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The Pan African Medical Journal 2024Mucin-producing adenocarcinomas (MAC) are an extremely rare, indistinct group of neoplasm having either a salivary gland origin or with prominent glandular component....
Mucin-producing adenocarcinomas (MAC) are an extremely rare, indistinct group of neoplasm having either a salivary gland origin or with prominent glandular component. The diagnosis is chiefly based on the histological aspect conjoined with immunohistochemical evaluation as clinico-radiographical features are non-specific. It can arise as a primary metastasis to soft tissues, most commonly from either lung, breast, kidney, or colon. This paper reports a 51-year-old woman with buccolingual gingival swelling having a final diagnosis of metastatic mucinous adenocarcinoma from the breast. A tissue biopsy was performed followed by immunohistochemistry that confirmed the diagnosis. They are extremely rare, making the diagnosis challenging as it may mimic a benign neoplasm. It accounts for approximately 1% of all oral malignant neoplasms having gingival propensity. The clinician should therefore take into account every diagnostic aspect while encountering such oral lesions to achieve proper patient welfare.
Topics: Female; Humans; Middle Aged; Gingival Neoplasms; Gingiva; Granuloma, Pyogenic; Mouth Neoplasms; Adenocarcinoma, Mucinous
PubMed: 38524106
DOI: 10.11604/pamj.2024.47.14.36983 -
Clinical Case Reports Mar 2024The mainstays of treatment for granuloma pyogenicum include careful evaluation of any penile growth, thorough excision of the polypoid, histological examination, and...
KEY CLINICAL MESSAGE
The mainstays of treatment for granuloma pyogenicum include careful evaluation of any penile growth, thorough excision of the polypoid, histological examination, and close monitoring to check relapse and management.
ABSTRACT
Pyogenic granuloma is an acquired noncancerous vascular proliferation that arises from the mucosa and skin, seldom subcutaneously or intravascularly. It is also referred to as telangiectasis granuloma or lobular capillary haemangioma. The risk factors include vascular abnormalities, medicines, hormones, and microtrauma. We discussed the case of a 24-year-old man who had a poorly managed ventral distal penile polypoid lesion at a peripheral hospital. Upon further histopathological examination, the diagnosis of pyogenic granuloma was made. Histopathologically speaking, the term "pyogenic granuloma" is misleading because the illness is not linked to the production of granulomas. Pyogenic granuloma's etiopathogenesis is still unknown; true hemangioma is thought to be a reactive hyperproliferative of the vasculature brought on by a variety of stimuli; pyogenic granuloma may be caused by uneven angiogenic factor production in response to minor local trauma or cutaneous disease. Histopathological analysis and surgical excision are the methods used for diagnosis and treatment. The mainstay of treatment for granuloma pyogenic granuloma includes careful evaluation of any penile growth, thorough excision of the polypoid, histological examination, close follow-up to check for relapse, and early management.
PubMed: 38464565
DOI: 10.1002/ccr3.8659 -
Cureus Jan 2024Pyogenic granuloma is a reactive lesion that is commonly seen in the skin and oral cavity. Though it is an unfortunate misnomer, being neither pyogenic nor a true...
Pyogenic granuloma is a reactive lesion that is commonly seen in the skin and oral cavity. Though it is an unfortunate misnomer, being neither pyogenic nor a true granuloma, the name has been used for years. In the oral cavity, it presents as a growth mostly situated on the gingiva, but may also occur on the tongue, buccal and labial mucosa, and palate, and may even be seen in relation to dental implants. The lesion is usually bright or purple red in color, soft in consistency, relatively painless, and appears highly vascularized. Local etiologic factors are usually poor oral hygiene or chronic irritation. Histopathologically it is an inflammatory hyperplasia of the connective tissue with exuberant vascularity. Sometimes, this lesion may present with unusual histopathological patterns, which could lead to difficulty in diagnosis. Long-standing pyogenic granuloma may show histologic changes such as localized osteogenesis in the matrix of the lesion which could potentially lead to complications in the area of the lesion. This article reports a rare case with rare histopathological features in an 18-year-old female presenting with long-standing soft tissue gingival growth.
