Rizwan Hamid, Altaf Chalkoo, Saima Tariq, Sheikh Bilal, Suhail Wani

The leiomyoma is a benign smooth-muscle neoplasm commonly found in the female genital tract, gastrointestinal tract, or skin. Leiomyomas of the oral cavity are unusual. Oral leiomyomas are uncommon due to the paucity of the smooth muscle in the mouth (except in blood vessels) and thus the involvement of jaw bones is extremely rare. Leiomyomas have been classified as solid angiomyoma, angioleiomyoma (vascular leiomyoma), and epithelioid variants. Angioleiomyomas are benign mesenchymal tumors derived from smooth muscle, which rarely occur in the oral cavity. Malignant transformation probably does not occur but careful histopathologic examination is still necessary to differentiate these benign lesions from their malignant counterparts due to different prognosis. Although uncommon in the maxilla and mandible, they should be included in the differential diagnosis of radiolucent lesions of jaw bones. An extensive search of literature was carried out on the Medline-PubMed and Google Scholar database using the keywords such as leiomyoma, angioleiomyoma, jaw bones, maxilla, mandible, intra-osseous to thoroughly search and collect all the reported cases of intraosseous leiomyoma (but our search was not limited to these terms only). To the best of our knowledge, only 23 cases of intraosseous leiomyomas have been reported so far in the jaw bones, among which only 8 belonged to angioleiomyomas. Herein, we report the 9th case of intraosseous angioleiomyoma, one of the variants of leiomyoma and overall 24th intraosseous leiomyoma in a 6-year-old female child, together with conventional histopathologic and immunohistochemical findings

Results of Surgical treatment of Nonunion of Humeral Shaft Fracture with Dynamic Compression Plate and Cancellous Bone Grafting

Introduction: Nonunion of humeral fractures afterconservative or surgical treatment represents a disablingcondition for the patient and a challenge for the surgeon. Studyaimed to evaluate the outcome of treatment of humeral shaftnonunions with dynamic compression plate and cancellousbone graft.Material and Methods: This study was conducted atDepartment of Orthopaedics, GMC Srinagar from June 2016to December 2019. Twenty patients were operated over thisperiod. Trauma was the cause of injury in majority of thepatients. Nonunion was atrophic in 80% and hypertrophic in20% of the individuals. All the patients had closed fractureat presentation, and 70% had received previous treatmentfrom traditional bone setters and 30% had failure of theconservative cast management.Results: The average time to union was 18 weeks. Treatmentpreviously from traditional bone setters significantly affectedthe time to fracture union (p<0.05). All fractures unitedsuccessfully.Conclusion: we concluded that treatment with dynamiccompression plating and cancellous bone grafting remains aneffective treatment option for nonunion of humeral shaft.

Isolated angiokeratomas of the tongue: A rare entity

Angiokeratomas consist of ectasias of dermal capillaries associated with an acanthotic and hyperkeratotic overlying epidermis. These dark red-to-purple, papular vascular anomalies can vary considerably in size, depth, and location. It is a skin disorder that rarely involves oral cavity. It can occur in localized or generalized form and is often associated with underlying metabolic disorder such as Fabry's disease and fucosidosis. It has many clinical variants with the same underlying histopathology. Mucosal involvement, including the oral cavity, is occasionally found either as a component of the systemic variety, called angiokeratoma corporis diffusum, or associated with cutaneous lesions in more locations. Isolated oral involvement seems to be rather infrequent, and only eighteen cases have been described in the world literature thus far. Isolated multiple angiokeratomas of tongue without plaque formation have been reported only four times before this. Here, we report a fifth case of isolated multiple angiokeratomas of tongue in a 16-year-old female which was confirmed by immunohistochemical pattern in consonance with a blood vessel origin, with expression of CD31, CD34, and von Willebrand factor. The lesion did not express D2-40 and CD45. No other malformation or metabolic disorder was found in the patient.