Malformations Of Development Research Articles

A case report on surgical excision of intracapsular osteochondroma of femur neck using medial approach without hip dislocation in a young male

Osteochondromas also called exostosis are commonest benign bone tumours. Traditionally Osteochondroma are considered as developmental malformations rather than true neoplasms and are thought to formed inside the periosteum due to separation of small epiphyseal growth plate cartilage. But recent studies suggested it’s relation with mutation in gene exotoxin 1 so now they are considered as true neoplasm. The lesions consist of a bony mass produced by progressive endochondral ossification of a growing cartilaginous cap. Most lesions are found during the period of rapid skeletal growth. Approximately 90% of patients only have a single lesion. Osteochondromas generally found on the metaphysis of a long bone near the physis like distal femur, proximal humerus, and proximal tibia. Due to risk of AVN after surgical management makes it difficult for excision. Due to close proximity to important neurovascular bundles these lesions can cause symptoms related to compression. Hip impingement is also common in these cases. Recurrence of osteochondromas are rare sometimes seen due to failure to remove the entire cartilaginous cap. A 24-year-old male presented with complaints of pain around the right hip and difficulty in walking and running since 2 year. On radiographic examination Right sided neck femur osteochondroma was diagnosed, which was located along the anteroinferior margin of the femur neck. Excision of the lesion was done in supine position using medial approach to hip without dislocation of the femur head. Femur neck osteochondroma should be removed surgically safely without dislocating hip. Osteochondroma must be removed completely with cartilagenous cap to avoid recurrence.

Chemical hazard of robotic hull in-water cleaning discharge on coastal embryonic fish

In-water cleaning (IWC) involves the removal of biofilms and foulants from the hull of a ship using brush or water jet. During IWC, several factors associated with the harmful chemical contaminants release to the marine environment, which can create “hotspots” of chemical contamination in coastal areas. To elucidate the potential toxic effects of IWC discharge, we investigated developmental toxicity in embryonic flounder, which are sensitive life stage to chemical exposure. Zinc and copper were the dominant metals, while zinc pyrithione was the most abundant biocide associated with IWC discharge in two remotely operated IWC. Discharge from IWC carried by both remotely operated vehicles (ROVs) produced developmental malformations including pericardial edema, spinal curvature, and tail-fin defects. In an analyses of differential gene expression profiles (fold-change of genes with a cutoff < 0.05) as assessed by high-throughput RNA sequencing, genes associated with muscle development were commonly and significantly changed. The gene ontology (GO) of embryos exposed to IWC discharge from ROV A activities highly enriched muscle and heart development, while cell signaling and transport were evident in embryos exposed to IWC discharge of ROV B. We analyzed the gene network by significant GO terms. In the network, TTN, MYOM1, CASP3, and CDH2 genes appeared to be key regulators of the toxic effects on muscle development. In embryos exposed to ROV B discharge, HSPG2, VEGFA, and TNF genes related to the nervous system pathway were affected. These results shed light on the potential impacts of muscle and nervous system development in non-target coastal organisms exposed to contaminants found in IWC discharge.

Maternal transfer of florfenicol impacts development and disrupts metabolic pathways in F1 offspring zebrafish by destroying mitochondria

Maternal exposure to antibiotics existing in the environment is a predisposing factor for developmental malformation with metabolic disorders in offspring. In this study, female zebrafish (3 months) were exposed to 0.05 mg/L and 0.5 mg/L florfenicol (FF) for 28 days. After pairing and spawning with healthy male fish, F1 embryos were collected and developed to 5 d post-fertilization (dpf) in clear water. And the adverse effects on the F1 generation were examined thoroughly. The fecundity of F0 female fish and the hatchability, mortality, and body length of F1 larvae significantly decreased in the treatment group. Meanwhile, multi-malformation types were found in the exposure group, including delayed yolk sac absorption, lack of swim bladder, and spinal curvature. Metabolomic and transcriptomic results revealed alterations in metabolism with dysregulation in tricarboxylase acid cycle, amino acid metabolism, and disordered lipid metabolism with elevated levels of glycerophospholipid and sphingolipid. Accompanying these metabolic derangements, decreased levels of ATP and disordered oxidative-redox state were observed. These results were consistent with the damaged mitochondrial membrane potential and respiratory chain function, suggesting that the developmental toxicity and perturbed metabolic signaling in the F1 generation were related to the mitochondrial injury after exposing F0 female zebrafish to FF. Our findings highlighted the potential toxicity of FF to offspring generations even though they were not directly exposed to environmental contaminants.

