ABSTRACT
Introduction: Peripheral ossifying fibroma (POF) is a solitary gingival growth thought to arise from the gingiva, periosteum or the periodontal ligament. It is a slow-growing, benign, progressive lesion that is limited in size. Case description: This article describes a case of ossifying fibroma of a peripheral variant that occurred in a 26-year-old female in the anterior region of the lower jaw and presented as a growth on the gingiva. Since it was difficult to diagnose clinically, a pathological evaluation was mandatory. Upon pathological confirmation of the diagnosis, the lesion was surgically excised up to the periosteum. This was deemed to be the required treatment yet, since the recurrence rate is high for POF (8% to 20%), the patient must be followed up yearly to check for recurrence.
Introduction: Le fibrome ossifiant périphérique (FOP) est une excroissance gingivale solitaire dont on pense qu'elle provient des gencives, du périoste ou du ligament parodontal. Il s'agit d'une lésion progressive, bénigne et à croissance lente dont la taille est limitée. Description du cas: Cet article décrit le cas d'une variante périphérique du fibrome ossifiant survenue chez une femme de 26 ans, dans la région antérieure de sa mâchoire inférieure et se présentant comme une excroissance sur la gencive. Comme il était difficile d'établir un diagnostic clinique, une évaluation pathologique a été nécessaire. Après confirmation pathologique du diagnostic, la lésion a été excisée jusqu'au périoste lors d'une opération chirurgicale. On a jugé ce traitement nécessaire, puisque le taux de récidive du FOP est élevé (entre 8 % et 20 %). La patiente doit faire l'objet d'un suivi annuel pour rechercher toute récidive éventuelle.
Subject(s)
Fibroma, Ossifying , Gingival Neoplasms , Humans , Female , Fibroma, Ossifying/surgery , Fibroma, Ossifying/pathology , Fibroma, Ossifying/diagnosis , Fibroma, Ossifying/diagnostic imaging , Adult , Gingival Neoplasms/surgery , Gingival Neoplasms/pathology , Gingival Neoplasms/diagnosis , Mandibular Neoplasms/pathology , Mandibular Neoplasms/surgery , Mandibular Neoplasms/diagnostic imaging , Mandibular Neoplasms/diagnosisABSTRACT
Herein, we detail a multidisciplinary approach and sequential treatment for two infants with congenital granular cell epulis (CGCE). Ultrasonic examinations at 34 weeks of gestation revealed prominent oral masses in both fetuses. To devise a carefully considered treatment strategy, a comprehensive multidisciplinary consultation including oral and maxillofacial surgeons, pediatricians, obstetricians, and anesthesiologists was convened. Following cesarean sections, the lesions were successfully removed, measuring approximately 30 × 15 mm and 30 × 20 mm in size, respectively. Immunohistochemical analysis showed that vimentin was positive, S-100 protein was negative, and NSE protein and CD68 protein were negative. These findings underscore the importance of prenatal diagnosis of congenital granular cell epulis for the effective management of these rare benign conditions.
Subject(s)
Granular Cell Tumor , Prenatal Diagnosis , Humans , Female , Pregnancy , Granular Cell Tumor/surgery , Granular Cell Tumor/pathology , Granular Cell Tumor/congenital , Prenatal Diagnosis/methods , Infant, Newborn , Gingival Neoplasms/surgery , Gingival Neoplasms/pathology , Gingival Neoplasms/congenital , Adult , Male , Ultrasonography, PrenatalABSTRACT
A 35-year-old patient presented with a painless, broad-based exophytic lesion in the buccal interdental region between teeth 13 and 14. Despite oral hygiene efforts the lesion persisted for around one year. Radiology excluded bone involvement, and histopathology after excision confirmed a fibromatous epulis, which is characterized by collagen-rich connective tissue. There was no recurrence within one-year follow-up. Surgical removal proved to be efficient.
