ABSTRACT
In 1986, a 60-year-old African American woman visited the Marquette University School of Dentistry with a complaint of a vague, dull pain in her lower left quadrant. Tooth No. 19 was extracted 10 years earlier because of extensive decay, and tooth No. 18 had received root canal therapy. A panoramic radiograph revealed the presence of ill-defined, multilocular, mixed (radiopaque-radiolucent) lesions present throughout the lower jaw. She was treated with antibiotics and scheduled for follow-up visits. When the symptoms persisted, tooth No. 18 was re-treated with root canal therapy and a representative biopsy was taken from the left mandibular area. The biopsy showed the presence of chronic osteomyelitis. The patient was treated with antibiotics and was scheduled for periodic check-up visits. In February 1995, she returned with the same symptoms in the left mandible. A panoramic radiograph showed persistence of the mixed radiopaque-radiolucent lesions throughout her mandible; however, the mass on the left side was more radiopaque and had assumed a "cotton wool" appearance. Tooth No. 18 was extracted and a biopsy was taken from the area. After correlating the clinical behavior, radiographic appearance, and histopathologic features, a diagnosis of florid osseous dysplasia with osteitis was made. This case represents a classic example of the difficulty in diagnosing fibro-osseous lesions using radiographic interpretation alone and the need to correlate the clinical, radiographic, and histopathologic features to reach a diagnosis. Additionally, the present case clearly shows treatment problems of an otherwise self-limiting condition when secondary involvement with osteomyelitis is also present. A brief description of the conditions that were included in the differential diagnosis and their management is presented.
Subject(s)
Fibrous Dysplasia of Bone/diagnostic imaging , Mandibular Diseases/diagnostic imaging , Cementoma/diagnosis , Diagnosis, Differential , Female , Fibrous Dysplasia of Bone/complications , Humans , Mandibular Neoplasms/diagnosis , Middle Aged , Osteitis Deformans/diagnosis , Osteomyelitis/complications , Osteomyelitis/diagnosis , RadiographyABSTRACT
Rhabdomyosarcoma is one of the most common malignancies of the mesenchymal tissue in the head and neck region. A case of a 26-year-old male with oral rhabdomyosarcoma is presented. The clinical and pathologic aspects of this malignancy are also reviewed. Furthermore, the histopathologic and ultrastructural features of this neoplasia are described and the important role of electron microscopy in diagnosis of the myogenic tumor is emphasized. Finally, different modes of treatment for the rhabdomyosarcoma are discussed.
