Facial Swelling as a Primary Manifestation of Multiple Myeloma

Angioneurofibroma of Face an Unusual Case: A Case Report

Neurofibroma may occur as a sporadic solitary lesion or as a part of neurofibromatosis,an autosomal dominant disorder first described by Daniel Friedrich von Recklinghausen in1882. Angioneurofibroma is considered as a new morphological variant of neurofibroma. These lesions can be mixed histopathologically with vascular tumors. A female patient presented with right side facial swelling,which is seen at childhood.On examination mass was measuring around 10 × 10 cm over right fronto temporoparietal region,which is soft in consistency and nodularity in between, pigmentary changes seen over overlying skin in some area, tumor is painless,not associated with functional deformity, not associated with thrill or fluctuancy,causing facial deformity. The mass was intially diagnosed as vascular malformation, however with subsequent histopathlogical assessment confirmed the diagnosis of Angioneurofibroma. We present our experience in managing this rare case.

Educational Case: Diagnostic Approach to Salivary Gland Neoplasms

The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology. For additional information, and a full list of learning objectives for all three competencies, seehttp://journals.sagepub.com/doi/10.1177/2374289517715040. ¹

Evaluation of oral and maxillofacial swellings using ultrasonographic features

Purpose

The aim of this study was to evaluate the characteristic features of oral and maxillofacial swellings that could be seen on ultrasonographic examinations.

Materials and Methods

Fifty patients with oral and/or maxillofacial swellings were randomly selected, thorough case histories and clinical examinations were done, ultrasonographic examinations with Doppler imaging were performed, and the features of every group were studied. Finally, histopathological evaluations were performed to identify the final diagnosis, according to which patients were classified into 5 groups; group I: inflammatory/space infection and abscess swellings, group II: cystic swellings, group III: lymph node swellings, group IV: benign swellings, and group V: malignant neoplastic swellings.

Results

A significant association (P<0.05), with a contingency coefficient of 0.88, was found between the histopathological and ultrasonographic diagnoses, with ultrasonography having a diagnostic accuracy of 89% in diagnosing maxillofacial swellings. The diagnostic accuracy of ultrasonography was 100% for lymph node and malignant swellings, followed by 98% for inflammatory and cystic swellings and 92% for benign swellings. The sensitivity of the ultrasonographic diagnosis was 100% for cystic, lymph node, and malignant swellings, followed by 91% for inflammatory swellings and 86% for benign swellings.

Conclusion

Ultrasonographic features with Doppler imaging greatly aid in obtaining accurate diagnoses of oral and maxillofacial swellings. Ultrasonography is a recommended imaging tool for differentiating maxillofacial swellings and classifying them accurately.