Single Umbilical Artery and Associated Fetal and Maternal Characteristics: A Cross Sectional Study

Background: Single umbilical artery is the most common developmental malformation of the umbilical cord. Its prevalence increases by multiple pregnancy, velamentous cord insertion, older maternal age, cigarrete smoking, maternal diabetes, hypertension or epilepsy. Since ethnic and genetic factors have been contributed to single umbilical artery occurrence and there is no similar study in Iran, we decided to evaluate fetuses with single umbilical artery diagnosis and describe maternal and fetal characteristics.&#x0D; Methods: This was a retrospective cross sectional study conducted on pregnant women having fetuses diagnosed with single umbilical artery at gestational age of 18 to 24 weeks referring to the perinatologist during 2019-2022. Data was analyzed by appropriate analytic tests were applied.&#x0D; Results: During study period, 67 fetuses had been diagnosed with single umbilical artery. Mean values of maternal age, gestational age, body mass index were 32.29 ± 5.83 years, 18.89 ± 1.57 weeks, and 26.46 ± 4.54 kg/m2, respectively. 59.7% of fetuses were male and 40.3% were female. 33 cases (49.2%) had no other associated malformations and choroidal cysts and intra-cardiac echogenic focies were the most prevalent abnormalities. As well, in 16 cases more than one malformation were detected. In cases with isolated single umbilical artery, no intrauterine growth retardation was evident.&#x0D; Conclusion: In line with previous studies, cardiac, gastrointestinal and renal malformation are the most common associated abnormalities seen in single umbilical artery malformation and in the presence of multiple anomalies intrauterine growth retardation is expected.

Fetal Tethered Spinal Cord: Diagnostic Features and Its Association with Congenital Anomalies

Objective We assessed the frequency and type of associated congenital anomalies encountered with fetal tethered spinal cord (TSC) determined prenatally. Method A retrospective review was conducted based on the associated fetal abnormalities following diagnosis of low-lying fetal conus medullaris during the prenatal ultrasound. Results Of the 26 fetuses with low-lying conus medullaris, four were solitary TSC and 22 had TSC combined with associated congenital malformations, including four cases with spina bifida occulta, four cases with spina bifida aperta, one case with severe hydrocephalus, and 13 cases with multisystem congenital malformations. Among all the 13 cases with combined multisystem congenital malformations, four cases had vertebral defects, anal anomalies, cardiac defects, trachea-esophageal fistula, renal anomalies, and limb anomalies (VACTERL) syndrome, two cases had combined kidney development abnormalities, one case had cloacal exstrophy (OEIS syndrome), and six cases had chromosomal abnormalities (one case of chromosome 7q deletion, two cases of trisomy 13 syndrome, one case of trisomy 18 syndrome, one case of trisomy 9 syndrome, and one case of chromosome 4p deletion). Conclusions Low-lying conus medullaris found during prenatal ultrasound examination were often associated with neural tube malformations or multi-systemic complex developmental malformations. The frequency of chromosomal abnormalities was 23.1%.

Cleft lip and palate

The term ‘oral cleft’ describes a spectrum of oro-facial developmental malformations in which there is an abnormal anatomical opening or division of the lip, palate or both. There are three main types: cleft lip (CL) alone, cleft lip with cleft palate (CL/CP), and cleft palate (CP) alone. They represent the most common facial anomaly worldwide. This article describes the embryological theory, aetiology, diagnosis and management of oral clefting, focusing on the functional impact of the condition, how patients may present, and clinical findings which may raise suspicion in primary care.

Surgical planning, histopathology findings and postoperative outcome in MR-negative extra-temporal epilepsy using intracranial EEG, functional imaging, magnetoencephalography, neuronavigation and intraoperative MRI

