Mass In Oral Cavity Research Articles

Rhinosporidiosis Presenting as a Large Oral Cavity Mass: A Case Report

Rhinosporidiosis Presenting as a Large Oral Cavity Mass: A Case Report

Large cell neuroendocrine carcinoma of oral cavity: A rare case report with review of literature

Abstract Neuroendocrine tumours (NETs) primarily affect the lungs and larynx. Primary neuroendocrine carcinomas (NECs) rarely occur in the oral cavity. The classification of these tumours is ambiguous; however, the literature acknowledges their aggressiveness. Merkel cell carcinoma (MCC) is rare and more common in the skin but could occur intraorally. MCC and NECs are aggressive neoplasms and recommend intensive treatment. In this case report, a 22-year-old female presented with an ulceroinfiltrative lesion in the left buccal mucosa of the cheek, which was diagnosed as primary NEC in the oral cavity. This patient underwent wide local lesion excision of oral cavity mass, ipsilateral selective neck node dissection of levels 1–4 and postoperative chemotherapy. This aggressive tumour type requires large local excisions with margins like Merkel cell skin carcinomas. To our knowledge, this is the youngest oral cavity primary neuroendocrine cancer patient to date in the literature.

Congenital Epulis in a Neonate: A Rare Cause of Oral Cavity Mass

Background: Congenital epulis is a benign tumor of the oral cavity, rarely seen in newborns. Clinical Description: A term, female neonate presented soon after birth with a 5 cm × 3 cm × 2.5 cm, firm, lobulated, noncompressible, nonfluctuant oral cavity mass, arising from the right maxillary alveolar ridge with a pedunculated base. Management and Outcome: The lesion posed an obstacle to the establishment of breastfeeds or paladai feeds along with the potential to compromise the airway for which the mass was excised in toto under general anesthesia. Histopathology revealed a lining of stratified squamous epithelium, large polygonal cells with abundant granular, eosinophilic cytoplasm, and a prominent vascular stroma with no evidence of malignancy suggesting the diagnosis of congenital epulis and immunohistochemistry confirming the same. Conclusion: Congenital epulis are rare tumors of the oral cavity which have excellent results if resected early.

Mature Cystic Oral Teratoma in a Neonate- A Case Report.

Neonatal oral cavity masses present complex diagnostic and management challenges, often involving respiratory distress. We present a case of a 1-day-old male neonate with an oral cavity mass and respiratory distress, whose antenatal scan revealed polyhydramnios and a nasopalatine cyst. Clinical examination revealed a 5 * 5cm cystic swelling arising from the right hard palate. CT scans confirmed an intraoral cystic lesion with a complete cleft palate and excluded oropharyngeal/neck extension. Aspiration of cystic fluid facilitated surgical excision, leading to a histopathological diagnosis of mature cystic teratoma. Primary closure of the soft palate defect was performed. Histopathological examination revealed it to be mature cystic teratoma. This case underscores the intricate interplay between antenatal imaging, clinical assessment, and surgical intervention in managing neonatal oral cavity masses. The successful excision and histopathological confirmation of a mature cystic teratoma highlights the significance of accurate diagnosis and timely intervention. The complexities surrounding neonatal oral cavity masses necessitate a comprehensive approach to optimize patient outcomes.

Metastatic Lung Adenocarcinoma to the Oral Cavity

Primary oral neoplasms are relatively common. They tend to have positive neck adenopathy at presentation. Metastatic deposits are rare, and mainly reported to the soft tissue of the oral cavity and to the jawbones. The possible primaries include gastrointestinal and genitourinary tracts. We report a case of an oral cavity mass with initial complaint of toothache and neck swelling with multiple neck nodes. Biopsies taken from the left retromolar trigone and supraclavicular lymph node revealed poorly differentiated metastatic adenocarcinoma. Computed tomography scan suggested primary lung cancer. Early detection of lung cancer should be the clinician’s concern. The presence of an oral mass already indicates a late stage of lung cancer with poor prognosis.

Tongue Schwannoma, an Uncommon Oral Cavity Mass

Schwannomas are benign tumors arising from the Schwann cells, located in the peripheral nerve sheath. The incidence of tumor in the oral cavity is <1%, and the tongue is the most prevalent place in that area. A 32-year-old Hispanic female was sent from the otolaryngology department with a diagnosis of an oral mucocele in the oral cavity floor, after 8 months complaining of dysphonia and dysphagia. Physical examination reveals a submucosal mass in the anterior and ventral portion of the tongue. After characterization with magnetic resonance and biopsy guided by tomography, she underwent surgical management, with no complications. Tongue schwannomas are often misdiagnosed based on their very low incidence. A proper approach including a good physical examination, imaging and histological characterization of the lesion, and proper surgical management of this entity, will lead to cure this condition, with a low relapse rate.

