Verruciform Xanthoma: Report of Three Cases

Veruciformni ksantom razmjerno je neuobičajena mukokutana lezija. Većina opisanih slučajeva bila je na mastikatornoj oralnoj mukozi, posebice gingivi. U ovom članku opisana su tri slučaja veruciformnog ksantoma na palatinalnoj gingivi. Lezije su bile male i bezbolne - dvije su bile papilarne, a jedna slična cvjetači. Histološki pregled otkrio je papilomatozu i akantozu povezanu s aglomeracijom ksantomatoznih stanica u papili vezivnog tkiva. Ksantomatozne stanice bile su pozitivne na antitijela CD 68, što upućuje na makrofagno podrijetlo. Sve su lezije bile obrađene konzervativnom kirurškom ekscizijom i nije bilo recidiva. Gledano diferencijalo dijagnostički i patogenetski, prema kliničkoj slici u obzir dolazi verukozni karcinom ili karcinom skvamoznih stanica. Kliničari bi zato trebali poznavati leziju, kako bi se izbjegle nepotrebne opsežne kirurške intervencije.Verruciform xanthoma is a relatively uncommon mucocutaneous lesion. Most of the reported cases occur in masticatory oral mucosa, especially the gingiva. This article reports three cases of verruciform xanthoma, all of which were located in the palatal gingiva. The lesions were small and painless. Two were papillary lesions, and the other was cauliflower-like. Histological examinations revealed papillomatosis and acanthosis associated with xanthoma cell aggregation within connective tissue papillae. Xanthoma cells were positive to CD 68 antibody, indicating a macrophage origin. All lesions were treated by conservative surgical excision, and no recurrence was observed. Differential diagnosis and pathogenesis of verruciform xanthoma are discussed. In some cases, its clinical appearance may resemble verrucous carcinoma or squamous cell carcinoma. Therefore, clinicians should be acquainted with this lesion to avoid an unnecessary excessive surgical intervention

Pleomorphic adenoma of the palate in a child: : a case report

Salivary gland tumors are rare in children and the incidence differs from the adult counterpart. When salivary gland tumors do arise in children, they preferentially affect major salivary glands, but minor salivary gland tumors have also been reported. We reported the first case of palatal pleomorphic adenoma in a 13 year-old child from Thailand. She came to Sawanpracharak hospital with the chief complaint of a swelling at the left side of the palate. The oral mucosa covering the lesion was intact. Occlusal radiograph revealed no bony destruction. Incisional biopsy was performed on this patient. The biopsy showed several ducts which were lined by cuboidal cells. These ducts were surrounded by myoepithelial cells, some of which had the plasmacytoid appearance The patient was treated by wide local excision and no recurrence was observed 8 years after the surgery. Differential diagnoses of a palatal swelling in children and treatment of pleomorphic adenoma at the palate were also discussed

Oral White Sponge Nevus in a Four-Generation Family: Case Report

Bijeli spužvasti nevus ili madež (WSN) rijedak je dobroćudni autosomno dominantni poremećaj obično poput mekane, bijele, spužvaste naslage na mukoznoj membrani, najčešće oralnoj. Pojavljuje se odmah nakon rođenja ili u djetinjstvu, bez obzira na spol. U prikazu je opisan slučaj dječaka u dobi od četiri godine i njegova 42-godišnjeg oca. Obojica su se žalili na bezbolne bijele lezije u usnoj šupljini. Obiteljska i porodična anamneza otkrila je da od osamnaestero članova njihove porodice njih jedanaestero (61,11%) ima WSN. Kliničkim pregledom otkrivena je difuzna, preklopljena, spužvasta bijela naslaga koja je obostrano zahvatila bukalnu sluznicu i druge dijelove oralne sluznice. Histološkim pregledom ustanovljena je akantoza, hiperkeratoza spongioza i eozinofilna kondenzacija u perinuklearnom području spinoznog sloja. Dijagnoza WSN-a postavljena je na temelju pozitivne porodične anamneze tijekom četiriju generacija, te kliničkih i histoloških značajki. Za WSN nema specifične terapije. Iako je bijeli spužvasti madež rijedak, potrebno ga je uključiti u diferencijalnu dijagnozu bijelih lezija u djetinjstvu, posebice u slučaju pozitivne obiteljske anamneze.The aim of the present article was to discuss two different case reports of the extra-oral odontogenic cutaneous sinus tracts with emphasis on their diagnoses and treatment plans. Odontogenic cutaneous sinus is a rare but well documented condition. It is usually misdiagnosed as a local skin lesion and mistreated by multiple surgical excisions and/or systemic antibiotics with eventual recurrence. This is because the primary dental etiology is overlooked. We have described two cases of extraoral cutaneous sinus tract of an odontogenic origin. In both cases there were complaints of pain and purulent/hemorrhagic discharge from the lesions. Clinical and radiological examination showed inactive teeth, which were infected periapically in both cases. Non-surgical endodontic treatment was successful in Case 1. Surgical intervention was performed in Case 2. Both patients responded well and healing was uneventful. An understanding of the pathogenesis of cutaneous sinus tract arising from dental infection will lead to proper early diagnosis and successful treatment

Prevalence of medically compromised conditions in dental patients

Objectives: To study the prevalence of medically compromised conditions in patients seeking dental treatments at the Faculty of Dentistry, Chulalongkorn University. Study design: The fi les of 58,317 patients seeking dental treatments at the Faculty of Dentistry, Chulalongkorn University from 2002-2004 were retrieved and reviewed for medically compromised conditions. Results: From a total of 58,317 patients, 7,167 patients (12.2%) had medically compromised conditions. The fi ve most prevalent conditions in descending order were allergy, hypertension, diabetes mellitus, heart diseases and thyroid diseases. Conclusions: Even though the prevalence of medically compromised conditions in dental patients is not high, dentists should bear in mind that some of the patients may harbor such conditions which are contraindicated for certain dental procedures or medication or require special attention when treating these patients. Therefore, a thorough history taking and careful clinical examinations are mandatory before commencing any dental treatment

Florid osseous dysplasia: report of a case presenting acute cellulitis

In this review, we examined a 45-year-old Asian man who had been diagnosed with florid osseous dysplasia (FOD) of the mandible and acute perimandibular cellulitis. This presentation occurred after a history of off-and-on swellings of the jaw and multiple treatments received at another hospital. An aggressive resection of the jaw was planned;however, the patient denied the treatment and came to our clinic to seek a second opinion. The patient was successfully treated by conservative surgery and antibiotic treatment with preservation of the jaw integrity and the mandibular neurovascular canal. Intraoperatively, a piece of a calcified mass was removed and submitted for histopathological examination. The specimen showed woven bone and densely sclerotic mass of calcified materials exhibiting reversal lines and inflammatory cell infiltration of the connective tissue. The definitive diagnosis was FOD with a secondary infection. Treatments for FOD were discussed

Intracranial extension of Schneiderian inverted papilloma: a case report and literature review

Inverted papilloma is an uncommon primary nasal tumor. Despite its benign nature, this tumor represents three typical characteristics: a high propensity of recurrence, local aggressiveness and association with malignancy. Inverted papilloma can reduce the patient’s quality of life due to compromised nasal function, extension to the orbit and brain. The authors reported the unusual case of a 72-year-old male patient with inverted papilloma, which fatally extended to the intracranial temporal fossa after multiple recurrences. To the authors’ knowledge, this is the twelfth case in the literature of inverted papilla extending into the temporal fossa. The current and pertinent literature in English, French and German was reviewed, and an algorithm for managing inverted papilloma was also proposed