Chondroblastoma of mandibular condyle: Case report and literature review
-
Xiaoqin Yang
und
Zhaoqiang Zhang
Abstract
Chondroblastoma is one of the uncommon benign bone tumors, particularly when located in the mandibular condyle. Such a location makes its diagnosis difficult when based on only its clinical presentation and radiographic features. Herein the current report presents a case of chondroblastoma of the mandibular condyle: its clinical presentation, radiographic features, and immediate condylar reconstruction after resection. Additionally, the relevant literature is discussed to provide clinical recommendations for its diagnosis and treatment. Chondroblastoma has been reported so infrequently in the temporomandibular joint (TMJ), more common entities should first be considered in the differential diagnosis of masses in this location. Osteochondroma is the most frequent bone neoplasm in the TMJ. Since a correct diagnosis is difficult, additional tools, such as magnetic resonance imaging (MRI) and immunohistochemical analyses, should be used for diagnostics and surgical planning.
1 Introduction
Chondroblastoma is a rare tumor of the bone, typically occurring at the epiphyses of long bones in the immature skeleton and accounting for less than 1% of primary bone tumors [1,2]. Primary bone tumors of the craniofacial bone are not common, comprising 2% of all primary bone tumors [3]. Chondroblastomas that arise in the craniofacial bone, particularly in the mandibular condyle, are rarer than other bones [1,4,5,6,7,8]. The current treatment recommendation is en bloc excision with preservation of important neurovascular structures [9,10]. However, condylectomy without condylar reconstruction may cause a lateral open bite on the contralateral side. Therefore, simultaneous condylar reconstruction is necessary and is recommended by most surgeons [11].
Herein the authors present a case of chondroblastoma located in the mandibular condyle for which the patient underwent immediate condylar reconstruction after resection. This article will discuss the clinical presentation, radiographic features, histological analysis, surgical treatment, and long-term follow-up for this case.
2 Case report
A 36-year-old Chinese female presented with a 10-month history of limited mouth opening (30 mm), tender swelling in the right TMJ area, progressive hearing impairment in the right ear, and slight crepitation on auscultation of the right TMJ. A physical examination revealed a round, subcutaneous mass with clear boundaries located on the right preauricular site; the mass was approximately 30 mm in diameter, moderately hard, immobile, and painful with condylar movement. There was no abnormal occlusal relationship or facial paralysis. Hematological and biochemical examinations were normal. A computed tomography (CT) scan showed a 3.5 cm2 × 4.0 cm2 expansive neoplasm located in the right TMJ region (Figure 1a, horizontal plane, white rectangular region), with an expansile osteolytic process that was eroding the mandibular condyle (Figure 1b, coronal plan, white arrows) and extending into the middle cranial fossa. MRI results confirmed an irregular neoplasm surrounding the mandibular condyle with an unclear joint space (Figure 1c, coronal plan, white rectangular region). Moreover, T1- and T2-elongated signal areas in the right mastoid were indicative of inflammation. There was no evidence of either dural or intracranial involvement, based on the CT and MRI results. Ultrasonography revealed a hypoechoic mass in the TMJ region with vague boundaries and poor visualization of the bloodstream. Based on clinical features and radiographic findings prior to surgery, several diagnoses were considered: a malignant lesion, such as a chondrosarcoma, osteosarcoma, or malignant fibrohistiocytoma; and a noninvasive lesion, such as a giant cell tumor, enchondroma, eosinophilic granuloma, or aneurysmal bone cyst.
The CT scan shows a 3.5 cm2 × 4.0 cm2 expansive neoplasm located in the right TMJ region (a, horizontal plane, white rectangular region), with an expansile osteolytic process that was eroding the mandibular condyle (b, coronal plan, white arrows). MRI results confirmed an irregular neoplasm surrounding the mandibular condyle with an unclear joint space (c, coronal plan, white rectangular region).
After preparation of the patient for surgery, excision of the lesion was carried out using a preauricular approach under general anesthesia. During surgery, a dark red neoplasm, measuring 4 cm in diameter with a hard but elastic consistency, was found. Additionally, the mandibular condyle and disc were surrounded and being eroded by the neoplasm (Figure 2a, white dashed region). Prior to surgery, histological examination of a frozen section was made on a small fragment of the mass, which revealed a low-grade malignant neoplasm. Subsequently, complete excision of the neoplasm and reconstruction of the mandibular condyle and disc were carried out.
