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Modeling Primary Bone Tumors and Bone Metastasis with Solid Tumor Graft Implantation into Bone
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Recurrent Malignancy in Osteoradionecrosis Specimen.

Hisham Marwan1, J Marshall Green2, Ramzey Tursun3

  • 1Chief Resident, Miller School of Medicine, University of Miami, Miami, FL.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|May 29, 2016
PubMed
Summary
This summary is machine-generated.

Malignancy is rarely found in osteoradionecrosis (ORN) resections, but surgeons must be aware. This study found 3.37% of ORN patients had cancer, necessitating a multidisciplinary approach for accurate diagnosis and treatment.

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Area of Science:

  • Oncology
  • Oral and Maxillofacial Surgery
  • Radiation Oncology

Background:

  • Osteoradionecrosis (ORN) is a known complication following head and neck radiation therapy, frequently affecting the mandible.
  • Malignant tumors can be incidentally discovered in surgical resections initially treated for ORN, though this is uncommon.

Purpose of the Study:

  • To investigate the prevalence of recurrent carcinoma, sarcoma, or new primary malignancies in surgical specimens from patients treated for ORN.
  • To assess the incidence of unexpected cancer diagnoses in patients undergoing osseous resection for ORN.

Main Methods:

  • Retrospective case series analysis of patients treated at a single institution.
  • Inclusion criteria: history of head and neck cancer with radiation (≥6,000 cGy), clinical ORN diagnosis, and surgical resection for ORN.
  • Data collected: microscopic evidence of malignancy in resected ORN specimens, patient demographics, and primary pathology.

Main Results:

  • Out of 564 patients, 14 (2.48%) showed microscopic evidence of cancer in ORN specimens.
  • Five patients (0.89%) had a second primary malignancy (1 lung, 4 oropharyngeal).
  • A total of 19 malignancies (3.37%) were identified among the ORN patient cohort, including one high-grade sarcoma.

Conclusions:

  • While malignancy in ORN resections is rare (3.37%), oral and maxillofacial surgeons must remain vigilant for its presence.
  • Diagnosing malignancy requires different treatment strategies than ORN, emphasizing the need for a multidisciplinary approach.
  • Awareness and thorough pathological examination are crucial for optimal patient outcomes.