Endodontic treatment of a cementoblastoma.

The benign cementoblastoma (true cementoma, osteoblastoma, giant osteoid osteoma) appears to be a true neoplasm of functional cementoblasts which proliferate at the apex of teeth to form an expansile tumor. It remains intimately attached to the tooth roots and occasionally involves the root canals themselves. Although the pulpal tissue remains vital, treatment has historically consisted of extraction of the involved tooth along with extirpation of the tumor. This mode of therapy for the benign cementoblastoma should not be confused with the entity called periapical cemental dysplasia (that is cementoma, periapical osteofibroma or osteofibrosis, cementifying fibroma, localized fibro-osteoma, and periapical fibrous dysplasia). In this latter lesion the treatment consists of simply recognizing the condition and establishing a schedule for periodic evaluation of the patient. In the case presented here enucleation of the cementoblastoma and endodontic therapy were selected as treatment modalities, despite the presence of buccal and lingual expansion of the cortical plates. There has been no recurrence of this growth during the 4-year follow-up period.

Acinic cell carcinoma of the cheek.

An additional case report of the rare minor salivary gland tumor, acinic cell adenocarcinoma, has been reported. This is the twenty-first case in which the cheek has been the primary site. The tumor was treated by wide local excision and the patient is currently being followed by a large medical center's tumor board.

Metastatic renal cell carcinoma from a primary tumor removed 14 years previously.

It is not uncommon for renal carcinomas to present with a solitary metastasis. However, this patient was initially seen with multiple metastatic lesions. The five-year survival rate in such cases is very low, i.e., less that 5%. It is unfortunate that the initial diagnosis of Wilm's tumor was in error, as postoperative radiation therapy might have been of some value in ablation of residual tumor foci. It is, however, doubtful that radiation therapy and/or chemotherapy would have altered the eventual outcome of this disease. Although the diagnosis of a clear cell metastatic tumor to the head and neck is difficult because of the multiplicity of clear cell malignancies that can occur in this area, a primary tumor of the kidney must always remain high in the differential diagnosis.

Heterotopic gastric mucosa of the tongue.

A cyst of the tongue lined by gastric mucosa is described, and eight previously reported cases are reviewed. All the patients with heterotopic gastric mucosa of the tongue have been males whose ages range from 2 months to 31 years, the sole exception being our case in a newborn infant. Six lesions were cystic and three were solid. Five were located on the anterior one-third of the tongue, three at the base, and one at the tip. Conservative excision is the procedure of choice, and of the patients reviewed, only our patient required a second excision. No additional abnormalities have been reported in these patients, except for one patient who had a double upper lip.

Oral warty dyskeratoma: literature review and report of case.

A case of intraoral warty dyskeratoma has been presented. Etiologic theories, diagnosis, and diagnostic techniques have been presented.

An ameloblastoma with myofibroblasts and intracellular septate junctions.

This report represents a review of the ultrastructural features of the simple ameloblastoma. Our ultrastructural data indicate that the stromal component of ameloblastoma is composed of myofibroblasts with associated collagen and basal lamina material. A unique feature of these myofibroblasts is the formation of plaque-like structures on extended cell processes which were identified as intracellular septate junctions. The epithelial component of ameloblastoma was shown to be composed of three distinct cell types which appear to represent a continuum for the ameloblast-like basal cell through an intermediate to an acanthomatous cell. The actual relationship between the three cell types is unclear.

Routine biopsy leading to the diagnosis of strongyloidiasis.

Routine removal of a third molar, together with histopathologic soft-tissue examination and a high index of suspicion, led to the diagnosis of a generalized Strongyloides stercoralis infestation. The case of a patient with this unusual combination of pathologic entities is presented.