Diagnosis and management of eosinophilic granuloma of the jaw: a case report

ABSTRACT The eosinophilic granuloma is the most common form of the Langherans’ cell histiocytosis. In the majority of cases it is represented by a unilocular osteolytic lesion which can occur in adults and children. It is an intraosseous destructive lesion characterized by the presence of vast numbers of eosinophils and histiocytes. It can be localized or multifocal. The tumor is more prevalent in the first two decades of life and tends to affect mandibular body and angle. Most frequent signs and symptoms are pain, swelling, ulceration, gingival necrosis, alveolar bone destruction with mobility and loss of teeth. Therapeutic interventions for this pathology are surgical curettage, local radiotherapy and chemotherapy. This article presents the case of a 9-year old patient who came in for treatment with facial swelling, pain, tooth mobility and intraoral ulcer in the vestibular sulcus of the right mandibular angle region. Imaging and incisional biopsy were obtained. After the histopathological examination confirmed the diagnosis of eosinophilic granuloma, the lesion was removed by curettage and a reconstruction titanium plate was inserted to avoid a pathological fracture. After 14 years of follow-up no recurrence was found and mandibular growth was not impaired. A discussion about this type of tumor is presented, based on the current literature.

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Lymphangioma of the skull base bones leading to cerebrospinal fluid rhinorrhea

Journal of Neurosurgery Pediatrics ◽

10.3171/ped.2008.2.10.276 ◽

2008 ◽

Vol 2 (4) ◽

pp. 273-276 ◽

Cited By ~ 4

Author(s):

Eiji Ito ◽

Kiyoshi Saito ◽

Tetsuya Nagatani ◽

Masaaki Teranishi ◽

Yuzuru Kamei ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Differential Diagnosis ◽

Skull Base ◽

Histopathological Examination ◽

Bone Destruction ◽

Lytic Lesion ◽

Csf Rhinorrhea ◽

Cerebrospinal Fluid Rhinorrhea ◽

Csf Leakage ◽

The Right

Lymphangioma localized to the bones of the skull base is rare. The authors report herein the case of a 5-year-old boy who presented with lymphangioma of the bone, localized to the skull base and leading to cerebrospinal fluid (CSF) rhinorrhea with meningitis. Neuroimaging demonstrated lytic destruction with a cyst in the right middle skull base. The patient was successfully treated with resection of the tumor and prevention of CSF leakage. Histopathological examination revealed a lymphangioma. An enlarging lymphangioma can lead to bone destruction. A differential diagnosis of a lytic lesion for a cyst at the skull base is important for proper case management.

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An Unusual Erupted Complex Composite Odontoma: A Rare Case

Case Reports in Dentistry ◽

10.1155/2013/106019 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Dawasaz Ali Azhar ◽

Mohammad Zahir Kota ◽

Sherif El-Nagdy

Keyword(s):

Histopathological Examination ◽

Distinct Entity ◽

Second Molar ◽

Dental Tissues ◽

Favorable Prognosis ◽

Developmental Disturbances ◽

Mandibular Body ◽

The Right ◽

First Time ◽

Saudi Male

Odontomas are malformations of the dental tissues and may interfere with the eruption of the associated tooth. Complex composite odontoma (CO) was described as a distinct entity for the first time by Broca in 1866. This lesion takes place due to the developmental disturbances where the dental components are laid down in a disorganized manner, due to failure of normal morphodifferentiation. Very few cases of erupted complex composite odontomas have been reported in the literature. The case reported here is of an odontoma found in the left mandibular body, associated with an impacted second molar of a 17-year-old Saudi male. Under local anesthesia the odontoma was surgically removed. Histopathological examination confirmed the diagnosis of CO. The impacted second molar which was left in the mandibular body erupted clinically after 6 months. Erupted CO is rarely seen in the mandibular left body. The early diagnosis, followed by a proper treatment at the right time, will result in a favorable prognosis.

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A Case of Nasopharyngeal Mycobacteriosis with Bony Erosion of the External Skull Base

Case Reports in Otolaryngology ◽

10.1155/2021/7500273 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Kohei Matsuo ◽

Satoshi Tanaka ◽

Masayuki Sakata ◽

Hiroki Takeda ◽

Akihiro Nagata ◽

...

