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INTRODUCTION: Apocrine adenocarcinoma (AA) is a rare gland cancer that appears in the elderly, especially males. Surgery is considered the first option for the management of this tumor. CASE PRESENTATION: We report two cases of AA that occurred at our Unit of Maxillofacial Surgery. Precisely a case of a woman with AA with a usual presence at the eyelid level and a case of a man with AA with an unusual presence at the neck level. DISCUSSION: This cancer generally arises in some specific areas of the body that present high concentrations of apocrine glands (such as in Case No.2). But it can also occur in less typical areas, such as the neck (such as in Case No.1). CONCLUSION: We discuss the surgical management of our cases: both based on our experience and literature data, we recommend extensive surgical excision.
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INTRODUCTION: Mandibular bone metastases should be suspected in all patients with temporomandibular joint disorder symptoms and lung cancer history. The purpose of this report is to present a case of metastasis to the mandibular condyle following pulmonary adenocarcinoma. CASE PRESENTATION: In December 2020, a 71-year-old patient was evaluated by the Department of Maxillofacial Surgery for the presence of a large osteolytic lesion in the left mandibular condyle. There were no changes to the face or occlusion, and mandibular movements were preserved. After surgical removal, histology revealed pulmonary adenocarcinoma metastasis. DISCUSSION: To date, only 7 cases of condylar metastases are described by lung cancer. This pathology's clinical and radiological features are almost always shaded and not specific. CONCLUSION: This study also focuses on rare conditions, such as metastases to the mandibular condyle. It also stresses the importance of a multidisciplinary approach both in the diagnostic and therapeutic process.
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Zoledronic acid (Zol) is a widely used intravenous aminobisphosphonate to treat both benign and malignant skeletal diseases, and bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a serious side effect whose pathophysiology remains poorly understood. Vascular Endothelial Growth Factor (VEGF) has been recognized to mediate BRONJ in cancer patients undergoing Zol treatment, however data on VEGF are lacking in patients with osteoporosis. Increasing evidences demonstrate that vitamin D influences VEGF levels. The aim of this study was to investigate the influence of Zol on VEGF levels and the possible role for vitamin D on the Zol mediated changes of VEGF concentration in women with postmenopausal osteoporosis. Twenty-eight postmenopausal women with osteoporosis were enrolled and randomized into two groups to receive Zol (5 mg) or placebo. At baseline, at day-3 and day-30 VEGF serum levels were measured; bone turnover markers, 25-hydroxyvitamin D [25(OH)D] and serum calcium were evaluated at baseline. In Zol-treated women, VEGF increased significantly on day-3, and then decreased on day-30. In the Zol-treated women, the percent change of VEGF levels between baseline and day-30 (-18% at day-30 vs. baseline, p = 0.01) was significantly associated with serum 25(OH)D values (r = 0.29, p = 0.028). At a stepwise multiple regression analysis, after correcting for age, BMI, time since menopause, femoral neck BMD, osteocalcin, C-terminal telopeptide of type 1 collagen, and baseline VEGF levels, 25(OH)D levels were independently associated with VEGF change (ß = 1.7, SE = 0.71, p = 0.03). For the first time, we detected early modifications of circulating VEGF in postmenopausal women receiving Zol for osteoporosis, identifying a vitamin D-dependent modulation of these changes.
