1/9. Congenital leiomyomatous epulis: a case report with immunohistochemical study.The histologic and immunohistochemical findings of an extremely rare case of congenital soft tissue mass on the alveolar ridge in an infant are reported. The lesion clinically mimicked an ordinary congenital epulis (congenital granular cell epulis, granular cell tumor of the newborn); however, histologically it consisted of a conglomerate of spindle-shaped cells, akin to smooth muscle cells, which formed interlacing and whorled fasciculi. nerve fibers with myxoid degeneration, capillaries and muscle walled small vessels intermingled with fasciculi of spindle-shaped cells. The border between the conglomerate of spindle-shaped cells and the surrounding connective tissue was not evident. Immunohistochemically, most of the spindle-shaped cells were intensely positive for antibodies to alpha-smooth muscle actin, HHF-35 and desmin. These findings suggest that the lesion was composed of mature smooth muscle cells that were of hamartomatous or choristomatous nature. The term 'congenital leiomyomatous epulis' is proposed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/9. Rare benign tumours of oral cavity--capillary haemangioma of palatal mucosa: a case report.Haemangiomas are benign tumours composed of blood vessels, they are probably developmental rather than neoplastic in origin. Haemangiomas are often present at birth but may become more apparent during life. The tumours appear as a flat or raised reddish-blue lesions and are generally solitary. They are occasionally seen on the palatal mucosa. Haemangiomas are classified on the basis of their histological appearance as capillary, mixed, cavernous or a sclerosing variety that tends to undergo fibrosis. Their differential clinical diagnosis is based on appearance. The tumours may be slowly progressive, involving extensive portions of the superficial and deep blood vessels. Function may be affected where development of the lesion is extra-invasive. Colour change on pressure is a common finding with return to the original colour on withdrawal of pressure. The case presented here was referred because of swelling and recurrent periodontal bleeding. The lesion was diagnosed as a capillary haemangioma through histopathology. Although different therapeutic procedures have been reported, in this case surgical excision was carried out under general anaesthesia following hospitalization. Despite their benign origins and behaviour, haemangiomas in the region of oral cavity are always of clinical importance to the dental profession and require appropriate clinical management. Dental practitioners and oral surgeons need to be aware of these lesions because they may pose serious bleeding risks.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
3/9. Serendipitous diagnosis of protein s deficiency.A 46-year-old male sought periodontal care for a swelling on his right mandibular gingiva. An excisional biopsy revealed a well-differentiated squamous cell carcinoma. Surgical treatment consisted of a right segmental mandibulectomy with ipsilateral right neck dissection and fibular free flap reconstruction. Two days after the surgical procedure, a weakened Doppler signal suggested vascular compromise of the graft. The patient was returned to the operating room where complete thrombosis of the internal jugular vein (recipient vessel) was observed. This event prompted a complete hematological evaluation that disclosed low serum levels of protein S. The patient was started on systemic heparin and local medicinal leeches. A week later, systemic warfarin sodium was added and successfully resolved the vascular compromise of the graft. Two years later, the patient is active and lives a full life with occasional adjustments of warfarin sodium. This case represents the first report on the treatment of gingival carcinoma that led to the serendipitous discovery of an unrelated and unusual systemic condition, protein s deficiency.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/9. Haemangiopericytoma of the maxillary gingiva: report of a case.AIM: Haemangiopericytoma (HPC) represents approximately 3% of all tumours in the head and neck. This tumour is a soft tissue tumour derived from mesenchymal cells with pericytic differentiation. We present the clinicopathological findings of a case. MATERIALS AND methods: A 69-year-old man was referred to our Department for a mass located on the right pre-molar maxillary gingiva; this mass caused problems during chewing, but was otherwise asymptomatic. RESULTS: Clinical examination revealed a nodular, pink lesion, 3.5 cm in diameter, which was lined with normal mucosa. The lesion was mobile in relation to the deep and superficial tissues. Microscopic analysis of the neoplasm showed a vascular rich pattern, constituted by vessels covered with flat endothelium and surrounded by abundant spindly cells. On the basis of these histological and immunohistochemical findings, the final diagnosis was HPC. CONCLUSIONS: HPC is an uncommon vascular tumour for which the biological behaviour is difficult to predict. In our patient, no recurrences or distant metastases were present at a 4 years follow-up.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/9. Congenital granular cell tumor (epulis): postnatal imaging appearances.A newborn girl with histologically confirmed epulis presented with a 2.6-cm mass protruding from her mouth. An ultrasound study performed in antenatal week 25 was unremarkable. Postnatal ultrasound showed a mass, hyperechoic centrally, hypoechoic peripherally, containing crowded branching vessels. MRI revealed a nonenhancing gingival mass exhibiting an isointense rim on T1-weighted imaging and a low-intensity rim on T2-weighted sequences. MRI better defined its gingival origin and lack of local extension. A gingival solid mass in a newborn with branching vessels and a peripheral rim on imaging may suggest congenital epulis.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