Keyword(s):

Skull Base ◽

Bone Erosion ◽

Histopathological Examination ◽

Bone Destruction ◽

Mycobacterial Infection ◽

Asian Woman ◽

Nerve Paralysis ◽

Malignant Lesions ◽

The Right ◽

Bony Erosion

Primary nasopharyngeal mycobacteriosis is a rare disease. We present a case in which skull base bone erosion appeared and was alleviated during the course of the treatment. Bone complications occur in osteoarticular mycobacteriosis, but their occurrence in primary nasopharyngeal mycobacteriosis has not been reported. A 77-year-old immunocompromised Asian woman presented with a right occipitotemporal headache. An ulcerative mass covered with a thick yellowish discharge was found in the roof and posterior walls of the right nasopharynx. Because histopathological examination indicated the presence of mycobacterial infection, we began using antituberculosis medication for the treatment because of the possibility of primary nasopharyngeal tuberculosis. However, this was followed by glossopharyngeal and vagus nerve paralysis. Computed tomography (CT) showed a diffuse enhancing mucosal irregularity in the nasopharynx with bony erosion of the external skull base. Deep tissue biopsy was repeated to differentiate it from malignant lesions, and drainage of pus from the right nasopharynx was confirmed. Subsequently, the headache, neurological findings, and the yellowish discharge disappeared, and the bony erosion of the external skull base was alleviated. Surgical intervention should also be considered for drug-resistant mycobacteriosis. We concluded that mycobacteriosis should also be considered apart from carcinoma even if CT shows a diffuse enhancing mucosal irregularity with bone destruction in the nasopharynx.

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Rhinofacial Conidiobolomycosis in a 16-Year-Old Girl

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v31i2.235 ◽

2016 ◽

Vol 31 (2) ◽

pp. 36-40

Author(s):

Xirxiz Vin C. Parilla ◽

Joseph E. Cachuela

Keyword(s):

Fungal Infection ◽

Eosinophilic Granuloma ◽

Granulomatous Inflammation ◽

Staining Technique ◽

Giant Cells ◽

The Philippines ◽

Body Type ◽

Lower Lip ◽

Facial Swelling ◽

The Right

Objectives : To present the case of a 16-year old girl with progressive facial disfigurement spanning 11 months due to Conidiobolomycosis. Methods: Design: Case Report Setting: Tertiary Government Hospital Patient: One Results: A 16-year-old girl presented with a severe facial deformity of 11 months duration. The lesion started as a swelling in the right nasal vestibule, which later involved the entire nose, forehead, cheeks, upper and lower lip. A series of tissue biopsies revealed varied results -- chronic inflammation, chronic granulomatous inflammation with foreign body type giant cells, and eosinophilic granuloma—resulting in delayed provision of appropriate treatment. On the fourth biopsy using Grocott methenamine silver staining technique, septate fungal hyphae were identified. With a diagnosis of rhinofacial conidiobolomycosis, she was started on Itraconazole 100mg three times daily for eight months. Her facial swelling subsided gradually during the course of treatment and no systemic drug-related complications were observed. Conclusion: Rhinofacial conidiobolomycosis is a rare chronic localized fungal infection that usually affects midline facial structures in immunocompetent hosts. Early detection and diagnosis, and appropriate medication can give rapid resolution. To the best of our knowledge, this may be the first documented case of rhinofacial conidiobolomycosis in the Philippines. Keywords: Conidiobolomycosis; Conidiobolus; fungal infection; Itraconazole, Therapeutic use

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Not all swellings are dental abscesses: A cautionary tale

Dental Update ◽

10.12968/denu.2021.48.4.279 ◽

2021 ◽

Vol 48 (4) ◽

pp. 279-282

Author(s):

Prateek Biyani ◽

Rachael Lundgren ◽

Alexandra Thompson ◽

Robert Orr

Keyword(s):

Maxillary Antrum ◽

Survival Rates ◽

Signs And Symptoms ◽

Cautionary Tale ◽

Poor Survival ◽

Dental Abscess ◽

Facial Swelling ◽

Oral Symptoms ◽

Red Flag ◽

The Right

Carcinomas of the maxillary antrum are rare and tend to present late, leading to poor survival rates. Two-thirds of cases will present with oral symptoms or facial swelling. Dentists should be aware of suspicious clinical and radiographic signs, which may help in early detection and treatment. We present the case of a 48-year-old female complaining of facial swelling. In preceding months, she had visited her GP and dentist numerous times, receiving antibiotics from each for suspected sinusitis and a dental abscess, respectively. Subsequent investigations confirmed an SCC of the right maxillary antrum, which unfortunately, could only be treated palliatively. CPD/Clinical Relevance: The reader should understand the classic findings for a maxillary antrum carcinoma. They should also increase their confidence and awareness in identifying red flag signs and symptoms.

