Recurrent right sublingual ranula, concomitant with ipsilateral submandibular salivary gland aplasia

AbstractINTRODUCTIONOral ranula is a retention cyst that arises from the salivary gland with recurrence rate of up to 25% after complete excision of ranula and up to 2% in case of complete excision of ranula and sublingual gland.Major salivary gland aplasia is a rare finding that is usually associated with other developmental anomalies.PRESENTATION OF CASEWe report a 15-year-old female patient presented with recurrent intraoral cystic swelling that was documented to be sublingual ranula. CT scan revealed also the absence of right submandibular salivary gland with persistence of its Whartons duct. This combination has never been reported previously.DISCUSSIONThe combination of recurrent sublingual ranula associated with aplasia of ipsilateral submandibular salivary gland and persistence of Whartons duct has never been reported before in the literature, a finding that may provide the base for future research.CONCLUSIONFurther research may prove similar associations between oral ranula and salivary gland aplasia, which may have clinical implications on diagnostic and management plan decisions

Correlation between clinical and magnetic resonance imaging (MRI) findings in temporomandibular disorders

This study was carried out to determine the value of Magnetic resonance imaging (MRI) as a diagnostic tool in patients with temporomandibular disorders. The clinical presentation and MRI findings on 88 temporomandibular joints belonging to 44 symptomatic patients were retrospectively studied. The disk position, configuration and signal intensity; mandibular condyle morphology and signal intensity; temporomandibular joint space and surrounding soft tissue abnormality were assessed. The correlation between the clinical and MRI findings was statistically analyzed using Fisher's exact (1-sided) test. Pain in the temporomandibular region was the most common clinical presentation, it accounts for 64% of cases. There was significant correlation between pain, and disc displacement with no reduction (DDWNR) and condylar hyperlaxity (p = 0.04, 0.03, respectively), as well as between clicking and each type of DD (p = 0.00). Statistically significant relationship was also found between tenderness, and DDWNR and presence of joint effusion (p = 0.02, 0.03, respectively) as well as between limitation of mouth opening and condylar marrow edema (p = 0.02). Causes of temporomandibular disorders can be well defined by clinical examination. However, MRI can be preserved for patients with pain in whom an initial medical conservative oral treatment failed in order to exclude other pathological process

Intrasplenic Arterial Aneurysms during Pregnancy

Splenic artery aneurysms account for about 60% of all visceral aneurysms. Pregnancy is a risk factor for splenic artery aneurysms rupture with high maternal mortality and fetal loss. Intrasplenic arterial aneurysms are extremely rare and have not been reported to be associated with pregnancy. This report presents a 34-year-old woman during the second trimester, admitted with severe left upper quadrant and left shoulder pain. She had two uncomplicated intrasplenic aneurysms. Splenectomy was done. She delivered a full term healthy girl. This is the first report of acute abdomen during pregnancy caused by intrasplenic artery aneurysms with maternal and fetal survival

Utility of free prostate specific antigen serum level and its related parameters in the diagnosis of prostate cancer

We evaluated the role of free prostate specific antigen (f-PSA) serum level and its related parameters in detecting prostate cancer. This retrospective study was conducted between January 2006 and March 2008. Trans-rectal ultrasound guided prostate biopsy was performed for 107 patients who had total PSA (t-PSA) level of either >4 ng/mL with or without palpable nodule or ≤4 ng/mL with palpable nodule on digital rectal examination. The perfor-mance measurements for f-PSA, percent free PSA (%f-PSA) and free PSA density (f-PSAD) were determined and compared with those for t-PSA and total PSA density (t-PSAD). Descriptive statistics for all variables of interest were calculated, and receiver operating characteristic curves were generated. Nine patients (8.4%) had normal histology, 69 patients (64.4%) had benign disease and 29 patients (27.1%) had prostate cancer. The performance of f-PSA in PCa detection was better than other evaluated parameters. The largest area under the curve for patients in the gray area (t-PSA range 4.1-10 ng/mL) was for f-PSA, with a value of 0.64 and a sensitivity and specificity of 44% and 87%, respectively. For %f-PSA, these values were 0.59, 63% and 62%, respectively. For patients with a t-PSA level of 10.1-20 ng/mL, they were 0.68, 67%, and 81%, respectively, for f-PSA, and 0.64, 67%, and 76%, respectively, for %f-PSA. In conclusion, f-PSA serum levels performed better than free to total PSA ratio and t-PSA for prostate cancer screening. It is of clinical value which could affect the biopsy decision avoiding unnecessary interventions