Alan R. Gould

Cinnamon-induced stomatitis venenata, Clinical and characteristic histopathologic features

Fourteen new cases of cinnamon-induced stomatitis are reported. Ten of these fourteen cases were first detected on the basis of histopathologic changes, which included hyperkeratosis, chronic lichenoid mucositis with plasmacytic infiltration, and marked chronic perivasculitis. Six cases of false-positive histopathologic findings are presented for comparison. It is recommended that when the histopathologic features described are recognized, cinnamon stomatitis should be considered.

Myositis ossificans traumatica of the masseter muscle: Review of the literature and report of two additional cases

Myositis ossificans traumatica of the masseter muscle is uncommon. The condition is benign and results in reactive heterotopic bone formation, usually producing limitation of opening of the jaws. Radiographic and microscopic examination can confirm the diagnosis. Treatment of myositis ossificans traumatica of the masseter muscle is surgical, with other modalities used when occurring in other muscles of the body.

Desmoplastic Fibroma of the Maxilla

A case of desmoplastic fibroma of the right maxilla is reported. The lesion presented as a painless mass in the right posterior alveolar ridge of a 22-year-old white man. Histologically, the lesion was composed of interlacing fascicles of benign-appearing fibroblasts in a varying ground substance of collagenous and myxoid tissue. The lesion was not encapsulated histologically and was invading between bone trabeculae resulting in resorption of the bone. A review of the literature reveals that a total of 30 cases of desmoplastic fibroma of the jaws have been reported. All of the mandibular lesions except two were reported to have occurred in the left side, with the molar-ramus region favored. The case reported here is, to the best of our knowledge, the first reported case of desmoplastic fibroma occurring in the maxillary alveolar process.

Localized oral histoplasmosis: A regional manifestation of mild chronic disseminated histoplasmosis

Abstract A case of mild chronic disseminated histoplasmosis in which the initial presenting clinical lesion occurred on the gingiva is reported. Ultrastructural features of the oral lesion are presented. The general spectrum of disease presentation in histoplasmosis is discussed, with emphasis on diagnosis and the significance of oral disease.

Malignant tumors of Stensen's duct.

A rare case of squamous cell carcinoma arising in Stensens duct is reported. The literature concerning malignant neoplasia originating in this site is reviewed, with attention given to the histopathologic diversity of neoplasms occurring in the duct, criteria for determination of origin in the duct, and outcomes of therapy.

Well-circumscribed mass of the lateral floor of the mouth

In June 1990. a 67-year-old woman was referred to the Oral and Maxillofacial Surgery Clinic for evaluation and treatment of an asymptomatic, firm swelling in the right anterior floor of the mouth. The patient’s chief complaint was an ill-fitting maxillary full denture and mandibular partial denture. The patient had been unaware of the mass. The patient’s medical history was significant for bilateral acoustic neuromas, which were removed surgically, one in 1981. the other in 1986. The patient was left with total bilateral deafness and mild seventh cranial nerve weakness bilaterally. The patient also had bilateral cataracts that were treated surgically 4 years previously. The patient’s health and family history were otherwise noncontributory. She was not taking medications and denied a history of drug allergies. On clinical examination, the patient appeared to be a thin. elderly woman without acute distress. She was afebrile and her vital signs were stable. Examination of the head and neck revealed a soft. discrete swelling of the right submental area. without any other significant findings. The floor of the mouth on the right was slightly elevated above the partially edentulous atrophic mandibular alveolar ridge (Fig 1). A nonpainful, ill-defined, freely movable, rubbery mass measuring 3.0 by 2.5 cm in diameter was palpable above the mylohyoid muscle. The overlying mucosa was nonulcerated and appeared normal. The mass did not appear to contribute to the ill fit of the lower partial denture. Salivary flow from Wharton’s ducts was clear and abundant bilaterally. A mandibular occlusal radiograph failed to disclose any abnormalities. Magnetic resonance imaging (Tz-weighted) revealed a 2.7 X 2.2-cm area of increased signal intensity in the right floor of the mouth (Fig 2). Patient movement limited the diagnostic value ofthe study. She was scheduled for an incisional biopsy in the outpatient oral surgery clinic under local anesthesia.

Garre's osteomyelitis of the mandible: the role of endodontic therapy in patient management

A report on the application of endodontic therapy in the treatment of Garres osteomyelitis of the mandible is presented. Elimination of pulpal and associated periapical infection through routine endodontic therapy is observed to be effective in allowing resolution of the local periostitis of Garres osteomyelitis. Guidelines for proper diagnostic assessment before the institution of specific therapeutic measures are emphasized.

Epithelium-connective tissue junction in follicular ameloblastoma and ameloblastic fibroma: an ultrastructural analysis

The ameloblastoma and ameloblastic fibroma are tumors of odontogenic origin. During odontogenesis, there is a sequence of inductive stimulations, or interactions, between the epithelium of the enamel organ and the connective tissue of the dental papilla. We review 7 cases of follicular ameloblastoma and 1 case of ameloblastic fibroma under the electron microscope to investigate possible induction-stimulated changes at the epithelium-connective tissue junction. Thickening of the basal lamina by a granulo-filamentous material was a universal finding. Horizontal proliferation and convolutions of this thickened material were found in 2 ameloblastomas. The ameloblastic fibroma evidenced fine aperiodic fibers perpendicular to the basal lamina. These changes are consistent with attempted inductive stimuli directed toward tooth formation.

Klippel-Trenaunay-Weber syndrome

Klippel-Trenaunay-Weber syndrome exhibits vascular anomalies including hemangiomas and varicose veins that commonly appear in the facial area. Characteristic findings involving the oral cavity include an enlarged maxilla, displacement of teeth, and malocclusions. Two cases are presented, with generalized and oral findings ranging from a mild to a very severe form of the syndrome.

Symmetrical gingival fibromatosis

Symmetrical gingival fibromatosis, a rare and unusual form of idiopathic gingival fibrous hyperplasia, has recently been identified as a distinct clinical entity. The clinical and histologic features of a case of this disorder are presented. The relationship of this clinical entity to generalized gingival fibromatosis is considered, and the histologic findings in the present case are discussed.