Deep convolutional network is a deep learning approach to optimize image recognition. This study aimed to apply DCNN to the reading of mandibular cortical thinning in digital panoramic radiographs. Digital panoramic radiographs of 1,268 female dental patients (age 45.2 ± 21.1yrs) were used in the reading of the mandibular cortical bone by two maxillofacial radiologists. Among the subjects, 535 normal subject’s panoramic radiographs (age 28.6 ±7.4 yrs) and 533 those of osteoporosis pationts (age 72.1 ± 8.7 yrs) with mandibular cortical thinning were used for training DCNN. In the testing of mandibular cortical thinning, 100 panoramic radiographs of normal subjects (age 26.6 ± 4.5 yrs) and 100 mandibular cortical thinning (age 72.5 ± 7.2 yrs) were used. The sensitive area of DCNN to mandibular cortical thinning was investigated by occluding analysis. The readings of DCNN were compared by two maxillofacial radiologists. DCNN showed 97.5% accuracy, 96% sensitivity, and 99% specificity in reading mandibular cortical thinning. DCNN was sensitively responded on the cancellous and cortical bone of the mandibular inferior area. DCNN was effective in diagnosing mandibular cortical thinning.
Although fine-needle aspiration biopsy (FNAB) has been widely accepted as a valuable tool for differential diagnosis of head and neck tumors, the diagnostic value of FNAB in the management of salivary gland tumors has been questioned. This case report presents a patient with mucoepidermoid carcinoma of parotid gland diagnosed as pleomorphic adenoma by FNAB and discusses the pitfalls in the diagnosis of malignant salivary gland tumors.
Central odontogenic fibroma (COF) is an uncommon slow growing benign neoplasm that is derived from the mesenchymal tissue. Differential diagnoses include fibrous dysplasia, calcifying odontogenic cyst, and central ossifying fibroma. Clinically, the lesion shows expansion of cortical bone. Radiologically, unilocular or multilocular lesion with well-defined borders is found. Histologically, fibroblastic tissues with bundle of collagens including inactive odontogenic epithelium can be observed. In this case report, a 45-year-old male with central odontogenic fibroma of the maxilla is examined. The lesion was surgically removed without any postoperative complications. In order to diagnose the disease properly, histopathologic analysis was performed.
Intraosseous hemangioma of the jaws is a rare disease as compared to other skeletal and soft tissue hemangiomas. Preoperative differential diagnosis is critical in that severe bleeding can cause both intra and postoperative complications. Surgical excision of the intraosseous hemangioma can be performed with the use of steroid injection or sclerosing agent into the lesion before the surgical approach. However, even with the embolization of the blood vessels before surgical excision, there still exists a risk of massive hemorrhage during the procedure for the larger lesions. In this report, we present a case of which first tentatively diagnosed as ameloblastoma thus the use of sclerosing agents or vascular embolization was not considered before the surgery. Although there was a strong tendency to intraoperative bleeding, delicate hemostasis was achieved with surgicel(Ethicon SARL, Johnson and Johnson, Switzerland), bosmin(Jeil Pharm, Republic of Korea), and electrocautery. The final histopathological examination confirmed an intraosseous hemangioma of the mandible. The patient is undertaken for follow-up period of 1 year and the prognosis is under favorable condition.
Salivary duct carcinoma is a highly malignant tumor that arises from salivary gland. Pathologically, Salivary duct carcinoma is similar to high-grade breast ductal carcinoma. The tumor is commonly associated with pain and facial paralysis and is known to have high rates of recurrence and metastasis. Surgical resection and postoperative radiation is mainstream of the treatment. In this study, we report a case of this tumor which was seen predominantly benign-looking in fine needle aspiration biopsy. The features of this tumor are presented with a review of literature.