ABSTRACT
@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To present a case of mandibular ameloblastoma with pulmonary metastasis after ten years and discuss the possible pathophysiology, diagnostic and therapeutic options.<br /><strong>METHODS:</strong><br /><strong> Design:</strong> Case Report<br /> <strong>Setting:</strong> Tertiary Private Hospital<br /><strong> Patient:</strong> One<br /><strong>RESULTS:</strong> A 27-year-old woman diagnosed with follicular variant ameloblastoma underwent left segmental mandibulectomy with iliac bone reconstruction in 2004. The titanium plates were removed in 2008 because of a recurrent orocutaneous fistula. She was apparently well until 2014, when she complained of intermittent, non-radiating, sharp and piercing, right upper back pains. Work-ups revealed multiple bilateral lung nodules. A CT scan-guided percutaneous needle biopsy of the right upper lung nodule revealed metastatic ameloblastoma. Opting for observation instead of chemoradiation, she remains asymptomatic on regular follow-ups with medical oncology, pulmonary medicine and otorhinolaryngology.<br /><strong>CONCLUSION:</strong> Though benign, ameloblastoma has a high propensity for local invasion and may metastasize. It is difficult to predict metastasis, even with adequate treatment of the primary lesion. There is no standard protocol to prevent or detect metastatic ameloblastoma, but regular and close follow up may ensure early diagnosis.</p>
Subject(s)
Humans , Female , Adult , Ameloblastoma , LungABSTRACT
@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> As a guide to the clinical practice of infiltration of local anesthesia into the pterygopalatine fossa via the greater palatine canal, this study sought to determine and record the mean CT scan measurements of the following: 1) palatal mucosal thickness, 2) length and width of greater palatine canal, and 3) length and width of pterygopalatine fossa among adult patients in a private tertiary hospital in Quezon City.<br /><strong>METHODS:</strong><br /><strong>Design:</strong> Retrospective, Descriptive Study<br /><strong>Setting:</strong> Tertiary Private Hospital<br /><strong>Subjects:</strong> Paranasal Sinus (PNS) CT Scans of 113 adult patients from January 2014 to May 2014 were reviewed and evaluated. Excluded were images with pathology that distorted the anatomy of the sinuses and surrounding structures.<br /><strong>RESULTS:</strong> Our study showed average CT scan measurements of 5.98 mm palatal mucosal thickness, 16.99 mm greater palatine canal length, 18.75 mm pterygopalatine fossa length, 2.37 mm greater palatine canal width and 2.58 mm pterygopalatine fossa width. Comparison of average measurements by sex was not statistically significant. There was statistical significance when comparing the right palatal mucosal thickness of 5.86 mm with the left which was 6.11 mm with p-value of 0.001. Comparison between the length of the right pterygopalatine fossa of 18.48 mm with the left side at 19.01 mm showed statistical significance with p-value of 0.01.<br /><strong>CONCLUSION:</strong> As the average measurement of the mucosal palatal thickness combined with the length of the greater palatine canal was 22.97 mm, we recommend bending the needle 23 mm from the tip in a 45 degree angle for adult patients who will undergo sinus surgery, control of posterior epistaxis, trigeminal nerve block and minor oral cavity surgeries.</p>
Subject(s)
Humans , Male , Female , Adult , Pterygopalatine Fossa , Anesthesia, Local , Needles , Epistaxis , Palate , Paranasal Sinuses , Mouth , Trigeminal Nerve , Palate , NoseABSTRACT
@#OBJECTIVES: To present a case of Rosai-Dorfman disease in an individual with a 14-year history of recurrent nasal polyposis and discuss its clinical presentation, physical examination, radiologic findings, histopathologic characteristics and available treatment. METHODS: Design: Case Report Setting: Tertiary Government Hospital Patient: One RESULTS: A 26-year-old Filipino diagnosed and repeatedly treated medically and surgically for recurrent nasal polyposis underwent repeat endoscopic sinus surgery. A histopathologic impression of Rosai-Dorfman disease was confirmed by positive S-100 and CD1a negative immunochemistry in conjunction with the morphologic findings. CONCLUSION: Rosai-Dorfman disease is a rare entity which should be considered when dealing with recurrent nasal polyposis that is intractable to initial medical and surgical therapies. Histopathologic findings of emperipolesis and immunohistochemical S-100 stains play a key role in the diagnosis but there is yet no definite treatment for this disease.
Subject(s)
Humans , Adult , Histiocytosis, Sinus , EmperipolesisABSTRACT
p style=text-align: justify;strongOBJECTIVE:/strong To describe a case of a papillary thyroid carcinoma presenting with a preauricular and an intracranial mass and review the literature on the metastatic nature and invasiveness of papillary thyroid carcinoma.br /br /strongMETHODS:/strong br /strongDesign:/strong Case Report br /strongSetting:/strong Tertiary Private Hospital br /strongPatient:/strong One br /br /strongRESULTS:/strong A 46-year-old female with a 12-year anterior neck mass and a two-year right pre-auricular pleomorphic adenoma on fine needle aspiration biopsy was found to have an intracranial mass on CT- scan. Total thyroidectomy and section biopsy of the preauricular mass yielded a final histopathologic report of follicular variant of papillary carcinoma, thyroid gland; and metastatic papillary thyroid carcinoma, follicular type, pre-auricular mass. The condition of the patient precluded neurosurgical intervention and RAI therapy and she underwent 23 sessions of external radiotherapy using 46Gy with significant diminution in size of the intracranial metastasis.br /br /strongCONCLUSION:/strong Papillary thyroid malignancy may be an indolent tumor but it is capable of distant metastasis. We should be alerted by host and tumor factors which can be predictors of a more radical papillary malignant disease whose management entails proper staging evaluation and good communication of prognostic data and available, realistic therapeutic options to patients using a multidisciplinary approach./p