Peripheral odontogenic myxoma in a 12-year-old girl: a rare entity

Peripheral odontogenic myxoma is a rare odontogenic tumor representing an extra osseous counterpart of central odontogenic myxoma. It is commonly seen in gingiva between the 3rd and 4th decades of life and appears predominantly in females. Compared to central odontogenic myxoma, it is a less aggressive, slow-growing lesion with a low recurrence rate. However, close postoperative follow-up is required because of the unlimited growth potential of incompletely removed lesions. It shares many features with other soft tissue myxoid proliferations occurring in the oral cavity and hence needs to be differentiated from them. Very few cases of peripheral odontogenic myxomas have been reported and, to the best of our knowledge, no case has been reported in a pediatric patient. We present an unusual case of peripheral odontogenic myxoma occurring in a 12-year-old girl located in the anterior mandibular gingiva, with an emphasis on differential diagnosis.

Expression of survivin and p53 in oral lichen planus, lichenoid reaction and lichenoid dysplasia: An immunohistochemical study

Context:

The malignant transformation potential of oral lichen planus (OLP) and related lesions is a subject of great controversy.

Aim:

The aim of this study was to compare the expression of proteins related to apoptosis and tumour suppressor gene processes in OLP, oral lichenoid reaction (OLR) and oral lichenoid dysplasia (OLD).

Materials and Methods

The immunohistochemical study was carried out to investigate the expressions of survivin and p53 in a total of 30 lesional biopsy specimens - 10 cases each of OLP, OLR and OLD. The expression rates were further compared with 10 control specimens of normal oral mucosa (NORM).

Results:

Immunoreactivity for p53 was seen in 7 cases (70%) of OLD, 4 cases (40%) of OLP and 2 cases (20%) of OLR and none of NORM. We obtained a significant difference (P = 0.01) in mean p53 expression between the different entities. The positive staining rate of survivin was found to be significantly different between OLD (50%), OLP (10%), OLR (0%), and normal mucosa (0%) (P = 0.004). There was a positive correlation between p53 and survivin expression in OLP and OLD using Pearson's correlation coefficient.

Conclusion:

Lichenoid dysplasia has shown p53 and survivin expression in the range of not OLP, but leukoplakia. On the other hand, OLR seems to be an innocuous lesion. The study results with OLP are inconclusive but points toward a small but important malignant potential in OLP. This kind of comparative study highlights the importance of biopsying OLP and related lesions for proper diagnosis and appropriate management.

First permanent molar root development arrest associated with compound odontoma

Trauma or infection to the primary tooth may have deleterious effects on the underlying developing tooth buds. Anatomically the root apices of primary teeth are in close proximity to the developing permanent tooth buds; hence spread of infection originating from pulp necrosis of primary tooth may not only affect the underlying tooth bud but may also affect the adjacent tooth buds. The extent of malformation depends on the developmental stage of tooth or the age of patient. Presented here is a rare case of complete arrest of maxillary first permanent molar root growth due to spread of periapical infection originating from second primary molar leading to failure of its eruption and finally extraction. Histopathlogical analysis revealed compound odontoma associated with maxillary first permanent molar.

Oral capillary haemangioma mimicking pyogenic granuloma: a challenge for diagnosis and management

Pyogenic granuloma (PG) is a localised granulation tissue overgrowth, in reaction to mild irritation. The aetiology of the lesion is not known, though it was originally believed to be a botryomycotic infection. The clinical diagnosis of such a lesion can be quite challenging. The purpose of this article is to report an unusual case of benign tumour in an adolescent boy who was clinically diagnosed as PG and histopathologically as capillary haemangioma. PG being a benign lesion; surgical excision was performed and predisposing irritants were removed.