Subject(s)
Gingival Neoplasms , Adult , Humans , Diagnosis, Differential , Fibroma/surgery , Fibroma/pathology , Fibroma/diagnosis , Gingival Neoplasms/surgery , Gingival Neoplasms/pathology , Gingival Neoplasms/diagnosisABSTRACT
BACKGROUND: The Union for International Cancer Control and American Joint Committee on Cancer tumor staging system is used globally for treatment planning. As it may be insufficient for tumor staging of lower gingival carcinomas, we proposed the mandibular canal tumor staging system. In this study, we aimed to compare the two systems for such tumor staging and to identify prognostic markers. METHODS: This multicenter, retrospective study included patients with lower gingival squamous cell carcinoma who underwent radical surgery during 2001-2018. We compared survival rates (Kaplan-Meier estimator) and patient stratification according to the two systems. RESULTS: The proposed system yielded more balanced patient stratification than the existing system. Progression in the tumor grade according to the proposed system was associated with a poorer prognosis. The 5-year overall and disease-specific survival rates for the entire cohort were 74.9% and 81.8%, respectively. Independent factors affecting overall survival were tumor stage according to the proposed system, excision margins, and number of positive nodes, whereas those affecting disease-specific survival were excision margins and number of positive nodes. CONCLUSIONS: Subsite-specific tumor classification should be used for patients with oral cancer, and our results suggest that mandibular canal tumor classification may be effective for patients with lower gingival carcinoma.
Subject(s)
Carcinoma, Squamous Cell , Gingival Neoplasms , Neoplasm Staging , Humans , Male , Retrospective Studies , Female , Middle Aged , Gingival Neoplasms/pathology , Gingival Neoplasms/surgery , Gingival Neoplasms/mortality , Aged , Prognosis , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/surgery , Carcinoma, Squamous Cell/mortality , Adult , Survival Rate , Aged, 80 and over , Mandible/pathology , Mandible/surgeryABSTRACT
BACKGROUND: Peripheral ossifying fibroma is a nonneoplastic inflammatory hyperplasia that originates in the periodontal ligament or periosteum in response to chronic mechanical irritation. Peripheral ossifying fibroma develops more commonly in young females as a solitary, slow-growing, exophytic nodular mass of the gingiva, no more than 2 cm in diameter. While various synonyms have been used to refer to peripheral ossifying fibroma, very similar names have also been applied to neoplastic diseases that are pathologically distinct from peripheral ossifying fibroma, causing considerable nomenclatural confusion. Herein, we report our experience with an unusual giant peripheral ossifying fibroma with a differential diagnostic challenge in distinguishing it from a malignancy. CASE PRESENTATION: A 68-year-old Japanese male was referred to our department with a suspected gingival malignancy presenting with an elastic hard, pedunculated, exophytic mass 60 mm in diameter in the right maxillary gingiva. In addition to computed tomography showing extensive bone destruction in the right maxillary alveolus, positron emission tomography with computed tomography revealed fluorodeoxyglucose hyperaccumulation in the gingival lesion. Although these clinical findings were highly suggestive of malignancy, repeated preoperative biopsies showed no evidence of malignancy. Since even intraoperative frozen histological examination revealed no malignancy, surgical resection was performed in the form of partial maxillectomy for benign disease, followed by thorough curettage of the surrounding granulation tissue and alveolar bone. Histologically, the excised mass consisted primarily of a fibrous component with sparse proliferation of atypical fibroblast-like cells, partly comprising ossification, leading to a final diagnosis of peripheral ossifying fibroma. No relapse was observed at the 10-month follow-up. CONCLUSIONS: The clinical presentation of giant peripheral ossifying fibromas can make the differential diagnosis from malignancy difficult. Proper diagnosis relies on recognition of the characteristic histopathology and identification of the underlying chronic mechanical stimuli, while successful treatment mandates complete excision of the lesion and optimization of oral hygiene. Complicated terminological issues associated with peripheral ossifying fibroma require appropriate interpretation and sufficient awareness of the disease names to avoid diagnostic confusion and provide optimal management.
