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3 Nemesis. Negative Effects in Medical Sciences Oral and Maxillofacial Surgery

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Central mucoepidermoid carcinoma of the maxilla, a challenging diagnosis

100%

Sibille L. , Olszewski R. , Magremanne M.

Nemesis. Negative Effects in Medical Sciences Oral and Maxillofacial Surgery

2023

tom 29

nr 1

1-19

Objective: To present a pictorial review on central mucoepidermoid carcinoma. Case report: Central mucoepidermoid carcinoma (CMEC), also known as intraosseous mucoepidermoid carcinoma (IMEC), is an extremely rare disease (less than 2-4% of all MEC). However, CMEC is the most frequent malignant salivary gland tumour found in intraosseous locations. Due to this unusual location, diagnosis of CMEC can be challenging. Therefore, CMEC is often mistaken for other intraosseous or odontogenic pathologies. Radiological assessment shouldinclude panoramic X-Ray, CBCT and thoracic CT, which should be performed after diagnosis. The recommended treatment includes radical resection surgery, followed by radiotherapy if indicated. A long-term follow-up is recommended for up to 10 years. Conclusion: The authors experienced the challenging diagnosis of CMEC through the case of a patient who presented with a slowly growing palatal mass.

Paget’s disease of bone, biphosphonates and jaw osteonecrosis: a case report

100%

Magremanne M. , Grysolle A. , Reychler H.

Nemesis. Negative Effects in Medical Sciences Oral and Maxillofacial Surgery

2019

tom 4

nr 1

15-15

Objective: Paget’s disease of bone is characterized by a focal increase in bone resorption and accelerated bone formation leading to a weaker and disorganised bone. Bisphosphonates (BPs) have been the treatment of choice of Paget’s disease since the 1990s. Medication related osteonecrosis of the jaw (MRONJ) is a rare event in non oncologic patients. We describe a rare case of Paget’s disease involving the maxilla with osteonecrosis in a context of bisphosphonate treatment. Case report: an 87-year-old woman presented with 4 episodes of bone necrosis in 15 years. In this case report there is a clear chronologic association between the occurrence of MRONJ and the administration of iv BP for Paget’s disease. Maxillofacial involvement of Paget’s disease occurs in less than 15% of cases. There is a lack of information in the literature about the association of MRONJ and Paget’s disease. Even if osteonecrosis of the jaw could be a consequence of the disease, in this case, it is more in relation to the BP treatment. Conclusions: Although MRONJ might be considered a rare condition in Paget’s disease, patients prior to starting antiresorptive therapy and in particular iv BPs should have a complete dental examination and panoramic X-Ray. Nemesis relevance: side effect of bisphosphonate treatment

Cutaneous cervical metastasis from an esophageal adenocarcinoma mimicking a dental cervical cellulitis: A case report

88%

Arnal-Etienne A. , Fourneau E. , Dewaele N. , Mengeot N. , Magremanne M.

Nemesis. Negative Effects in Medical Sciences Oral and Maxillofacial Surgery

2024

tom 36

nr 1

1-15

Cutaneous metastases occur in 0.5 to 9% of all cancers. Esophageal cancer is one of the most aggressive cancers worldwide. Most cutaneous metastases from esophageal cancer were related to squamous cell carcinomas. Few cases have been described about cutaneous metastases related to esophageal adenocarcinomas. These metastases mostly affect patients over 60 years-old, and present as cutaneous asymptomatic nodules. A 69-year-old male presented with a painless and extensive left neck cutaneous induration and erythema. The lesion that was initially diagnosed as a dental cervical cellulitis by his dental practitioner. The patient was known since 2019 to suffer from a esophageal adenocarcinoma whose first treatment was surgery. The patient was currently under immunotherapy for a local recurrence. We firstly assessed the uncommon cervical cellulitis by carrying out an injected head and neck computed tomography (CT) scan which showed an unspecific skin, dermal and muscular infiltration of the left cervical region. The 18-FDG PET/CT demonstrated a suspicious fixation of the neck that was followed by a skin biopsy. The histological and immunohistochemical examination showed the metastatic adenocarcinomatous origin of the cervical skin lesion. The patient was upstaged to a stage IV of his esophageal cancer and started palliative chemotherapy. Special attention must be paid in case of diffuse cervical skin infiltrations, even in the presence of a dental infection, in patients with cancer, in order to perform the correct diagnosis.