Osteoblastoma: presentación de caso clínico y revisión de la literatura / Maxillary osteoblastoma: report of a case and review of literature

El Osteoblastoma (OB) es un tumor benigno formador de tejido óseo de aparición muy rara en los maxilares. Su diagnóstico puede ser un gran reto para el patólogo bucal, ya que las características histopatológicas se asemejan a otros tumores más frecuentes en el macizo maxilofacial; por lo que es importante conocer a profundidad sus características clínicas, radiográficas e histopatológicas que nos conduzcan al diagnóstico asertivo de OB. Hasta los actuales momentos la última recopilación de casos de OB maxilares publicados en la literatura fue hecha por Morelos et al hasta el año 2011, quien obtuvo 88 casos. El objetivo de esta investigación fue realizar una revisión bibliográfica exhaustiva de casos documentados hasta la fecha en revisiones sistemáticas previas, obteniéndose 119 casos de OB maxilares. Adicionalmente, se aporta un caso más de OB de maxilar superior a la literatura académica...

Osteoblastoma is a rare bone-forming tumor that very rarely involves the jaws. The diagnosis should be very difficult to oral pathology expert because their histopathologic features are resembled with other bony tumors of the maxillofacial region. Therefore, is very important have depth knowledge about the clinical, radiographic and histopathologic features of OB, to make the correct diagnosis. Before this report, the last collection of maxillary OB cases was made by Morelos et al until the year 2011; they obtained 88 cases in their study. The main aim of this research was provide a systematic review of previously published cases; the result was 119 cases of maxillary OB. In addition, this paper added one more case of this rare lesion to the academic literature...

Benign tumors and tumor-like lesions of the calcaneum: A study of 12 cases.

Benign tumors of the calcaneum are rare. Cystic lesions such as simple bone cysts and aneurysmal bone cysts are commonly seen. Aims and Objectives: To evaluate tumors of the calcaneum, which were seen over a 12-year period. Materials and Methods: We analyzed noninfectious, noninflammatory, benign lesions of the calcaneum seen in the Orthopedic Out Patient Department from 1991 to 2003. Twelve such tumors were encountered. There were 11 males and one female and their ages varied from 18 to 53 years with a median of 31. Data was collected from the histopathology reports, radiographs, and inpatient and outpatient records. One of the coauthors reviewed the histopathologic findings of all the tumors. Results: Twelve benign lesions were seen in 12 patients. In our series, cysts predominated, with three aneurysmal bone cysts and five simple bone cysts. The other benign tumors were: one fibrous dysplasia, one vascular hamartoma, one osteoblastoma, and one chondromyxoid fibroma. The bone cysts were treated by curettage, with or without bone grafting, except for one large aneurysmal bone cyst, which was treated by excision of the calcaneum. The postoperative function in this patient was good, with modified footwear. Conclusion: The calcaneum is an uncommon site for most bone tumors, and in our series, bone cysts were the most common benign lesions. Curettage and bone grafting or the use of bone substitutes can be effectively used in the treatment of symptomatic bone cysts of the calcaneum.

Cytotoxicity evaluation of Persica mouthwash on cultured human and mouse cell lines in the presence and absence of fetal calf serum.

