Palatal solitary neurofibroma simulates a salivary gland neoplam Publication date: Available online 7 November 2019 Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology Author(s): Pooja Sharma, Mala Kamboj, Anjali Narwal Abstract Spindle cell lesions of head and neck are very diverse entities. These may vary from benignity to malignancy. They exhibit a wide diversity ranging from benign fibroma to malignant peripheral nerve sheath tumor. These can be neural, myofibroblastic, fibroblastic, muscle, vascular, odontogenic, epithelial in origin. Such variable tissues involved provide a diagnostic challenge to the oral pathologists. Among these, neural tumors are very rare in oral cavity. A case of spindle cell tumor, which clinically mimicked pleomorphic adenoma, is presented. On histopathology it appeared like a spindle cell tumor. On further investigations like immunohistochemistry, it was diagnosed as neurofibroma. Neurofibromas may present as solitary or associated with neurofibromatosis. In our case, it is of solitary type. Till today only few cases of solitary neurofibromas of hard palate have been reported. Present case report is a rare presentation of solitary extraosseous neurofibroma on hard palate.

A venous aneurysm in the buccal mucosa region Publication date: Available online 18 October 2019 Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology Author(s): Yosuke Fukushima, Yuta Isozaki, Mao Endo, Megumi Yumoto, Yumiko Kawata, Tsuyoshi Sato Abstract A 67-year-old female presented at our hospital with an indolent tumor in the buccal mucosa region. A spherical and movable, elastic soft tumor of approximately 10 mm was found under the right buccal mucosa. Contrast-enhanced magnetic resonance imaging revealed a 14 × 13-mm mass with smooth edges and a non-uniform contrast effect. She was diagnosed with a benign tumor of the buccal mucosa region, and a tumorectomy was performed. Histopathological examination revealed a cyst-like enlargement with visible vasculature. Because the tumor was isolated, she was finally diagnosed with a venous aneurysm (VA).

Giant infiltrating angiolipoma of buccal space—Report of a rare case Publication date: Available online 14 October 2019 Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology Author(s): Nisha Shetty, Adarsh Kudva, Abhay T. Kamath, Mary Mathew, Monica Charlotte Solomon Abstract Angiolipoma is an histological subtype of lipoma that arise from adipose tissue. They occur in trunk and extremities more commonly and are rarely found in the maxillofacial area. Infiltrating and non-infiltrating types are the two subtypes of Angiolipoma, and they have a marked degree of vascularization with an admixture of mature adipocytes. The infiltrating type is rare in head and neck regions and should be considered in the differential diagnosis of head and neck lesions as it infiltrates into surrounding structures causing muscular pain and nerve deficits and also has a high rate of recurrence. Management of angiolipomas requires complete surgical excision. In this report, we present a case of a Giant Infiltrating Angiolipoma in Buccal Space of a 51-year-old man.

Oral self-injury associated with septicaemia in a case of Cornelia de Lange syndrome Publication date: Available online 11 October 2019 Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology Author(s): Kazuto Okabe, Ryuji Kaneko, Takamasa Kawai, Fumiya Kano, Yuya Ohta, Hideharu Hibi Abstract Self-injury (SI) can be defined as deliberate harm to one’s own body without conscious suicidal intent. This report describes a case of septicaemia triggered by SI. The patient was a 40 year-old woman, who was diagnosed with Cornelia de Lange syndrome (CdLS). She was hospitalized in a medical long-term care sanatorium and was recently transferred from a familiar sanatorium. She started to bite herself on the mandibular labial alveolar mucosa; this had never been observed. As the self-biting wound gradually increased and the resultant inflammation spread to surrounding tissues, she was referred to our hospital. During the course of treatment, she suffered from septicaemia secondary to aspiration pneumonia. When a case of SI is encountered, clinicians should be aware of the possibility of progression from local infected foci, such as a self-biting wound to septicaemia, and make appropriate interventions at an early stage without underestimating the seriousness of such a condition.

A case of spindle cell/pleomorphic lipoma on inferior border of the mandible Publication date: Available online 3 October 2019 Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology Author(s): Kanako Munakata, Seiji Asoda, Shin Usuda, Hidetaka Miyashita, Tomoya Soma, Toshihiro Hasegawa, Chiharu Ogawa, Sadao Ohyama, Tomohiro Yamauchi, Miho Kawaida, Kaori Kameyama, Taneaki Nakagawa, Hiromasa Kawana Abstract Spindle cell lipomas and pleomorphic lipomas are uncommon and distinct variants of benign lipomas. Although spindle cell lipomas and pleomorphic lipomas were originally considered different entities, the recent WHO classification defines them as spindle cell/pleomorphic lipoma (SCL/PL). This is because of their similar clinical features and the existence of intermediate histopathological features between them. A 77-year-old male presented to our clinic with a painless swelling on the left inferior border of the mandible. Computed tomography revealed a clearly defined mass in the subcutaneous lesion. With a histopathological diagnosis of myxolipoma, demonstrated by biopsy, excisional surgery was performed under general anesthesia. The histopathology revealed SCL/PL with the presence of spindle cells and mature adipocytes. No tumor recurrence had been noted at two year after surgery.

Dedifferentiated chondrosarcoma of the maxilla. Report of a rare tumor in an extremely rare localization Publication date: Available online 3 October 2019 Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology Author(s): Alireza Khooei, Shahriar Mohammadreza Sharifian, Mahdi Karimi Shahri, Shirin Taraz Taraz Jamshidi, Nooshin Sedaghat Sharifi Abstract Dedifferentiated chondrosarcoma is a rare primary bone neoplasm and it is extremely rare in paranasal sinuses and skull bones in particular. Herein we describe a case of dedifferentiated chondrosarcoma of the maxilla extending to the orbit in a 51 year-old man.

