Unique Clinical Appearance Research Articles

A Unique Clinical Appearance of Upper Maxillary Premolar associated with Dentigerous Cyst: Case Report

During dental development, a variety of hereditary and environmental variables interact to cause dental abnormalities. The etiology may involve multi-tiered, multi-directional, and multi-factorial processes. Fusion is a dental anomaly that happens during tooth development, where two separated teeth bud fuse together to form a single tooth. The morpho-differentiation or histo-differentiation stages of tooth development, genetic and environmental variables can induce developmental dental abnormalities. A clinical resemblance of a "double-headed" maxillary second upper left premolar with two crowns, formed on the both coronal and apical root end or whether it is just a hypercementosis of apical root discovered after surgical extraction and enucleation of cyst. Investigations to confirm such unique findings were performed. This case report discusses the importance of clinical, radiographic and laboratory investigations to confirm the unique appearance of the maxillary second premolar.

Pulp Polyp Exhibiting a Unique Worm-shaped Presentation in an Ectopic Deciduous Tooth: A Novel Case Report

Pulp polyp is a reactive lesion that occurs as a result of chronic long standing caries. Dental caries is common in children for a variety of reasons, including increased bacterial colonisation, frequent exposure to dietary sugars, improper bottle feeding technique, low community water fluoride levels, inadequate tooth brushing, and a lack of parental knowledge about oral health. Failure to treat such carious lesions during childhood will result in chronic long-term caries leading to pulpal necrosis or reactionary proliferations of pulpal tissue known as pulp polyp. Apart from caries, trauma can also lead to hyperplastic behaviour of the pulp. Pulp polyps are most commonly found in the molars due to their abundant blood supply, whereas their presence in the anterior teeth is considered uncommon. Pulp polyp can cause anxiety among parents when they spot it in their child’s oral cavity. This is due to the unique clinical appearance, discomfort while having food and occasional bleeding while irritated. This case report presents an unusual presentation of pulp polyp in an 11-years-old female patient with a chief complaint of pain, discomfort, and bleeding on irritation. Its peculiar worm-shaped clinical appearance in the anterior attached gingival region imposed a diagnostic dilemma which on histological examination was confirmed to be pulp polyp and was excised subsequently. Therefore, emphasises the fact that pulp polyps are not only limited to the occlusal surface of posterior teeth with a typical mushroom-shaped appearance but also have a wide range of presentations regardless of their location and appearance

Congenital hypertrophy of the retinal pigment epithelium

Congenital hypertrophy of the retinal pigment epithelium is a benign pigmented lesion of the posterior pole with a unique clinical appearance. It is flat, round, and has sharp edges. While it is usually black, it may have internal lacunae without pigment. The lesion may also be all hypopigmented. Over many years, the lesions may grow slightly and change their pigmentation. Even though malignant transformation is extremely rare, annual examinations should be performed.

Pityriasis versicolor with a unique clinical appearance

Pityriasis versicolor with a unique clinical appearance

Metastatic Brain Mass Caused by Slow-Growing Small-Cell Lung Cancer: Differential Vascular Endothelial Growth Factor Expression in Primary and Metastatic Tumor

Brain metastasis is a critical complication of small-cell lung cancer (SCLC), resulting in rare long-time survival. We report a case of a 72-year-old man who displayed a very unique clinical appearance, with a large metastatic brain tumor that grew much faster than primary SCLC. The brain tumor expressed high levels of vascular endothelial growth factor (VEGF) that was negative in primary lung tumor. The patient, who underwent brain surgery and chemotherapy against SCLC, has survived for > 2 years with a good performance status since initial brain symptoms occurred. Weak expression of VEGF in primary tumor might be associated with good prognosis. However, VEGF upregulation could occur after metastasis, resulting in aggressive tumor growth.

A case of neglected inverted papilloma with invasion to the skin

Inverted papilloma is an uncommon and locally aggressive benign tumour of the sinonasal region, which tends to recur after surgical resection and is occasionally associated with squamous cell carcinoma. The following report describes the initial history, physical examination, radiological studies, operative and histopathologic reports and differential diagnosis of a case of inverted papilloma with wide extension into the adjacent structures and unique clinical appearance.

