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T Lombardi

Publications and source records attributed to T Lombardi.

At least 19 recordsLinked to original sources
PubMed2006

[Chondroblastic osteosarcoma of the mandible: a case report with 14 years follow-up].

INTRODUCTION: Osteosarcoma, the second most frequent primary malignant bone tumor, is usually found in long bones: femur, tibia or humerus with only 6 to 7% of cases occurring in the jaws. Patients with osteosarcoma of the mandible usually complain of a swelling, which can be painful or not, accompanied by paresthesia of one of the trigeminal nerve branches in about 20% of cases. OBSERVATION: We report a case of chondroblastic osteosarcoma of the mandible affecting a 33-year-old woman with 14 years follow-up illustrating the difficulties of a rapid diagnosis. DISCUSSION: The prognosis of osteosarcoma of the mandible relies on its histological grade and the amount of time elapsing from diagnosis to treatment onset. The treatment of choice is radical surgery providing a 5-year survival rate up to 80%. The definitive surgical treatment is usually performed only after several interventions because operative-room pathology cannot be obtained due to the necessity of decalcification. In order to avoid multiple resections, an interim bridging with a reconstructive plate with a condylar head can be proposed before definitive graft reconstruction. The prognosis of osteosarcoma of the mandible is better than that of long bones. Chemotherapy or radiotherapy, which are very efficient for osteosarcoma in general, do not change the prognosis of osteosarcoma of the mandible.

Adult↗
PubMed2006

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↗
PubMed2006

Mixed testicular germ cell tumor presenting as metastatic pure choriocarcinoma involving the maxillary gingiva.

Gingival metastases are infrequent and invariably associated with a widespread disease and a poor prognosis. Because of their unremarkable clinical appearance, they can be difficult to distinguish from more common gingival hyperplastic or reactive lesions, such as pyogenic granuloma, peripheral giant cell granuloma, and peripheral ossifying granuloma. We are reporting here an unusual case of a 36-year-old man with a mixed testicular germ cell tumor presenting as a metastatic pure choriocarcinoma involving the maxillary gingiva, extending from the first left premolar to the left second maxillary molar, mimicking a 'benign looking' gingival mass. Gingival metastases may be the first manifestation of a widespread metastatic disease and therefore particular attention must be paid to gingival lesions associated with atypical clinical symptoms and/or signs.

Adult↗
PubMed2005

[Bisphosphonates-related jaw osteonecrosis].

INTRODUCTION: The latest generations of bisphosphonates constitute a major advance in the management of disorders including Paget's disease, osteoporosis, and osteolytic bone tumors. Recent reports describe numerous cases of osteonecrosis of the jaw in patients treated with bisphosphonates. Some of these reports mention predisposing factors, including surgical procedures, chemotherapy, and radiotherapy. CASES: In the past 12 months, we have observed and treated 9 cases of maxillary osteonecrosis, which we present summarily. DISCUSSION: Some of our cases (3 of 9), like many of those described in literature, do not present predisposing factors. The osteonecrosis may thus be due mainly to the effect of bisphosphonates that, by blocking bone remodeling, may cause excessive bone mineralization. If this hypothesis is confirmed, these cases of osteonecrosis may be due to excess doses. Better dose adjustment should thus help prevent this complication.

Adolescent↗
PubMed2004

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↗
PubMed2003

Multisystem Langerhans' cell histiocytosis (Hand-Schüller-Christian disease) in an adult: a case report and review of the literature.

Langerhans' cell histiocytosis (LCH) is a rare and enigmatic clonal disorder that affects mainly children. It is characterized by single or multiple granulomatous mass lesions composed of cells with the Langerhans' cell phenotype. Clinical presentation and behavior are heterogeneous and can range from a solitary lytic bone lesion (i.e., eosinophilic granuloma) with a favorable course to a fatal disseminated leukaemia-like form, with a wide spectrum of intermediate clinical presentations between these two extremes. Although LCH typically involves the bone, lesions can be found in almost all organs. We are reporting the case of a multisystem LCH in a 47-year-old patient who presented with a panhypopituitarism and diabetes insipidus, and who, 5 years later, developed mandibular, mastoid and femoral lesions. The final diagnosis of LCH was made on mandibular biopsy.

Adult↗
PubMed2003

Infiltrating intramuscular lipoma of the temporal muscle. A case report with molecular cytogenetic analysis.

Intramuscular lipomas are uncommon benign mesenchymal tumors which infiltrate skeletal muscle and are exceedingly rare in the head and neck region. Because of the infiltrating nature of the lesion and a high propensity for recurrence, they are sometimes difficult to distinguish from well-differentiated liposarcomas (WDLS). We report, the first case of an infiltrating lipoma of the temporal muscle in a 62-year-old white man who presented with a slow growing mass in the left temporal region. The histopathological examination showed diffuse infiltration of the striated muscle fibers by mature adipocytes. There were no lipoblasts or cells with atypical nuclei as described in WDLS. We performed interphase fluorescence in situ hybridization (FISH) analyses using painting probes for chromosome 12 and a specific probe for the MDM2 gene and comparative genomic hybridization. The results did not identify MDM2 or 12q amplification and therefore confirmed the benign nature of the lesion.