The mandibular condyle and disc were surrounded and being eroded by the neoplasm (a, white dashed region). A reverse L-shaped osteotomy line was drawn at the posterior part of the ramus. The proximal bone segment was then moved superiorly to reconstruct the mandibular condyle and fixed using an L-shaped miniplate (b, white dashed region shows temporal muscle). (c) A 3D reconstruction of postoperative CT images show the reconstructed mandibular condyle. (d) Depicts the neoplasm (black arrow) and damaged mandibular condyle (white arrow).
The reconstruction technique was the same as we have described in previous literatures [11,12]. Before surgery, the detailed cephalometric analysis and dental model evaluation were performed to fabricate an individual acrylic surgical splint. The splint was fixed between the maxilla and mandible in order to establish a new stable occlusal relationship. A reverse L-shaped osteotomy line was drawn at the posterior part of the ramus. Moreover, the final position of the proximal bone segment in the glenoid fossa was determined by the position of the ramus after the splint was fixed. The proximal bone segment was then moved superiorly to reconstruct the mandibular condyle and fixed using an L-shaped miniplate, while the temporalis myofascial flap was reversed anteroinferiorly to fill into the space. (Figure 2b, white dashed region shows temporal muscle). A 3D reconstruction of postoperative CT images show the reconstructed mandibular condyle (Figure 2c). Figure 2d depicts the neoplasm (black arrow) and damaged mandibular condyle (white arrow). Histologically, the lesion consisted of both polygonal and round mononuclear chondroblasts with grooved nuclei as well as multinucleated giant cells (Figure 3a, black arrows) in an eosinophilic cartilaginous matrix. Only rare mitotic activity was observed. An immunohistochemical stain for S-100 protein was positive in the tumor cells (Figure 3b), suggesting their chondroid differentiation. Based on these findings, the lesion was finally diagnosed as a chondroblastoma of the mandibular condyle. After surgery, the patient recovered hearing in the right ear. A 5-year follow-up showed no signs of recurrence, and the patient was satisfied with the function of the TMJ and was free of pain when opening her mouth.
Histologically, the lesion consisted of both polygonal and round mononuclear chondroblasts with grooved nuclei as well as multinucleated giant cells (a, black arrows) in an eosinophilic cartilaginous matrix. An immunohistochemical stain for S-100 protein was positive in the tumor cells (b).
The patient provided an informed consent to the whole treatment procedure. Further, informed consent was obtained from the patient for the publication of this case report and any accompanying images.
3 Discussion
Chondroblastoma is an unusual benign neoplasm of the bone. It was first reported by Codman in 1931 as a chondromatous giant cell tumor and was renamed benign chondroblastoma by Jaffe and Lichtenstein in 1942 [6,13]. Classic chondroblastomas occur at the ends of long bones, including the proximal tibia, proximal humerus, and distal femur, in children and young adults in their second decade of life, with a male:female ratio of approximately 2:1 [9]. In contrast, chondroblastomas of the craniofacial bone generally occur in older patients with an average of 47.8 years. Chondroblastoma of the craniofacial bone was first reported by Denko and Krauel in 1955 [14]. To date, approximately 60 cases of chondroblastoma of the craniofacial bone have been reported [15]. To date, only 13 cases of chondroblastoma in TMJ have been reported in English literature, of which two involved extraosseous lesions without bone invasion [9,16]. Lesions that occur at the temporomandibular joint can exhibit symptoms of swelling, and other symptoms are similar to those associated with other temporomandibular disorders, such as progressive functional restrictions, including focal pain, joint sound, and limited mouth opening, are the most important warning symptom [17,18], but in this case, facial swelling and hearing impairment were more prominent.
The radiological appearance of chondroblastoma has been described as an osteolytic process with sharply defined sclerotic margins on radiographs. In this case, the enhanced CT scan findings revealed an irregularly lobulated expansile mass with bony destruction. Although commonly reported in the literature [19], calcifications were not evident in the current case. The MRI features, however, are controversial. Flowers et al. reported a chondroblastoma of the skull in which the tumor showed hypointensity on T1-weighted images, hyperintensity on T2-weighted images, and marked contrast enhancement [19]. Kutz et al. [15]. described intermediate signal intensity on T1-weighted images and marked hyperintensity on T2-weighted images in their series. Jee et al. [20]. reported that the solid components of chondroblastomas in long bones usually reveal hypointensities on T2-weighted images, which were attributed to abundant levels of immature chondroid matrix, hemosiderin, and calcifications that were microscopically evident. The features of the tumor in the present case were similar to these previously mentioned observations.
