TREATMENT OF CONFOUND COMMINUTED MANDIBULAR FRACTURES

AGGRESSIVE FIBROMATOSIS OF THE MAXILLA

Aggressive fibromatosis is best difined as a group of non-encapsulated, non-metastasizing fibrous tumors that have tendency for local recurrence. This tumor is chariaterized histologically by fibroblastic proliferation and clinically by the potential to infiltrate and to recur after surgical excision, but not metastasize. The most common anatomic location have been the abdominal muscle and the extrimities. The incidence of the head and neck is mentioned as from 9.5% to 50% of all desmoid tumors. Within this area, 40%-to 80% of the tumors are located in the neck, but rare in oral cavity. Histologically the tumor is composed of proliferative fibroblasts with a collagenous component. The degree of cellularity varies from area to area and from tumor to tumor. The cells are usually spindle-shaped and the nuclei present only slightly polymorphism, but mitosis are rare and never atypical. Oral fibromatosis has been described as fibrosarcoma, pseusarcoma, pseudosarcomatous fibrosarcoma, metastasizing fibromatosis, juvenile aggressive fibromatosis, and aggressive fibromatosis, but Wilkin and Waldron suggested that the aggressive fibromatosis was a more appropriate term, reflecting the invasive characteristics of the tumor. The treatment of aggressive fibromatosis is traditionally surgical resection with an area of tumor free tissue. But when the complete surgical excision is not possible, radiation and chemotherapy also can be used. Clinically the tumor reported to be not painful in most cases, but capable of rapid growth. Careful clinical and histological examinations are essential for correct diagnosis. We report a case of aggressive fibromatosis. Occurring of the maxilla in 10 year female patient.

A case report of pigmented dermatofibrosarcoma protuberans (Bednar tumor)

Bednar tumor was described by Bednar in 1957. The histologic pattern of this tumor shows similar to dermatofibrosarcoma protuberans (DFSP) but melanin pigments are scattered within the tumor, It's rare neoplasm accounting for approximately 1-5% of all case of DFSP. Clinically, this tumor is considered to be intermediated malignancy, because of slow growth and frequent local recurrence and lack of distant metastasis. The majority are located on the trunk and the upper and lower extremities, but extremely rate in the head and neck area. Microscopically, this tumor is characterized by tight storiform spindle cells and long slender cells that admixed with a small population of melanin containing dendritic cells. This dendritic cells are the primary features distinguising this lesion from conventional DFSP. Complete surgical excision and close follow-up case are necessany for this neoplasm because of probable intermediate malignancy. A patient was admitted to Our Department of Oral and Maxillofacial Surgery due to swelling on right parotid area and numbness of the right lower lip on September, 1994, By clinical examinations and C-T finding, we dignosed tentatively as myxoma or pleomorphic adenoma. Surgical excision of this tumor was performed with parotidectomy and mandibular osteotomy under the frozen biopsy. By final microscopic and electromicroscopic examination and immunohistochemical study, this tumor was diagnosed as Bednar tumor. So, we report a case of pigmented DFSP with review of literatures.