Faculty Bibliography

Surgical resection of aggressive solid or multicystic ameloblastoma is a well-documented and accepted treatment modality. Controversies exist, however, with regard to the extent of operative intervention. Unresectable lesions have been treated with radiation or combined radiation and chemotherapy. The authors present a case report of a patient with recurrent ameloblastoma who underwent simultaneous hard- and soft-tissue reconstruction.

BACKGROUND:The purpose of this study was to describe the computed tomography (CT) findings in pancreatic tuberculosis (PT). METHODS:We retrospectively reviewed the CT features in six patients with PT, three of whom had AIDS. RESULTS:Pancreatic lesion masses were found in four patients, small (< 1 cm) low-attenuation pancreatic nodules in one, and diffuse enlargement of the pancreas in one. The pancreatic lesion masses were found in all the non-AIDS patients and in one patient with AIDS and were located in the head of the pancreas in two cases and involved the body, neck, and head of the gland in the other two. The masses showed low attenuation in two cases, soft-tissue attenuation in one, and appeared as an infiltrating inhomogeneous lesion with retropancreatic spread, encasing the celiac trunk and superior mesenteric artery in one. Low-attenuation peripancreatic and/or periportal adenopathies with peripheral rim enhancement were found in three cases, and slight bile duct dilatation was evident in four. Four patients had disseminated tuberculosis, whereas pancreatic and peripancreatic tuberculosis were the sole manifestation of tuberculosis in the other two. CONCLUSION/CONCLUSIONS:The present data suggest that PT usually appears as a nonspecific focal lesion mass in HIV-seronegative patients, whereas there is a variable spectrum of CT findings including focal lesion mass, multiple small low-attenuation pancreatic nodules, or diffuse enlargement of the gland in AIDS patients. Low-attenuation peripancreatic and periportal adenopathies with peripheral rim enhancement and other data of disseminated tuberculosis are ancillary findings that should support a diagnosis of PT.

Surgical access to fractures of the ascending ramus of the mandible is limited when standard techniques are employed. A new method using a facial rhytidectomy technique is described, and seven cases treated by this method are presented. The advantage of this technique includes excellent exposure, predictable and safe dissection, inconspicuous facial scar and minimal postoperative complications.

Visualization of subcondylar fractures is limited, and rigid fixation technically difficult, employing standard open surgical techniques--especially when the condyle is displaced out of the glenoid fossa. The majority of condylar neck fractures are treated by closed reduction with maxillomandibular fixation, to obviate the potential for permanent injury to the facial nerve. The technique described employs an anterior parotid, two-layer, sub-SMAS (superficial musculo-aponeurotic system) approach via a rhytidectomy incision that reliably identifies and preserves the neural elements and provides direct access to the pericondylar region. The thirteen patients presented here exhibited satisfactory functional and aesthetic results. Complications included temporary nerve palsies, plate fractures, and a hematoma.

We analyzed 3 cases of malignant ovarian germ cell tumors (MOGCTs), comprising 1 dysgerminoma and 2 immature teratomas, by banded chromosome analysis and by in situ hybridization (ISH) using a chromosome 12p painting probe. We found evidence of 12p abnormalities in two of them. A possible common genetic pathway of origin of a subset of MOGCTs with testicular germ cell tumors (TGCTs) is discussed.

We have studied six cases of choriocarcinomas in the female by conventional cytogenetic analysis and by in situ hybridization using a 12p painting probe, and found evidence for chromosome 12 abnormalities in two of them. Abnormalities of chromosome 12 are a common occurrence in genitourinary tumors of the female, but their significance is not known. We discuss the present findings in relation to those in malignant ovarian germ cell tumors (MOGCTs).