Quiste bucal mandibular infectado bilateral: reporte de caso estudiado con CBCT / Bilateral mandibular infected buccal cyst: report of a case studied by CBCT

El quiste bucal mandibular infectado (QBMI), también conocido como quiste de bifurcación, es un quiste odontogénico inflamatorio poco frecuente y descripto por primera vez por Stoneman y Worth. Ha sido incluido en la clasificación de la OMS de quistes y tumores odontogénicos en 1992. Este quiste suele darse, específicamente, en pacientes entre 6 y 13 años, y su localización más frecuente son el primer y segundo molar permanente y, eventualmente, segundo premolar. Su fisiopatología sigue sin estar clara y se han propuesto múltiples teorías. Este quiste se observa como una inflamación en el vestíbulo del molar afectado. Los síntomas frecuentes son dolor en el área afectada y supuración, pero también muchos casos permanecen asintomáticos. Radiográficamente se describe como un área radiolúcida circunferencial. El quiste está revestido con un epitelio escamoso no queratinizado con infiltrado inflamatorio de células en el tejido conectivo. La mayoría de las características clínicas e histológicas son similares a las reportadas para los quistes paradentales, de ahí la importancia de un buen diagnóstico radiográfico complementario en base a tomografía computada de haz cónico. Los enfoques conservadores suelen ser el tratamiento de elección, con la enucleación del quiste y el seguimiento del diente afectado (AU)

Mandibular infected buccal cyst (MIBC), also known as bifurcation cyst; it is a rare inflammatory odontogenic cyst first described by Stoneman and Worth. It was included in the WHO classification of cysts and odontogenic tumours in 1992. It usually occurs, specifically, in patients between 6 and 10 years of age and its most frequent location is the first and second permanent molars, and eventually the second premolar. Its pathophysiology remains unclear and multiple theories have been proposed. This cyst is seen as an inflammation in the vestibule of the affected molar. Frequent symptoms are pain in the affected area and suppuration, but many cases remain asymptomatic. Radiographically it is described as a circumferential radiolucent area. The cyst is lined with a nonkeratinized squamous epithelium with an inflammatory cell infiltrate in the connective tissue. Most of clinical and histological characteristics are like those reported for paradental cysts, hence the importance of a good complementary radiographic diagnosis based on cone beam computed tomography. Conservative approaches are usually the treatment of choice, with enucleation of the cyst and monitoring of the affected tooth (AU)

Enhanced expression of IL-34 in an inflammatory cyst of the submandibular gland: a case report.

BACKGROUND: Cysts of the salivary glands are common lesions that occur in the context of various etiologies. Although the diagnostic importance of cysts in salivary gland diseases has been well studied, molecular mechanisms that control the related pathological process remain largely unknown. IL-34 is a novel cytokine that was discovered recently as a tissue-specific ligand of colony stimulating factor-1 receptor. Since its discovery, accumulating evidence has revealed emerging roles of IL-34 in various pathological conditions and has been suggested to correlate remarkably with inflammation. In this study, we report a medical case of an inflammatory cyst within the submandibular gland, through which evaluating the possible involvement of IL-34 in salivary gland disorders. CASE PRESENTATION: A 37-year-old male patient suffered from a sudden swelling in the right submandibular region, started initially small and had gradually increased in size to reach 3-4 cm in 1 week, accompanied by pain and local fever. Ultrasonography and MRI imaging revealed the existence of a well-defined cystic lesion with sharp borders measuring 39.8 mm × 19.7 mm within the right submandibular gland. The cyst was removed surgically, and the diagnostic decision was determined based on histopathological observations as an inflammatory cyst in the submandibular gland. Sections were generated from different regions of the surgically resected inflammatory cyst and used to examine IL-34 expression by immunohistochemistry compared to normal salivary gland tissues. Immunohistochemical staining showed enhanced expression of IL-34 in the ductal epithelial cells and endothelial cells of blood vessels, with a tendency to be accompanied with high infiltration of immune cells, which suggests a possible involvement of IL-34 in the pathogenesis of salivary gland inflammation. CONCLUSIONS: In this report, we introduce interesting findings of enhanced IL-34 expression in a case of an inflamed submandibular gland. Our findings emphasize the pathological roles of IL-34 as an inflammation amplifier and angiogenic enhancer in inflammatory conditions, such as in salivary gland disorders.

Pneumocephalus following Dorsal Laminectomy: An Unusual Complication.

