A 55-year-old male patient was referred to the Department of Oral Pathology, Manubhai Patel Dental College and Hospital and Oral Research Institute, Vadodara, Gujarat, India with a chief complaint of painless growth in the mandibular anterior gingival region since four months. Patient's medical and dental history was noncontributory. Intraoral examination showed an ovoid pigmented growth on the labial gingiva of mandibular anterior region, soft in consistency, grayish black in colour, measuring about 2.6 X 1.7 X 0.8cm. It was sessile, lobulated extending superiorly to the middle third of mandibular central incisors, inferiorly upto the labial vestibule, covering the labial mucosa and extending upto the buccal mucosa in right third molar region. The growth extended to the lingual aspect of mandibular anterior gingival region which was grayish black in colour, soft in consistency measuring about 4.1 X 1.7 X 1.2 cm extending from distal aspect of left mandibular lateral incisor to distal aspect of right lesion was seen covering the mandibular first premolar. The pigmented lesion was seen covering the mandibular marginal gingiva both buccally and lingually and buccal vestibule of the right side extending till the retromolar area [ H&E stained sections of incisional biopsy specimen showed nodular mass of malignant melanocytes invading into the connective tissue. The malignant cells were atypical, hyperchromatic, spindle shaped cells with vesicular, hyperchromatic nuclei and prominent nucleoli. Few mitotic figures were also seen. The cells contained fine melanin granules that appeared brownish in colour. These cells were distributed into sheets and groups in the juxta-epithelial region and mucosa. The overlying epithelium was stratified squamous and showed dysplastic features such as hyperchromatism and loss of polarity 7]. Immunohistochemical staining was performed to confirm the origin of the malignant cells. HMB 45, which is the preferred marker for melanocytes, was used and the cells showed high positivity for HMB 45 marker thus confirming diagnosis of melanoma [Table/ Fig-8].Based on the histopathological features and immunohistochemistry, a confirmatory diagnosis of invasive nodular malignant melanoma was given. DisCussionMelanoma constitutes only 3%-5 % of all cutaneous malignancies, and accounts for most skin cancer related deaths (77%) [1]. Oral melanoma is aggressive neoplasm which accounts for less than 0.5% of all melanomas commonly affecting palate and maxillary gingiva whereas mandible, tongue, buccal mucosa and upper and lower lip are less frequently affected [2,3]. Our patient is one of those rare case with the lesion occurring in the mandibular gingiva. It occurs in adults between 55 and 65 years of age and exhibits a male predilection. In our case also the age and gender of the patient was in accordance with the above mentioned findings [4]. Although there is no racial predilection, Afro-Americans and Asians are more commonly affected than Caucasians [5]. The aetiology of oral malignant melanoma is u...
Background: Fine Needle Aspiration Cytology (FNAC) is simple, quick, inexpensive and minimally invasive technique used to diagnose different types of swellings located in the head and neck.Methods: A prospective study was performed in a tertiary health care centre from January 2016 to September 2016 in Vadodara, Gujarat. Fine Needle Aspiration Diagnosis was correlated with detail of relevant clinical findings and investigation.Results: In this study, total of 260 cases of suspected cervical lymphadneopathy were subjected to cytological evaluation. The lesions cases were broadly categorised as inflammatory lesions, cystic lesions, benign tumor & tumor like conditions, salivary gland lesions and malignant lesions. Out of these 260 cases, 184 cases were given the diagnosis of either inflammatory or benign conditions and rest 76 cases were diagnosed positive for malignancy. Out of 76 cases positive for malignancy, 65 cases gave the diagnosis of Squamous cell carcinoma metastasing to lymphnode. Conclusion:Fine Needle Aspiration Cytology is easy, simple, safe and non invasive procedure for diagnosis of head and neck swelling and easy way for surgeon whether to decide surgery or not.
Introduction In practice, the diagnosis of certain oral lesions must be made by biopsy. A biopsy constitutes an essential diagnostic tool in application to patients with oral pathology. However oral biopsy is not routinely performed in general dental practice. The present study aimed to explore the attitudes of General Dental Practitioners (GDPs) towards oral biopsy for diagnosis of oral lesions in Vadodara city, Gujarat, India. Methodology A questionnaire was distributed to 200 general dental practitioners, consisting of several items addressing the socio-demographic and professional aspects and their attitudes towards oral biopsy procedures. Results Our study showed that 73% of the GDPs do not perform a biopsy on their own. Out of which 32% of GDPs gave the reason of lack of skills and knowledge while 7% of GDPs lacked confidence in performing a biopsy on their own. 28% of the GDPs were not aware of the medium of specimen preservation. Conclusion There is a need for better education and training of GDPs to perform oral biopsy procedures on their own and create awareness among them about the proper referral of the specimen to oral histopathological centers which will aid in accurate diagnosis of the lesions.
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