Sindrom mulut terbakar

viii,78 hlm

Oral Pathology

384 hlm

Epidemiology of ameloblastomas of the jaws; A report from the Netherlands

Objectives: To provide epidemiological data of ameloblastomas of the jaws in the Netherlands over a 25-year time period (1985-2010) and to compare these data with data from other parts of the world. Material and Methods: The data of all patients diagnosed with a primary ameloblastoma of the jaws in the Netherlands in the period 1985-2010 have been retrieved from the nationwide histopathology and cytopathology network and registry in the Netherlands (PALGA). The pathology reports were screened and only those cases were included in which a distinct diagnosis of primary, histopathologically benign, intraosseous ameloblastoma was rendered. The average population in The Netherlands during this period amounted approximately 15 million people. Results: An annual incidence rate was approximately 1,5 per million population, the male-female ratio being 1.4: 1. The age at the time of diagnosis was 44.1 years. The average age in males was 46.3 years compared to an average age in females of 41.3 years, the difference being significant (p <= 0.05). The results were compared with those available in only a small number of publications worldwide. Conclusions: There is no strong evidence for significant differences of the true incidence of ameloblastomas worldwide, neither for a gender predilection. The diagnosis is generally made at a somewhat lower age in women; this phenomenon is even much stronger in the Black population, irrespective of gender. No proper explanation for this finding can be provide

Distant metastases of adenoid cystic carcinoma of the salivary glands and the value of diagnostic examinations during follow-up

Adenoid cystic carcinoma (ACC) accounts for approximately 10% of all neoplasms of the salivary glands. Late distant metastases and local recurrences are responsible for a rather low long-term survival rate. To study the metastasizing pattern of ACC of the salivary glands in 51 patients. Fifty-one patients with an ACC in the intraoral/sublingual salivary glands (n = 30), parotid gland (n = 8), submandibular gland (n = 2), maxillary sinus (n = 6), and nasal cavity (n = 5) have been studied. The male-female ratio was 1:1, the mean age was 54.3 (range, 19-81) years. In 30 cases treatment consisted of surgery and radiotherapy. In 13 cases surgery alone was carried out. The average follow-up time was 117.8 (range, 1-171) months. In 28 cases (54.9%) distant metastases occurred, and in 3 patients (5.8%) regional lymph node metastases occurred. In 12 of the 28 patients with distant metastases (42.8%), only the lungs were involved, whereas in 5 of the 28 patients (17.8%), the distant metastases occurred in other organs (eg, bones and brain). In 11 of the 28 patients (39.2%) metastases were found both in the lungs and other organs. Twenty-four of the 51 patients (47.0%) died because of their tumor. The average time between the occurrence of lung metastases and death was 32.3 months and between the occurrence of metastases elsewhere and death 20.6 months. Distant metastases of ACC of the salivary glands occur most often in the lungs. Although these lung metastases are the first to occur, these patients die later than patients with distant metastases in other organs. The value of annual chest films or other tests for the presence of distant metastases during follow-up after surgical removal of an ACC seems rather questionabl

Regional lymph node involvement and its significance in the development of distant metastases in head and neck carcinoma

Background. The incidence of distant metastases in head and neck cancer patients is rising because of greater locoregional control of the disease. Methods. The relative risks for having distant metastases as first site of failure relative to the regional lymph node involvement were determined. Results. The overall incidence was 10.7%, with a clear relationship between the number of involved lymph nodes and extranodal spread on one hand, and distant spread on the other hand. The group with histopathologic presence of disease in the neck had twice as much distant metastases as did those with histopathologic absence (13.6% versus 6.9%). Patients with more than three histologically positive lymph nodes were most at risk for having distant metastases (46.8%). The presence of extranodal spread meant a threefold increase in the incidence of distant metastases, compared with patients without this feature (19.1% versus 6.7%). Conclusions. Patients with three or more positive nodes and with extranodal spread may benefit from adjuvant systemic therapy

Recurrence at the primary site in head and neck cancer and the significance of neck lymph node metastases as a prognostic factor

Background. Biologic aggressiveness of head and neck carcinoma is reflected in its capability to metastasize to regional lymph nodes and its propensity to recur after treatment. Methods. The authors report on 244 patients treated at the Department of Otolaryngology‐Head and Neck Surgery of the Free University Hospital, Amsterdam, The Netherlands, with excision of primary tumor with incontinuity neck dissection with or without postoperative radiation therapy between January 1973 and July 1986. All patients had surgical margins free of tumor. Results. The overall recurrence rate was 12.3%. Stages T3–4 and the presence of more than three positive nodes on histopathologic examination were associated with a 16.2% and 26.2% incidence in recurrence at the primary site, respectively. No prognostic influence arose from primary tumor localization, three or fewer positive nodes, extranodal spread, and postoperative radiation therapy. Conclusions. Patients with T3–4 disease and those with more than three positive lymph nodes may benefit from novel adjuvant treatment modalities

Diagnostic delay in autoimmune oral diseases.

OBJECTIVES Autoimmune diseases affect about 5% of the general population, causing various systemic and/or topical clinical manifestations. The oral mucosa is often affected, sometimes as the only involved site. The misdiagnosis of oral autoimmune diseases is and underreported issue. METHODS This narrative review focuses on diagnostic delay in oral autoimmune diseases (oral lichen planus, oral pemphigus vulgaris, mucous membrane pemphigoid, oral lupus erythematosus, orofacial granulomatosis, oral erythema multiforme and Sjogren syndrome). An extensive literature research was conducted via MEDLINE, Embase and Google Scholar databases for articles reporting the time spent to achieve the correct diagnosis of oral autoimmune diseases. RESULTS Only 16 studies reported diagnostic delay in oral autoimmune diseases. Oral autoimmune vesiculobullous diseases are usually diagnosed after 8 months from the initial signs/symptoms, the Sjogren Syndrome diagnosis usually requires about 73 months. No data exist about the diagnostic delay in oral lichen planus, oral lupus erythematosus, orofacial granulomatosis, and oral erythema multiforme. CONCLUSIONS The diagnosis of oral autoimmune diseases can be difficult due to the non-specificity of their manifestations and the unawareness of dentists, physicians, and dental and medical specialists about these diseases. This can lead to a professional diagnostic delay and a consequential treatment delay. The delay can be attributed to the physicians or/and the healthcare system (Professional Delay) or the patient (Patient's Delay)