ObjectiveMRI-negative drug-resistant epilepsy presents a challenge when it comes to surgical planning, and surgical outcome is worse than in cases with an identified lesion. Although increasing implementation of more powerful MRI scanners and artificial intelligence has led to the detection of previously unrecognizable lesions, in some cases even postoperative pathological evaluation of electrographically epileptogenic zones shows no structural alterations. While in temporal lobe epilepsy a standardized resection approach can usually be performed, the surgical management of extra-temporal lesions is always individual. Here we present a strategy for treating patients with extra-temporal MRI-negative epilepsy focus and report our histological findings and patient outcome. MethodsPatients undergoing epilepsy surgery in the Department of Neurosurgery at the University Hospital Erlangen between 2012 and 2020 were included in the study. Inclusion criteria were: (1) failure to identify a structural lesion on preoperative high-resolution 3 Tesla MRI with a standardized epilepsy protocol and (2) preoperative intracranial EEG (iEEG) diagnostics. ResultsWe identified 8 patients corresponding to the inclusion criteria. Second look MRI analysis by an experienced neuroradiologist including the most recent analysis algorithm utilized in our clinic revealed a possible lesion in two patients. One of the patients with a clear focal cortical dysplasia (FCD) finding on a second look was excluded from further analysis. Of the other 7 patients, in one patient iEEG was performed with subdural electrodes, whereas the other 6 were evaluated with depth electrodes. MEG was performed preoperatively in all but one patient. An MEG focus was implemented in resection planning in 3 patients. FDG PET was performed in all, but only implemented in one patient. Histopathological evaluation revealed one non-lesional case, 4 cases of FCD and 2 cases with mild developmental malformation. All patients were free from permanent neurological deficits and presented with Engel 1A or 1B outcome on the last follow-up. ConclusionWe demonstrate that extra-temporal MRI-negative epilepsy can be treated successfully provided an extensive preoperative planning is performed. The most important diagnostic was stereo-EEG, whereas additional data from MEG was helpful and FDG PET was rarely useful in our cohort.

Fetal pharyngeal glial heterotopia manifested as polyhydramnios: a rare case with difficult prenatal diagnosis

BackgroundGlial heterotopia is a rare congenital developmental malformation that presents as tumor-like lesions of the nerve tissue that grow outside the nervous system, but are not true tumors. At present, most cases are reported in neonates and children and are very rarely found in fetuses. The present report describes a case of fetal pharyngeal glial heterotopia and associated imaging findings to better understand the disease in the future.Case presentationA 32-year-old pregnant woman was admitted to the hospital with polyhydramnios. An ultrasound examination revealed a hypoechoic mass in the neck of the fetus. Magnetic resonance imaging showed a well-defined mass with significant compression of the esophagus and airway. The amniotic fluid index was approximately 40 cm. Considering that difficulty swallowing and breathing may occur due to compression by the mass after birth, tracheotomy and mass resection should be performed immediately. The difficulty of the tumor resection procedure and the nature of the tumor are both factors affecting the prognosis of the fetus. The pregnant woman eventually chose to induce labor. The fetal pharyngeal mass was then resected and its pathological examination indicated pharyngeal glial heterotopia.ConclusionsPolyhydramnios due to pharyngeal glial heterotopia is extremely rare and accurate prenatal diagnosis is challenging. Clinical diagnosis of glial heterotopia in preterm fetuses is difficult. Therefore, understanding glial heterotopia is helpful to improve clinical treatment options.

Brain heterotopia formation by ciliopathic breakdown of neuroepithelial and blood-cerebrospinal fluid barriers.

The developmental functions of primary cilia and the downstream signaling pathways have been widely studied; however, the roles of primary cilia in the developing neurovascular system are not clearly understood. In this study, we found that ablation of genes encoding ciliary transport proteins such as intraflagellar transport homolog 88 (Ift88) and kinesin family member 3a (Kif3a) in cortical radial progenitors led to periventricular heterotopia during late mouse embryogenesis. Conditional mutation of primary cilia unexpectedly caused breakdown of both the neuroepithelial lining and the blood-choroid plexus barrier. Choroidal leakage was partially caused by enlargement of the choroid plexus in the cilia mutants. We found that the choroid plexus expressed platelet-derived growth factor A (Pdgf-A) and that Pdgf-A expression was ectopically increased in cilia-mutant embryos. Cortices obtained from embryos in utero electroporated with Pdgfa mimicked periventricular heterotopic nodules of the cilia mutant. These results suggest that defective ciliogenesis in both cortical progenitors and the choroid plexus leads to breakdown of cortical and choroidal barriers causing forebrain neuronal dysplasia, which may be related to developmental cortical malformation.

