ABSTRACT
Tumoural and cystic lesions are common findings in the daily practice of dental professionals and maxillofacial radiologists. However, simultaneous lesions are rare and represent a diagnostic challenge to overcome. Among tumoural pathologies, odontomas are the most common odontogenic tumour of the jaws. Cystic transformation or development from the tumoural capsule are well recognized in situations such as ameloblastomas originated from a dentigerous cyst. Otherwise, despite literature reports, dentigerous cysts arising from odontomas are very rare and could lead to misdiagnosis. Here, we report a case of a complex odontoma associated with a dentigerous cyst in the maxillary sinus, focussing on the tomographic features and a differential imaging approach to the diagnosis of these lesions.
Subject(s)
Dentigerous Cyst/diagnostic imaging , Maxillary Sinus Neoplasms/diagnostic imaging , Odontoma/diagnostic imaging , Adult , Dentigerous Cyst/complications , Diagnosis, Differential , Humans , Male , Maxillary Sinus Neoplasms/complications , Odontoma/complications , Tomography, X-Ray ComputedABSTRACT
La epistaxis constituye una emergencia frecuente en otorrinolaringología. Diariamente se presentan, en servicios de urgencia de hospitales y clínicas, pacientes portadores de hemorragia nasal asociadas o secundarias a hipertensión arterial, traumatismos faciales o procesos tumorales de la región facial. Generalmente, en una gran parte de ellas el taponamiento anterior y/o posterior constituye la terapia más efectiva y la hemorragia se controla rápidamente. Sin embargo, hay pacientes en los que por las características de su cuadro clínico o por lesiones vasculares traumáticas, requieren de un manejo más agresivo para controlar definitivamente esta situación de urgencia. La embolización arterial de la arteria maxilar interna constituye una alternativa eficaz para controlar, en forma definitiva, las hemorragias nasales recurrentes o incohercibles. Dada la particular irrigación de la región facial, que permite acceder a una gran cantidad de circulación colateral es posible efectuar este procedimiento sin riesgos para la irrigación facial, que requiere del apoyo y soporte de la imagenología invasiva en manos de un operador experimentado. Se describen tres casos clínicos de pacientes con epistaxis severa, portadores de traumatismos por proyectil y tumor de seno maxilar, que requirieron como alternativa final la embolización de la arteria maxilar interna. Se describe la técnica y los resultados obtenidos.
Subject(s)
Humans , Male , Adult , Middle Aged , Maxillary Artery , Embolization, Therapeutic , Epistaxis/therapy , Carcinoma, Squamous Cell/complications , Epistaxis/etiology , Wounds, Gunshot/complications , Maxillary Sinus Neoplasms/complications , Treatment Outcome , EmergenciesABSTRACT
The angiofibroma of the nasopharynx is a benign tumor, sitting in the epipharynx of adolescents, but considered malignant owing to its local spreading power. Aside from the characteristics symptoms -nose bleeding and nasal obstruction- the A. of the paper has signaled a certain delay in the secondary sexual maturity of 2 of the 6 youth in all studied. In these 2 the tumor was detected at 9 and 12 years-of-age, respectively. Furthermore, these 2, showed destruction of inner structures of the nose when surgery was undertaken; adversely the other 4 showed normal inner nasal structures. The whole group was followed up for ten years, and only those 2 needed a treatment with chorionic gonadotrophin for the completeness of secondary sexual aspects.