Sinonasal paraganglioma: a case report

Objective

To highlight the importance of a high index of suspicion and meticulous evaluation of a patient with bleeding sinonasal mass in the diagnosis of sinonasal paraganglioma.

Method

Case report of a 39-year-old female who presented with a bleeding lobulated left nasal mass necessitating multiple blood transfusions is presented.

Result

Diagnostic investigations revealed that the patient was HIV-positive (ELISA and Western blot) and a tumour histology of paraganglioma. She had a CD4⁺ count of 487 cells/mm³. The urinary vanillylmandelic acid assay and echocardiography were normal. Subsequently, she had complete tumour excision through a medial maxillectomy and has remained without a recurrence 12 months after.

Conclusion

To our knowledge, this is the first report in the world literature of sinonasal paraganglioma in a HIV-positive patient and the first reported case of sinonasal paraganglioma in Africa. It is, however, not clear from this report if the patient’s HIV status preceded her development of the paraganglioma or not.     

Chronic pain disorder manifesting as dental pain: case report

Chronic pain disorder is a challenging presentation for the dental surgeon, and carries considerable impairment for the affected individual. Patients undergo extensive unnecessary investigations and treatments before the correct diagnosis is reached. It is frequently a diagnosis of exclusion. We report the case of a 46-year-old man who experienced persistent severe orofacial pain superimposed upon pain involving other anatomical regions for more than 20 years. He received treatment by eight specialties and at five national centres with increasingly poor outcome.The importance of early recognition of medically unexplained pain will be discussed. Clinical Relevance: Dentists should have a high index of suspicion of pain disorder in those with multiple complaints of chronic pain in order to avoid unnecessary investigation and treatment.     

A mass lesion misdiagnosed as a malignant tumor in the masticator space: a case report

Temporomandibular disorder (TMD) is common, affecting up to 28 % of the population. Inflammatory conditions, developmental abnormalities, and neoplasms involving the masticator space can result in symptomatic TMD, which may present with signs such as pain and trismus. Because TMD treatments, including surgical management, differ according to the underlying cause, imaging plays an important role in identifying the precise category of TMD. Here, we report a case of an inflammatory lesion in the right cheek of a 47-year-old woman with symptoms of TMD from both clinical and radiographic perspectives. Computed tomography and magnetic resonance imaging in the present case showed atypical findings for TMD caused by an inflammatory lesion. This knowledge should be added to the list of possible imaging findings in cases exhibiting TMD.     

An unusual bilateral cervical paraganglioma: a case report

Paragangliomas are neoplasms originating from paraganglion tissue derived from mesoderm, the most common location being adjacent to carotid bifurcation. Rarely these tumours can be bilateral. We present here a case of bilateral paraganglioma occurring in a young woman. On one side the tumour was arising from the vagus nerve and on the other, from the carotid body. Clinical, radiological and histopathological features and treatment dilemmas are discussed.     

Adenoid cystic carcinoma manifesting as maxillary jaw pain refractory to conventional treatment: a case report

Adenoid cystic carcinoma is an indolent, slow-growing tumor that may first cause low-grade pain in the affected region. This article describes a case involving adenoid cystic carcinoma of the maxilla that was present for approximately nine years. Prior to diagnosis, five dentists reported that the patient had anisocoria, migraine headaches, and low-to-moderate upper jaw pain that was refractory to conventional therapy. A surgical resection was performed; after a period of soft tissue healing, radiation therapy was initiated. The surgical defect was obturated using an interim removable prosthesis while awaiting final reconstruction by a maxillofacial prosthodontist. This article examines possible reasons why this lesion was not diagnosed sooner and discusses how this case should raise the general dentist's awareness of such lesions.     

Mandibular involvement of solitary plasmocytoma: a case report

Plasma cell neoplasms (multiple myeloma, solitary plasmocytoma of bone and extra medullar plasmocytoma) are characterized by a monoclonal neoplastic proliferation of plasma cells. Solitary plasmocytoma of bone (SPB) is a localized form of them. SPB is most frequently seen in vertebrae and secondarily in long bones. Its presence in jaws is extremely rare and when it is seen, angulus and ramus mandible are most common sites of occurrence. Prognosis of SPB is worse than extra medullar plasmacytoma (EMP) and approximately 50% of SPB will transform to multiple myelom. A 76-year old woman consulted to our clinic with a chief complaint of slowly developed swelling in her mandible. She had an operation from caput femur because of plasmocytoma two months before. Panoramic radiography revealed a radiolucent lesion in the mandibular anterior region, 60x35 mm in dimension. Aspiration biopsy was performed and histopathological examination was reported as plasmocytoma. She was referred to the oncology department for treatment but died before the treatment finished.     

