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Biomedical subjects

R Küffer

Publications and source records attributed to R Küffer.

13 recordsLinked to original sources

Periapical central giant cell granuloma misdiagnosed as odontogenic cyst.

AIM: To present the clinicopathological features of a series of four periapically located central giant cell granulomas (CGCGs) that were misdiagnosed and treated as being of endodontic origin. SUMMARY: Four cases of periapical CGCGs were submitted with a clinical diagnosis of either radicular or residual cyst. In two cases, root canal treatment had been performed previously. The patients were two women and two men whose age ranged from 31 to 85 years. Two cases were located in the mandibular premolar-molar region, and two in the anterolateral region of the maxilla. Two lesions were submitted for histological examination with a diagnosis of radicular cyst whereas the remaining two were submitted with a diagnosis of residual cyst. KEY LEARNING POINTS: Periapical giant cell lesions may be unilocular and therefore misdiagnosed as an endodontic lesion because of their radiographic similarity to an inflammatory periradicular lesion, especially if the teeth have been root filled or if the vitality is negative or doubtful. It is important to follow up the healing process of a periapical radiolucency related to a root filled tooth and, in case of persistence, to perform surgery and to submit the specimen for histological examination.

Adult↗

Orofacial granulomas after injection of cosmetic fillers. Histopathologic and clinical study of 11 cases.

BACKGROUND: Purposely, cosmetic injections in orofacial tissues of various resorbable, biodegradable, or permanent fillers may be followed by development of foreign-body granulomas. The aim of this article is to contribute to the histologic identification of the filler material. METHODS: Histologic and clinical features of 11 cases of granulomas on orofacial fillers are described. RESULTS: Only 3/11 patients knew the nature of the injected product. Four histologic patterns were found: (i) Artecoll, (ii) Dermalive, and (iii) New-Fill granuloma, all three of the classic giant cell granuloma type, differing in respect of foreign particles; and (iv) Liquid Silicone granuloma, which featured a cystic and macrophagic type. Information was often missing or misleading, patients or practitioners being reluctant to give the details. CONCLUSION: Increasing demand for orofacial tissue augmentation makes pathologists face new, and sometimes, puzzling granuloma types. Identification of the foreign product might be required for therapeutic or medico-legal reasons.

Acrylates↗

Focal cemento-osseous dysplasia involving a mandibular lateral incisor.

AIM: To report a case of focal cemento-osseous dysplasia (FCOD) affecting a single tooth misdiagnosed as an inflammatory periapical lesion. SUMMARY: The patient, a black 47-year-old woman complained of pain affecting the right side of the mandible. Routine X-ray examination discovered a periapical radiolucency on the mandibular left lateral incisor (tooth 32), which was otherwise normal and not carious. As the response of this tooth to a vitality test was doubtful, the lesion was diagnosed as a periapical granuloma or cyst secondary to pulpal necrosis. Endodontic treatment and curettage of the periapical lesion were performed, and histological examination of the curettage material revealed a localized osseous dysplasia. KEY LEARNING POINTS: FCOD may rarely affect only one tooth, resembling a periapical granuloma or cyst. Careful diagnosis is of paramount importance in cases of questionable periapical lesions affecting normal-looking teeth, before beginning treatment. FCOD generally requires no treatment. Biopsy is warranted in case of doubt.

Cementoma↗

Premalignant lesions of the oral mucosa. A discussion about the place of oral intraepithelial neoplasia (OIN).

Oral precancerous lesions are traditionally classified as leukoplakia, erythroplakia, erythroleukoplakia, and distinguished from precancerous conditions. Major attention is focused on leukoplakia, and no distinction made whether dysplasia is or not present. Malignant transformation is a multistep process that should be approached also from the histological, and not merely from the clinical standpoint. Intraepithelial neoplasia, a notion created for the uterine cervix and already extended to other mucosae, should be adapted to the oral mucosa and used as diagnostic term. OIN (oral intraepithelial neoplasia) is not only a change in terminology, but also a progress in the unifying concept of precursors of squamous cell carcinoma, suppressing the useless discussion between severe dysplasia and carcinoma in situ. Furthermore, grading lesions as low or high grade OIN increases diagnostic consistency. OIN is suspected on three clinical patterns reflecting histological changes: mosaic, irregular keratosis, erythroplakia (or intermediate aspects), but dysplastic mucosa may also appear normal clinically.