A 16-year-old male presented at Bangur Institute of Neurosciences Neurosurgery Outpatient Department with history of gradually progressive paraparesis for 5 months associated with stiffness, urinary hesitancy, and urge incontinence for last 2 months. Magnetic resonance imaging spine was done which showed cystic intradural extramedullary space occupying lesion at D4/D5 to D9. Patient had 2 episodes of generalized tonic-clonic seizure on the day 4. Computed tomography scan showed pneumocephalus. Histopathological examination report was that of nonspecific inflammatory cyst.

Quiste folicular inflamatorio en posición atípica: Revisión de la literatura a propósito de un caso / Follicular inflammatory cyst in atypical location: Case report and literature review

Objetivos: Mostrar la importancia de la histopatología en el diagnóstico del quiste folicular inflamatorio para un correcto tratamiento y la relevancia de una nomenclatura precisa. Material y Métodos: Búsqueda en Pubmed, ScienceDirect, EBSCO-host de «odontogenic-cysts¼, «dentigerous cyst of inflammatory origin¼ y "follicular inflammatory-cyst¼ como key-words, full-text en inglés o español de los últimos 10 años. Resultados: Paciente 10 años de edad, presenta tumoración vestibular de zona de diente 5.3, de consistencia dura, asintomático y cubierto por mucosa normal. Diente asociado sin lesiones cariosas. La radiografía evidenció una extensa área radiolúcida bien definida, rodeando la corona del diente 1.3, desplazando y reteniéndolo. Tras evaluación radiográfica, los diagnósticos diferenciales fueron tumor-odontogénico-adenomatoide, queratoquiste y QD. La histopatología confirmó QFI. Originándose la lesión a partir de la pieza 5.4 con tratamiento pulpar. Conclusiones: Se debe considerar al QFI como una lesión similar a otros quistes inflamatorios (paradentales o radiculares). Se sugiere considerar en dentición mixta, que QFI y quiste radicular del diente temporal son la misma lesión y las diferencias en su aspecto clínico dependerán del tiempo de evolución y la relación de proximidad entre folículo y proceso inflamatorio del diente temporal.

Objectives: To show the importance of histopathology in the diagnosis of follicular inflammatory cyst for a correct treatment and the relevance of a precise nomenclature. Material and Methods: Pubmed search, ScienceDirect, EBSCO-host "odontogenic cysts", "inflammatory dentigerous cyst" and "follicular inflammatory cyst" as keywords, full text in English or Spanish for the last 10 years. Results: A 10-year-old patient presented vestibular tumor of the tooth area 5.3, with a hard consistency, asymptomatic and covered by normal mucosa. Associated tooth without carious lesions. The radiograph evidenced a radiolucent area with well-defined limits, around the crown of the tooth 1.3, displacing and retaining it. After radiographic evaluation, the differential diagnoses were tumor-odontogenic-adenomatoid, keratocyst and QD. Histopathology confirmed QFI. Originating the lesion from piece 5.4 with pulp treatment. Conclusions: The QFI should be considered as an similar to other inflammatory (paradental or root) cysts. It is suggested to consider in mixed dentition, that QFI and radicular cyst of the temporal tooth are the same lesion and the differences in their clinical aspect will depend on the evolution time and the proximity relation between follicle and inflammatory process of temporal temporal.

Quiste odontogénico inflamatorio: aislamiento de Pseudomonas stutzeri. Relevancia diagnóstica / Isolation of Pseudomonas stutzeri from an odontogenic inflammatory cyst: Diagnostic relevance

Pseudomonas stutzeri se encuentra ampliamente distribuido en el medio ambiente, ocupando diversos nichos ecológicos; pero su aparición en procesos infecciosos de interés clínico es el de patógeno oportunista. El aislamiento de P. stutzeri en un quiste inflamatorio odontogénico es un verdadero hallazgo microbiológico que no presenta antecedentes en la bibliografía científica odontológica. En este caso particular, el aislamiento se obtuvo a partir de material quirúrgico proveniente de un quiste odontogénico inflamatorio ubicado en la pieza dentaria 1.2 con necrosis pulpar concomitante. Se emplearon técnicas diagnósticas complementarias como radiografías, tomografías, estudios anatomopatológicos y microbiológicos. Los resultados permitieron clasificar el proceso como quiste inflamatorio infectado con P. stutzeri. La tipificación y la caracterización del perfil de sensibilidad de la cepa aislada permitieron adecuar la terapéutica antibiótica de manera específica. El análisis microbiológico permitió establecer la etiología del proceso infeccioso, la adecuación del tratamiento y el restablecimiento de los tejidos comprometidos.

