Immediate Functional Loading of an Implant-Supported Fixed Prosthesis at the Time of Ablative Surgery and Mandibular Reconstruction for Squamous Cell Carcinoma

2010 ◽  
Vol 36 (3) ◽  
pp. 225-230 ◽  
Author(s):  
Guillaume Odin ◽  
Thierry Balaguer ◽  
Charles Savoldelli ◽  
Gérard Scortecci
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
External Beam Radiotherapy ◽  
Mandibular Reconstruction ◽  
Implant Placement ◽  
Fibula Free Flap ◽  
Ablative Surgery ◽  
Fixed Prosthesis ◽  
Implant Loading

Abstract The authors describe a case of squamous cell carcinoma of the oral cavity managed by ablative surgery, mandibular reconstruction with a fibula free flap, and implant placement during the same session. Immediate functional implant loading, respecting the principles of basal implantology, was performed 48 hours later using a highly rigid, screw-secured fixed prosthesis that served as an external fixator for the implants and grafted bone. Implant loading before external beam radiotherapy improves flap stability, bone consolidation, and quality of life. Functional and esthetic outcomes were evaluated 2 years after radiotherapy was completed.

A PROSPECTIVE RANDOMIZED STUDY TO COMPARE THE CONCURRENT CHEMO-RADIATION VERSUS HYPO-FRACTIONATED CHEMO-RADIATION IN LOCALLY ADVANCED CERVICAL CANCER.

2021 ◽  
pp. 40-42
Author(s):  
Arpan Jana ◽  
Pabitra Das ◽  
Poulami Gupta ◽  
Phalguni Gupta
Keyword(s):  
Cervical Cancer ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
External Beam Radiotherapy ◽  
Locally Advanced ◽  
Intracavitary Brachytherapy ◽  
External Beam ◽  
Carcinoma Cervix ◽  
Advanced Carcinoma

Background: Concurrent chemo-radiation is the standard treatment worldwide for locally advanced squamous Cell carcinoma cervix. However, conventional chemo-radiotherapy is also associated with unacceptable local and systemic failure rates for locally advanced disease. Biologically squamous cell carcinoma of head- neck cancer and cervical cancer behaves quite similarly in response to radiotherapy. So, it can be expected that, altered fractionation can increase the local control in case of squamous cell carcinoma cervix than conventional radiotherapy. There is no randomised control trial for carcinoma cervix till date, which compares conventional chemo-radiation with hypo-fractionated chemo-radiation. Aims And Objectives: The present study was planned to compare local disease control and acute toxicity of conventional chemo-radiation with hypo-fractionated chemo-radiation in locally advanced carcinoma cervix. Materials And Methods: In Conventional Chemo-radiation Arm A patients (n=30) received external beam radiotherapy 50 Gy in 25 fractions in 5 weeks accompanied by weekly intravenous Cisplatin 40mg/m2 followed by intracavitary brachytherapy 7 Gy per fraction once in a week for 3 weeks. The second group of hypo-fractionated Arm B received external beam radiotherapy 45 Gy in 20 fractions in 4 weeks accompanied by weekly intravenous Cisplatin 40mg/m2 followed by intracavitary brachytherapy 9 Gy per fraction once in a week for 2 weeks. Results: Grade II diarrhea were seen more in Arm B 17 (56.66%) compare to Arm A 12(40%) and grade III diarrhea was seen 4 (3.33%) in Arm B and 2(6.66%) in Arm A. At 2 months and 6 months after completion of treatment Complete response were 25 (83.4%) in Arm A compare to 22 (73.3%) in Arm B and 20 (74.1%) in Arm A and 18 (72%) in Arm B respectively. Conclusion: Hypo-fractioned radiotherapy may be used as an alternate protocol for treatment of locally advanced carcinoma cervix with acceptable toxicities.

scholarly journals Squamous Cell Carcinoma of the Scalp Masquerading as Trichilemmal Tumor of the Scalp

2014 ◽  
Vol 5 (3) ◽  
pp. 144-147
Author(s):  
Sudhir Naik ◽  
Rajshekar Halkud ◽  
A Nanjundappa ◽  
Siddharth Biswas ◽  
M Samskruthi ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Malignant Transformation ◽  
Squamous Cell ◽  
Meta Analysis ◽  
External Beam Radiotherapy ◽  
Management Protocol ◽  
Proliferating Trichilemmal Tumor ◽  
Enhanced Computed Tomography ◽  
Split Skin