Lymphangioma CircumscriptaA Diagnostic Dilemma

Lymphangiomas are developmental malformations that present as benign hamartomas of lymphatic channels. They present at birth or before two years of age, with 50-70% predilection for the head and neck region and less frequently reported in the oral cavity. However, affected sites in the oral cavity include the tongue, palate, gingiva, buccal mucosa, lips and alveolar ridge. Lymphangioma of the buccal mucosa is rare, only 27 cases of lymphangioma of buccal mucosa have been reported till date, out of which seven were in children. The prognosis is good for most patients, but recurrence has also been reported in some cases. This present case is of Lymphangioma Circumscriptum in a 13-year-old child involving right buccal mucosa and lip since birth. This lesion was surgically removed under general anaesthesia and there was a recurrence of the lesion after one year of follow-up. In the literature there was no reported case of Lymphangioma Circumscriptum involving the lip of a child, so this present case was the firstreported case of Lymphangioma Circumscripta involving the lip in a child with recurrence.

Satisfying outcome of vagus nerve stimulation applied in the treatment of a patient with drug-resistant epilepsy caused by periventricular nodular heterotopia

Introduction. Periventricular nodular heterotopia (PNH) is a developmental malformation of the cerebral cortex characterized by abnormal migration of neurons into the cortical plate and is often associated with drug-resistant focal epilepsy. Case report. A 33-year-old female patient suffered from drug-resistant epilepsy, which was predominantly characterized by focal seizures, with occasional seizures that had a focal onset and progressed into bilateral tonic-clonic seizures. Magnetic resonance imaging showed bilateral heterotopic nodules in the occipital horns of the lateral brain ventricles. 18-Fluoro-deoxyglucose positron emission tomography ? FDG-PET scan demonstrated a zone of reduced glucose metabolism on the right temporal region. Electroencephalogram suggested focal electrocortical activity on the temporo-parieto-occipital regions, predominantly on the right temporal side. The woman was treated with polytherapy (valproic acid, lamotrigine, levetiracetam, oxcarbazepine, pregabalin, clobazam, and lacosamide), but it did not affect the seizure frequency. Due to the bilateral localization of the heterotopic nodules, surgical treatment was not recommended. After a multidisciplinary assessment, we decided on vagus nerve stimulation (VNS) and achieved satisfying seizure control. Conclusion. Patients with PNH require multidisciplinary assessment and treatment, while in this report we have a case of a patient in whom satisfying control of drug-resistant epilepsy was achieved after the implantation of the VNS device.

A Rare Case of Two Superior Vena Cava with Two Azygos Veins in a Cadaver

In embryonic life developmental malformation of thoracic veins can lead to anomalies of the Superior vena cava and major thoracic veins like Azygos system. Double superior vena cava and double azygos vein are rare congenital anomaly with the incidence of 0.3%. These types of congenital anomalies may or may not be presented with clinical symptoms. This case was noted during the routine cadaveric dissection of thoracic region and heart for medical students in department of Anatomy, we found double superior vena cava (persistent left superior vena cava) along with double (paired) azygos vein in a female cadaver. Right superior vena was formed by the union of right subclavian and right internal jugular vein which receives the arch of right azygos before it opened into the right atrium. Left superior vena cava was formed by the union of left subclavian and left internal jugular vein and it also receives the arch of left azygos vein before it entered into the right atrium. In present case coronary sinus was separated from left persistent superior vena cava and it opened in the persistent left superior vena cava. There was no communication between both the superior vena cava. On right side Azygos vein was normal and open into right superior vena cava. On the left side hemiazygos was in continuation with the accessory azygos vein and it also forming the arch and opened into persistent left superior vena cava. There were no other congenital anomalies present in the heart. These types of congenital anomalies extremely very rare where the left superior vena cava opens into the right atrium directly and coronary sinus opens in to this left superior vena cava. Majority of such types of cases remain asymptomatic. Some cases may be detected accidently during diagnostic or surgical procedures like cardiac angiography, cardiac catheterization, by- pass and dialysis or during autopsy or institutional cadaveric dissection.

Investigation of the effects of metal oxide nanoparticle mixtures on Danio rerio and Xenopus laevis embryos

ABSTRACT In this study, the toxic effects of single TiO2, ZnO and Fe2O3 nanoparticles (NPs) and their binary and ternary combinations on the embryonic development of Xenopus laevis and Danio rerio were evaluated. It was aimed to determine the median lethal concentrations, growth retardation and developmental malformation effects and the effects of mixed nanoparticle exposure to selected enzyme biomarkers resulting from the exposure of embryos to NPs. The results showed that ZnO NPs, which are the most toxic according to the highest lethality level, cause developmental delay and malformations. The Fe2O3 and TiO2 NPs caused growth retardation only in D. rerio embryos. It was determined that double and triple combinations of NPs did not cause significant lethality in both species. Biochemical markers showed that mixed NPs could lead to greater toxicity compared to single exposures. The results also revealed that TiO2 or Fe2O3 NPs caused an increase in toxicity when co-existing with ZnO NP due to additive effects. Overall, the results showed that D. rerio was more susceptible to NP exposure in terms of growth and mortality than X. laevis. However, studies that are more comprehensive are needed to better understand the toxicity mechanism of metal oxide NP mixtures.

