Mucocele of the dorsal surface of the tongue : a case report

Mucoceles represent one of the most common lesions of the oral cavity, developing as a result of saliva accumulation. The most frequent affected area is the lower lip, followed by floor of mouth, ventral tongue and buccal mucosa. Despite numerous reports of mucoceles originating on the ventral surface of the tongue, only scarce cases of such a lesion identified on the dorsal tongue surface have been described. In this report a mucocele developed on the dorsal tongue of a 74-year-old woman is described. Additionally a review of previously published mucoceles of the dorsal surface of the tongue is provided and discussed. A 74-year-old female patient was referred for a painless swelling on the dorsal surface of the tongue of 1 month duration. Possible clinical diagnosis included granular cell tumor and lingual thyroid gland. Proper blood testing for TSH, T3 and T4 as well as ultrasonography were requested, found to be within normal limits. An excisional biopsy was performed and tumor was removed with no intra-operative complications. Histopathological examination was consistent with a mucocele, exhibiting an amorphous material surrounded by granular connective tissue without epithelial lining on the periphery. Patient was examined on regular follow-up basis, with no signs of recurrence for the last 1 year. Mucoceles of the dorsal tongue surface represent rare clinical entities, necessitating the need for further case reports to be published in order to widen our understanding of their clinical features

Lichenoid lesions of the upper lip : a retrospective study of 24 cases

Lichenoid lesions of the upper labial mucosa, without other oral or extraoral manifestations seem to be rare. The clinicopathologic features of 24 such cases are presented and the pertinent literature is reviewed. 24 Caucasian patients that clinically presented lichenoid features on the upper labial mucosa, with or without lichenoid lesions on the adjacent gingiva, were included in the study. Clinical features were extracted from the patients? records, while dental plaque/calculus accumulation and composite resin restorations of the adjacent teeth were recorded. Four cases where an incisional biopsy was performed were further evaluated. There were 8 males and 16 females, with a mean age of 62.7 years. 64.2% were under hypertensive therapy. In 13 cases gingival involvement was noticed, 16 cases exhibited calculus deposition, while 6 cases presented with composite resin fillings of the adjacent teeth. In 4 cases an incisional biopsy was performed showing features of lichenoid reaction. In 37.5% significant improvement was observed after topical treatment with corticosteroids and antimicrobial agents. Lichenoid lesions of the upper lip may represent a distinct variety of oral lichenoid lesions, but as the number of cases reported so far is too small for definite conclusions on pathogenesis and management to be made, a long-term follow-up is mandatory

Oral verruciform xanthoma : report of 13 new cases and review of the literature

Oral verruciform xanthoma (OVX) is a rare lesion. The purpose of the present study is to describe the clinical features of 13 OVXs and review all cases reported in the English literature. Thirteen cases of OVX diagnosed during a 47-year period were retrospectively collected. The patients? gender and age, as well as the main clinical features of the lesions were retrieved from the biopsy request forms. Pubmed®, Scopus® and Google ScholarTM electronic databases were searched with the key word ?verruciform xanthoma?. Only cases of histologically confirmed OVX were included in the study. The 13 OVXs represented approximately 0.04% of 35,617 biopsies accessioned during the study period. They affected 13 patients, 8 males and 5 females with a mean age of 48.8±14 years. They mainly appeared as asymptomatic granular nodules or plaques, with elastic or normal consistency and white color, in the gingiva or hard palate. Literature review yielded 416 cases of OVX. With the addition of cases of the present study, 429 cases of OVX have been presented in the English literature. OVX has a slight male predominance with a male to female ratio of 1.4:1 and the majority of patients are in the 5th to 7th decade of life. Clinically, OVX mainly presents as an asymptomatic, single, papillary or granular plaque or nodule, with elastic or soft consistency and white, red or pink color. It measures approximately 1cm and is most commonly located on the gingiva, tongue, hard palate or buccal mucosa. The treatment of choice is surgical excision with little rates of recurrence. Verruciform xanthoma is a rare lesion most often encountered on the ginigival mucosa. As its clinical presentation is not pathognomonic, it should be included in the differential diagnosis of verrucous or papillary lesions

Synchronous occurrence of two lateral periodontal cysts in the same patient. Report of a rare case and review of the literature

We present a case of a patient with two lateral periodontal cysts in the maxilla and the mandible, respectively, and review the English literature on multiple lateral periodontal (LPCs) cysts and/or gingival cysts (GCs) and botryoid odontogenic cysts (BOCs). The patient was a 59 year-old female with two fluctuant swellings covered by semi-lucent mucosa on the attached gingiva between the maxillary and mandibular right canine and first premolar teeth, respectively. Periapical radiographs revealed at the respective sites between the roots of the canine and first premolar teeth areas unilocular radiolucencies. Intra-operatively, the presence of bone cavities was confirmed at both sites. The microscopic features were consistent with LPC. The review of the English literature on multiple LPCs and/or GCs and BOCs found seven reports of multiple LPCs, four of multiple GCs, and two with an LPCs and a GC. It is concluded that multiple LPCs have been rarely reported in the literature, but should be included in the differential diagnosis of multifocal radiolucencies lateral to vital teeth. The possibility of multiple lesions in different locations should direct to a thorough clinical and radiographic examination in a patient diagnosed with an LPC or GC

