Primary tuberculosis of the TMJ: presentation of a case and literature review

Tuberculosis (TB) is a frequent health problem. The prevalence of extrapulmonary TB has increased in the last couple of years. Head and neck tuberculosis forms nearly 10% of all extrapulmonary manifestations of the disease. TB of the temporomandibular joint (TMJ) is rare; only a few cases have been reported. The clinical appearance of TB infection of the TMJ has been described as unspecific, resembling arthritis, osteomyelitis, cancer or any kind of chronic joint diseases. This article describes a 22-year-old woman with pain and left preauricular swelling. Magnetic resonance imaging and computed tomography showed an expansive process with destruction of the left condyle and condylar fossa. A fine needle aspiration examination of the swelling showed non-specific granulomatous inflammation. In the following days, a preauricular fistula developed, of which a swab and biopsy specimens were taken. Histological and microbiological examinations revealed an infection with Mycobacterium tuberculosis. The initial antituberculosis treatment consisted of a combination of four antibiotics and could be reduced to two antibiotics in the course of treatment. The treatment was completed successfully after 9 months.     

Primary orbital liposarcoma: case report and review of the literature

Primary orbital liposarcoma is an extraordinarily rare tumour. Lack of specific diagnostic findings, scarcity of published series and a primary anatomical location make its management complicated. Surgery should conserve visual function in well located, low-grade tumours that do not invade ocular structures. Complementary RT should also be performed.     

Primary tuberculosis of the tongue: a case report

AIM: The purpose of this article is to report a rare case of primary tuberculosis of the tongue. BACKGROUND: Tuberculosis is an infectious, chronic granulomatous disease that can involve almost any organ in the body, but primary lesions are usually confined to the lungs. Oral lesions are an infrequent occurrence in tuberculosis, and tuberculosis of the oral cavity is often a consequence of active pulmonary tuberculosis. Although primary tuberculosis in the oral cavity has been documented, it is a rare occurrence. REPORT: A 42-year-old male patient presented with chief complaints of severe pain and ulceration on the ventrolateral surface of the left side of the tongue, measuring about 1.25 x 1.50 cm with surrounding erythema and induration of one-month duration. The ulcer was initially painless but became painful later with increased severity over time. The sore tongue caused difficulty in eating, drinking, swallowing, and even talking. The patient also complained of malaise for some duration, but there was no history of fever, cough, weight loss, and his bladder-bowel habits were normal. An excisional biopsy differentiated the lesion from squamous cell carcinoma and confirmed the diagnosis. SUMMARY: Even though primary tuberculosis in the oral cavity is a rare finding, it must be included in the differential diagnosis of mucosal lesions. This case provides a clinical example of the importance of this inclusion for the well being of the patient and for the community due to the communicable nature of the disease.     

Ectopic lingual thyroid: a case report

A rare case of lingual thyroid of massive size is being reported in a 28-year-old female patient who presented with dysphonia, fullness in the throat, dysphagia and breathing difficulties. Fibre-optic nasopharyngoscopy revealed a sessile mass occupying the whole of the oro and hypopharynx. The mass was excised and histopathological examination was reported as thyroid tissue. Postoperatively the patient remained euthyroid and did not require thyroxine supplements since the hypoplastic thyroid gland in the prelaryngeal region remained functional.     

Phantom bite: a case report and literature review

Objective:

Phantom bite is a rare and challenging condition that dentists may encounter in their daily clinical practice. Patients with phantom bite typically present with many failed repeated occlusal treatments, such as full-mouth prosthetic reconstructions and orthodontic treatments, to overcome their distressing symptoms.

Method and result:

A 55-year-old female with no history of medical problems presented with bite discomfort. She complained of discomfort from a “bite” and pressure-like feeling in her right upper three maxillary posterior teeth. Examination revealed no temporomandibular disorder (TMD) abnormalities. A thorough evaluation of her oral structures revealed no dental, periodontal, or mucosal pathologies.

Conclusion:

Owing to the great potential of conditions for financial loss and litigation problems, dentists, particularly those who perform bite-changing procedures, should be aware of this condition. This case is presented to highlight many of the clinical characteristics of phantom bite.     

Intraoral perineurioma: report of a case with a review of the literature

Perineurioma is a rare benign peripheral nerve sheath tumour that occurs as an intraneural or extraneural form. To the best of our knowledge, this is the second reported case of an intraoral submucosal extraneural perineurioma. The tumour was symptomless, measured 2 cm in diameter and occurred in the nasolabial fold of a 46-year-old black female. Awareness of the occurrence of this neoplasm in the oral cavity is important to promote detection and differentiation from other benign spindle tumours, which occur intraorally. All reported cases of perineurioma have been benign and cure is effected by localized surgical excision.     

