Armoured brain is a rare condition where dense calcification occurs over the brain. It can result in mass effect and raised intracranial pressure. Most often, it happens due to trauma, subdural effusion, infection, or after VP shunt. There is controversy in its treatment. Most published literature does not support removing the calcification. We describe a rare case of idiopathic chronic calcified subdural hematoma with relatively short history which was successfully treated by microsurgical removal of calcification over the brain. This resulted in complete expansion of the brain with relief in symptoms.
Solitary Plasmacytoma (SP) is a rare disease characterized by a localized proliferation of neoplastic monoclonal plasma cells, without evidence of systemic disease. The aetiology of SP remains unknown, but chronic stimulation, overdose irradiation, viruses, and gene interactions in the reticuloendothelial system have been suggested as the etiologic factor. While pain is the most common symptom of osseous mandible SP, it is usually painless in the maxilla and may manifest orally with paresthesia, swelling, soft tissue masses, mobility and migration of teeth, haemorrhage, or pathologic fracture due to cortical destruction of bone. Because the amount of haemopoitic bone marrow in the maxilla is decreased, oral involvement of the maxilla is less common than that of the mandible. A 46-year-old male patient presented with the chief complaint of mobility of his upper left back teeth and swelling over his left-side palatal area. Clinical examination was suggestive of benign odontogenic tumors and salivary gland tumors, while two-dimensional (2D) and three-dimensional (3D) imaging were suggestive of malignant tumors arising from either alveolar bone or maxillary sinus. The laboratory investigations and biopsy revealed solitary plasmacytoma of maxilla. There were clinical symptoms of paresthesia and mobility, but no other signs of malignancy were observed. As the case report concludes, all necessary investigations need to be conducted to exclude all other pathologies, so that treatment can begin as soon as possible.
Salivary Duct Carcinoma (SDC) is a rare typically high grade, aggressive malignancy arising from the ductal epithelium of salivary glands characterised by ductal formations and central necrosis having pathomorphological resemblance to ductal breast carcinoma. Parotid and submandibular salivary glands are the most commonly affected while very few cases involving the minor salivary glands of the palate, labial mucosa, floor of mouth have been reported. This high grade malignancy must be treated aggressively by complete local excision with radical neck dissection and postoperative radiation therapy seems to offer maximum benefit for the patients. This article highlights a case of a 80-year-old male patient having an intra oral ulcer over a swelling which was since 5 years on the left side of upper lip with left submandibular lymph nodes enlargement is reported. An immunohistochemical analysis of the biopsy specimen was carried out which concluded a SDC. The swelling was surgically excised followed by postoperative radiotherapy and adjuvant chemotherapy. The patient was on a regular follow-up for two and a half years without any local recurrence or distant metastasis.
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