Surgical Management of Compound Odontoma in a Pediatric Patient: A Case Report.

Odontomas are the most common type of benign odontogenic tumors, representing around 70% of all odontogenic tumors of the jaws. Odontoma is typically present in the first and second decades of life. Morphologically, compound odontomas appear as deposited dental tissues in a pattern that makes a tooth-like structure. Compound odontomas can occur in any area of the jaws; however, the anterior maxilla is the most common location of compound odontomas. In the current report, we aimed to remove the tumor surgically to avoid unwanted consequences of odontomas, such as eruption disturbance, root resorption, tooth malalignment, and cortical bone expansion.  An 11-year-old female patient presented to the pediatric dental clinic in Security Forces Hospital, Makkah, Saudi Arabia, complaining of multiple carious teeth. A routine panoramic radiograph showed a well-defined radiopaque mass surrounded by a thin halo in the right maxillary anterior region. This mass comprised multiple small, tooth-like structures. Upon pulpation, a palatal bulge was detected on the right side of the anterior part of maxilla. Since the patient showed anxious dental behavior and needed comprehensive dental treatment, she was scheduled for surgical removal of the mass under general anesthesia. Tiny tooth-like structures were removed and sent to the histopathological examination to confirm the diagnosis. Follow-up appointments for the patients were scheduled to be after two weeks, one month, and six months. In conclusion, this case highlights the importance of early diagnosis and prompt surgical intervention in managing compound odontomas to avoid the unwanted consequences of the tumor.

Feasibility and safety of preauricular incision for extracapsular dissection in benign parotid tumors.

PURPOSE: Parotidectomy techniques continuously evolve to improve outcomes while minimizing morbidity. This study investigates the rationale behind developing and evaluating the feasibility and safety of extracapsular dissection (ECD) via preauricular incision for benign parotid tumors in the anterior or superior part of the parotid gland. METHODS: The preauricular approach is developed to address the increasing demand for minimally invasive techniques that prioritize both functional and aesthetic outcomes. Minimizing visible scarring and preserving facial nerve function offers a compelling solution for patients seeking optimal cosmetic results without compromising surgical efficacy. Patient assessments included cosmetic contentment, functional repercussions, and disease management throughout the follow-up. RESULTS: Eight patients underwent ECD via the preauricular approach, demonstrating favorable outcomes with preserved facial nerve function and minimal complications. CONCLUSION: This study highlights the potential of the preauricular approach as a preferred option for managing benign parotid tumors in the anterior or superior parotid region, emphasizing aesthetic outcomes and preserving gland function. LEVEL OF EVIDENCE: IV.

The safety and feasibility of laparoscopic partial splenectomy: analysis of perioperative indications from different vascular subtypes and improvement of surgical approach.

INTRODUCTION: While laparoscopic splenectomy (LS) has been widely used in benign splenic tumor, more concerns have been raised for postoperatively short-term and long-term complications. Laparoscopic partial splenectomy (LPS) is a surgical option, to preserve splenic function, and reduce postoperative complications. The aim of our study was to retrospectively identify the safety and feasibility of LPS compared with LS in patients with splenic benign tumor. MATERIALS AND METHODS: From 2014 to 2024, a total of 165 patients diagnosed with occupational splenic lesions underwent splenectomy, of whom 87 underwent LPS and 78 underwent LS. We compare the perioperative parameters and long term follow up between these two groups. RESULTS: The etiology of splenic space-occupying lesions was nonparasitic splenic cysts, followed by splenic lymphangioma and splenic hemangioma. Of the patients with LPS, 55 underwent conventional surgery with blockage of the splenic arterial branch and resection along the ischemic line (RAIL), and 32 underwent with our modified total splenic blood supply blockade followed by resection alone the tumor edge (RATE). The tumor size, the operative time and estimated blood loss were comparable between the LPS and LS groups. One patient developed abnormal signs during the LPS procedure and was promptly referred for LS. The LPS group had fewer pancreatic leakage, incision infection, and pulmonary infection. As for different vascular types, patients with LS under all branches of the splenic artery had a longer time to resume postoperative feeding. As for the comparison of RAIL and RATE, estimated blood and operative time were significantly reduced in patients receiving RATE. Postoperative complications were the same in patients underwent each surgical procedures. CONCLUSION: LPS is a viable approach for patients with splenic benign tumor. We introduce the tumor artery supply types to indicate the resection region. Our RATE technique has proven to be clinically effective and safety.

Laparoscopic excision of an incidental vascular tumor.

