Intact Mucosa Research Articles

ADENOID CYSTIC CARCINOMA IN THE MOUTH FLOOR: A CASE REPORT

A 55-year-old woman sought out the stomatology clinic, complaining of a nodule under the tongue with three years of evolution. Clinical examination revealed a mobile nodule of firm consistency, covered by intact mucosa of normal color, measuring about 2 cm, located on the left mouth floor. In view of the hypotheses of benign or glandular mesenchymal neoplasia, an excisional biopsy was performed. During surgery, the posterior part of the lesion was attached to the musculature. Histopathological examination showed malignant glandular neoplasia, characterized by islands of basaloid cells containing multiple pseudocystic cylindrical spaces filled with basophilic material. The surgical margins were compromised of the neoplasm. The diagnosis was adenoid cystic carcinoma. The patient underwent surgery with a safety margin and radiotherapy. After treatment of the mucositis caused by radiotherapy, the patient was rehabilitated with removable dental prostheses and is undergoing clinical follow-up with no signs of recurrence after 18 months. A 55-year-old woman sought out the stomatology clinic, complaining of a nodule under the tongue with three years of evolution. Clinical examination revealed a mobile nodule of firm consistency, covered by intact mucosa of normal color, measuring about 2 cm, located on the left mouth floor. In view of the hypotheses of benign or glandular mesenchymal neoplasia, an excisional biopsy was performed. During surgery, the posterior part of the lesion was attached to the musculature. Histopathological examination showed malignant glandular neoplasia, characterized by islands of basaloid cells containing multiple pseudocystic cylindrical spaces filled with basophilic material. The surgical margins were compromised of the neoplasm. The diagnosis was adenoid cystic carcinoma. The patient underwent surgery with a safety margin and radiotherapy. After treatment of the mucositis caused by radiotherapy, the patient was rehabilitated with removable dental prostheses and is undergoing clinical follow-up with no signs of recurrence after 18 months.

Multiple Esophageal Leiomyomas: Case Report

Esophageal leiomyoma is uncommon. It is the most common benign tumor of the esophagus accounting for 0.4% of esophageal neoplasms and approximately two-thirds of benign esophageal tumors. About 90% of them are reported to be solitary and intramural lesions, and multiple or diffuse lesions seem to be very rare. We report the observation of a 75 years old male patient who was evaluated for chronic epigastric pain, Physical examination findings were typically normal, the patient underwent upper GI endoscopy. In esophagus, many submucosal tumor covered with intact mucosa, varying between 5mm and 20mm in size and located in the middle and lower part of oesophagus were noted. The radial endoscopic ultrasonography showed multiple (>10 masses), homogenous hypoechoic masses with clear margins, originated from the submucosa layer with normal surrounding structures, located in the middle and lower part of the oesophagus, and their size was < 2 cm, these lesions are followed periodically as they have a slow growth rate and negligible risk of malignant transformation. Multiple esophageal leiomyomas seems to be very rare, EUS is a valuable technique for the diagnosis of the disease and for making treatment decisions.

An atypical Esthesioneuroblastoma of the sphenoid sinus: a case report.

A 27-year-old male patient with no medical history, complained of a headache, a unilateral right nasal obstruction, epistaxis, and anosmia for 2 months. Nasal endoscopy showed a pinkish-gray mass filling the right nasal cavity. An enhanced-contrast CT scan was performed and objectified a mildly enhancing extensive mass of the sphenoid sinus with bone erosion of the left wall of the sinus and intracranial involvement. An intranasal biopsy was performed, resulting in a histopathological diagnosis of olfactory neuroblastoma. Our case was staged as stage C according to the Kadish staging. The tumor was inoperable, the patient had chemotherapy, radiotherapy, and pain management. ENB is an aggressive malignant tumor derived from the specialized olfactory neuroepithelium of the upper nasal cavity. Several published reports confirm ectopic cases of ENB throughout the nasal cavity and the central nervous system. Because sinonasal malignant lesions are rare and difficult to distinguish from their benign counterparts. ENBs appears as a soft, glistening, polypoidal, or nodular mass covered by intact mucosa or as friable masses with ulceration and granulation tissue. A radiological, CT scan through the skull base and paranasal sinuses with intravenous contrast should be performed. ENBs are solid, enhancing nasal cavity masses that may manifest erosion into nearby osseous. MRI provides better discrimination between tumor and secretions and optimal assessment of orbital, intracranial, or brain parenchymal involvement. The biopsy is the next important step in securing a diagnosis. Classic treatment strategies of ENB are based on surgery or radiotherapy as unique modalities or a combination of surgery and radiation therapy. More recently, chemotherapy has been introduced in the therapeutic armamentarium since ENB has proven to be chemosensitive. The elective neck dissection remains controversial. Long-term follow-up is mandatory for patients with ENB. While most ENBs originate in the superior nasal vault and present with typical symptoms of nasal obstruction and epistaxis in the late stages of the disease, uncommon manifestations should be considered as well. Adjuvant therapy should be considered in patients with advanced disease and unresectable disease. A continuing follow-up period is needed.

