A rare case of schwannoma of maxillary sinus

Schwann cell tumor or schwannomas is the benign nerve sheath tumors, which arise mostly from head and neck region and rarely from the nasal and paranasal sinuses. Of these, very few arise solely from the maxillary sinus. This is a case report of a 25-year-old female patient presenting with painful swelling below the right eye turned out to be a rare case of schwannoma arising solely from the maxillary sinus. Details of clinical history, examination, histopathological finding, radiological finding, treatment, and follow-up have been presented

Inclusion of carbohydrate antigen 242 in addition to carbohydrate antigen 19.9 in serological workup of carcinoma gall bladder: a case series analysis

Background: Common antigenic pool is seen because of shared embryonic origins of gall bladder cancer (GBC) and pancreas. Hence, we analyzed the role of serum carbohydrate antigen 242 (CA242) which has been studied in pancreatic cancer, in GBC. The objectives were to identify whether serum CA242 provides added advantage in diagnosis of GBC when compared to controls and to determine its cut-off value. Methods: Serum CA 19-9 level was determined by chemiluminescent micro particle assay and CA242 by enzyme linked immunosorbent assay (ELISA) of age matched cases and controls. Results: Total enrolled patients were 83 including 10 (11.7%) healthy volunteers, 22 (25.9%) chronic cholecystitis cases, and 53 (62.4%) patients with histological evidence of carcinoma. Mean age of presentation of GBC was 51.64 SD10.88 years with F: M ratio of 5.6:1. Pain (90.6%, 48/53) accompanied with jaundice was significantly associated with GBC well reflected by significantly raised serum total bilirubin (p=0.011), direct bilirubin (p=0.008) along with alkaline phosphatase levels (p=0.001). Significantly higher median value of CA 19-9 and CA242 was observed in GBC when compared to CC and healthy volunteers (p<0.001) with a significant correlation between tumor size (>2.5 cm) and serum levels of CA242. The best cut-off limit for CA242 was 45.25 IU/ml. The specificity for carcinoma diagnosis increased to 100% when CA242 was included along with CA 19.9 in serological estimation. Conclusions: We recommend that CA antigen 19-9 may be complimented with CA242 for serological identification of malignancy in the gall bladder

Oral Submucous Fibrosis- Correlation between Clinical Findings and Histopathological Grading

Introduction Oral Submucous fibrosis (OSMF) occurs in young adults, who are in the habit of chewing tobacco mixed with areca nut and its various commercially available preparations. The disease results in progressive inability to open the mouth due to the submucosal fibrosis initiated by chronic inflammation affecting mainly oral mucosa. Authors undertook the present study to correlate the clinical features of OSMF to histopathological features and to find out aetiopathological factors of this condition. Materials and Methods A total of 123 clinically diagnosed OSMF patients, in the age range of 17 to 70 years were studied. Mouth opening was measured using a scale and was recorded in millimeters. Incisional biopsy was taken from the representative areas in the oral cavity. The patients were graded clinically and histopathologically and results were analyzed and discussed. Result Most of the patients were in the age group of 20-30 years (37.4%) with male predominance. The duration of either tobacco or areca nut chewing ranged from 1 to 35 yrs. Most patients had these habits for 6-19 yrs. Majority (55.3% & 54.5%) of the patients belonged to grade-2 (clinical grading) and intermediate grade (HPE grading) respectively. The HPE grading showed significant and direct association with duration of ill habits. The HPE grading showed significant and direct association with clinical grading (χ2=204.08, p<0.001). Discussion The HPE grading showed significant and direct association with duration of ill habits and also with clinical findings of restriction of mouth opening and inter incisal distance. The HPE findings showed significant and direct association with clinical grading i.e. when the clinical grading increases, the histopathological grading also increases. Conclusion OSMF is a disease with a high incidence. It also carries a significant risk of transformation to oral cancer. As no effective medical and surgical treatment is available for this condition; it is desirable to diagnose OSMF at early stages

Oral Submucous Fibrosis- Correlation between Clinical Findings and Histopathological Grading

Introduction Oral Submucous fibrosis (OSMF) occurs in young adults, who are in the habit of chewing tobacco mixed with areca nut and its various commercially available preparations. The disease results in progressive inability to open the mouth due to the submucosal fibrosis initiated by chronic inflammation affecting mainly oral mucosa. Authors undertook the present study to correlate the clinical features of OSMF to histopathological features and to find out aetiopathological factors of this condition. Materials and Methods A total of 123 clinically diagnosed OSMF patients, in the age range of 17 to 70 years were studied. Mouth opening was measured using a scale and was recorded in millimeters. Incisional biopsy was taken from the representative areas in the oral cavity. The patients were graded clinically and histopathologically and results were analyzed and discussed. Result Most of the patients were in the age group of 20-30 years (37.4%) with male predominance. The duration of either tobacco or areca nut chewing ranged from 1 to 35 yrs. Most patients had these habits for 6-19 yrs. Majority (55.3% & 54.5%) of the patients belonged to grade-2 (clinical grading) and intermediate grade (HPE grading) respectively. The HPE grading showed significant and direct association with duration of ill habits. The HPE grading showed significant and direct association with clinical grading (χ2=204.08, p<0.001). Discussion The HPE grading showed significant and direct association with duration of ill habits and also with clinical findings of restriction of mouth opening and inter incisal distance. The HPE findings showed significant and direct association with clinical grading i.e. when the clinical grading increases, the histopathological grading also increases. Conclusion OSMF is a disease with a high incidence. It also carries a significant risk of transformation to oral cancer. As no effective medical and surgical treatment is available for this condition; it is desirable to diagnose OSMF at early stages