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

Granular cell tumor presenting as a tongue nodule: two case reports

<p>Abstract</p> <p>Introduction</p> <p>Granular cell tumor is an uncommon neoplasm that can occur in any part of the body, including the orofacial region. The tumor is usually benign, but there are reports of cases in which the tumor shows a locally aggressive behavior, malignancy, and distant metastases. The most widely accepted hypothesis is that granular cell tumor arises from the altered metabolism of Schwann cells. The tumor is typically asymptomatic and appears as a nodule that does not exceed 3 cm.</p> <p>Case presentation</p> <p>In case 1, a 26-year-old Caucasian man was seen at the Oral Medicine out-patient clinic of the São José dos Campos Dental School, Universidade Estadual Paulista, with a 'small blister on the tongue', which he had noted approximately three years ago. The nodule was located on the dorsum of the tongue, measured about 1.5 cm in diameter, and was not tender to palpation. Treatment consisted of an excisional biopsy performed on the basis of the diagnostic hypothesis of granular cell tumor, which was confirmed by microscopic analysis. In case 2, a 31-year-old Caucasian woman attended the out-patient clinic of the São José dos Campos Dental School, Universidade Estadual Paulista, with a five-year history of a 'painful lump on the tongue'. Intra-oral examination revealed the presence of a nodular lesion measuring approximately 0.8 cm in diameter, which was located deep in the submucosa of the right lateral margin of the tongue. Treatment consisted of an excisional biopsy performed on the basis of the differential diagnosis of neurofibroma and granular cell tumor. Microscopic analysis defined the final diagnosis of granular cell tumor.</p> <p>Conclusions</p> <p>Granular cell tumor is an uncommon tumor that must be carefully diagnosed and treated correctly.</p

Dysaesthesia in the mental nerve distribution triggered by a foreign body: a case report

INTRODUCTION: Foreign bodies' entrapments in the mandibular and submandibular regions are quite common. CASE PRESENTATION: We report an unusual case of foreign body (amalgam filling) entrapment over the mental foramen causing dysaesthesia in the distribution of the mental nerve. An interesting sign was blue discoloration of the overlaying oral mucosa which was interpreted as amalgam tattooing. CONCLUSION: Surgical removal of the foreign object eliminated the reported symptoms

Management and prognostic factors of recurrent pleomorphic adenoma of the parotid gland: personal experience and review of the literature

The aim of this study was to investigate the management and prognostic determinants of recurrent pleomorphic adenoma (RPA). A retrospective analysis was performed to examine the clinical features, the prevalence of surgical complications, and new recurrences of RPA. Tumor recurrence rate was estimated by the Kaplan–Meier method, and the prognostic value of some of the variables was tested by univariate analysis using the log rank test. The study focused on 33 patients, 18 female (54.5%) and 15 male (45.5%), aged 12–71 years (median 41). A total or extended total parotidectomy was performed in 16 cases (48.5%), a superficial parotidectomy in 10 cases (30.3%), and a local excision in 7 cases (21.2%). In ten patients (30.3%), a branch or the trunk of the facial nerve was deliberately sacrificed. Major complications included one unexpected definitive paralysis of the marginal mandibular branch of the facial nerve and 14 cases of Frey syndrome. Follow-up varied from 2 to 25 years (median 10.5 years), and there were 11 new recurrences (33.3%) within a period varying from 1 to 16 years (median 6 years). The estimated tumor recurrence rates were 14.1 ± 6.6% at 5 years, 31.4 ± 9.4% at 10 years, 43.0 ± 10.8% at 15 years, and 57.2 ± 14.8% at 20 years. Presence of a multinodular lesion and the type of intervention performed were significantly associated with a higher probability of recurrence. RPAs are prone to new recurrences, especially when multinodular and treated with a local excision. Surgical treatment should include facial nerve resection in selected cases. Follow-up for the patient’s lifetime is warranted

Regulation of mTORC1 Signaling by pH

BACKGROUND: Acidification of the cytoplasm and the extracellular environment is associated with many physiological and pathological conditions, such as intense exercise, hypoxia and tumourigenesis. Acidification affects important cellular functions including protein synthesis, growth, and proliferation. Many of these vital functions are controlled by mTORC1, a master regulator protein kinase that is activated by various growth-stimulating signals and inactivated by starvation conditions. Whether mTORC1 can also respond to changes in extracellular or cytoplasmic pH and play a role in limiting anabolic processes in acidic conditions is not known. METHODOLOGY/FINDINGS: We examined the effects of acidifying the extracellular medium from pH 7.4 to 6.4 on human breast carcinoma MCF-7 cells and immortalized mouse embryo fibroblasts. Decreasing the extracellular pH caused intracellular acidification and rapid, graded and reversible inhibition of mTORC1, assessed by measuring the phosphorylation of the mTORC1 substrate S6K. Fibroblasts deleted of the tuberous sclerosis complex TSC2 gene, a major negative regulator of mTORC1, were unable to inhibit mTORC1 in acidic extracellular conditions, showing that the TSC1-TSC2 complex is required for this response. Examination of the major upstream pathways converging on the TSC1-TSC2 complex showed that Akt signaling was unaffected by pH but that the Raf/MEK/ERK pathway was inhibited. Inhibition of MEK with drugs caused only modest mTORC1 inhibition, implying that other unidentified pathways also play major roles. CONCLUSIONS: This study reveals a novel role for the TSC1/TSC2 complex and mTORC1 in sensing variations in ambient pH. As a common feature of low tissue perfusion, low glucose availability and high energy expenditure, acidic pH may serve as a signal for mTORC1 to downregulate energy-consuming anabolic processes such as protein synthesis as an adaptive response to metabolically stressful conditions

Tecniche estetiche coadiuvanti la Chirurgia Ortognatica: La lipoaspirazione cervico- facciale ed il face -lift

POZZI EDITORE, ROM

Facial nerve functionality after parotid tumors surgery

The purpose of this study is to show the connection among tumor histology, surgical treatments and facial nerve postoperative functionality. A retrospective review was conducted on 69 patients with benign and malignant parotid tumors: they underwent surgical treatment for benign and malignant parotid tumors at the Maxillofacial Division of Rome University "La Sapienza" from 1988 to 1997. In our series of patients, we performed conservative superficial parotidectomy, conservative total parotidectomy and radical parotidectomy. Tumor enucleation was reserved for those neoplasms with a limited and restricted mass. The surgical approach was based on mass extension and on histopathologic features. Our findings showed that a careful and a timely diagnosis is very important in order to select a conservative surgical treatment for benign and intermediate grade of malignancy tumors with limited dimensions. Most aggressive histological types, and large mass dimensions require a radical treatment with consequent facial nerve postoperative dysfunctions. Our experience demonstrates that this surgical approach provides a very high rate of success in the cure of tumors and a low rate of facial nerve postoperative dysfunctions