Stafne bone defects (SBDs) are asymptomatic mandibular lingual bone depressions mainly caused by soft tissue inclusions. The most common form of SBDs is posterior; the anterior variant of SBD is relatively uncommon. Although posterior SBD is easily diagnosed by the unique location on radiography, anterior SBD is sometimes misdiagnosed and confused with other pathological entities owing to the location. We report herein a case of simultaneous unilateral anterior and posterior SBDs. In the present case, definitive diagnosis for the anterior mandibular cavity was unclear, as in reported cases. Surgical exploration was thus performed for the lesion in the anterior mandibular cavity. Pathologic examination of the removed tissue showed salivary gland with chronic inflammation. Postoperatively, no functional disturbance has been observed. Management of the posterior SBD was conservative, with radiographic follow-up. To the best of our knowledge, this represents the first report of simultaneous unilateral anterior and posterior SBDs.
Mucosa-associated lymphoid tissue (MALT) lymphoma is a type of extranodal marginal zone B-cell lymphoma and is a distinct subtype of non-Hodgkin's lymphoma.Primary MALT lymphomas can also occur in the oral cavity, although their appearance in this location is rare. The neoplastic cells of which MALT lymphomas are composed express B-cell antigens and show monotypic immunoglobulin expression with light-chain restriction.Although neoplastic MALT lymphoma cells do not express CD5, previous studies have shown that CD5 positive MALT lymphomas are more prone to dissemination than those that do not express CD5. Moreover, there are some reports that describe kappa- and lambda- dual light chain expression in B cell malignant neoplasms.A 66-year-old Japanese woman with swelling of the right buccal mucosa was referred to our hospital. The lesion was excised and was pathologically diagnosed as a MALT lymphoma tumor with a t(11;18)(q21;q21) chromosome translocation.Swelling of the right buccal mucosa recurred 2 years later. The recurrent tumor was then excised and pathologically diagnosed as MALT lymphoma.Immunohistochemical examination of CD5, lambda, and kappa expressions revealed that the primary tumor was positive for CD5, kappa, and lambda, but the recurrent tumor was weakly positive for CD5 and kappa.With respect to lambda positivity, the recurrent tumor showed negativity.Our study suggests that immunohistochemical expression of CD5, kappa, and lambda in oral MALT lymphoma have the risk of recurrence.We first described the recurrence of CD5 positive MALT lymphoma in the oral cavity and compared the immunohistochemical expressions of CD5, lambda, and kappa between the primary and recurrent tumors.
We report herein a case of functional and aesthetic rehabilitation with maxillary prosthesis supported by only two zygomatic implants for a patient with severe maxillary defect resulting from subtotal maxillectomy for malignant melanoma of the upper gingiva. A 76-year-old woman was referred to our facility with non-painful discoloration of the upper gingiva. After several examinations, a clinical diagnosis of malignant melanoma of the upper gingiva (cT3N1M0 stage IVA, American Joint Committee on Cancer) was made. Subtotal maxillectomy utilizing Le Fort I osteotomy and functional neck dissection were performed. A conventional resection denture was made and employed postoperatively, but was unable to be suitably retained due to insufficient residual maxillary structures. Six months after tumor resection, two zygomatic implants were inserted into bilateral zygomatic bones. Magnetic attachments were applied as a mechanism for attaching the implants and resection denture. After application of these implants, retention and stability of the prosthesis was considerably improved. The patient became able to eat a normal diet. From an aesthetic perspective, the depressed upper lip was also properly restored, leading to an acceptable facial appearance.
A case of disseminated intravascular coagulation (DIC) presenting after surgery for facial trauma associated with multiple facial bone fractures is described. With regard to the oral and maxillofacial region, DIC has been described in the literature following head trauma, infection, and metastatic disease. Until now, only 5 reports have described DIC after surgery for facial injury. DIC secondary to facial injury is thus rare. The patient in this case was young and had no medical history. Preoperative hemorrhage or postoperative septicemia may thus induce DIC.
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