A histopathological examination of chondroblastoma is generally characterized by sheets of polygonal, mononucleated, and neoplastic chondroblasts with thick and sharply defined cell membranes, eosinophilic cytoplasm, and round-to-indented nuclei. Interspersed within the chondroblasts are scattered collections of osteoclast-type giant cells. Also, chondroblastoma typically presents with a pink chondroid matrix and shows a distinctive pericellular deposition of calcium, which creates a “chicken-wire” formation [21]. There was sparse mitosis in this present case, but in some cases of chondroblastoma, high mitotic activity is found.
Chondroblastoma of the bone is presumed to arise from the epiphyseal cartilage prior to complete ossification because of its usual presentation in the second decade [1]. However, Spahr et al. [4] suggested that it originates from the articular hyaline cartilage, because it is anatomically attached to the articular surface of the mandibular condyle, confined to the TMJ region, and arises after the second decade.
The treatment strategies for chondroblastoma in previous cases included total en bloc excision, curettage, irradiation, and surgery combined with radiation. The most effective modality appears to be total excision with or without radiation [9]. The conservative treatment of tumors invading the temporomandibular joint using curettage alone results in a recurrence rate >55% [22]. Radiotherapy must be restricted to incomplete surgical excisions because postradiation sarcoma has been reported previously [23]. There are no reports of metastatic chondroblastoma in craniofacial bones, although there was one case of pulmonary metastasis from a noncraniofacial bone chondroblastoma [1]. Currently, chemotherapy is not a recommended treatment for chondroblastoma. A review of the literature reveals that patients with craniofacial bone chondroblastoma treated with curettage develop unacceptably high rates of recurrent disease that require secondary procedures [9]. Patients who instead undergo either en bloc excision or total resection of the tumor show no evidence of recurrence at an average follow-up of 12 months [9]. The current recommendation for treatment of chondroblastoma is en bloc excision with preservation of important neurovascular structures. Condylar reconstruction can be achieved by Transport Disc Distraction Osteogenesis, costochondral graft, a local pedicled bone graft, rib graft, sternoclavicular graft, or a custom-fitted total joint prosthesis. At present, autogenous costochondral graft is the most commonly used for TMJ reconstruction; however, this method led to some inevitable disadvantages, such as donor site deformity, the second surgical site exploration, and bone resorption [24]. A local pedicled bone graft attached to the medial pterygoid muscle formed by vertical ramus osteotomy is the most commonly used approach in our center because it avoids the second surgical site exploration and donor site deformity, and reduces the bone necrosis or resorption [11,12]. In this case, the proximal bone segment was attached by the medial pterygoid muscle, and this method could improve the stability of bone graft. Moreover, to avoid malocclusion after condylar resection, the mandibular condyle was reconstructed by the superior advancement of the posterior segment of the ramus. In this way, stable occlusion, satisfactory TMJ function, and elimination of pain on mouth opening were observed, and mandibular deviations were alleviated during the follow-up. However, further studies with more cases and longer follow-up period are necessary.
4 Conclusion
Chondroblastoma has been reported so infrequently in the TMJ, more common entities should first be considered in the differential diagnosis of masses in this location. Osteochondroma is the most frequent bone neoplasm in the TMJ. Chondroblastoma is often misdiagnosed as granulation tissue or a giant cell tumor. Additional tools, such as MRI and immunohistochemical analyses, should be used for diagnostic and surgical planning. Because of its high recurrence after surgical curettage, complete surgical excision and long-term follow-up are recommended as the treatment for chondroblastoma.
Abbreviations
- TMJ
-
temporomandibular joint
- CT
-
computed tomography
- MRI
-
magnetic resonance imaging
Acknowledgements
Not applicable.
-
Funding information: This work was supported by the Science Research Cultivation Program of Stomatological Hospital, Southern Medical University (No. PY2020016).
-
Conflict of interest: None declared.
-
Data availability statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
References
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© 2021 Xiaoqin Yang et al., published by De Gruyter
This work is licensed under the Creative Commons Attribution 4.0 International License.
