Professional Documents
Culture Documents
one of the main characteristic feature of cancer that it always penetrate the
basement membrane , so when you see a lesion with no boundaries you will think
it's sinister and nasty
radiographic feature
- lesion of mixed density,
- multilocular or unilocular
- step leader pattern
treatment :- resection with 1 cm safety margin .
it's a very rare tumor very unlikely to phase in your entire life , only
200 cases were reported worldwide .
mixed radiopaque radio lucent lesion associated with an impacted
tooth
ct scan coronal cut showing mid facial bone , obliterated left sinus
with mixed lesion
treatment it resection with 1 cm margin
fibro-osseous
disaeas
fibrous
dysplasia
cementosseous
dysplasia
Fibro-osseous
neoplasm
fibrous dysplasia
- polystotic
-mono stotic
there is a type of imaging called bone scan to show the activity of the
bone over the body , the inject the patient with a tracer in then take
radionucluar image to see where it's more absorbed the tracer name is
Technetium-99m .
Fibro-osseous neoplasm
ossifying fibroma :
chondroma
osteoma
is a benign tumor of bone
asymptomatic radio opacity
periferal osteama or endoosteol osteoma
What's important to us in Osteoma is what is called Gardner's
Syndrome,where there will be multiple osteomas, Intestinal polyps,
fibromas of skin, epidermal cyst ,impacted teeth, and odontomas.
so we send him to a GI specialist to do endoscopy to find multiple
intestinal polyps ,the findings in the maxillofacial won't harm him but
what is consider fetal is the intestinal polyps
synovial chondramatosis
happens in the capsule around
the TMJ
small particles inside synovial
membrane
pain and swelling , and sounds
lose of occlusion& posterior
open bite
treatment open the capsule and
clean it
Osteochndroma
benign lesion containing bone and
cartilage
on MRI it appears as extraneous
appendages toward the TMJ.
It's usually more radiopaque than
the surrounding mandible
very unlikely to see
angiogram :- is an imaging
modality for the blood vessel , the
intervenisional radiologist will
inject all the blood vessel that
might supply that area ,in the
maxillofacial area the Dr will inject
the facial blood vessel
it will give us that theres a
large vessel due to
embryological problem that
supply the radio lucent lesion
the treatment in high flow is embolization to occlude the vessel
that supply the area by special material and it's done by the
intervenional radiologist and it's very dangerous procedure.
so the lesion that was supplied by the vessel be blood free , then the
maxillofacial surgeon will intervene and enucleate and clean the area now
why is this because although we occlude the vessel and the area now is
dry but the body has the ability to form collateral vessels .
so one of the treatment option is just to occlude the area while the better
option is enucleate the lesion after the embolization and to put a bone
graft so that the space will be close so if collateral vessel occurred it will
not have a room to cause vascular mal formation .
paget disease
more common in men , it resemble fibrous dysplasia because it has
stages
one of the clinical scenarios that the patient came to your clinic
complaining that his hat wont fit his head anymore or as to dentist
his denture, headache and symptoms due to vascular and nerves
compressions
panoramic radiograph you will find the cotton wool appearance
Resorption of bone will occur, then the area will be highly vasculrised, afterwards
there will be sclerosing phase
those patient will die mainly because of left side heart failure
because the bone resorption is taking place all over the body and it's
being replaced by blood, so the heart now is obligated to pump heart
to the bone all over the body ending by having heart failure
one of the difficulties that during the second stage there will be high
blood supply in the body, so if we tried to do surgery in this area we
may face tremendous bleeding and the patient may die !!