1,721,037 research outputs found
Cystic lesion in parotid region: an unexpected diagnosis
No full textBenign tumours of salivary glands represent 2%-3% of all tumours and parotid gland is most often affected. Keratocystoma is a rare benign tumour with multilocular cystic lesions filled with keratin materials. Histologically, it is characterised by solid epithelium islands containing keratinised lamellae with multicystic spaces. We report a case of a woman in her mid-70s with painless mass in her left parotid gland which increased in size over 1 year. Ultrasound scan revealed a 38x20 mm diameter hypoanechoic mass. Neck CT with contrast medium and fine needle aspiration were performed with diagnostic hypothesis of Warthin tumour. So, extracapsular parotid dissection with no facial nerve damage was performed. Histological examination revealed a keratocystoma. The patient had a 16-month follow-up without signs of relapse or malignancy. Despite its rarity, keratocystoma must be considered among the possible differential diagnostic hypotheses when we find parotid masses, to ensure the best treatment to the patient
Neoformazione esofitica mandibolare in una giovane paziente
No full textUna donna caucasica di 18 anni si presentava all’osservazione presso il Settore di Medicina Orale (Università degli Studi di Palermo) data la comparsa di una neoformazione localizzata in zona trigono retromolare destro.
L’anamnesi patologica non evidenziava la presenza di patologie sistemiche attuali o pregresse.
La paziente era in buone condizioni di salute, riferiva di non assumere farmaci e di non avere subito alcun intervento chirurgico; dichiarava di non avere mai fumato. La paziente riferiva un lento e progressivo accrescimento della lesione, in assenza di sintomatologia algica.
L’esame obiettivo extra-orale non evidenziava linfoadenopatie latero-cervicali o altre anomalie. All’esame obiettivo intra-orale si rilevava una neoformazione esofitica a larga base di impianto, distalmente all’elemento 4.7. La lesione aveva circa 1 cm di diametro, la mucosa di rivestimento era di colorito rossastro, con aree di ipercheratosi e di erosione. La lesione risultava mobile rispetto ai piani sottostanti. Alla palpazione si apprezzava una consistenza fibrosa duro-elastica. La paziente esibiva una radiografia endorale in cui si apprezzava la presenza di una radio-opacità con margini netti all’interno della lesione.
In considerazione della crescita della lesione e dell’aspetto clinico-radiografico benigno, si prescriveva alla paziente un’ortopantomografia (OPT)
Progrip versus ProFlor: two fixation-free devices for laparoscopic inguinal hernia repair-the Pro/Pro study, a randomized clinical trial
No full textTrial design: This randomized, multicenter clinical trial evaluates laparoscopic bilateral inguinal hernia repair outcomes by comparing the Progrip self-fixating mesh to the ProFlor 3D dynamic regenerative scaffold. Methods: Adults aged 18-85 years with clinically diagnosed bilateral primary inguinal hernias were enrolled and randomized into two treatment groups (Progrip or ProFlor) using block randomization. Operative time, intra- and postoperative complications, recurrence rates, postoperative pain, and quality of life were assessed over a 24-month follow-up. The allocation was not blinded to investigators or patients. Results: From January 2021 to June 2022, 150 patients underwent laparoscopic TAPP repair. Eighteen were lost to follow-up (5 in the ProFlor group, 13 in the Progrip group). A total of 132 patients (67 ProFlor, 65 Progrip) were analyzed. The ProFlor group demonstrated shorter operative times, fewer intra- and postoperative complications, and reduced early postoperative pain compared to the Progrip group. Patients in the ProFlor arm achieved faster recovery and earlier return to daily activities. Notably, none of the ProFlor patients experienced chronic pain, whereas 10.8% of Progrip patients developed this complication. Hernia recurrence was observed in 2 Progrip patients, while no recurrences were reported in the ProFlorTM group. Conclusion: In this randomized trial, both devices proved feasible and effective for laparoscopic repair of bilateral inguinal hernias. However, the ProFlor scaffold was associated with reduced postoperative pain, absence of chronic pain, and no recurrences during follow-up compared to Progrip. While these findings are encouraging, further studies with larger cohorts and longer-term follow-up are warranted to confirm the potential benefits of the ProFlor scaffold and its role in routine clinical practice. Trial registration: This study was registered at ClinicalTrials.gov with number NCT06556498
Emangioma capillare lobulare della lingua: caso clinico
No full textUna donna caucasica di 62 anni si presentava all’osservazione degli autori presso l’U.O.S.D. di Medicina Orale e Odontoiatria per pazienti fragili (AOUP P. Giaccone di Palermo) data la comparsa di una neoformazione localizzata sull’apice della lingua
