- Publikační typ
- abstrakt z konference MeSH
Úvod a cíl: Retrospektivní studie se zaměřila na klinicko-biopticky verifikované případy proliferativní verukózní leukoplakie (PVL). Cílem práce je poukázat na nutnost korelace orálních projevů PVL s klinickým, ale i rentgenologickým vyšetřením parodontu. Metodika: Studie hodnotila průběh onemocnění PVL u 53 pacientů sledovaných v letech 1994 až 2024 na Oddělení orální medicíny Stomatologické kliniky FN Plzeň. Mimo anamnesticko-patologické korelace byly posuzovány rovněž aspekty koincidence s dalšími lézemi ústní sliznice, tvorba dysplazie v průběhu tohoto agresivního onemocnění a četnost maligní transformace. Slizniční projev onemocnění byl pravidelně porovnáván s klinickým i rentgenologicky ověřeným stavem parodontu. Výsledky: Za dispenzarizace došlo k recidivě v 56 % případů (n = 30/53) a ke zvratu v orální dlaždicobuněčný karcinom (OSCC) u 38 % pacientů (n = 20/53). Onkologická recidiva nastala v pěti případech (9 %). Většinu pacientů s maligní transformací tvořily ženy, a to 70 % (n = 14/20). Závěr: Na rozdíl od ostatních onemocnění ústní sliznice je v rámci dispenzarizace PVL zhotovení snímků OPG nebo CBCT diagnosticky přínosnější. U mnoha pacientů s lézemi v oblasti alveolární sliznice a gingivy dochází v odpovídajících lokalitách k výrazné resorpci až usuraci alveolární kosti v případě probíhající maligní transformace. Maligní transformace PVL je skutečně četná, v naší skupině až v 38 %. Pro riziko diagnostické záměny orálního lichen planus a chronické hyperplastické kandidózy s počínající PVL je nutno zpřísnit dispenzární pravidla i u těchto případů.
Introduction and aim: Retrospective study focused on clinically and biopsy-proven cases of proliferative verrucous leukoplakia (PVL). The aim of the work is to point out the necessity of correlation of oral manifestations of PVL with clinical and radiological examination of the periodontium. Methods: The study evaluated the process of PVL disease in 53 patients followed between 1994 and 2024 at the Oral Medicine Department, Dentistry Clinic, University hospital in Pilsen. Apart from anamnestic-pathological correlations, also the aspects of coincidence with other lesions of the oral mucosa, the formation of dysplasia during this aggressive disease and the frequency of malignant transformation were assessed. The mucosal manifestation of the disease was regularly compared to the clinical and radiological state of the periodontium. Results: During dispensary, recurrence occurred in 56% of cases (n = 30/53) and transformation into oral squamous cell carcinoma (OSCC) in 38% of patients (n = 20/53). Oncological recurrence was in five cases (9%). The majority of patients with malignant transformation were women with 70% (n = 14/20). Conclusion: In contrary to other diseases of the oral mucosa, taking OPG or CBCT images is diagnostically more beneficial within the PVL dispensary. In several patients with lesions in the area of the alveolar mucosa and gingiva, there is significant resorption of the alveolar bone in the corresponding locations in the case of an ongoing malignant transformation. Malignant transformation of PVL is indeed high, up to 38% in our group. Due to the risk of diagnostic confusion of oral lichen planus and chronic hyperplastic candidiasis with incipient PVL, it is necessary to tighten the dispensary rules for these cases as well.
- MeSH
- dospělí MeSH
- karcinogeneze MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory úst patofyziologie MeSH
- orální leukoplakie * diagnostické zobrazování komplikace patofyziologie patologie MeSH
- retrospektivní studie MeSH
- senioři MeSH
- spinocelulární karcinom patofyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- klinická studie MeSH
Chronic hyperplastic candidiasis (CHC) presents a distinctive and relatively rare form of oral candidal infection characterized by the presence of white or white-red patches on the oral mucosa. Often mistaken for leukoplakia or erythroleukoplakia due to their appearance, these lesions display nonhomogeneous textures featuring combinations of white and red hyperplastic or nodular surfaces. Predominant locations for such lesions include the tongue, retro-angular mucosa, and buccal mucosa. This paper aims to investigate the potential influence of specific anatomical locations, retro-angular mucosa, on the development and occurrence of CHC. By examining the relationship between risk factors, we present an approach based on machine learning (ML) to predict the location of CHC occurrence. In this way, we employ Gradient Boosting Regression (GBR) to classify CHC lesion locations based on important risk factors. This estimator can serve both research and diagnostic purposes effectively. The findings underscore that the proposed ML technique can be used to predict the occurrence of CHC in retro-angular mucosa compared to other locations. The results also show a high rate of accuracy in predicting lesion locations. Performance assessment relies on Mean Squared Error (MSE), Root Mean Squared Error (RMSE), R-squared (R2), and Mean Absolute Error (MAE), consistently revealing favorable results that underscore the robustness and dependability of our classification method. Our research contributes valuable insights to the field, enhancing diagnostic accuracy and informing treatment strategies.