Hypoglossal nerve palsy caused by a large vagal paraganglioma: case report

We present a vagal paraganglioma in a 74-year-old woman, who presented with dysphagia, dysarthria and hoarseness.     

Amyloidosis of medium-sized arteries presenting as perioral mass: a case report

We report a case of amyloidosis localized to the medium-sized arteries of the face and presenting as prominent perioral swelling. The condition was identified as primary AL-type amyloidosis on the basis of immunohistochemical reactivity, predominantly for anti-lambda light chain antibody within amyloid deposits. Subsequent radiographic and laboratory evaluation of the patient disclosed multiple myeloma. Although amyloid deposits were subsequently detected in the temporal arteries, evidence of widespread amyloidosis has not been observed after 1 year of follow-up. To the best of our knowledge, this is the first report of myeloma-associated amyloidosis mainly localized to the medium-sized arteries of the face.     

Heterotopic neuroglial tissue as a congenital laterocervical mass: A case report

Heterotopic neuroglial tissue in the head and neck area is a rare clinical entity which can cause airway obstruction and feeding problems during the neonatal period. The case is presented of heterotopic neuroglial tissue as a congenital laterocervical and intraoral mass in a neonate.     

Tonsilloliths appearing as multiple opacities on panoramic imaging: case report

Tonsilloliths are dystrophic calcifications that can form in tonsillar crypts. They can be asymptomatic or a component of tonsillitis. This article presents a case of tonsilloliths that appeared on a panoramic image as multiple opacities.     

Primary oral malignant melanoma: a case report

A rare case of primary oral malignant melanoma with widespread metastasis to nose, lacrimal passages, face and liver has been described.     

A solitary maxillary central incisor treated orthodontically: a case report

The presentation of a solitary maxillary central incisor is reported and its association with other congenital abnormalities discussed. It is an important finding for dental health professionals, since it may indicate the presence of other significant midline congenital abnormalities. It may also indicate the presence of associated disorders that profoundly affect growth and development and which, once identified, may be treated     

上颌骨肿块为首发症状的多发性骨髓瘤1例

多发性骨髓瘤是一种浆细胞恶性增殖性疾病,该疾病较好发于男性患者,好发年龄60~70岁。多发性骨髓瘤的首发症状表现形式多样,病灶累及上下颌骨较为常见,但是以颌骨病灶为首发症状较为罕见,本文描述一位55岁女性患者以右侧上颌骨肿块及颏部麻木为首发临床表现,颌骨增强CT及PET/CT检查,结合病理检查,最终诊断为多发性骨髓瘤,提醒口腔医生遇到无法解释的颌骨肿块或感觉异常时,需将多发性颌骨骨髓瘤纳入鉴别诊断,防止误诊或漏诊。     

Neurofibromatosis and fibrous dysplasia manifesting in the same patient: a rare case report

Neurofibromatosis and fibrous dysplasia show the presence of café‐au‐lait spots, bone lesions, and endocrinopathies. There has been speculation whether neurofibromatosis and fibrous dysplasia are different manifestations of the same disease or if these conditions are in some way related. We provide a case of whether neurofibromatosis and fibrous dysplasia complicated by hyperparathyroidism and osteoporosis.     

Familial malignant osteopetrosis in children: a case report

The clinical, radiological, pathological and laboratory findings of two brothers with autosomal recessive malignant osteopetrosis are presented. Our findings are similar to characteristics previously reported in the literature about patients with osteopetrosis. The 6‐year‐old male patient was pale and had petechiae on his arms and legs. He also had macrocephalia, splenomegaly, severe pancytopenia, genu valgus, hypocalcemia, amaurosis, cessation of physical development, generalized bone sclerosis and recurrent infections with a history of multiple incidences of acute otitis media. Generalized bone sclerosis and irregular sclerosis of the maxilla and mandible were seen on radiographs. The oral mucosa was apparently normal but permanent tooth eruption was delayed although there was early loss of deciduous teeth. The recommended treatment was blood transfusion and therapy with antibiotics when necessary; a bone marrow transplant was not possible due to lack of a compatible donor.