ABSTRACT
Verrucous carcinoma also known as Ackerman’s tumour is a variant of well differentiated squamous cell carcinoma that affects cutaneous and mucosal surfaces. Ackerman’s tumour accounts for 1-10% of cases of Squamous Cell Carcinoma in the epithelial lining of oral mucosa and gingiva. It appears as slowly enlarging warty, exophytic cauliflower like overgrowth, grey or white in colour and is seen commonly in older males.1 Tobacco consumption has been the primary aetiology of verrucous carcinoma.2,3 The oncogenic viruses HPV 16 and 18 are also implicated in the aetiology of this condition.4 Other etiological factors may include smoking, poor hygiene and alcohol abuse. Verrucous carcinoma shows typical clinical behaviour being locally invasive. The rate of nodal metastasis is less, neck dissection and radiotherapy are the least opted modalities for treatment. The treatment of this is usually surgical excision and prognosis is fair. In this paper we report a typical gingival presentation of verrucous carcinoma bilaterally along with the clinicopathological diagnosis and a review of scientific literature.
ABSTRACT
Aims and objectives: Odontogenic infections, if not properly controlled, can spread to adjacent head and neck fascial spaces. However, because of the complicated anatomic structure of the head and neck, fascial space infections are often difficult to be determined by clinical examinations. The aim of the present study was to investigate ultrasonographic characteristics of fascial space infections and to correlate ultrasonography (USG) findings with those of magnetic resonance imaging (MRI). To assess the role of USG and MRI in diagnosing superficial and deep fascial space infections. Materials and methods: Total of 15 subjects clinically diagnosed with space infections secondary to the odontogenic cause were included in this potential study. The fascial space involvements were examined with USG and MRI. Results: A total of 31 fascial space infections were clinically identified in the subjects, comprising 24 superficial (77.41%) and 7 deep spaces (22.58%), whereas, ultrasonography successfully identified 30 involved fascial spaces, with 28 superficial (93.33%) and 2 deep spaces (6.66%). USG, staging for odontogenic fascial space infections revealed 2 edematous changes, 15 cellulitis, and 13 abscesses. Conclusion: Ultrasonography could be reflected to be an inexpensive, non-invasive technique in detecting the spread of odontogenic infections to the superficial fascial spaces.
ABSTRACT
Background: Several systems including pathologic criteria alone or in combination with clinical features have been proposed to differentiate between benign and malignant adrenocortical tumors and assess their prognosis. The Weiss system appears to be the most commonly used method for assessing malignancy but there are only a few studies which have evaluated its diagnostic power. Since we see large adrenocortical carcinoma (ACC), we attempt to evaluate the diagnostic power of Weiss system in large ACC. Materials and Methods: In this study clinicopathological characteristics of 42 adrenocortical neoplasms are studied and classified into adrenocortical adenoma (ACA) and ACC based on Weiss score of less than or equal to three or greater than three. Results: The histological criteria of Weiss appeared to predict tumor prognosis accurately. Five year survival of patients with Weiss scores of less than or equal to three was 100% compared to 0% of those with Weiss scores greater than three. The average weights of ACA and ACC were 13.0 plus/minus 8.4 grams and 621.1 plus/minus 335.2 grams respectively; average sizes of ACA and ACC were 2.8 plus/minus 1.0 cmsand 13.6 plus/minus 3.7 cms respectively. Conclusion: Weiss score was found to be a good prognostic factor for tumors of the adrenal cortex.
ABSTRACT
BACKGROUND: Primary cardiac tumors are rare. There are only a few reports of such tumors from India. METHODS AND RESULTS: We report our experience with 34 patients with primary cardiac tumors operated on at our institute between December 1989 and October 2001. The study group comprised 16 males and 18 females with a mean age of 40.05 +/- 13.06 years (range 7-65 years). The predominant symptoms were breathlessness and congestive heart failure. In addition, 1 patient presented with peripheral embolism with impending limb ischemia that necessitated emergency embolectomy. Echocardiography was confirmatory in the diagnosis of all the benign tumors, whereas the malignant tumors were incidentally found during surgery. All the patients survived the operation. Complete resection of the tumor was possible only in benign tumors; however, malignant tumors were partly removed to relieve obstruction. All the excised benign tumors showed no recurrence on a mean follow-up of 54.78 +/- 31.30 months (range 3-108 months). Myxoma was found in 31 patients, left ventricular fibroma in 1, and leiomyosarcoma in 2. Both the patients with malignant tumors developed recurrence postoperatively, and succumbed to extensive distant metastases. CONCLUSIONS: The long-term outcome of surgery was excellent in patients with benign cardiac tumors. However, malignant tumors had an unchanged prognosis, although symptomatic relief was achieved.