Fibrosarcoma of the mandible: a diagnostic dilemma.

Fibrosarcoma is a malignant mesenchymal neoplasm of fibroblasts that rarely affects oral cavity and can cause local recurrences or metastasis. The aetiologic factors are still unknown, but many authors have reported the radiation therapy history as an important aetiological factor, followed by trauma and underlying conditions like Paget's disease, fibrous dysplasia or chronic osteomyelitis. Fibrosarcoma of mandible is rare, with an incidence which ranges from 0-6.1% of all primary fibrosarcomas of the bone. This paper has described a case of a swelling in the mandible of a 17-years old female who had a radiolucency in association with crown of an impacted tooth and foci of radiopacity, which led to a misdiagnosis of either an odontogenic lesion or a bone tumour, but proved to be a fibrosarcoma on histopathological and immunohistochemistry investigations.

Sialolithiasis in a 10 year old child.

Sialolithiasis is often observed in the oral region, and is caused by the development of a calculus in the salivary gland or duct. This disease is mostly seen in adults or young adults, and seldom develops in children. Of all the cases of sialolithiasis, only 3% are seen in the pediatric population. The clinical presentation typically consists of a painful swelling of the involved salivary gland at meal times, as the obstruction is most acute at this time. The clinical signs often lead to an easy diagnosis. The salivary gland most commonly affected is the submandibular gland. In this paper, we have reported the case of a 10 year old female with sialolithiasis of the left submandibular duct. The treatment consisted of the use of lemon and orange drop candies, which stimulated the salivary flow and in turn resulted in the expulsion of stone.

Plasmacytoma masquerading as an abscess.

Plasma cell neoplasia is a lymphoid neoplastic proliferation of B cells and has been classified as multiple myeloma, solitary plasmacytoma, and extramedullary plasmacytoma. Extramedullary plasmacytoma is defined as neoplastic proliferation of plasma cells in the soft tissue. Extramedullary plasmacytoma of the head and neck is very uncommon tumors, representing approximately 0.4% of all head and neck malignancies; amongst them, plasmacytoma of the maxilla is extremely rare. We present a case of a 70-year-old male with swelling on the right middle third of the face, mimicking an abscess, but proven to be extramedullary plasmacytoma. This report discusses the clinical, radiographic, histological, and immunohistochemical features of extramedullary plasmacytoma.

Ectrodactyly, ectodermal dysplasia, cleft lip, and palate (EEC syndrome).

The ectodermal dysplasias (EDs) are a large and complex group of diseases. More than 170 different clinical conditions have been recognized and defined as ectodermal dysplasias. Commonly involved ectodermal-derived structures are hair, teeth, nails, and sweat glands. In some conditions, it may be associated with mental retardation. We report a case of 10-year-old male child with ectrodactyly, syndactyly, ED, cleft lip/palate, hearing loss, and mental retardation.

Increased expression of CK8 and CK18 in leukoplakia, oral submucous fibrosis, and oral squamous cell carcinoma: an immunohistochemistry study.

OBJECTIVE: Oral squamous cell carcinoma (OSCC) may be preceded by potentially malignant disorders such as leukoplakia and oral submucous fibrosis (OSF) and has a greater than normal risk of malignant transformation. Very little is known of cytokeratin (CK) alterations in OSF, leukoplakia, and OSCC. The aim of this study was to evaluate and compare the expression of CK8 and CK18 in normal oral mucosa, oral epithelial dysplasia, OSF, and OSCC by immunohistochemistry. STUDY DESIGN: Paraffin-embedded normal (n = 10), dysplasia (n = 10), OSF (n = 10), and OSCC (n = 10) tissues were stained with CK8 and CK18 by immunohistochemistry. RESULTS: Increased expression of CK8 and CK18 was seen in dysplasia, OSF, and OSCC. Staining pattern and intensity showed variations, with intensity of staining in basal and suprabasal layers for CK8 and CK18. CONCLUSIONS: Intensity of staining in the basal layer for CK18 was statistical significant, suggesting CK8 and CK18 as surrogate markers of malignant transformation.

Ameloblastic fibro-odontoma masquerading as odontoma.

Ameloblastic fibro-odontoma (AFO) is a rare, benign epithelial mixed odontogenic tumor. It occurs as an intraosseous lesion, generally asymptomatic and more prevalent in children and adolescent. AFO is found on radiographic evaluation of patients with unerupted or impacted teeth in many cases. Histological examination reveals a fibrous soft tissue, islands of odontogenic epithelium and a disordered mixture of dental tissues. The treatment modality in most cases involves conservative surgery with enucleation. We present a case of 13-year-old boy with a missing right central incisor, mimicking-like odontoma on radiograph but proved to be AFO and treated with enucleation with preservation of impacted tooth. There was no recurrence after one year of follow-up. This report discusses the clinical, radiographical, histological features and surgical assessment to preserve the impacted tooth associated with AFO.

A disguised tuberculosis in oral buccal mucosa.

Tuberculosis is a major cause of morbidity and mortality worldwide. It is a chronic granulomatous disease that can affect any part of the body, including the oral cavity. Oral lesions of tuberculosis, though uncommon, are seen in both the primary and secondary stages of the disease. This article presents a case of tuberculosis of the buccal mucosa, manifesting as non-healing, non-painful ulcer. The diagnosis was confirmed based on histopathology, sputum examination and immunological investigation. The patient underwent anti-tuberculosis therapy and her oral and systemic conditions improved rapidly. Although oral manifestations of tuberculosis are rare, clinicians should include them in the differential diagnosis of various types of oral ulcers. An early diagnosis with prompt treatment can prevent complications and potential contaminations.

A rapid and noninvasive method to detect dried saliva stains from human skin using fluorescent spectroscopy.

OBJECTIVE: Saliva is one of the vital fluids secreted in human beings. Significant amount of saliva is deposited on the skin during biting, sucking or licking, and can act as an important source in forensic evidence. An enzyme, α amylase, gives a characteristic emission spectrum at 345-355 nm when excited at 282 nm and this can be identified by using fluorescent spectroscopy and can help in forensic identification. This study describes a rapid method to detect dried saliva on the human skin by fluorescent spectroscopy. MATERIALS AND METHODS: This study included 10 volunteers, who deposited their own saliva on skin of their ventral forearm by licking and water on the contralateral arm as control. This study was carried out at Central Leather Research Institute, Chennai. STUDY DESIGN: Ten volunteers deposited their own saliva on skin of their ventral forearm by licking. A control sample of water was deposited at the contralateral arm. Each sample was excited at 282 nm and emission spectrum was recorded. RESULTS: The emission spectra of 10 swab samples taken from dried saliva were characterized at the primary peak of 345 to 355 nm whereas the emission spectrum of water as a control was recorded at 362 nm. CONCLUSION: The presence of emission spectrum at 345-355 nm with excitation at 282 nm proves to be a strong indicator of saliva deposited on human skin.