Method to control tongue position and open source image segmentation for cone-beam computed tomography of patients with large palatal defect to facilitate digital obturator design Publication date: Available online 23 September 2019 Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology Author(s): Taseef H. Farook, Mohammed A. Mousa, Nafij B. Jamayet Abstract Objective To allow for easy segmentation in open source image processing software with minimal effort and human errors and facilitate the overall process of CAD based obturator design. Method The patient’s existing lower denture was modified with cross-arch tongue cribs/bars made of thermoplastic impression material which acted as a restrictive barrier for the tongue. A cone-beam computed tomography (CBCT) was done and the images were then carried over to an open source image processing software and the defect site was segmented from the DICOM and picked for conversion into 3D model. The 3D model could then be used to design the prosthesis in CAD software. Result The method of control and segmentation produced better texture and morphological details. The digital obturator designed was able to engage peripheral margins on the 3D model. Conclusion The use of tongue restriction technique and open-source image segmentation can be a cost effective and viable option for easing the overall process of digitally designing an obturator for palatal defect.

Oral and cutaneous manifestations of langerhans cell histiocytosis: report of two cases Publication date: Available online 21 September 2019 Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology Author(s): Jefferson da Rocha Tenório, Camilla Vieira Esteves, Daniele Heguedusch, Suzana Cantanhede Orsini Machado de Sousa, Celso Augusto Lemos-Júnior Abstract Langerhans cell histiocytosis (LCH) is a rare myeloid proliferative disorder characterized by abnormal proliferation of Langerhans cells, which can produce focal or systemic manifestations. Oral mucosa lesions of LCH are a diagnostic challenge, because of their destructive osteolytic character that could simulate other types of diseases in this region. Presently we report a regular case of LCH in a 12-year-old boy and an unusual one that presented concomitantly oral and skin lesions, in a 67-year-old woman. The two reported cases presented two different manifestations of this condition in different ages, showing the difficulty in general dentistry, mainly in pediatric and geriatric clinic that should considered LCH as differential diagnosis for the oral mucosa lesions with periodontal impairment.

Application of the dredging method in a case of recurrent ameloblastoma that had spread over a large region of the mandible Publication date: Available online 20 September 2019 Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology Author(s): Wataru Kakuguchi, Yoichi Ohiro, Seitaro Nakazawa, Ryo Naito, Yasuhito Moritani, Yoshiyuki Nakamichi, Hiromasa Horimukai, Tetsuya Kitamura, Kanchu Tei Abstract Ameloblastomas have a high post-surgical recurrence rate. They often recur after simple conservative surgeries, such as enucleation. The dredging method was thus developed as an alternative, conservative treatment of ameloblastoma. This method accelerates new bone formation and enables surgeons to remove all tumors, leading to lower recurrence rates than deflation and/or enucleation alone. However, no reports have examined whether the dredging method is effective in recurrent cases of ameloblastomas. A 49-year-old male was referred to our hospital due to right mandibular swelling. This patient had been treated for ameloblastoma with the dredging method until 25 years ago at our hospital. The patient was not seen again after 1 year from the last surgery. A clinical and histopathological diagnosis of recurrent ameloblastoma of the right mandible was made. We applied the dredging method, judging it to be adequate for tumor removal while preserving the jaw bone. A panoramic radiograph revealed mandibular bone restoration with each surgery and removal of all tumor cells had been completed. The patient was followed-up and no recurrence of ameloblastoma was found by 1.5 years following his final surgery. Additionally, the patient was permitted to wear dentures. In the present report, we show that the dredging method was applicable for a case of recurrent ameloblastoma that had spread over a large region of the mandible. The dredging method further allowed the patient to restore denture occlusion by preserving the jaw bone.

Periosteal reaction as a risk factor for poor outcomes after surgical treatment for medication-related osteonecrosis of the jaw: A retrospective analysis of 205 surgeries Publication date: Available online 17 September 2019 Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology Author(s): Yumi Kawaoka, Yuka Kojima, Shunsuke Sawada, Madoka Funahara, Saki Hayashida, Hirokazu Yutori, Maho Murata, Sakiko Soutome, Masahiro Umeda Abstract Objective To investigate the relationship between the presence of periosteal reaction and the outcome of surgical treatment for medication-related osteonecrosis of the jaw (MRONJ) and determine the appropriate bone resection method for periosteal reaction. Methods We retrospectively reviewed the medical records of 163 patients who underwent 205 surgeries for MRONJ in the Department of Dentistry and Oral Surgery, Kansai Medical University Hospital and the Department of Oral and Maxillofacial Surgery, Nagasaki University Hospital. The evaluated parameters were as follows: patient age and sex, site of involvement, stage, trigger, primary disease, type of antiresorptive agent, duration of antiresorptive therapy, presence/absence of preoperative drug holiday, use of corticosteroids, presence/absence of diabetes, leukocyte count, serum albumin and creatinine levels, surgery type, preoperative computed tomography (CT) findings, and treatment outcome. Preoperative CT parameters included separation of the sequestrum, osteosclerosis, and periosteal reaction. The correlation between each variable and the treatment outcome was analyzed using Cox regression analyses. Results The 1-year cumulative cure rate was 81.5%. Multivariate analysis revealed that malignancy (primary disease), a low average albumin value, and the presence of periosteal reaction were independent risk factors for a poor treatment outcome. Complete healing was achieved in 10 of 12 cases where the bone showing periosteal reaction was surgically resected, whereas complete healing was not observed in 22 of 36 cases with residual periosteal reaction after surgery. Conclusions Preoperative periosteal reaction is a predictor of a poor outcome after surgical treatment for MRONJ. Clinicians should consider complete resection of the bone showing periosteal reaction.