Angiolymphoid hyperplasia with eosinophilia (ALHE) is a vascular inflammatory disease characterized by painless mass in the dermis, subcutaneous tissue, or both in the head and neck region. However, occurrence in the oral mucosa is extremely rare. In this study, we report a case of ALHE that occurred on the upper lip and discuss the histopathological features and management.
Although fine-needle aspiration biopsy (FNAB) has been widely accepted as a valuable tool for differential diagnosis of head and neck tumors, the diagnostic value of FNAB in the management of salivary gland tumors has been questioned. This case report presents a patient with mucoepidermoid carcinoma of parotid gland diagnosed as pleomorphic adenoma by FNAB and discusses the pitfalls in the diagnosis of malignant salivary gland tumors.
Mucoepidermoid carcinoma(MEC) is the most common salivary gland malignancies. As its name implies, the MEC is composed of a mixture of mucus-secreting cells and epidermoid cells. Histologically, MECs have been categorized into one of three grades : low, intermediate, or high grade. Although the MEC is the most common salivary gland tumor in both adults and children, MEC of sublingual gland accounts for only 1% of epithelial salivary tumors. This case report presents the histopathological features and management of MEC of the sublingual gland.
Clear cell odontogenic carcinoma (CCOC) is an extremely rare odontogenic neoplasm; Only a few cases have been reported in the English literatures. It displays a propensity for the mandible, most commonly presenting in the fifth to seventh decades, with a female predilection. The clinical and radiological manifestations are multiple and the diagnosis is histological. Histological feature is of large islands and strands of uniform cells with round or ovoid nuclei and clear cytoplasm. Clinically, painless swelling is the most common symptom, followed by pain, teeth mobility, and paresthesia. CCOC has a good prognosis after surgery. This case report presents the histopathological and clinical features of CCOC excised from the mandible.
Lipomas are the most common benign mesenchymal tumors composed of mature adipocytes. They are usually slow-growing, soft and asymptomatic masses. Angiolipomas are rare benign soft tissue tumors that are distinguished from common lipomas by a marked degree of vascularization. The diagnosis and prognosis of angiolipomas are based entirely on the findings of histological evaluations. Angiolipoma, showing characteristics of both lipoma and hemangioma, usually develop in the trunk and extremities, and rarely arise in the head and neck region. Angiolipoma of the cheek is very rare. This report presents the clinical and histopathological features of infiltrating angiolipoma excised from the cheek.
Pleomorphic adenoma is the most common benign tumor of the salivary glands. About 80-90% of pleomorphic adenoma occurs in the parotid gland and about 5-10% of them occur in the submandibular gland and sublingual gland. The rest proportion comprises the minor salivary glands. The palate is the most common area, followed by the lips and the cheeks. Pleomorphic adenoma of the submandibular gland shows clinically a slow-growing, painless mass found on submandibular aspect. In this case report, we report a case of pleomorphic adenoma of the right submandibular gland in a 63-year old female patient who was referred from the department of neurosurgery, due to the heterogenous mass detected by computed tomography (CT) and magnetic resonance imaging (MRI)
Warthin tumor, also known as papillary cystadenoma lymphomatosum is a benign neoplasm which occurs mostly in the parotid gland. It is the second most common benign neoplasm of the parotid gland, following pleomorphic adenoma. In occasion, the size of neoplasm grows slowly, and there is no symptom, except swelling. To prevent the recurrence, some surgeons prefer superficial parotidectomy, but the others prefer local resection with minimal surrounding tissue due to its low recurrence rate. We present a case of Warthin tumor of 55-year-old male.
Oral hyperpigmentation is common in patients older 40 years. But lesions in a newborn are unusual and congenital melanotic macule of the tongue has rarely been reported. A 2-month-old infant with 3 pigmented lesion on the right side of the dorsal tongue was evaluated. They were brown black but not homogeneous in color, smooth, nonblanchable, and nonpalpable, with irregular margins. We recommend excisional biopsy under general anesthesia because of possibility of malignancy, but parents refuse invasive procedure. On a following-up examination of the child at the age of 1 year, the pigmented lesions were unchanged. We report a case of congenital melanotic macules on the tongue and a review of literature about the lesion.
Subcutaneous emphysema is a rare but serious side effect of dental and oral surgery procedures. The condition is characterized by air being forced underneath the tissue, leading to swelling, crepitus on palpation, and with potential to spread along the fascial planes to the periorbital, mediastinal, pericardial, and/or thoracic spaces. A wide range of causes have been documented for the origin of subcutaneous emphysema during dental treatment including: crown preparations, other operative procedures, endodontic therapy, extractions, as well as oral surgery procedures.
The patient was a 58-year-old woman who presented to the Seoul Saint mary’s hospital emergency department with a chief complaint of facial edema, dyspnea and chest discomfort after periodontal treatment using an air-flow equipment in local dental clinic. During treatment in the emergency department, oxygen therapy and intravenous injection of steroid and anti-histamine was done. it was noted that the patient had pain and swelling on left lower molar region, pus discharging on same site. Severe edema was observed on periorbital region to neck with heatness. An audible crepitus sound was heard during palpation on facial area. Neck CT scan and antibiotic therapy was done, as symptom suggesting dental abscess is observed. 3 hours after injection of antibiotics, the patient’s symptom was relieved, but she felt chest discomfort continuously. CT scan with constrast depicted confluent and extensive soft tissue emphysematous changes involving face and deep neck spaces and pneumomediastinum. The patient was refered to thoracic surgery department, oxygen therapy was decided continuously. After 10 hours, patient’s chief complaint was resolved, and discharged. After 1 week, all symptom was disappear and follow-up neck CT scan finding was disappearance of edema and pnuemomediastinum.
We report a case of cervical subcutaneous emphysema and pneumomediastinum occurring after periodontal treatment using an air-flow equipment and case on the diagnosis and treatment of subcutaneous emphysema and pneumomediastinum, along with a review of the literature.