Malignant fibrous histiocytoma of the mandible - A case report and review of published case reports.

The natural history of malignant fibrous histiocytoma (MFH) is still heavily debated. It's anonymous natural history is precisely denoted by its new adapted terminology 'undifferentiated pleomorphic sarcoma (UPS)'. Thus to diagnose a lesion as UPS, it is vital to correlate its histopathological features along with its immunohistochemical (IHC) expressions to confirm the tumor cell lineage. MFH is extremely rare in mandible with the literature search in PubMed database revealing only 13 case reports of MFH involving the mandible. Among these, only 7 case reports provide IHC details of the case. Without IHC data it is not possible to determine the accuracy of the diagnosis in the remaining 6 cases. Here we report an additional 8th case of MFH involving the ramus and angle of the mandible. Histopathology revealed proliferating malignant spindle cells interspersed with histiocyte-like cells. The tumor cells were strongly positive for vimentin and CD68 and were negative for S-100, epithelial membrane antigen (EMA) and cytokeratin (CK). The diagnosis was made by correlating the histopathological findings with the IHC profile. The report also provides the data (clinical, radiographic, histopathological, immunohistochemical features and treatment details) extracted from the 7 confirmed MFH case reports involving the mandible.

Granular cell ameloblastoma: A rare case report and review of literature.

Ameloblastoma is a benign locally aggressive type of odontogenic tumor derived exclusively from the epithelium. Histologically, ameloblastoma is classified into many variants, of which granular cell ameloblastoma (GCA) is a rare type, characterized by nest of large eosinophilic granular cells. This article describes a case of GCA in a 50-year-old female patient with clinical, radiological, and histological features along with a systematic review of the literature.

Recurrent juvenile psammomatoid ossifying fibroma with secondary aneurysmal bone cyst of the maxilla: a case report and review of literature.

Juvenile ossifying fibroma is a benign fibro-osseous lesion commonly affecting the extra-gnathic craniofacial skeleton of the young individuals. The psammomatoid and trabecular variants are its two histopathological subtypes having distinctive clinico-pathological characteristics. Secondary aneurysmal bone cysts are frequently reported to arise in the pre-existing fibro-osseous lesions but rarely reported in the psammmomatoid variant of the juvenile ossifying fibroma. Such hybrid lesions, especially massive in size, tend to exhibit a greater aggressive growth potential and higher recurrence rate and mandate complete surgical removal of the lesion along with a long-term follow-up. The objective of this case report was to present a rare incident of recurrent psammomatoid ossifying fibroma associated with a secondary aneurysmal bone cyst in the maxillary jaw bone of a young patient and review the similar published reports in the English literature.

Adenoid cystic carcinoma of alveolar mucosa: A rare case report.

Adenoid cystic carcinomas are rare epithelial malignancies of salivary glands that show slow growth and local invasion with recurrences seen many years after diagnosis. Upto 50% of tumors occur in intraoral minor salivary glands usually in the hard palate. Tumors on the alveolar mucosa are extremely rare. We present a case of adenoid cystic carcinoma on the right alveolar mucosa in a 35 year old female. The case is been presented for its rarity.

Leprosy of the hard palate: A rare case report.

Leprosy is a chronic granulomatous infection caused by Mycobacterium leprae, a bacillus that presents a peculiar tropism for the skin and peripheral nerves. Leprosy instigates various types of clinical presentation and exerts influence on the patient's immune response. The clinical gamut of leprosy ranges from the tuberculoid form (TT) to the disseminative and progressive lepromatous form (LL). Oral lesions are uncommon but, when present, occur in the lepromatous form and are broadly divided into nonspecific and specific lesions. In this article, we present a case of leprosy of the hard palate in a 25-year-old male. The case is been presented for its rarity.

Accidental local infiltration of formalin into the buccal mucosa: A case report and review of the literature.

Formalin is a hazardous chemical, yet it is the choice of fixative for diagnostic pathology. Dental surgeons routinely use formalin for preservation of oral biopsy specimens. Literature search revealed that during regular biopsy procedures, unintentional injection with formalin has occurred, and such rare seven cases have been reported till date. In addition to the literature review, the present article describes first case of accidental local infiltration with formalin into the buccal mucosa during a biopsy procedure, its damaging effect on the oral tissues, subsequent judicious management of the patient and successful tissue reconstruction with collagen membrane.

Kerosene: Contributing agent to xylene as a clearing agent in tissue processing.

