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OBJECTIVE: Cystic lesions of the jaw are common pathologies of chronic swelling of the jaw in oral and maxillofacial regions. Different treatment modalities have been described in the literature. However, the existence and proper treatment of these cysts remains a contentious topic. The aims of this review were to discuss the complexity of various surgical treatment and as factors with potential to influence outcome treatment. Finally, a practical and a rational clinical guideline for the management of such lesions have been suggested. MATERIALS AND METHODS: A literature search without language limitation was performed in 2018 using MEDLINE, PubMed, Scopus, and Embase. Keywords for the search included the following terms: jaws cyst, cystic lesions, odontogenic cysts, cystic tumors, pseudocysts, treatments, therapy, wound healing, bone regeneration, and teeth involved cysts. Prospective or retrospective clinical studies with a sample size of n ≥ 5 were evaluated and included in this review. The exclusion criteria were studies with unclear reporting of the treatment applied or outcome, nonhuman studies, case reports, letters, preface, comments, and cystic lesions associated to syndrome. After the full reading, 30 articles were included in the quantitative synthesis for the review. No meta-analysis could be performed due to the heterogeneity of the studies included. Clinical radiographic images were presented to illustrate the principles of some surgical treatments. CONCLUSION: Conservative surgery with primary closure defect (less than 4 cm) remains an initial approach, which reduces the morbidity of aggressive surgeries and obtains the complete bone healing before 24 months of postoperative. Marsupialization is considered as the most common option for the treatment of large cystic lesions when cases are carefully selected. Evocyst is an attractive new technique of obtaining complete bone defect healing within <3 months.
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Extraskeletal myxoid chondrosarcoma (EMC) is a rare tumor with an estimated incidence of <3% among of all soft-tissue sarcomas. It is characterized by a multinodular architecture, abundant myxoid matrix, and malignant chondroblast-like cells arranged in cords. The tumor is an entity from chondrosarcomas of bones, commonly found in the soft tissues of the lower extremities at 80%. There are very limited reports of this tumor in the head and neck, especially in the parotid gland. The purpose of this paper is to describe an EMC located at an unusual site in the parotid gland, and briefly, the literature review with special reference to the clinicopathological features and the treatment approach was discussed.
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<p><b>OBJECTIVE</b>To explore the curative effect of surgery and selerotherapy for massive venous malformations of the tongue.</p><p><b>METHODS</b>From January 2005 to December 2014, subtotal resection or debulking for 15 cases of massive venous malformation in the tongue was undertaken with multiple sessions of pre- and post-operative injection therapy of pingyangmycin, lauromacrogol and absolute ethanol.</p><p><b>RESULTS</b>All signs associated with the lesions including eating, sleep and speech disorders disappeared after treatment. Complete or near complete resolution was achieved in 9 cases, and a significant reduction in size in a further 6 cases after surgical excision and peri-operative sclerotherapy.</p><p><b>CONCLUSIONS</b>For massive venous malformations of the tongue, surgical excision combined with multiple sessions of sclerotherapy is a good treatment option.</p>
Subject(s)
Humans , Bleomycin , Therapeutic Uses , Combined Modality Therapy , Methods , Ethanol , Therapeutic Uses , Injections, Intralesional , Polyethylene Glycols , Therapeutic Uses , Sclerosing Solutions , Therapeutic Uses , Sclerotherapy , Tongue , Treatment Outcome , Vascular Malformations , Therapeutics , Veins , Congenital AbnormalitiesABSTRACT
Pingyangmycin (bleomycin A5 hydrochloride, PYM) is one of the anti-neoplastic agents which have been commonly used to treat venous malformations. However, the underlying mechanism by which PYM treats venous malformations remains poorly understood. It was reported that venous endothelial cells could recruit neutrophils via adhesion molecules (E-selectin, ICAM-1, ICAM-3, VCAM-1) during the acute/chronic inflammation and subsequent histological fibrosis after sclerotherapy with PYM. This study explored if the expression of E-selectin, ICAM-1, ICAM-3 and VCAM-1 in human venous malformation endothelial cells could be affected by PYM. HVMECs were cultured from human venous malformation tissue. Expressions of E-selectin, ICAM-1, ICAM-3 and VCAM-1 on HVMECs in response to PYM were analyzed by cell ELISA. The relative levels of mRNA expression in the cells were semi-quantified. The results showed that PYM up-regulated the expressions of E-selectin, ICAM-3, VCAM-1 and ICAM-1 in both time- and concentration-dependent manner. Our findings suggested that PYM could induce the expression of adhesion molecules in HVMECs, which might be a possible mechanism by which sclerotherapy by intralesional injection of PYM treats venous malformations.