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- Effect of late-onset hemorrhagic cystitis on PFS after haplo-PBSCT
- Comparison of Dako HercepTest and Ventana PATHWAY anti-HER2 (4B5) tests and their correlation with silver in situ hybridization in lung adenocarcinoma
- VSTM1 regulates monocyte/macrophage function via the NF-κB signaling pathway
- Comparison of vaginal birth outcomes in midwifery-led versus physician-led setting: A propensity score-matched analysis
- Treatment of osteoporosis with teriparatide: The Slovenian experience
- New targets of morphine postconditioning protection of the myocardium in ischemia/reperfusion injury: Involvement of HSP90/Akt and C5a/NF-κB
- Superenhancer–transcription factor regulatory network in malignant tumors
- β-Cell function is associated with osteosarcopenia in middle-aged and older nonobese patients with type 2 diabetes: A cross-sectional study
- Clinical features of atypical tuberculosis mimicking bacterial pneumonia
- Proteoglycan-depleted regions of annular injury promote nerve ingrowth in a rabbit disc degeneration model
- Effect of electromagnetic field on abortion: A systematic review and meta-analysis
- miR-150-5p affects AS plaque with ASMC proliferation and migration by STAT1
- MALAT1 promotes malignant pleural mesothelioma by sponging miR-141-3p
- Effects of remifentanil and propofol on distant organ lung injury in an ischemia–reperfusion model
- miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway
- Identification of LIG1 and LIG3 as prognostic biomarkers in breast cancer
- MitoQ inhibits hepatic stellate cell activation and liver fibrosis by enhancing PINK1/parkin-mediated mitophagy
- Dissecting role of founder mutation p.V727M in GNE in Indian HIBM cohort
- circATP2A2 promotes osteosarcoma progression by upregulating MYH9
- Prognostic role of oxytocin receptor in colon adenocarcinoma
- Review Articles
- The function of non-coding RNAs in idiopathic pulmonary fibrosis
- Efficacy and safety of therapeutic plasma exchange in stiff person syndrome
- Role of cesarean section in the development of neonatal gut microbiota: A systematic review
- Small cell lung cancer transformation during antitumor therapies: A systematic review
- Research progress of gut microbiota and frailty syndrome
- Recommendations for outpatient activity in COVID-19 pandemic
- Rapid Communication
- Disparity in clinical characteristics between 2019 novel coronavirus pneumonia and leptospirosis
- Use of microspheres in embolization for unruptured renal angiomyolipomas
- COVID-19 cases with delayed absorption of lung lesion
- A triple combination of treatments on moderate COVID-19
- Social networks and eating disorders during the Covid-19 pandemic
- Letter
- COVID-19, WHO guidelines, pedagogy, and respite
- Inflammatory factors in alveolar lavage fluid from severe COVID-19 pneumonia: PCT and IL-6 in epithelial lining fluid
- COVID-19: Lessons from Norway tragedy must be considered in vaccine rollout planning in least developed/developing countries
- What is the role of plasma cell in the lamina propria of terminal ileum in Good’s syndrome patient?
