Clinical and histological aspects of malignant inverted sinonasal papilloma. Two case reports.

The inverted sino-nasal papilloma is a benign epithelial lesion, ranging from 1% to 5% of the tumors that reside in this area. It is characterized by a tendency towards local bone destruction, recurrence and malignant transformation. This is a presentation of two cases diagnosed and surgically treated for malignant inverted papiloma, which started in the epithelium of the maxillary sinuses. The cases had in common the late presentation of the patient to the surgeon, thus the local destruction was significant with extension towards the eye socket and the base of the skull. The treatment of choice was the surgical resection of the maxillary bone with a prosthetic reconstruction of the defect followed by radiotherapy. After a careful analysis of the two cases, a series of statements regarding the diagnosis and treatment of this rare pathology were recommended.

Histological patterns in orbital malignant tumors.

There is a wide variety of tumors affecting the orbit. The most encountered histological type of malignant orbital tumor is the basal cell carcinoma followed by the malignant melanoma and the squamous cell carcinoma. The authors conducted a retrospective review of the malignant orbit tumors from the Department of Oral and Maxillofacial Surgery, University Emergency Hospital of Sibiu, Romania. The main surgical methods implied were tumor resection, exenteration and extended exenteration. The reconstruction was performed with the help of local flaps using different techniques: advancement, translation or rotation. The use of local flaps allowed for a good esthetic outcome and a decrease in the healing time.

Malignant ameloblastoma in an 8-year-old child with metastasis to the lung: case report with a clinicopathologic analysis.

Ameloblastomas are rare tumors of odontogenic origin, accounting for 1% of all oral tumors. They are benign, but locally highly aggressive tumors. We report here the unusual case of an 8-year-old patient with multicystic mandibular ameloblastoma, who was submitted to surgery for two relapses in six years and metastasized to the lung two years after initial surgery. The first lesion, diagnosed as follicular ameloblastoma, was treated conservatively with enucleation and curettage. Two years later the tumor relapsed into multicystic granular form. A marginal conservative resection was performed, keeping the basilar contour of the mandible, due to the age of the patient. Three months later, on a routine follow-up examination, a lung metastasis was detected with no signs of tumor in the mandibular bone and the patient was submitted to upper right lobectomy. Three years later a new recurrent tumor was detected in the alveolar process and another marginal resection was performed. Histologically, the tumor showed the follicular growth pattern. After a disease-free period of over five years, the patient was again submitted to surgery for mandibular reconstruction. The mandibular bony defect was filled with iliac bone blocks and four dental implants. He underwent oral rehabilitation with an implant-supported overdenture. With a follow-up period of 22 years since first surgery, the patient is currently free of disease.