Epidermoid cyst of floor of mouth

&lt;p&gt;Epidermoid cysts are developmental malformations which are soft, mobile and slow-growing masses and they are unattached to the overlying skin. The most common cervical location of these cysts is the floor of the mouth without any gender predilection. The following report presents a case on epidermoid cyst and its management and a discussion on various differential diagnoses. This report presents a case with a painless swelling over the floor of mouth with dysphagia, dysarthria and orthopnea. Thorough history and examination of the swelling was done. Preoperative assessment was made with CT imaging. Complete surgical excision of the mass was done via intraoral approach under general anaesthesia with an uneventful recovery period. Swellings over the floor of mouth can be congenital, infectious, inflammatory or tumours. Preoperative evaluation can be done by taking thorough history, examination and radiological imaging. Surgical excision is the treatment of choice for epidermoid cysts with approach based on its relation with the mylohyoid muscle.&lt;/p&gt;

Dendritic spine loss in epileptogenic Type II focal cortical dysplasia: Role of enhanced classical complement pathway activation.

Dendritic spines are the postsynaptic sites for most excitatory glutamatergic synapses. We previously demonstrated a severe spine loss and synaptic reorganization in human neocortices presenting Type II focal cortical dysplasia (FCD), a developmental malformation and frequent cause of drug-resistant focal epilepsy. We extend the findings, investigating the potential role of complement components C1q and C3 in synaptic pruning imbalance. Data from Type II FCD were compared with those obtained in focal epilepsies with different etiologies. Neocortical tissues were collected from 20 subjects, mainly adults with a mean age at surgery of 31 years, admitted to epilepsy surgery with a neuropathological diagnosis of: cryptogenic, temporal lobe epilepsy with hippocampal sclerosis, and Type IIa/b FCD. Dendritic spine density quantitation, evaluated in a previous paper using Golgi impregnation, was available in a subgroup. Immunohistochemistry, in situ hybridization, electron microscopy, and organotypic cultures were utilized to study complement/microglial activation patterns. FCD Type II samples presenting dendritic spine loss were characterized by an activation of the classical complement pathway and microglial reactivity. In the same samples, a close relationship between microglial cells and dendritic segments/synapses was found. These features were consistently observed in Type IIb FCD and in 1 of 3 Type IIa cases. In other patient groups and in perilesional areas outside the dysplasia, not presenting spine loss, these features were not observed. In vitro treatment with complement proteins of organotypic slices of cortical tissue with no sign of FCD induced a reduction in dendritic spine density. These data suggest that dysregulation of the complement system plays a role in microglia-mediated spine loss. This mechanism, known to be involved in the removal of redundant synapses during development, is likely reactivated in Type II FCD, particularly in Type IIb; local treatment with anticomplement drugs could in principle modify the course of disease in these patients.

Research progress of persistent hyperplastic primary vitreous with Peters anomaly

Persistent hyperplastic primary vitreous is a rare congenital ocular developmental malformation caused by the failure of regression of the primary vitreous during the embryonic development period. Peters anomaly is a monogenetic disease of congenital anterior segment dysgenesis. Recent studies have shown that these two diseases may occur concomitantly and be associated with a variety of systemic abnormalities. This review demonstrates the basis of ocular embryonic development, research status of molecular genetics, clinical manifestations, surgical objectives and progress of treatment of persistent hyperplastic primary vitreous with Peters anomaly, in order to provide guidance for clinical practice and research as well as to promote further progression of related gene detection.

Hyaline Protoplasmic Astrocytopathy in the Setting of Epilepsy.

