An unusual case of a glandular odontogenic cyst

A case of an adult Nigerian female patient, who was found to have an unusual lesion, namely a glandular odontogenic cyst of the anterior mandible, is described. This lesion was found to be an extensive intra-bony lesion with alveolar expansion and was initially associated with infection and mobile teeth. Treatment for this ranges from curettage to block excision. There is a significant recurrence rate for these lesions and long-term follow-up is advised. CLINICAL RELEVANCE: This case highlights that a high index of suspicion is needed for unusual pathology.     

Single-step apical barrier placement in immature teeth using mineral trioxide aggregate and management of periapical inflammatory lesion using platelet-rich plasma and hydroxyapatite

We present here a case report of a tooth with an immature root with a large periapical lesion. The open apex was managed by placing an apical barrier using mineral trioxide aggregate, and the periapical lesion was treated surgically. A combination of platelet-rich plasma (PRP) and hydroxyapatite graft (HA) was used to achieve faster healing of the periapical lesion. The case was followed up for 11 months. The indications and advantages of apical barrier placement, periapical surgery, and the role of PRP and HA in postsurgical healing are discussed.     

Central odontogenic fibroma. A report of two controversial cases illustrating diagnostic dilemmas

Two unusual cases of central odontogenic fibroma are described and used to illustrate differential diagnostic problems in this controversial group of lesions. The first case had a cystic lesion noted on routine radiography in the left ramus of the mandible. This particular case was unusual histologically as it showed in addition to typical areas of odontogenic fibroma a small inflamed cyst lined by epithelium containing many hyaline bodies. The second case presented with anaesthesia of the right lower lip and an enlarged chin prominence. The lesion was diagnosed as an odontogenic fibroma but with a somewhat unusual histological appearance in that there were abundant areas of osseous metaplasia throughout the lesion.     

Malformazione arterovenosa del margine linguale somigliante a un’ulcera neoplastica: caso clinico e revisione della letteratura

ObjectivesThe purpose of this study is to describe a rare case of arteriovenous malformation (AVM) developed on the tongue of a patient aged 47 years.Materials and methodsThe lesion appeared like an ulcerated swelling on the right margin of the tongue. An incisional biopsy was performed to clarify the nature of the lesion, thought to be malignant. No bleeding was noticed during the biopsy. The lesion was diagnosed as an intramuscular AVM. Arteriogram and embolization of the right lingual artery were performed, then the lesion was totally removed under general anaesthesia.Results and ConclusionsAt 2 years after surgery there was neither clinical nor radiological evidence of recurrence. Diagnosis of AVMs is usually made from anamnesis and examination of the lesions. In this case, a biopsy was performed in order to clarify the nature of a lesion mimicking an oral carcinoma.     

Mandibular hyperostosis. A case report

A case of hyperostosis of the left hemimandible medial face in a young patient is reported. This in an interesting case both for the remarkable size and the location of the lesion and because it was unique and asymmetrical; as a matter of fact this pathology, frequent on the jaws, is usually symmetrical and bilateral. The most probable etiopathogenetic hypothesis for the case presented to our observation seems to be an unknown localized stimulation of osteoblastic cells. Considering its size, the lesion was removed.     

Giant cell fibroma: a case report

This article describes a case of giant cell fibroma in a 3-year-old boy, which is an uncommon age for this lesion. The cause of this pathology has not been determined. The lesion was excised by electro surgery and submitted to a histological exam, which confirmed the diagnosis. No recurrence was observed. Pediatric dentists should be capable to diagnose and treat this kind of lesion despite this lesion being an unusual pathology among children.     

An oral soft tissue lesion associated with a sinus mass

A case of an inflammatory nasal polyp extending through an oroantral fistula and appearing as an intraoral soft tissue lesion is discussed. Although this is apparently a rare occurrence, the nature of the lesion was suggested by the history, clinical appearance, and radiographic findings. Surgical intervention and removal of the inflammatory lesion was followed by complete healing with closure of the oroantral fistula.     

Human labial orf: a case report.

A case of orf in a 59-year-old man with no direct contact with farm animals is reported. The patient presented with an ulcerating lesion on the upper lip and the diagnosis was confirmed by electron microscopy from a smear of the lesion. The unusual case history, differential diagnosis and method of diagnosis are discussed.     

