Malignant Fibrous Histiocytoma of the Maxilla: A Case Report

PURPOSE: Malignant fibrous histiocytoma (MFH) is mainly a soft tissue sarcoma containing fibroblast-like cells and histiocytic cells. MFH in bone accounts for 5% of all malignant bone tumors. MFH of the maxilla is extremely rare and difficult to diagnose due to its scarcity. Treatment mainstay is a complete surgical excision. Radiation therapy is also available when surgery alone is incomplete. Prognosis is not clear but can be devastating. Authors report one case of MFH developed in the maxilla. METHODS: A 24-year-old man firstly diagnosed as fibrous dysplasia based on CT findings. Considering facial contour, partial excision was done. But pathology report confirmed malignant fibrous histiocytoma and secondary wide excision was done including zygoma and grossly all affected area. After surgery, radiation therapy was continued. RESULTS: There are no evidence of tumor recurrence after clinical and radiological treatment. CONCLUSION: MFH of maxilla is very rare and this can leads to misdiagnosis in many clinicians. Surgeon should differentiate this disease from fibrous dysplasia and pathology and MRI are accurate methods for diagnosis of MFH.

Retrospective Study of Postoperative Radiation Therapy in Keloids Treatment

PURPOSE: Keloid is a clinical term characterized by elevation and extension of scar tissue beyond wound margin. Currently, there is no known treatment that shows consistent effect in all patients. Postoperative radiation therapy is known to prevent recurrence of keloid. METHODS: We reviewed data of patients who had undergone operation or operation followed by radiation therapy at our institute for the last 12 years. Follow up was possible in 39 patients(21 patients treated only by operation and 18 treated by operation and radiation therapy) We then investigated recurrence in both groups by VAS score. By mail, patients were asked to score their current condition on the bar in 4 aspects(itching, pain, mass lesion(by patients and other persons)). Two criteria were used for defining successful treatment. One is the case which total VAS score was 0, and the other is sum of VAS score of mass lesion was 0 to 5. RESULTS: In the former, recurrence rate is 90.5% in operations-only group but 66.7% in operations plus radiation therapy group(p 0.05). In the latter, recurrence rate is 66.7% in operation-only group but 22.2% in operations plus radiation therapy group(p 0.05). CONCLUSION: These results shows postoperative radiation therapy is effective method in keloid treatment.

Simple open reduction of mandibular angle fracture using the champy's osteosynthesis line

Mandibular angle fracture causes facial aesthetic problem and functional derangement of mastication. For the open reduction of the mandibular angle fracture, various methods have been developed according to the approaching route, fixation material, fixation position and the fixation number. There remains controversis in managing the mandibular angle fracture. We treated the mandibular angle fracture using non-compressive miniplate along the Champy's ideal osteosynthesis line. For accurate reduction of mandibular angle fracture and maintain centric relation, one or two K-wires were inserted to the inferior border of both fracture segments and both fracture segments and both segments were approximated by manual force or rubber bandage. Maintaining the anatomical reduction of fracture site, fixation was done on vestibular flat area aling the medial side of extermal oblique ridge defined as Champy's osteosynthesis line with one malleable non-compression 4-hole miniplate and screws. After the fixation of plate, K-wires and rubber bandaging for intermaxillary fixation were removed. With maintaining the arch bar, exercise and soft diet were encouraged at the first postoperative day. Through the above procedure, we have experienced satisfactory osteosynthesis and good occlusion. This method has the advantages like that easy and minimal dissection, no external visible scar, no nerve damage and providing simple and ideal osteosynthesis. We present cases of mandibular angle fractures with the review of the literature.

Simple Technique of Brow Lift

No abstract available.