Pseudomonas stutzeri is distributed widely in the environment, and occupies different ecological niches. However, it is found in clinically relevant infections as an opportunistic pathogen. Isolation of P. stutzeri from an odontogenic inflammatory cyst is an uncommon microbiological finding that has not been reported to date. In the case presented here, the bacterium was isolated from surgical material obtained from excision of an inflammatory odontogenic cyst located in the tooth 1.2, and presenting with concomitant pulp necrosis. Complementary techniques such as radiographs, CAT scans, and histopathological and microbiological studies were used to establish definitive diagnosis. The obtained results allowed classifying the process as an inflammatory cyst infected by P. stutzeri. Biotyping and characterization of the susceptibility profile of the isolated strain allowed adjusting the antibiotic therapy more specifically. The microbiological studies allowed establishing the etiology of the infectious process, adjusting the treatment plan, and re-establishing tissue integrity.

[Isolation of Pseudomonas stutzeri from an odontogenic inflammatory cyst: Diagnostic relevance]. / Quiste odontogénico inflamatorio: aislamiento de Pseudomonas stutzeri. Relevancia diagnóstica.

Pseudomonas stutzeri is distributed widely in the environment, and occupies different ecological niches. However, it is found in clinically relevant infections as an opportunistic pathogen. Isolation of P. stutzeri from an odontogenic inflammatory cyst is an uncommon microbiological finding that has not been reported to date. In the case presented here, the bacterium was isolated from surgical material obtained from excision of an inflammatory odontogenic cyst located in the tooth 1.2, and presenting with concomitant pulp necrosis. Complementary techniques such as radiographs, CAT scans, and histopathological and microbiological studies were used to establish definitive diagnosis. The obtained results allowed classifying the process as an inflammatory cyst infected by P. stutzeri. Biotyping and characterization of the susceptibility profile of the isolated strain allowed adjusting the antibiotic therapy more specifically. The microbiological studies allowed establishing the etiology of the infectious process, adjusting the treatment plan, and re-establishing tissue integrity.

Rushton bodies: a pathological enigma / Corpos de Rushton: um enigma patológico

O cisto odontogênico inflamatório mais comum é o cisto radicular. Ele se forma como resultado de necrose pulpar devido à presença de dentes cariados. Os corpos de Rushton podem ser vistos como estruturas irregulares na superfície do epitélio dos cistos odontogênicos. Este relato apresenta um caso raro de um cisto radicular mostrando corpos de Rushton em um paciente do sexo masculino de 47 anos de idade.

The most common inflammatory odontogenic cyst is the radicular cyst. It forms as a result of pulp necrosis due to the presence of carious teeth. Rushton bodies may be seen as irregular structures on the surface epithelium of odontogenic cysts. We present a rare case of a radicular cyst showing rushton bodies in a 47-year-old male patient.

An inflammatory dentigerous cyst shows rim uptake on bone scan: a case report.

Dentigerous cysts are developmental odontogenic jaw cysts, commonly manifesting in the 2nd and 3rd decades of life. This article presents an extremely rare case of dentigerous cyst showing increased uptake in the peripheral rim on bone scan. Herein, we discuss the clinical, radiographic, and histologic features of dentigerous cysts as well as the pathological mechanism underlying their activities on the bone scan. Bone scan was a sensitive tool for detecting the biologic activity of dentigerous cyst in our case.

Perfil epidemiológico, clínico y terapéutico de los quistes odontogénicos en Santiago de Cuba / Epidemiological, clinical therapeutic profile of odontogenic cysts in Santiago de Cuba i: en

