NDLI: Metastatic Melanotic Neuroectodermal Tumor of Infancy: Report of a Case and Review of the Literature.

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Metastatic Melanotic Neuroectodermal Tumor of Infancy: Report of a Case and Review of the Literature.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Azarisamani, Amir Petrisor, Daniel Wright, John Ghali, Ghali E.
Description	Author Affiliation: Azarisamani A ( Resident, Department of Oral and Maxillofacial Surgery, Oregon Health & Science University, Portland, OR.); Petrisor D ( Assistant Professor, Department of Oral and Maxillofacial Surgery, Oregon Health & Science University, Portland, OR. Electronic address: petrisor@ohsu.edu.); Wright J ( Professor and Chair, Department of Diagnostic Sciences, Texas A&M Health Science Center Baylor College of Dentistry, Dallas, TX.); Ghali GE ( Professor and Chair, Department of Oral and Maxillofacial Surgery, LSU Health Sciences University, Shreveport, LA.)
Abstract	Melanotic neuroectodermal tumors of infancy (MNTI) are rapidly growing pigmented tumors that occur predominantly within bony head and neck structures. There are fewer than 400 cases reported in the literature with the majority affecting the maxilla. Locations in other intraosseous and extraosseous structures have been characterized, including the mandible (6% of MNTIs). Infants in the first year of life are primarily affected. Surgical resection is the primary treatment modality with and without adjuvant chemotherapy for malignant tumors, which comprise less than 25 cases in the literature, and of metatstatic mandibular tumors, which has only been documented in one other case. The purpose of this investigation is to review associated literature and present a case highlighting treatment considerations of a metastatic mandibular MNTI. We present the case of a six month old boy with a rapidly growing bluish mass of the right mandible. Preoperatively incisional biopsy led to a diagnosis of MNTI and subsequent surgical planning involved hemimandibulectomy from the right mandibular condyle to the left posterior body region with one centimeter margins. At the time of initial surgery, enlarged lymph nodes removed from the neck demonstrated abnormality consistent with metastatic spread of the tumor. Islands of tumor cells were noted: small, round, bluestaining cells resembling neuroblasts with mitotic activity as well as pigmented cells containing melanin. Because of regional node metastasis, chemotherapy was completed following surgery. The patient recovered and was followed without evidence of recurrence. At 3.5 years postresection, a secondary reconstruction was completed using a fibula osteocutaneous free flap combined with a costochondral rib graft. In reviewing similar cases of malignant MNTI reported in the literature, a search of the MEDLINE database until 2014 was performed. These were evaluated based on management type and outcome, including surgical and chemotherapeutic treatments and the incidence of recurrence or metastasis.
File Format	HTM / HTML
ISSN	02782391
Issue Number	12
Journal	Journal of Oral and Maxillofacial Surgery
Volume Number	74
e-ISSN	15315053
Language	English
Publisher	Elsevier
Publisher Date	2016-12-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Content Type	Text
Resource Type	Article
Subject	Oral Surgery Otorhinolaryngology Surgery

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