Angina bullosa haemorrhagica: presentation of eight new cases and a review of the literature.

Angina bullosa haemorrhagica (ABH) describes the acute and sometimes painful onset of oral blood-filled vesicles and bullae not attributable to blood dyscrasia, vesiculo-bullous disorders, systemic diseases or other known causes. The haemorrhagic bullae spontaneously burst after a short time resulting in ragged, often painless, superficial erosions that heal spontaneously within 1 week without scarring. Although the pathogenesis is still unclear, ABH seems to be a multifactorial phenomenon: dental or functional trauma seems to be the major provoking factor. The lesions of ABH can be easily confused with other mucosal diseases. It is important that the presentation of this benign disorder is distinguished from other more serious disorders with similar presenting features. The aim of this paper is to report the clinical features of eight cases of ABH, in an attempt to distinguish ABH from other blistering diseases of oral mucosa and to describe their management.

Liposarcoma involving the periodontal tissues. A case report.

Liposarcomas constitute 15 to 20% of all soft tissue tumors. They are extremely rare in the head and neck and in the oral cavity. A 30-year-old patient was seen for a soft, painless mass in the right palate. Through panoramic radiography it was possible to observe a radiolucent area with sharp margins in the right upper quadrant. The lesion, after an incisional biopsy, was diagnosed as a "myxoid liposarcoma." The patient underwent a wide excision of the lesion with bone laminectomy and he is well at a 4-year follow-up. The differential diagnosis included salivary gland tumors and palatal abscess.

Periosteal osteosarcoma of the jaws: report of 2 cases.

Osteosarcoma (OS) occurs most often in the long bones. OS of the jaws has clinical and biologic aspects different from those of the long bones. They tend to occur at an older mean age, pain and swelling are more typical, and prognosis is more favorable. Nearly all OS shows a very prominent central intramedullary bone component. Only rarely are juxtacortical (peripheral) OS located in the jaws. There are 2 main types of juxtacortical OS, periosteal and parosteal. We present 2 cases of OS of the jaws where the clinical, radiologic, and histologic findings pointed to a diagnosis of periosteal OS. Both patients presented, in fact, with lesions located superficially on the bone surface with no marrow involvement. Both tumors were characterized by the presence of a moderately differentiated chondroblastic tumor with foci of osteoid and bone formation. Periosteal OS should be differentiated microscopically from periosteal chondrosarcoma, intramedullary OS with periosteal extension, high-grade surface OS, and parosteal OS. The clinical differential diagnosis was done, in these cases, for epulis, gingival tumors, peripheral odontogenic fibroma, peripheral ossifying fibroma, pyogenic granuloma, peripheral giant cell granuloma, and mesenchymal malignant tumors.

Oral ulceration as a presenting sign of unknown sarcoidosis mimicking a tumour: report of 2 cases.

Oral lesions seem to be rather infrequent in sarcoidosis, and only 43 cases have been described in the English literature. Clinically most oral lesions appear as non-tender well-circumscribed swellings or submucosal nodules. Superficial ulceration is unusual. The authors present two cases in which the first presenting symptom of an unknown sarcoidosis was the presence of an oral ulcerated lesion with indurated margins that could easily have been misdiagnosed for a squamous cell carcinoma. It must be stressed that in all ulcerated lesions of the oral cavity, squamous cell carcinoma must always be considered in the differential diagnosis.

Paraneoplastic pemphigus: a report of two cases.

Paraneoplastic pemphigus (PNP) seems to be a separate autoimmune mucocutaneous disease. Forty-five cases have been reported. Almost all cases of PNP are associated with a tumour, mostly with haematologic malignancies. Pemphigus-like autoantibodies are detected by direct and by indirect immunofluorescence studies. These autoantibodies appear to be directed against a novel set of autoantigens. Two cases are presented with clinical, histologic, immunofluorescence and immunoprecipitation findings characteristic of PNP.

Ameloblastic fibro-odontoma: report of two cases.

Ameloblastic fibro-odontoma is a rare odontogenic tumour. It affects young people and is usually located in the posterior jaws. Two cases of this tumour are presented: both lesions had produced an asymptomatic swelling. The histology showed the presence of an odontogenic epithelium immersed in a fibrous mesenchyme; dental hard tissues were also present. No recurrences were found after 12 and 4 years from the surgical enucleation of the tumour.

Squamous odontogenic tumour: report of two cases.