Subject(s)
Fibroma, Ossifying , Gingival Neoplasms , Humans , Fibroma, Ossifying/surgery , Fibroma, Ossifying/pathology , Fibroma, Ossifying/diagnostic imaging , Male , Aged , Diagnosis, Differential , Gingival Neoplasms/pathology , Gingival Neoplasms/surgery , Gingival Neoplasms/diagnostic imaging , Gingival Neoplasms/diagnosis , Maxillary Neoplasms/pathology , Maxillary Neoplasms/surgery , Maxillary Neoplasms/diagnostic imaging , Tomography, X-Ray Computed , Maxilla/pathology , Maxilla/diagnostic imaging , Maxilla/surgeryABSTRACT
We describe a case of mandibular gingival carcinoma with hypercalcaemia and leukocytosis caused by tumour-derived parathyroid hormone-related protein (PTHrP) and granulocyte colony-stimulating factor (G-CSF). A 54-year-old man presented to our Department of Oral and Maxillofacial Surgery with a chief complaint of a left-sided mandibular gingival ulcer. A 42 mm × 20 mm sized ulcer was found on the left lower molar gingiva. Squamous cell carcinoma was pathologically diagnosed. The patient underwent a hemimandibulectomy, left-sided radical neck dissection, plate reconstruction, pectoralis major musculocutaneous flap reconstruction, and tracheostomy under general anaesthesia. Pathologically, two metastatic lymph nodes were identified. Residual tumour was suspected at the resection margins. Eight weeks after surgery, the patient started postoperative concurrent chemoradiotherapy (CCRT). Two weeks after CCRT, the patient developed hypercalcaemia. Serum levels of PTHrP and G-CSF increased in parallel with the progression of hypercalcaemia and leukocytosis. Immunohistochemical analysis of the surgical specimen showed positivity for G-CSF. Based on these clinical and pathological findings, the patient was diagnosed with hypercalcaemia and leukocytosis associated with malignancy and was treated with denosumab. Irradiation was terminated at 50 Gy because CT showed rapid disease progression. Chemotherapy was initiated, however, four weeks after the start of chemotherapy, a CT scan showed increased metastases and pleural dissemination. Therefore, chemotherapy was discontinued. One week after the chemotherapy was discontinued, the patient died of respiratory failure.
Subject(s)
Carcinoma, Squamous Cell , Gingival Neoplasms , Granulocyte Colony-Stimulating Factor , Parathyroid Hormone-Related Protein , Humans , Male , Middle Aged , Gingival Neoplasms/pathology , Gingival Neoplasms/surgery , Carcinoma, Squamous Cell/pathology , Leukocytosis/etiology , Hypercalcemia/etiology , Fatal Outcome , Mandibular Neoplasms/pathology , Mandibular Neoplasms/surgeryABSTRACT
Peripheral ossifying fibroma (POF) is a reactive, benign gingival enlargement. Its etiology is not fully known. It can be seen in many different sizes in the mouth. The histopathological appearance of POF is mineralized tissue and fibrous proliferation. All relevant soft and hard tissues must be removed to prevent recurrence. Periodontal tissue remaining after excision is important for tooth preservation. With large lesions, the loss of healthy periodontal tissue is also large. Periodontal surgical approaches are important to preserve the remaining periodontal tissue. The positive effects of autogenously obtained titanium-prepared platelet-rich fibrin (T-PRF) and connective tissue graft (CTG) on soft tissue are well known. A 34-year-old woman presented with a fibrous and pedunculated gingival mass in the upper left canine premolar region. The operation was performed with complete excision of the lesion down to the bone along with the surrounding healthy tissue. Periodontal treatment of the large defect created after excision of a large POF lesion was performed with laterally positioned flap, CTG and T-PRF. The periodontal tissue and defect were noted to heal in a healthy manner at the 6-month follow-up. POF is a benign lesion; however, it has a high recurrence rate. Complete elimination of the lesion is crucial to prevent recurrence. Periodontal surgical methods and biomaterials applied after surgical excision are significant to maintain the periodontal health of the remaining teeth and tissues.
