were no local or generalised reactions.

Contrast Media↗

[SCC antigen: a sensitive and specific tumor marker for squamous cell carcinoma?].

The diagnostic value of serum concentrations of squamous-cell carcinoma (SCC) antigen was evaluated on 48 untreated patients with squamous-cell carcinoma of the lung or oro-maxillo-facial region. To test for specificity SCC antigen was also looked for in 55 patients with various other epithelial neoplasms, in 18 with inflammatory lung disease, and in 43 with liver and 34 with renal function abnormalities. The sensitivity rate of SCC antigen in squamous-cell carcinoma of the lung was 53%, in carcinoma of the oromaxillofacial region 34%. Both groups differed significantly from all other groups, except for patients with abnormal renal function more than half of whom had raised serum concentrations. The proportion of false-positive SCC values was 11% each for patient with inflammatory lung disease and other epithelial neoplasias, and 7% for patients with abnormal liver function. SCC is not a specific marker for squamous-cell carcinoma. Its clinical value probably lies mainly in monitoring the course of such tumours.

Antigens, Neoplasm↗

Smokeless tobacco use and cancer of the upper respiratory tract.

The most recent epidemiologic review of the cancer risks associated with smokeless tobacco use appeared in 1986, when 10 studies were available. This review describes 21 published studies, 20 of which are of the case-control type. We characterize each study according to the specific anatomic sites and according to the type of smokeless tobacco products for which it provides relative risks of cancer. The use of moist snuff and chewing tobacco imposes minimal risks for cancers of the oral cavity and other upper respiratory sites, with relative risks ranging from 0.6 to 1.7. The use of dry snuff imposes higher risks, ranging from 4 to 13, and the risks from smokeless tobacco, unspecified as to type, are intermediate, from 1.5 to 2.8. The strengths and limitations of the studies and implications for future research are discussed.

Case-Control Studies↗