ABSTRACT Background Adnexal components tumors of the skin are very rare and are seen as benign lesions of the scalp in aged women. Trichilemmal tumor is usually benign and rarely under-goes malignant transformation in a stepwise manner starting with an adenomatous stage of the trichilemmal cyst to an epitheliomatous stage of the proliferating trichilemmal tumor (PTT) evolving into the carcinomatous stage of the malignant proliferating trichilemmal tumor (MPTT). Case report A 53-year-old woman reported with huge swelling in the posterior region of the scalp. The swelling was mobile and soft to firm in consistency not fixed to the skull bone. The surface was smooth and getting under the swelling was not possible, needle biopsy reported as trichilemmal tumor. Contrast enhanced computed tomography (CECT) neck did not show any nodes in the neck, especially the posterior compartment. The tumor was widely excised with 1 cm margin and the periosteum was kept intact with split skin graft. An area of periosteal adher ence to the tumor seen was excised. The histopathology report on serial sectioning reported grade 1 moderately differentiated squamous cell carcinoma (SCC). Postoperative external beam radiotherapy of 66 Gy was given. The patient is being followed up and no recurrence is seen. Conclusion Malignant transformation in a proliferating trichilemmal tumor a rare entity and should be differentiated from SCC and the better prognostic trichilemmal carcinoma. A protocolbased adjuvant therapy is available for squamous cell carcinoma but not for trichilemmal carcinoma (TLC) and MPTT. A major meta-analysis may help to establish a clinical outcome-based classification and management protocol for these tumors. How to cite this article Nanjundappa A, Halkud R, Venugopal B, Chavan P, Sidappa KT, Biswas S, Samskruthi M, Naik SM. Squamous Cell Carcinoma of the Scalp Masquerading as Trichi-lemmal Tumor of the Scalp. Int J Head Neck Surg 2014;5(3):144-147.

Secondary Mandibular Reconstruction After Oral Squamous Cell Carcinoma Resection

2010 ◽  
Vol 21 (1) ◽  
pp. 59-63 ◽  
Author(s):  
Oliver Seitz ◽  
Marc Harth ◽  
Shahram Ghanaati ◽  
Thomas Lehnert ◽  
Thomas J. Vogl ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Mandibular Reconstruction

scholarly journals Primary Intraosseous Squamous Cell Carcinoma of the Anterior Mandible Arising in an Odontogenic Cyst in 34-Year-Old Male

Reports ◽  
2020 ◽  
Vol 3 (2) ◽  
pp. 12
Author(s):  
Sara Negrello ◽  
Arrigo Pellacani ◽  
Mattia di Bartolomeo ◽  
Giuditta Bernardelli ◽  
Riccardo Nocini ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Dentigerous Cyst ◽  
Treatment Protocol ◽  
Lower Canine ◽  
First Choice ◽  
Fibula Free Flap ◽  
Anterior Mandible

Primary intraosseous squamous cell carcinoma (PIOSCC) is a rare and aggressive malignancy arising exclusively within the jaws, without any initial connection with the oral mucosa. The etiology and the epidemiology are unclear due to the rarity of the disease, and there is no current universally accepted staging or treatment protocol. Clinically, the posterior mandible is the most affected site, and common symptoms are swelling and pain. The diagnosis is often difficult either because it requires stringent criteria to be satisfied or because of the absence of a pathognomonic histological pattern. Aggressive surgery is the first-choice treatment, often followed by radiotherapy. The lymph nodal status seems to be the most important factor influencing the prognosis, which is usually poor, with a 5-year survival rate ranging from 30% to 40%. In the present article, we report an unusual case of cystogenic PIOSCC interesting the anterior mandible of a young 34-year-old male, which came to our attention after complaint about recurrent infective episodes affecting a dentigerous cyst (impacted lower canine) discovered ten years before. The age, site, and extension are uncommon. Extensive surgical treatment with fibula free flap reconstruction, adjuvant therapy, and salvage surgery was carried out. The patient was disease-free at a 31-month follow-up.

scholarly journals Recurrence of cancer cervix in patients treated by radical hysterectomy followed by adjuvant external beam radiotherapy

1970 ◽  
Vol 36 (2) ◽  
pp. 52-56 ◽  
Author(s):  
Fauzia Sobhan ◽  
Farzana Sobhan ◽  
Arif Sobhan
Keyword(s):  
Squamous Cell Carcinoma ◽  
Local Recurrence ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Radical Hysterectomy ◽  
External Beam Radiotherapy ◽  
Late Recurrence ◽  
Distant Recurrence ◽  
External Beam ◽  
Distant Failure

One hundred and twenty patients with FIGO stage Ib-IIa cervical cancer who had radical hysterectomy prior to January 2003 in different hospitals of Bangladesh and thereafter received external beam pelvic radiotherapy (RT) at National Institute of Cancer Research and Hospital, Dhaka were studied. Until December 2007, 50 (42%) patients developed recurrence. Thirty-four (70%) patients experienced local recurrence, 13 (26%) distant recurrence and 2 (4%) both local and distant recurrence. Of 15 patients with distant metastasis, 6 (40%) experienced it in extra-pelvic lymph nodes. The median time to recurrence was 19 months (range 6-120 months) for local failure, 33 months (range 12-108 months) for distant failure and 25 months (range 13-36 months) for those with both local and distant failure. Eighty percent recurrences occurred within 36 months. There was significant correlation between lymph node metastasis and recurrence. All 5 (100%) patients with adenocarcinoma who had positive nodes experienced local recurrence compared with 18 of 49 (37%) squamous cell carcinoma patients with positive nodes. Recurrence more than 5 years after treatment developed in 5 (4%) patients. Mentionable, 4 (80%) out of 5 patients with late recurrence had squamous cell carcinoma with negative pelvic nodes. DOI: 10.3329/bmrcb.v36i2.6987Bangladesh Med Res Counc Bull 2010; 36: 52-56

