This study was performed as a part of serial experiments of applying convolutional neural network(CNN) in determining osteoporosis on panoramic radiograph. The purpose of this study was to investigate how sensitively CNN determine osteoporosis on cropped panoramic radiograph. Panoramic radiographs from 1268 female patients(mean age 45.2 ± 21.1 yrs) were selected for this study. For the osteoporosis group, 633(mean age 72.2 ± 8.5 yrs) were selected, while for the normal group 635(mean age 28.3 ± 7.0 yrs). AlexNet was utilized as CNN in this study. A multiple-column CNN was designed with two rectangular regions of interest on the mandible inferior area. An occluding method was used to analyze the sensitive area in determining osteoporosis on AlexNet. Testing of AlexNet showed accuracy of 99% in determining osteoporosis on panoramic radiographs. AlexNet was sensitive at the area of cortical and cancellous bone of the mandible inferior area including adjacent soft tissue.
A 63-year-old man with a 2-year history of a slowly growing mass in the chin area was referred to the Department of Oral and Maxillofacial Surgery, Dankook University Dental Hospital. Physical examination revealed a 1.2 × 1.0 cm bluish mass in the middle of his chin, which was tentatively diagnosed as a hemangioma. Considering the size and location of the lesion, an excisional biopsy was performed under local anesthesia. Bleeding and other complications were not observed. The results of histopathological examination revealed glomangioma. This study aimed to report a case of solitary glomangioma arising in the chin, which is not the usual location of this tumor. To the best of our knowledge, this is the first report of a solitary glomangioma in the chin area in the oral and maxillofacial surgery literature.
Sarcomatous transformation of fibrous dysplasia (FD) is rare and can occur in patients with McCune-Albright syndrome (MAS). To date, there have been several cases of malignant transformation of FD in the craniofacial area of patients with MAS. Here, we report an additional case of secondary osteosarcoma arising from FD in the mandible of a 41-year-old woman with MAS. The patient complained of rapid swelling in the right facial area, which was initially misdiagnosed as soft tissue sarcoma at another hospital. After neoadjuvant concurrent chemoradiotherapy resulting in poor response, the lesion was surgically resected in our hospital, and the final diagnosis of secondary osteosarcoma was rendered. Currently, post-operative adjuvant chemotherapy is in progress. As a result of our review of 17 reported cases showing malignant transformation in FD/MAS, the M/F ratio was 1:1.1, and the median age at onset of malignancy was 28.6 years. The most commonly affected site was the craniofacial bones (n=13; 76%), and the most common histopathologic type of malignancy was osteosarcoma (n=14; 82%). More than half of the patients (8/15; 53.3%) died within 1 year, mainly due to lung metastasis (6/8; 75%). Taken together, since MAS patients with malignant transformation of FD have a relatively poor prognosis, accurate diagnosis based on histopathologic findings as well as clinical and radiographic information is important to select optimal treatment.