Cerebral hyaline protoplasmic astrocytopathy (HPA) is a clinicopathologic entity characterized by eosinophilic cytoplasmic inclusions within astrocytes. It has been observed in a subset of patients with early-onset epilepsy, brain malformations, and developmental delay. The exact association of this entity with epilepsy is still unknown. This report, with its review of the literature, aims to summarize HPA features to raise awareness regarding this entity. We report on 2 HPA cases and critically review the literature. Approximately 42 cases of HPA have been reported, including the 2 cases presented here, consisting of 23 female and 19 male patients. Patient age ranged from 3 to 39 years. All patients had early-onset seizures (3-20 months of age), ranging from partial to generalized, that were refractory despite treatment with antiepileptic drugs. Postoperative follow-up intervals ranged from 2 to 93 months, and the clinical outcome was graded according to the Engel classification, showing variable results. Clinicians should consider HPA in differential diagnosis in patients with intractable seizures, especially when they are associated with developmental delay and brain malformations. Increasing awareness of this entity among pathologists may promote better understanding of this condition as well as better diagnosis and treatment for these patients.

Outcome of Newborns with Tracheoesophageal Fistula: An Experience from a Rapidly Developing Country: Room for Improvement.

This is a retrospective review of the medical electronic charts of patients with TEF that were followed at Sidra Medicine in the state of Qatar. The review included the patients who were operated upon in the period of 2011-2021 but continued to follow at our institution in the period of 2018-2021. Demographic data, associated anomalies, preoperative, operative, and postoperative courses, and growth parameters were collected. A total of 35 patients with TEF (24 males and 11 females) were collected. 49% were full term. We identified seven patients (20%) with isolated TEF, TEF with VACTERL association in 29% of our patients, other chromosomal anomalies in 17%, or associated with other anomalies (not related to VACTERL) in 34% of the patients. The majority of the patients (94%) were of type C-TEF (TEF with esophageal atresia-EA/TEF). All patients were operated except for one patient who died at 2 days of life due to cardiac complications. Median age at which surgery was performed was 2 days (range 1-270 days). Median follow-up was 32 months (range 7-115 months). Immediate postoperative complications were encountered in eleven patients (33%) and included anastomosis leak in 12%, air leak in 6%, sepsis in 6%, chylothorax in 3%, vocal cord palsy and fistula recurrence (combined) in 3%, and failure of TEF closure in 3% of the patients. Long-term respiratory complications were encountered in 43% of our patients. Long-term gastrointestinal complications included gastroesophageal reflux (GERD) in 63%, dysphagia in 31%, and anastomotic stricture in 34% of the patients. Growth was affected in around a quarter of the patients at 6 months after surgery and 22% at 12-month assessment postoperatively. While only five patients died at our institution, only one was directly related to failure of TEF closure and postoperative complications. This descriptive study reports the clinical outcome of TEF from a rapidly developing country. The distribution of the patients' characteristics and postoperative complications was almost comparable to those from developed countries. This study would aid in addressing the prognostic factors and establishment of evidence-based management pathways of newborns with TEF to improve the clinical outcome in our center and other pediatric tertiary centers in developing countries.

Multiple hamartomas of the oral cavity with bifid tongue and cleft palate: A unique observation

Background: Hamartomas are developmental tumor-like malformations, comprising a mixture of cytologically mature tissues that are indigenous to their anatomical location. Within the oral cavity, these lesions are usually multifocal, relatively small, and asymptomatic, and have been frequently linked to present as a manifestation of the oro-facial-digital-syndrome. Case Presentation: A 2-day-old female newborn was referred with two masses protruding from the oral cavity, feeding difficulties, and dribbling of milk during feeding. The patient had no dysmorphic features and no obvious associated anomalies. On careful examination, there was one mass protruding from the undersurface of a bifid tongue with another larger mass that seemed to originate from the hard palate. Complete surgical excision of both masses and repair of the bifid tongue were done to relieve the baby’s feeding difficulties. Histopathological examination of both specimens confirmed the diagnosis of multiple hamartomas. Conclusion: The occurrence of multiple and large oral hamartomas in newborns might result in feeding difficulties that necessitate urgent surgical intervention. The association of lingual and palatal hamartomas, with bifid tongue and cleft palate, is a unique observation that is not reported in the English literature.

Compound odontoma: A case report on 42 denticles hodgepodge in maxilla

Compound odontomas are the commonest benign odontogenic tumours of jaws affecting mostly children and adolescents. These developmental malformations display many tooth-like structures or denticles that consist of well-defined dental tissues with diverse morphologies. Majority of these lesions occur as intraosseous masses in the maxillary anterior region and are incidental radiographic findings. These are primarily associated with retention of primary teeth and delayed eruption of permanent teeth. The preferred treatment for these lesions is conservative surgical excision followed by a histopathological diagnosis. This case report presents a rare case of compound odontoma displaying numerous denticles (42 in number) in the maxillary anterior region of a 12-year-old male child and its surgical management.