6/9. Gingival granular cell tumor of the newborn: immunoperoxidase investigation with anti-S-100 antiserum.The gingival granular cell tumor (GGCT) of the newborn is a rare, benign tumor, most often observed in the canine area of the maxilla of female infants. The main histologic features are not controversial and involve the occurrence of sheets of granular cells and a prominent vascular component. Conversely, ultrastructural studies agree on limited features and give rise to different hypotheses of mesenchymal origin. S-100 immunoperoxidase investigation of one case shows that, unlike those of granular cell tumor (granular cell myoblastoma) granular cells of GGCT do not react positively for S-100 protein, thus suggesting that the GGCT and the granular cell myoblastoma have a different histogenesis. It confirms also the occurrence of smaller, isolated, spindled, nongranular S-100-positive cells of indeterminate nature, distributed at the periphery of some blood vessels.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/9. hemangioendothelioma of the gingiva. Histopathologic and therapeutic considerations.The hemangioendothelioma is a benign neoplasm, rarely observed in the mouth. In the literature, reports on the treatment and on the therapeutic results are lacking. This type of gingival neoplasm was observed in a young adult male. It was located in the attached gingiva in the upper and in the lower jaw, covering almost the entire coronal part of the anterior teeth. An exhaustive internal and neurological examination revealed no associated general disease. The gingival biopsies displayed the typical characteristics of a hemangioendothelioma: proliferation of the blood vessels, with a reduced lumen surrounded by swollen endothelial cells. The treatment consisted of a meticulous mechanical plaque control, chlorhexidine rinses, gingivectomy procedures and a monthly professional prophylaxis. 3 years after the periodontal treatment, the gingival structures remained clinically healthy. In the biopsies, only a small amount of inflammatory cells could be detected. This report shows a case of benign gingival neoplasms of unknown etiology in which meticulous plaque control, combined with extensive gingivectomies and repeated professional prophylaxis may have prevented or, at least, retarded the recurrence of the lesion.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/9. Primary intraoral epithelioid hemangioendothelioma presenting in childhood: review of the literature and case report.Epithelioid hemangioendothelioma (EH) is a recently described vascular neoplasm of borderline or intermediate malignant potential. This tumor arises from medium- to large-sized vessels, primarily involves the soft tissues of the extremities as well as the liver and lung, and rarely occurs in the head and neck region. Only eight well-documented cases of intraoral EH have been reported. We present an additional pediatric case of EH confined to the oral cavity and review the literature regarding EH presenting as an intraoral mass. EH is characterized histopathologically as an epithelioid lesion arranged in nests, strands, and trabecular patterns with infrequent vascular spaces. Occasional erythrocytes within intracytoplasmic lumina may be seen in tumor cells. Ultrastructural examination typically shows intracytoplasmic lumina with pseudopodial cellular membrane extensions. The cytoplasm usually contains intermediate filaments infrequently associated with weibel-palade bodies. Neoplastic cells are immunoreactive for factor VIIIR:Ag and ulex europaeus. Histopathologic features, which may be associated with aggressive clinical behavior, include significant cellular atypia, one or more mitoses per 10 high-power fields, an increased proportion of spindled cells, focal necrosis, and metaplastic bone formation. Because of the intermediate malignant potential of epithelioid hemangioendothelioma, complete tumor resection is recommended for intraoral lesions.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/9. Advanced imaging of carcinoma of the mandibular gingiva.OBJECTIVE: To evaluate the validity of MRI in detecting spread of mandibular gingival carcinoma within the bone marrow. SCHEME: Three patients with mandibular gingival carcinoma were examined by panoramic radiography, CT, MRI and radionuclide scanning. The resected mandibles were examined histologically for invasion of bone marrow by the tumor. RESULTS: With MRI the bone marrow in all cases had a low signal intensity on the T1-weighted images, a high signal intensity on the T2-weighted, and high signal intensity on the contrast-enhanced T1-weighted. In one case there was an obvious evidence of tumor invasion of the bone marrow histologically, but in two cases only dilatation of the blood vessels and evidence of hemorrhage associated with tumor. CONCLUSION: MRI is not specific for detecting tumor invasion of bone marrow in mandibular gingival carcinoma.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |