Braden S. Bybee , Robert S. Julian , Brian M. Woo , Adnan Mubasher
{"title":"Desmoplastic melanoma of the lower lip: A case report in an 82-year-old male","authors":"Braden S. Bybee , Robert S. Julian , Brian M. Woo , Adnan Mubasher","doi":"10.1016/j.omsc.2025.100413","DOIUrl":"10.1016/j.omsc.2025.100413","url":null,"abstract":"<div><div>This case report details the diagnosis and management of desmoplastic melanoma (DM) in an 82-year-old male presenting lower lip mass. DM is a rare, aggressive form of melanoma characterized by spindle-shaped cells within a dense fibrous stroma, often making diagnosis challenging due to its amelanotic and indurated nature. The patient presented with a 2cm × 2cm mass. After biopsy, the lesion was confirmed as DM with a Breslow thickness of 5.1mm, indicating advanced disease.</div><div>The patient underwent wide local excision with reconstructive surgery, partial parotidectomy, and selective neck dissection. Postoperatively, the lesion was re-excised to achieve negative margins. Immunotherapy with Pembrolizumab was initiated due to the stage IIB classification. The patient declined adjuvant radiation therapy but has shown no signs of recurrence on a follow-up PET scan nine months later.</div><div>This case highlights the diagnostic challenges of DM, especially on the lip, and underscores the importance of early biopsy in atypical lesions. Achieving clear surgical margins is crucial for improving outcomes, as local recurrence is a significant concern. Intraoperatively, frozen sections are not routinely performed on desmoplastic melanoma due to lack of diagnostic value and high rate of false negative. Permanent H&E sections with indicated staining can take 1–3 days to obtain results. The multidisciplinary approach, involving surgery, oncology, and radiation therapy, remains essential for optimal patient management. Although the role of adjuvant therapies is still debated, this case contributes to growing evidence suggesting the benefit of adjuvant treatments in reducing local recurrence and improving prognosis.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 3","pages":"Article 100413"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Tumor Transformation: Case of conversion of Ossifying Fibroma to Osteosarcoma post-excision in a young male","authors":"Sagar Rane, Nitin Bhola, Chetan Gupta","doi":"10.1016/j.omsc.2025.100409","DOIUrl":"10.1016/j.omsc.2025.100409","url":null,"abstract":"<div><div>Ossifying fibroma (OF) is a benign fibro-osseous tumor characterized by slow growth and a low recurrence risk, primarily affecting the mandible in young females. Although OF is typically non-invasive, rare cases demonstrate locally aggressive behavior, requiring surgical resection. Post-surgical transformation of into osteosarcoma, a rare malignancy with a prevalence of 0.7 per million in the jaw, is exceptionally uncommon. This report presents a rare case of a 28-year-old male initially diagnosed with ossifying fibroma, managed surgically through excision and reconstruction with an iliac crest graft. Despite achieving negative margins, the lesion underwent malignant transformation into fibroblastic osteosarcoma within a month, presenting diagnostic and therapeutic challenges.</div><div>The malignant transformation was confirmed through histopathological and immunohistochemical evaluations, revealing a high Ki-67 labeling index (60 %), indicative of aggressive tumor behavior. Following multidisciplinary tumor board discussions, the patient underwent extensive surgical management, including composite resection, segmental mandibulectomy, neck dissection, and microvascular reconstruction with a free fibula osteocutaneous flap. Despite its rarity, this case highlights the need for vigilant follow-up and comprehensive diagnostic workups for recurrent or progressive lesions post-OF resection.</div><div>This report contributes to the limited literature on malignant transformation in fibro-osseous lesions, emphasizing the importance of differentiating benign conditions from low-grade malignancies and discussing the role of surgical intervention in such transformations. Further research is required to elucidate the mechanisms of transformation, optimize management strategies, and improve outcomes for patients with similar rare pathologies.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 3","pages":"Article 100409"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gustavo Andres Grimaldi Finol , Ammar Khalafalla , Mohamed Amir , Saba Hawamdeh , Moustafa Al Khalil , Ismail Farag , Ayoub Alaud
{"title":"Revolutionizing maxillofacial care: Exploring denosumab's impact on giant cell granuloma – A comprehensive case series and literature review","authors":"Gustavo Andres Grimaldi Finol , Ammar Khalafalla , Mohamed Amir , Saba Hawamdeh , Moustafa Al Khalil , Ismail Farag , Ayoub Alaud","doi":"10.1016/j.omsc.2025.100408","DOIUrl":"10.1016/j.omsc.2025.100408","url":null,"abstract":"<div><div>Giant cell lesions (GCLs) of the maxillofacial complex present a therapeutic challenge due to their aggressive nature and potential for recurrence. Traditional treatment modalities often includes surgical intervention with varying degrees of success and associated morbidities. In recent years, denosumab, a monoclonal antibody targeting the RANK ligand pathway, has emerged as a promising alternative in the management of GCLs. This article provides a comprehensive overview of denosumab's efficacy, safety profile, and clinical outcomes in treating GCLs through a meticulous analysis of case series and literature review. We describe denosumab's potential as a novel therapeutic option, offering improved outcomes and reduced morbidity for patients with GCLs in the maxillofacial region with the presentation of two cases using a comprenhesive diagnosis and management. On the other hand, this article highlights the need for further prospective studies to stablish optimal dosing regimens, long-term efficacy, and potential adverse effects, for enhanced patient care and management strategies in this challenging clinical scenario.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 3","pages":"Article 100408"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144502675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Flávio Fidêncio de Lima , Maria Carolina de Sousa Melo , Thamyryz Rafaela Almeida Simões , David Fischer , Luiz Carlos Magno Filho