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A rare case of intraosseous lipoma of distal tibia – A case report and review of literature

Bhutan Health Journal ◽

10.47811/bhj.117 ◽

2021 ◽

Vol 7 (1) ◽

pp. 29-33

Author(s):

Kuenzang Wangdi ◽

Sonam Choden

Keyword(s):

Differential Diagnosis ◽

Case Report ◽

Histopathological Examination ◽

Osteolytic Lesion ◽

Plain Radiograph ◽

Distal Tibia ◽

Medial Aspect ◽

Intraosseous Lipoma ◽

Male Predominance ◽

The Right

Introduction: Intraosseous lipoma is a very rare neoplasm accounting for < 0.1 % of primary bone tumors. Pain is the leading symptom in majority of the reported cases but it can be asymptomatic. There is slight male predominance in occurrence of this lesion. The plain radiological findings are not specific and requires differential diagnosis. The lesion is mostly diagnosed by histopathological examination. Case report: A 31-year-old male presented with localized pain around the medial aspect of right ankle joint for one week. Examination revealed mild tenderness over the distal part of the right tibia over the medial aspect. Plain radiograph of the right leg showed well-defined expansile osteolytic lesion with sclerotic rim and calcified matrix at metaphysis of distal tibia. MRI showed enhancing T1-weighted hypo intense and T2-weighted hyperintense lesion. For this case, radiological impression was giant cell tumor with differential diagnosis of aneurysmal bone cyst and fibrous dysplasia. However, the histopathological examination showed intraosseous lipoma, consistent with stage II of Milgram’s classification. Conclusions: Although the diagnosis of intraosseous lipoma can be very challenging due to its rarity and indistinct plain radiograph findings, combination of computed tomography or magnetic resonance imaging may be useful by being able to show the presence of fat within the lesion. However, the clinicians, surgeons and radiologist should be familiar and be aware of these findings to be able to come to a correct diagnosis since not all cases need surgery and can be managed conservatively.

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Eosinophilic Granuloma Involving the Femoral Neck

Case Reports in Orthopedics ◽

10.1155/2013/809605 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4

Author(s):

Hoari Krishnan ◽

Taek Rim Yoon ◽

Kyung Soon Park ◽

Je Hyoung Yeo

Keyword(s):

Femoral Neck ◽

Bone Grafting ◽

Rare Case ◽

Iliac Crest ◽

Screw Fixation ◽

Histopathological Examination ◽

Eosinophilic Granuloma ◽

Osteolytic Lesion ◽

Neck Of Femur ◽

Iliac Crest Bone Grafting

We present a very rare case of eosinophilic granuloma involving the neck of femur in a 17-year-old male. The patient was treated with curettage and autologous iliac crest bone grafting with prophylactic screw fixation, and the diagnosis was confirmed by histopathological examination. Currently, it has been 14 years since the first surgery and the patient is well with no recurrence or relapse, and the osteolytic lesion has disappeared.

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Appendicular Tuberculosis as Manifestation of Gastrointestinal Tuberculosis: A Case Report

Jurnal Respirasi ◽

10.20473/jr.v7-i.3.2021.122-126 ◽

2021 ◽

Vol 7 (3) ◽

pp. 122

Author(s):

Yuliza Yuliza ◽

Alfian Nur Rosyid ◽

Wiwin Is Effendi ◽

Prastuti Asta Wulaningrum ◽

Herley Windo Setiawan

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Histopathological Examination ◽