Anastomosing hemangioma (AH) is an exceedingly rare benign vascular tumor, often mistaken for malignant neoplasms due to its histological features. First described in 2009, AH has been documented in various sites, including the kidney, liver, and adrenal gland. This report presents a 64-year-old man who, following a bicycle accident, underwent imaging that revealed a nodule suspicious for a paraganglioma in the right para-caval region. Despite the high radiotracer uptake on 68Ga-DOTANOC PET scan, which suggested paraganglioma, the patient remained asymptomatic and laboratory tests ruled out excessive catecholamine secretion. Surgical excision led to a diagnosis of AH, distinguished by its unique anastomosing vascular pattern and histological similarity to angiosarcoma. This case underlines the diagnostic challenges and potential for overtreatment of AH, highlighting the need for heightened awareness and careful histopathological and imaging evaluation to avoid misdiagnosis and ensure appropriate management.

Decoding a Rare Case of Pleomorphic Adenoma: A Case Report and Review of the Literature.

Diagnosing palatal swellings is crucial for various reasons, mainly because these swellings can signal a range of health problems, from benign conditions to more serious diseases. Here, we have reported an interesting case of long-standing palatal swelling. Accurate diagnosis typically involves a combination of clinical examination, patient history, imaging studies, and possibly biopsy or other laboratory tests. Since each condition has unique characteristics and treatment approaches, differential diagnosis is essential for ensuring effective management. This case highlights the importance of considering pleomorphic adenoma in the differential diagnosis of palatal tumors and demonstrates the effectiveness of surgical management. A literature review is also presented, discussing the clinical, radiological, and histopathological features of this rare entity. Accurate diagnosis and timely intervention are crucial for effective treatment and maintaining overall oral health.

Atypical presentation of long-standing hand neurofibroma: A case report.

INTRODUCTION AND IMPORTANCE: A solitary neurofibroma of the hand is an uncommon condition that typically lacks distinct symptoms, often resulting in misdiagnosis and prolonged morbidity. While it primarily affects younger individuals, it can also present in older adults. This article discusses an extraordinary case of a long-standing neurofibroma in the hand. CASE PRESENTATION: A 70-year-old right-handed individual, known to have hypertension and a pacemaker, presented with a mass on the palm of his left hand. This mass was associated with tingling and mild pain, particularly after excessive use of the hand. Recently, he had experienced partial limitations in hand movement due to the mass's pressure. Following a thorough clinical assessment, he underwent surgical excision of the mass under local anesthesia. Histopathological findings confirmed the diagnosis of neurofibroma. The follow-up was generally uneventful, apart from some persistent tingling sensations. CLINICAL DISCUSSION: Solitary neurofibromas affecting small nerves are not frequently encountered in clinical practice and usually appear as a slowly progressive mass that may cause pain and tingling. There are no particular radiological approaches that can definitively diagnose this condition; however, histopathological findings have proven effective in confirming the diagnosis. CONCLUSION: Long-term hand neurofibroma is an infrequent disorder that typically lacks prominent symptoms, highlighting the critical need for medical assessment. Surgery is the only effective treatment for hand cases, providing both a definitive diagnosis and the possibility of being performed with regional anesthesia.

Eccrine Poroma of the Palm: A Case Report and Literature Review.

Eccrine poroma is a non-cancerous tumor that arises from the intraepidermal portion of the eccrine sweat glands. It usually appears as a solitary lesion on an extremity, commonly on the foot or sole, and is often subject to delayed or inaccurate diagnosis in clinical settings. This article describes a rare case of eccrine poroma located on the palm. It discusses the clinical and histological features, diagnostic difficulties, recurrence risks, and the possibility of malignant transformation associated with this condition.

Osteolipoma of the hand: A case report.

INTRODUCTION: Osteolipoma is a rare variant of lipoma characterized by osseous metaplasia within adipose tissue. Its occurrence in the hand is exceptionally uncommon. This article aimed to report a case of osteolipoma in the hand. CASE PRESENTATION: A 46-year-old right-handed Asian woman presented to the orthopedic polyclinic complaining of a painless mass on the palm of her left hand for four years. Physical examination revealed a solid, mobile, non-tender mass with well-defined margins. Radiographic imaging showed a well-circumscribed soft tissue mass with fat and central calcification. The patient underwent surgical excision, and a histopathological examination confirmed the osteolipoma. A six-month follow-up revealed no recurrence, and the patient could resume her daily activities. DISCUSSION: This case highlights the importance of including osteolipoma in the differential diagnosis of hand masses, especially those with radiographic evidence of calcification. The rarity of this entity in the hand requires a high index of suspicion for accurate preoperative diagnosis. CONCLUSION: While rare, osteolipoma of the hand should be considered in the differential diagnosis of soft tissue masses with osseous components. Complete surgical excision remains the treatment of choice, offering diagnostic confirmation and therapeutic intervention.