{"title":"Enhanced fixation techniques in orthognathic surgery for improved nasal aesthetics","authors":"Flávio Fidêncio de Lima , Maria Carolina de Sousa Melo , Thamyryz Rafaela Almeida Simões , David Fischer , Luiz Carlos Magno Filho","doi":"10.1016/j.omsc.2025.100410","DOIUrl":"10.1016/j.omsc.2025.100410","url":null,"abstract":"","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 3","pages":"Article 100410"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144597540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A case report of classical presentation of rare melanotic neuroectodermal tumor of infancy","authors":"Anumesh Dahal , K.C. Krishna , Sarala Khadka , Dewan Karki","doi":"10.1016/j.omsc.2025.100386","DOIUrl":"10.1016/j.omsc.2025.100386","url":null,"abstract":"<div><div>Melanotic neuroectodermal tumor of infancy (MNTI) is a rare neoplasm in infants, often mimicking aggressive malignancies or odontogenic lesions, particularly on maxillary or mandibular alveolar ridges. We report a 4-month-old male presenting with a one-month history of swelling in the right upper mouth, rapidly increasing over 15 days. Clinical examination showed a firm, bluish swelling on the right maxillary alveolus. Provisional diagnosis included rhabdomyosarcoma, with differential diagnoses of peripheral giant cell granuloma and small round cell tumor. Imaging revealed an expansile soft tissue mass in the right maxilla without systemic involvement. Surgical excision under general anesthesia was performed. Histopathology confirmed MNTI, supported by immunohistochemistry markers such as CK and HMB45 positivity. The patient showed no recurrence or complications over eight months of follow-up, with normal growth and healing in the affected region. This case underscores the importance of differentiating MNTI from malignancies in infants. Early diagnosis and surgical intervention are essential. A timely treatment and close follow-up ensures favorable outcomes in MNTI cases.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 2","pages":"Article 100386"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143478697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Giant dentigerous cyst encasing an impacted third molar in the maxillary sinus: A unique case study with comprehensive literature review","authors":"Naida Hadziabdic , Edina Lazovic Salcin , Nedim Sulejmanagic , Halid Sulejmanagic","doi":"10.1016/j.omsc.2025.100396","DOIUrl":"10.1016/j.omsc.2025.100396","url":null,"abstract":"<div><div>Dentigerous cysts are developmental cysts that are commonly associated with impacted teeth. These cysts can appear atypically in the maxillary sinus. Usually, they do not cause symptoms and are incidentally discovered through radiographic examinations. However, larger cysts may lead to a symptomatic presentation.</div><div>This report presents a case of a substantial dentigerous cyst in the maxillary sinus with an impacted wisdom tooth in a fifteen-year-old male. The surgical procedure, involving decompression and enucleation under local anesthesia, was conducted a month after the diagnosis. Histopathological examination confirmed the diagnosis of dentigerous cyst. This study emphasizes postoperative complications diagnosed using cone-beam computed tomography (CBCT).</div><div>Periodic panoramic radiographic examinations in pediatric patients should be conducted solely based on individualized clinical indications, ensuring compliance with current radioprotection standards. This approach facilitates the early detection of maxillomandibular pathologies such as cysts while minimizing unnecessary radiation exposure and prioritizing patient safety.</div><div>Cone-beam computed tomography (CBCT) is recommended for accurate diagnosis, treatment planning, and postoperative monitoring.</div><div>Surgeons are encouraged to tailor each operation individually to optimize patient outcomes.</div><div>Excised tissue should be subjected to histopathological examination to establish a precise diagnosis.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 2","pages":"Article 100396"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brett A. Wilson, Jeffrey H. Brooks, Sloan B. Ashabranner, Franklin B. Ivers
{"title":"Large intraosseous xanthoma of the mandible – A case report","authors":"Brett A. Wilson, Jeffrey H. Brooks, Sloan B. Ashabranner, Franklin B. Ivers","doi":"10.1016/j.omsc.2025.100404","DOIUrl":"10.1016/j.omsc.2025.100404","url":null,"abstract":"<div><div>Xanthoma is derived from the Greek word xanthos, meaning yellow, and is related to the altered metabolism of lipids resulting in their accumulation in skin, tendon sheaths, and internal organs. Xanthomas manifest as yellowish papules, plaques, or nodules and are characterized by lipid-laden macrophages (foam cells). Xanthoma of bone is extremely rare and, when present, is often secondary to dyslipidemias or endocrine disorders. The former would be considered a secondary intraosseous xanthoma of bone. A xanthoma that is identified within bone in the absence of dyslipidemia or endocrine disease is considered a primary intraosseous xanthoma. When a xanthoma presents in the maxilla or mandible, it is considered an intraosseous xanthoma of the jaw. The first intraosseous xanthoma of the jaw was reported in 1964 and was referred to as a xanthogranuloma of the mandible. Since that initial report, less than 60 total cases have been reported in the English literature. The cases reported are typically small in size and amenable to enucleation and curettage. Our report contributes to the existing literature by providing a unique case example, highlighting the potential for these lesions to progress to a considerable size, impact adjacent anatomical structures, and necessitate more aggressive treatment.