Soft Tissue Enhancement and Implant Placement Following Partial Mandibulectomy Due to Squamous Cell Carcinoma

2017 ◽  
Vol 43 (4) ◽  
pp. 291-296 ◽  
Author(s):  
Fabio Bernardello ◽  
Giampietro Bertasi ◽  
Ralph Powers ◽  
Sergio Spinato ◽  
Andrea Viaggi ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Soft Tissue ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Ventral Surface ◽  
Scar Tissue ◽  
Implant Placement ◽  
Tissue Enhancement

Many dental procedures allow for implant placement in partially or totally edentulous patients. Despite the availability of various implant and abutment types on the market, it often becomes quite challenging to achieve the biological and esthetic goals in a patient who has ridge deficiencies. Problems arise from the lack of adequate bone quality and quantity.1,2 Soft tissue form and maintenance is also a consideration to evaluate.3 Primary reconstructive techniques following segmental mandibulectomy is evolving and improves quality of life. A seldom encountered complication is the discovery and treatment of a malignant process (for example, squamous cell carcinoma). Oral squamous cell carcinoma (OSCC) is one of the most aggressive malignancies worldwide and accounts for more than 90% of all oral cancers.4 It is ranked as the sixth leading cause of cancer mortality worldwide. The most common sites of OSCC are the lateral ventral surface of the tongue, the floor of the mouth and buccal mucosa. For most oral cavity cancers, surgery is the initial treatment of choice (often involving the full or partial removal of bony jaw structure).5 Radiation or chemoradiation is added postoperatively if disease is more advanced or has high-risk features. Successful cancer therapy can affect the quantity and quality of soft tissue in areas where implants are planned, thus affecting the initial placement and the long-term success of the implants. Complications can be numerous; especially difficult is implant treatment in the mandibular anterior area where inadequate alveolar height results in the lingual floor and the vestibule becoming contiguous.6 Further complicating treatment is the presence of scar tissue (often found following cancer surgery and radiotherapy). The present case is a report of the combination of a soft tissue enhancement and implant placement following partial mandibulectomy resulting from the treatment of oral squamous cell carcinoma. A video abstract is available for viewing at https://youtu.be/dZ9t3j4ufOc?list=PLvRxNhB9EJqbqjcYMbwKbwi8Xpbb0YuHI.

scholarly journals Surgical Management of Oral Squamous Cell Carcinoma in Dhaka Dental College Hospital; 31 patients

2018 ◽  
Vol 8 (2) ◽  
pp. 10-13
Author(s):  
Farjana Sultana ◽  
Md Rezaul Karim ◽  
Ismat Ara Haider
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Cancer ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Multidisciplinary Treatment ◽  
Oral Carcinoma ◽  
Whole Body ◽  
Definitive Treatment ◽  
Ablative Surgery

Cancer is a major cause of death throughout the world. Oral cancer is one of the six most frequently occurring cancer.1 In Bangladesh, the number of new cancer cases of whole body per year is about 200000 of which oral cancer is about 20%.2 In our neighboring country India, accounts for thirty-five percent of all newly diagnosed cancers in men. The etiology of oral cancer is well established in most instances with consumption of tobacco in any form and alcohol being the most common etiologic agents. Recently, however, exposure to the human papilloma virus has been implicated in young patients with oral carcinoma. The exact mechanism of carcinogenesis in this setting remains to be elucidated .3 Surgery is the most well established mode of initial definitive treatment for a majority of oral cancers. The factors that affect the choice of treatment are related to the tumor and the patient. Primary site, location, proximity to bone and depth of infiltration are factors, which influence particular surgical approach. Advanced reconstructive techniques that allow free transfer of soft tissue and bone improve the functional and aesthetic outcomes following major ablative surgery .Over the course of the past thirty years there has been improvement in the overall survival of patients with oral carcinoma largely due to the improved understanding of the biology of local progression, early identification and treatment of metastatic lymph nodes in the neck and employment of adjuvant post-operative radiotherapy or chemotherapy. Either the role of surgery in oral cancer has evolved with integration of multidisciplinary treatment approaches employing chemotherapy and radiotherapy sequentially or concurrently .Surgical expertise is required for rehabilitation of functional and aesthetic defects created by initial treatment of cancer. Thus, surgery and services of a surgeon remain central to the management of oral cancer.4 A cross sectional study of 31patients undergoing surgery for the treatment of oral squamous cell carcinoma was carried out at Department of Oral & Maxillofacial Surgery ,Dhaka Dental college & hospital from May 2016 to July2017. Here 31 patients, of them male 13 and female 18 having 31 to 80years age ranges of oral squamous cell carcinoma who underwent surgery and reconstruction were included in this study. All patients were referred to oncologist after surgery. Aim of this study was to assess the status of disease, to provide the patient surgical treatment as a first line therapy, to find out any post-operative complications. Update Dent. Coll. j: 2018; 8 (2): 10-13

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