[Malignant melanoma of the mandibular gingiva]. / Le mélanome malin de la gencive mandibulaire.

INTRODUCTION: The oral melanoma (OM) account for 1% of all melanomas. The prognosis is poor despite an adequate locoregional control of the disease. OBSERVATION: A 47 year old women consulted for a blackish lesion of the mandibular gingiva next to tooth 37. Intraoral examination showed a dark pigmented lesion on the lingual side of the left mandibular molar region, extending from tooth 37 to the trine retro left molar. The biopsy confirmed the diagnosis of mucosal nodular melanoma. A wide surgical excision without ipsilateral neck dissection was performed. The treatment was completed by 30 Gy external beam radiotherapy, the patient died 18 months after the first consultation. DISCUSSION: Oral melanomas have a poor prognosis probably because they are generally detected late. The most common sites for oral melanomas are the palate and maxillary gingival, malignant melanoma of the mandibular gingiva is extremely rare. About 30% of OM is preceded by areas of oral pigmentation for several months or years. The prognosis is poor with a 5% to 20% five-year survival rate.

[Eagle syndrom: A case report]. / Le syndrome de Eagle : à propos d'un cas.

INTRODUCTION: The Eagle syndrome is a rare entity characterized by a hypertrophy of the styloid process responsible for clinical signs in connection with compression of the vasculonervous structures of vicinity. CASE REPORT: Female 40 years old who complained for 7 years about intense right temporo-parietal headache, associated with ocular pains, otalgia, tinnitus and swallowing problems. These symptoms were unilateral. The only notable antecedent was an extraction of the wisdom teeth of the lower arc 10 years before. CONCLUSION: The Eagle syndrome is an unusual syndrome ignored by the majority of the clinicians. The simple palpation of the oropharyngeal walls (tonsils) makes it possible to evoke the diagnosis. This suspicion will be confirmed by Xrays. The surgery presents few risks and the patient is released of symptoms very quickly.

[Recurrent ameloblastoma on a rib graft after 33 years (a case report and review of the literature)]. / Récidive d'un améloblastome sur greffe costale après 33 ans (à propos d'un cas et revue de la littérature).

INTRODUCTION: The recurrence of an ameloblastoma is generally due to insufficient margins of resection or to the aggressiveness of the tumour which is regarded as locally malignant. Recurrencies on autologus osseous graft are rare in the literature. We report the case of a recurrent ameloblastoma on autologus rib graft which occurred 33 years after the surgery. OBSERVATION: A 59 year old man, underwent at the age of 26 years a tumoral removal of a left mandibular cyst with reconstruction by costal graft. The histopathologic diagnosis was an ameloblastoma with healthy limits and without invasion of the soft tissues. He consulted recently for a tumour located at the left side of the symphysis and presenting an endo-oral component bending at the level of the floor of the mouth. The CTscan objectified a cystic hypodensity well defined inside the rib graft. The patient underwent a surgery performed by a mixed approach (endo-oral and cervical). The tumour was removed with macroscopically healthy margins. CONCLUSION: The pathogenesis of the recurrence of an ameloblastoma on autologus osseous graft is still not well understood. Thus, it is recommended to get healthy margins in case of en bloc resection requiring to make the limits of the resection at least at one centimeter from the tumour. A very longterm follow-up clinical and radiological is also mandatory.

[Cervicofacial lymphangioma in adults (10 case reports)]. / Les lymphangiomes cervico-faciaux de l'adulte (à propos de 10 cas).

INTRODUCTION: Cystic cervico-facial lymphangioma (DDFL) are relatively rare. Because of their size and site, they pose a real problem in treatment. The authors present a retrospective study about 10 cases. MATERIALS & METHODS: The mean age of this series of patients was 31 years, with a slight female preponderance. Ultrasound scanning is sufficient to establish the diagnosis. CT or MRI scan helps to show whether there is parapharyngeal or mediastinal extension. RESULTS: Every patient in this series underwent operation. We had one recurrence and two postoperative neurological sequelae. DISCUSSION: Although there is little difficulty in the diagnosis of this condition, it is difficult to treat because of extension which involve the face, the floor of mouth and tongue base, and also the major structures in neck. Current interest is centred on treating these lesions with sclerosis agents, either for recurrence or, according to some authors, as a first therapeutic option.