BACKGROUND: Research methodology in oral and maxillofacial pathology has illimitable potential. The tissue processing involves many steps of which one of the most important step is "Clearing," which is a process of replacing dehydrant with a substance which is miscible with embedding medium or paraffin wax. Xylene is one of the common clearing agents used in laboratory, but it is also hazardous. The main aim of this study is to substitute conventionally used xylene by a mixture of kerosene and xylene in clearing steps without altering the morphology and staining characteristics of tissue sections. This will also minimize the toxic effects and tend to be more economical. MATERIALS AND METHODS: One hundred and twenty bits of tissue samples were collected, each randomly separated into 4 groups (A, B, C and D) and kept for routine tissue processing till the step of clearing; during the step of clearing instead of conventional xylene, we used mixture of xylene and kerosene in 4 ratios ([A-K:X - 50:50]; [B-K:X - 70:30]; [C - Ab. Kerosene]; [D - Ab. Xylene - as control]) and observed for the light microscopic study adopting H and E staining, IHC (D2-40), Special stains (periodic acid-Schiff and congo red) procedure. The result was subjected to statistical analysis by using Fisher's exact test. RESULTS: The results obtained from the present study were compared with control group, i.e., D and it was observed that Groups A and B were absolutely cleared without altering the morphology of tissue and cellular details; optimum embedding characteristics and better staining characteristics were also noted, whereas Group C presents poor staining characteristics with reduced cellular details. Embedded tissues in Group C presented with rough, irregular surface and also appeared shrunken. CONCLUSION: Combined mixture of xylene and kerosene as a clearing agent in different ratio, i.e., Group A (K:X - 50:50) and B (K:X - 70:30) can be used without posing any health risk or compromising the cellular integrity.

Evaluating the efficacy of osteopontin expression as a prognostic marker in oral squamous cell carcinoma in the Indian subpopulation.

AIM: This study aimed to correlate the prognostic value of osteopontin (OPN) expression using both tissue and plasma samples from patients with clinically and histologically confirmed oral squamous cell carcinoma (OSCC). METHODS AND MATERIALS: The study group comprised of sixty patients (n = 60), which were clinically and histologically diagnosed for oral squamous cell carcinoma (OSCC). The Control group comprised of ten (n = 10) healthy volunteers. Plasma OPN levels were assayed using a quantitative enzyme-linked immunosorbent assay (OPN ELISA). Expression of OPN was also identified and evaluated by immunohistochemistry in tissue sections. These OPN expressions were then correlated with different parameters like age, sex, site, clinical presentation, tumor node metastasis (TNM) staging, histopathological grading and lymph node metastasis. STATISTICAL ANALYSIS: One-way analysis of variance (ANOVA) was used to evaluate the difference in tissue intensity and plasma OPN levels between the OSCC and the normal control groups. RESULTS: The distribution of the plasma OPN levels and tissue OPN intensity in OSCC cohorts were compared to histopathological grades and analyzed. When evaluated OPN expression in tissue had higher intensity observed in OSCC (95% +ve) cases. And the mean plasma OPN concentration in OSCC cohort was more in comparison to the normal cohort. The results clearly showed that the plasma OPN levels and intensity grading in tissue correlated with tumor grades. CONCLUSION: The study highlights OPN as a biomarker for prognosis in OSCC in both plasma and tissue samples. We would like to emphasize on the evaluation of plasma OPN as a protocol of blood examination for all cancer patient, as it may serve as an indicator for tumor progression and potential risk of metastasis.

Adenomatoid odontogenic tumor with clear cell changes.

Adenomatoid odontogenic tumor (AOT) has a limited biological profile and been an attention-grabbing tumor for a century for its origin. Though described earlier, it was widely accepted after Harbitz from Norway reported about this uncommon benign tumor in 1915. There has been a long debate as whether this tumor is a hamartoma or a neoplasm. Here, we present a case of AOT in a 20-year-old female with details of clinical, radiological and histological features along with clear cell changes, signifying AOT to be more aggressive in nature than assessed from earlier literature. Thus, we did an extensive search of PubMed literature on AOT with all its histopathological features associated until date to find the report of clear cell changes yet.

Ectopic teeth in ovarian teratoma: a rare appearance.

Teratoma consists of tissues derived from all the three germ layers, and there may be presence of appendages as a representation of these germ layers as well. Teratomas of the ovary are known to occur in a fairly large number of women. These may be present clinically at a much later stage, permitting a limited treatment plan. Newer diagnostic techniques are always welcome in identifying these lesions. This case report discusses the case of a 40-year-old woman with a large teratoma in the right ovary and its diagnostic and surgical modalities.

Granulocytic Sarcoma of Parotid Gland in a 4-Year-Old Child with Subleukemic AML: A Diagnostic Challenge!

A 4-year-old male child presented to our outpatient department with large swelling in the parotid region. Routine investigations were all within normal limits, and evaluation of complete blood count was normal except for anaemia. Excisional biopsy as a therapeutic diagnosis was done. Microscopic examination showed monomorphic population of discohesive, hyperchromatic small round cells having high N : C ratio, coarse chromatin, conspicuous nucleoli, and sometimes angulated nuclei lying in sheets. Immunohistochemistry was done to rule out possible differential diagnosis. Fine needle aspiration from the swelling showed predominant population of blast cells. Myeloperoxidase and PBO were strongly positive, and diagnosis of granulocytic sarcoma was confirmed.

Photodynamic therapy: the imminent milieu for treating oral lesions.

Photodynamic therapy (PDT) is used in curative and palliative treatment of head and neck squamous cell carcinoma (HNSCC) and other oral lesions. Oral infections (such as mucosal and endodontic infections, periodontal diseases, caries, and peri-implantitis) are among the specific targets where PDT can be applied Photodynamic therapy (PDT) efficacy depends on the local dose deposited in the lesion as well as oxygen availability in the lesion. Further long-term clinical studies are necessary in establishing a more specific place of the technique in the field of dentistry.