PD19-11 DIABETES CAUSES TEMPORAL CHANGES IN CHOLINERGIC-MEDIATED BLADDER CONTRACTILITY DUE TO INFLAMMATION VIA THE NLRP3 INFLAMMASOME IN FEMALE AKITA MICE

You have accessJournal of UrologyCME1 Apr 2023PD19-11 DIABETES CAUSES TEMPORAL CHANGES IN CHOLINERGIC-MEDIATED BLADDER CONTRACTILITY DUE TO INFLAMMATION VIA THE NLRP3 INFLAMMASOME IN FEMALE AKITA MICE Michael Odom, Francis Hughes, Huixia Jin, and J. Todd Purves Michael OdomMichael Odom More articles by this author , Francis HughesFrancis Hughes More articles by this author , Huixia JinHuixia Jin More articles by this author , and J. Todd PurvesJ. Todd Purves More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003285.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The most common complication of diabetes is bladder dysfunction which is driven in the female Akita type 1 diabetic mouse by inflammation mediated by the NLRP3 inflammasome. It is unclear how diabetes affects signaling pathways responsible for bladder contractility and if this is mediated by NLRP3. Using a female Akita model that develops a temporal progression from bladder overactivity to underactivity, we investigated effects on the cholinergic signaling pathways. To accomplish this we utilized ex vivo myography to determine how neurotransmitter release from efferent nerve terminals and muscarinic receptor activation is impacted in bladders of non-diabetic and diabetic mice±the NLRP3 gene. METHODS: Akita mice were crossbred with NLRP3-/- mice to yield non-diabetics and diabetics±NLRP3 gene. Females were aged to 15 and 30 weeks when respective overactive and underactive bladder phenotypes are evident. For ex vivo myography, bladder strips with intact mucosa were used. Efferent neurotransmitter-mediated contractions were assessed using electric field stimulation (EFS)±the muscarinic receptor antagonist atropine. Contractility to carbachol, a muscarinic receptor agonist, was also assessed (n=5-10 per group). RESULTS: At 15 weeks, diabetic NLRP3+/+ mice have increased EFS contractility (p<0.05) but NLRP3 gene deletion prevented this pathology in diabetics. At 30 weeks, EFS contractions were no longer dysregulated. EFS was repeated in the presence of atropine to determine the cholinergic contribution. In the presence of atropine, no significant differences were noted in diabetic animals – indicating the increase in contractility at 15 weeks was due to upregulated cholinergic mechanisms. No changes in contractions to carbachol were noted at either time point. This indicates the increased contractility to EFS was not due to increased muscarinic receptor activity but rather an increase in acetylcholine release. CONCLUSIONS: Diabetes increases cholinergic neurotransmitter release and bladder contractility in mice with an overactive bladder as a consequence of inflammation driven by NLRP3. This suggests an NLRP3 inhibitor may be an effective therapy to prevent overactive bladder and eliminate the need for conventional anti-cholinergic treatments. Source of Funding: NIH-K12 DK100024; NIH-RO1 DK117890 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e581 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Odom More articles by this author Francis Hughes More articles by this author Huixia Jin More articles by this author J. Todd Purves More articles by this author Expand All Advertisement PDF downloadLoading ...