Syringocystadenoma Papilliferum: A Challenging Clinical Diagnosis in a Patient With a Persistent Scalp Lesion After Trauma.

Syringocystadenoma papilliferum is a rare, hamartomatous benign tumor originating from either the eccrine or apocrine sweat glands. We report a case of a 30-year-old female who presented with a 10-year history of an asymptomatic, slow-growing scalp lesion following head trauma. A scalp examination revealed a single, rounded 3 mm fleshy erythematous nodule with a central crust in the right parietal area. a biopsy revealed downward papillomatous extensions in the epidermis and multiple epithelial sheets with dilated ducts lined by columnar cells in the dermis. A diagnosis of syringocystadenoma papilliferum was confirmed based on these clinicopathological findings. The patient was reassured and underwent complete surgical excision of the lesion.

Keratocystoma of the Parotid Gland: A Rare Case and Review of the Literature.

Keratocystoma of the parotid gland is a rare benign salivary gland tumor. In 2022, the World Health Organization added keratocystoma to the classification of benign parotid tumors. Recently, our hospital encountered a case involving a 2-year-old child, making this the youngest patient reported to date. We excised part of the parotid gland and lesion under general anesthesia while preserving the facial nerve. There was no local recurrence during the 1-year follow-up period after surgery. Despite its rarity, it is essential to consider the possibility of keratocystoma and distinguish it from other benign neoplastic lesions of the parotid gland.

Retroperitoneal ancient schwannoma presenting as left flank pain and moderate unilateral hydronephrosis: A case report and literature review.

Key Clinical Message: Benign ancient retroperitoneal schwannomas (BARS) exhibit abdominal masses and flank pain to incidental findings at more advanced stages. Histopathological and immunohistochemical analysis is essential for confirmation of benign nature. Our patient was misdiagnosed as ureteric colic, highlighting the need to consider BARS in differential diagnosis to prevent complications like hydronephrosis. Abstract: Ancient schwannomas are usually benign neoplasms that originate from Schwann cells of peripheral nerves. We present a novel case of a 24-year-old young male with left flank pain and nausea which was initially thought to be left ureteric colic. However, in-depth imaging and biopsy revealed a retroperitoneal mass. The definitive diagnosis was narrowed down to Benign Retroperitoneal Ancient Schwannoma (BARS) via immunohistochemistry and histopathological analysis. This often marble-shaped S100 protein-positive tumor is an under-recognized and potential cause of hydronephrosis if localized near the renal structures. In addition, the retroperitoneal location with infrarenal abdominal aortic adherence is another rare peculiarity in the present case that demands prompt diagnosis and surgical excision to avoid any cardiovascular sequelae such as hypotension and abdominal pain, as indicated by the natural history of growth of this benign tumor. Therefore, timely excision of this benign tumor prior to its further proliferation is paramount. We initially planned laparoscopic removal but adopted excision via laparotomy because of the proximity of the vital structures. The postoperative course of the patient was uneventful and subsequently the patient's presenting complaint of left abdominal flank pain greatly improved. The patient was advised to undergo follow-up computed tomography scan of kidney ureter bladder and RFT evaluation 6 months postsurgery which indicated no evidence of recurrence or iatrogenic complications. The diagnosis and management of the present case share valuable experiences for similar future cases worldwide.

Anatomical study and clinical outcomes of endoscopic transoral surgery for benign salivary gland tumors in the parapharyngeal space.

The existing literature provides little insight into the efficacy of transoral endoscopy in exposing benign tumors originating from salivary glands in the parapharyngeal space at the parotid gland base and resecting part of the deep lobe with a safe margin. This study aims to investigate the efficacy of the endoscopic transoral approach for the visualization and resection of such tumors. Through transoral endoscopic cadaveric dissections and surgical procedures, we examined the anatomical structures of the parapharyngeal space and the deep lobe of the parotid gland, identifying key anatomical landmarks. We conducted a retrospective analysis of 19 patients with benign salivary gland-derived tumors in the parapharyngeal space who underwent transoral endoscopic resection. Intraoperative visualization of the tumor pedicle and the deep lobe of the parotid gland was successfully achieved in all cases, allowing for resection with safe margins. During a median follow-up period of 54.0 months, imaging revealed no signs of recurrence. Endoscopic transoral approach provides effective visualization of the deep lobe of the parotid gland and the medial portion of the parotid bed from the parapharyngeal space. Benign tumors of salivary gland-derived in this area can be well exposed and safely resected with adequate margins.