Subject(s)
Calcinosis , Fibroma, Ossifying , Gingival Neoplasms , Female , Humans , Adult , Fibroma, Ossifying/surgery , Fibroma, Ossifying/pathology , Gingival Neoplasms/surgery , Gingival Neoplasms/pathology , Gingiva/surgery , Gingiva/pathologyABSTRACT
Congenital epulis is a rare tumor; when voluminous and ulcerated, appearance can generate concern. Nevertheless, it is a benign lesion that is easily treated with surgery. This is a retrospective study, with the presentation of 2 cases treated by the same team from 2016 to 2020 and a bibliographic review (PubMed and Elsiever). This surgical team is based in Buenos Aires, working in the private medical system. Congenital epulis is an infrequent, benign tumor affecting females predominantly, appearing at birth on the alveolar median ridge of the maxilla. Its pathogenesis is uncertain. Voluminous tumors interfere with feeding, but respiratory interference is exceptional. Histologically, this tumor is similar to the granular cell tumor but has different clinical characteristics and Periodic Acid Schiff stain. Prenatal diagnosis with ecographic or magnetic resonance imaging is ideal; if undiagnosed prenatally, clinical diagnosis is done based on typical features. Surgical excision is the treatment of choice.
Subject(s)
Gingival Neoplasms , Granular Cell Tumor , Infant, Newborn , Female , Pregnancy , Humans , Gingival Neoplasms/diagnostic imaging , Gingival Neoplasms/surgery , Retrospective Studies , Granular Cell Tumor/diagnostic imaging , Granular Cell Tumor/surgery , Maxilla/pathology , Prenatal DiagnosisABSTRACT
The treatment of advanced lower gingival carcinoma requires postoperative chemoradiotherapy; therefore, simultaneous hard-tissue reconstruction may not be indicated. In these cases, mandibular reconstruction is performed using a temporal reconstruction plate and various skin flaps. Herein, we reported 2 cases of advanced lower gingival carcinoma treated with a novel computer-assisted patient-specific, fully custom-made mandibular reconstruction plate system(Cosmofix®)in combination with a pedicle/free flap. In case 1, an 80-year-old female patient was diagnosed with right lower gingival carcinoma( cT4aN3bM0, Stage â £B). Under general anesthesia, she underwent tracheostomy, bilateral neck dissection, segmental mandibulectomy, and mandibular reconstruction using Cosmofix® in combination with an ulnar forearm free flap. In case 2, an 81-year-old male patient was diagnosed with right lower gingival carcinoma(cT4aN2bM0, Stage â £A). The patient underwent maintenance dialysis and required minimally invasive surgery using a pedicle flap. Under general anesthesia, the patient underwent tracheostomy, right modified radical neck dissection, segmental mandibulectomy, and mandibular reconstruction using Cosmofix® in combination with a pectoralis major myocutaneous flap. Postoperative facial morphology, occlusion, eating, swallowing, articulation, and other dysfunctions were minimal in both the cases. Adjuvant chemoradiotherapy was recommended. In conclusion, the utilization of the Cosmofix® system enabled both esthetic and functional reconstruction following segmental mandibulectomy for advanced lower gingival carcinoma.
Subject(s)
Carcinoma , Gingival Neoplasms , Mandibular Reconstruction , Plastic Surgery Procedures , Male , Female , Humans , Aged, 80 and over , Gingival Neoplasms/surgery , Surgical Flaps/surgery , Carcinoma/surgeryABSTRACT
El épulis congénito es una patología neonatal muy rara. Se trata de un tumor benigno pediculado de la mucosa de los maxilares, más frecuentemente localizado en maxilar superior en relación 2-3/1. Se describe el caso de un recién nacido de sexo femenino, de término, adecuado, vigoroso. Se constata al nacimiento la presencia de un épulis congénito que causa alteraciones de la succión. Se realiza intervención quirúrgica temprana, con resolución de la patología sin complicaciones.
Congenital epulis is a very rare neonatal pathology. It is a benign pedunculated tumor of the jaw mucosa, most frequently located in the upper jaw in a 2-3 / 1 ratio. The case of a newborn, female, term, adequate, vigorous is described. Noting at birth a congenital Epulis that causes suction alterations. Early surgical intervention is perfomed with resolution of the pathology without complications.