Challenges in the diagnosis of oral squamous cell carcinoma mimicking medication-related osteonecrosis of the jaws: a multi-hospital-based case series
No full textSolid variant of mammary "adenoid cystic carcinoma with basaloid features" merging with "small cell carcinoma"
Full text linkWe describe a rare case of a solid variant of a mammary adenoid cystic carcinoma with basaloid features (sbACC) and its coexistence with a "small cell" carcinoma (SCC), identified and confirmed by histological and immunohistochemical observations: the absence of glandular structures and PAS-positive globules, positivity for neuroendocrine markers (NSE, synaptophysin and chromogranin), and negativity for 34betaE12 and SMA actin were the aspects suggesting the presence of SCC. Furthermore, positivity for CD10 was found both in sbA CC and in SCC, supporting the hypothesis that the two components share the same histogenetic myoepithelial origin and represent an example of dedifferentiation along neuroendocrine phenotype lines occurring in a multipotential neoplastic stem line, already committed towards a myoepithelial phenotype. To our knowledge, this is the first reported c ase of a solid basaloid adenoid cystic carcinoma merging with an SCC carcinoma. Furthermore, it is the first study in which CD10 was used to investigate the histogenesis of the two neoplastic components. © 2005 Elsevier GmbH. All rights reserved
In vivo optical coherence tomography imaging in a case of mucous membrane pemphigoid and a negative Nikolsky's sign
No full textThere is currently a growing interest in new diagnostic tools of the oral cavity and mucosa which are non-invasive,
repeatable and reliable. A diagnosis of a suspected, autoimmune pathology was made regarding a 57-yearold
patient with desquamative gingivitis. However, a negative Nikolsky’s sign did not seem to indicate a diagnosis
of mucous membrane pemphigoid neither was there any indication as to the optimum location for an incisional
biopsy. As an imaging method, the use of optical coherence tomography (OCT) has enabled the obtaining of
tomographic (cross-sectional) scans of tissue. Such images are acquired prior to and after verifying Nikolsky’s
sign, thereby enabling the clinician to identify the presence (or not) of subepithelial bullae. Thereafter, an assessment
of changes in the subepithelium (the split) can be performed, even in the absence of a suitable clinical picture,
such as, for example, a negative Nikolsky’s sign. Histological analysis and the use of indirect
immunofluorescence have facilitated a diagnosis of mucous membrane pemphigoid, an autoimmune pathology,
which can be confirmed with the appearance of subepithelial bullae. OCT was found to be a valid, non-invasive,
auxiliary diagnostic device, capable of revealing in vivo and real-time bullae, which were hitherto clinically undetectable
Diagnostic and prognostic value of magnetic resonance imaging in the detection of tumor depth of invasion and bone invasion in patients with oral cavity cancer
No full textTo evaluate the accuracy of preoperative contrast-enhanced magnetic resonance imaging (MRI) in the assessment of radiological depth of invasion (rDOI) and bone invasion in patients with oral cavity cancer, and the prognostic value of preoperative rDOI
Histological findings of osteonecrosis spotted prior to tooth extractions. Should we consider tooth extraction still the main trigger event?
Full text linkOsteonecrosis of the jaw (ONJ) is an adverse drug reaction described as the progressive destruction and death of bone that affects the mandible and maxilla of patients exposed to the treatment with medications known to increase the risk of disease, in the absence of a previous radiation treatment.
Tooth extraction often precedes the manifestation of ONJ; indeed, it is sometimes called trigger event and it have also been considered as risk factors for the onset of ONJ.
As a consequence, some of the guidelines recommend avoiding tooth extractions in patients at risk of ONJ; however, a growing body of evidence indicates that dental/periodontal infection prior to extraction, rather than dental extraction may represent the main local risk factor for ONJ.
Ten patients at risk of ONJ have undergone tooth extractions. They were identified and included in our retrospective monocentric clinical investigation.
Patients underwent tooth extractions with standardized procedures (PROMaF protocol), and bone biopsies were taken.
Extractions were performed due to symptomatic, non-restorable teeth in patient at risk of ONJ; histological findings of ONJ were observed in all samples.
This outcome may highlight that the proof of non‐exposed ONJ might be the histopathologic confirmation of necrotic bone, as stated by European task force on MRONJ. Additionally, alveolar biopsy should possibly be taken in every case of suspected ONJ, which needs an proper and prompt management for successful healin
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