1/27. melanoma of the face and mouth in nigeria. A review and comment on three cases.The absolute incidence of melanoma at all sites in blacks is higher than is commonly credited. There is a shift in site incidence to less pigmented areas including the mucosae but oral melanoma is still rarely reported in Africans. An unusual case of facial melanoma arising in a childhood naevus, and two oral melanomas, all in Nigerians, are described. The salient clinical features and the treatment of these cases are discussed, and the possible relationship between pigmented patches and melanomas in the mouths of blacks is examined.- - - - - - - - - - ranking = 1keywords = mouth (Clic here for more details about this article) |
2/27. Merkel cell carcinoma of the skin and mucosa: report of 12 cutaneous cases with 2 cases arising from the nasal mucosa.BACKGROUND: Merkel cell carcinoma (MCC) is an uncommon skin tumor that most frequently arises on sun-exposed facial sites. It rarely occurs on mucous membranes of the head region. The primary MCC is usually treated by wide excision followed by radiation to the primary site and regional lymph nodes. Using traditional surgery the local recurrence rate ranges from 20 to 50%. In our clinic, mohs surgery is used to excise the primary MCC completely, followed by radiation. Here we present our treatment experiences and outcomes. OBJECTIVE: To document our experience of MCC treated by mohs surgery. We present our series of 12 cases of MCC, 2 cases of which arose from mucosal sites of the nasal cavity. methods: We reviewed 12 cases of MCC from the Mohs clinic database. We also reviewed the literature for cutaneous and mucosal MCC. RESULTS: There were 12 cases of MCC: 10 cutaneous and 2 mucous. The site distribution of cutaneous MCC was eight on the head, one on the neck, and one on the groin. Of these, nine were treated by Mohs excision. Two patients developed local recurrence following Mohs treatment. The local recurrence rate was 22% (2 of 9). The sites of mucosal MCC were the nasal septum and nasopharynx. One case had a history of previous radiation and developed an MCC 40 years later. This case also demonstrated epidermotropic spread of merkel cells to the overlying mucous epithelium. This patient required extensive intranasal and cranial surgery to remove the tumor. Both patients with mucosal MCCs died of their disease. The overall mucocutaneous survival of MCC at 1 year was 80% and at 2 years was 50%. CONCLUSION: In our series, local control of the primary MCC was achieved in 70% of patients (7 of 10) using combined Mohs excision and radiation. Two recurrences had primary tumors larger than 3.5 cm in diameter, while the other case was nonresectable by mohs surgery. Tumor size appeared to determine the degree of local control. When the postoperative Mohs defect was less than 3.0 cm in diameter, local and regional control appeared to be more favorable. When the primary facial MCC is relatively small, removal by mohs surgery followed by radiation was effective, therapeutic, and less disfiguring. Mucosal MCC is rare and may occur as a long-term sequelae after radiation therapy to the skin.- - - - - - - - - - ranking = 0.4061961345622keywords = cavity (Clic here for more details about this article) |
3/27. Repair of full thickness defect of the nose using an expanded forehead flap and a glabellar flap.We describe a method to repair full thickness defects of the nose using a glabellar flap as the lining of the nasal cavity and an expanded forehead flap for external closure. We consider our method useful in the reconstruction of a nose with a full thickness defect for which the flap donor site is limited. The patient was a 45-year-old man who underwent resection of a basal cell carcinoma located over the dorsum of the nose which was associated with a hemangioma simplex on the face. As a result, about two-thirds of the nose, from the dorsum to the tip, as well as a part of the right cheek became deficient and the right nasal cavity became exposed. The nose was reconstructed using the above-mentioned method. The result was satisfactory both cosmetically and functionally.- - - - - - - - - - ranking = 0.81239226912439keywords = cavity (Clic here for more details about this article) |
4/27. Solitary fibrous tumour of the face: a rare case report.Solitary fibrous tumour is a rare mesenchymal neoplasm that most commonly involves the pleura. The diagnosis of solitary fibrous tumour is primarily histological. It consists of histological and positive immunohistochemical findings of CD-34 and vimentin. Recently, solitary fibrous tumour has been reported to occur in extrapleural soft tissues, such as the orbit, nasal cavity, abdominal cavity, parotid gland, scalp and neck. In an extensive review of the literature, we found no reports of solitary fibrous tumour arising in the facial soft tissue, other than in the parotid gland. This rare location of an uncommon lesion can lead to a confusing diagnosis. We report a case of solitary fibrous tumour originating in the temporal region of the face, and call for awareness of this tumour among plastic surgeons.- - - - - - - - - - ranking = 0.81239226912439keywords = cavity (Clic here for more details about this article) |