A epúlide congênita é uma patologia neonatal muito rara. É um tumor pedunculado benigno da mucosa dos maxilares, mais frequentemente localizado no maxilar superior na proporção de 2-3/1. Descreve-se o caso de um recém-nascido, do sexo feminino, a termo, adequado, vigoroso. Verificando ao nascimento uma Epúlide congênita que causa alterações na sucção. A intervenção cirúrgica precoce é realizada com resolução da patologia sem complicações.
Subject(s)
Humans , Male , Infant, Newborn , Gingival Neoplasms/surgery , Gingival Neoplasms/diagnosis , Gingival Neoplasms/pathologyABSTRACT
To provide references for the diagnosis and treatment of congenital granular cell tumor (CGCT), by comprehensive analysis of the clinical data, histopathological and immunohistochemical results. Patients with CGCT were involede, from March 2015 to November 2020, at the Department of Oral and Maxillofacial Surgery of the First Affiliated Hospital of Zhengzhou University. A total of 6 children, aged 3-16 days, 1 male and 5 female, 5 maxillary and 1 mandibular, with maximum tumor diameter of 6-70 mm, were included. The lesions of CGCT were single and connected to the alveolar ridge by a pedicle. The surface of the tumor was covered with a vascular network, and two cases had ulcers on the surface of the tumor. All 6 cases had the tumor removed surgically and there was no recurrence or metastasis in the follow-up visit. Although CGCT is rare, it is a benign tumor and generally does not recur or metastasize after surgery, and has a good prognosis. The prenatal imaging, clinical manifestations after delivery, pathological characteristics and immunohistochemical analyses may provide reference for early diagnosis and treatment of CGCT.
Subject(s)
Gingival Neoplasms , Granular Cell Tumor , Child , Diagnosis, Differential , Female , Gingival Neoplasms/surgery , Granular Cell Tumor/diagnosis , Granular Cell Tumor/metabolism , Granular Cell Tumor/surgery , Humans , Male , PregnancySubject(s)
Gingival Diseases , Gingival Neoplasms , Gingival Diseases/surgery , Gingival Neoplasms/surgery , HumansABSTRACT
Congenital granular cell epulis is a congenital growth rarely found on the gingiva of neonates. These remarkably large tumours present in an infant's mouth may impede with feeding, respiration or adequate mouth closure. Recognition of this entity and prompt treatment are essential for preventing any difficulties for the neonate. This is a case report of a 35-day-old female neonate who presented with a single exophytic lesion in the maxillary alveolar ridge. The differential diagnosis, management regimens and complications of this condition are reviewed. The lesion was excised under intravenous sedation and subjected to histopathological analysis. Based on the microscopic findings, the diagnosis of congenital granular cell epulis was confirmed. Clinicians including paediatricians, sonographers, dentists and surgical pathologists should be able to timely recognise and intervene such tumours as they may be potentially harmful to the infant.
Subject(s)
Gingival Neoplasms , Granular Cell Tumor , Alveolar Process , Diagnosis, Differential , Female , Gingiva , Gingival Neoplasms/diagnosis , Gingival Neoplasms/surgery , Granular Cell Tumor/diagnosis , Granular Cell Tumor/surgery , Humans , MaxillaABSTRACT
Vertical mandibular invasion of lower gingival squamous cell carcinoma (LGSCC) determines the method of resection, which significantly affects the patient's quality of life. Therefore, in mandibular invasion by LGSCC, it is extremely important to monitor progression, specifically whether invasion is limited to the cortical bone or has progressed to the bone marrow. This retrospective study aimed to identify the diagnostic and predictive parameters for mandibular invasion, particularly vertical invasion, to enable appropriate selection of the method of mandibular resection. Of the patients who underwent surgery for LGSCC between 2009 and 2017, 64 were eligible for participation in the study based on tissue microarrays (TMA) from surgical specimens. This study analyzed morphological features using computed tomography (CT), and metabolic characteristics using maximum standardized uptake value (SUVmax), peak value of SUV (SUVpeak), metabolic tumor volume (MTV), and total lesion glycolysis (TLG). Moreover, immunohistochemical analysis of proteins, including parathyroid hormone-related protein (PTHrP), interleukin-6 (IL-6), E-cadherin, and programmed cell death-1 ligand 1 (PD-L1), was performed. Statistical analysis was performed using univariate logistic regression analysis with the forward selection method. The present study showed that MTV (≥2.9 cm3) was an independent diagnostic and predictive factor for positivity of mandibular invasion. Additionally, TLG (≥53.9 bw/cm3) was an independent diagnostic and predictive factor for progression to bone marrow invasion. This study demonstrated that in addition to morphological imaging by CT, the volume-based parameters of MTV and TLG on fluorine-18 fluorodeoxyglucose positron emission tomography were important for predicting pathological mandibular invasion in patients with LGSCC. A more accurate preoperative diagnosis of vertical mandibular invasion would enable the selection of appropriate surgical procedure for mandibular resection.
