Aggressive central giant cell granuloma of the mandible: A case report and review of literature

Mandibular aggressive central giant cell granuloma is a rare non-neoplastic giant cell tumour characterised by pain, bone destruction, tooth root resorption, jawbone cortical perforation, and high recurrence rate. This is a case of a 10-year-old boy who presented to the Dental Surgical outpatient clinic of University of Uyo Teaching Hospital with a three-year history of left jaw swelling. The clinical diagnosis was fibrous dysplasia of the left hemi-mandible. Consequently, left hemi-mandibulectomy was performed, and subsequent histopathological diagnosis was aggressive central giant cell granuloma of the mandible. This article presents this rare diagnosis and explores its classification, aetiopathogenesis, clinico-pathological features and management.

Clinicopathological Study Of Oral Cavity Mass Lesions In A Tertiary Care Centre Of North India

Background: Oral mass lesions, especially the potentially malignant and malignant lesions are a major health concern for a developing country like India. They pose a serious health and economic burden.Aims: This study was carried out to analyze the clinical profile and reaffirm the frequency of various causes causing mass lesions in oral cavity in different age-groups in a tertiary care centre of North India.Materials and Methods:All patients who had oral mass lesions and attended Departments of Otorhinolaryngology, General Surgery and the Dentistry of Hind Institute of Medical Sciences, Safedabad, Barabanki and Department of Surgery of School of Medical Sciences and Research, Sharda University, Greater Noida in two years (2015-2016) were included in the study.Statistical Analysis:All the analysis was carried out on SPSS 17.0 version (Chicago, Inc., USA). The results are presented in percentages. The Chi-square test was used to assess the associations between categorical variables. The p-value<0.05 was considered significant.Results:Of 126 cases with oral lesions, we found that 66 (52.4%) were benign, 12 (9.5%) were pre-malignant and 48 (38.1%) were malignant lesions. Squamous papilloma was the most common benign lesion followed by fibroepithelial hyperplasia. The premalignant lesions observed in our study in the decreasing order of frequency were leukoplakia, lichen planus and submucous fibrosis. The malignant lesions comprised of squamous cell carcinoma and verrucous carcinoma. Conclusion:In our study it was found that though the benign oral lesions are commoner that malignant but still these form significant numbers. Hence the origin and the nature of oral cavity lesion should not be decided on clinical assessment alone but should also take into account the histopathological evaluation of the lesion also.

CT-guided percutaneous biopsy for the diagnosis of mediastinalmass lesion / 医学研究生学报

Objective Few reports are seen on the application of CT-guided percutaneous biopsy ( CT-PB) in the diagnosis of mediastinal mass lesion ( MML) .This study aimed to investigate the clinical application value and safety of CT-PB in detection of MML. Methods This retrospective study included 81 patients hospitalized in our Department of Respiratory and Critical Care Medi-cine, who underwent CT-PB for MML.We performed cytological and histological examinations of the biopsy specimens and immunohisto-chemical staining on the morphologically malignant samples .With the final diagnosis as the gold standard ,we analyzedthe accuracy , speci-ficity, sensitivity, positive and negative predictive values , and com-plications of CT-PB in the diagnosis of MML . Results CT-PBwas successfully performed in all the 81 cases,definite diagnosis achieved in 77 (95.1%),malignancy detected in 68 (84%), benign lesions in 10 (12.3%),and fibrous hyperplasia /massive necrosis in 2 (2.5%).The sensitivity, specificity, and positive and negative predictive values were 94.4%, 100%, 100%and 69.2%, respectively. All the patients were well tolerated without serious complications . Conclusion For patients with mediastinalmass lesion , CT-guided percutaneous biopsy is an efficient and safe diagnostic tool with high sensitivity , specificity , and diagnostic accuracy , which may con-tribute to the subsequent treatment .

Imaging Diagnostic Dilemma of Large Subchorionic Hematoma.

Vaginal bleeding in first-half of pregnancy occurs in one-fourth of all pregnant women. This case report mainly highlights the occurrence of large subchorionic hematoma (SH) (area >13.7 cm2/, stripping of >50% of chorionic circumference) in first trimester. Usually, large SHs occur in second trimester, are associated with pregnancy loss but are relatively uncommon in first trimester. This case describes a 32-year-old G2P1L1’ who presented with complaints of vaginal spotting, was misdiagnosed to have threatened abortion with twin gestation. Later, the diagnosis was confirmed to be a large SH. Patients with large SH are at greater risk for eventual fetal death, hence the need for serial scanning to determine final outcome of their gestation.

A Case of Immunoglobulin G4-Related Cardiac Tumor around the Coronary Artery / 日本心臓血管外科学会雑誌

Immunoglobulin G4 (IgG4)<bk wid=1q><bm>-related disease can occur in various organs, most of which comprise glandular or ductal tissue. We report a case of IgG4-related disease which occurred in a cardiovascular lesion. A 69-year-old man was found to have a tumorous lesion around the coronary artery. Open chest biopsy showed the diffuse lymphoplasmacytic infiltration, occasional eosinophils and numerous IgG4-positive plasma cells within the lesions. The serum concentration of IgG4 in the postoperative period was 1,080 mg/dl (reference range, <135). We diagnosed IgG4-related periarteritis manifesting as a tumor around the coronary artery. This case suggests that IgG4-related disease can occur around the coronary artery and manifest as a periarterial mass lesion.

