Aggressive fibromatosis (non-familial desmoid tumour): therapeutic problems and the role of adjuvant radiotherapy.

Aggressive fibromatosis is a rare soft tissue tumour with a high tendency to local recurrence, even after apparently adequate resection. Wide local excision with a margin of at least 3 cm, depending on the anatomical location, should be performed to improve rates of recurrent disease. There is no consensus concerning the role of radiotherapy in the treatment of these lesions.

Juvenile ossifying fibroma. An analysis of 33 cases with emphasis on histopathological aspects.

Juvenile ossifying fibroma (JOF) is a maxillofacial fibro-osseous lesion that may show cell-rich osteoid strands or psammoma-like ossicles. Whether both types are variants of a single entity or different lesions under the same diagnostic label is a subject of debate. This problem was investigated by analyzing a series of 33 patients with lesions having one or both of the above histological appearances.

Psammomatoid ossifying fibroma of the paranasal sinuses. An extragnathic variant of cemento-ossifying fibroma. Report of three cases.

Psammomatoid ossifying fibroma (POF) is a diagnostic designation for a sinonasal or orbital fibroosseous lesion characterized by numerous small round mineralized spherules lying in a fibroblastic stroma. We report 3 cases. One occurred in the frontal sinus of an 18-years-old male; 1 in the frontal sinus of a 20-year-old male and 1 in the maxillary sinus of a 36-year-old male.

Malignant parotid tumors: clinical use of MR imaging and histologic correlation.

Magnetic resonance (MR) imaging was performed in 116 patients in whom a parotid mass lesion was clinically suspected. Eighty-six patients had benign disease. The 30 patients in whom a malignant tumor was found were further evaluated.

Protocol for the prevention and treatment of oral sequelae resulting from head and neck radiation therapy.

In addition to the desired antitumor effects, head and neck radiation therapy induces damage in normal tissues that may result in oral sequelae such as mucositis, hyposalivation, radiation caries, taste loss, trismus, soft-tissue necrosis, and osteoradionecrosis. These sequelae may be dose-limiting and have a tremendous effect on the patient's quality of life. Current policies to prevent these sequelae primarily are based on clinical experience and show great diversity.

Peripheral ameloblastoma. A case report and review of the literature.

Peripheral ameloblastoma is a benign odontogenic tumor with the same histological characteristics as the centrally located ameloblastoma, but appearing in the gingiva and mucosa of the tooth-bearing area of the jaws. A review is presented of 53 cases: 45 being reported as peripheral ameloblastoma and 8 as basal cell carcinoma of the gingiva, including the case presented. Based on the review it is recommended to treat this lesion by local excision including a small margin of healthy tissue.

A survey of prevention and treatment regimens for oral sequelae resulting from head and neck radiotherapy used in Dutch radiotherapy institutes.

Radiation treatment plays an important role in the management of head and neck cancer. Unfortunately several radiation-induced side effects may occur including mucositis, hyposalivation, radiation caries, trismus and osteoradionecrosis. It is generally accepted that most side effects can be prevented or reduced in severity.

Carbon dioxide laser surgery of oral leukoplakia.

Oral leukoplakia is a precancerous lesion of the oral mucosa. The risk of malignant transformation depends on the clinical and histologic classification and the location of the lesion. For a nonhomogeneous leukoplakia, this risk is 23.

Effect of selective elimination of the oral flora on mucositis in irradiated head and neck cancer patients.

Recently it has been reported that chlorhexidine 0.1% rinsing was not successful in eradication of gram-negative bacilli in patients who have head and neck cancer. These bacilli could play a role in irradiation mucositis.

Mucositis prevention by selective elimination of oral flora in irradiated head and neck cancer patients.

Mucositis induced by irradiation is the reactive inflammatory-like process of the oropharyngeal mucous membranes following irradiation. Bacteria colonizing the oral tissues are thought to contribute to this inflammatory process. The eradication of Gram-negative bacilli (selective elimination of oral flora) in fifteen comparably irradiated head and neck cancer patients was found to be associated with a significant reduction in mucositis compared with two groups of 15 patients receiving either placebo or chlorhexidine rinsing.

[Prevention of oral mucositis in head and neck irradiation].

Head-neck irradiation is associated with oral complications. During the irradiation period patients are most burdened by mucositis. Changes of the oral flora with colonisation with the more pathogenic aerobic Gram-negative bacilli seems crucial in the development and severity of mucositis.

Chlorhexidine inactivation by saliva.

Chlorhexidine mouth rinsing is commonly used for oral flora reduction. Indigenous microorganisms (viridans streptococci) are significantly suppressed, while "hospital-acquired" gram-negative bacilli are not affected in vivo. To explain the discrepancies between good in vitro and poor in vivo activity of chlorhexidine, minimum bactericidal concentration values for 120 isolates were studied by means of a standard dilution method in fresh whole saliva, broth, and glucose 5%.

[Oral aspects of radiotherapy and/or chemotherapy in the head and neck area].

Patients who are treated with irradiation and/or chemotherapy for head and neck cancer are at risk for several oral complications. The most frequent occurring complications, the prevention of these complications, and the responsibilities of the general practitioner are described.

[Treatment of oral cancer].

Patients with oral cancer are usually treated in cancer units. Surgery and radiotherapy are the most important treatment modalities, as has been discussed in this review article. The prognosis of small cancers, that have not yet produced metastatic lymph nodes is excellent.

Scoring irradiation mucositis in head and neck cancer patients.

Irradiation mucositis is defined as an inflammatory-like process of the oropharyngeal mucosa following therapeutic irradiation of patients who have head and neck cancer. Clinically, it is a serious side effect because severe mucositis can cause generalized problems (weight loss, nasogastric tube feedings) and interferes with the well-being of the patient seriously. Grading mucositis is important for the evaluation of preventive and therapeutic measures.

Effect of chlorhexidine rinsing on the oropharyngeal ecology in patients with head and neck cancer who have irradiation mucositis.

Oral flora is thought to contribute to irradiation mucositis in patients with head and neck cancer. Neglect of oral hygienic care may also contribute to mucositis. The purpose of this prospective, randomized, placebo-controlled, double-blind study was to evaluate the effect of chlorhexidine 0.

Massive osteolysis of the skull and its therapeutic implications: a case report.

A case of massive osteolysis of the skull and its histology is described. Removal of the bone defect with a margin of normal bone and covering of the defect by cranioplasty is advised and may arrest the disease.

Xeroderma pigmentosum: squamous cell carcinoma of the tongue.

A case report is presented of a 9-year-old boy with xeroderma pigmentosum complementation group C, who died from a squamous cell carcinoma arising from the tip of the tongue. Treatment with etretinate and in a later phase with indomethacin and prednisolone was not effective, except for a limited initial response of the tumour to etretinate.