- Case Report
- Rivaroxaban triggered multifocal intratumoral hemorrhage of the cabozantinib-treated diffuse brain metastases: A case report and review of literature
- CTU findings of duplex kidney in kidney: A rare duplicated renal malformation
- Synchronous primary malignancy of colon cancer and mantle cell lymphoma: A case report
- Sonazoid-enhanced ultrasonography and pathologic characters of CD68 positive cell in primary hepatic perivascular epithelioid cell tumors: A case report and literature review
- Persistent SARS-CoV-2-positive over 4 months in a COVID-19 patient with CHB
- Pulmonary parenchymal involvement caused by Tropheryma whipplei
- Mediastinal mixed germ cell tumor: A case report and literature review
- Ovarian female adnexal tumor of probable Wolffian origin – Case report
- Rare paratesticular aggressive angiomyxoma mimicking an epididymal tumor in an 82-year-old man: Case report
- Perimenopausal giant hydatidiform mole complicated with preeclampsia and hyperthyroidism: A case report and literature review
- Primary orbital ganglioneuroblastoma: A case report
- Primary aortic intimal sarcoma masquerading as intramural hematoma
- Sustained false-positive results for hepatitis A virus immunoglobulin M: A case report and literature review
- Peritoneal loose body presenting as a hepatic mass: A case report and review of the literature
- Chondroblastoma of mandibular condyle: Case report and literature review
- Trauma-induced complete pacemaker lead fracture 8 months prior to hospitalization: A case report
- Primary intradural extramedullary extraosseous Ewing’s sarcoma/peripheral primitive neuroectodermal tumor (PIEES/PNET) of the thoracolumbar spine: A case report and literature review
- Computer-assisted preoperative planning of reduction of and osteosynthesis of scapular fracture: A case report
- High quality of 58-month life in lung cancer patient with brain metastases sequentially treated with gefitinib and osimertinib
- Rapid response of locally advanced oral squamous cell carcinoma to apatinib: A case report
- Retrieval of intrarenal coiled and ruptured guidewire by retrograde intrarenal surgery: A case report and literature review
- Usage of intermingled skin allografts and autografts in a senior patient with major burn injury
- Retraction
- Retraction on “Dihydromyricetin attenuates inflammation through TLR4/NF-kappa B pathway”
- Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part I
- An artificial immune system with bootstrap sampling for the diagnosis of recurrent endometrial cancers
- Breast cancer recurrence prediction with ensemble methods and cost-sensitive learning
Artikel in diesem Heft
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- Rapid Communication
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- Impact of body mass index on left atrial dimension in HOCM patients
- Expression and clinical significance of CMTM1 in hepatocellular carcinoma
- miR-142-5p promotes cervical cancer progression by targeting LMX1A through Wnt/β-catenin pathway
- Comparison of multiple flatfoot indicators in 5–8-year-old children
- Early MRI imaging and follow-up study in cerebral amyloid angiopathy
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- miR-128-3p inhibits apoptosis and inflammation in LPS-induced sepsis by targeting TGFBR2
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- Fertility problems in males carrying an inversion of chromosome 10
- Acute myeloid leukemia with leukemic pleural effusion and high levels of pleural adenosine deaminase: A case report and review of literature
- Metastatic renal Ewing’s sarcoma in adult woman: Case report and review of the literature
- Burkitt-like lymphoma with 11q aberration in a patient with AIDS and a patient without AIDS: Two cases reports and literature review
- Skull hemophilia pseudotumor: A case report
- Judicious use of low-dosage corticosteroids for non-severe COVID-19: A case report
- Adult-onset citrullinaemia type II with liver cirrhosis: A rare cause of hyperammonaemia
- Clinicopathologic features of Good’s syndrome: Two cases and literature review
- Fatal immune-related hepatitis with intrahepatic cholestasis and pneumonia associated with camrelizumab: A case report and literature review
- Research Articles
- Effects of hydroxyethyl starch and gelatin on the risk of acute kidney injury following orthotopic liver transplantation: A multicenter retrospective comparative clinical study
- Significance of nucleic acid positive anal swab in COVID-19 patients
- circAPLP2 promotes colorectal cancer progression by upregulating HELLS by targeting miR-335-5p