A Prospective Study on the Incidence, Patterns and Premorbid Conditions of Traumatic Subdural Hygroma

The origin and clinical importance of subdural hygroma(SDG) are still uncertain. Its pathogenetic mechanism and natural history have not yet been settled. Although the incidence of traumatic SDG has been reported to be 5-20% of posttraumatic space-occupying lesions, the true incidence has not been documented in prospective study. Therefore, authors have tried to determine the incidence of traumatic SDG prospectively during past six months. Serial computed tomography(CT) or magnetic resonance imaging(MRI) studies were done in all patients who were admitted to our department after head injuries. Data on the age, sex, Glasgow coma scale(GCS) on admission, and initial CT findings were collected and analyzed to determine the true incidence, pattern and premorbid conditions for the development of traumatic SDG. Serial CT or MRI scans were performed on the date of admission, the second to sixth hospital day, and the seventh to fourteenth hospital day. Study population consisted of 115 patients, excluding 31 expired, discharged, or transferred patients within a week. Subdural hygroma was noted in 42(35.6%) patients. It shared 45.2% of posttraumatic mass lesion. More than half (54.7%) of patients aged 40 or more had subdural hygromas. They were generally delayed lesions, due to the fact that most of them(81%) were observed at four days or more after the injury. All hygromas were located at the frontal or fronto-temporo-parietal regions. Bilaterality was seen in 54.7%. SDGs occurred earlier when the age of the patients were 40 years old or more(p=0.037). It occurred earlier when the initial CT scans were normal, when there was no accompanying traumatic intracranial lesions, and high GCS on admission. However, these differences were statistically not significant(p>0.05). These results suggest that the premorbid conditions for the development of subdural hygroma were sufficient potential subdural space and separation of the dural border cell layer, although former seemed to be more important that the later. Osmotic dehydration in the aged victims should be serially reevaluated, because the subdural hygroma may develop when the intracranial pressure is excessively low.

CT-Guided Stereotaxis of Intracranial Mass Lesions: Its Complications and Diagnostic Accuracy of Biopsy

Surgical resection may not be the appropriate first treatment for all intracranial mass lesions, especially for deep or midline lesions. And a precise histopathological diagnosis is mandatory to develop adequate and specific treatments. The advent of modern imaging and CT-compatible stereotactic frames has greatly simplified the performance of streotactic procedure for small and deep seated brain tumors. We present a 44-month experience on 94 stereotactic procedures of intracranial mass lesions, using Brown-Roberts-Wells(BRW) and Cosman-Roberts-Wells(CRW) system. Procedures were undertaken with the patient under the local anesthesia for biopsy(78 procedures), cyst aspiration and/or Ommaya reservoir insertion(9 procedures), and brachytherapy(5 procedures) and under the general anesthesia for stereotactic-guided microsurgery(2 procedures). Procedural objectives were satisfactorily accomplished with no mortality and an overall complication rate of 8.5%(8 of 94 procedures). The postoperative complications were transient and not seriour, except aggravation of obstructive hydrocephalus in two cases of lateral ventricular tumors. Specific and correct histological diagnoses were achieved in 73(94%) of 78 biopsy. We could not obtain a specific diagnosis in 3 cases(2 cases of reactive gliosis, 1 case of necrosis). And in two cases with a diagnosis of anaplastic astrocytoma and oligodendroglioma grade I on the basis of surgical specimens by craniotomy, stereotactic biopsy revealed astrocytoma grade II and nonspecific inflammation respectively. Our data suggest that CT-guided stereotactic biopsy is a reliable and safe method for histologic diagnosis of brain-tumoral conditions and the method of choice for deep-seated and midline lesions.

CT-Guided Stereotaxis of Intracranial Mass Lesions: Its Complications and Diagnostic Accuracy of Biopsy

Surgical resection may not be the appropriate first treatment for all intracranial mass lesions, especially for deep or midline lesions. And a precise histopathological diagnosis is mandatory to develop adequate and specific treatments. The advent of modern imaging and CT-compatible stereotactic frames has greatly simplified the performance of streotactic procedure for small and deep seated brain tumors. We present a 44-month experience on 94 stereotactic procedures of intracranial mass lesions, using Brown-Roberts-Wells(BRW) and Cosman-Roberts-Wells(CRW) system. Procedures were undertaken with the patient under the local anesthesia for biopsy(78 procedures), cyst aspiration and/or Ommaya reservoir insertion(9 procedures), and brachytherapy(5 procedures) and under the general anesthesia for stereotactic-guided microsurgery(2 procedures). Procedural objectives were satisfactorily accomplished with no mortality and an overall complication rate of 8.5%(8 of 94 procedures). The postoperative complications were transient and not seriour, except aggravation of obstructive hydrocephalus in two cases of lateral ventricular tumors. Specific and correct histological diagnoses were achieved in 73(94%) of 78 biopsy. We could not obtain a specific diagnosis in 3 cases(2 cases of reactive gliosis, 1 case of necrosis). And in two cases with a diagnosis of anaplastic astrocytoma and oligodendroglioma grade I on the basis of surgical specimens by craniotomy, stereotactic biopsy revealed astrocytoma grade II and nonspecific inflammation respectively. Our data suggest that CT-guided stereotactic biopsy is a reliable and safe method for histologic diagnosis of brain-tumoral conditions and the method of choice for deep-seated and midline lesions.