Ewing's sarcoma in mandibular similar to dental abscess.

Ewing's sarcoma is a rare malignant neoplasm that comprises approximately 4-6% of primary bone tumors. In most cases, femur and pelvis are affected, and less commonly the head and neck areas (in the jaws, usually the mandible). These tumors have been reported more frequently in males, mostly aged 5-20 years old. Systemic symptoms and signs such as fever, weight loss, anemia, leukocytosis, and elevated erythrocyte sedimentation rate (ESR) may be the first signs in oral Ewing's sarcoma. Such signs and symptoms are also seen in odontogenic infections and abscess. In one case, the patient went to a dentist with pain, swelling, and abscess similar to odontogenic infection and patient's tooth was pulled due to misdiagnosis. This tumor has an aggressive clinical behavior and is identified with rapid growth and high probability of metastasis at diagnosis. Thus, it is necessary to differentiate it from a dental abscess. As for the treatment of Ewing's sarcoma, first the tumor must undergo chemotherapy to reduce its size and, eventually, it undergoes extensive surgery. This case report deals with a 16-year-old patient wrongly diagnosed with odontogenic infection and abscess, and hospitalized. As the symptoms did not remit, biopsy was carried out and the patient was operated on with Ewing's sarcoma diagnosis.

Mandibular intraosseous schwannoma in a child: Report of a rare case.

Intraosseous schwannomas is a very rare neoplasm, and less than 50 cases have been reported in the medical literature. In this article, the clinical, radiographic and histopathologic appearances of a rare case of intraosseous schwannomas are presented. The importance of this case is that other benign central lesions such as odontogenic tumors and cysts might be included in differential diagnosis. This case was recognized in a 9-year-old child, which is a very rare occurrence. The diagnosis was confirmed by immunohistochemical staining with S100 protein.

Metastatic anaplastic large cell lymphoma of the oral cavity.

Lymphoma is a malignant neoplasm of lymphoid tissue which is divided into 2 groups: Hodgkin and non-Hodgkin. About 85% of non-Hodgkin lymphomas are B-cell lymphomas, and T-cell lymphomas are unusual. Anaplastic large cell lymphoma (ALCL) is a kind of non-Hodgkin lymphoma with T or NK cell origin that is rarely seen in the oral cavity and only 10 cases have been reported up to now. Here we present a case of ALCL metastasized to the oral cavity in a 32- year- old man with pervious history of ALCL which caused an ulceration in the posterior area of the hard palate. Radiography showed irregular resorption of alveolar bone. Histopathologic examination of the incisional biopsy revealed neoplastic proliferation of large and bizarre cells with hyperchromatic nuclei and numerous giant cells and atypical mitoses. Immunohistochemistry markers (CK, LCA, CD3, CD30, CD20) confirmed the diagnosis of ALCL.

The relation of pericoronal third molar follicle dimension and bcl-2/ki-67 expression: An immunohistochemical study.

BACKGROUND: Most common impacted teeth are the mandibular third molars and decision about extraction of them is usually controversial. The presence of pericoronal pathologic changes is an acceptable reason for removal of impacted teeth. Differences in the proliferation rate and apoptosis of odontogenic epithelial cells may influence on the formation of odontogenic epithelial lesions. Therefore, the aim of the present study is to evaluate the immunohistochemical expression of the bcl-2 apoptosis-inhibiting protein and the cell-cycle-related ki-67 antigen in pericoronal follicle of impacted third molars with ≥2.5 mm and <2.5 mm radiolucency. MATERIALS AND METHODS: This was a cross-sectional study that 20 follicles with <2.5 mm radiolucency and 20 follicles with ≥2.5 mm radiolucency were selected by a professional radiologist in digital panoramic radiographs and then referred to a surgeon. Formalin fixed paraffin-embedded tissues were immunohistochemical analyzed for immunoreactivity of bcl-2 protein and ki-67 antigen. The data was analyzed using logistic regression, Spearman correlation coefficient and t-test and Mann-Whitney. P<0.05 was considered significant. RESULTS: The findings showed correlation between size of the third molar's follicles and expression of bcl-2 protein (P < 0.001, r = 0.556) but there was no correlation between size of third molar's follicles and staining with ki-67 antigen (P = 0.546, r = 0.098). The follicles with radiolucency ≥2.5 mm showed increased immunoreactivity for bcl-2 protein. CONCLUSION: The results of study suggest that impacted third molars with radiolucency ≥2.5 mm may be associated with deregulation of cell death, indicated with increased expression of the anti- apoptotic protein bcl-2, while cell proliferation (ki-67) does not seem to play a significant role.