Giant abdominal tumor - would you think adrenal?

Adrenal cavernomas are rare benign tumors, and those of giant dimensions are exceptional. Usually, they are symptomless or they induce symptoms and signs due to compression over nearby organs. We present the case of a 68-year-old woman, who complained of abdominal enlargement and abdominal pain in the left part of the abdomen. Imagistic investigations (native and contrast abdominal computed tomography) revealed an inhomogeneous retroperitoneal mass of 210∕182∕200 mm, containing calcifications. Laboratory findings were not relevant, just a slight and non-significant elevation of carcinoembryonic antigen and a slight elevation of C-reactive protein. Diagnosis of cancer of undetermined origin was considered, and surgery was performed. During surgery, a giant encapsulated inhomogeneous tumor of 330 mm, with cystic areas, was removed, without assessing the origin. Primary or secondary tumors (metastasis from breast, intestinal, lung, renal or skin cancer) were taken into account. Only histopathology and immunohistochemistry revealed the diagnosis of adrenal cavernoma. Until this moment, we found only one published article in the medical literature with similar dimensions of an adrenal cavernoma as in our case. Even if rare, hemangioma of the adrenal gland must be considered during the differential diagnosis of an adrenal tumor.

Immunohistochemical study of experimentally drug-induced gingival overgrowth.

The increasing frequency of using in the medical practice drugs that have the potential to induce gingival overgrowth (GO) and the existence of many unknown aspects in GO etiopathogenesis have prompted us to carry out this immunohistochemical experimental animal study. We conducted a cell proliferation study by Ki67 immunostaining and a cytokeratin (CK) study using anti-pan-CK AE1∕AE3 and anti-MNF116 antibodies, investigating the differences induced by different classes of drugs that are more frequently involved in the induction of GO. The results of our study indicate that CK AE1∕AE3 plays an important role not only in normal cellular proliferation, but also in hypertrophic tissues, and can be considered a marker of the proliferative process occurring in GO. Immunostaining for the anti-MNF116 antibody was weaker and inconsistent in intensity compared to anti-CK AE1∕AE3 antibody, its staining pattern appearing as diffuse or zonal.

Histological and immunohistochemical aspects of the atrophic dental pulp modifications of abutment teeth.

BACKGROUND: Reducing the thickness of hard dental tissues through the preparation of teeth for fixed prosthodontics represents an aggression for the dentin-pulp complex and may cause changes in dental pulp tissues, by means of acute or chronic inflammation, or by asymptomatic, atrophic modifications. AIM: The aim of the study was to histological and immunohistochemical evaluate samples of dental pulp selected from previously prepared teeth, which had been functioning as abutment teeth for some years. PATIENTS, MATERIALS AND METHODS: The starting point of the study was a statistical study conducted on a batch of 276 patients, of which 64 needed to change the fixed prosthetic restorations. Some of the existing abutment teeth were extracted, others presented previously performed root canal treatments and others required endodontic treatment. RESULTS: Of the 21 samples taken, 12 showed atrophic pulp modifications, represented by low cellularity, collagen fibrosis, vascular congestion, and pulpal calcifications. CONCLUSIONS: Certain irreversible atrophic changes can be observed in abutment teeth's pulps, a fact that justifies the need of performing pre-prosthetic endodontic treatment.

Clinical, statistical, histological and immunohistochemical aspects of periodontal changes in patients with diabetes mellitus.

BACKGROUND: Both diabetes mellitus (DM) and periodontal disease are the most widespread chronic inflammatory diseases that affect a very large number of the population worldwide. AIM: This study's aim was to compare the status of dental hygiene in a group of patients with DM, with patients in the control group, and to histologically analyzing the gum from the subjects with DM. PATIENTS, MATERIALS AND METHODS: The study sample was made up of 53 control subjects and 107 diabetics aged 19-80 years old. We evaluated the following parameters: the plaque index (PI) and the calculus index (CI), according to Simplified Oral Hygiene Index, and the gingival index (GI), according to the Löe & Silness criterion, correlated with glycosylated hemoglobin and the blood sugar levels. RESULTS: For all hygiene indices, the mean values recorded for the control group were significantly lower than the mean values recorded for any sub-category in the diabetic groups. CONCLUSIONS: DM contributes unfavorably to the evolution of periodontal disease. The poor glycemic control and the improper oral hygiene have a negative impact on the health of the periodontium, highlighted by increased scores on PI, CI and GI scales.

Basal cell carcinoma of the nasal pyramid excision margins: a retrospective study.

Basal cell carcinoma (BCC) is the most frequent skin cancer and its location in the nasal pyramid poses treatment problems. The main issue is how large the resection margins should be. The article presents a retrospective study on patients with BCCs of the nose. Thirty-seven patients were included and the correlations between incomplete resections and tumor dimensions, resection margins or histological sub-type were investigated. Of the 37 patients, only five had tumor-positive excision margins, but no correlation with the above-mentioned factors could be found. An overall tendency to over-resection was detected, contrary to the tendency depicted in the literature, but the incomplete resection rate (13.5%) is comparable with other reports. Further studies are needed, on a larger population in order to generate guidelines to better medical practice on this matter.