5/27. Solitary fibrous tumor in the mental region.Solitary fibrous tumor (SFT) is a rare, benign, soft tissue tumor that most commonly occurs in the pleura; however, it has recently been described in other sites of the body. To date, eight examples of oral SFT have been reported. This paper is a description of the first case of an SFT occurring as a soft tissue tumor in the mental region. Histologically, the tumor was composed predominantly of rather uniform spindle-shaped fibroblastic cells arranged in vague fascicles or in a haphazard fashion, intermingled with abundant collagen fibers. Immunohistochemically, the tumor cells were positive for CD34 and vimentin, and weakly positive for muscle actin and alpha-smooth muscle actin. The diagnosis of SFT may be difficult as this tumor shares a number of histological features with other soft tissue tumors. awareness of its occurrence in the oral cavity is important so that confusion with other spindle cell neoplasms can be avoided.- - - - - - - - - - ranking = 9.2389712376212keywords = oral cavity, cavity (Clic here for more details about this article) |
6/27. Familial external angular dermoid: evidence for a genetic link?Congenital craniofacial dermoid cysts are hamartomas of ectodermal and mesodermal origin, made up of keratinizing epithelium lining a cavity containing dermal skin appendages. They usually present as an asymptomatic, firm, round mass, usually noticed at birth or in the first year. They are thought to occur as a result of ectodermal sequestration at lines of fusion during embryological development.Although nasal and epibulbar dermoid cysts have occurred in families and have been associated with inheritable gene defects, there has previously been no evidence for a similar etiology in external angular cases. We present the first description of external angular dermoids occurring in siblings suggesting that this subgroup may, in some instances, also have a genetic origin.- - - - - - - - - - ranking = 0.4061961345622keywords = cavity (Clic here for more details about this article) |
7/27. epidermodysplasia verruciformis: 14 members of a pedigree with an intriguing squamous cell carcinoma transformation.A 38-year-old farmer was apparently well until 5 years of age. At this age, the patient's mother found mildly itchy, raised eruptions over the scalp during combing of the scalp hair. Since then, the eruptions have progressed insidiously to involve the face and other parts of the body, with a preponderance over the face, upper back, and chest, including the palms. The soles, oral cavity, and genital tract were unaffected. The lesions were persistent in nature and showed no remission or exacerbation. Mild to moderate pruritus/discomfort was experienced following sunlight exposure. A prominent, raised eruption appeared on the right side of the forehead 9 years ago, 25 years after the initial eruptions, which in due course ulcerated. It was progressive in nature and acquired a large size. Two years later, it was diagnosed as squamous cell carcinoma, for which liquid nitrogen cryosurgery was performed. There was a recurrence of the lesion at the site of surgery, which was excised 4 months later. Subsequently, there was a sudden flare up at the same site. It was badly infected with maggot infestation. The relentless course of the disease was evident by the appearance of two similar lesions, one on the right half of the nose and the other on the left preauricular region. A short while ago, fatigue and loss of weight were also recorded. Bladder and bowel functions were normal and there was no loss of appetite, hoarseness of voice, or breathlessness. Four of the patient's six children (three sons and one daughter) were reported to have similar lesions all over the body. In addition, nine other relatives were also affected. Accordingly, a total of 14 (12 males and two females) family members were found to be affected from amongst 41 individuals (26 males and 15 females) spread across several generations (Fig. 1). There was a second-degree consanguinity of marriage, with the patient's grandmother and wife's father being brother and sister. skin surface examination was marked by multiple, discrete, flat-topped, scaly, brownish-black papules of diverse morphology, from hypopigmented macules to verrucous lesions, with a few coalescing to form plaques. The scales were brown, dry, and adherent (Fig. 2a). The lesions were conspicuous by their presence over the face, neck, and front and back of the chest. The extremities were also affected. Nevertheless, the soles and genitalia were spared. The oral mucosae, hair, and nails were normal. Koebner's phenomenon was explicit, whereas Auspitz's sign was not demonstrable. In addition, a perceptible nodulo-ulcerative lesion (size, 3 in x 2 in) with indurated, raised, averted margins was encountered on the right side of the forehead. The ulcer was tender and had a fetid discharge. Necrotic slough was prominent over its base. Similar lesions were located on the left preauricular region and right half of the nose. hematoxylin and eosin-stained sections prepared from biopsies taken from representative lesions of epidermodysplasia verruciformis and squamous