- Ratios between circulating myeloid cells and lymphocytes are associated with mortality in severe COVID-19 patients
- Risk factors of left atrial appendage thrombus in patients with non-valvular atrial fibrillation
- Clinical features of hypertensive patients with COVID-19 compared with a normotensive group: Single-center experience in China
- Surgical myocardial revascularization outcomes in Kawasaki disease: systematic review and meta-analysis
- Decreased chromobox homologue 7 expression is associated with epithelial–mesenchymal transition and poor prognosis in cervical cancer
- FGF16 regulated by miR-520b enhances the cell proliferation of lung cancer
- Platelet-rich fibrin: Basics of biological actions and protocol modifications
- Accurate diagnosis of prostate cancer using logistic regression
- miR-377 inhibition enhances the survival of trophoblast cells via upregulation of FNDC5 in gestational diabetes mellitus
- Prognostic significance of TRIM28 expression in patients with breast carcinoma
- Integrative bioinformatics analysis of KPNA2 in six major human cancers
- Exosomal-mediated transfer of OIP5-AS1 enhanced cell chemoresistance to trastuzumab in breast cancer via up-regulating HMGB3 by sponging miR-381-3p
- A four-lncRNA signature for predicting prognosis of recurrence patients with gastric cancer
- Knockdown of circ_0003204 alleviates oxidative low-density lipoprotein-induced human umbilical vein endothelial cells injury: Circulating RNAs could explain atherosclerosis disease progression
- Propofol postpones colorectal cancer development through circ_0026344/miR-645/Akt/mTOR signal pathway
- Knockdown of lncRNA TapSAKI alleviates LPS-induced injury in HK-2 cells through the miR-205/IRF3 pathway
- COVID-19 severity in relation to sociodemographics and vitamin D use
- Clinical analysis of 11 cases of nocardiosis
- Cis-regulatory elements in conserved non-coding sequences of nuclear receptor genes indicate for crosstalk between endocrine systems
- Four long noncoding RNAs act as biomarkers in lung adenocarcinoma
- Real-world evidence of cytomegalovirus reactivation in non-Hodgkin lymphomas treated with bendamustine-containing regimens
- Relation between IL-8 level and obstructive sleep apnea syndrome
- circAGFG1 sponges miR-28-5p to promote non-small-cell lung cancer progression through modulating HIF-1α level
- Nomogram prediction model for renal anaemia in IgA nephropathy patients
- Effect of antibiotic use on the efficacy of nivolumab in the treatment of advanced/metastatic non-small cell lung cancer: A meta-analysis
- NDRG2 inhibition facilitates angiogenesis of hepatocellular carcinoma
- A nomogram for predicting metabolic steatohepatitis: The combination of NAMPT, RALGDS, GADD45B, FOSL2, RTP3, and RASD1
- Clinical and prognostic features of MMP-2 and VEGF in AEG patients
- The value of miR-510 in the prognosis and development of colon cancer
- Functional implications of PABPC1 in the development of ovarian cancer
- Prognostic value of preoperative inflammation-based predictors in patients with bladder carcinoma after radical cystectomy
- Sublingual immunotherapy increases Treg/Th17 ratio in allergic rhinitis
- Prediction of improvement after anterior cruciate ligament reconstruction
- Effluent Osteopontin levels reflect the peritoneal solute transport rate
- circ_0038467 promotes PM2.5-induced bronchial epithelial cell dysfunction
- Significance of miR-141 and miR-340 in cervical squamous cell carcinoma
- Association between hair cortisol concentration and metabolic syndrome
- Microvessel density as a prognostic indicator of prostate cancer: A systematic review and meta-analysis
- Characteristics of BCR–ABL gene variants in patients of chronic myeloid leukemia
- Knee alterations in rheumatoid arthritis: Comparison of US and MRI
- Long non-coding RNA TUG1 aggravates cerebral ischemia and reperfusion injury by sponging miR-493-3p/miR-410-3p
- lncRNA MALAT1 regulated ATAD2 to facilitate retinoblastoma progression via miR-655-3p
- Development and validation of a nomogram for predicting severity in patients with hemorrhagic fever with renal syndrome: A retrospective study
- Analysis of COVID-19 outbreak origin in China in 2019 using differentiation method for unusual epidemiological events
- Laparoscopic versus open major liver resection for hepatocellular carcinoma: A case-matched analysis of short- and long-term outcomes
- Travelers’ vaccines and their adverse events in Nara, Japan
- Association between Tfh and PGA in children with Henoch–Schönlein purpura
- Can exchange transfusion be replaced by double-LED phototherapy?
