Cases reported "Palatal Neoplasms"

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1/36. Palatal lymphoepitheliomas and a review of head and neck lymphoepitheliomas.

    AIM: Lymphoepithelioma is principally a tumour of the nasopharynx with only sporadic cases arising elsewhere in the head and neck. We describe the clinical and imaging features of a group of rare lymphoepitheliomas related to the palate. patients AND methods: Four patients with lymphoepithelioma of the palate are described. In each case we retrospectively reviewed the clinical records, laboratory results, and imaging which consisted of computed tomography (CT) and ultrasound in all four cases and magnetic resonance imaging (MRI) in two patients. RESULTS: All four patients were ethnic Chinese (non-smokers, non-drinkers). All cases were Epstein-Barr virus (EBV) related. Tumour was related to the palate in two cases and extended into the nasal cavity in one patient. The fourth patient had a tumour in the floor of the nasal cavity with invasion of the palate on biopsy but not imaging. Cervical lymphadenopathy was seen in two cases, and the nasopharynx was normal in all the four patients. CONCLUSION: Lymphoepitheliomas occur in the region of the palate, where they are also EBV related in southern Chinese. Compared with the keratinizing squamous cell carcinomas, patients with lymphoepitheliomas have a better prognosis and these tumours are not tobacco or alcohol related. They should not be misdiagnosed as metastatic nasopharyngeal carcinoma (NPC), particularly since the nasopharynx is invariably normal on imaging and adequate nasopharyngeal biopsy is negative for malignancy.
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2/36. liposarcoma involving the periodontal tissues. A case report.

    Liposarcomas constitute 15 to 20% of all soft tissue tumors. They are extremely rare in the head and neck and in the oral cavity. A 30-year-old patient was seen for a soft, painless mass in the right palate. Through panoramic radiography it was possible to observe a radiolucent area with sharp margins in the right upper quadrant. The lesion, after an incisional biopsy, was diagnosed as a "myxoid liposarcoma." The patient underwent a wide excision of the lesion with bone laminectomy and he is well at a 4-year follow-up. The differential diagnosis included salivary gland tumors and palatal abscess.
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3/36. Abrikossoff's tumor.

    Abrikossoff's tumor is a disease that more commonly affects the oral cavity but can also occur at other sites. It develops between the second and sixth decades of life, more frequently among women and blacks. The neoplasm can affect all parts of the body. The head and neck areas are affected in 45% to 65% of cases and of these, 70% are located interorally (tongue, oral mucosa, hard palate). The benign form shows polygonal cells with granular, eosinophilic cytoplasm and small nuclei. The malignant form, however, is associated with a high mitotic index and pleomorphic cellular tissue. The clinical aspect of the neoformation is a swelling covered by mucus of normal appearance. Studies of the neoformation show that in addition to the objective examination, further instrumental research is necessary, i.e., with nuclear magnetic resonance or computed tomography with contrast CT scan. However, the only examination that can confirm the clinical diagnosis is the histological examination. The only treatment for Abrikossoff tumor is surgery. The surgical treatment provides for an extirpation of the neoformation with the overhanging mucus and the underlying periosteum. In this work, the authors discuss a case of Abrikossoff tumor affecting the mucus of the right side of the hemipalate in a 53-year-old patient and present a review of the literature.
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4/36. Intraoral salivary duct carcinoma: case report with immunohistochemical observations.

    Salivary duct carcinoma is an uncommon malignant salivary gland tumor that occurs predominantly in the parotid gland. Oral involvement is extremely rare, with few cases having been reported in the literature. The tumor is characterized by an aggressive behavior and has a poor prognosis. We describe a case of salivary duct carcinoma arising in the hard palate of a 63-year-old man. Immunohistochemical analysis revealed that tumor cells tested positive for cytokeratin, epithelial membrane antigen, proliferating cell nuclear antigen, Ki67, p53, laminin, and collagen IV. Despite radical surgical resection, bilateral neck dissection, and postoperative radiotherapy, liver metastases developed, and the patient subsequently died of his disease.
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5/36. Solitary plasmacytoma and extramedullary plasmacytoma of the paranasal sinuses and soft palate.

