ABSTRACT
Diatoms are photosynthetic algae with a siliceous exoskeleton. Diatoms are utilized by a wide array of industries for applications such as filtration and pest control. Unsubstantiated claims have also propelled their societal reach to trendy oral and topical uses. This case highlights a rare case of an oral granuloma secondary to diatoms. An 80-year-old woman presented with a mobile, firm, asymptomatic submucosal mass on her lower left mandibular vestibular mucosa. Histopathology showed a non-caseating granulomatous reaction to diatoms. Her only verified contact with a diatomaceous earth product was a dental impression using alginate after upper front teeth trauma 5 months before. Although there have been several cases of allergic contact dermatitis attributed to diatoms, there are no reported cases of diatom-induced granuloma formation found in the literature. There are, however, ample data on granulomas initiated by silica. Given the silica-based composition of diatoms, and the broad use of diatoms in industry and alternative medicine, it is unclear why diatom-induced granulomas are not more widely described. This report may alert clinicians to the existence of diatom granulomas and incline them to tailor their history to cover questions about possible exposure when evaluating patients presenting with a localized oral lesion.
Subject(s)
Diatomaceous Earth/adverse effects , Granuloma, Foreign-Body/diagnosis , Mouth Mucosa/pathology , Silicon Dioxide/adverse effects , Aged, 80 and over , Biopsy , Crowns/adverse effects , Diatoms/ultrastructure , Female , Granuloma, Foreign-Body/etiology , Granuloma, Foreign-Body/pathology , Granuloma, Foreign-Body/surgery , Humans , Phytoplankton/ultrastructureABSTRACT
Two cases of a rare variant of adenomatoid odontogenic tumor encompassed by a prominent reactive cemento-osseous proliferation are reported. This unique variant of adenomatoid odontogenic tumor has only been seen twice in the authors' collective experience. Literature documenting the histopathologic patterns of adenomatoid odontogenic tumor and the occurrence of other combined lesions other is reviewed and discussed.
Subject(s)
Ameloblastoma/pathology , Cementoma/pathology , Fibroma, Ossifying/pathology , Maxillary Neoplasms/pathology , Odontogenic Tumors/pathology , Adult , Ameloblastoma/diagnostic imaging , Ameloblastoma/surgery , Cementoma/diagnostic imaging , Cementoma/surgery , Diagnosis, Differential , Female , Fibroma, Ossifying/diagnostic imaging , Fibroma, Ossifying/surgery , Humans , Maxillary Neoplasms/diagnostic imaging , Maxillary Neoplasms/surgery , Odontogenic Tumors/diagnostic imaging , Odontogenic Tumors/surgery , Radiography, Panoramic , Tomography, X-Ray ComputedABSTRACT
Primordial odontogenic tumor (POT) was first described in 2014. It typically presents in the posterior mandible of a child or adolescent as a "dentigerous cyst-like" well-circumscribed radiolucency associated with an unerupted molar. POT consists of an ellipsoidal mass of dental papilla-like myxoid connective tissue entirely enveloped in a delicate membrane of ameloblastic epithelium. It shows features of a developing tooth with a huge dental papilla, and because it is devoid of dental hard tissue, it could be regarded a soft tissue odontoma. The lesion histologically mimics early (primordial) stages of tooth development. This report describes a case of POT and POT-like proliferations in an unrelated complex odontoma.