- circ_0005962 functions as an oncogene to aggravate NSCLC progression
- Circular RNA VANGL1 knockdown suppressed viability, promoted apoptosis, and increased doxorubicin sensitivity through targeting miR-145-5p to regulate SOX4 in bladder cancer cells
- Serum intact fibroblast growth factor 23 in healthy paediatric population
- Algorithm of rational approach to reconstruction in Fournier’s disease
- A meta-analysis of exosome in the treatment of spinal cord injury
- Src-1 and SP2 promote the proliferation and epithelial–mesenchymal transition of nasopharyngeal carcinoma
- Dexmedetomidine may decrease the bupivacaine toxicity to heart
- Hypoxia stimulates the migration and invasion of osteosarcoma via up-regulating the NUSAP1 expression
- Long noncoding RNA XIST knockdown relieves the injury of microglia cells after spinal cord injury by sponging miR-219-5p
- External fixation via the anterior inferior iliac spine for proximal femoral fractures in young patients
- miR-128-3p reduced acute lung injury induced by sepsis via targeting PEL12
- HAGLR promotes neuron differentiation through the miR-130a-3p-MeCP2 axis
- Phosphoglycerate mutase 2 is elevated in serum of patients with heart failure and correlates with the disease severity and patient’s prognosis
- Cell population data in identifying active tuberculosis and community-acquired pneumonia
- Prognostic value of microRNA-4521 in non-small cell lung cancer and its regulatory effect on tumor progression
- Mean platelet volume and red blood cell distribution width is associated with prognosis in premature neonates with sepsis
- 3D-printed porous scaffold promotes osteogenic differentiation of hADMSCs
- Association of gene polymorphisms with women urinary incontinence
- Influence of COVID-19 pandemic on stress levels of urologic patients
- miR-496 inhibits proliferation via LYN and AKT pathway in gastric cancer
- miR-519d downregulates LEP expression to inhibit preeclampsia development
- Comparison of single- and triple-port VATS for lung cancer: A meta-analysis
- Fluorescent light energy modulates healing in skin grafted mouse model
- Silencing CDK6-AS1 inhibits LPS-induced inflammatory damage in HK-2 cells
- Predictive effect of DCE-MRI and DWI in brain metastases from NSCLC
- Severe postoperative hyperbilirubinemia in congenital heart disease
- Baicalin improves podocyte injury in rats with diabetic nephropathy by inhibiting PI3K/Akt/mTOR signaling pathway
- Clinical factors predicting ureteral stent failure in patients with external ureteral compression
- Novel H2S donor proglumide-ADT-OH protects HUVECs from ox-LDL-induced injury through NF-κB and JAK/SATA pathway
- Triple-Endobutton and clavicular hook: A propensity score matching analysis
- Long noncoding RNA MIAT inhibits the progression of diabetic nephropathy and the activation of NF-κB pathway in high glucose-treated renal tubular epithelial cells by the miR-182-5p/GPRC5A axis
- Serum exosomal miR-122-5p, GAS, and PGR in the non-invasive diagnosis of CAG
- miR-513b-5p inhibits the proliferation and promotes apoptosis of retinoblastoma cells by targeting TRIB1
- Fer exacerbates renal fibrosis and can be targeted by miR-29c-3p
- The diagnostic and prognostic value of miR-92a in gastric cancer: A systematic review and meta-analysis
- Prognostic value of α2δ1 in hypopharyngeal carcinoma: A retrospective study
- No significant benefit of moderate-dose vitamin C on severe COVID-19 cases
- circ_0000467 promotes the proliferation, metastasis, and angiogenesis in colorectal cancer cells through regulating KLF12 expression by sponging miR-4766-5p
- Downregulation of RAB7 and Caveolin-1 increases MMP-2 activity in renal tubular epithelial cells under hypoxic conditions
- Educational program for orthopedic surgeons’ influences for osteoporosis
- Expression and function analysis of CRABP2 and FABP5, and their ratio in esophageal squamous cell carcinoma
- GJA1 promotes hepatocellular carcinoma progression by mediating TGF-β-induced activation and the epithelial–mesenchymal transition of hepatic stellate cells
- lncRNA-ZFAS1 promotes the progression of endometrial carcinoma by targeting miR-34b to regulate VEGFA expression
- Anticoagulation is the answer in treating noncritical COVID-19 patients
- Effect of late-onset hemorrhagic cystitis on PFS after haplo-PBSCT
- Comparison of Dako HercepTest and Ventana PATHWAY anti-HER2 (4B5) tests and their correlation with silver in situ hybridization in lung adenocarcinoma
- VSTM1 regulates monocyte/macrophage function via the NF-κB signaling pathway
- Comparison of vaginal birth outcomes in midwifery-led versus physician-led setting: A propensity score-matched analysis
- Treatment of osteoporosis with teriparatide: The Slovenian experience
- New targets of morphine postconditioning protection of the myocardium in ischemia/reperfusion injury: Involvement of HSP90/Akt and C5a/NF-κB
- Superenhancer–transcription factor regulatory network in malignant tumors