AN INTRIGUING CASE OF LARYNGEAL FIBROLIPOMA - CASE REPORT AND REVIEW OF LITERATURE

Although fibrolipomas are common benign mesenchymal tumors and are frequently found in trunk and limbs, their occurrence in head and neck is rare and still rarer is their endolaryngeal presence. They may cause clinical dilemma due to their rarity and varied clinical presentations from progressive dysphagia to acute airway obstruction. We present a case of laryngeal fibrolipoma in an adult Indian male who presented with progressive obstructive sleep apnea and sudden appearance of a mass in oral cavity which was removed via transoral endoscopic approach. Keywords– Fibrolipoma larynx, lipoma, obstructive sleep apnea, transoral excision

Clinical and Complementary Diagnosis of Sinus Neoplasia in Horses

Background: Sinus neoplasms are reported as low frequency in horses. Its clinical characteristics are often nonspecific, depend on complementary methods for diagnosis, and when diagnosed, generally they are already advanced, limiting therapeutic possibilities. The objective of this case series was to detail clinical aspects and complementary exams for sinus neoplasms for early diagnosis, comparing them with the literature.Cases: Four horses were treated at the College of Veterinary Medicine and Animal Science of the University of São Paulo, with different clinical signs and previous diagnoses, which when evaluated by respiratory endoscopy, radiography, oral cavity evaluation and histopathological exams, revealed the diagnosis of anaplastic carcinoma, poorly differentiated carcinoma, ossifying fibroma and lymphoma. Previous diagnosis, based mainly on clinical signs, were sinusitis secondary to apical infection, ethmoidal hematoma, sinus cyst and sinusitis secondary to periapical disease. The cases of anaplastic carcinoma (case 1) and lymphoma (case 4) presented with an advanced degree of the disease with involvement and destruction of paranasal structures and adjacent tissues, in addition to a poor general condition, which made surgical treatment impossible and led to euthanasia. In these cases, previous treatment was made to apical infection and periodontal disease with secondary sinusitis, but negative evolution led to suspicion of neoplasia, confirmed by histopathological exam of incisional biopsy of the mass in oral cavity. Benign ossifying fibroma (case 3) presented with progressive respiratory difficulty due to occlusion of the lumen of some nasal meatus and radiographic signs of invasion and deformation of the adjacent bones, it was submitted for surgical excision and there was no recurrence until hospital discharge. The poorly differentiated carcinoma (case 2) was a multilobulate neoformation in the ethmoidal region, similar to ethmoid hematoma in endoscopic and radiographic evaluation, it was submitted for excision and two sessions of electrochemotherapy with bleomycin, associated with administration of piroxicam, which obtained a good result until the period of 1 year after discharge.Discussion: It was found that many characteristics are common with these types of neoplasms, and the clinical signs, such as nasal secretions, airway obstruction, increased facial volume, severe alterations in oral cavity, although unspecific, suggest the differential diagnosis for neoplasms. It is important to differentiate from other diseases noting the evolution and growth of these tumors, like in cases 1 and 4, especially the growth to internal tissues, using complementary methods described here, like endoscopic and radiographic examination. Late identification or even manipulation of neoplasms, without proper diagnosis, leads to a few prognoses regarding life. When it is possible to perform surgical excision, complementary methods are important to guide the procedure, and definitive diagnosis is made through histopathologic exam and some need immunohistochemistry analysis. Cases 2 and 3 had surgical access, were submitted to excision and treatment with good results, both with close monitoring in first months and prolonged quality of life. These results highlight the importance of complementary methods for early diagnosis, correct intervention and monitoring of evolution.Keywords: sinus neoplasia, paranasal sinus, tumor, head, horses.

Mucocutaneous presentation of Kaposi sarcoma of rapid growth in a young male with HIV infection.