Localized gingival enlargements. A clinicopathological study of 1187 cases

To describe the incidence, demographic and clinical features of 1187 localized gingival enlargements. 1187 cases of localized gingival enlargements diagnosed during a 20-year period were retrospectively collected. The patients? gender and age, as well as the main clinical features of the tumors were retrieved from the biopsy report forms. The 1187 localized gingival enlargements represented 6.23% of 19.044 biopsies performed during the study period. 756 females and 427 males were affected with a mean age of 41.92±19.68 years. The lesions appeared as smooth (52.4%), granular (17.9%) or rough (13.16%) tumors, elastic (50.73%) or soft (29.56%) in consistency and red (60.8%), normal (28.58%) or white (8.17%) in color. The majority of the lesions (85.17%) were reactive in origin with pyogenic granuloma being the most common. In 1.1% of the cases a diagnosis of malignant lesion was rendered. All localized gingival enlargements should be submitted for microscopic examination because in approximately 1% of cases they are malignant

Transient lingual papillitis: a retrospective study of 11 cases and review of the literature

Transient lingual papillitis (TLP) is a common, under-diagnosed, inflammatory hyperplasia of one or multiple fungiform lingual that has an acute onset, and is painful and transient in nature. Eleven cases of TLP were diagnosed based on their clinical features. Information on demographics, clinical characteristics, symptoms, individual or family history of similar lesions, medical history, management and follow-up were extracted from the patients’ records. The English literature was reviewed on TLP differential diagnosis, pathogenesis and management. The study group included 8 females and 3 males (age: 10-53 years, mean age 31.7±12.88 years). Seven cases were classified as generalized form of TLP and 4 as localized form. Nine cases were symptomatic. Time to onset ranged from 1 to 14 days. A specific causative factor was not identified in any case and management was symptomatic. Although TLP is not considered as a rare entity, available information is limited. Diagnosis is rendered clinically, while biopsy is required in cases with a differential diagnostic dilemma. TLP should be included in the differential diagnosis of acute, painful tongue nodules

Non-healing tongue ulcer in a rheumatoid arthritis patient medicated with leflunomide. An adverse drug event?

Leflunomide is a member of the disease modifying anti-rheumatic drugs group used as a treatment modality in active rheumatoid and psoriatic arthritis. “Oral ulcers” are reported in 3-5% of leflunomide medicated rheumatoid arthritis patients with adverse events, but they are not described in detail in the literature. We present a case of an ulcer in the tongue of a rheumatoid arthritis patient managed with leflunomide and contemplate on its pathogenesis

Recurrence in a patient with a 10-year history of sinonasal mucosal melanoma manifesting as facial swelling

Sinonasal mucosal melanoma is a rare tumor that develops slowly and may manifest with non specific signs and symptoms, causing significant delay in diagnosis. Local recurrence is common and usually occurs within the first two years after the initial treatment. Prognosis of recurrent lesions is poor and 5-year survival ranges between 10-47%. We report the clinical, radiographic, histopathological and immunohistochemical findings of a recurrent sinonasal mucosal melanoma which was diagnosed 10 years after the initial treatment, in a patient who presented with unilateral facial swelling and one-sided difficulty in breathing of two years duration. We discuss the causes of late diagnosis and review the negative predictive factors for recurrence and survival. As early diagnosis is of paramount importance for prognosis, we emphasize the signs and symptoms of patients with a history of sinonasal mucosal melanoma which should raise the suspicion for recurrence, in spite of a long time interval since diagnosis

Tumors of the labial mucosa:a retrospective study of 1045 biopsies

To investigate the relative frequency of localized mucosal swellings of the upper and lower labial mucosa, the clinical-pathological diagnosis agreement and whether patient?s age and gender and tumor?s site and size may raise the suspicion of neoplasm. Retrospective analysis was performed on upper or lower labial mucosal tumors, histopathologically diagnosed between 2009-2018. The diagnostic categories developmental/reactive tumors, benign and malignant neoplasms were associated with patient?s age and gender and tumor?s site and size; clinical-pathological diagnosis agreement was, also, evaluated. Overall, 1000 (95.7%) developmental/reactive tumors, 35 (3.3%) benign and 10 (1%) malignant neoplasms were found. Upper/lower lip tumor ratio was 0.14:1. The diagnostic category was significantly associated with age (p1cm were independent predictors for neoplasms. Patients presenting 2 or 3 of these variables were 20.2 times (p?1cm in patients?60 years have significantly higher probability to be neoplasms

Application of nano-hydroxyapatite/chitosan scaffolds on rat calvarial critical-sized defects : a pilot study

The purpose of this pilot study was to evaluate for the first time the effect of 75/25 w/w nano-Hydroxyapatite/Chitosan (nHAp/CS) scaffolds on Guided Bone Regeneration (GBR) in rat calvarial critical-sized defects (CSDs). Six adult Sprague Dawley rats, 3 males and 3 females, were used. Two CSDs, full thickness and 5mm in diameter, were trephined in both sides of the parietal bone. The right CSD was filled with nHAp/CS scaffold, while the left CSD remained empty, as the control group. The wound was sutured in layers. Rats were euthanized with diethyl ether inhalation at 2, 4 and 8 weeks after surgical procedure. Histological and histomorphometric analysis was performed within distinct regions of interest (ROI): the lateral area inward of the middle sagittal seam; the lateral area outward of the middle sagittal seam and the central area. The mean surface of newly formed bone (in ?m2) in the lateral area inward of the middle sagittal seam of all rats was significantly higher (P=0.039) in the experimental group (91733.00±38855.60) than the control group (46762.17±25507.97). The NOex-c, defined as total number of osteocytes (OST) in newly formed bone surface in experimental group [experimental OST] minus the total number of osteocytes in newly formed bone surface in control group [control OST], was significantly greater (P=0.029) at 4th week post-surgery. Within the experimental group, a statistically significant increase (P=0.042) in the surface of newly formed bone was noticed in rats euthanized in 4th week compared with rats euthanized in 2nd week after surgery in the lateral area inward of the middle sagittal seam. The results of this study suggest that 75/25 w/w nHAp/CS scaffolds should be considered as a suitable biomaterial for GBR