PubMed: 38410319
DOI: 10.7759/cureus.53021 -
Biomedicines Jan 2024Intussusceptive angiogenesis (IA) and intussusceptive lymphangiogenesis (IL) play a key role in the growth and morphogenesis of vessels. However, there are very few...
Intussusceptive angiogenesis (IA) and intussusceptive lymphangiogenesis (IL) play a key role in the growth and morphogenesis of vessels. However, there are very few studies in this regard in vessel tumors (VTs). Our objective is to assess the presence, characteristics, and possible mechanisms of the formation of intussusceptive structures in a broad spectrum of VTs. For this purpose, examples of benign and malignant blood and lymphatic VTs were studied via conventional procedures, semithin sections, and immunochemistry and immunofluorescence microscopy. The results demonstrated intussusceptive structures (pillars, meshes, and folds) in benign (lobular capillary hemangioma or pyogenic granuloma, intravascular papillary endothelial hyperplasia or Masson tumor, sinusoidal hemangioma, cavernous hemangioma, glomeruloid hemangioma, angiolipoma, and lymphangiomas), low-grade malignancy (retiform hemangioendothelioma and Dabska tumor), and malignant (angiosarcoma and Kaposi sarcoma) VTs. Intussusceptive structures showed an endothelial cover and a core formed of connective tissue components and presented findings suggesting an origin through vessel loops, endothelialized thrombus, interendothelial bridges, and/or splitting and fusion, and conditioned VT morphology. In conclusion, the findings support the participation of IA and IL, in association with sprouting angiogenesis, in VTs, and therefore in their growth and morphogenesis, which is of pathophysiological interest and lays the groundwork for in-depth molecular studies with therapeutic purposes.
PubMed: 38397861
DOI: 10.3390/biomedicines12020258 -
Cureus Jan 2024The oral cavity is frequently affected by gingival pyogenic granuloma (PG), a benign tumor that is known for its quick growth and tendency to hemorrhage. The clinical...
The oral cavity is frequently affected by gingival pyogenic granuloma (PG), a benign tumor that is known for its quick growth and tendency to hemorrhage. The clinical presentation, diagnostic procedure, and treatment of a patient with gingival pyogenic granuloma are all detailed in this case study. A female individual aged 25 years in otherwise good condition arrived with a sessile gingival tumor in the anterior mandibular region that was expanding quickly. During dental hygiene procedures, there was intermittent bleeding and discomfort related to the lesion. Based on histology analysis and clinical examination, PG was diagnosed. The course of treatment included surgical excision followed by a histological analysis to ensure total eradication. Appointments for follow-up revealed adequate healing and no indications of recurrence. This case study aims to demonstrate the need for prompt diagnosis, appropriate treatment, and diligent follow-up to effectively manage gingival pyogenic granuloma. Dental professionals can better treat patients and achieve better results with a thorough understanding of this common oral lesion and its management.
PubMed: 38357065
DOI: 10.7759/cureus.52273 -
Ear, Nose, & Throat Journal Feb 2024To perform a systematic review of published cases of nasal lobular capillary hemangioma (LCH) during pregnancy. PubMed, Embase, Scopus, Web of Science, and LILACS. We...
To perform a systematic review of published cases of nasal lobular capillary hemangioma (LCH) during pregnancy. PubMed, Embase, Scopus, Web of Science, and LILACS. We searched electronic databases from inception to June 30, 2022. Case report and case series that reported clinical data on nasal LCH during pregnancy were included. Categorical variables were expressed as proportions and numerical variables as mean ± standard deviation or median (interquartile range). Twenty-three studies (20 case reports and 3 case series) involving 29 patients were included. The mean age was 30.5 ± 5.3 years. A total of 62% cases were diagnosed in the third trimester of pregnancy. The most frequent (62%) location of LCH was the nasal septum. All cases presented with epistaxis. A total of 48% cases were treated by surgical excision after delivery and the recurrence was 11%. Our review shows that nasal LCH during pregnancy usually manifests in the third trimester. This lesion can be treated by surgical excision with a relatively low risk of recurrence.