    Solitary plasmacytoma of the paranasal sinuses are uncommon neoplasms of B lymphocyte origin. They comprise one per cent of all head and neck tumours of the upper respiratory tract. They can be solitary plasmacytomas of the bone (SPB), an extramedullary plasmacytoma or a local manifestation of multiple myeloma. Conversion to multiple myeloma happens more frequently in SPB. radiotherapy is the common modality of treatment with, or without, adjuvant chemotherapy. Extramedullary plasmacytoma carries a better prognosis than a solitary plasmacytoma of the bone. We report four cases of solitary plasmacytoma of the bone and an extramedullary plasmacytoma of the paranasal sinuses and soft palate.
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6/36. Intraoral melanoma: long-term follow-up and implication for dental clinicians. A case report and literature review.

    Primary intraoral melanoma is a rare neoplasm with a poor prognosis, accounting for 1% to 8% of all melanoma in europe and the united states. The incidence (12%) and 5-year survival rate (17.4%) are higher in japan. We report a case of oral lentiginous melanoma in a Japanese-American man who survived disease-free for more than 5 years after surgery, radiation therapy, and chemotherapy but developed chronic mucositis of the palate under the denture in the primary radiated field. This lesion responded to antifungal therapy. Subsequent multiple biopsies ruled out the recurrence of melanoma but demonstrated prolonged melanocytic hyperplasia and focal epithelial atypia. We reviewed clinical differences in oral melanoma reported in the united states and Japanese literature, and describe the wide variety of oral clinical features of postoperative radiation and chemotherapy, as well as the oral tissue changes caused by denture-induced mucositis and candidiasis in such patients. Dental clinicians should conduct a thorough head, neck, and oral follow-up with increased vigilance in patients with a history of prior cancer.
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7/36. Oral mucosal melanoma: a series of case reports.

    INTRODUCTION: Due to the rarity of oral malignant melanomas case reports are a necessary source of information. Ten new cases are reported with a minimum follow-up of 3 years. patients AND methods: patients were treated during a period of 10 years. Clinical, demographic and pathologic findings were examined. RESULTS: In 6 males (60%) and 4 females with a mean age of 64.3 years the tumour locations were: hard palate-maxillary gingiva (3 cases), maxillary gingiva (2), lower gingiva (2), tongue (2), hard/soft palate-buccal mucosa (1). Pre-existing melanotic pigmentation had been present in 4 patients. Four patients were in stage I, 5 in stage II, and 1 in stage III. Surgical excision was the primary treatment in 9 cases. Five patients underwent simultaneous neck dissections. All patients received radiation and multimode adjuvant therapies. After a 3-year follow-up 3 patients are still alive (50% (2/4) of those presenting in stage I and 20% (1/5) in stage II). CONCLUSIONS: Due to the rarity of oral melanoma, individual experience is limited. The poor prognosis and the different treatments reflect this situation.
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8/36. MALT lymphoma of the paranasal sinuses and the hard palate: report of two cases and review of the literature.

    Extra-nodal low-grade B-cell lymphomas arising in the gastrointestinal tract recapitulate the structure and features of mucosa-associated lymphoid tissue, called "MALT lymphomas." In the head and neck region except for the salivary glands the occurrence of this neoplasm is very rare. The authors report on two such cases of MALT lymphoma, one of the hard palate in a 71-year-old woman and the other of the paranasal sinuses in a 69-year-old woman with the history of chronic sinusitis. Such chronic inflammatory conditions can induce the development of MALT lymphoma. Clinical elaboration should include computerized tomography (CT) and magnetic resonance imaging (MRI) for the assessment of tumor extension, bone destruction, lymph node involvement and differentiation of mucosal thickening from tumor mass. biopsy for histopathological diagnosis is mandatory. Treatment should be surgery, irradiation or combined radio-chemotherapy depending on the stage of the disease.
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9/36. Vidian metastasis of adenoid cystic carcinoma.

    head and neck tumors may invade perineural space, especially the maxillary division of the trigeminal nerve and the pterygopalatine fossa (PPF). Computed tomography (CT) and magnetic resonance imaging (MRI) signs of perineural extension include essentially the obliteration of the PPF fatty content and the enlargement and erosion of neural foramina. We report a case of perividian metastasis studied with CT and MRI.
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10/36. Basaloid-squamous carcinoma of the palate.

    Basaloid-squamous carcinoma is a rare, nonsquamous cell tumor presenting in the head and neck that has recently been described. The clinical and histopathologic features of basaloid-squamous carcinoma derived from the 12 reported cases in the literature, including our case resembling an arteriovenous malformation, are described. The important interaction of the operating surgeon with the surgical pathologist in guiding the extent of the resection is emphasized.
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