A case report of osteochondroma of the frontotemporosphenoidal suture.

Osteochondroma, also known as osteocartilaginous exostosis, is the most frequent benign bone tumour of the skeletal system. Despite its preference for long bones (tibia and femur), osteochondroma may occur in some short bones developing endochondral ossification. Seventy-five percent of the patients present only with a single lesion, whereas 25% have multiple lesions; this last clinical condition, defined as osteochondromatosis (disorder of autosomal dominant inheritance) shows a high risk of malignant transformation (about 11%). In the craniofacial area this tumour is very rare. The sites of predilection are the coronoid process and mandibular condyle, even though osteochondromas arising from the base of the skull, maxillary sinus and zygomatic arch have been previously described. However, an osteochondroma originating from the frontotemporosphenoidal suture has not been reported before in the literature. We present a unique case of osteochondroma of the frontotemporosphenoidal suture. Moreover, the relevant international literature has been reviewed and all diagnostic and surgical matters have been discussed.

Surgical treatment of recurrences of pleomorphic adenoma of the parotid gland.

From 1989 to 1999 a retrospective study was conducted on 7 patients with recurrent pleomorphic adenomas of the parotid gland who were referred to the MaxilloFacial Department of the University of Rome "La Sapienza" after having undergone surgery elsewhere. The mean time interval between the first operation and recurrences ranged from 15 months to 13 years, and the average time interval was 7.7 years. Implantability of the lesion and inadequate surgery that produced rupture of tumour capsule and tumour cells bleeding into surrounding glandular parenchyma, were the reasons for tumour recurrence. The instrumental examinations used for planning the surgical treatment to be applied and for studying the relations of recurrence with glandular parenchyma were CT (with contrast medium) or MR of head and neck. These patients underwent total parotidectomy with facial nerve preservation and no recurrence occurred in any patient. The results of this study underscore the importance of adequate surgical excision of initial recurrences as well as primary tumours to prevent tumour recidivism. Finally, tumour control rates and facial nerve preservation are enhanced with formal parotidectomy for recurrent tumour when feasible.