Se realizó un estudio descriptivo, prospectivo y longitudinal de 230 quistes odontogénicos de la cavidad bucal, intervenidos quirúrgicamente en el Servicio de Cirugía Maxilofacial del Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora de Santiago de Cuba, en el período 2000-2008, con vistas a caracterizarles desde los puntos de vista clínico, epidemiológico y terapéutico. Entre los resultados principales sobresalió que los quistes inflamatorios presentaron mayor incidencia que los de desarrollo, en una proporción 1,8:1. Ambos grupos de quiste prevalecieron en el sexo masculino, con proporción de 2,4:1 en relación con el femenino. La edad promedio general fue de 38,4±11,2 años (con un rango entre 18 y 71 años) y el tamaño de 3,01±1,54 cm. Hubo predominio de los quistes de la mandíbula en dichos grupos, siendo los sectores de bicúspides molares (maxilar superior) y el área del tercer molar inferior los más afectados. La técnica de tratamiento de elección resultó ser la quistectomía, asociada o no a material de relleno en la cavidad quística. El índice general de recidiva fue bajo y la quistotomía presentó mayor porcentaje, a causa de los queratoquistes. Las complicaciones peroperatorias y posoperatorias indicaron una morbilidad baja.

A descriptive, prospective, longitudinal study of 230 odontogenic cysts of the oral cavity was carried out, which were surgically treated in the Maxillofacial Surgery Department of "Saturnino Lora” Provincial Teaching Clinical Surgical Hospital of Santiago de Cuba, from 2000 to 2008, to characterize them from the clinical, epidemiological and therapeutic points of view. The main results revealed a higher incidence of inflammatory cysts than development cysts, with ratio of 1.8:1. Male sex prevailed in both groups, with ratio of 2.4:1 relative to female sex. The overall mean age was 38.4±11.2 years (with a range between 18 and 71 years) and the size of 3.01±1.54 cm. There was a prevalence of mandibular cysts in these groups, being the areas of molar bicuspids (maxilla) and of lower third molar the most affected. The technique of choice treatment was cystectomy, associated or not with filling in cystic cavity. Overall recurrence rate was low and cystotomy had a higher percentage due to keratocysts. Peroperative and postoperative complications showed low morbidity.

Quiste Folicular Inflamatorio: Revisión Bibliográfica y Reporte de Tres Casos Clínicos

El quiste folicular se ubica según la clasificación de la OMS como un quiste inflamatorio, siendo una patología poco frecuente. Se presenta en los niños entre los 5 a 12 años, es más frecuente en hombres y la zona anatómica más afectada es la región mandibular correspondiente a los premolares. La etiología, es inflamatoria ya que existe una progresión del proceso inflamatorio de los molares temporales tratados endodónticamente hacia el folículo del premolar. El tratamiento de ésta patología varía desde la extracción del diente temporal hasta un tratamiento más invasivo como la enucleación del quiste. La selección del tratamiento depende de diferentes factores como la edad del paciente, tamaño de la lesión, compromiso de estructuras adyacentes, ubicación del diente retenido etc. Generalmente el pronóstico es bueno. Se presenta una revisión de la literatura sobre el quiste folicular inflamatorio, y tres casos pediátricos. Se revisarán las características clínicas, imagenológicas, posibles diagnósticos diferenciales y el tratamiento.

The follicular cyst was classified by the OMS in 1992 as an inflammatory cyst. The prevalence is poor and may be encountered in patients between 5 and 12 years old. There is a male predilection and a higher prevalence in the mandibular premolars The pathogenesis is a result of the progression from a periapical inflammation from an overlying primary tooth that has been pulpotomized to the premolar follicle. The treatment for the follicular cyst varies from the extraction of the primary tooth to enucleation of the cyst. The selection of the treatment depends on the age of the patient, extension of the cyst, the compromise of the adjacent structures, location of the impacted tooth etc. Generally the prognosis is excellent. A review of the literature about the follicular cyst and three pediatric cases will be presented. The clinical and radiographic features, differential diagnosis and treatment will be discussed.

A Case of Presacral Inflammatory Cyst, Causing Medial Deviation of Pelvic Ureteral Course / 대한비뇨기과학회지

A case of presacral inflammatory cyst occurring in a 22 year old male soldier is presented. He complained of lower abdominal pain and tenderness, intermittent severe back pain and flank pain, intermittent chill and fever, frequency, dysuria, G-I trouble Excretory urogram showed mild pyelocalyectasis of left kidney and medial displacement of left pelvic ureter. On colon enema sigmoid showed smooth round displacement to midline, and marked anterior displacement of rectum was found. On cystoscopic examination 5F ureteral catheter couldn't be passed over above 2 Cm, from left ureteral orifice with marked resistance. Presacral inflammatory cyst was found in exploration laparotomy by transperitoneal approach, and excision with drainage was performed. The postoperative course was uneventful and pelvic ureter restored its natural coures.