Testicular epidermoid cyst: A rare entity - Case report.

INTRODUCTION AND IMPORTANCE: Epidermoid cysts (ECs) of the testicle are rare benign lesions that can mimic more serious testicular masses. Accurate diagnosis is essential for proper management, often requiring surgical intervention to confirm the nature of the mass. CASE PRESENTATION: A 21-year-old male presented with chronic pain in his right scrotum. Physical examination revealed a firm mass within the right testis. Ultrasound and MRI findings were consistent with an intratesticular EC. The patient underwent partial orchidectomy for further evaluation and treatment. CLINICAL DISCUSSION: Histopathological analysis confirmed the diagnosis of an epidermoid cyst, characterized by a well-defined lesion with keratin-filled cystic spaces. The differential diagnosis for testicular masses includes both benign and malignant conditions. Imaging alone may not be sufficient to distinguish between these possibilities, making surgical exploration and histopathological examination necessary for definitive diagnosis. CONCLUSION: This case highlights the importance of considering epidermoid cysts in the differential diagnosis of testicular masses in young males. Surgical intervention, such as partial orchidectomy, not only provides a definitive diagnosis but also serves as a therapeutic measure. The patient had an uneventful postoperative recovery, emphasizing the efficacy and safety of the surgical approach in such cases.

Leiomyoma: An Exceptional Benign Tumor of the Kidney.

Renal leiomyoma is a benign finding in kidney pathology. It has been documented in various organs; renal location is less frequent and has been rarely documented in the literature. We present here the case of a renal leiomyoma revealed by an abdominal mass and flank pain. The diagnosis of certainty is histological, generally on surgical specimens. Due to the challenges associated with clinically diagnosing this tumor, a high level of suspicion is warranted when a patient presents with sizable and clearly defined renal lesions.

A Case of an Ossifying Fibroma of the Mandible Suspected as a Static Bone Cavity.

Ossifying fibroma (OF) is a benign fibro-osseous lesion characterized by the proliferation of fibrous connective tissue containing immature bone and/or cementum-like hard tissue. Although the pathogenesis of OF remains unclear, trauma, previous extractions, and periodontitis are considered potential trigger factors. OF is more common in women aged from the second to fourth decades. Clinically, OF is characterized by slow-growing and asymptomatic swelling, often observed incidentally on radiological examinations. OF occurs more frequently in the mandible, particularly above the mandibular canal. Herein, we present a rare case of OF in an 18-year-old man initially misdiagnosed as a static bone cavity. The lesion was first observed as a radiolucent finding below the left mandibular canal on a panoramic radiograph. Later, cone-beam computed tomography (CBCT) imaging revealed the presence of calcifications within the lesion. Additionally, CBCT confirmed the presence of the lesion within the lingual cortical bone, revealing lingual swelling and thinning of the outer cortex. Enucleation was successfully performed under general anesthesia without any postoperative complications. Histopathological examination confirmed the diagnosis of OF, revealing mineralized tissue and proliferating fibrous connective tissue. This case underscores the challenges in diagnosing OF, particularly when it is located below the mandibular canal, emphasizing the importance of thorough imaging and differential diagnosis to avoid misinterpretation as a static bone cavity.

Laparoscopic anatomical partial splenectomy for extremely rare isolated splenic lymphangioma in an adult: a case report and literature review.

Background: Benign tumors of the spleen are rare compared to those of other parenchymal organs, accounting for less than 0.007% of all tumors, and are often found incidentally. Splenolymphangiomas are much rarer, commonly occur in children, and tend to have multiple foci. Splenic lymphangiomas are rare in adults, and fewer than 20 adult patients with isolated splenic lymphangiomas have been reported. In this article, we report the case of a middle-aged female patient with isolated splenic lymphangioma who underwent laparoscopic anatomical hypophysectomy of the lower pole of the spleen. We also summarize the existing literature on splenic lymphangioma diagnosis and available treatment options. Case presentation: A 58-year-old middle-aged woman was found to have a mass approximately 60 mm in diameter at the lower pole of the spleen during a health checkup that was not accompanied by other symptoms or examination abnormalities. After completing a preoperative examination with no contraindications to surgery, the patient underwent laparoscopic anatomical splenectomy of the lower extremity of the spleen. The patient recovered well without complications and was discharged from the hospital on the 7th postoperative day. Histopathological and immunohistochemical results confirmed the diagnosis of splenic lymphangioma. Prompt surgical intervention is safe and necessary when splenic lymphangiomas are large or associated with a risk of bleeding. Conclusion: Splenic lymphangiomas are rare and require early surgical intervention in patients with large tumor diameters or those at risk of rupture and bleeding. After rigorous preoperative evaluation and preparation, laparoscopic anatomical partial splenectomy is safe and feasible for surgeons with experience in laparoscopic surgery.