The Specifics of Neovascularization of Wound Defects in the Oral Mucosa during Its Regeneration under a Piezoelectric Polymer Membrane.

We studied restoration of microvessels in the oral mucosa wound defects under a polymer piezoelectric membrane (group 2) and without it (group 1). The control group included animals with intact mucosa. On day 3, the expression of the vascular endothelial growth factor (VEGF) increased in all experimental groups, while the expression of CD34 increased only in group 2, which attested to intensive neoangiogenesis. On day 7, we observed a decrease in VEGF expression and an increase in CD34 expression that was more pronounced in group 2, which reflected the beginning of blood vessels maturation. More rapid formation and maturation of blood vessels in group 2 was confirmed by electron microscopy: on day 7, endothelial cells with mature organelles and signs of active transcapillary exchange were seen. On day 12, the immature blood vessels still predominated in group 1, while in group 2, the expression of angiogenesis markers decreased though remained above the control, which created prerequisites for the complete restoration of wound area vascularization in group 2. In group 1, the expression of VEGF and CD34 was significantly below the control, which attested to the development of poorly vascularized scar tissue.

Role of Endoscopic Ultrasound-Guided Fine Needle Aspiration (EUS-FNA) in the Diagnosis of Suspicious Malignant Esophageal Strictures.

(1) Background: The accurate diagnosis of esophageal strictures is quite critical for optimizing medical intervention. However, the diagnosis of suspicious malignant esophageal strictures with intact mucosa appearance and negative biopsy results is challenging. This study aimed to evaluate the role of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in the diagnosis of suspicious esophageal strictures. (2) Methods: We retrospectively analyzed the cases with suspicious malignant esophageal strictures that underwent EUS-FNA, with or without rapid on-site evaluation (ROSE), in our hospital from April 2017 to September 2022. Their clinical manifestations, imaging examinations, gastroscopic examinations, EUS-FNA results, and therapeutic strategies were retrospectively recorded and analyzed. (3) Results: A total of 23 patients (15 male and 8 female) were enrolled in this study. Based on EUS-FNA results, 18 patients were diagnosed with malignancies, including 16 cases of primary esophageal cancer (13 squamous carcinomas and 3 adenocarcinomas), 1 case of mediastinal cancer, and 1 case of metastatic esophageal cancer; 1 case of tuberculosis was also confirmed by EUS-FNA. Among 4 cases of ambiguous diagnosis with EUS-FNA, 1 was diagnosed with an esophageal glomus tumor after surgical removal, and 2 patients survived for several years without medical intervention, which hinted at the possibility of benign esophageal strictures. No major complications, including bleeding or perforation, were observed. (4) Conclusions: EUS-FNA may serve as a safe and effective diagnostic tool in suspicious malignant esophageal strictures with accurate specimen acquisition, especially for biopsy-negative cases.

WEO Newsletter.

WEO Newsletter.

Modified transseptal approach in endoscopic transsphenoidal pituitary surgery.

Transsphenoidal pituitary surgery is commonly performed via a direct transostial approach with a posterior septectomy. However, a technique via an endoscopic transseptal route has been described that avoids a posterior septectomy, but it comes with its own disadvantages. This paper describes a modification, and discusses its pros and cons. The initial incision in the mucosa is placed level with the anterior middle turbinate. The mucoperichondrial flap is raised ipsilaterally until the sphenoid sinus ostium. An incision is made at the osseocartilaginous junction, and the contralateral mucoperichondrial flap is raised. The bony septum and posterior aspect of this flap is excised. The size and position of this window can be adapted. At the end of the operation, the lateralised intact mucoperichondrial flap is moved back to the midline. Excision or deflection of the cartilaginous septum is not required. It maintains an intact septal mucosa on one side and avoids a septal perforation.

AIUM Official Statement: Guidelines for Cleaning and Preparing External- and Internal-Use Ultrasound Transducers and Equipment Between Patients as Well as Safe Handling and Use of Ultrasound Coupling Gel.

AIUM Official Statement: Guidelines for Cleaning and Preparing External- and Internal-Use Ultrasound Transducers and Equipment Between Patients as Well as Safe Handling and Use of Ultrasound Coupling Gel.

