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Treatment of oral ranula in HIV-positive patient
Authors:Yusuke Kusano  Ryoukichi Ikeda  Yutaro Saito  Muneharu Yamazaki  Yutaka Tateda  Shiori Kitaya  Fumi Shoji  Takahiro Suzuki  Naoya Noguchi  Masafumi Seki  Nobuo Ohta
Affiliation:1. Division of Otolaryngology, Tohoku Medical and Pharmaceutical University, Sendai 981-0905, Japan;2. Division of Infectious diseases and infection control, Tohoku Medical and Pharmaceutical University, Sendai 981–0905, Japan;1. Department of Otolaryngology - Head and Neck Surgery, University of Modena and Reggio Emilia, University Hospital of Modena, Via del Pozzo 71, Modena, Italy;2. PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, IRCCS - Arcispedale Santa Maria Nuova, Viale Risorgimento 80, Reggio Emilia, Italy;3. Department of Otolaryngology Head and Neck Surgery, Ospedale Maggiore, Largo Nigrisoli 2, Bologna, Italy;1. Departments of Otolaryngology, Japanese Red Cross Society Himeji Hospital, 12-1 Shimoteno 1-Chome, Himeji City, Hyogo 670-8540, Japan;2. Department of Otolaryngology Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama City, Okayama 700-8558, Japan;3. Departments of Pathology, Japanese Red Cross Society Himeji Hospital, 12-1 Shimoteno 1-Chome, Himeji City, Hyogo 670-8540, Japan;4. Departments of Inspection technology, Japanese Red Cross Society Himeji Hospital, 12-1 Shimoteno 1-Chome, Himeji City, Hyogo 670-8540, Japan;1. Department of Cardiology, University Hospital IRCCS Fondazione Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy;2. Centre for Inherited Cardiovascular Diseases, University Hospital IRCCS Fondazione Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy;1. Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, North 15 West 7, Sapporo 060-8638, Japan;2. Royal National Throat Nose and Ear Hospital, UCLH Foundation Trust, London, United Kingdom;3. Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA;4. Division of Head and Neck Surgery, University of São Paulo Medical School and Department of Head and Neck Surgery and Otolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil;5. Department of Head and Neck Surgery and Otolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil;6. Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland;7. Department of Otolaryngology, Hospital Universitario Central de Asturias, ISPA, IUOPA, University of Oviedo, CIBERONC, Oviedo, Spain;8. University of Udine School of Medicine, Udine, Italy;9. Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA;10. International Head and Neck Scientific Group, Padua, Italy
Abstract:HIV-associated salivary gland disease refers to the pathology in head and neck lesions such as ranula, salivary gland swelling, xerostomia, and benign lymphoepithelial cysts in the parotid gland. Here, we present a unique case of the ranula patient with HIV infection treated with OK-423 sclerotherapy. Case report: The patient was a 42-year-old Japanese male with a few months history of oral floor swelling. Computed tomography (CT) showed a low-density area limited within the right floor of the mouth. Magnetic resonance imaging (MRI) revealed a distinct T2-high intensity area localized on the same location. The puncture fluid was bloody mucus, and the cytology was no malignancy. We diagnosed a simple ranula. He was, however, found to be HIV-antibody positive at the examination before treatment by chance. He was referred to the department of infectious diseases and definitively diagnosed HIV infection by western blot. We chose OK-432 sclerotherapy because of its minimally invasive and the risk of HIV infecting medical staff. Two times OK-432 injection made the lesion disappear. Conclusion: The case indicated that OK-432 sclerotherapy could be effective for ranula related to HIV.
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