Tongue Spindle Cell Rhabdomyosarcoma: A Rare Case Report and Literature Review.

Rhabdomyosarcoma (RMS) is a malignant soft tissue neoplasm with its origin in the skeletal muscle and is extremely rare in adults. By the World Health Organization (WHO), a new variant of RMS has been classified, i.e. the spindle cell (Sc) and sclerosing (S) RMS. While the Sc-RMS shows intersecting fascicles of nonpleomorphic spindle cells, the S-RMS is characterized by a marked hyalinization in a pseudovascular growth pattern associated with round-to-spindled tumour cells. According to the analysed data, the Sc/S-RMS variant has a worse outcome than other variants. The new classification of the Sc/S-RMS variant is valuable to the clinical practice. There are not many oral Sc/S-RMS cases reported. The aim of this paper is to demonstrate that an early diagnosis, an adequate treatment and a multidisciplinary approach have a positive effect on the prognosis of the patient. In this study, we analyse a new case of Sc-RMS variant in a young adult with an early diagnosis and a favourable outcome as a result of an appropriated multidisciplinary treatment: early surgery, radiotherapy and chemotherapy treatment.

Prospective study to evaluate the influence of joint washing and the use of hyaluronic acid on 111 arthrocentesis.

BACKGROUND: Temporomandibular dysfunction is a generic term that covers a large number of clinical problems affecting not only temporomandibular joint but also the masticatory musculature and related structures. Arthrocentesis is used in patients with joint pathology in which conservative treatment has failed. METHODS: A prospective, observational, analytical cohort study has been carried out to evaluate the results of 111 arthrocentesis. We have performed an inferential statistics study between the variables: improvement of pain and improvement in the oral opening with the variables and access joint, washing joint, hyaluronic acid infiltration, and type of joint pathology. RESULTS: Joint washing and intra-articular hyaluronic acid injection significantly improved the pain at 1-week, 1-month, and 3-month postarthrocentesis, although this improvement was limited in time, at 6 months, joint washing and hyaluronic acid infiltration are no longer significant. Only the joint access (p = 0.014) and the type of joint pathology (p = 0.028) are significant. CONCLUSIONS: The effectiveness of joint access in the arthrocentesis at 6 months is high, although less than at 1-month and 3-month postarthrocentesis. The type of joint pathology is another important factor. Patients with degenerative pathology worsen the most after 6-month postarthrocentesis. Arthrocentesis could avoid the evolution of acute pathology.

Epidemiological Study of the Socioeconomic Impact of Mandible Fractures in a Spanish Tertiary Hospital: Review of the Literature.

INTRODUCTION: Mandibles fractures are one of the most frequent pathologies treated in an Oral and Maxillofacial Department and represent a serious public health problem. MATERIALS AND METHODS: We present a retrospective study of patients treated for mandible fractures by the Oral and Maxillofacial Surgery Department in a Spanish tertiary hospital during 2010-2012. RESULTS: One hundred and thirty-nine patients with 201 mandible fracture sites were assisted in our department; 15% were female and 85% were male, with a male-to-female ratio of 5.5:1. The observed mean age was 35 years with a range between 15 and 89 years. The most frequent etiology of fractures was the assault (43%) followed by falls (32%). The most common fracture site was the mandibular angle (35%), followed by the parasymphysis (30%). Concerning combined fractures (60%), the most repeated association was the angle and the parasymphysis. The principal imaging test for diagnosis was the orthopantomography. The intermaxillary fixation was performed in the 25% of cases, and the rest of mandible fractures were fixed by osteosynthesis. The surgical treatment had an average of 4.2 days after the trauma, and the mean time of hospitalization was 6.5 days. CONCLUSION: The principal aim of the treatment of mandible fractures is to restore the function of the patient occlusion. A malocclusion after surgery may decrease the patient quality of life, so a correct fracture reduction could shrink health spending. After the result shown in the present study, the social education should be improved in the developed countries with the objective of decline in the amount of aggressiveness.

Are Comorbidities Associated With Overall Survival in Patients With Oral Squamous Cell Carcinoma?

PURPOSE: Oral squamous cell carcinoma (OSCC) is a highly prevalent type of immunogenic cancer with a low survival rate in patients with comorbidities owing to toxic habits. MATERIALS AND METHODS: A retrospective cohort study was conducted of patients with resectable OSCC at a tertiary Spanish hospital from 2011 to 2014. The primary predictor variables were comorbidity and immune biomarkers. Comorbidity was assessed using the Adult Comorbidity Evaluation-27 (ACE-27) and scored from 1 to 3 (mild to severe decompensation, respectively). The immune biomarkers were neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR). The primary outcome variable was 5-year overall survival (OS). Other study variables were stage, margin, and neck management. Receiver operating characteristic curves were built for each ratio. For the survey of immune biomarkers, area under the curve was computed to determine cutoff points and investigate their association with OS. Kaplan-Meier estimates of survival and Cox proportional hazards models were used for longitudinal analysis. RESULTS: Overall 215 patients were identified (median age, 67 yr; range, 32 to 96 yr; median follow-up, 31 months; range, 7 to 78 months); 159 patients had at least 1 comorbid condition. Results showed that a severe comorbidity (according to the ACE-27) increased the risk of death by 4 times in patients with OSCC regardless of stage. NLR, dNLR, LMR, and PLR were associated with OS in the univariate study. Cutoff points to predict increased mortality were 3, 1.9, 2.6, and 66 for NLR, dNLR, LMR, and PLR, respectively. Age, comorbidity, stage, margins, and management of the neck were important independent predictors of decreased OS in OSCC. PLR was marginally associated with OS in the multivariate model. CONCLUSION: These results suggest that comorbidity and NLR, dNLR, LMR, and PLR are associated with 5-year OS in patients with resectable OSCC.

