Epulis - Clinical Appearance and Histopathological Analysis

Epulis je benigna promjena na gingivi koja vanjskim izgledom djeluje kao tumor, a po histološkoj slici više odgovara prijelaznim oblicima upalnoga procesa. Pojavljuje se u nekoliko histoloških slika: Epulis gigantocellularis, Epulis granulomatosa, Epulis fibromatosa, kongenitalni epulis, Epulis gravidarum, Epulis haemangiomatosa, Epulis fissuratum, papilarna hiperplazija, piogeni granulom i iritacijski fibrom. Epulis se pojavljuje dvostruko češće u žena nego u muškaraca, nešto češće se javlja u gornjoj čeljusti, a podudarnost kliničke i patohistološke dijagnoze je 48%. Obrađene su kliničke i patohistološke dijagnoze u razdoblju od šest godina da bi se dobio uvid u zastupljenost epulisa kao opisnoga termina među kliničkim dijagnozama. Takvo sabiranje različitih procesa pod jedno ime, koje je nastalo na temelju lokalizacije, bez histopatološke provjere ne daje pravu sliku u kojem se postotku javlja u kliničkoj praksi. Za razlikovanje epulisa od drugih sličnih stanja na gingivi kao najvažnija metoda rabi se patohistološka raščlamba. Važnost epulisa je u tome što je to razmjerno česta tvorba pod čijom sličnom kliničkom slikom može biti različita histopatološka građa i upravo provjerom te građe od patologa kirurg dobiva i opravdanje za operativni zahvat. Iz navedenoga slijedi da bi ponovno uvođenje preciznoga nazivlja patoloških promjena i njihovo jasno patohistološko obrađivanje uvelike pridonijelo da se donese ispravna dijagnoza, a time i primijeni odgovarajuća terapija.Epulis is a benign lesion on the gingiva whose external appearance resembles a tumour, while histologically it looks more like a transitional form of an inflammatory process. It occurs in several histological forms: Epulis gigantocellularis, Epulis granulomatosa, Epulis fibromatosa, congenital epulis, epulis gravidarum, Epulis haemangiomatosa, Epulis fissuratum, papilarna hyperplasia, piogeno granulom and irritative fibroma. Epulis occurs twice as often in women than in men, and slightly more frequently in the upper jaw, and conformity of clinical and histopathological diagnoses is 48%. Clinical and histopathological diagnoses were analysed during a period of six years in order to obtain insight into the frequency of epulis as the described term among the clinical diagnoses. Such a collection of different processes under one name, which emerged on the basis of localisation, without histopathological confirmation, does not offer the correct information on the percentage in which it occurs in clinical practice. Histopathological analysis is used as the most important method for differentiating epulis from other similar conditions on the gingiva. The importance of epulis is that it is a relatively frequent formation, under whose similar clinical appearance can be different histopathological material, and verification of this material on the part of the pathologist, provides the surgeon with justification for performing the operation. From the foregoing it follows that the introduction of precise terms for such pathological lesions and their correct histopathological analysis would greatly contribute to correct diagnosis, and consequently the application of appropriate therapy

Schwannoma with secondary erosion of mandible: case report with a review of the literature

Schwannoma (neurilemmoma) is a common, histologically distinctive, benign, usually encapsulated, peripheral nerve tumour of Schwann cell origin. We report a case of schwannoma arising from soft tissue near the mandible. A 53-year-old female presented at our department with painless swelling of lingual mucosa of the mandible. The first molar was extracted 20 months before. Panoramic radiograph showed a suspected residual cyst. It was impossible to determine prior to surgery whether this was a peripheral nerve sheath tumour. The lesion was completely removed; the tumour appears to have originated in soft tissue and caused secondary erosion of the mandible