Oral myiasis: a case report and literature review

Myiasis is the infestation of tissues and organs of animals and humans by certain Dipteran fly larvae. This phenomenon is well documented in the skin, especially among animals and people in tropical and subtropical areas. Oral myiasis is a rare condition and can be caused by several species of Dipteran fly larvae and may be secondary to serious medical conditions. Upon removal of the larvae, the tissues seem to recover with no subsequent complications and with no need for further treatment. Here we describe a case of oral myiasis within the gingiva of a healthy young man caused by the larvae of Wohlfahrtia magnifica (Family Sarcophagidae), in which infection may have been due to ingestion of infested flesh. Reviewing the literature revealed that most cases of oral myiasis tend to be multiple and to occur in anterior segments of the jaws rather than in posterior segments as in the case we describe here.     

Hereditary angioedema: a case report and literature review

Hereditary angioedema is an autosomal dominant condition with a typical presentation of diffuse edematous, painless, and nonpitting swelling of the soft tissues. The disease manifests itself primarily in the extremities, face, airway, and abdominal viscera. Proper diagnosis and treatment are essential as this condition has the capacity of becoming life-threatening due to potential airway embarrassment. This case report demonstrates the complexity of diagnosing and treating hereditary angioedema. Hereditary angioedema often is overlooked on a differential diagnosis of patients suffering from diffuse swelling and/or abdominal discomfort. Nonetheless, the diagnosis of hereditary angioedema should be included when assessing patients who display the proper symptomology and familial history of the condition.     

传染性单核细胞增多症一例及文献复习

传染性单核细胞增多症（IM）是一类常见的由EB病毒感染所引起的急性传染性疾病,由于临床表现缺乏特异性,常被误诊。本文报道1例以颈部淋巴结肿大为首发症状的IM,结合文献对该疾病的临床表现、病原学诊断、抗病毒治疗及激素治疗方面进行讨论、分析。     

Oral pemphigus vulgaris: a case report with review of the literature

Pemphigus vulgaris is a chronic autoimmune mucocutaneous disease that initially manifests in the form of intraoral lesions, which spread to other mucous membranes and the skin. The etiology of pemphigus vulgaris is still unknown, although the disease has attracted considerable interest. The pemphigus group of diseases is characterized by the production of autoantibodies against intercellular substances and is thus classified as autoimmune diseases. Most patients are initially misdiagnosed and improperly treated for many months or even years. Dental professionals must be sufficiently familiar with the clinical manifestations of pemphigus vulgaris to ensure early diagnosis and treatment, since this in turn determines the prognosis and course of the disease. Here, we report a case of pemphigus vulgaris that was misdiagnosed in its earliest stage.     

Erythema multiforme: a literature review and case report

Erythema multiforme is a florid mucocutaneous disease characterized by oral, cutaneous, and ocular manifestations. The cutaneous lesions are pathognomonic because of their unique "target-like" appearance. A severe form of EM has been termed "Stevens-Johnson Syndrome". Although the etiology of EM is unknown, much of the research suggests an immunological association with HSV. The diagnosis of EM is based on signs and symptoms, and a differential diagnosis should include other ulcerative, mucocutaneous diseases, such as erosive lichen planus, pemphigus, varicella zoster, ANUG, TEN, aphthous stomatitis, and primary HSV. Therapeutic measures are palliative, including a soft bland diet, topical anesthetics, and corticosteroids. A case of EM is described which underscores the appearance of the disease and its clinical course.     

Osteoplastic ameloblastoma: a case report and literature review

Ameloblastoma with bone formation is rare. We report a case of a 55-year-old woman with ameloblastoma accompanied by prominent osteoplasia. Histopathological examination exhibited an abundant stromal component between tumor nests. Therefore, she was diagnosed as the desmoplastic variant, except for the numerous bone trabeculae. The distinction between new bone formation and invasion of the bone marrow poses a problem. A thin rim of fibrous bone that can be accentuated by Masson-trichrome staining suggests the former.     

Endodontic-related paresthesia: a case report and literature review

Introduction

Endodontic-related paresthesia is a potential complication despite the development of endodontic materials and techniques. We describe a case of periapical lesion-induced paresthesia that was successfully treated endodontically. The literature review of endodontic-related paresthesia is also presented.

