Clinical and histological control of fine-needle aspiration biopsy (FNAB) diagnosis of 72 kidney masses observed between 1981 and 1988 confirmed 34 benign and 33 malignant lesions, but did not confirm four malignant and one benign lesions, giving a total diagnostic accuracy of 93.05%. The role of FNAB in selecting cases to be sent to surgery was investigated by comparing the incidence of useful surgery (for benign and primary malignant neoplasias) and the incidence of useless surgery (for nonneoplastic lesions and secondary malignant neoplasias) in nephrectomized patients who either had (group A, 27 patients) or didn't have (group B, 198 patients) preoperative FNAB. The differences were highly significant (P less than 0.001). Furthermore, patients operated for malignant neoplasias (20 in group A; 117 in group B) displayed highly significant differences (P less than 0.001) with respect to renal vein infiltration (1 in group A versus 22 in group B) and local-regional lymph node metastases (1 in group A versus 15 in group B). In conclusion, FNAB is a reliable method for selecting cases for surgery and for aiding in the diagnosis of malignant neoplasias.
Ameloblastic carcinoma (AC) is an uncommon malignant odontogenic tumor that can be difficult to differentiate from ameloblastoma and can arise directly as an undifferentiated lesion or from a pre-existing benign lesion. The current study presents a novel case of primary maxillary AC and review the literature on AC of the maxilla. The review of the literature indicates that secondary tumors and posterior localization are associated with a higher tendency for recurrence and, often, multiple recurrences. Surgical therapy, eventually followed by radiotherapy, is the treatment modality most frequently applied, while the role of chemotherapy remains unclear. Several new cases of maxillary AC have been recently described in literature, making this pathology more frequent than previously considered; this is perhaps an indication of an increased diagnostic sensibility, rather than a real increase in the incidence of the disease itself.
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