Biomedical subjects
Publications and source records attributed to R W Correll.
The foregoing case is an example of amyloidosis in which biopsy of a hemorrhagic vesicle on the buccal mucosa established the diagnosis. Once the diagnosis was made, the patient's cardiomyopathy, nephrotic syndrome, hepatomegaly, GI hemorrhage, hematuria, and oral lesions readily were explained.
The adenomatoid odontogenic tumor is an uncommon, extremely benign odontogenic lesion that should be differentiated from the other osseous lesions. The surgical management should be conservative without expectation of recurrence.
Regardless of what name is used to identify the lesion and its nature of origin, clinicians should be aware of the clinical features and biologic activity of this relatively common oral abnormality and be prepared to reassure patients of the innocuous nature of the lesion.
An unusually large, asymptomatic, exophytic mass of the palate with a papillary surface architecture--characteristic of an oral squamous papilloma--has been presented. The cause of the squamous papilloma is unknown. Surgical excision, with microscopic examination of removed tissue, is the preferred treatment. Recurrence or malignant change, or both, are unusual.
An example of a large and symptomatic nasopalatine duct cyst is presented. This cyst is the most common type of developmental or fissural cyst occurring in the maxilla. Treatment for most patients is conservative surgical excision. The excised tissue should be submitted for histopathologic examination to establish a definitive diagnosis and to rule out the possibility of a more serious lesion.
The case presented here demonstrates the radiographic changes characteristic of osteopetrosis; and in conjunction with normal laboratory findings, the diagnosis is confirmed. Of particular interest is the lack of history of bone fractures or infection, in view of multiple previous extractions. Practitioners must be careful not to assume that such a history implies immunity to complications. Once the diagnosis of osteopetrosis has been made, treatment for all patients should be directed toward restoration and retention of teeth with emphasis on excellent oral hygiene.
An example of pemphigus vulgaris with initial clinical manifestations confined to the mouth has been presented. Clinicians must recognize this serious disease and understand that probably more than half of the patients with pemphigus vulgaris will first experience oral lesions, and almost all will, at some time, have oral vesiculoulcerative lesions.
A case of hereditary intestinal polyposis and orofacial pigmentation is presented. Recognition of the characteristic pigmentation by dentists may lead to early diagnosis of associated hamartomatous polyps or neoplastic disease that may be life-threatening.
The dentigerous cyst is the most common developmental odontogenic cyst and appears as an asymptomatic, well-defined radiolucent area surrounding the crown of an impacted tooth. Because of potential serious complications, lesions that are consistent radiographically with a dentigerous cyst should be totally removed and examined microscopically to establish a definitive diagnosis.
Mucous membrane pemphigoid is a relatively rare, chronic scarring vesiculobullous disease that frequently affects the oral and ocular mucosa. Other mucous membranes and skin are less frequently affected. Characteristic oral lesions include desquamative gingivitis, and extragingival ulcers and collapsed vesicles and bullae. Ocular involvement may lead to blindness. Local and systemic corticoid hormones, dapsone, and periodontal therapy have all been used with variable success to treat the disease.
A patient with inflammatory papillary hyperplasia of the palate and edentulous ridges was treated by electrosurgery. The clinical and microscopic appearance of inflammatory papillary hyperplasia is discussed as well as the causes, treatment, and prevention.
We have presented a case of BMG with concomitant fissured tongue, a not uncommon association for two rather common oral diseases. BMG is relatively simple to recognize, and the diagnosis most commonly is based on clinical appearance and history of the presence of the lesions. Clinicians should be aware, however, of the similarity, clinically and histologically, of lesions of BMG with other, more serious diseases such as psoriasis and Reiter's syndrome. Patients with characteristic lesions of BMG should be evaluated closely for signs and symptoms of these other diseases.
A female infant with a congenital granular cell epulis on the maxillary gingiva has been described. This is consistent with the most common clinical presentation of this lesion. The similarities and differences of this lesion are compared with granular cell tumor.
The appearance of two gingival cysts in the area of the mandibular right canine and first premolar is reported in a 46-year-old black man (Fig 1) along with a single cyst in the same location in another patient (Fig 2, 3). Gingival cysts are compared with lateral periodontal cysts. The similarities in location, clinical behavior, morphologic appearance, and age of occurrence would indicate a strong relationship. The gingival cyst probably represents the extraosseous counterpart of the intraosseous lateral periodontal cyst. A distinction based on strict clinical, radiographic, and surgical criteria should be made between these cysts.
A typical example of irritation fibrosis arising in the buccal mucosa has been presented. Clinicians are cautioned that although this common oral lesion generally appears clinically in a fairly characteristic manner, to rule out a more serious, similar appearing disease, these lesions should be surgically excised and examined microscopically.
A patient with a well-differentiated liposarcoma at the base of the tongue is reported. The patient experienced many local recurrences over 37 years yet remained free of metastases. Liposarcomas of the oral cavity are rare and are not usually included in the differential diagnosis of soft tissue masses in the oral region. As these tumors may occur anywhere that adipose tissue is found, the possibility of a slowly enlarging asymptomatic, grossly well-defined, soft to firm mass being a liposarcoma must be remembered. Because of the difficulties sometimes experienced in histologically distinguishing between low-grade well-differentiated liposarcoma and certain lipomas, any recurrence of a lipoma should be viewed with a great deal of suspicion about the original diagnosis.
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