Methods

The patient sought treatment from a general practitioner for lower lip paresthesia as the only symptom. Paresthesia was present on the left side of the lower lip extending from the mandibular midline to the second premolar both extraorally and intraorally in the area of mental nerve stem. Apical lesion of an endodontically treated second premolar with short obturation was observed radiographically. Retreatment was unsuccessful at reaching the apex; instead, swelling, pain, and extension of numbness on the region resulted, and the patient was referred to an endodontist.

Results

The root canal chemomechanical debridement was completed, and calcium hydroxide was placed for the follow-up. Two months later the symptoms had significantly improved, the radiograph indicated partial healing, and the tooth was obturated. The healing progressed so that the symptoms completely resolved within a year after the treatment.

Conclusions

Periapical pathosis might cause paresthesia with a good potential for healing after appropriate endodontic treatment. Complications might be prevented by careful preoperative examination, good quality radiographs, and good instrumentation, irrigation, and obturation techniques. However, according to the literature paresthesia might still occur. In case of treatment-related paresthesia in which apical extrusion of endodontic materials is observed, the need for surgical debridement (especially in cases of extrusion of obturation materials) should be considered within 48 hours.     

Invasive rhinomaxillary mucormycosis: a case report with a review of the literature

Mucormycosis is a rare, often fatal disease that is caused by zygomycetes, which are common fungi frequently found in the soil and decaying vegetation. Diabetes mellitus, malnutrition, and an immunocompromised state favor the growth of various microorganisms, including zygomycetes and the normal flora of the oral cavity, which are otherwise nonpathogenic, leading to opportunistic infections. Here we report a case of mucormycosis presenting with extensive necrosis of the maxilla along with rhinocerebral involvement in a 60-year-old patient suffering from uncontrolled diabetes with ketoacidosis.     

Paraneoplastic pemphigus: a case report and review of literature

Paraneoplastic pemphigus (PNP) is an autoimmune mucocutaneous disease frequently associated with lymphoproliferative disorders. The rare combination of the disease with other malignancies such as different types of carcinomas, sarcomas, melanoma and skin tumours has also been reported. Most patients develop very severe oral ulceration and conjunctival ulceration with or without genital ulceration resembling the features of Steven's Johnson's syndrome or most severe forms of drug eruptions. The possibility of PNP should be borne in mind when a patient presents with extensive oral ulceration if clinical, histopathological and results of direct immunofluorescence are not pathognomonic for a specific diagnosis. The issue becomes even more important as some patients with PNP have no diagnosed malignancy at the time of presentation. We document a case of PNP in a 29-year-old female who suffers from non-Hodgkin's lymphoma.     

Juvenile dermatomyositis: literature review and report of a case

Dermatomyositis is a rare disease of unknown origin, which affects both children and adults. In the juvenile form, dermatomyositis is a multisystem disease, characterized by myositis; an erythematous rash over the bridge of the nose, around the eyes, and on the trunk and limbs; vasculitis; and dilatation of the capillaries in the nail beds and gum margin. Late development of calcinosis is seen in approximately two-thirds of the patients. This case describes a 5-year-old dental patient diagnosed with dermatomyositis. This article includes the clinical manifestations of dermatomyositis in the body and in the oral cavity as well as the considerations that should be taken when treating these patients.     

Primary cheiloplasty on an elderly man: case report and review of the literature

It is rare for surgeons in the United States to perform primary repair of a cleft lip on an adult. However, in developing nations with limited specialized health care, late presentation for primary cheiloplasty occurs due to limitations in access to care, lack of awareness of treatment availability, and inability to afford treatment. Oral and maxillofacial surgeons who participate in humanitarian surgical mission trips to the developing world may encounter this subpopulation of cleft patients. The following case report describes the repair of an incomplete bilateral cleft lip in a 68-year-old man performed during a mission trip to rural Bangladesh. Based on an extensive literature search, this is the oldest patient to have undergone primary cheiloplasty reported in the English-language surgical literature.     

Primary tuberculosis clinically presenting as gingival enlargement: a case report

Tuberculosis is a chronic systemic granulomatous disease which rarely affects the oral cavity. Oral lesions can be either primary or secondary to systemic tuberculosis, the former being rare. This is a never-before reported case of primary tuberculosis presenting as a localized diffuse gingival enlargement in an 11-year-old Indian female patient. The diagnosis was reached through identification of positive histopathological features, Tuberculin test results, presence of anti-tubercular antibodies confirmed by a polymerase chain reaction. In view of the recent increase in the incidence of tuberculosis and the prevalence of the same, it is reasonable to include tuberculosis in the differential diagnosis of gingival enlargements. This is essential to avoid any serious complications for both the clinician and patient due to a delay in the diagnosis of such a rare but plausible oral condition.