Development of a gum recession model in an experiment

Background: The article presents experimental studies conducted on Wistar rats in the amount of 50 individuals. An artificial gum recession defect was created.Aim: to evaluate the effectiveness of creating a gum recession model in the proposed way.Material and methods: Experimental animals at the beginning of the study had an intact oral mucosa: pale pink color, without pathological changes. An experimental model of gum recession was created by excision of V-shaped periodontal tissues from the vestibular surface in the area of the lower jaw incisors of a rat, then a DispodentPak No. 000 retraction thread was applied in the area of the lower central incisors in the circular ligament of the tooth to a depth of 1.5 mm, and Vitrebond dental glass ionomer cement was applied to the vestibular surface of the neck of the tooth of the lower incisors, with at the same time, prednisone is administered intramuscularly at the rate of 12 mg / kg of animal weight on the 1st, 3rd and 5th day. For the experiment, female white rats in the amount of 50 individuals were used as a model. All animals were divided into 2 groups depending on the method of creating a gum recession defect. In the control group of rats, the defect was created according to the standard procedure by conducting a V-shaped incision.Results: When creating the proposed model of experimental gum recession, the clinical and pathomorphological picture is achieved under the influence of local factors: V-shaped gum incision, retraction thread, dental glass ionomer cement. To suppress the processes of self-regeneration of the gums, the optimal dose of prednisone is administered.Conclusions: On the 3rd day of the experiment, a V-shaped defect was observed in animals. On the 10th day, clinical signs of gum recession are determined: a defect with a depth of 2 mm. The average depth of recession in animals was (2 ± 1.7 mm). A relatively short process of modeling a gum recession (no more than a month). In this case, a local lesion of the gum is created, not burdened by any other pathology in the animal, and having both local and general (stress) pathogenetic factors, against the background of changes in the reactivity of the organism, which corresponds to the modern theory of the occurrence of recession as a polyethological disease in humans.

Комплексный подход в консервативном лечении хронического тонзиллита

Chronic tonsillitis (CT) is one of the most common diseases among the pathologies of the ENT organs; in outpatient practice, its share ranges from 4% to 35%. The palatine tonsils (PT) are participants in cellular and humoral immunity. It is important to develop new therapeutic approaches that most effectively influence the tissue focus of inflammation. The attention of clinicians is drawn to the use of physiotherapeutic methods of treating CT. Data were obtained on the ability of nitric oxide (NO) to penetrate deep into tissue through intact skin and mucous membranes. We hypothesized that inclusion of intralacunar exposure to nitrogen monoxide in complex therapy for patients with chemotherapy may be the most effective and promising due to the antibacterial and immunostimulating effect of the gas. 120 patients were examined (Me 36±10,55 years). The control group consisted of 54 practically healthy volunteers (Me 38±10,9 years). The patients were divided into 3 groups, all of them underwent 10 treatment procedures every other day: in the 1st group, treatment of the PT with 0,9% NaCl solution, 40 mL, using the Tonsillor-MM device, and manual washing of the PT with 0,9% NaCl solution, 40 mL, by Belogolovov method with intralacunar injection of chlorophyllipt oil solution, 1.0 mL; in group 2, treatment was supplemented with therapy of low-intensity laser radiation (LILR); in group 3, intralacunar exposure to exogenous nitric oxide. The activity of NETosis transformation of leukocytes was assessed in whole blood and smears from the surface of PT lacunae according to the developed method before treatment and 1 month after treatment. To assess local and systemic immunity, the levels of lactoferrin, lysozyme, and sIgA were determined in blood serum, oral fluid, and swabs from the surface of PT lacunae. The combination of washing the lacunae of the PT and LILR gives a pronounced therapeutic effect, and the inclusion of local NO-therapy procedures in the complex increases the effectiveness of treatment by local action on the tissue focus of inflammation.