cell carcinoma revealed their diagnostic features. epidermodysplasia verruciformis showed features of hyperkeratosis and acanthosis with hardly any papillomatosis. Marginal elongation of the rete ridges was present. Extensive vacuolization was a remarkable feature, and was largely confined to the upper stratum Malpighian and the granular cell layer. Some of the vacuolated cells were fairly large; their nuclei were located in the center and had variable pyknosis. The granular cell layer was uniformly thickened, whereas the stratum corneum had a loosely felted (basket-weave) appearance. The dermis was apparently normal (Fig. 2b,c). The other microsection(s) from squamous cell carcinoma were conspicuous by the presence of hyperkeratosis, acanthosis, and irregular masses of epidermal cells, proliferating downwards and invading the dermis. Varying proportions of differentiated squamous cells formed their bulk. These cells were atypical, characterized by variations in size and shape, hyperplasia and hyperchromasia of the nuclei, absence of prickles, chas, characterization of individual cells, and the presence of both mitotic and atypical mitotic figures (Fig. 3b).- - - - - - - - - - ranking = 9.2389712376212keywords = oral cavity, cavity (Clic here for more details about this article) |
8/27. Multiple infundibulocystic basal cell carcinomas: case report of unique unilateral presentation.BACKGROUND: Basal cell carcinoma shows a wide spectrum of clinical and histologic appearances. A distinct tumor variant with follicular infundibulocystic differentiation is recognized, and there are only a few reports on its clinical presentation and management. OBJECTIVE: To report a case of multiple infundibulocystic basal cell carcinomas with a unique unilateral presentation. methods: A clinical history was obtained. photographs were taken, and punch biopsies were performed. RESULTS: An 83-year-old Caucasian female presented with multiple unilateral, asymptomatic, skin-colored, dome-shaped papules around the right mouth for 11 years without apparent change. Punch biopsies revealed findings typical of infundibulocystic basal cell carcinoma. CONCLUSIONS: A patient with clinically indolent multiple unilateral infundibulocystic basal cell carcinomas is described. Given the location of these multiple lesions, standard treatment modalities for basal cell carcinomas would have significant cosmetic and functional implications. A management approach with clinical follow-up and surgical intervention only for changing lesions is discussed.- - - - - - - - - - ranking = 0.2keywords = mouth (Clic here for more details about this article) |
9/27. lymphoma in the infraorbital region.BACKGROUND: B-cell lymphomas are rare neoplasms in the oral cavity. They are significant to dentists because the oral complications associated with treatment mean that dentists can play an important role in their detection. CASE DESCRIPTION: The authors describe the case of a 55-year-old man with nonhealing ulcers, swelling and pain six months after maxillary left canine extraction. As it occurred in the infraorbital region after canine tooth extraction, the authors suspected B-cell lymphoma. Clinical examination revealed infraorbital edema with regional submandibular lymphadenopathy. Intraoral examination revealed a nonhealing ulceration with ill-defined borders in the surrounding mucosa. It was 5- x 5-centimeters in diameter and gray-white. The histopathologic examination showed diffuse, atypical, lymphoid cell infiltration and immuno-histochemically positive staining. After the histopathologic examination, the authors referred the patient to a medical center for treatment. CLINICAL IMPLICATIONS: dentists should look for signs of B-cell lymphoma when a patient has extended pain and swelling after an extraction.- - - - - - - - - - ranking = 9.2389712376212keywords = oral cavity, cavity (Clic here for more details about this article) |
10/27. Application of a mandibular nerve block using an indwelling catheter for intractable cancer pain.We report a case in which a mandibular nerve block using an indwelling catheter was employed for pain management in a terminal case of orofacial cancer. The patient was a 74-year-old female weighing 27 kg. She had a 27-month history of mouth floor and tongue cancer. The cancer recurred and spread to bilateral face and neck. The severest pain mainly originated from the right mandibular region. Two steps of pain relief were performed for the patient. First, pain control using 1% lidocaine or 0.25% bupivacaine administered intermittently or continuously through an indwelling catheter in the mandibular nerve was performed for 1 week to estimate the amount of pain relief thereby obtained. Second, a neurolytic block was applied to the mandibular nerve through the catheter. After the neurolytic block, the total dosage of morphine and diclofenac remained unchanged for 2 months. We conclude from the present case that this technique is an excellent means of obtaining long-term pain control in patients with intractable orofacial cancer pain.- - - - - - - - - - ranking = 0.2keywords = mouth (Clic here for more details about this article) |
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