Desmoplastic Trichilemmoma of the Facial Region Mimicking Invasive Carcinoma

Trichilemmoma is a hamartomatous proliferation arising from cells of hair follicle. Its desmoplastic variant simulates an invasive carcinoma. In this tumor, the cell of origin seems to be located in the superficial level of the hair follicle just below the basement membrane at the sebaceous gland level. We present a similar case which presented with an asymptomatic nodular lesion in the region above the upper lip on left side. Fine needle aspiration cytology raised the cytological possibility of a malignancy for which the lesion was excised. On histopathology the lesion was diagnosed as desmoplastic trichilemmoma. The case highlights the difficulty encountered in differentiating a benign adnexal tumor from malignant lesion based on cytology alone. Moreover, the extensive desmoplasia on histopathology raises the suspicion of invasive malignancy which requires to be carefully excluded. The superficial features of trichilemmoma and lack of cellular atypia is a useful diagnostic clue in such a situation. Positivity of CD34 can also be used to differentiate from basal cell carcinomas. The case reported here had a solitary lesion, but follow up is required for development of more lesions or multiple hamartomas in other organs as a part of Cowden’s disease.     

Odontoma-producing intraosseous calcifying odontogenic cyst: case report

The present report describes a case of odontoma-producing intraosseous calcifying odontogenic cyst in a 36-year-old Black male in the right mandibular bicuspid region. The lesion involved an unerupted permanent canine, which was displaced to the mandible base and a calcified mass that was later recognized as an odontoma. The lesion was surgically removed.     

Multiple leiomyomatous hamartoma in the oral cavity

Leiomyomatous hamartoma (LH) is congenital lesion rarely seen in oral cavity. In English literature, all reported cases appeared as solitary lesion in alveolar ridge or the tongue, and there have never been a report showing a case of multiple occurrence of this lesion. A quite rare case of multiple LH occurred in a 2-year-old Japanese boy is presented. A polypoid lesion was presented at incisive papilla and two isolated lesions in the tongue dorsum, one appeared as a polypoid mass in the posterior dorsum and other as a small spindle-shaped agger in the anterior dorsum. All of them were histologically diagnosed as LH.     

Acute leukemia. An atypical case presenting with gingival manifestations.

A case of acute myeloblastic leukemia is reported in which the mode of presentation was an atypical gingival lesion. A definite diagnosis was not made until the patient was in a final stage due to non-diagnostic histologic material. One must be suspicious of any gingival lesion, particulary if there is a sudden onset of bleeding or hyperplasia. Leukemia must be considered even if initial investigations are negative, as in the case presented.     

Effect of unintentionally extruded mineral trioxide aggregate in treatment of root perforation with periradicular lesion: a case report

This case report describes the effect of unintentionally extruded mineral trioxide aggregate (MTA) into periradicular lesions on the prognosis of periradicular healing in maxillary right molar with periradicular lesion. A 39-year-old male patient with a periradicular lesion from the root perforation of his maxillary right first molar was referred to our Department. A root canal retreatment was performed and the root perforation was filled with MTA. During this procedure, an unintentionally extrusion of MTA into the periradicular lesion occurred. At follow-up, the tooth was asymptomatic and at radiography a repair of the lesion was evident. No endodontic surgical treatment was necessary. In this case the healing was possible despite the extrusion of the MTA. This might be due to the biologic properties of the MTA.     

Nonsurgical endodontic treatment of a two-rooted maxillary central incisor

This case report presents an uncommon case of a two-rooted maxillary central incisor with a periapical radiolucent lesion. A 17-yr-old female patient was referred for dental consultation after a motorcycle accident. The maxillary left central incisor had a bifurcated root that was confirmed by radiographs taken at different angles. Nonsurgical endodontic therapy was performed. At the 1 yr recall examination, the tooth was asymptomatic and the radiograph showed that the periapical radiolucent lesion had healed.     