Subject(s)
Gingival Neoplasms , Squamous Cell Carcinoma of Head and Neck , Humans , Fluorodeoxyglucose F18 , Multimodal Imaging , Positron Emission Tomography Computed Tomography , Prognosis , Quality of Life , Radiopharmaceuticals , Retrospective Studies , Squamous Cell Carcinoma of Head and Neck/diagnostic imaging , Squamous Cell Carcinoma of Head and Neck/surgery , Tumor Burden , Gingival Neoplasms/diagnostic imaging , Gingival Neoplasms/surgeryABSTRACT
Many patients with mental retardation have a limited awareness of abnormalities in the oral cavity, making early detection of oral cancer difficult. Moreover, during examination and treatment, these patients may not understand well-intentioned verbal explanations and may express their anxiety through nonverbal communication. Herein we discuss a case in which favorable results were obtained when surgical treatment was performed on a maxillary gingival carcinoma patient with mental retardation. The patient was a 61-year-old man who was admitted to our hospital with maxillary gingival pain. A biopsy revealed well-differentiated oral squamous cell carcinoma(cT4aN0M0, Stage â £A). Hemi-maxillectomy was performed and postoperative recovery was uneventful. A maxillary prosthesis was provided for oral rehabilitation. At the 5-year follow-up, there were no signs of recurrence or metastasis. This case illustrates the importance of collaboration between oral maxillofacial surgeons and specialists from related departments for the comprehensive management of patients with mental retardation.
Subject(s)
Bone Neoplasms , Carcinoma, Squamous Cell , Gingival Neoplasms , Intellectual Disability , Maxillary Neoplasms , Mouth Neoplasms , Skin Neoplasms , Male , Humans , Middle Aged , Gingival Neoplasms/complications , Gingival Neoplasms/surgery , Carcinoma, Squamous Cell/complications , Carcinoma, Squamous Cell/surgery , Carcinoma, Squamous Cell/pathology , Maxillary Neoplasms/complications , Maxillary Neoplasms/surgery , Maxillary Neoplasms/pathologyABSTRACT
We report a case of cavernous sinus metastasis following postoperative maxillary gingival squamous cell carcinoma. An 83-year-old man was referred to our hospital due to pain in the left maxillary gingiva. Contrast-enhanced computed tomography imaging showed a mass lesion with bone destruction in the left maxillary gingiva. Biopsy indicated the presence of squamous cell carcinoma(T4bN1M0, Stage â £B), and the tumor was resected under general anesthesia. Four months after surgery, the patient experienced headache, and orbital pain, failing vision, and movement disorder of the left eye appeared. Magnetic resonance imaging revealed a tumor invading the cavernous sinus and orbit. The lesion was clinically diagnosed as metastatic cavernous sinus following postoperative left maxillary gingival carcinoma. Although the patient underwent chemotherapy, he died from multiple organ failure about 5 months after surgery.
