Extra adrenal paragnglioma of oral cavity: A rare case report

Paragangliomas are neuroendocrine tumors similar to pheochromocytomas but arising from extra adrenal site. It is a very rare tumor in an intraoral site, we found a single case of intraoral paraganglioma in a literature, and hence as per our best knowledge this is only the second case of paraganglioma presented in an intraoral location. We present here a case report of paraganglioma on the ventral surface of the tongue. A 37 years old lady presented with a large asymptomatic swelling on the ventral surface of the tongue from one year. The past medical history and familial history were non relevant to the swelling. Surgical excision was performed and histopathological examination of the specimen revealed the diagnosis of extra adrenal paraganglioma. The case is being presented here for its rarity in an intraoral location.

Primary Intra-Osseous Basaloid Squamous Cell Carcinoma of Mandible: Report of Rare Case with Proposed Diagnostic Criteria

Basaloid squamous cell carcinoma (BSCC) is a distinctive variant of squamous cell carcinoma (SCC) characterised by nests of basaloid cells. BSCC is an aggressive and rare tumor of head and neck region; and is relatively rare in oral cavity in comparison to SCC. Although, infrequent, but primary intra-osseous SCC (PIOSCC) has been reported in the jaws. There are separate diagnostic criteria for this lesion and a classification for primary intra-osseous carcinoma has been described. No evidence was found in the published literature about primary intra-osseous BSCC (PIOBSCC). We, herein, present a case of giant osteodestructive lesion of the posterior mandible which was diagnosed as PIOBSCC with a correlation of histopathological and immunohistochemical features. As per the best of our knowledge, this is the first case of PIOBSCC of the jaw. There is no diagnostic criterion of PIOBSCC in the literature owing to the extreme rarity of this tumor. A diagnostic criterion is proposed here to make the diagnosis of this tumor easier.

Report of a Rare Case of Epitheliod Hemangioendothelioma in Tongue

Epitheloid hemangioendothelioma (EHE) is a rare vascular neoplasm of intermediate malignant potential. EHE commonly involves lungs, liver soft tissue, and bone. EHE is extremely rare in tongue and up to our best knowledge only nine cases of EHE of tongue reported in the literature. Clinicallyو EHE usually presents as an asymptomatic mass. Microscopically, EHE exhibits proliferation of epitheloid cells and spindle shaped endothelial cells. Epitheloid cells show cytoplasmic vacuoles with few cells containing RBCs. A 34-year-old male presented to our institution with the chief complain of swelling on the base of the tongue from eight months. Surgical excision was done. An extensive work up of immunohistochemistry was done using different markers including CD 31, CD 34, Ki 67, Factor VIII, and BCL2. Correlation of histopathology and immunohistochemistry confirmed the diagnosis of EHE. The follow up period of 2 years was uneventful.

Immunohistochemical differentiation between spindle cell lipoma and neurofibroma of oral cavity using CD34 and SOX10

Spindle cell lipoma (SCL), also called as pleomorphic adenoma, is a rare variant of lipoma histopathologically characterized by an admixture of mature fat cells with spindle cells and occasionally mast cells with myxoid connective tissue stroma and thick bends of birefringent collagen. Although buccal mucosa is the most common location for oral lipomas, for SCL, it is an exceedingly rare location. We report a case of an asymptomatic swelling of buccal mucosa that simulated the features of neurofibroma on histopathological examination, and the final diagnosis of SCL was made on the basis of immunohistochemical features. This is the first documentation of oral SCL using SOX10 to achieve the final diagnosis.

Central Acinic Cell Carcinoma of the Mandible Simulating as Benign Odontogenic Lesion: A Case Report

Centrally occurring salivary gland tumors are rare. Because of a considerable overlap between the clinical and histopathological features, this group of tumors often produces a diagnostic difficulty to the clinicians and oral pathologists. Acinic cell carcinoma (ACC) is an unusual, low-grade, malignant salivary gland tumor that represents approximately 2% of the salivary gland tumors with almost 90% arising in the parotid gland. The rest involve the submandibular and the minor salivary gland. ACC of the jaw is extremely rare and, to our knowledge, only 8 cases have been reported in the English literature. Herein, a case of primary intraosseous ACC of the mandible in a 31-year-old woman is presented. The present case is unique, as the central ACC has never been reported in a patient in the third decade of life. The complete surgical removal of the tumor was carried out under general anesthesia along with the extraction of teeth #31, #32, #41, and #42. The follow-up period of 1-year was uneventful.

Ortho Keratinized Odontogenic Cyst with Dentinoid Formation

Orthokeratinized odontogenic keratocyst (OOC) was first identified as orthokeratinized variant of odontogenic keratocyst in 1981 by Wright, due to its different histology and relatively low recurrence rate. Parakeratinized odontogenic cyst is now considered as keratocystic odontogenic tumor (KCOT) owing to its neoplastic nature. Although rare, calcification in the form of dystrophic calcification, dentinoid and cartilage has been reported in KCOT, but calcification in OOC is extremely rare and no case in English literature has been reported so far. Here, we report the first case of OOC with calcification located in the mandible of a 40-year female.