Genital porokeratosis: a series of 10 patients and review of the literature

Porokeratosis (PK) is an uncommon disorder of epidermal keratinization with a unique clinical appearance, unknown aetiology, and an unpredictable outcome. Genital PK (defined as localized PK confined to the genital area in this study) is extremely rare and is not well documented. To evaluate the clinical manifestations, histopathology, clinical course and treatment response for genital PK. We reviewed the clinicohistological data from 10 patients with genital PK seen at Chang Gung Memorial Hospital from 1990 to 2005. Seven patients had lesions only in the genital area, and three patients had genital and adjacent areas involved. All patients were male and the mean age at initial diagnosis was 46.0 years (range 36-59). All but one patient presented with pruritic lesions. Three patients (30%) had diabetes mellitus. No malignant transformation was observed. Surgical excision was the most effective treatment if it could be performed. Genital PK appeared more frequently in the Asian population than in reports from western countries. Genital PK presented mostly as pruritic lesions in Taiwan, with a wide age distribution. Long-term follow-up might be needed.

Pityriasis versicolor with a unique clinical appearance

We experienced an atypical case of pityriasis versicolor with a unique clinical appearance and undescribed mycological features. Although Malassezia sp. was cultured from the keratotic material, the fungal elements observed in the material were not readily identified as Malassezia. The diagnosis was established with the aid of immunohistochemical and ultrastructural studies with the aetiological agent being identified as M. globosa.

Varicella-zoster.

Varicella-zoster.

Pityriasis versicolor with a unique clinical appearance

We experienced an atypical case of pityriasis versicolor with a unique clinical appearance and undescribed mycological features. Although Malassezia sp. was cultured from the keratotic material, the fungal elements observed in the material were not readily identified as Malassezia. The diagnosis was established with the aid of immunohistochemical and ultrastructural studies with the aetiological agent being identified as M. globosa.

Inflammatory Carcinoma of the Breast: Characteristic Findings of MR Imaging.

Inflammatory breast carcinoma (IBC) Shows a unique clinical appearance and has an extremely poor prognosis. Although immediate intensive therapy has been proposed, diagnosis of this disease tends to be delayed as its clinical features can be confused with acute mastitis. The conventional imaging modalities including mammography and ultrasonography are of limited value in the diagnosis of IBC, as it is difficult to delineate specific findings of the swollen dense breast. Recently, magnetic resonance (MR) imaging has been widely applied to breast diseases. One of the excellent features of this modality is its diagnostic ability in dense breasts. However, few trials to evaluate the capability of this new modality for IBC have been documented. In recent years, we found that a characteristic feature in 5 cases of IBC was a strong signal on T2-weighted images (T2WI) of MR imaging at the retromammary and subcutaneous area. Pathological features of the retromammary area showed marked interstitial edema and focal lymphatic involvement by tumor cells. These characteristic images obtained by MR imaging may be suggestive of inflammatroy breast carcinoma. Furthermore, subtracted dynamic MR imaging indicated the site of the tumor. Therefore, the application of MR imaging for swollen breasts would assist in the immediate diagnosis of IBC and would contribute to appropriate and timely therapy.

Chondrodermatitis multinodularis anthelicis bilateralis and Its Treatment by Modified Stenström Approach

Chondrodermatitis nodularis helicis is frequently found as a solitary, tender, nodular, unilateral lesion on the upper helical part of the pinna. It affects most commonly white men over the age of 40 and shows typical histopathological findings. The case of a patient with these histopathological characteristics but a unique clinical appearance of bilateral symmetrical multinodular lesions of the anthelix is presented and the treatment described.

Persistent Facial Ulcerations with a Unique Clinical Appearance: Possible Trigeminal Trophic Syndrome

We reported a 53-year-old woman with a persistent facial ulcer which moved gradually from the right marginal portion of the nasal root to the right lateral canthus along the margin of the right lower eyelid. The ulcer healed spontaneously. A similar ulcer developed at the entrance of the right anterior naris. The clinical findings were suggestive of squamous cell carcinoma, deep mycosis, mycobacterial infection, or a related condition. However, no definitive diagnosis could be made from the clinicopathological findings or the laboratory examinations, including bacterial, mycobacterial, and fungal cultures. The characteristic location of the lesion, and course of the disease, however, suggested the diagnosis of trigeminal trophic syndrome.

Giant solitary sebaceous gland hyperplasia clinically simulating epidermoid cyst

We report an unusual case of sebaceous gland hyperplasia manifested clinically as a large solitary intracutaneous nodule, which was at first diagnosed as an epidermoid cyst. Histologically, the nodule consisted of a single large central cavity connected with numerous fully-matured sebaceous glands. We discuss the unique clinical appearance and its histopathological differential diagnosis including sebaceous adenoma, sebaceous trichofolliculoma, organoid nevus and sebaceous gland hyperplasia.