Giant keratocystic odontogenic tumor: a challenging diagnosis.

The keratocystic odontogenic tumor, although a benign lesion, is peculiarly aggressive with a high recurrence rate. Its involvement with the maxillary antrum is atypical. We report the unusual case of a 20-year-old male patient with an extensive antral tumor associated with an impacted third molar, which was initially misdiagnosed as a dentigerous cyst. Clinical, radiographic, and histopathologic aspects were analyzed to provide useful information for the correct diagnosis, treatment, and prognosis within a multidisciplinary approach.

Orofacial amyloidosis--unusual -presentation of a rare condition: A case report.

Orofacial amyloidosis is an extremely rare and generally a benign condition. In contrast to systemic amyloidosis, other organs are not involved; however, extensive investigations are recommended to intercept any systemic involvement. Diagnosis is confirmed by histological examination and Congo red staining. This condition does not have a known etiology, and hence no general consensus exists regarding its management. We are presenting a case of a 65-year-old female patient with orofacial amyloidosis having ocular and extensive oral involvement.

Lymphoepithelial carcinoma arising from the maxillary antrum: a clinicopathological report of a rare lesion in an unusual site.

Lymphoepithelial carcinoma (LEC) of the maxillary sinus is an exceedingly rare malignancy. It may be asymptomatic or present with non-specific obstructive nasal symptoms which makes its pre-operative diagnosis very challenging. This report describes our clinical and radiological findings in a 45-year-old Indian female patient with locally-advanced LEC of the right maxillary antrum. Histopathological and immunohistochemical results are also discussed. The case was effectively managed by external beam radiotherapy and the patient has remained disease-free at 20-month follow-up.

Estimation and comparison of salivary secretory leukocyte protease inhibitor in human immunodeficiency virus patients and healthy individuals.

AIM: Transmission of human immunodeficiency virus (HIV) in the oral cavity is a rare event, despite detectable virus in saliva and oropharyngeal tissues of infected persons, unlike other mucosal sites. Secretory leukocyte protease inhibitor (SLPI) has been suggested as the main soluble factor responsible for the HIV inhibitory effect of saliva. The study was designed to estimate and compare the salivary SLPI levels in HIV patients and healthy controls. Furthermore, the relationship between salivary SLPI levels and disease severity was also investigated. MATERIALS AND METHODS: Unstimulated whole saliva specimens were collected from 60 HIV-infected and 20 healthy subjects. Disease severity was determined by CD4 count in HIV subjects, who were divided into two groups: ≥200 cells/µL (n = 30) and < 200 cells/µL n = 30. Salivary SLPI levels were determined by enzyme-linked immunosorbent assay. RESULTS: Numerically higher SLPI levels were observed in HIV subjects 193.342 ng/mL vs. 190.587 ng/mL; P = 0.517. A nonsignificant negative correlation was noted between CD4 counts and SLPI levels r = -0.037, P = 0.781. CONCLUSION: The salivary anti-HIV factor, SLPI, is not only preserved in HIV infection but its concentration may even get enhanced in the infection. However, the clinical significance of SLPI levels and disease severity should be investigated further with a larger sample of patients.

Extensive Gingival Enlargement in Siblings: A case report.

Gingival fibromatosis is characterised by varying degrees of fibrotic gingival overgrowth that can be caused by a variety of aetiological factors. Hereditary gingival fibromatosis (HGF) is a rare genetic disorder, characterised by a slowly progressive, benign enlargement of keratinised gingiva. The condition may be found in an autosomal dominant or autosomal recessive mode of inheritance, the former being more common. It usually develops as an isolated disorder but can be one feature of a multisystem syndrome. Accordingly, HGF has been divided into two forms: non-syndromic and syndromic. The gingival enlargement can be localised or generalised, but usually involves both arches. The authors describe a case of non-syndromic generalised severe HGF, involving the maxillary and mandibular arches in two brothers. This report focuses on the diagnosis, treatment, and control of the disease. The pattern of inheritance and histopathologic characteristics are also emphasised.

Angioedema: a diagnostic dilemma / Angioedema: um diagnóstico dilema

Introduction: Angioedema is a rare but potentially life threatening (fatal laryngeal edema) disease. It is a relapsing subcutaneous or submucosal edema caused by various factors. The episodes can vary significantly from one individual to another. Causative factors should always be sought, but a large proportion of patients have the idiopathic form of the disease. A minority of patients represent a diagnostic and treatment challenge. A comprehensive history and close monitoring of response to treatment are the most cost effective diagnostic and treatment tools. Objective: This paper presents a highly representative clinical case of idiopathic variety of the disease where a ten year old boy reported with a complaint of swelling over right side of the face and upper lip since 4 hours. Conclusion: There was no associated pain or discomfort. There was slight itching in the same area prior to the appearance of swelling. Condition showed prompt improvement following antihistamines.

Introdução: Angioedema é uma doença rara, porém, com potencial risco à vida (edema fatal de laringe).É um edema subcutâneo ou submucoso recidivante causado por vários fatores. Os episódios podem variar significativamentede um indivíduo para outro. Fatores causadores da doença sempre devem ser pesquisados, mas uma grande proporção dos pacientes tem a forma idiopática da doença. Uma minoria de pacientes representaum desafio no diagnóstico e tratamento. O histórico completo e o acompanhamento da resposta ao tratamentosão as ferramentas de diagnóstico e tratamento de menor custo. Objetivo: Este trabalho apresenta um casoclínico altamente representativo da variedade idiopática da doença: um menino de dez anos se apresentou comqueixa de inchaço no lado direito da face e no lábio superior nas últimas 4 horas. Conclusão: Não havia dorassociada ou desconforto, havia leve coceira na mesma área, anterior ao aparecimento de inchaço. A condiçãomostrou rápida melhora após medicação com anti-histamínicos.

Salivary interleukin-1ß levels in patients with chronic periodontitis before and after periodontal phase I therapy and healthy controls: a case-control study.

BACKGROUND: The role of interleukin (IL)-1ß in periodontal disease pathogenesis is well researched. This study aimed to assess and compare the salivary IL-1ß levels in patients with chronic periodontitis before and after periodontal phase I therapy and periodontally healthy controls. Further, relationships between IL-1ß levels and various clinical parameters were explored. METHODS: Twenty-eight patients with moderate-to-severe generalized chronic periodontitis and 24 age-, race-, and ethnicity-matched controls participated in this study. Saliva samples were obtained from all patients. The clinical parameters recorded were clinical attachment loss (AL), probing depth, bleeding on probing, periodontal index, and gingival index. Clinical evaluation and sample collection were repeated 1 month after periodontal phase I therapy in patients with periodontitis. IL-1ß levels were assessed using enzyme-linked immunosorbent assay. RESULTS: Mean IL-1ß levels in patients with periodontitis at baseline (1,312.75 pg/mL) were significantly higher (P <0.0001; eight-fold) than in controls (161.51 pg/mL). Although treatment in patients with periodontitis resulted in significant reduction in IL-1ß levels (mean: 674.34 pg/mL; P = 0.001), they remained significantly higher (P <0.0001; four-fold) than control levels. There were significant correlations between IL-1ß levels and all clinical parameters (P <0.01) except percentage sites with clinical AL >2 mm (P >0.05). CONCLUSIONS: The data indicate that IL-1ß levels are raised in the saliva of patients with chronic periodontitis, which are reduced after phase I therapy, suggesting a close association between salivary IL-1ß and periodontitis. Additional longitudinal studies are needed to validate salivary IL-1ß as a marker for periodontal disease.