A 26-year-old male with a medical history of risk sexual behavior, is brought to the Emergency Room (ER) with complaints of dyspnea associated with an oral cavity mass. At the interrogation, he referred that the symptomatology started 2 months ago with a lesion of approximately 1cm, originated from the upper gum. Patient also reported dysphonia, and dysphagia due to the expansion of the mass, and a weight loss of 10 kilograms. At physical examination a purple-black colored mass was identified coming from the oral cavity (A), including the upper gums with extension into the palate, reaching the uvula (B), the mass had exophytic margins, no tenderness at palpation with a fetid smell, multiple maculopapular violaceous lesions of approximated 1cm located in the neck, thorax and upper extremities. At palpation, bilateral cervical and inguinal adenopathies were detected, blood pressure within range, tachycardic, tachypneic but with oxygen saturation of 94% at room-air and a body temperature of 36.8°C. The laboratory tests reported anemia and thrombocytopenia, hyponatremia and an antigen-antibody test positive to HIV. A skin biopsy from skin violaceous lesions in forehead reported a positive result for Human Herpes Virus 8, within the next 48 hours the patient started with fever and hypoxemia (So2 84%), antibiotic therapy was started with levofloxacin under suspicion of bacterial pneumonia, within the next day the patient presented hemoptysis; thus, a bronchoscopy was ordered. During the bronchoscopy the patient exhibited hypotension, despite intravascular fluid resuscitation; the patient entered cardiac arrest with no response to cardiopulmonary resuscitation.

Complete atrioventricular block as an initial manifestation of recurred oral cavity cancer: a case report

BackgroundIntracardiac invasion of head and neck cancer is extremely rare. Here, we report a case of recurred oral cavity cancer presenting with complete atrioventricular (AV) block caused by cardiac metastasis.Case presentationA 70-year-old male presented with dizziness for 2 days. He had a history of oral cavity cancer a year ago, and the tumor was treated by surgical excision after induction chemotherapy and concurrent chemoradiation therapy. Electrocardiography showed complete AV block with ventricular escape rate of 43 beats per minute. Cardiac imaging revealed about 4.0 × 2.0 cm-sized mass invading interventricular septum and AV nodes and protruding into the right ventricle. Magenetic resonance imaging of head and neck demonstrated recurred mass in oral cavity and maxillary sinus. Fluorodeoxyglucose-positron emission tomography showed hypermetabolic lesion in both oral cavity and the heart around interventricular septum and atrioventricular node indicating recurred oral cavity cancer with cardiac metastasis. Permament pacemaker of DDD type was implanted for the symptomatic complete AV block, and palliative chemotherapy was initiated.ConclusionThe present case demonstrated that oral cavity cancer can metastasize to the heart, and complete AV block may be an initial manifestation of the recurrence of extracardiac cancer with intracardiac invasion.

Congenital Epulis of the Newborn: A Case Report

Background: Congenital epulis (CE) also known as congenital granuler cell tumor is a rarely encountered pathology the majority of which originates from the gingival mucosa, particularly the anterior portion of the maxillary alveolar ridge. CE mostly seen in girls. CE with unclear histogenesis and etiology is seen at birth as a solitary mass in oral cavity. Apart from non-congenital epulis, it contains granular cells. So lesion is named congenital granular cell tumor. CE has a benign histopathology and after surgery there is no recurrence reported in the literature. Aim: The purpose of this case report, is to present, 5 day-old female neonatal girl who was seen CE on the left maxillary alveolar ridge on the region of the future incisors. Case Presentation: The tumoral lesion was well-circumscribed and 10 mm in diameter, smooth surfaced and red in colour much like alveolar mucosal tissue. Tumoral lesion was affecting oral feeding due to obstruction. Excisional biopsy was performed under topical anesthesia. The histopathology was reported as congenital epulis. During the 4 months follow-up, we have seen no complication. Conclusion: CE is a neonatal congenital tumor which is very rare. The treatment of CE is surgical excision. Unless the early treatment is not executed, tumor may cause difficulties in oral feeding and respiration. Therefore it should be excised in an early period.

Computed tomography and magnetic resonance imaging of maxillofacial lesions in renal osteodystrophy.

