Plasmacytoma of the mandible: A diagnostic conundrum

Plasma cell dyscrasias are neoplastic proliferation of monoclonal plasma cells that encompass a wide range of entities. Plasmacytoma may present as one of two distinct clinical entities: Multiple myeloma and solitary plasmacytoma. The incidence of solitary plasmacytoma is 2-5% among all plasma cell neoplasms and it commonly involves long bones and vertebrae. Its occurrence in the jaw is extremely rare and only 4.4% are seen in mandible. Clinically, plasmacytoma of mandible presents as pain, tooth migration, hard and soft tissue swelling or pathological fracture. Radiologically, it presents as unilocular or multilocular lesion mimicking odontogenic tumour creating a diagnostic dilemma.We report a series of 3 cases of plasmacytoma of the mandible with comprehensive details of clinico-radiological, histological, immunohistochemistry findings and treatment with a review of the literature.These three cases were clinically mistaken for Ameloblastoma, Odontogenic tumour and Oral cancer respectively. There was one case of Solitary Plasmacytoma and two cases on further workup proved to be multiple myeloma. All these cases were confirmed by immunohistochemistry.Plasmacytoma of mandible is very rare. It is usually mistaken for other common mandibular lesions and oral cancers. Every attempt must be made to diagnose them precisely as management is quite specific. To best of our knowledge, this is the first series of plasmacytoma of the mandible in the Indian literature.

Conservative Surgical Approach to Odontogenic Myxoma Involving Anterior Maxilla: A Case Report

A rare, benign odontogenic tumour - Odontogenic myxoma has a locally aggressive behavior, and is relatively rare in the maxilla. A variety of surgical approaches for this type of tumour have been tried but no clear-cut management protocol has been defined. This case addresses the surgical management of odontogenic myxoma and its behavior in the clinical setting.

Extraosseous odontogenic fibroma with a clear cells component: a 5-year follow-up

The extraosseous/peripheral odontogenic fibroma (E/POF) is a benign mesenchymal odontogenic tumour found on the gingival surface with clinical characteristics identical to those of reactive lesions. A histopathological analysis is the only method for determining the difference between reactive lesions and these neoplastic lesions, whose recurrence potential varies between 38.9% and 50%, highlighting the importance of correct diagnosis. The following report describes an E/POF case with a clear cells component, as well as a long-term follow-up treatment, which we emphasise due to its potential for recurrence.

Monitoring enlarged dental follicles: case report and literature review of an unusual presentation of a unicystic ameloblastoma

An ameloblastoma is a benign, yet locally aggressive odontogenic tumour. The vast majority (80%) of ameloblastomas arise in the mandible, and unicystic ameloblastomas are commonly found in relation to an unerupted lower third molar. We present the case of a 39-year-old patient with an incidental finding of an enlarged dental follicle around an unerupted lower third molar that progressed to an extensive unicystic ameloblastoma. This ameloblastoma was decompressed and marsupialized before enucleation to reduce the risk of pathological fracture due to the extensive size of the tumour. CPD/Clinical Relevance: The case is relevant to general dental practitioners when considering monitoring dental follicles of unerupted teeth because the enlarged dental follicle described progressed to an extensive odontogenic tumour.

Adenomatoid Odontogenic Tumour - The Master of Disguise

Adenomatoid odontogenic tumour, truly coined as one of the masters of disguise of orofacial pathologies, was first reported in the literature by Steen Lands.1 Philipson and Brin used the terminology adenomatoid odontogenic tumour for this pathology with its commonly accepted abbreviation AOT.2 Later on, adenomatoid odontogenic tumour (AOT) name was accepted by the World Health Organization (WHO) in 1971. In 2005, WHO revealed the histological variants of the adenomatoid odontogenic tumour and classified it as a tumour comprised of odontogenic epithelium showing various patterns in histopathologic view within a mature connective tissue stroma.3 It is seldom noticed neoplasm which comprises only 3 % of all the odontogenic tumours. It was commonly found in the maxilla with female predilection and mostly in association with impacted canines.4-6 Adenomatoid odontogenic tumour is an odontogenic epithelial tumour usually seen in females in their second decade of life. The tumour is slow growing in nature which eventually results in painless expansion of jaw. The maxilla is commonly affected than mandible. Being benign in nature, most of the AOT cases usually got treated with conservative surgical enucleation but the greater size of tumour can leave behind an oro-facial defect. To prevent such type of incident, it is important to diagnose them early and treat accordingly. Herewith, we are presenting a case report of adenomatoid odontogenic tumour of mandible in a male patient.