PubMed: 38345001
DOI: 10.1177/01455613241230218 -
Journal of Clinical Medicine Jan 2024The period of pregnancy is characterized by a multitude of diverse changes that exert a notable impact on the oral cavity of women. During this gestational phase,... (Review)
Review
The period of pregnancy is characterized by a multitude of diverse changes that exert a notable impact on the oral cavity of women. During this gestational phase, patients necessitate tailored oral care and specific recommendations to preempt and address potential oral diseases. This systematic review aimed to perform a detailed analysis of the research studies that focused on the oral manifestations observed in pregnant women. A meticulous search was conducted in the databases Medline, Scopus, and Scielo by employing the following search terms: ((pregnant OR pregnancy)) AND (("oral manifestation*") OR ("oral health")). Articles that were published between 2013 and 2023 and written in English or Spanish and studies that scrutinized oral manifestations in pregnant women and included a diagnosis conducted by a qualified dentist were selected; we excluded articles published before 2013, articles that could not be accessed in full text, studies whose patients were not pregnant women at the time of the study, studies where patients were selected because they had a specific disease, studies where the clinical examination was not performed by a dentist, and articles written in languages other than English or Spanish. Subsequently, the risk of bias in the chosen articles was assessed in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) scale. A total of 20 studies were included in the analysis, following the exclusion and inclusion criteria. These studies were categorized as cross-sectional, cohort, longitudinal, or case-control. Various oral manifestations in pregnant women were examined, with five studies comparing these manifestations with those observed in nonpregnant women. The most prevalent oral manifestations associated with pregnancy encompass dental caries, periodontitis, gingivitis, pyogenic granuloma, and candidiasis. Nonetheless, less common lesions may also emerge during the course of pregnancy.
PubMed: 38337401
DOI: 10.3390/jcm13030707 -
International Journal of Surgery Case... Mar 2024Ocular surface squamous neoplasia (OSSN) may have atypical or unusual presentations and may attain large sizes especially in cases of delayed presentation resulting in...
Variable presentations of six conjunctival/limbal ocular surface squamous neoplasia (OSSN) cases: How good is our clinical judgment evidenced by the correlation to the histopathological findings and diagnosis?
INTRODUCTION
Ocular surface squamous neoplasia (OSSN) may have atypical or unusual presentations and may attain large sizes especially in cases of delayed presentation resulting in late diagnosis, treatment, and eventual guarded visual prognosis. We are reporting an interesting cases series of OSSN with variable clinical presentations to highlight the importance of the pre-operative clinical judgment and tissue diagnosis.
PRESENTATION OF CASES
Six patients (4 females and 2 males; mean age 59 years; range 42-79 years) were included with suspicious conjunctival lesions. The maximum dimension of the lesions was 17 mm. The initial suspected pre-operative clinical diagnosis -other than OSSN- included pterygium/pinguecula (n = 2), benign squamous papilloma (n = 1), cyst versus pyogenic granuloma (n = 1), and lymphoma (n = 1). This work has been reported in line with the PROCESS criteria.
DISCUSSION
The final histopathological diagnosis was unexpectedly invasive squamous cell carcinoma (SCC) in 4, one SCC in-situ, and squamous dysplasia in one. The primary treatment included MMC 0.02 % for 2 cycles for chemo-reduction in one of the cases where OSSN was suspected. Excisional biopsy was performed eventually for all lesions with application of one or more of the following modalities: MMC 0.02 %, absolute alcohol 99 %, and cryotherapy to the conjunctival margin. No tumor recurrence was noted in any of the patients after an average period of follow-up of 26 months. Even though the outcome was good, tumor-related morbidity and delay in the referral by general ophthalmologists are to be considered.