This study aims to describe the computed tomography (CT) and magnetic resonance (MR) imaging appearance of maxillofacial lesions in renal osteodystrophy. We retrospectively reviewed the CT and MR imaging of maxillofacial region in 9 patients (6 females and 3 males with mean age of 31 yr) with renal osteodystrophy. They presented with facial swelling (n = 6), facial disfigurement (n = 2), and oral cavity mass (n = 1). They underwent CT and MR imaging of the maxillofacial region. Brown tumors (n = 6) were seen in the mandible (n = 4) and maxilla (n = 2). They appeared as mixed lytic and sclerotic (n = 4) and sclerotic (n = 2) lesions at CT. The lesions appeared as hypointense at T1-weighted images and of mixed signal intensity at T2-weighted images with intense contrast enhancement (n = 6). Uremic leontiasis ossea (n = 2) appeared at CT as diffuse hyperostosis with protruded maxilla and obliterated sinus. At MR imaging, there was expansion of the maxilla with obliteration of the maxillary sinuses and protrusion of the mandible. The lesion exhibited low signal intensity at T1-weighed images. At T2-weighted images, the lesion showed low signal intensity with small hyperintense lesions. Dystrophic calcification (n = 2) was seen in the parotid and the check. We concluded that CT and MR imaging are helpful for diagnosis and treatment planning of maxillofacial lesions of patients with renal osteodystrophy.

Primary extranodal non-Hodgkin's lymphoma of oral cavity--a single centre retrospective study.

Extra nodal involvements of non-Hodgkin's lymphomas (NHL) are not so uncommon, but the involvement of oral cavity by NHL is very rare. The present study involved retrospective analysis of patients from year 2001 to 2011, who presented with oral mass and on evaluation were diagnosed to have primary extranodal NHL of oral cavity at a tertiary cancer care centre in South India. There were seven patients treated for primary NHL of oral cavity at our institute in last 10 years. The median age at presentation was 43.2 years (range 29-65 years). There were five males and two females. Oral tongue was the most common site (three patients) followed by alveolus (two patients). The other sites of involvement included gingivobuccal sulcus in one patient and hard palate in one patient. All patients were initially evaluated at oral oncology department for gradually increasing ulcerative mass in oral cavity. None of the patients had B symptoms. In our study, plasmablastic lymphoma was the most common type of NHL, followed by diffuse large B cell lymphoma (DLBCL) and peripheral T cell lymphoma, not otherwise specified (PTCL, NOS). Out of seven patients, two were HIV positive, both having plasmablastic lymphoma. Four out of the seven patients received a combination of chemotherapy and radiotherapy and three patients received only chemotherapy. Only three patients could complete the prescribed chemotherapy and radiotherapy schedule and were alive and diseases free with a median follow-up of 21 months. Involvement of oral cavity by lymphoma is rare. Plasmablastic lymphoma was the most common oral cavity NHL in our patients. Although number of cases in present study was less, our data suggests that oral NHL has aggressive course with less favorable outcome. Further large sample studies incorporating rituximab-based chemotherapy and more aggressive chemotherapy for plasmablastic lymphoma will be helpful for better understanding of treatment outcome.

Plasmablastic lymphoma in an elderly immunocompetent patient

Plasmablastic lymphoma (PBL) is a distinct type of diffuse B cell lymphoma that typically occurs in the oral cavity of patients with HIV infection or immunodeficiency status. PBL is characterized by its plasmablastic morphology and an immunophenotype indicative of a plasma cell differentiation. We present a case of a 75-year-old HIV-negative and Epstein-Barr virus (EBV)-negative patient presenting with an isolated oral cavity mass. The tumor consisted of a monotonous proliferation of undifferentiated large cells with relatively abundant cytoplasm, eccentrically located round nuclei with prominent nucleoli and numerous mitoses. Immunohistochemically, these cells were negative for CD45 and B cell antigens, while they showed diffuse positivity of CD138 and focal staining for epithelial membrane antigen (EMA), indicating plasma cell differentiation. Based on these histopathological and immunohistochemical characteristics, we diagnosed it as PBL. The patient received chemotherapy and is alive with locally persistent disease 3 years after diagnosis. To date, only several cases of oral PBL have been reported in HIV-negative, EBV-negative and immunocompetent patients. PBL should be included in the differential diagnosis of oral mass lesions and careful evaluation of the morphology and awareness of the existence of this uncommon type of lymphoma can lead to a correct diagnosis.

Chronic Hyperplastic Polypoid Tonsillitis

ABSTRACTChronic tonsillitis is commonly seen in children. Tonsillitis presenting as unilateral pedunculated mass in oral cavity and leading to obstruction of airway is very rare. We report a patient who presented with mass in oropharynx measuring 5 × 2 × 1 cm and review of literature, management and implication of this benign lesion.How to cite this articlePatil VM, Kustagi AV, Patil RM. Chronic Hyperplastic Polypoid Tonsillitis. Int J Otorhinolaryngol Clin 2012;4(3):160-161.