ABSTRACT
Pingyangmycin (bleomycin A5 hydrochloride, PYM) is one of the anti-neoplastic agents which have been commonly used to treat venous malformations. However, the underlying mechanism by which PYM treats venous malformations remains poorly understood. It was reported that venous endothelial cells could recruit neutrophils via adhesion molecules (E-selectin, ICAM-1, ICAM-3, VCAM-1) during the acute/chronic inflammation and subsequent histological fibrosis after sclerotherapy with PYM. This study explored if the expression of E-selectin, ICAM-1, ICAM-3 and VCAM-1 in human venous malformation endothelial cells could be affected by PYM. HVMECs were cultured from human venous malformation tissue. Expressions of E-selectin, ICAM-1, ICAM-3 and VCAM-1 on HVMECs in response to PYM were analyzed by cell ELISA. The relative levels of mRNA expression in the cells were semi-quantified. The results showed that PYM up-regulated the expressions of E-selectin, ICAM-3, VCAM-1 and ICAM-1 in both time- and concentration-dependent manner. Our findings suggested that PYM could induce the expression of adhesion molecules in HVMECs, which might be a possible mechanism by which sclerotherapy by intralesional injection of PYM treats venous malformations.
Subject(s)
Humans , Bleomycin , Pharmacology , Cell Adhesion Molecules , Genetics , Metabolism , Cells, Cultured , Endothelial Cells , Metabolism , Endothelium, Vascular , Metabolism , Gene Expression , GeneticsABSTRACT
The purpose of this paper was to evaluate the relationship between the thrombosis and secretory duct dilation, lesion size, clinical types, nature (primary or recurrent) and duration of illness in the development of ranula. A total of 229 cases of sublingual gland cysts were treated with surgical resection from Jan. 1990 to Feb. 2010. The patients' data were investigated on histopathological findings, size of ranula, the clinical types, nature of ranula (primary or recurrent) and duration of illness. Sections from the paraffin-embeded blocks were HE-stained. CK expression was immunohistochemically detected. Among 229 cases the incidence of venous thrombosis was 58.52%. The incidence of venous thrombosis with or without duct dilation was 73.25% and 26.39% respectively, with a significant difference between the two groups (P0.05). It is concluded that the formation of venous thrombosis was related to the dilation of secretory duct, lesion size, clinical types, duration of lesion but formation of venous thrombosis was not related to the nature (primary or recurrent) of ranulas.
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Objective To observe the change of vascular endothelial cells and structure of the auricular posterior vein caused by freezing or pingyangmycin injection alone and freezing in combination with pingyangmycin injection,to investigate the effect of these treatments on the vein. Methods Eighteen rabbits were divided into 3 groups of 6 each, and another rabbit was used as a control. (Pingyangmycin) was injected into the auricular posterior vein in the first group, spray freezing within 20 seconds on the auricular posterior vein was performed in the second group,and freezing in combination with pingyangmycin injection was performed in the third group. Light microscope and transmission electron microscope were used to observe the change of auricular posterior vein in the rabbits.Results Proliferation of endothelial cells,and thickening of vessel wall were induced by pingyangmycin. Thrombus formation, tissue oedema and inflammatory infiltration induced by spray freezing within 20 seconds were reversible. Thrombus formation, proliferation of endothelial cells and thickening of the vessel wall was induced by freezing in combination with pingyangmycin injection.Conclusion Freezing and pingyangmycin injection have the synergistic effect, resulting in the proliferation of endothelial cells, thrombus formation, thickening of vessel wall, and even occlusion of vessels.
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<p><b>OBJECTIVE</b>To establish a method of culturing endothelial cells (EC) from human vascular malformation.</p><p><b>METHODS</b>Venous malformation specimens obtained from the patient undergoing oral surgery were plated into glass, plastic and gelatin-coated dishes. Pure cultures of human vascular malformation endothelial cells (VMEC) were isolated by the ways of discarding the tissues at early stage of primary culture, scraping and trypsinizing. Morphological characteristics were studied under phase-contrast microscope and electron microscope (EM), and determined by immunohistochemistry.</p><p><b>RESULTS</b>The cells were pure and could be maintained in culture up to 4 approximately 5 passages, or 40 approximately 50 days. VMEC formed contact-inhibited "cobblestone" monolayer on glass and plastic, and capillary-like "tubes" on gelatin. EM revealed that there were Weibel-Palade bodies in the culture cells. The cells showed positive staining for CD(34), vWF, and negative for alpha-SMA.</p><p><b>CONCLUSIONS</b>The culture technique for growing VMEC has been established. And these cells can provide a useful tool for studying biological characteristics of human vascular malformation in vitro.</p>
Subject(s)
Humans , Cell Culture Techniques , Cells, Cultured , Endothelial Cells , Cell Biology , Endothelium, VascularABSTRACT
Objective: To study the relationship between different patterns of invasion and extracapsular spread in lymph node metastasis from squamous cell carcinoma of tongue. Methods: Pattern of invasion described by Anneroth was used to evaluate the malignance grade of tongue cancer and immunohistochemical and HE staining were used to detect the extracapsular spread in successive cases of tongue cancer with radical neck dissection. Results: Lymph node metastasis was observed in 0/5 of the cases with pattern I invasion,3/8 pattern II,5/6 pattern III and 1/1 pattern Ⅳ. Extracapsular spread occurred as totally or partly replacement of the lymph node by the tumourcells. The tumour cells infiltrated between lymph nodes, perinodal fibroadipose tissue or sternocleidmastoid muscle in the form of cell cluster or isolated cell. Conclusion: Pattern of invasion is a significant factor for evaluating the malignance grading of tongue cancer. Radical neck dissection should be used to treat the tongue cancer with pattern III or IV invasion.