Chromosomes, Human, Pair 12↗
PubMed2003

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↗
PubMed2002

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↗
PubMed2002

[Solitary circumscribed neuroma (palisaded encapsulated neuroma) of the oral mucosa].

BACKGROUND: The solitary circumscribed neuroma or "Palisaded Encapsulated Neuroma" is an infrequent benign tumor of the skin of adults, often localised on the face, around the orifices. The involvement of the oral mucosa or of the vermilion border of the lips is rare. CASE REPORTS: In our 5 cases, a small painless and more or less protruding nodule had been present for years on the mucosa of the hard palate (50 year-old man, 43 year-old woman), the soft palate (63 year-old woman), the vermilion border of the lower lip (48 year-old woman), and the gingiva (26 year-old man). The non specific clinical aspect did not permit a correct diagnosis. DISCUSSION: Histologically, the solitary circumscribed neuroma is formed by a proliferation of Schwann cells arranged in interlacing bundles, featuring one or several well-limited nodules, sometimes surrounded by a thin capsule. At first sight, this aspect might sometimes mimic schwannoma or neurofibroma. The lesion is interspersed with a variable amount of axons. An association with neurofibromatosis or MEN syndrome type IIb has never been found. Even after incomplete excision the solitary circumscribed neuroma does not recur, a fact supporting a reactive rather than a neoplastic origin.

Adult↗
PubMed2001

Absence of leukocyte microchimerism in oral lichen planus (OLP): an in situ hybridisation study.

Oral lichen planus (OLP) is a relatively common chronic inflammatory disease. The majority of patients are between 30 and 50 years of age with a higher incidence in females. The aetiology is unknown and various hypotheses on the pathogenic mechanisms, including autoimmunity, have been proposed over the years. In the present study, we investigated whether leukocyte microchimerism, a biological situation implicated in the aetiology of some autoimmune diseases, might play a role in the pathogenesis of OLP. We used in situ hybridisation to identify Y chromosome DNA in a series of formalin-fixed paraffin-embedded oral mucosa biopsies of women with established clinical and histological disease who had given birth to a male child. The positive control, two mucosal specimens from a man with OLP, showed over 90% of keratinocytes and cells within the inflammatory infiltrate, a positive nuclear signal. The negative control, biopsies from three women having carried only female foetuses and one nulliparous woman, all with OLP, did not show any nuclear signal. In the fifteen selected cases of OLP biopsies from women who had only male offspring, nucleated cells containing the Y chromosome were not detected within the chronic inflammatory infiltrate. These results suggest that unlike some other immunologically mediated diseases, leukocyte microchimerism does not seems to be involved in the pathogenesis of OLP.

Adult↗
PubMed2001

Polishing-paste-induced silica granuloma of the gingiva.

Polishing-paste-induced silica granuloma of the gingiva, an uncommon condition, may mimic various local or systemic pathological entities. A 33-year-old woman and a 42-year-old man were referred for a localised refractory gingival inflammation. Clinical diagnoses included allergy, lichen planus and herpes. Biopsy showed well-demarcated non-caseating granulomas, associating epithelioid and Langhans giant cells. Special bacterial and mycological stains were negative. Systemic examination and laboratory tests ruled out sarcoidosis and Crohn's disease. Polarised light revealed birefringent crystalline foreign material. A diagnosis of silica granuloma was made. Both patients had frequent dental hygiene treatment including polishing with abrasive paste, suggesting an iatrogenic implantation of the foreign bodies. Gingival damage can result from the use of some dental materials containing silica. Often asymptomatic, sometimes producing visible lesions, granulomatous gingivitis may mislead into wrong diagnosis and treatment. Old silica granulomas may become symptomatic if the patient contracts sarcoidosis.

Adult↗
PubMed2001

Metastatic transitional cell carcinoma of the urinary bladder presenting as a mandibular gingival swelling.

Oral cavity metastases mostly originate from the breasts, lungs, or kidneys. Transitional cell carcinoma (TCC), the most frequent malignant tumor of the urinary bladder, rarely metastasizes to the jaws. To the best of our knowledge, only 8 cases of bladder carcinoma have been reported in the English literature to metastasize to the jawbones. A new case of mandibular metastasis of urinary bladder TCC with extension to the gingiva is presented in a 64-year-old white man. The patient was referred for a periodontal infection of the upper right first molar. The clinical examination also showed a gingival swelling located in the lower left premolar region with a hypoasthesia of the left side of the lower lip. The gingival mass was biopsied, and the microscopy showed a mandibular metastatic TCC of the urinary bladder extending to the gingiva. Periodontists should be aware that, although gingival metastases are rare, when they occur they may mimic other local benign pathological conditions.

Bicuspid↗
PubMed2001

[Palatine lesion].

Explore the source record for details and available documents.

Antiviral Agents↗
PubMed1999

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↗
PubMed1999

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↗