-Aim:The purpose of this paper was to report an additional case of ameloblastic carcinoma of the left hemi-mandible and to review and analyze clinical, radiological and histopathologic features, treatment modalities and prognosis. Presentation of case: A 70 year old malepatient presented to Maxillofacial Department for a painful swelling of the left cheek. An ameloblastic carcinoma of the left hemi-mandible was diagnosed. He underwent radical surgical intervention comprising hemimandibulectomy, supraomohyoid neck dissection, and fibula free-flap reconstruction. Postoperative radiotherapy was employed. Discussion: Ameloblastic carcinoma of the mandible is a rare aggressive tumor with a poor prognosis. It can be seen in different ages. The most common symptom is a rapidly progressing painful swelling. It is defined as a malignant epithelial odontogenic tumor that retains the features of ameloblastic differentiation with cytologic features of malignancy. Non therapeutic consensus is established. However, wide surgical excision with radiotherapy is the most common treatment. Conclusion: Diagnosis of ameloblastic carcinoma at early stage and close periodic screening for metastasis are necessary to improve patient prognosis.
Introduction: Pathological fractures of the mandible are rare. They account for approximately 2% of all mandibular fractures. The main purpose of the study is to report our experience concerning this condition and to analyse data and review the literature available. Material and methods: This study reviewed retrospectively the records of patients who presented to the department of Plastic and Maxillofacial surgery between 2000 and 2008 with a pathological fracture of the mandible. The collected data included age, sex, mechanism of injury, aetiology, anatomic site of fracture, treatment and complications. Results: There were 10 patients with an average age of 48 years and 10 months. There were three cases of fracture due to a local malignancy, two cases of osteoradionecrosis, two cases of mandibular cysts, one patient presenting a mandibular histiocytosis, one patient with a metastatic carcinoma (Thyroid), and one case related to mandibular atrophy. Most common mechanisms of injury were chewing and falls. Pathological fractures were often located in the body of the mandible. A surgical approach was performed in most cases. Conclusion: Surgical management of pathological fractures of the mandible depends largely on the aetiology. Complications occur more often because of local condition and bad oral hygiene.
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