Basal Cell Adenoma of Hard Palate Involving Maxillary Alveolus

Minor salivary glands are relatively rare location for these tumors. Microscopically, they are composed of isomorphic cells, similar to basaloid cells with palisading arrangement and distinctive basement membrane like material. Herein, we report a case of BCApresenting as a soft tissue growth of left hard palate involving maxillary alveolus of a 41-year male.

Osteogenic Sarcoma of Mandible

Osteosarcoma (OS) is a malignant neoplasm characterised by the formation of osteoid matrix by neoplastic cells. It is the most common primary malignant bone tumor accounting for 20% of all sarcomas, although its occurrence in the jaw is rare. It shows typical clinical behaviour but varied radiological and histopathological features. It presents various histological aspects. We report a case of 30-year male presented with a painful swelling of mandible, diagnosed as OS after histopathological evaluation.

Extra-Osseous Odontogenic Myxoma of Maxillary Gingiva

Odontogenic myxomas are rare odontogenic tumors of jaw characterised by accumulation of mucoid ground substance with little collagen. Peripheral odontogenic myxoma (POM) is extra-osseous variant of odontogenic myxomas, occurring solely in the soft tissue covering the tooth bearing portion of jaws. POM is exceedingly rare, less than 10 cases have been published till date. A case of POM is reported here in a 27-year female which was provisionally diagnosed as pyogenic granuloma.

Assessing Difficulties Encountered by Dental Students Studying Oral Pathology and Addressing Their Concerns

INTRODUCTION

The present scenario of Oral Pathology and Oral Histology as a subject is alarming. In spite of so many advancements in terms of books, internet and conferences there are still lacunae between the understanding and interest for the subjects in the students. It can be partly due to the fact that the students perceive it as a non-clinical subject having a lesser scope for practice.

AIM

The present study was aimed at evaluating the students approach towards oral pathology department and the subject. The purpose of the study was to analyze practical hurdles encountered by students and to find out solutions to overcome them.

MATERIALS AND METHODS

The cross-sectional questionnaire based study was done with BDS students of People's Dental Academy, Bhopal, India, to gauge the understanding of their knowledge in the subject of Oral Pathology and Oral Histology. Questionnaire comprised of 28 multiple choice questions under five parameters. The data recorded was subjected to statistical analysis using chi-square test.

RESULTS

We found that study samples were efficient enough in terms of following instructions related to their day to day training. Although they were content with light microscope, they thought that some more interactive sessions could be beneficial for them in Oral Pathology.

CONCLUSION

Through our study we found out that the students are well oriented on the whole about Oral Pathology. They certainly encounter difficulties which are easy to handle if proper measures are taken. We through our study would like the readers to be aware of the changing trends in teaching and to incorporate them routinely.

Ancient schwannoma of gingiva - A rare case report

Oral schwannomas (OSs) are rare benign tumors of oral cavity derived from peripheral nerve sheath, composed of proliferation of schwann cells in a characteristic pattern. AS are long-standing lesions which exhibit degenerative changes and atypia due to which they could be mistaken for malignancy. The mean age of occurrence of AS in oral cavity is 43 years, and no case of oral AS has been reported in a pediatric patient so far. Here, we present a rare case of AS of oral cavity in a 10-year-old male child.

Angioleiomyoma of Gingiva Masquerading as Pyogenic Granuloma

Leiomyomas are benign soft tissue neoplasms that arise from smooth muscles. Three distinctive patterns of leiomyoma have been described as piloleiomyomas, angioleiomyomas and genital leiomyomas. Here in, we report the case of 39-year male with chief complain of growth on his lower left front region of the jaw. On the basis of clinical examination, it was provisionally diagnosed as pyogenic granuloma; however, histopathological examination made to the final diagnosis of angioleiomyoma. Excision led to uneventful recovery.

A Comparative Evaluation of Gustafson’s Formula and New Formula for Age Estimation in India – A Forensic Study

The choice to use teeth for age determination is well accepted due to their longevity ability of being resilient to change. The total of 228 extracted teeth collected from the patients visited to the Department of Oral and Maxillofacial Surgery, NIMS Dental College, Jaipur, the teeth were without dental fillings and without and/or cavity selected. The known age was from 21 to 70 years with the average age of 43.46 years. For age estimation the method according to Gustafson was used. Every tooth was subject to longitudinal section of the midpulpal area. The following dental parameters were studied in each case: attrition, periodontal bone loss, root translucency, secondary dentin deposition, cementum apposition and root resorption. Total scores of different parameters plotted against the chronological age and regression formula was obtained. Using this formula ages were estimated, Gustafson formula was also applied in the same scores and ages estimated. The results of the chronological and estimated age by both formulae have been statistically compared using Pearson’s correlation and regression analysis. The results showed strong correlation (0.92; p<0.001) between chronological and estimated age by using both formulae. We found the mean error of ± 5.47 by using newly derived and formula and ± 6.35 by Gustafson’s formula. As a result of our study it was found that newly derived formula provides better results in comparison with Gustafson’s formula in Indian population. A positive correlation between age and total scores of physiological changes also revealed.