Rapid diagnosis of laryngeal cancer using Raman fluorescence spectroscopy

Aims: to provide a scientific and practical justification for the use of Raman fluorescence spectroscopy in the early express-diagnostics of laryngeal cancer. Patients and methods. A total of 83 patients with a diagnosis of laryngeal cancer were examined. The spectra of the intact mucous membrane of the larynx, the anatomical structures of the larynx in cancer and precancer were analyzed. The individual features of the bands of Raman scattering of light and fluorescent signals in intact tissues, in case of dysplasia, and squamous cell carcinoma of the larynx were evaluated. To compare the data of Raman fluorescence spectroscopy, the histological method was used in this study. The study evaluated the sensitivity and specificity of the method. To take the spectra, a laser setup was used using both fluorescent and Raman components, with a wavelength of 532 nm. Measurements were taken immediately after removal of the laryngeal tissue (1-5 seconds) involved in the malignant process. Results. In this study, using Raman fluorescence spectroscopy, individual spectral characteristics of the tissues of the larynx were obtained in intact tissues and in laryngeal cancer, as well as in dysplasia (precancer). In this study, in the above groups there are differences both in fluorescence signals and in Raman scattering bands. This information can be useful in the early diagnosis of laryngeal cancer for the clinicians. Conclusions. In the future, Raman fluorescent medical technologies can be used for the purpose of early express diagnostics of tumor diseases of the larynx. Clinical Medicine and Public Health and Healthcare in general need the development of technologies of this kind in order to improve the quality and efficiency of diagnosing and treating diseases at the stage of their initiation.

Bin1 targeted immunotherapy alters the status of the enteric neurons and the microbiome during ulcerative colitis treatment

Ulcerative colitis (UC) is a common chronic disease of the large intestine. Current anti-inflammatory drugs prescribed to treat this disease have limited utility due to significant side-effects. Thus, immunotherapies for UC treatment are still sought. In the DSS mouse model of UC, we recently demonstrated that systemic administration of the Bin1 monoclonal antibody 99D (Bin1 mAb) developed in our laboratory was sufficient to reinforce intestinal barrier function and preserve an intact colonic mucosa, compared to control subjects which displayed severe mucosal lesions, high-level neutrophil and lymphocyte infiltration of mucosal and submucosal areas, and loss of crypts. A dysbiotic microbiome may lead to UC. We determined the effects of Bin1 mAb on the gut microbiome and colonic neurons and correlated the benefits of immunotherapeutic treatment. In the DSS model, we found that induction of UC was associated with disintegration of enteric neurons and elevated levels of glial cells, which translocated to the muscularis at distinct sites. Further, we characterized an altered gut microbiome in DSS treated mice associated with pathogenic proinflammatory characters. Both of these features of UC induction were normalized by Bin1 mAb treatment. With regard to microbiome changes, we observed in particular, increase in Enterobacteriaceae; whereas Firmicutes were eliminated by UC induction and Bin1 mAb treatment restored this phylum including the genus Lactobacillus. Overall, our findings suggest that the intestinal barrier function restored by Bin1 immunotherapy in the DSS model of UC is associated with an improvement in the gut microbiome and preservation of enteric neurons, contributing overall to a healthy intestinal tract.

Endoscopic enucleation of gastric choristoma in a child

Introduction. In pediatric practice, one may encounter various volumetric formations of the stomach, both benign and malignant. The verification and localization of the neoplasma is the most difficult issue in everyday work. Most often, benign tumors are represented by a rounded submucosal formation, covered with an intact mucous membrane. The most common formations that can be found in a child are leiomyomas. Objective is to present the first experience of endoscopic submucosal dissection and enucleation of the choristoma in a child. Clinical observation. The girl was admitted for inpatient treatment with complaints of prolonged (2 years) abdominal syndrome and mass formation of the antrum of the stomach. According to CT data, a voluminous soft tissue formation 8 × 7 × 12 mm in size was revealed in the antrum of the stomach, which does not accumulate a contrast agent. When performing esophagogastroduodenoscopy and endosonography, a submucosal formation of the prepyloric stomach was visualized, with dimensions of 7 × 10 mm. The macroscopic picture of the tumor corresponded to gastric leiomyoma. However, given the clinical picture, it was impossible to exclude the chorous stomach. Thus, the diagnosis was formulated: volumetric formation of the stomach. Leiomyoma? Choristoma? In the course of further treatment, surgical treatment was performed, in the amount of submucosal enucleation of the formation. According to the morphological study, the remote formation corresponded to the ectopic pancreatic tissue. Conclusion. Choristoma does not always have a “classic” appearance with retraction in the center, and the clinical picture is of great importance in the verification of neoplasma. Endoscopic submucosal removal of gastric choristoma is a minimally invasive and effective method of surgical treatment that can be used in children.

