The Spectrum of Gnathic Osteosarcoma: Caveats for the Clinician and the Pathologist

Seven expansile jaw lesions in patients ranging from 7 to 63 years are presented to illustrate diagnostic and management issues pertaining to cases ultimately proven to be gnathic osteosarcoma (GO). Six of the cases in our series were low-grade osteoblastic and one high-grade chondroblastic. None of our cases exhibited the characteristic “sunburst” radiopaque appearance described for GO. All of our cases displayed cortical expansion and one showed development of diastema. Two occurred in the maxilla and five in the mandible. Two of the patients with mandibular lesions presented initially with pain; all other patients were asymptomatic. Lack of pain resulted in a delay in diagnosis due to postponement of consultation or biopsy. Two cases underwent initial shallow non-representative biopsies, requiring a second biopsy for definitive diagnosis, further delaying treatment. Those biopsies were initially interpreted as pyogenic granuloma and peripheral ossifying fibroma, respectively. GO should always be considered in the differential diagnosis of expansile jaw lesions. Bone biopsies of lesions exhibiting pain and expansion of cortical plates should include medullary bone in order to minimize sampling error. In addition, all rapidly growing or painful exophytic bone lesions, and presumed soft tissue lesions that may involve underlying bone, should be examined histopathologically, and receive clinical and radiographic follow-up until complete resolution or healing is evident, regardless of the diagnosis. Based on the positive outcomes of the patients in our series, the prognosis of GO appears to be relatively favorable when compared to other sarcomas and osteosarcomas of long bones

Zika outbreak of 2016: insights from twitter

An outbreak of the Zika virus in 2016 caused great concern among the general public and generated a burst of tweets. The aim of this study was to develop a better understanding of the types of discussions taking place. Tweets were retrieved from the peak of the Zika outbreak (as identified by Google Trends). Tweets were then filtered and entered in NVivo to be analysed using thematic analysis. It was found that tweets on Zika revolved around seven key themes: pregnancy, travel and the Olympics, mosquitoes and conspiracy, health organisations, health information, travel and tracking, and general discussions around Zika. Our results are likely to be of interest to public health organisations disseminating information related to future outbreaks of Zika and we develop a set of preliminary recommendations for health authorities