Intraoperative evaluation of bony margins with frozen-section analysis and trephine drill extraction technique: A preliminary study.

The aim of this study was to examine the use of trephine drill specimens from mandible bony margins subjected to standard histologic fresh-frozen processing for intraoperative documentation of malignant bony infiltration in oral cancer.Eighty-four drill specimens were extracted from bony mandibular resection margins of 20 patients with oral cancer. Histologic results of decalcification and of intraoperative frozen-section analysis were compared.Sixty-eight (81%) of 84 specimens showed no tumor infiltration, whereas 16 (19%) were positive in frozen section analysis. Four specimens (4.8%) were evaluated as free of tumor invasion, but showed erosion of the bone by the tumor after decalcification. One specimen (2.4%) was positive, but no invasion could be found with standard decalcification. Overall, there was 94% (79) consistency between the 2 techniques, with a sensitivity of 79% and specificity of 98%.This technique promises to be suitable for intraoperative detection of malignant bone infiltration

[Giant ameloblastoma of the jaw]

Ameloblastomas represent benign, epithelial alveolar tumors, which originate from epithelial enamel cells (ameloblasts). Due to their locally aggressive character, they may develop pathological significance. Radical surgery remains the therapy of choice. As demonstrated by the case of a 71-year-old patient with giant ameloblastoma of the upper jaw, early resection is recommended. The high propensity for recurrence demands long-term post-operative follow-up, since late recidive tumours may also occur

[The leishmaniasis - a parasitel infection as differential diagnosis of malignant tumours of oral mucosa. A case report and review of literature.]

Although parasitel infections in northern Europe are rare, it must be considered as differential diagnosis of malignant tumours of mucous membrane.With increasing tourisms in endemic areas, infections with parasite pathogen are spreading in non-endemic areas as well. In this case a mucous membrane malignancy with clinical feature of ulcer on unusual location was imitated. In this reported case the patient suffers with hepatitis c, causing cirrhosis of the liver and making a liver transplantation necessary. In this patient a history of a leishmaniosis which had been treated successful by the tropical institute is reported, but because of a new actually leishmaniosis-infection a liver transplantation is contraindicated. Under oral therapy with Miltefosin (IMPADIVO((R))) a remission was successful.The leishmaniosis is a classical tropical disease. WHO reported a morbidity of nearly 12 million people in 88 countries around the world especially in tropical areas. Repeatedly infections in northern Europe caused by the phlebotonus-sandflies are described.Therefore leishmaniosis must be considered as differential diagnosis in suspect lesions of mucous membrane