Gastric submucosal mass lesions.

Gastric submucosal mass lesions are a collection of tumours that arise in the stomach and are deep to the mucosal layer. Distinct from gastric epithelial carcinomas, these tumours are generally more indolent. They are often found incidentally on upper endoscopy. Most often they present as smooth protuberant masses covered by normal intact gastric mucosa. The majority are asymptomatic. Endoscopic ultrasound (EUS) is frequently employed to further characterize the lesions. EUS can be diagnostic of some lesions, such as lipomas, and can be used to guide fine needle aspiration to diagnose others. Adding to the traditional management approaches of observation and surgical resection, numerous new and emerging endoscopic therapies are now being used to resect these gastric tumours. This review focuses on evolving strategies in the diagnosis and management of submucosal mass lesions. Although surgical intervention was once the lone option for intervention, there are an increasing number of endoscopic therapies. There have also been advancements in neoadjuvant therapies and in distinguishing the malignant potential of submucosal mass lesions. Gastric submucosal lesions are common. EUS is frequently indicated in the evaluation and diagnosis. For tumours for which observation is not recommended, novel endoscopic therapies may offer less invasive management options.

Immunoglobulin Disorders and the Oral Cavity: A Narrative Review.

The oral mucosa is a mechanical barrier against the penetration and colonization of microorganisms. Oral homeostasis is maintained by congenital and adaptive systems in conjunction with normal oral flora and an intact oral mucosa. Components contributing to the defense of the oral cavity include the salivary glands, innate antimicrobial proteins of saliva, plasma proteins, circulating white blood cells, keratinocyte products of the oral mucosa, and gingival crevicular fluid. General disturbances in the level of immunoglobulins in the human body may be manifested as pathological lesions in the oral mucosa. Symptoms of immunoglobulin-related general diseases such as mucous membrane pemphigoid (MMP), pemphigus vulgaris (PV), linear IgA bullous dermatosis (LABD), Epidermolysis Bullosa Aquisita (EBA), and Hyper-IgE syndrome (HIES) may appear in the oral cavity. In this review, authors present selected diseases associated with immunoglobulins in which the lesions appear in the oral cavity. Early detection and treatment of autoimmune diseases, sometimes showing a severe evolution (e.g., PV), allow the control of their dissemination and involvement of skin or other body organs. Immunoglobulin disorders with oral manifestations are not common, but knowledge, differentiation and diagnosis are essential for proper treatment.

DENTIGEROUS CYST IN AN EDENTULOUS ELDERLY PATIENT WITH TOOTH DILACERATION

An 87-year-old female patient complained of a severe pain and swelling in the anterior maxilla with a 1-month history. There were no changes in the extraoral clinical examination on the day of the appointment. The patient was edentulous for several years. The intraoral examination revealed swelling of firm consistency covered by an intact mucosa in the left anterior maxilla, extending to the hard palate and buccal vestibule. Radiographic examination showed a tooth with severe dilaceration within a well-defined unilocular radiolucency measuring 2 × 2.5 cm. The differential diagnosis included benign odontogenic cyst or tumor. Aspiration puncture revealed a yellowish, opaque liquid. Excisional biopsy and extraction of impacted tooth was carried out. Microscopic examination showed a cystic cavity limited by two-layered cubic epithelium and areas of hyperplasia. The cystic capsule exhibited dense mononuclear inflammatory infiltrate. The diagnosis of dentigerous cyst was established. After 6 months of follow-up, no recurrences were detected. An 87-year-old female patient complained of a severe pain and swelling in the anterior maxilla with a 1-month history. There were no changes in the extraoral clinical examination on the day of the appointment. The patient was edentulous for several years. The intraoral examination revealed swelling of firm consistency covered by an intact mucosa in the left anterior maxilla, extending to the hard palate and buccal vestibule. Radiographic examination showed a tooth with severe dilaceration within a well-defined unilocular radiolucency measuring 2 × 2.5 cm. The differential diagnosis included benign odontogenic cyst or tumor. Aspiration puncture revealed a yellowish, opaque liquid. Excisional biopsy and extraction of impacted tooth was carried out. Microscopic examination showed a cystic cavity limited by two-layered cubic epithelium and areas of hyperplasia. The cystic capsule exhibited dense mononuclear inflammatory infiltrate. The diagnosis of dentigerous cyst was established. After 6 months of follow-up, no recurrences were detected.

