General practitioner's radiology casebook XIII. Odontoma and cementoma.
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Chondrosarcoma of the jaws arises from vestigial rests and is considered a rare entity, although it is more common than its benign counterpart. Occasionally it may be extremely difficult under the microscope to decide whether a case is benign or malignant. The treatment of choice is surgical with wide margins. In our review of the literature we found 169 cases of oro-facial chondrosarcoma including two from our Institution. There was a 2:1 male/female ratio and the maxilla was involved twice as frequently as the mandible. Over half of the cases were between 20 and 50 years old.
Results of immediate reconstruction of the defects resulting from excision of cancer of the cheek, lower jaw, upper jaw and lip in 13 patients using temporal island, deltopectoral and cervicoacromial flaps have been described. The surgical techniques have been outlined. Previous radiotherapy is not a contraindication for primary excisional and reconstructive procedures although the incidence of postoperative gangrene of the flap was greater in these cases.
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Two alveolar ridge lymphangiomas in a black neonate were identified. No case of neonatal lymphangioma in a non-black has been reported. The majority of treatments for lymphangiomas have been either surgical removal or allowing for spontaneous regression. Both treatments were tried in this case with equal success. The treatment of choice may be to allow for spontaneous regression with periodic monitoring, if the lesion is not endangering the child, thus avoiding surgery.
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