Carcinoma in Situ↗

Epithelial odontogenic ghost cell tumour of the mandibular gingiva.

The epithelial odontogenic ghost cell tumour (EOGCT) is considered as a solid 'neoplastic' variant of the calcifying odontogenic cyst and is an uncommon lesion for which various names have been proposed over the years. We describe here an extraosseous case occurring on the edentulous mandibular gingiva in the right bicuspid area of a 70-year-old woman. The lesion was a painless nodule that appeared clinically as a hyperplastic mass, which was considered to be of reactive nature. Radiographic examination showed a localised resorption of the underlying mandibular bone. The tumour was excised; there was no recurrence at a 2-year follow-up examination.

Aged↗

Intravascular papillary endothelial hyperplasia of the mouth: report of six cases and literature review.

OBJECTIVE: Oral intravascular papillary endothelial hyperplasia (IPEH) is an uncommon, reactive vascular lesion with no specific clinical features. Microscopically two subtypes have been described: a pure and a mixed form. The importance of IPEH is in its resemblance to angiosarcoma. The aim of this study was to evaluate both the prevalence of IPEH in a consecutive series of oral vascular malformations and the clinico-pathological features. MATERIALS AND METHODS: Histological sections of 103 consecutive cases filed as vascular malformations were reviewed for histopathological criteria of IPEH. RESULTS AND CONCLUSION: We found six cases of oral IPEH, of which three were diagnosed previously. Five of these cases were in males, and the mean age was 58 years. It was usually described as a blue or reddish nodule. The lower lip mucosa was the most common site followed by the tongue and the upper lip. Histologically, thrombi were always present and five out of the six lesions appeared in a mixed form, while only one was in a pure form. Three cases were diagnosed at an early stage and in the other three, the lesions were well-established. In this series, IPEH associated with vascular malformation was more common than reported in previous studies. Lesions at early stages, especially in the mixed form, may be unnoticed.

Adult↗

Mandibular osteosarcoma with unusual expression of alpha-actin smooth muscle antibody.

Mandibular osteosarcoma is a rare neoplasm, appearing in young adults as a mass often accompanied by pain, occasionally with paraesthesias, gingival haemorrhages and mobility of teeth, and rarely with ulceration of the skin or mucosa. Roentgenological lytic and/or sclerotic findings are non-specific. Some patients have a previous history of Paget's disease, antecedent radiation treatment, or fibrous dysplasia. Malignant osteoid production can be minimal, resulting in diagnostic difficulties. We report a case of a 33 year-old woman, who, in the absence of a clinical soil associated with the condition, was presented with advanced disease. Immunohistochemical study using alpha-actin smooth muscle antibody disclosed bizarre tumor cells with "dendritic" appearance, to our knowledge, never described thus far. This report draws attention to this uncommon neoplasm and reviews the pertinent literature related to this entity.

Actins↗

Nasal dermoid sinus cyst.

Nasal dermoid sinus cyst is one of the diagnoses of midline nasal masses in children. This retrospective study analyzes the various theories regarding the origin of this congenital abnormality, the differential diagnosis, and the value of magnetic resonance imaging, as well as the various surgical options available.

Child, Preschool↗

Eosinophilic ulceration of the oral mucosa. A case report.

Chronic ulcerative lesions affecting the maxillary vestibular mucosa and the lower labial mucosa of a white female patient are described. Histopathologic examinations indicated a diagnosis of eosinophilic ulceration. Clinical aspects, pathogenesis, and histopathology of this uncommon lesion are discussed.

Diagnosis, Differential↗

[The intraepithelial carcinoma of the mouth mucosa and its anatomo-clinical variants].

Contrary to common opinion the intraepithelial cancer of the buccal mucosa presents clinical symptoms, but they are discreet and different from those observed in an invasive carcinoma. Usually, there is leucoplakia with an erythema and an irregular keratosis or a punctuated one. There is an erythematous variation (Queyrat's erythroplasia) which is without keratinasation. Only histological evidence can confirm the diagnosis cancer. It should be differentiated against Bowen's disease and the light, intermediated and severe dysplasias.

Bowen's Disease↗