Compound odontoma of the maxillary sinus

@#<p style="text-align: justify;">In 1863,the term odontoma was introduced by Paul Broca which he described as a tumor formed by overgrowth of transitory or complete dental tissue.The World Health Organization classified them under mixed benign odontogenic tumors because of their origin from epithelial and mesenchymal cells exhibiting different structures of dental tissue (enamel,dentin,cementum and pulp).There are two distinct  types:  compound  and  complex.  Compound  odontoma  is composed of all odontogenic tissue in an orderly fashion resulting in many teeth-like structures but with no morphological resemblance to normal teeth whereas a complex odontoma appears as an irregular mass with no similarity even to rudimentary teeth.<br />The pathogenesis of odontomas has not been completely established although the most accepted etiology is related to trauma, infection, growth pressure and genetic mutations in one or more genes that cause disturbances in the mechanism controlling tooth development.<br />Patients with compound odontoma are often asymptomatic. It is usually detected on routine radiography upon examination of an unerrupted tooth.Odontomas can occur anywhere in the jaws and are usually found associated with or within the alveolar process.<br />However,the presence of an odontoma in the maxillary sinus is very rare.We present a female patient with a compound odontoma in the maxillary sinus initially managed as nasal vestibulitis with maxillary sinusitis.</p>

Parathyroid carcinoma manifesting as recurrent nephrolithiasis

@#<p style="text-align: justify;"><strong>OBJECTIVES:</strong> To  present  a  rare  case  of  primary  parathyroid  carcinoma  and  discuss  its  clinical findings and management.<br /><strong>METHODS:</strong><br /><strong>Design:</strong> Case Report<br /><strong>Setting:</strong> Tertiary Government Hospital<br /><strong>Patient:</strong> One<br /><strong>RESULTS:</strong> A 54-year-old woman presented with a 3-year history of recurrent nephrolithiasis despite several  courses  of  shock  wave  lithotripsy.  She  had  persistent  hypercalcemia  and  parathyroid hormone levels were noted to be elevated. Neck ultrasound showed a hypoechoic solid nodule measuring  approximately  1.7  x  1.6  cm  in  the  lateral  inferoposterior  aspect  of  the  left  thyroid lobe. Parathyroid scintigraphy revealed a focal uptake on the left lower thyroidal bed. The patient underwent  left  inferior  parathyroidectomy  with  subtotal  thyroidectomy  and  isthmusectomy Frozen  section  reported  a  parathyroid  tumor  and  the  final  histopathologic  results  revealed  a parathyroid carcinoma.<br /><strong>CONCLUSION:</strong> A  rare  case  of  parathyroid  carcinoma  was  presented  manifesting  with  recurrent nephrolithiasis.  Elevated  serum  calcium  and  intact  parathyroid  hormone  (iPTH)  can  confirm  a primary  hyperparathyroid  problem.  Neck  ultrasound  and  parathyroid  scintigraphy  help  in  the localization of a parathyroid tumor. Only final histopathologic results can confirm the diagnosis of parathyroid carcinoma. Complete surgical excision is the treatment of choice and offers a good prognosis.</p>