ABSTRACT
Abstract Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor of the jaws, histologically characterized by the presence of agglomerates of cells with eosinophilic cytoplasm. The patient, a 62-year-old Caucasian woman, presented an intraosseous lesion in the mandibular symphysis. A clinical examination revealed a discrete volumetric increase with a hard consistency, palpable to extraoral and intraoral examinations. Imaging studies revealed an extensive radiolucent area, without defined limits, extending from the region of the right second premolar to the left canine. Incisional biopsy analysis indicated a diagnosis of CCOC. The treatment proposed was segmental resection of the mandible with a safety margin. After six months without recurrence, definitive mandibular reconstruction was performed using an iliac crest graft, followed by rehabilitation with implant-supported denture after five months. After three years of post-resection follow-up, the patient has shown no evidence of recurrence or metastasis. She continues to be under follow-up. To conclude, CCOC must be considered a malignant tumor with aggressive behavior. Previous studies have shown that resection with free margins is a treatment with a lower rate of recurrence. Nevertheless, long-term follow-up is necessary for such patients.
Subject(s)
Humans , Female , Mandibular Neoplasms/surgery , Odontogenic Tumors/surgery , Adenocarcinoma, Clear Cell/surgery , Biopsy , Radiography, Panoramic , Mandibular Neoplasms/pathology , Mandibular Neoplasms/diagnostic imaging , Odontogenic Tumors/pathology , Odontogenic Tumors/diagnostic imaging , Bone Transplantation/methods , Treatment Outcome , Adenocarcinoma, Clear Cell/pathology , Adenocarcinoma, Clear Cell/diagnostic imaging , Mandibular Osteotomy/methods , Ilium/transplantation , Middle AgedABSTRACT
Local and regional recurrences are the main sites of treatment failure in patients with oral and oropharyngeal squamous cell carcinoma. Treatment failure depends fundamentally on tumor biologic behavior, previous treatment and the initial clinical stage. The rates of loco-regional recurrences range from 25 to 48%, and distant metastasis rarely occur in an isolated manner. When recurrent cancer is significant and there are no distant metastasis salvage surgery is the most widely used treatment approach. Most of these patients were previously treated with radiotherapy. Therefore, when recurrence occurs, salvage surgery is the only possible treatment option with curative intent. The aim of this study was to review the data in the literature regarding results of salvage surgical treatment for patients with recurrent oral and oropharyngeal carcinomas