[Synovial chondromatosis : Results from the histopathological arthritis register of the German Society for Orthopedic Rheumatology]. / Die Synoviale Chondromatose : Ergebnisse aus dem histopathologischen Arthritisregister der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh).

BACKGROUND: Synovial chondromatosis, or osteochondromatosis, is a rare benign disorder that occurs in joints, tendon sheaths, or bursae, characterized by cartilage proliferations of varying sizes and shapes, often with ossifications. In this study the prevalence, sensitivity, gender predominance, differential diagnoses, and primary localization of synovial chondromatosis are analyzed within the Histopathological Arthritis Registry of the German Society for Orthopedic Rheumatology. METHODS: All cases of patients diagnosed with "synovial chondromatosis" from the Histopathological Arthritis Registry of the German Society for Orthopedic Rheumatology were retrospectively examined, covering the period from 1 January 2018, to 31 December 2022. RESULTS: Between 1 January 2018, and 31 December 2022, there were 14 cases of synovial chondromatosis out of a total of 13,222 cases in the Histopathological Arthritis Register of the German Society for Orthopedic Rheumatology. The available data include primary localization, and age and gender of the patients. Among the 13,222 cases in the Histopathological Arthritis Register of the German Society for Orthopedic Rheumatology, 14 were histopathologically confirmed as synovial chondromatosis. This resulted in a prevalence of 0.1% or 1.13 per 1,000 cases. The correct clinical presumptive diagnosis was made in 5 cases, yielding a sensitivity of 35.7%, 95% confidence interval (CI) 12.8% to 64.9%. DISCUSSION: Differential diagnoses for this condition include pigmented villonodular synovitis, tenosynovial giant cell tumor, and chondrosarcoma. Synovial chondromatosis frequently occurs in large joints such as the knee, hip, and the temporomandibular joint. A peak incidence is described in the fifth decade of life. However, the disorder can also occur in children. For the first time, the study was able to provide data for Germany based on a large sample. Additionally, initial statements regarding the prevalence and sensitivity of synovial chondromatosis could be made. The aim of this work is to raise awareness of this very rare disease to enable faster and more efficient diagnosis. The study also highlights the importance of histopathology in the diagnosis of synovial chondromatosis.

Metastasizing pleomorphic adenoma of parotid gland: Case report.

Pleomorphic adenoma is a benign tumor and the most common salivary gland neoplasm. Metastasizing pleomorphic adenoma shares histological characteristics with pleomorphic adenoma but exhibits malignant behavior, including local lymph node involvement and/or distant metastasis. Several potential risk factors for metastasizing pleomorphic adenoma have been identified, some of which are associated with incomplete tumor clearance due to inadequate surgical techniques used in the treatment of primary pleomorphic adenoma. Here, we present a rare case of metastasizing pleomorphic adenoma originating from the parotid gland and describe its clinical features. The patient was a 75-year-old female with a surgical history of enucleation of a pleomorphic adenoma in the left parotid gland. Total parotidectomy and left neck dissection were performed for the left parotid tumor this time, and the patient attended one postoperative outpatient visit but subsequently was lost to follow-up.

An Unexpected Giant: A Case of Massive Paratesticular Extra-mammary Myofibroblastoma.

Mammary-type myofibroblastomas (MFBs) are benign spindle cell tumors, typically presenting in common locations such as the breast, abdomen, and inguinal region. We present a case of a 66-year-old male with a four-year history of painless scrotal swelling. The preoperative diagnosis was challenging, with an initial suspicion of soft tissue sarcoma. A complete surgical excision was performed, revealing a well-circumscribed, encapsulated mass. The tumor measured 30 x 20 x 14 cm, weighing 5.28 kg. Histopathology confirmed an MFB. This exceptionally large paratesticular MFB emphasizes the diagnostic difficulty of such tumors. Surgical resection remains the treatment of choice, with an excellent prognosis. This case highlights the importance of considering MFB in the differential diagnosis of scrotal masses, even with atypical presentations.

Mucocele: A Case Report.

Mucoceles are the most common minor salivary gland disorder and represent the second most frequent benign soft tissue tumors of the oral cavity, following irritative fibroma. Various treatment modalities have been suggested for mucocele among which different types of lasers being the most recent and advanced. In the present case reports, diode laser was used for the excision of mucocele on the lower lip, and the advantages of it over the conventional scalpel method were minimal discomfort, bleeding, recurrence, and better compliance among patients.