CONCLUSION
Conjunctival OSSN has wide presentation clinically and can be challenging in terms of diagnosis. Histopathological evaluation is essential for a definitive diagnosis and treatment. Accurate clinical diagnosis might affect the management plan with consideration for topical therapeutic modalities, however, these cases are best managed by wide excision using the no-touch technique and double-freeze-thaw cryotherapy to the conjunctiva with consideration of topical chemotherapy.
PubMed: 38330700
DOI: 10.1016/j.ijscr.2024.109359 -
Clinical, Cosmetic and Investigational... 2024Acquired digital fibrokeratoma (ADF) is rare in clinical practice and is easily misdiagnosed. Herein, 5 cases of patients (3 males and 2 females) with ADF are reported....
Acquired digital fibrokeratoma (ADF) is rare in clinical practice and is easily misdiagnosed. Herein, 5 cases of patients (3 males and 2 females) with ADF are reported. The mean age at onset was 42.6 years, and the mean disease duration was 3 years. Four patients had ADF on the hands, and 1 patient had ADF on the foot. The clinical manifestations were all solitary, skin-colored papules, with a firm texture and smooth surface, protruding from the skin surface. In 3 patients, ADF manifested as columnar protrusions, and in 2 patients, ADF manifested as dome-shaped protrusions. For all 5 patients, the diameters of the lesions were <1 cm. Clinically, all 5 patients were misdiagnosed (ie, eccrine poroma (EP), common warts, rudimentary polydactyly, pyogenic granuloma (PG), and acral fibroma). All cases of ADF were confirmed by histopathology. The histopathological manifestations of ADF were as follows: finger-like protrusions on the skin surface; collagen fiber bundles running vertically to the epidermis seen in the dermis; and thick red-stained collagen fibers connected with the normal dermal connective tissue below. All 5 patients underwent surgical resection; the distance between the incision margin and the edge of the tumor was 2-3 mm, and the surgical depth was the deep dermis. No recurrence was observed in more than half a year of follow-up after surgery.
PubMed: 38314146
DOI: 10.2147/CCID.S447798 -
Medicina Oral, Patologia Oral Y Cirugia... Mar 2024Collagen is a component of Pyogenic Granuloma (PG) and Peripheral Ossifying Fibroma (POF) and performs different functions in these lesions. The objective of this study...
BACKGROUND
Collagen is a component of Pyogenic Granuloma (PG) and Peripheral Ossifying Fibroma (POF) and performs different functions in these lesions. The objective of this study is to evaluate the role of collagen and immunostaining for Transforming Growth Factor beta (TGF-β) in the clinical and microscopic findings of PG and POF.
MATERIAL AND METHODS
PG (n=20) and POF (n=20) were selected for clinical evaluation (sex, age, localization, size and evolution time) and microscopic analysis (picrosirius red staining for collagen analysis and immunohistochemistry for TGF-β) performed in the superficial and deep areas of the two lesions. ANOVA/Bonferroni and t-test, Pearson correlation and χ2 were used to compare the sites and parameters analyzed (p<0.05, GraphPad Prism 5.0).
RESULTS
The depth of PG presented the highest amount of collagen (p<0.001), and its surface showed the lowest amount of type 1 collagen (yellow-red strong birefringence). Type 1 collagen gradually increased in depth of PG, surface and depth of POF (p<0.001). The number of TGF-β+ cells was lower on the surface of PG compared with the depth of PG and the two areas of POF (p<0.001). Sex and localization did not affect these parameters, but the profile of collagen and immunostaining for TGF-β suffered from modifications by the time of evolution and the size of the lesion.
CONCLUSIONS
Although PG and POF are reactive gingival lesions, the expression of TGF-β and its role in collagen showed different biological behaviors in these lesions, suggesting different biological origins for its components.
Topics: Humans; Fibroma, Ossifying; Collagen Type I; Granuloma, Pyogenic; Collagen; Gingival Neoplasms; Transforming Growth Factor beta
PubMed: 38288849
DOI: 10.4317/medoral.26268