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 2","pages":"Article 100404"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Application of low-profile patient-specific surgical cutting guides in the management of craniofacial fibrous dysplasia: A case report and review of current surgical approaches","authors":"Mahdi Zakeri , Brian Kinard","doi":"10.1016/j.omsc.2025.100399","DOIUrl":"10.1016/j.omsc.2025.100399","url":null,"abstract":"<div><div>Managing craniofacial fibrous dysplasia (FD) poses significant challenges, particularly in balancing functional and aesthetic outcomes. Traditional approaches often require broad exposure through coronal flaps or midfacial degloving, leading to increased morbidity and extended recovery. This case report highlights a minimally invasive approach for a 20-year-old female with disfiguring zygomaticomaxillary FD. Through computer-aided surgical simulation (CASS), low-profile patient-specific recontouring guides were employed to perform precise bone recontouring through transconjunctival and intraoral incisions. Postoperative imaging confirmed accurate bone removal when superimposed with the preoperative plan. The patient achieved satisfactory facial symmetry with reduced morbidity. This approach demonstrates that combining CASS with low-profile patient specific recontouring guides can optimize outcomes for complex craniofacial FD cases. Further research and comparative studies are necessary to fully assess the long-term benefits of this technique in surgical managing FD and other benign craniofacial lesions.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 2","pages":"Article 100399"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143842651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Inleel Lundgård Shino , Mohammedreza Sefidroodi , Stratos Vassis , Kasper Dahl Kristensen , Thomas Klit Pedersen , Jytte Buhl , Sven Erik Nørholt
{"title":"Integrating aligners with surgery first: A novel case report on single-jaw, multi-segmented maxillary osteotomy","authors":"Inleel Lundgård Shino , Mohammedreza Sefidroodi , Stratos Vassis , Kasper Dahl Kristensen , Thomas Klit Pedersen , Jytte Buhl , Sven Erik Nørholt","doi":"10.1016/j.omsc.2025.100392","DOIUrl":"10.1016/j.omsc.2025.100392","url":null,"abstract":"<div><div>Technological advancements have made the integration of clear aligner therapy (CAT) with orthognathic surgery a reality. This case report outlines an innovative, patient-specific workflow that merges CAT with the surgery first orthognathic approach (SFOA), developed in collaboration with engineers to facilitate in-house production of surgical guides and pre-adapted titanium plates. Objective evaluation was performed using the peer assessment rating (PAR) index. The patient achieved the intended occlusal relationship without discomfort in the temporomandibular joint (TMJ) and experienced no surgical complications. The surgical and occlusal outcomes have remained stable with reduced scores in the PAR index, reflecting improved objective assessment post treatment. This case report is the first of its kind to describe a single-jaw, multi-segmented maxillary osteotomy in SFOA using CAT. It demonstrates precise individualized planning in a multidisciplinary approach integrating CAT with SFOA making it feasible in cases involving a single jaw segmented Le Fort 1 osteotomy.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 2","pages":"Article 100392"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Oral mycetoma of the upper lip nasolabial region in a healthy host: A case report and minireview of diagnostic and therapeutic considerations","authors":"Kenichi Ogata , Michiaki Akashi , Shintaro Kawano","doi":"10.1016/j.omsc.2025.100400","DOIUrl":"10.1016/j.omsc.2025.100400","url":null,"abstract":"<div><div>Oral mycetoma, or fungal ball, is a rare entity typically affecting immunocompromised individuals; its presentation in the oral cavity, particularly the upper lip of healthy hosts, is exceedingly rare. We report a unique instance of upper lip nasolabial mycetoma in a 60-year-old immunocompetent male presenting with painless swelling. Initial imaging (magnetic resonance imaging/ultrasonography) revealed a well-defined, fluid-filled nodule, mimicking a benign neoplasm or mucocele. Excisional biopsy and subsequent histopathological examination with Grocott methenamine silver staining definitively diagnosed mycetoma, revealing encapsulated abscesses with filamentous fungal hyphae, suggestive of Aspergillus etiology. This case highlights the diagnostic ambiguity of atypical fungal infections in immunocompetent patients and underscores the necessity to consider fungal etiologies in the differential diagnosis of oral lesions, irrespective of patient immune status. Histopathology remains crucial for definitive diagnosis and appropriate management. Surgical excision with 1-year follow-up proved to be an effective therapeutic modality for localized oral fungal mycetoma in this healthy individual.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 2","pages":"Article 100400"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143830073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}