Mucosal malignant melanoma is an uncommon tumor of the head and neck, and patient cannot easily recognize the lesion. Most patients are diagnosed with advanced lesions, and the 5-year survival rate is very low. Therefore, intraoral pigmented lesions require an incisional biopsy for differential diagnosis from malignant melanoma. As the size of the tumor increases, lesion showing vertical growth and lymph node metastasis increases, and the prognosis becomes poor. In this study, we report a case of mucosal malignant melanoma in the oral cavity that shows radial growth and no lymph node metastasis despite its relatively large size.
It is well documented that giant cells can be observed in some types of odontogenic tumors such as central odontogenic tumor and dentinogenic ghost cell tumor. However, the presence of stromal giant cells has only rarely been reported in ameloblastoma, although being the most common epithelial odontogenic tumor. In this study, we present a novel case of peripheral ameloblastoma associated with peripheral giant cell granuloma arising in the mandibular alveolar mucosa of a 65-year-old male patient. The possible pathogenesis of this combined lesion will be discussed, in addition to the review of previous reports of ameloblastoma accompanied by stromal giant cells.
Bisphosphonate-associated osteonecrosis (BRONJ) is an adverse event associated with bisphosphonate drug treatment. An 81-year-old female has been taking bisphosphonates orally once a month for three years complained of pain in the left mandibular molar area after implant placement. Tenderness and fistula were formed. Extensive osteosclerosis in posterior area of the left mandible and bone resorption around distal side of #37i were shown on radiographs. She was given oral antibiotics for 6 weeks and bone resorption was improved. A 70-year-old male had a history of intravenous injection of bisphosphonates for blood cancer complained of #46i implant mobility. There was buccal fistula on #45 site. Radiographically, severe bone resorption and extensive osteosclerosis were shown. He was treated with removal of implant and inflammatory tissue. Patients who have taken bisphosphonates may develop BRONJ after tooth extraction or implant placement and are needed to meticulous plaque control for preventing BRONJ.
Intraosseous vascular malformation, a representative vascular disease, rarely occurs in the oral and maxillofacial region, especially the maxilla. An 18-year-old female patient was referred to our department with the chief complaint of a radio-opaque mass in the maxilla. A biopsy was attempted at a local dental hospital before visiting our hospital, but it was not completed due to severe intraoperative bleeding. The patient presented swelling and induration in the right maxillary region without pain, local heat, or fluctuation. According to radiographic and clinical examinations, intraosseous vascular malformation or a bone-forming tumor such as aggressive osteoblastoma was suspected. Therefore, an open biopsy of the lesion was performed under general anesthesia. Histopathological examination revealed that the lesion consisted of bony trabeculae with fibrous connective tissue and numerous vascular structures, and the lesion was diagnosed as intraosseous vascular malformation.