A case of necrotizing sialometaplasia clinically mimicking a malignant tumor of the palate

Necrotizing sialometaplasia is a rare lesion that mimics malignant neoplasm, which is characterized by salivary gland metaplasia, necrosis, and inflammation. We present a case of necrotizing sialometaplasia that presented as an ugly ulcer at the junction of the soft and hard palates; the lesion was clinically suspected to be a malignant lesion.A 62-year-old man was referred to our department with a complaint of severe pain during swallowing. A crater-like ulcer lesion was observed extending from the maxillary tuberosity to the soft palate. Histopathological diagnosis of necrotizing sialometaplasia was confirmed on biopsy. This lesion was spontaneously relieved.     

Primary tuberculosis: an unusual finding in the oral cavity

The unusual involvement of the oral cavity in tuberculosis and the non-specific nature of its presentations mean that diagnosis of tuberculosis is often delayed and is an unexpected finding. The aim of this paper is to present a case of primary tuberculosis and discuss the implications of the manifestations and diagnosis of oral tuberculosis. This paper presents an unusual case of a painless, papillary, erythematous lesion in the anterior region of a maxillary edentulous ridge. When the patient concerned was first seen by the author, the lesion had been present for six months. There was cervical lymphadenopathy and it was diagnosed initially as a malignant lesion. Eventually, after biopsy and ultrasound examination, the diagnosis of primary oral tuberculosis was reached. The patient was managed solely by anti-tubercular drug therapy.     

Plasmacytoma of anterior maxilla mimicking periapical cyst

Abstract An unusual case of plasmacytoma mimicking a large periapical cyst in the anterior maxilla is described. Of the involved teeth, 22 was discoloured and had an open, immature apex, a feature strongly suggestive of the lesion being of pulpal origin. The case was treated by a conservative endodontic approach, but failed to show any improvement. Apical surgery comprising complete enucleation of the cystic lesion and extraction of the involved tooth was carried out. The unexpected histopathological finding was a plasmacytoma.     

Plasma cell granuloma with severe cortical bone destruction of the mandible appearing as a malignant lesion—A case report

We experienced a case of plasma cell granuloma of the mandible appearing as a malignancy in a 22- year-old man. Plasma cell granuloma tends to be diagnosed as a potential malignancy as radiography reveals irregular bone destruction with an obscure margin. Therefore, plasma cell granuloma is classified as an inflammatory pseudotumor which may occur in any organ or soft tissue, including lung, vagina, bladder, and larynx. In the present case, the lesion was initially diagnosed as a malignant lesion on the basis of imaging analysis, but was later diagnosed histopathologically as a inflammatory lesion. This report reinforces the existence of inflammatory pseudotumors in the oral region, as well as the need for clarification of the unknown nature of inflammatory pseudotumors.     

Epithelial inclusion cyst after free gingival graft: a case report

There have been few case reports of cystic lesions occurring after gingival grafting. There are three reports of this type of sequela after connective tissue grafting, but this is the first known case of a cystlike lesion developing secondarily to a free gingival graft procedure. The bulky tissue, which had developed under the previously grafted area, was properly excised under local anesthesia. The small specimen removed was sent for histologic analysis. A new gingival graft was performed immediately after the lesion enucleation, as the cystic lesion had dislocated the earlier graft. The surgical wound healed uneventfully, and no recurrence was seen 18 months later The microscopic sections showed a cystic cavity lined with an orthokeratinized, hyperplastic, stratified squamous epithelium covered with fibrous connective tissue. The development of a cystlike lesion following a free gingival graft is, to date, an unpublished event. The fact that most cystic lesions appear in the mandibular lateral incisor-canine-first premolar area deserves further consideration.     

A lesion of endodontic origin misdiagnosed as a globulomaxillary cyst.

This report presents a case of a lesion originating from a pulpless central incisor misdiagnosed as a globulomaxillary cyst. The initial diagnosis of globulomaxillary cyst was made solely from radiographs by observing an almond-shaped radiolucency between the lateral incisor and cuspid. No pulp testing was performed before surgical removal of the lesion. The final diagnosis of an endodontic lesion caused solely by a pulpless central incisor was complicated by the initial lack of a pulpal response from the lateral incisor next to the surgical site. By delaying the start of endodontic treatment, pulp sensibility returned to the lateral incisor and the diagnosis of an endodontic lesion caused only by a pulpless central incisor was confirmed.