Low Grade Myofibroblastic Sarcoma of the Oral Cavity: A Case Report and Review of the Literature
Justin MacRae,
Ramiz Mogannam,
Hillel Ephros,
Amer Akmal
Issue:
Volume 8, Issue 2, December 2022
Pages:
16-20
Received:
26 April 2022
Accepted:
10 May 2022
Published:
10 August 2022
DOI:
10.11648/j.ijcoms.20220802.11
Downloads:
Views:
Abstract: Low-grade myofibroblastic sarcoma (LGMS) is a rare malignant neoplasm of the soft tissue with a predilection for the head and neck. To date, there are no optimal treatment strategies. This report describes a case of LGMS of the left side retromolar pad region in a 26-year-old otherwise healthy woman with initial presentation of a two-month history of a painless and progressively growing soft tissue mass. Incisional biopsy was completed revealing “fragments of granulation tissue with marked acute and chronic inflammation, and fibrosis”. Based on history and physical examination, the decision was made to complete an excisional biopsy in the operating room due to the location of the lesion and the proximity of the lingual nerve. Pathology report then revealed “cellular myofibroblastic neoplasm, favor low grade myofibroblastic sarcoma”. TNM staging was completed based on NCCN guidelines with subsequent imaging. The treatment plan included marginal resection of the left posterior mandible via trans-oral incisions with oncological margins, resection of lingual nerve with subsequent allogenic nerve grafting, extraction of left mandibular first and second molar, and complex primary closure. The patient is planned to have a secondary reconstruction via anterior iliac crest bone graft completed with simultaneous implant placement. We discuss the differential diagnosis, clinical, histological and therapeutic features of LGMS as it is understood in the literature.
Abstract: Low-grade myofibroblastic sarcoma (LGMS) is a rare malignant neoplasm of the soft tissue with a predilection for the head and neck. To date, there are no optimal treatment strategies. This report describes a case of LGMS of the left side retromolar pad region in a 26-year-old otherwise healthy woman with initial presentation of a two-month history ...
Show More
Exacerbation of Denosumab-Related Osteonecrosis of the Jaw After Discontinuation of Denosumab: A Case Report
Masahiko Okubo,
Tsuyoshi Sato
Issue:
Volume 8, Issue 2, December 2022
Pages:
21-24
Received:
8 October 2022
Accepted:
28 October 2022
Published:
8 December 2022
DOI:
10.11648/j.ijcoms.20220802.12
Downloads:
Views:
Abstract: Denosumab, a bone antiresorptive agent, is used to treat patients with osteoporosis or bone metastasis. It has been reported that denosumab, like bisphosphonates, causes osteonecrosis of the jaw (ONJ). Some clinical case reports have shown that the discontinuation of denosumab ameliorates ONJ. Herein, the authors present a case in which denosumab cessation exacerbated osteonecrosis in a patient who suffered from denosumab-related osteonecrosis of the jaw (DRONJ). A 56-year-old female patient was referred to us with swelling and pain in the left buccal region. The patient had metastatic breast cancer (cT3N1M1, stage IV) and had been treated with a triplet regimen of paclitaxel, capecitabine, and bevacizumab. In addition, denosumab (Ranmark®, 120 mg) had been subcutaneously injected for 3 years. She had no history of bisphosphonate use or radiotherapy in the head and neck region. Her left mandibular second molar was extracted at a dental clinic with only slight pain. Clinical examination revealed swelling and pain in the left buccal region, bone exposure in the intraoral left mandibular region with pus discharge, limited mouth opening, and subcutaneous abscess formation with fever. After the cessation of denosumab, image inspection revealed a spreading radiolucent lesion and extensive periosteal reaction in the bilateral mandible. It should be noted that DRONJ may worsen despite denosumab holidays.
Abstract: Denosumab, a bone antiresorptive agent, is used to treat patients with osteoporosis or bone metastasis. It has been reported that denosumab, like bisphosphonates, causes osteonecrosis of the jaw (ONJ). Some clinical case reports have shown that the discontinuation of denosumab ameliorates ONJ. Herein, the authors present a case in which denosumab c...
Show More
