Delayed diagnosis of a primary intraosseous squamous cell carcinoma: A case report

Primary intraosseous squamous cell carcinoma is a rare malignant central jaw tumor derived from odontogenic epithelial remnants. Predominantly, it affects mandible, although both jaw bones may be involved. This report describes a 60-year-old man who was initially misdiagnosed with a periapical infection related to the right lower wisdom tooth. After four months, the patient presented to a private dental clinic with a massive swelling at the right side of the mandible. Panoramic radiographs and advanced imaging revealed a lesion with complete erosion of the right ramus, which extended to the orbital floor. A biopsy from the mandibular angle revealed large pleomorphic atypical squamous cells, which is the primary microscopic feature of a poorly differentiated squamous cell carcinoma.

Rare finding of Eustachian tube calcifications with cone-beam computed tomography

Soft tissue calcification is a pathological condition in which calcium and phosphate salts are deposited in the soft tissue organic matrix. This study presents an unusual calcification noted in the cartilaginous portion of the Eustachian tube. A 67-year-old woman presented for dental treatment, specifically for implant placement, and cone-beam computed tomography (CBCT) was performed. The CBCT scan was reviewed by a board-certified oral and maxillofacial radiologist and revealed incidental findings of 2 distinct calcifications in the cartilaginous portion of the Eustachian tube. To the authors' knowledge, no previous study has reported the diagnosis of Eustachian tube calcification using CBCT. This report describes an uncommon variant of Eustachian tube calcification, which has a significant didactic value because such cases are seldom illustrated either in textbooks or in the literature. This case once again underscores the importance of having CBCT scans evaluated by a board-certified oral and maxillofacial radiologist.

Evaluation of canalis basilaris medianus using cone-beam computed tomography

The aim of this report is to present two cases of canalis basilaris medianus as identified on cone-beam computed tomography (CBCT) in the base of the skull. The CBCT data sets were sent for radiographic consultation. In both cases, multi-planar views revealed an osseous defect in the base of the skull in the clivus region, the sagittal view showed a unilateral, well-defined, non-corticated, track-like low-attenuation osseous defect in the clivus. The appearance of the defect was highly reminiscent of a fracture of the clivus. The borders of osseous defect were smooth, and no other radiographic signs suggestive of osteolytic destructive processes were noted. Based on the overall radiographic examination, a radiographic impression of canalis basilaris medianus was made. Canalis basilaris medianus is a rare anatomical variant and is generally observed on the clivus. Due to its potential association with meningitis, it should be recognized and reported to avoid potential complications.

Incidental occurrence of an unusually large mastoid foramen on cone-beam computed tomography and review of the literature

The incidental finding of an enlarged mastoid foramen on the right posterior mastoid region of temporal bone is reported, together with a discussion of its clinical significance. A 67-year-old female underwent the pre-implant assessment of a maxillary left edentulous region. A cone-beam computed tomographic (CBCT) image was acquired and referred for consultation. Axial CBCT slices revealed a unilateral, well-defined, noncorticated, low-attenuation, transosseous defect posterior to the mastoid air cells in the right temporal bone. The borders of the osseous defect were smooth and continuous. No other radiographic signs suggestive of erosion or sclerosis were noted in the vicinity. The density within the defect was homogenous and consistent with a foramen and/or soft tissue. The patient's history and physical examination revealed no significant medical issues, and she was referred to a neuroradiologist for a second opinion. The diagnosis of an enlarged mastoid foramen was made and the patient was reassured.

Fossa navicularis magna detection on cone-beam computed tomography

Herein, we report and discuss the detection of fossa navicularis magna, a close radiographic anatomic variant of canalis basilaris medianus of the basiocciput, as an incidental finding in cone-beam computed tomography (CBCT) imaging. The CBCT data of the patients in question were referred for the evaluation of implant sites and to rule out pathology in the maxilla and mandible. CBCT analysis showed osseous, notch-like defects on the inferior aspect of the clivus in all four cases. The appearance of fossa navicularis magna varied among the cases. In some, it was completely within the basiocciput and mimicked a small rounded, corticated, lytic defect, whereas it appeared as a notch in others. Fossa navicularis magna is an anatomical variant that occurs on the inferior aspect of the clivus. The pertinent literature on the anatomical variations occurring in this region was reviewed.