Signs And Symptoms ◽

Definitive Diagnosis ◽

Chronic Abdominal Pain ◽

Gastrointestinal Tuberculosis ◽

Clinical Presentations ◽

Histopathology Result ◽

The Right

Introduction: Gastrointestinal tuberculosis (GI TB) is quite rare with 3% incidence of all extrapulmonary involvement. Appendicular TB may occur in 0.1 - 3% of cases. Diagnosis is often difficult because the patient usually complains about chronic abdominal pain and fever. A definite diagnosis is based on histopathological examination of resected specimens from the appendectomy procedure.Case: We present a 37-year-old male patient admitted to the hospital with chronic abdominal pain, fever, nausea, and loss of body weight. The patient never had a persistent cough, hemoptysis, or night sweating. Physical examination showed pain and muscular rigidity in the right iliac area during palpation with Blumberg's sign and Rovsing's sign positive. Abdomen ultrasound imaging showed an appendicular abscess. The patient underwent appendectomy afterwards with histopathology result showing TB. The patient was treated with first category anti-tuberculosis drugs (ATD).Discussion: Diagnosis of appendicular TB is difficult due to unspecific clinical presentations. Appendicular TB patients often complain of signs and symptoms which are similar to acute appendicitis. These conditions can delay ATD treatment because the definitive diagnosis could be made after histopathological examination.Summary: Appendicular TB is a rare case of extrapulmonary TB. It can present as acute appendicitis. The definitive diagnosis is based on the histopathological examination. It is recommended to check the appendicectomy specimens histopathologically to exclude TB or other diseases.

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Multimodular Assessment of a Traumatic Bone Cyst Overlapped with Apical Periodontitis

Case Reports in Dentistry ◽

10.1155/2020/8829305 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Davide Musu ◽

Giulia Bardini ◽

Hagay Shemesh ◽

Claudia Dettori ◽

Elisabetta Cotti

Keyword(s):

Osteolytic Lesion ◽

Bone Cyst ◽

Multidisciplinary Treatment ◽

Signs And Symptoms ◽

Surgical Excision ◽

Apical Periodontitis ◽

Diagnostic Assessment ◽

Radiographic Examination ◽

Second Molar ◽

The Right

Traumatic bone cyst (TBC), a “pseudocyst” that usually affects long bones, is a rare lesion among cystic lesions in the jaws. The most commonly affected site is the posterior mandible. Most of the time, TBC is asymptomatic and discovered during routine radiographic examination. The treatment recommended for TBC is surgical exploration followed by curettage of the bony walls, which also serves as a diagnostic procedure. A 27-year-old Caucasian male with a noncontributory medical history was referred to our department for the endodontic evaluation of the mandibular right first and second molars, which were connected to an extensive asymptomatic osteolytic lesion. A multimodular diagnostic assessment involving CBCT imaging, ultrasound, and histopathologic examination led to a definite diagnosis of a TBC overlapping with apical periodontitis (AP). Subsequently, a multidisciplinary treatment approach was performed, including surgical excision and biopsy of the lesion, endodontic retreatment of the right mandibular first molar, and postsurgical root canal treatment of the second molar. During the follow-up period of five years, the patient was reassessed periodically once a year and showed, in the absence of signs and symptoms, progressive healing of the affected area. The present article reports a case following the CARE guidelines of a TBC combined with AP where a multimodular diagnostic assessment was performed and discusses the possible pathogenetic mechanisms involved in its generation.

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Popliteal artery thrombosis secondary to a tibial osteochondroma

VASA ◽

10.1024/0301-1526/a000101 ◽

2011 ◽

Vol 40 (3) ◽

pp. 251-255 ◽

Cited By ~ 4

Author(s):

Gruber-Szydlo ◽

Poreba ◽

Belowska-Bien ◽

Derkacz ◽

Badowski ◽

...

Keyword(s):

Case Report ◽

Magnetic Resonance Angiography ◽

Popliteal Artery ◽

Doppler Ultrasonography ◽

Histopathological Examination ◽

Previous History ◽

Plain Radiography ◽

Artery Thrombosis ◽

History Of ◽

The Right

Popliteal artery thrombosis may present as a complication of an osteochondroma located in the vicinity of the knee joint. This is a case report of a 26-year-old man with symptoms of the right lower extremity ischaemia without a previous history of vascular disease or trauma. Plain radiography, magnetic resonance angiography and Doppler ultrasonography documented the presence of an osteochondrous structure of the proximal tibial metaphysis, which displaced and compressed the popliteal artery, causing its occlusion due to intraluminal thrombosis..The patient was operated and histopathological examination confirmed the diagnosis of osteochondroma.

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