Squamous odontogenic tumour is a benign odontogenic tumour composed of a well-differentiated squamous epithelium immersed in a fibrous connective tissue stroma. It is a rare tumour and a recent literature review yielded only 36 cases. Two cases of squamous odontogenic tumour are presented, 1 located in the maxilla and the other in the mandible: 1 of these cases showed a periodontal involvement. The radiographic picture was fairly characteristic in 1 case, with a radiolucent lesion between the roots of the second mandibular premolar and the first molar, while, in the other case, it was possible to observe the presence of a lesion located at the apex of a molar. The tumours were enucleated, and no recurrences were observed after 5 years.

[Bilateral adenolymphoma (Warthin's tumor) of the parotid. The anatomicoclinical, diagnostic and therapeutic aspects of 2 cases]. / L'adenolinfoma (tumore di Warthin) bilaterale della parotide. Aspetti anatomo-clinici, diagnostici e terapeutici di due casi.

Cystadenoma lymphomatosum or Warthin's tumor of the parotid glands appears bilateral in 8-10% of cases, synchronous (rarely), metachronous (frequently) and sometimes with multicentric aspects. After the review of the epidemiological, pathogenetic, clinical, radiographic and histologic data, the authors present two cases of bilateral Warthin's tumor, metachronous (7 years), nodular-isolated in the first one and metachronous (5 years), nodular-multicentric in the second one. The patients after CAT scan and NMR examinations, and a fine needle aspiration biopsy were treated with superficial parotidectomy with preservation of the facial nerve. In our experience the management of patients affected by Warthin's tumors, needs the following steps: CAT scan and NMR examinations to outline multiple and bilateral lesions, fine needle aspiration biopsy, superficial parotidectomy with preservation of the facial nerve, an extended follow-up (10 years after the last surgery).

Epidermal growth factor receptor expression in squamous papillomas of the oral mucosa.

Aim of the present study was to investigate the immunocytochemical expression of Epidermal Growth Factor receptor (EGFr) in normal oral mucosa and in 12 oral papillomas in which the presence of Human Papilloma Viruses (HPV) had been ascertained through in situ hybridization. The study reveals that in normal oral mucosa EGFr is usually expressed in basal cell layers whereas in oral papillomas EGFr is detectable throughout the whole thickness of the lesions. Furthermore, when HPV type 6 is present (10 cases) in the lesion, the pattern of expression of EGFr is almost exclusively membranous whereas in two HPV type 16-induced papillomas the reaction product with monoclonal anti-EGFr Antibodies appears confined to the intracytoplasmic paranuclear area. The present investigation, therefore, seems to show a peculiar correlation between HPV infection and EGFr immunoreactivity in papillomas of the oral mucosa. The pattern of immunoreactivity appears to be related to the specific type of HPV detectable in the lesion and it may possibly depend on the interactions between host and viral genomes. Those interactions might be different for HPV 6 and HPV 16 and may consequently lead to divergent expression of EGFr.

[Primary oral peripheral chondrosarcoma. Anatomo-clinical aspects and presentation of 2 cases with periodontal onset]. / Il condrosarcoma periferico orale primitivo. Aspetti anatomo-clinici e presentazione di due casi ad insorgenza parodontale.

After a brief analysis of the anatomoclinical aspects of chondrosarcoma in general and of the characteristic and particular aspects of the forms with maxillofacial onset (lower age of onset, elective sites of onset anterior in the maxillary and posterior in the mandible, often insignificant standard X-ray pictures, high percentage of error in clinical and histological diagnosis) two cases of peripheral periodontal onset, with low degree of malignity (grade 1), with aspecific clinical and radiological aspects, both locally recurrent several times after nonradical surgery are reported.

[Clinico-statistical, morphologic and microstructural analysis of 400 cases of sialolithiasis]. / Analisi clinico-statistica, morfologica e microstrutturale di 400 casi di sialolitiasi.

After reviewing the successive phases of lithogenesis, from dyschylia to outright calculosis, the clinico-epidemiological data on 400 cases of salivary calculosis with incidence according to location (94% submandibular, with 72% intraductal calculi), sex (70% male), age (86% between the second and fifth decades), concomitant pathologies (diabetes mellitus in 25% of cases, arterial hypertension in 20% of cases, chronic hepatopathies in 10% of cases) are presented. The morphological and microstructural aspects of the calculi, observed in polarised light under the optical microscope are reported. The scanty quantity of inorganic tissue contained and the presence of multiple and multidirectional growth nuclei in every calculus examined are pointed out.