Case Report of Diagnostic Dilemma – Fibrous Dysplasia/Osteosarcoma

Among bone tumours of head neck region, benign tumours of bone are common, while malignant tumours are very rare. These benign tumours constitute about 75% of all bone tumours. Most of these bone tumours present clinically with pain, swelling and symptoms of compression of vascular and neural structures. Surgery is not required for these bone tumours unless patient experiences any discomfort as diagnosis is made on plain radiographs. Only 2% of all benign tumours may undergo malignancy[1]. Fibrous dysplasia (FD) is a less common skeletal developmental anomaly of the bone, which is often misdiagnosed as malignant bone tumour. It manifests as defect in osteoblastic differentiation and maturation and affects a single bone or may involve multiple bones2. Osteosarcoma is a malignant mesenchymal tumour, predominantly affecting the long bones and occasionally seen affecting the maxillofacial region. It accounts for 15–35% of all primary bone tumours and 4–8% of sarcomas of jaw[4]. In osteosarcoma, males are more commonly affected than females. The aim of this article is to represent a rare case of bone tumour of the upper jaw in 10-year-old boy, which was initially suspected as osteosarcoma and later confirmed as FD.

ORAL PEMPHIGUS - A CASE REPORT

PEMPHIGUS is a serious chronic skin disease characterized by the appearance of vesicles & bullae, small or large fluid filled blisters that develop in cycles. The term pemphigus refers to a group of autoimmune blistering diseases of skin and mucous membranes that are characterized histologically by intraepidermal blisters due to acantholysis and immunopathologically by an in vivo bound & circulating IgG directed against the cell surface of keratinocytes. Pemphigus vulgaris is the most common form and frequently affects oral cavity. Main antigen is Dsg 3 (desmoglein) but 50% of patients also have autoantibodies to Dsg 1. Dsg 3: Dsg 1 is directly proportional to severity. We present a case of pemphigus occurring in the oral cavity of a 45-year-old male. Treatment with oral prednisolone and topical steroid resulted in remission of the disease. Clinical features, histological features and treatment of pemphigus vulgaris will be discussed.