Background and Aims: The effectiveness of an ideal antimicrobial agent depends on its ability to kill microbes while causing minimal toxicity to host cells. Several studies have been reported on the antimicrobial effects of chewing sticks (Salvadora persica) on oral bacteria. The purpose of this study was to evaluate the cytotoxic effects of Persica™ and chlorhexidine (CHX) mouthwashes on cultured human and mouse cell lines. Materials and Methods: This was an experimental study. The toxic effects of four dilutions of Persica™ and CHX mouthwashes on KB, Saos-2, J744 A1, and gingival fibroblast cells were evaluated by MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide] assay. The effect of fetal calf serum (FCS) components on the cytotoxicity of these mouthwashes was also investigated. Statistical Analysis: Analysis of variance and the Kruskal-Wallis test were used to evaluate the results. Results: The results indicated that Persica™, at concentrations higher than 0.1%, exerted a very significant cytotoxic effect on all the cell lines (P < 0.01). CHX, at a concentration of 0.001%, exerted toxic effects only on gingival fibroblasts; concentrations higher than 0.001% were required to produce significant cell death in the other cell lines. At all the concentrations under study, both Persica™ and CHX exerted significantly greater cytotoxic effects in the absence of FCS than in its presence (i.e., in control culture medium). The toxicities of both mouthwashes were attenuated in the presence of FCS (10%). Conclusion: Our results indicate that both Persica™ and CHX mouthwashes are toxic to macrophage, epithelial, fibroblast, and osteoblast cells in a concentration-dependent manner.

Osteoblastoma monostótico costal: presentación de un caso y revisión de la literatura / Costal monostotic osteoblastoma: a case report and literature review

Se presenta el caso de un paciente de 31 años de edad, en cuya radiografía simple de tórax se observó una radiopacidad en la zona del quinto arco costal izquierdo y con localización posterior. Se realizaron exámenes complementarios hematológicos e imagenológicos para determinar las características morfológicas de dicho hallazgo. Fue intervenido quirúrgicamente y se realizó la exéresis de dicho tumor. Los resultados anatomopatológicos arrojaron la presencia de un osteoblastoma, con afectación de un solo arco costal posterior. Los tumores de la pared costal, y especialmente los benignos, son poco frecuentes, por lo cual se decidió presentar este caso y los aspectos más relevantes y actuales respecto a esta variedad de tumores(AU)

The case of a 31-year-old female patient, with simple chest X-ray in which it was observed a radioopacity in the zone of the left fifth costal arch with posterior localization was presented. Hematological and imaging complementary tests were made to determine the morphological characteristics of this finding. She was operated on and an exeresis was performed. The anatomopathological results showed the presence of an osteoblastoma with affectation of just one posterior costal arch. The tumors of the costal wall and, specially, the benign are uncommon. Therefore, it was decided to present this case and the most important and current aspects on this variety of tumor(AU)

Classical osteoblastoma, atypical osteoblastoma, and osteosarcoma: a comparative study based on clinical, histological, and biological parameters

OBJECTIVE: To investigate the biological behavior of classical and atypical osteoblastomas in comparison to osteosarcomas. METHODS: Based on histological parameters, 30 osteoblastomas were subclassified as classical osteoblastomas (23/30) or atypical osteoblastoma (high cellularity, prominent blue osteoid, and epithelioid osteoblasts-7/30). Comparative immunohistochemical and clinical analysis was performed in 17 cases of patients with high-grade osteosarcoma. Formalin-fixed, paraffin-embedded archival tissue was immunostained for p53 and proliferation cell nuclear antigen. Tumors with positive p53 stain underwent molecular analyses for fragments of exon 10. RESULTS: The mean proliferating cell nuclear antigen indexes for classical osteoblastoma, atypical osteoblastoma, and osteosarcoma were 33 percent, 61 percent, and 79 percent, respectively. The atypical subgroup showed similar results to those of the osteosarcoma group (P < 0.001). p53 protein was detected in 4 (13 percent) osteoblastomas (3 of these were atypical osteoblastoma), and 4 osteosarcomas (23 percent) also showed p53 positivity. DNA mutation performed in p53-positive cases was confirmed in exon 10 in 2 atypical osteoblastomas (2/3), 1 classical osteoblastoma (1/1), and 1 osteosarcoma (1/4). Disease recurrence was correlated with p53 expression (P = 0.009), atypical subtype (P = 0.031), spiculated blue bone on histology (P = 0.018), and proliferatingcell nuclear antigen labeling index > 40 (P = 0.015). CONCLUSION: These results validate atypical osteoblastoma as an entity, with p53 and proliferation cell nuclear antigen immunoexpression closer to that of osteosarcoma than of classical osteoblastoma. Proliferating cell nuclear antigen labeling index and p53 may be useful predictors of recurrence.

