Hybrid Ameloblastoma of Anterior Maxilla: A Rare and Puzzling Pathologic entity - Case Report with Systematic Review.

Hybrid ameloblastoma has a variable clinical, radiological, and histopathological presentation. They contain two or more different histologic types and their biologic comportment is still arguable. We herein present a case of a hybrid variant of desmoplastic ameloblastoma which is the first of its kind to have ever been reported due to its unusual location in the maxillary anterior region, along with systematic review of clinicopathologic features of reported cases immunohistochemical markers may act as an adjunct in the accurate diagnosis of these lesions.

Diagnostic efficacy of color Doppler ultrasound in evaluation of cervical lymphadenopathy.

BACKGROUND: To evaluate the efficacy of color Doppler ultrasound (CDUS) in differentiating benign and malignant cervical lymph nodes by detecting differences in blood flow patterns. MATERIALS AND METHODS: In this cross-sectional prospective study, 25 untreated patients with clinical evidence of cervical lymphadenopathy were evaluated. CDUS was performed for 80 cervical lymph nodes. The gray scale parameters of the lymph node and intranodal perfusion sites were the key CDUS features used to differentiate between reactive and metastatic lymph nodes. Histopathological confirmations were obtained and compared with the results of CDUS. RESULTS: Initially, 53 cervical lymph nodes were evaluated by clinical examination. Twenty-seven additional lymph nodes (53 + 27 = 80) were discovered by CDUS evaluation. Gray scale parameters for lymph nodes such as size of lymph node, shape of lymph node, and presence or absence of hilum revealed highly significant results (P < 0.0001). Color Doppler flow signals revealed that central/hilar flow was characteristic for benign nodes whereas peripheral/mixed flow was characteristic for malignant nodes, the findings were highly significant (P < 0.0001). Gray scale and color Doppler features are used to differentiate benign and malignant nodes. CONCLUSION: Within the limitations of this study, CDUS evaluation was found to be highly significant with a high sensitivity and specificity over clinical evaluation CDUS examination provides a prospect to reduce the need for biopsy/fine needle aspiration cytology in reactive nodes.

Computed tomography based forensic gender determination by measuring the size and volume of the maxillary sinuses.

PURPOSE: Identification of human body or remains after death is a forensic procedure, which is difficult to perform and is mandatory by law and in compliance with social norms. Sexing the recovered human remains is an integral part of the identification process. Maxillary sinus can be used for gender determination as it remains intact even when the skull and other bones may be badly damaged in casualties where the body is incinerated. Computed tomography (CT) provides an excellent method for examining maxillary sinuses. MATERIALS AND METHODS: CT images were used to measure the mediolateral, superoinferior, and anteroposterior dimensions and the volume of the maxillary sinuses in 30 patients (15 males and 15 females) to investigate whether these parameters could be used to determine the gender of an individual for forensic identification. The t-test for independent samples was used to compare these values in males and females and the data were subjected to discriminative analysis using SPSS software. RESULTS: Our method was able to predict the gender with an accuracy of 80.0% in males and 86.7% in females, with an overall accuracy rate of 83.3%. CONCLUSION: The accuracy rate in this study was comparable, if not higher than many other methods that have been used to predict the gender of an individual from skeletal remains. The length, width, height, and volume of the maxillary sinuses together with other bones could be used for gender determination with a fair degree of accuracy when the whole skeleton is not available.

Computed Tomography in Diagnosis of Admantinoma.

CONTEXT: Admantinoma is second most common benign odontogenic tumor which clinically appears as an aggressive odontogenic tumor, often asymptomatic and slow growing, associated with symptoms such as swelling, dental malocclusion, pain, and paresthesia of the affected area. The radiographic appearance may vary from unilocular to multilocular radiolucencies, imparting a characteristic honey comb, soap bubble appearance or may resemble a caricature of spider. CASE REPORT: This report highlights the importance of conventional and advanced imaging in the diagnosis of large and invasive lesions. Patient reported with complaint of swelling in jaw, which progressively increased; and was found to be bony hard, both intra- and extraorally. Radiographs revealed large multilocular radiolucency on left body and ramus of mandible with soap bubble pattern and knife edged root resorption. Computed tomographic examination evaluated the extent of the lesion, internal structure, and relation to adjacent structures; further a reconstructed image was obtained to evaluate extent of destruction in three dimensions. CONCLUSION: Computed tomography has an important role in the diagnosis and treatment planning is imperative as it is superior in revealing the cortical destruction and extension into the neighboring soft tissues than conventional radiography.

Dentinogenic ghost cell tumor - a neoplastic variety of calcifying odontogenic cyst: case presentation and review.