- β-Cell function is associated with osteosarcopenia in middle-aged and older nonobese patients with type 2 diabetes: A cross-sectional study
- Clinical features of atypical tuberculosis mimicking bacterial pneumonia
- Proteoglycan-depleted regions of annular injury promote nerve ingrowth in a rabbit disc degeneration model
- Effect of electromagnetic field on abortion: A systematic review and meta-analysis
- miR-150-5p affects AS plaque with ASMC proliferation and migration by STAT1
- MALAT1 promotes malignant pleural mesothelioma by sponging miR-141-3p
- Effects of remifentanil and propofol on distant organ lung injury in an ischemia–reperfusion model
- miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway
- Identification of LIG1 and LIG3 as prognostic biomarkers in breast cancer
- MitoQ inhibits hepatic stellate cell activation and liver fibrosis by enhancing PINK1/parkin-mediated mitophagy
- Dissecting role of founder mutation p.V727M in GNE in Indian HIBM cohort
- circATP2A2 promotes osteosarcoma progression by upregulating MYH9
- Prognostic role of oxytocin receptor in colon adenocarcinoma
- Review Articles
- The function of non-coding RNAs in idiopathic pulmonary fibrosis
- Efficacy and safety of therapeutic plasma exchange in stiff person syndrome
- Role of cesarean section in the development of neonatal gut microbiota: A systematic review
- Small cell lung cancer transformation during antitumor therapies: A systematic review
- Research progress of gut microbiota and frailty syndrome
- Recommendations for outpatient activity in COVID-19 pandemic
- Rapid Communication
- Disparity in clinical characteristics between 2019 novel coronavirus pneumonia and leptospirosis
- Use of microspheres in embolization for unruptured renal angiomyolipomas
- COVID-19 cases with delayed absorption of lung lesion
- A triple combination of treatments on moderate COVID-19
- Social networks and eating disorders during the Covid-19 pandemic
- Letter
- COVID-19, WHO guidelines, pedagogy, and respite
- Inflammatory factors in alveolar lavage fluid from severe COVID-19 pneumonia: PCT and IL-6 in epithelial lining fluid
- COVID-19: Lessons from Norway tragedy must be considered in vaccine rollout planning in least developed/developing countries
- What is the role of plasma cell in the lamina propria of terminal ileum in Good’s syndrome patient?
- Case Report
- Rivaroxaban triggered multifocal intratumoral hemorrhage of the cabozantinib-treated diffuse brain metastases: A case report and review of literature
- CTU findings of duplex kidney in kidney: A rare duplicated renal malformation
- Synchronous primary malignancy of colon cancer and mantle cell lymphoma: A case report
- Sonazoid-enhanced ultrasonography and pathologic characters of CD68 positive cell in primary hepatic perivascular epithelioid cell tumors: A case report and literature review
- Persistent SARS-CoV-2-positive over 4 months in a COVID-19 patient with CHB
- Pulmonary parenchymal involvement caused by Tropheryma whipplei
- Mediastinal mixed germ cell tumor: A case report and literature review
- Ovarian female adnexal tumor of probable Wolffian origin – Case report
- Rare paratesticular aggressive angiomyxoma mimicking an epididymal tumor in an 82-year-old man: Case report
- Perimenopausal giant hydatidiform mole complicated with preeclampsia and hyperthyroidism: A case report and literature review
- Primary orbital ganglioneuroblastoma: A case report
- Primary aortic intimal sarcoma masquerading as intramural hematoma
- Sustained false-positive results for hepatitis A virus immunoglobulin M: A case report and literature review
- Peritoneal loose body presenting as a hepatic mass: A case report and review of the literature
- Chondroblastoma of mandibular condyle: Case report and literature review
- Trauma-induced complete pacemaker lead fracture 8 months prior to hospitalization: A case report
- Primary intradural extramedullary extraosseous Ewing’s sarcoma/peripheral primitive neuroectodermal tumor (PIEES/PNET) of the thoracolumbar spine: A case report and literature review
- Computer-assisted preoperative planning of reduction of and osteosynthesis of scapular fracture: A case report
- High quality of 58-month life in lung cancer patient with brain metastases sequentially treated with gefitinib and osimertinib
- Rapid response of locally advanced oral squamous cell carcinoma to apatinib: A case report
- Retrieval of intrarenal coiled and ruptured guidewire by retrograde intrarenal surgery: A case report and literature review
- Usage of intermingled skin allografts and autografts in a senior patient with major burn injury
- Retraction
- Retraction on “Dihydromyricetin attenuates inflammation through TLR4/NF-kappa B pathway”
- Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part I
- An artificial immune system with bootstrap sampling for the diagnosis of recurrent endometrial cancers
- Breast cancer recurrence prediction with ensemble methods and cost-sensitive learning
