Ambika Gupta

Masson's hemangioma: A rare intraoral presentation

An otherwise healthy 19-year-old female patient had painless swelling in her left buccal mucosa. No precipitating factors were identified. Pathological analysis demonstrated the mass to be a Massons hemangioma, a papillary proliferation of thin-walled capillaries intimately associated with thrombus. A very rare tumor occurring in oral cavity with only 80 cases being published in literature until date.

A nonhealing ulcer of mandibular alveolar ridge

CASE PRESENTATION A 60-year-old man presented to the oral and maxillofacial surgery clinic at the Pt. B. D. Sharma Institute of Health Sciences, Rohtak, with a chief complaint of painful ulceration in the oral cavity for the past 2 months. A private practitioner extracted his mandibular left posterior teeth 3 months previously. According to the patient, the extraction wound did not heal even after 3 weeks, and apparently it had been slowly increasing in severity during this period. The patient was then referred to our oral and maxillofacial surgery clinic. At the initial examination, the patient presented with an ulcerated lesion with indurated rolled margins extending anteroposteriorly from the left mandibular canine region to the first molar region on the crest of the alveolar ridge and laterally, involving the buccal vestibule along its length (Figure 1). The lesion was painful on palpation and was covered with a yellowish pseudomembrane. No cervical lymphadenopathy was noted. The patient was concerned that the lesion in his mouth might be related to a malignancy. His medical history revealed that he had poorly controlled diabetes treated with insulin injection. He had been treated by the Department of General Medicine with prednisolone (wysolone) 7.5 mg for 8 months for the treatment of sarcoidosis. The patient did not report dyspnea, cough, nausea, or abnormal bowel movements, although he did report a severalmonth history of evening rise of body temperature, loss of appetite, increased fatigue, and mild generalized malaise. Physical examination revealed a thin frail patient with mild hepatosplenomegaly, no associated abdominal tenderness, and no cardiac or respiratory problems. He was seronegative for HIV, HBV, HCV, and tuberculosis. The laboratory investigations revealed raised angiotensinconverting enzyme (156 U/L), blood glucose levels both fasting (134 mg/dL) and postprandial (288 mg/dL), and glycosylated hemoglobin (8.3%). The complete hemogram and blood biochemistry were within normal ranges. Contrastenhanced computerized tomography (CECT) for chest and abdomen revealed evidence of mild hepatosplenomegaly, but no evidence of lymphadenopathy. An orthopantomogram revealed bone loss in the region of the mandibular left first and second premolars.

Report of a rare cyst at a rare site: Heterotopic gastrointestinal cyst partially lined with dermoid cyst epithelium

Heterotopic gastrointestinal cysts (HGCs) of the oral cavity are rare benign lesions mimicking benign or malignant pathologies. These cysts are usually discovered during infancy but may not appear until well into adulthood. The epithelial lining of these cysts shows variable presentation with the presence of an enteric lining as an essential component. The histogenesis is related to entrapment of undifferentiated, noncommitted endoderm within the oral cavity during the 3rd–4th week of fetal life. We report a rare case of oral HGC located at a very rare site, i.e., infratemporal fossa with histopathologic features that included portions resembling dermoid cyst also. Histopathology and etiopathogenesis of the lesion are discussed. Origin from misplacement of embryonic remnants, i.e., undifferentiated endodermal cells is suggested.

Orofacial Cysticercosis: A Review

Cysticercosis is a common healthcare problem, especially in developing countries. Orofacial presentation of the disease is rare. It usually manifest as an asymptomatic nodular swelling that is difficult to differentiate clinically, from other orofacial swellings. Diagnosis of cysticercosis is usually not possible clinically owing to its rarity and asymptomatic presentation in orofacial region. Ultrasonography (USG) is the initial and most reliable diagnostic modality for cysticercosis. This review discusses the various oral manifestations, differentials and investigations for oral cysticercosis.

Classical Cases of Lymphangioma - As Multiple Vesicular Eruptions.

Lymphangiomas are uncommon congenital hamartomas of the lymphatic system, usually diagnosed in infancy and early childhood. They are rarely situated in oral cavity and most commonly identified on the anterior two-thirds of the tongue. Though rarely seen in the oral cavity, lymphangiomas are the entities which should be taken into consideration by the clinician while examining vesicular lesions of the oral cavity. Early recognition is of utmost importance for the initiation of proper treatment and to avoid serious complications. We hereby report two classical cases of lymphangioma of the buccal mucosa with multiple vesicular eruptions, a rare site.

Unilocular anterior mandibular swelling

PURPOSE To report a rare case of chondromyxoid fibroma, presenting as an unilocular anterior mandibular swelling, which is one of the least common tumours of bone comprising less than 1% of bone tumours and to review the differential diagnosis and literature for a better understanding of this disease as well as addressing the controversies in respect with its treatment. MATERIALS AND METHODS Previous reports about this lesion in literature were reviewed wherein data was recorded about the age, sex, race, location of pathology, presenting signs and symptoms, duration of pathology, size, radiographic findings, treatment and any recurrence on follow-up. RESULTS 25 cases were studied and data compiled. Multisectional histopathological examination is advocated to differentiate it from osteosarcoma. Enucleation with or without curettage with long-term follow-up has been considered to be a satisfactory treatment modality. CONCLUSION The rarity of the lesion, limited data on the clinical presentation, histological dilemma and treatment options replete with controversies make it a tough predicament. A thorough understanding of the disease and treatment options is indispensable to treat such a case.