A Case of Alveolar Soft Part Sarcoma in Floor of Mouth Mimicking Ranula

Alveolar soft part sarcoma (ASPS) is a rare, aggressive mesenchymal malignancy that comprises of approximately 1% of all soft tissue sarcomas. About 60 cases of ASPS arising in the head and neck have been reported, with most of them occuring in the orbit and tongue. An ASPS found in the mouth floor is extremely rare, with only one single case reported in eng lish literature. Because of its rarity and slow growing feature, it can be misdiagnosed as a benign oral cavity mass or a vascular neoplasm. We herein report a new case of mouth floor ASPS, which mimicked a ranula in a child. In our patient of 12 year-old girl, tumor was located at the floor of mouth. She was successfully treated with surgical excision without adjuvant radiation or chemotherapy.�

Lymphangiomatous polyp of the tonsil

Lymphangiomatous polyps are non-neoplastic developmental lesions comprised of tissue elements native to the nasopharynx and categorised as hamartoma. Lyphangiomatous polyp of tonsil is a kind of hamartomatous lesion that has been described by different nomencultures such as lymphangietatic fibrous polyp, polypoid lymphangioma of the tonsil, hamartomatous tonsilar polyp, pedunculated squamous papilloma and so on. The pedunculated polyps of the palatine tonsil are relatively rare. Because of the unusual clinical and pathological features of these polyps, pathologists and clinicians alike may have difficulty in classifying them correctly. Various symptoms associated with these polypoid masses are acute tonsillitis, recurrent sore throat, blood in sputum, dysphagia, mass in throat, slowing deglutition and lump in throat. Microscopically, it is lined by squamous epithelium and its stroma is composed of variably loose or more dense collagenous tissue and adipose tissue, usually containing dilated lymphatic channels and various components of lymphoid tissue. In this report we present our experience on a case of lymphangiomatous polyp of tonsil. A 32-year-old woman was admitted to Imam Reza Hospital with a polypoid and painful oral cavity mass on the upper lobe of the right pharyngeal tonsil which had been present for 2 months. The patient underwent a right tonsillectomy. She had the following symptoms: recurrent and acute one-sided tonsillitis, recurrent sore throat, sensation of foreign body, halitosis, sleep apnea, shortness of breath and snoring. She was not a smoker with any previous history of surgery or treatment. The physical examination revealed cervical lymphadenopathy. Grossly it was a 2.8 × 2.5 × 1.8cm, firm polypoid mass that was attached to the tonsil. The cut surface was a creamy soft tissue. Histologicaly the polyp was covered by squamous epithelium with hyperkeratosis and its stroma was composed of dialated lymphatic vascular channels, varying amounts of fibrous connective tissues and aggregates of lymphoid tissues.

Metastatic breast cancer of the oral cavity

Objective To present a rare case of breast carcinoma initially presenting as an oral cavity mass. Study design Case report with review of the literature. Results A case is presented of a postmenopausal woman with a remote history of treated breast carcinoma who was declared disease-free 2 years before presentation. She presented with an enlarging vestibule mass consistent with metastatic breast carcinoma. Subsequent investigations revealed widely metastatic disease for which the patient was referred for palliative chemotherapy. Conclusions Metastatic disease to the oral cavity represents only 1% of all oral cavity malignancies. A high index of clinical suspicion is necessary when evaluating patients with a history of non–head and neck carcinoma.

Heterotopic neuroglial tissue presenting as oral cavity mass with intracranial extension

Heterotopic neuroglial tissue is a rare congenital lesion with predilection in head and neck region. We report a case of a newborn who presented with an oral cavity mass with intracranial extension and later respiratory distress that was successfully excised via transcranial and transcervical approach.

The Prenatal Diagnosis of an Oral Cavity Mass

The obstetrical sonography examination includes coronal imaging of facial structures to determine the presence of abnormalities. Enlargement or pathology involving the salivary glands rarely occurs. In this case, a coronal sonographic view between the bottom lip and the tongue showed a mass originating under the tongue. The mass was posterior to the tongue, pushing the tongue superior. Sonography demonstrated the tongue and oral mass extruding forward from the oral cavity. The pathology report diagnosed an enlarged salivary sublingual gland. The sublingual gland is usually the smallest of the four major salivary glands located within the oral cavity.