- Publikační typ
- časopisecké články MeSH
In our study, the effect of the use of autofluorescence (Visually Enhanced Lesion Scope-VELscope) on increasing the success rate of surgical treatment in oral squamous carcinoma (OSCC) was investigated. Our hypothesis was tested on a group of 122 patients suffering from OSCC, randomized into a study and a control group enrolled in our study after meeting the inclusion criteria. The preoperative checkup via VELscope, accompanied by the marking of the range of a loss of fluorescence in the study group, was performed before the surgery. We developed a unique mucosal tattoo marking technique for this purpose. The histopathological results after surgical treatment, i.e., the margin status, were then compared. In the study group, we achieved pathological free margin (pFM) in 55 patients, pathological close margin (pCM) in 6 cases, and we encountered no cases of pathological positive margin (pPM) in the mucosal layer. In comparison, the control group results revealed pPM in 7 cases, pCM in 14 cases, and pFM in 40 of all cases in the mucosal layer. This study demonstrated that preoperative autofluorescence assessment of the mucosal surroundings of OSCC increased the ability to achieve pFM resection 4.8 times in terms of lateral margins.
- Publikační typ
- časopisecké články MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
The reconstruction of oral tongue and floor of mouth defects after resections of squamous cell carcinoma is a challenging task in reconstructive surgery aiming for appropriate restoration of oral function and quality of life improvement. In this study, the authors introduce the innovative reconstruction technique of medium-sized defects consisting of tunnelized facial artery myomucosal island flap and submandibular gland flap as the local chimeric flap pedicled on facial vessels. A retrospective case series evaluation of 4 patients suffering from oral cavity cancer (stages III and IVa), who underwent transoral tumor excision with neck dissection and immediate reconstruction in the time period September 2020 to July 2021, was conducted. No flap losses or flap-related complications were identified. No recurrences occurred during the follow-up at 11.0±4.5 months (range: 6-16 mo, median=11 mo). Tunnelized facial artery myomucosal island flap and submandibular gland flap local chimeric flap expands the reconstruction options of medium-sized defects after ablative oral cancer surgery in carefully selected patients primarily not suitable for free flap reconstructions.
- MeSH
- arterie MeSH
- chirurgické laloky krevní zásobení MeSH
- dlaždicobuněčné karcinomy hlavy a krku MeSH
- kvalita života MeSH
- lidé MeSH
- nádory hlavy a krku * MeSH
- nádory úst * chirurgie patologie MeSH
- podčelistní slinná žláza chirurgie patologie MeSH
- retrospektivní studie MeSH
- spinocelulární karcinom * chirurgie patologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
BACKGROUND: An ocular adnexal apocrine adenocarcinoma (OAAA) is an extremely rare, but potentially aggressive and life-threatening tumor with ill-defined management based only on recommendations from a limited number of reported cases. The development of cervical lymphocele following neck dissection is a very rare complication, but one with well established methods for prevention and treatment. Here we describe a previously unreported case of salvage surgery including neck dissection for OAAA in addition to an emergence of cervical lymphocele. A literature review of current knowledge on both pathological conditions is included. METHODS AND RESULTS: A 58-year-old man suffering from OAAA, previously treated with multiple eye-sparing excisions and adjuvant proton therapy, underwent salvage surgery for locoregional recurrence of the tumor. A partial orbitectomy with orbital exenteration, primary reconstruction and left-sided neck dissection was performed. The procedure was complicated by a cervical lymphocele resolved after the surgical therapy. The patient remained disease-free during the one-year follow-up. CONCLUSION: OAAA is a locally aggressive tumor with potential to local or distant metastatic spread. Whole-body staging, regular clinico-radiological follow-up and stage-dependent therapy with surgery as the first-choice treatment is required. A cervical lymphocele as a complication of especially left-sided neck dissection is managed with a conservative or surgical therapy according to the level of lymph leakage, extent and localization of lesions, presence of local or systemic disorders and the period from primary surgery.
- MeSH
- adenokarcinom * patologie chirurgie MeSH
- krční disekce škodlivé účinky metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokální recidiva nádoru MeSH
- lymfokela * etiologie chirurgie MeSH
- nádory prsu * chirurgie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- přehledy MeSH