OBJETIVOS: Investigar o comportamento biológico de osteoblastomas clássicos e atípicos comparados com osteossarcomas. MÉTODOS: Com base em parâmetros histológicos classificamos um grupo de 30 osteoblastomas nos subgrupos de osteoblastomas clássicos (23/30) e de osteoblastomas atípicos (que apresentam como característica grande celularidade, osteóide azul proeminente e osteoblastos epitelióide-7/30). Como efeito de comparação dos resultados imunohistoquímicos e análise clínica, avaliamos 17 pacientes com osteosarcoma de grau avançado. Os cortes histológicos com bloco de parafina fixado em formalina foram imunocorados para p53 e antígeno nuclear de célula em proliferação. Tumores com coloração positiva para p53 tiveram análise molecular para fragmentos do exon 10. RESULTADOS: O índice médio de antígeno nuclear de célula em proliferação para osteoblastoma clássico, osteoblastoma atípico e osteosarcoma foram de 33 por cento, 61 por cento e 79 por cento, respectivamente. O subgrupo atípico demonstrou resultados similares aos dos osteosarcomas (p<0,001). Foram detectadas proteína p53 em 4 (13 por cento) osteoblastomas; 3 desses foram osteoblastomas atípicos, sendo que 4 osteosarcomas (23 por cento) também demonstraram p53 positivo. A mutação do DNA nos casos positivos de p53 foi confirmada no exon 10 em dois osteoblastomas atípicos (2/3), um osteoblastoma clássico (1/1) e um osteosarcoma (1/4). A recorrência da doença foi correlacionada com a expressão do p53 (p=0,009), subtipo atípico (p=0,031), osso azul espiculado no resultado da histologia (p=0,018), e índice de marcação pelo antígeno nuclear de célula em proliferação > 40 (p=0,015). CONCLUSÃO: Esses resultados validam os osteoblastomas atípicos como entidade real, com imunoexpressão das proteínas p53 e antígeno nuclear de célula em proliferação mais perto do osteosarcoma do que do osteoblastoma clássico. O índice de marcação pelo antígeno nuclear de célula em proliferação e o p53 podem...

Fibroma ossificante juvenil trabecular (tipo OMS): relato de um caso e discussão de parâmetros de diagnóstico diferencial / Trabecular (who-type) juvenile ossifying fibroma: report of a case and

O fibroma ossificante juvenil (FOJ) é uma neoplasia benigna que tem sido distinguida dos fibromas ossificantes pela idade dos pacientes afetados (geralmente abaixo dos 15 anos), sítio anatômico preferencial de ocorrência (maxila), e comportamento biológico agressivo. Nós relatamos um caso atípico de um FOJ de grandes dimensões envolvendo a maxila direita de uma paciente de 28 anos que provocou perfuração das corticais ósseas vestibular e palatina em seis meses deevolução. Uma ampla discussão de critérios histológicos para estabelecimento do diagnóstico deste tumor também foi realizada

An unusual presentation of giant cell tumour (osteoclastoma).

The number of well-documented true giant cell tumours arising in any of the craniofacial bones is small, but they do exist. A 19 year old female, Ms. KS, presented with complain of progressive enlargement of facial bones especially jaw bones, then orbit symmetrically since the age of 7. There was bilateral gross enlargement of mandible, maxilla, orbital walls, causing displacement of eye medially and upwards. The visual acuity of both eyes were 6/36 and 6/18 with best correction. Extra ocular movements were restricted because of bony growth and conjunctiva over inferior fornix were keratinized due to exposure. Fine needle aspiration (FNAC) from the side of bony growth showed plenty of osteoclasts with multinucleated giant cells. The level of serum alkaline phosphatase were highly increased. She underwent orbitotomy and a part of tissue was sent for biopsy which revealed multiples of mononucleargiant cells and tumour cells.