Subject(s)
Breast Neoplasms , Carcinoma, Squamous Cell , Cavernous Sinus , Gingival Neoplasms , Skin Neoplasms , Male , Humans , Aged, 80 and over , Gingival Neoplasms/drug therapy , Gingival Neoplasms/surgery , Cavernous Sinus/surgery , Cavernous Sinus/pathology , Skin Neoplasms/pathology , Carcinoma, Squamous Cell/drug therapy , Carcinoma, Squamous Cell/surgery , Carcinoma, Squamous Cell/pathology , Breast Neoplasms/pathology , PainABSTRACT
We report a case of advanced lower gingival carcinoma treated with a computer-assisted custom-made surgical guide and reconstruction plate system(TruMatch®)in combination with a pectoralis major myocutaneous flap. In a 74-year-old male patient, a neoplastic lesion with a 30×30 mm periapical induration was observed around an extraction socket of left mandibular third molar. After various examinations, we diagnosed lower gingival carcinoma(cT4aN2bM0, Stage â £A). The patient was a paraplegic with a spinal cord injury, and reconstruction of mandible with free flap was not indicated, requiring minimally invasive surgery. Therefore, a surgical guide and reconstruction plate were prepared preoperatively using the Tru- Match® system. Under general anesthesia, the patient underwent tracheostomy, left modified radical neck dissection, segmental mandibulectomy, and reconstruction of the mandible using this system in combination with a pectoralis major myocutaneous flap. Postoperatively, the patient had minimal dysfunction. Currently, at 18 months follow up postoperatively, good prognosis was observed. In conclusion, this is a useful surgical system with accurate and less invasive surgery for segmental mandibulectomy of advanced lower gingival carcinoma.
Subject(s)
Bone Neoplasms , Carcinoma , Gingival Neoplasms , Mandibular Reconstruction , Plastic Surgery Procedures , Male , Humans , Aged , Gingival Neoplasms/surgery , Surgical Flaps/surgery , Mandible/surgery , Carcinoma/surgery , Bone Neoplasms/surgery , ComputersABSTRACT
Background Congenital epulis is a benign tumor of upper gingiva. Larger lesions interfere with mouth closing and normal feeding and may obstruct airways. We present a neonate with a large epulis. Case Report: A full term 3 kg 5 days female baby had a 20 cm × 15 cm gingival mass protruding from the oral cavity, connected by a pedicle attached to right upper gingiva (Figure 1). Multiple trophic ulcers had developed in the mass after birth. Mouth closing and normal feeding were hampered. The mass was excised surgically and baby improved. Conclusion: A large congenital epulis, though worrisome to parents, can be satisfactorily managed by surgical excision and has a good prognosis.
Subject(s)
Gingival Neoplasms , Female , Gingival Neoplasms/congenital , Gingival Neoplasms/pathology , Gingival Neoplasms/surgery , Humans , Infant, NewbornABSTRACT
To provide references for the diagnosis and treatment of congenital granular cell tumor (CGCT), by comprehensive analysis of the clinical data, histopathological and immunohistochemical results. Patients with CGCT were involede, from March 2015 to November 2020, at the Department of Oral and Maxillofacial Surgery of the First Affiliated Hospital of Zhengzhou University. A total of 6 children, aged 3-16 days, 1 male and 5 female, 5 maxillary and 1 mandibular, with maximum tumor diameter of 6-70 mm, were included. The lesions of CGCT were single and connected to the alveolar ridge by a pedicle. The surface of the tumor was covered with a vascular network, and two cases had ulcers on the surface of the tumor. All 6 cases had the tumor removed surgically and there was no recurrence or metastasis in the follow-up visit. Although CGCT is rare, it is a benign tumor and generally does not recur or metastasize after surgery, and has a good prognosis. The prenatal imaging, clinical manifestations after delivery, pathological characteristics and immunohistochemical analyses may provide reference for early diagnosis and treatment of CGCT.
Subject(s)
Child , Female , Humans , Male , Pregnancy , Diagnosis, Differential , Gingival Neoplasms/surgery , Granular Cell Tumor/surgeryABSTRACT
Oral malignant melanomas are rare neoplasms of the oral cavity which present significant diagnostic ambiguity. The etiology is unclear though the stimulation of melanoblasts by genetic, epigenetic, and traumatic causes that have been proposed in etiopathogenesis. Clinically, it presents as a pigmented swelling or growth which remains asymptomatic until it advances to later stages. It is highly invasive and metastasizes quickly; hence, it has a very poor prognosis with a survival rate of only 7%. Early diagnosis of the neoplasm and thorough investigation is not only necessary for prompt treatment but also necessary for a favorable prognosis.