Basal cell carcinoma, odontogenic cysts, brain and skeletal abnormalities (Gorlin Goltz Syndrome) in a 46-year-old woman

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To present the case of a 46-year-old woman with basal cell carcinoma, odontogenic cysts, brain anomalies and skeletal abnormalities.<br /><strong>METHODS:</strong><br /><strong>Design:</strong> Case Report<br /><strong>Setting:</strong> Tertiary National University Hospital<br /><strong>Patient:</strong> One<br /><strong>RESULTS:</strong> A 46-year-old woman consulted for a non-healing, necrotic left orbital ulcer that started as a skin-colored, papilla-like lesion on the upper eyelid. There were also hyperpigmented lesions with ill-defined borders over both paranasal areas. Tissue biopsies revealed basal cell carcinoma. Radiologic imaging showed cystic lesions in the mandible, straightening of cervical vertebrae and calcifications of the falx cerebri, tentorium cerebelli, pineal gland and choroid plexus. Based on established major and minor clinical and radiologic criteria, we arrived at a diagnosis of Gorlin Goltz Syndrome or Nevoid Basal Cell Carcinoma Syndrome (NBCCS). She underwent wide excision of the left orbital mass with exenteration, excision of left and right paranasal masses, left total parotidectomy with facial nerve preservation, enucleation of mandibular cyst and cervicofacial reconstruction with skin grafts of the left orbital area and ala.<br /><strong>CONCLUSIONS:</strong> NBCCS is a rare autosomal dominant disorder with a high tendency for neoplasms and developmental anomalies. Diagnosis can easily be missed if the physician is unaware of its classic but bizarre presentation. Early recognition and prompt specialist referral is very important in order to prevent complications and provide better prognosis. Patients should be reminded of the importance of follow-up as other presentations of the syndrome may manifest later in life and family genetic screening and counseling should be undertaken.</p>

Motorcycle related cranio-maxillofacial injuries at a tertiary hospital in the Philippines

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To describe the type and determine the number of motorcycle related cranio-maxillofacial injuries that were seen by the ORL service in the emergency room of a tertiary hospital from January 2013 to December 2013.<br /><strong>METHODS: </strong> <br /><strong>Design:</strong> Cross sectional retrospective chart review<br /><strong>Setting:</strong> Tertiary National University Hospital<br /><strong>Participants:</strong> One hundred nine (109) charts of patients seen atr the emergency room from Jnuary 2013 to December 2013 were reviewed<br /><strong>RESULTS:</strong> Of the 109 charts of patients involved in vehicular accidents, there were 76 documented cases of motorcycle related accidents. Of these, 91% involved males and 9% involved females. Seventy one percent (71%) did not wear helmets of whom 36% were young adult males between the ages of 18-30 years. Those that wore helmets had a total of 27 different facial fracture sites: 19% zygomatic tripod fractures, 15% temporal bone fractures and 11% with no fractures noted. Among those who did not wear helmets 75 fractures were noted. Twenty four percent (24%) were tripod fractures, 15% temporal bone fractures and 12% maxillary fractures. only one did not incur any fractures.<br /><strong>CONCLUSION:</strong> Most cranio-maxillofacial fractures seen at the emergency room were from motorcycle related injuries (70%). Despite implementation of Republic Act 10054 (The Motorcycle Helmet Act of 2009) majority of motorcycle-related accidents are still incurred by riders without helmets.</p>