Project description:Lipoma is the most common benign soft tissue tumor. Lipomas are relatively uncommon tumours in the oral cavity accounting only 1-4 %. Half of oral lipomas are in the cheek and the remaining is found in the tongue, floor of the mouth, lips, palate, and gingival mucosa. We are reporting a case of lipoma that occurred in the hard palate, which is extremely rare.
Project description:Mucinous cholangiocarcinoma is extremely rare and its clinicopathological features remain unclear. The present study aimed to analyze published data on mucinous cholangiocarcinoma. Medical databases were searched from 1980 to 2016, and clinicopathological data for 16 mucinous cholangiocarcinoma patients were obtained. Characteristic imaging findings, including hypovascular tumor with peripheral enhancement on computed tomography and angiography, extremely high intensity on T2-weighted magnetic resonance images, intratumoral calcification and luminal communication between the tumor and bile duct on cholangiography, were noted. Mucinous cholangiocarcinoma was correctly diagnosed in one patient only, with some patients diagnosed as low-malignant biliary cystic tumors preoperatively. Five cases were followed up after the first medical examination, and three of these were initially diagnosed as biliary cystadenoma or intraductal papillary neoplasm of the bile duct. All five tumors showed marked enlargement within 4 months of follow up. Macroscopically, the resected tumors were non-cystic/solid in seven cases, and cystic in seven. Tumor diameter ranged from 5 cm to 22 cm, and mucoid cut surface, lobulation, lack of capsule and papillary growth were observed. Microscopically, co-existing intraductal papillary neoplasm of the bile duct was noted in three of five patients with available data. Nine of 10 cases in whom the pathological stage was reported had advanced disease with lymph node and/or distant metastasis, and 5-year survival was achieved in one microinvasive case only. Overall 1- and 3-year survival rates were 60.1% and 40.1%, respectively. The possibility of mucinous cholangiocarcinoma should be considered when biliary cystic tumors are detected on imaging modalities, despite the rarity of this tumor.
Project description:A 69-year-old male truck driver with history of chronic anal fissures and facial basal cell carcinoma developed rectal bleeding and pain, and was diagnosed with a 5cm basal cell cancer of the anus with sphincter invasion. His workup entailed physical exam, CT and MRI which confirmed external and internal sphincter invasion without evidence of distant metastatic disease. After review of chemoradiation and surgical options, the patient elected to proceed with robotic-assisted abdominoperineal resection with end colostomy with complex local-tissue reconstruction. He is now two years out and disease free. While radiation and surgery have both been described in the literature as viable treatments, surgical resection may be the best option for patients with large lesions with sphincter invasion, who travel from afar and have occupational restrictions. This case highlights the importance of a multidisciplinary approach in assessing the patient with a rare disease process, presenting all viable options for treatment, and electing the optimal treatment through shared decision making.
Project description:Tuberculosis is a chronic granulomatous systemic infectious disease caused by Mycobacterium tuberculosis. The oral lesions found in tuberculosis are relatively rare and may present as ulcers, erythematous patches, indurated lesions, nodules or as bony jaw lesions. Oral tubercular lesions sometimes present a confusing clinical presentation and can be overlooked. Hence, we document a case of tuberculous osteomyelitis of the maxilla in a 19-year-old female patient, who was initially treated for multiple periodontal dental abscesses, which later proved to be tubercular osteomyelitis of the maxilla. Although it is a rare occurrence, the differential diagnosis of tuberculous osteomyelitis must always be considered when it fails to respond to routine therapy.