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We report a case of a fibrous odontogenic lesion occurring in the maxilla of a man in his 60s. The patient presented with an asymptomatic radiolucent area related to the upper left premolar on radiography. Histological examination of the lesion obtained through an incisional biopsy revealed dense fibrous connective tissue containing small, rounded islands of odontogenic epithelium. The differential diagnoses included central odontogenic fibroma and sclerosing odontogenic carcinoma. Despite being completely different entities, the histological similarities between the two tumors raise diagnostic challenges, with fibrous connective tissue and odontogenic epithelium being the common features. Owing to the finding of unclear small or thin epithelial nests with a high nuclear-cytoplasmic ratio and despite its small size, the lesion was suspected of being malignant, and a maxillary resection was performed. Sections from the resected specimen displayed a small or tiny odontogenic epithelium with cellular atypia and invasion by epithelial cells in and around the nerve fasciculi; therefore, a final diagnosis of sclerosing odontogenic carcinoma was made. Nonetheless, the presence of an odontogenic epithelium in or around the nerve fascicles is not always an evidence of malignancy in the jaw. Caution should be exercised when differentiating invasive epithelia from epithelial residues to provide appropriate treatment. [ABSTRACT FROM AUTHOR]

This report describes a rare case of a 63-year-old man with a lymphoma in the right mandibular ramus with periosteal reaction. Computed tomography (CT) images showed a soft tissue density (28 × 48 × 32 mm) around the right mandibular foramen. Bone-mode CT images showed diffuse bone destruction of the right mandibular ramus. Moreover, a periosteal reaction was seen on the lingual cortical bone of the right mandibular ramus. Histopathologic examination found a diffuse large B-cell lymphoma. [ABSTRACT FROM AUTHOR]

A case of metastatic adenocarcinoma from gastric cancer to the mandibular canine region is reported. Computerized tomography (CT) scanning revealed a small round enhanced inhomogeneous mass, indicating an osteolytic lesion on radiographic classification. Although chemotherapy and radiation therapy was performed, the mass increased, and a subsequent CT scan showed further calcifications within the tumor, indicating progression from an osteolytic to a mixed lesion. [Copyright &y& Elsevier]

Summary: To explain the adaptation technique using an intra-oral cone (IOC) for radiation therapy, and to determine the optimal schedule resulting in a high local control rate and an acceptable complication rate using direct electron beam radiation for the treatment of tongue cancer. Thirty patients with the tongue cancer (T1:T2:T3=16:11:3) were treated with 6–15MeV electron radiation using an IOC. Twenty-six patients were treated with electron radiation using an IOC with or without an excisional biopsy. The other four patients were treated with a combination of the external beam radiation and electron radiation using the IOC. In order to formulate a safe and effective treatment program, we calculated the biologically effective dose (BED). The two- and five-year local control rates for all patients were 63% and 52%, respectively. The two- and five-year overall survival rates for all patients were 73% and 69%, respectively. Local control was achieved in 12 of 15 patients who were irradiated with a BED of 90.9Gy10 or more, whereas it was not achieved in nine of the 15 patients who were treated with less than a BED of 90.9Gy10 (p =0.03). The application of electron radiation using an IOC for the treatment of tongue cancer provides acceptable local control and adverse effect rates, especially for elderly patients considered to be high risk for complications from anesthesia. The optimum BED10 value for the treatment of early tongue cancer using the IOC technique appears to be at least 90.9Gy10. [Copyright &y& Elsevier]