CONTEXT: The calcifying odontogenic cyst (COC), also referred to as calcifying ghost cell odontogenic cyst (CGCOC) is a heterogeneous lesion existing either as cystic or solid variant. Due to the fact that all CGCOC lesions are not cystic, and the biological behavior is often not consistent with a cyst, there has always been a controversy as to whether COC is a cyst or a tumor. The dentinogenic ghost-cell tumor (DGCT), a solid variant of the COC, is an uncommon odontogenic neoplasm occurring predominantly in later life. Case report is followed by a concise review and disambiguation of controversial terminologies regarding nomenclature of COC. CASE REPORT: We report a case of 33-year-old female patient who presented with an insidious, steadily increasing swelling on the left side of her face since 8 months. Patient reported slight difficulty in eating because of reduced intraoral space and an obvious concern with facial disfigurement. There was no contributory dental or medical history. Intraorally, a hard, well defined, bicortical swelling was noted in left maxillary region with slight mobility of the associated teeth and normal appearing overlying mucosa. A provisional diagnosis of adenomatoid odontogenic tumor was made, and orthopantomogram, paranasal sinus radiograph and computed tomograpy scan of the face were acquired. A radiographic diagnosis of COC was made, which was subsequently confirmed on histopathology postenucleation of the tumor mass. COC has been seen to be of extensive diversity in its clinical and histopathological features as well as in its biological behavior. CONCLUSION: The present case of 33-year-old female was diagnosed as DGCT, a tumorous form of COC, due to its characteristic histological features; numerous ghost cells and dentinoid material.

Mucinous cystadenoma: A rare entity.

Cystadenoma is a rare benign salivary gland tumor that chiefly originates in the minor salivary glands as a cystic growth with papillary projections into the cystic lumen without the lymphoid element. It is further classified into two histopathological variants that have been recognized by World Health Organization as the papillary and the mucinous forms of cystadenoma. Clinically, it is difficult to differentiate from other benign minor salivary tumors and mucous retention phenomenon. Diagnosis is chiefly based on characteristics histological features. It is believed that the salivary gland tumors are difficult to diagnose and interpret because there are varied patterns of presentation. The study of salivary gland disorders has increased in leaps and bounds. The authors report a case of mucinous cystadenoma of the minor salivary gland on the hard palate, which is even rarest of the rarely reported cystadenomas of the minor salivary glands.

Prevalence study of oral mucosal lesions, mucosal variants, and treatment required for patients reporting to a dental school in North India: In accordance with WHO guidelines.

UNLABELLED: The aim of the study was to evaluate the prevalence of oral mucosal lesions (OML) in adult patients reporting to the dental outpatient department at the Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India. The purpose was to determine the priorities in oral health education, preventive measures, and identify the group in urgent need of treatment. MATERIALS AND METHODS: The study was conducted over a period of 6 months in 2010, when 8866 subjects were offered structured interviews and standardized extraoral and intraoral examinations according to the World Health Organization (WHO) guidelines. RESULT: Overall prevalence of OML was 1736 (16.8%), the most prevalent being smoker's palate (10.44%) followed by leukoplakia (2.83%), oral submucous fibrosis (1.97%), oral candidiasis (1.61%), recurrent aphthous stomatitis (1.53%), oral lichen planus (0.8%) and others (0.78%). The highest prevalence of the tobacco habit in both forms was recorded in the group aged 40-44 yearsand those aged between 60 and 64 years who wore dentures. Lesions were most prevalent in those aged 40-44 years with a significant predominance of males at 3:1 (M = 12.6% and F = 4.3%). Patients who consumed tobacco in any form or wore dentures had a significantly higher prevalence of OML (P < 0.001). The highest number of lesions were on the palate (59.7%) followed by buccal mucosa (19.9%). Various normal mucosal variants were recorded. Fordyce's granules (0.13%), fissured tongue (3.3%), leukoedema (1.47%), and lingual varices (2.73%) were also recorded. The tongue showed the highest number of variants (64.4%). Patients were grouped according to the treatment needed under the WHO criteria. One hundred and ninety-seven patients were given oral hygiene instructions only, whereas 1422 patients were advised on change of habit and a follow-up and 674 patients needed definitive treatment. CONCLUSION: This study thus highlights diagnostic criteria, multifactorial risk factors to make standard measurements of OML a basis for planning and evaluating oral health programs for data collection.

Trabeculae type of juvenile aggressive ossifying fibroma of the maxilla: Report of two cases.

Juvenile ossifying fibroma (JOF) is a rare controversial fibroosseous lesion affecting the craniofacial skeleton and occurring commonly in children and young adults. It is highly aggressive and has a high tendency to recur. It is distinguished from the adult variant of ossifying fibroma on the basis of age, site, clinical behavior and microscopic appearance. Because of its high recurrence rate, which is 30-58%, complete excision is essential. Early diagnosis will circumvent the necessity of radical treatment. We report a rare case of trabecular JOF of maxilla where a computed tomography scan was taken to further support the characteristic feature of the lesion.