Primary blastomycosis of oral cavity.

BACKGROUND: Blastomycosis is an uncommon male-predominant disease caused by the fungus Blastomyces dermatitidis. The lungs are most commonly affected, and other organs are usually involved by dissemination. Clinical feature and pathohistologic findings are similar to the appearance of squamous cell carcinoma. METHODS AND RESULTS: A 52-year-old male patient who has lived as a farmer on the countryside in Argentina for 35 years presented with an initial histopathologic diagnosis of a squamous cell carcinoma of the right lower jaw. There was no history of pulmonary disease, in particular fever, coughing, or hemoptysis. Final pathohistologic evaluation after resection revealed B. dermatitidis infection. This article presents the first described case of oral manifestation of B. dermatitidis infection in Switzerland. CONCLUSIONS: Manifestation of blastomycosis in oral tissue can mimic the feature of a squamous cell carcinoma and can therefore be a diagnostic pitfall that head and neck surgeons and a pathologist should be aware of.

Bilateral myositis ossificans of the masseter muscle after chemoradiotherapy and critical illness neuropathy--report of a rare entity and review of literature.

Myositis ossificans in the head and neck is a rare heterotropic bone formation within a muscle. Besides fibrodysplasia ossificans progressiva, traumatic and neurogenic forms are described in the literature. We are presenting the case of a 35-year-old female patient with a very rare form of MO of both masseter muscles after 4 weeks of intensive care because of complications (critical illness neuropathy) after chemotherapy. Therefore, special attention should be paid to surgical trauma. As in the present case, radiotherapy, long-time intubation with immobilization and critical myopathy and neuropathy can cause MO with severe problems, such as trismus and reduced mouth hygiene, which can lead to reduced quality of life.

Quality of life and psychiatric morbidity in patients successfully treated for oral cavity squamous cell cancer and their wives.

PURPOSE: To assess quality of life (QOL) and psychiatric morbidity in successfully treated oral cavity squamous cell cancer (OC-SCC) survivors and their wives. PATIENTS AND METHODS: Thirty-one men successfully treated for OC-SCC (mean, 3.7 years since diagnosis; UICC stages I to IV) together with their wives were assessed by questionnaires referring to QOL (WHOQOL-BREF), physical complaints (EORTC QOL-H&N35), and symptoms of anxiety and depression (HADS). Prevalence of psychiatric disorders was assessed by the Mini International Neuropsychiatric Interview (M.I.N.I.). RESULTS: Irrespective of tumor stage, a considerably high global QOL both in OC-SCC survivors and their wives could be detected when compared with an age-matched cancer-free population. No significant difference between the mean scores of 4 domains of the QOL (exception: environmental domain) was found between patients and their wives. In patients, lower QOL was associated with more physical complaints (social eating, swallowing, and pain) and higher levels of psychological distress (HADS); whereas in wives, QOL was found to be related to levels of psychological distress. In the M.I.N.I., a high prevalence of psychiatric disorders, particularly anxiety disorders, was found in wives (38.7%); but was lower in patients (16.2%). Patients and wives diagnosed with a psychiatric disorder reported significantly lower QOL. CONCLUSION: Both in OC-SCC patients and their wives a considerably high overall QOL can be found. "Social eating," "swallowing," and "sexuality" in patients and psychiatric disorders in wives seem to be strongly related to global QOL. The high prevalence of anxiety disorders in wives, however, should alert clinicians and the health care community. Thus, surgical improvement of somatic problems and treatment of psychiatric disorders should be addressed in individuals reporting an impaired global QOL.

[Bisphosphonate-induced osteonecrosis of the jaws--a guide to diagnosis, therapy and prevention of BON in dental practice]. / Die Bisphosphonat-assoziierte Osteonekrose der Kiefer.

Since four years from now on more and more information about bisphosphonate induced osteonecrosis of the jaws is published not only in professional journals, but also in the mass media. The result is a growing uncertainty of patients, but also professionals in dealing with this group of medication. Usually bisphosphonates are prescribed for treatment of severe osteoporosis, but also for treatment of metastatic bone disease and tumor induced hypercalcemia. The following article gives information about bisphosphonates, bisphosphonate induced osteonecrosis of the jaws (BON) and potential risk factors. Additionally it shows the typical clinical picture, necessary diagnostic measures and informs about possible prevention strategies especially for dentists in daily practice.