CIRCUMSCRIBED SOLITARY NEUROMA AFFECTING TONGUE IN A PEDIATRIC PATIENT: A RARE CASE REPORT AND LITERATURE REVIEW

A 12-year-old male patient was referred to the clinic with the main complaint of “tongue wart,” with an evolution time of 2 years. In the intraoral examination, a pedicle nodule on the posterior of the tongue approximately 0.5 cm in diameter, asymptomatic, and an intact lining mucosa were observed. The diagnostic hypotheses were fibrous hyperplasia, lipoma, neuroma, granular cell tumor, or other benign neoplasm. Excisional biopsy was performed, and microscopic examination showed a well-circumscribed nodular proliferation in the form of interwoven bundles of spindle cells, compatible with circumscribed solitary neuroma (CSN). A literature review was carried out regarding this lesion in the oral cavity and 71 reported cases were found. However, the present case is the first to report CSN in a pediatric patient. It was concluded that CSN should be included as a differential diagnosis of nodular lesions that affect pediatric patients. A 12-year-old male patient was referred to the clinic with the main complaint of “tongue wart,” with an evolution time of 2 years. In the intraoral examination, a pedicle nodule on the posterior of the tongue approximately 0.5 cm in diameter, asymptomatic, and an intact lining mucosa were observed. The diagnostic hypotheses were fibrous hyperplasia, lipoma, neuroma, granular cell tumor, or other benign neoplasm. Excisional biopsy was performed, and microscopic examination showed a well-circumscribed nodular proliferation in the form of interwoven bundles of spindle cells, compatible with circumscribed solitary neuroma (CSN). A literature review was carried out regarding this lesion in the oral cavity and 71 reported cases were found. However, the present case is the first to report CSN in a pediatric patient. It was concluded that CSN should be included as a differential diagnosis of nodular lesions that affect pediatric patients.

AN UNUSUAL INTRAORAL LIPOMA: A CASE REPORT

Intraoral lipoma is a relatively rare painless benign tumor derived from mesenchymal connective tissue. A 58-year-old White male patient in good health was examined for a slow growing painless nodule on the palate which had been present for 6 years. There were no changes in the extraoral clinical examination. The intraoral examination revealed a sessile nodule of soft consistency on the right side of the hard palate covered by an intact mucosa and measuring approximately 2 × 2 cm. Radiographic examination showed no signs of bone changes. The clinical differential diagnosis included benign salivary gland tumor and mesenchymal tumor. Excisional biopsy was performed under local anesthesia, and the surgical specimen was sent to an anatomic pathology laboratory. Microscopic examination showed collections of mature adipocytes and scarce fibrous connective tissue stroma. The diagnosis of lipoma was established. After 5 months of follow-up, satisfactory wound healing and no recurrences were detected.

LIPOMA OF THE FLOOR OF THE MOUTH: A CASE REPORT

Lipoma is the most frequent mesenchymal neoplasm but rare in the oral cavity, representing 1% to 4% of benign oral neoplasms. We report a case of 50-year-old female patient reporting a painless growth under the tongue present for 2 years. Intraoral examination revealed a sessile nodule of soft consistency, covered by an intact mucosa on the right anterior buccal floor, measuring approximately 1.5 × 1.5 cm. The clinical differential diagnosis included lipoma and other benign mesenchymal tumors. An excisional biopsy under local anesthesia was performed. The surgical specimen had a yellowish color and soft consistency and floated in the formalin solution. Microscopic examination showed mature adipocytes and a variable amount of collagen bundles and blood vessels. The diagnosis of lipoma was established. After 10 months of follow-up no recurrence was detected.