No abstract

No abstract

Highlights Primary intraosseous carcinoma arising in a dentigerous cyst is a rare observation. There are no clinical or radiological pathognomonic characteristics and the diagnosis is often made fortuitously. A surgical excision with clear margin is the cornerstone of treatment. A systematic and careful microscopic analysis of any cyst, even if look like benign, should be undertaken.

Introduction: Oral metastases are rare and represent only 1% of malignant diseases of the oral cavity, but they are often associated with poor prognosis. The primary tumor is recognizable in most cases; however, in 27.6% of cases, metastasis is the first clinical manifestation. Observation: An 82-year-old consulted for the recent appearance of a 1-cm-wide gingival tumor on 46. Since this patient had metastatic clear cell renal cell carcinoma, oral metastasis was confirmed by histopathology. In the following weeks, other oral metastases appeared. Palliative radiotherapy was the chosen treatment option, but the patient died before he could benefit from it. Discussion: Multiple oral metastases are rare, and metastasis of renal origin is not the most frequently encountered. The metastatic dissemination pathway described is hematogenous or lymphatic. Diagnosis is often easy if the primary tumor is already identified, but is a challenge if it is not, because the lesion often has a nonspecific appearance. Different surgical, radiotherapeutic, and medical therapeutic options exist, but are often palliative. A new immunotherapy route is under development and looks promising in the treatment of renal cell carcinoma. Conclusions: Oral metastasis often has poor prognosis, and management of the lesion is problematic. However, current research suggests a therapeutic and prognostic improvement.

Any patient with a herpes zoster infection of the mandibular branch of the trigeminal nerve should benefit from early oral monitoring, especially in elderly population where traumatic dental prostheses are common, because osteonecrosis can occur.

Introduction: Disseminated intravascular coagulation (DIC) is a complexe systemic disorder characterized by a widespread activation of the coagulation, that may lead to thrombosis, ischemia and finally, end-organ failure. The clinical presentation of DIC depends on the site of intravascular coagulation and the severity of the disease process. Avascular osteonecrosis is a pathological state, that can occur secondary to DIC and where a reduced vascular supply leads to ischemia and bone necrosis. Observation: A 83 years old patient was sent to the oral surgery department for tooth mobility in the premaxilla, following the diagnosis of sepsis and DIC induced acute myeloid leukemia, one month ago. The examination showed an exposed avascular bone behind the 12-11-21. A diagnosis of DIC induced osteonecrosis of the premaxilla was made. A resection surgery was then programmed. Discussion: DIC may generates thrombi that might occlude intraosseous vessels in the premaxilla, and lead to bone necrosis. The maxilla is supplied by multiple branches of external carotide artery, therefore, usually, there is a lower risk of osteonecrosis in the maxilla. Nevertheless, since 1993, 4 cases of avascular necrosis of the maxilla secondary to DIC are repported in literature. Conclusion: This kind of complication, although being rare, can be dramatic for the patient as bone and aesthetic defects. Early support and management of these complications is necessary.

HighlightsMandibular arteriovenous malformation (AVM) are very unusual condition.They remain frequently undiagnosed until a severe bleeding occurs during an oral surgical procedure.This case was a real diagnostical challenge: clinical presentation and initial radiographic examination was atypical.Curently there is no guideline to manage this kind of pathology.

Résumé -Introduction : La maladie de Rendu Osler (MRO) est une maladie génétique autosomique dominante liée à un trouble de l'angiogenèse. Son incidence est en moyenne de 1 pour 5000 habitants. Son diagnostic est basé sur la présence de télangiectasies cutanéo-muqueuses, des épistaxis récidivantes, des malformations artério-veineuses viscérales et un contexte héréditaire. Observation : Le cas d'une patiente atteinte de MRO a été diagnostiqué au cours d'une consultation odontologique de routine. Le bilan a mis en évidence des malformations vasculaires viscérales. Un diagnostic familial a également été réalisé. Discussion : La MRO possède de nombreuses formes cliniques. Un dépistage précoce est indispensable pour détecter les malformations artério-veineuses (MAV). Les MAV peuvent avoir de multiples complications en fonction de leur taille et de leur siège. Le traitement de la MRO se focalise sur les MAV. Les molécules modulatrices de l'angiogenèse constituent une thérapeutique d'avenir. Abstract -Rendu Osler disease revealed by orofacial telangiectasia. Introduction: Rendu-Osler syndrome (ROS)is a development disorder of the vasculature transmitted in an autosomic dominant mode. The average incidence is 1 in 5000 people. The diagnosis is based on skin and mucosal telangiectasia, nose bleeds, visceral arteriovenous malformations (AVM) and a familial history. Observation: We describe the case of a patient who came for a routine oral examination. She was diagnosed with Rendu-Osler syndrome. Visceral vascular malformations were observed. They required supervision. A family diagnosis was also undertaken. Discussion: ROS has many clinical forms. Early detection is essential to detect arteriovenous malformations (AVM). AVM may have many complications, depending on their size and location. The treatment of ROS is directly dependent on the treatment of AMV. Angiogenetic modulating molecules are a future therapeutic option.