Ioannis Dimitrakopoulos

Primary tuberculosis of the oral cavity

Two cases of primary tuberculosis of the mouth are reported. Painless ulceration of long duration and enlargement of the regional lymph nodes that did not respond to conservative and antibiotic therapy were the main manifestations of the disease in both cases. In the first case the tubercle ulcer was located in the lower buccogingival sulcus of a 17-year-old girl. In the second case the lesion occurred as a chronic periodontal inflammation around the gingiva of the left lower second molar tooth. When the tooth was extracted, a painless ulceration appeared around the socket, which was filled by granulation tissue. Histopathologic examination; bacteriologic, serologic, and blood tests; and chest x-ray film confirmed the diagnosis. Predisposing factors that might favor primary inoculation of tubercle bacilli into oral mucosa are also discussed. Finally we emphasize that in such cases it is essential to attempt to locate a possible primary site elsewhere in the body before oral tuberculosis is considered the primary disease.

Follicular lymphoid hyperplasia of the palate: Report of a case and review of the literature

The follicular lymphoid hyperplasia of the palate is a very rare benign lymphoproliferative lesion that closely resembles lymphomas, clinically or histopathologically or both. A case of follicular lymphoid hyperplasia of the palate is reported. Clinically, the lesion presented as a firm, painless, nonulcerated, nonfluctuant and slowly growing swelling on one side of the palate. The biopsy showed the typical histologic features: multiple germinal centers with a rim of well-differentiated B lymphocytes together with a mixed, mainly mononuclear infiltrate with many plasmacytoid lymphocytes. The clinicopathologic features are described and integrated into a review of the 19 previously recorded cases. The diagnosis of a follicular lymphoid hyperplasia should always be considered in cases of palatal swelling.

Displacement of three dental implants into the maxillary sinus in two patients. Report of two cases

IntroductionReconstruction of the posterior edentulous maxilla with dental implants has become a popular practice worldwide. However, the poor bone quality and quantity in this area is sometimes related with complications. Dental implant displacement into the maxillary sinus is a rare complication.Case reportIn the present paper, we present two patients with three implants displaced into the maxillary sinus. The implants were removed soon after their displacement, using the classic intraoral approach, through the anterior wall of the maxillary sinus. The operation was performed under local anesthesia for both of the patients. The postoperative course was uneventful for both of the patients without any wound dehiscence. Recovery remained uneventful, without any signs of postoperative sinusitis.DiscussionImplant displacement into the maxillary sinus is of rare occurrence and usually related to inadequate bone quality and quantity. Dental implants into the maxillary sinus usually act as foreign bodies and should be removed, to avoid the development of sinus complications. Removal of dental implants from the maxillary sinus can be performed either with functional endoscopic sinus surgery, or with intraoral operation through the anterior maxillary wall especially in fresh cases and in the presence of oroantral communication.

Solitary fibrous tumor of the tongue: case report and literature review

Solitary fibrous tumor (SFT) is an uncommon spindle cell neoplasm with unpredictable behavior. It was originally described in the pleura, but is now known to occur in various locations. SFT of the tongue is rare, with only four cases on record. An SFT of the anterolateral part of the left side of the tongue, which occurred in a 48 year-old man is recorded. The tumor was resected and the patient remains free of recurrence 3 years postoperatively.

Congenital lipoma of the tongue. Report of a case

A case of a congenital lipoma of the tongue in a 20-day old female infant is reported. The tumor was completely removed and follow-up showed excellent healing without recurrence.

Salivary Gland Trauma: A Review of Diagnosis and Treatment

Salivary gland trauma is uncommon. Parotid gland and duct injuries are far more common than injuries to submandibular and sublingual glands due to anatomic position. Several methods of treating salivary duct injuries and their complications have been advocated. Optimal treatment outcomes can be achieved with early diagnosis, adequate evaluation, and proper management. This article presents current diagnostic and treatment protocols of salivary gland trauma. The anatomy of the salivary glands is briefly described and clinical cases are also presented to illustrate the treatment options described.

Inflammatory myofibroblastic tumour of the maxillary sinus and the oral cavity

BackgroundInflammatory myofibroblastic tumours (IMT) are benign lesions that mimic malignant neoplastic processes due to their infiltrating and destructive nature. They can be found anywhere in the body, although they are most commonly located in the lung. IMTs of the head and neck region are rare entities.Case reportWe report a case of a maxillary IMT with an enlarged intraoral component which was adequately treated with surgical excision without long-lasting additional corticosteroid treatment.DiscussionInflammatory myofibroblastic tumours can be easily misdiagnosed as malignant neoplastic processes due to their destructive nature. Proper diagnosis is essential to avoid mutilating and disfiguring surgical procedures.

Basal cell carcinoma arising in association with a maxillary keratocyst in a patient with Gorlin–Goltz syndrome. Report of a case

IntroductionGorlin–Goltz syndrome, also known as nevoid basal cell carcinoma syndrome, is an autosomal dominant inherited disorder which is characterized by the presence of multiple basal cell carcinomas, maxillary keratocysts, and musculoskeletal anomalies.Case reportWe present a case of a patient suffering from Gorlin–Goltz syndrome who developed an intraosseous basal cell carcinoma associated with a recurrent maxillary keratocyst. To our knowledge, this is the first case of malignant transformation of a keratocyst into a basal cell carcinoma described in the literature.ConclusionThis case highlights the importance of careful histologic examination of keratocysts excised in patients suffering from Gorlin–Goltz syndrome.

Textiloma of the frontal bone twenty years after craniotomy for Apert syndrome.

INTRODUCTION The presence of intracranial foreign body granulomas is an unusual condition. They can be caused by foreign substances which are either inadvertently or deliberately left in the surgical field. Some foreign materials (textilomas, gossypibomas, gauzomas, muslinomas) along with the resulting foreign body reaction, in the surrounding tissue, can cause infection or abscess formation in an early stage whereas others remain clinically silent for many years. PATIENT We present the case of a foreign body granuloma (textiloma) caused by a gauze which had been placed, during a corrective craniotomy, in a patient with Apert syndrome at the age of five. At presentation the clinical and radiological findings were suggestive of an infection. RESULTS Surgical exploration of the region demonstrated the presence of gauze, in a frontal bone defect, surrounded by large masses of reactive granular tissue which were extended to the underlying dura mater. The symptoms resolved completely after the foreign bodys retrieval. CONCLUSION Foreign body granulomas, although rare, must always be taken under consideration in the differential diagnosis of craniofacial masses or procedures; especially in cases where a previous craniofacial operation has taken place.

Acinic cell carcinoma of the maxillary sinus: A case report

A case of acinic cell carcinoma of the maxillary sinus is presented. As can be assumed from the number of reported cases, this is an uncommon site for this tumor to occur.