Recidiva de carcinoma escamoso de lengua durante el embarazo. Revisión de la literature / Recurrence of squamous cell carcinoma of the tongue during pregnancy. Review of the literatura

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Precisión de la PAAF (punción aspiración con aguja fina) y la TAC (tomografía axial computerizada) en la diferenciación de tumores benignos y malignos de parótida en una serie de casos / Accuracy of FNAC and CT in the differentiation of benign and malignant parotid tumours in a case series

Introducción: Los tumores de parótida, además de la gran diversidad de tipos que existen, son histológicamente complejos. Su diagnóstico preoperatorio, principalmente en cuanto a diferenciar tumores benignos de malignos es importante a la hora realizar un tipo de cirugía u otra. La punción-aspiración con aguja fina (PAAF) es una herramienta simple, rápida, y de bajo coste, poco invasiva y bien tolerada, que se usa en el diagnóstico preoperatorio de estos tumores. Material y métodos: Sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo de la PAAF y la tomografía computadorizada (TAC) en la diferenciación de tumores benignos y malignos de parótida operados durante los años 2010 a 2014 por el Servicio de Cirugía Oral y Maxilofacial. Resultados: La sensibilidad de la PAAF es de un 50%, baja, similar a los artículos publicados, mientras que la especificidad es alta, de un 98,7%. La PAAF ofrece una fiabilidad alta en el diagnóstico de tumores malignos, a pesar de su baja sensibilidad. Sin embargo, cuando el diagnóstico es no concluyente, o benigno que no sea adenoma pleomorfo o tumor de Whartin, la fiabilidad para excluir malignidad disminuye. Conclusión: La baja sensibilidad de la PAAF para diferenciar tumores malignos de benignos en la parótida hace que no podamos dejar de lado otras pruebas diagnósticas, la clínica y sobre todo la visión intraoperatoria de cada cirujano. Sobre todo cuando el diagnóstico es no concluyente. A pesar de esto, es una técnica utilizada de forma sistematizada y que ayuda a tomar decisiones prequirúrgicas (AU)

Introduction: Parotid tumours, in addition to the wide variety of types, are histologically complex. Differentiating between benign and malignant tumours in preoperative diagnosis is important in deciding the type of surgery required. Fine needle aspiration cytology (FNAC) is a simple, quick, low-cost, low-invasive and well-tolerated tool used in the preoperative diagnosis of these tumours. Material and methods: we calculated the sensitivity, specificity, predictive positive value (PPV) and negative predictive value (NPV) of FNAC and computed tomography (CT) in the differentiation of benign and malignant parotid tumours operated between 2010 to 2014 in the oral and maxillofacial surgery department of the University Hospital Miguel Servet. Results: The sensitivity of FNAC is 50%, while the specificity is high, at 98.7%. FNAC offers high reliability in the diagnosis of malignant tumours, despite its low sensitivity. However, when the diagnosis is indeterminate or benign, other than pleomorphic adenoma or Whartin tumour, the reliability to exclude malignancy decreases. Conclusion: The low sensitivity of FNAC to differentiate malignant from benign parotid tumours, means that we cannot rule out other diagnostic tests, clinical symptoms and especially the intraoperative vision of each surgeon. Especially when the diagnosis is indeterminate. Nevertheless, it is a technique used in a systematised way and helps in pre-surgical decision-making (AU)

Accuracy of FNAC and CT in the differentiation of benign and malignant parotid tumours in a case series. / Precisión de la PAAF (punción aspiración con aguja fina) y la TAC (tomografía axial computerizada) en la diferenciación de tumores benignos y malignos de parótida en una serie de casos.

INTRODUCTION: Parotid tumours, in addition to the wide variety of types, are histologically complex. Differentiating between benign and malignant tumours in preoperative diagnosis is important in deciding the type of surgery required. Fine needle aspiration cytology (FNAC) is a simple, quick, low-cost, low-invasive and well-tolerated tool used in the preoperative diagnosis of these tumours. MATERIAL AND METHODS: we calculated the sensitivity, specificity, predictive positive value (PPV) and negative predictive value (NPV) of FNAC and computed tomography (CT) in the differentiation of benign and malignant parotid tumours operated between 2010 to 2014 in the oral and maxillofacial surgery department of the University Hospital Miguel Servet. RESULTS: The sensitivity of FNAC is 50%, while the specificity is high, at 98.7%. FNAC offers high reliability in the diagnosis of malignant tumours, despite its low sensitivity. However, when the diagnosis is indeterminate or benign, other than pleomorphic adenoma or Whartin tumour, the reliability to exclude malignancy decreases. CONCLUSION: The low sensitivity of FNAC to differentiate malignant from benign parotid tumours, means that we cannot rule out other diagnostic tests, clinical symptoms and especially the intraoperative vision of each surgeon. Especially when the diagnosis is indeterminate. Nevertheless, it is a technique used in a systematised way and helps in pre-surgical decision-making.