Background Benign osteoblastoma is a rare tumor of bone representing less than 1% of all tumors of the maxillofacial region. There is a slight predilection for the mandible. More frequent sites for this tumor are the vertebral column, sacrum, long bones, and calvarium. A small predilection in males exists. The age of occurrence ranges from 5 to 37 years, with an average of 16.5. Clinically, patients have pain and swelling. The tumor contains a wellvascularized, osteoblastic connective tissue stroma. Osteoclasts may also be present. Osteoid with varying degrees of calcification, as well as immature bone, is noted. Case report Very few cases of osteoblastomas occurring in the jaws have been reported in the literature. This is one such a rare case report of OB occurring in a 45 year old female patient with a swelling in right lower back region since 5 years. Summary and conclusion Osteoblastoma has to be differentiated from other bone lesions for correct diagnosis. Many bone producing lesions possess some overlapping clinical, radiographic or histopathological findings similar to osteoblastoma. Understanding and correlating all these features is of utmost importance. This helps in correctly diagnosing and helps in adequate management of this rare entity, giving a good prognosis.
INTRODUCTIONSpinal cord development occurs through three consecutive stages, gastrulation (gestational weeks 2-3) with formation of notochord, primary neurulation (weeks 3-4) produces the upper most nine tenths of the spinal cord and secondary neurulation and retrogressive differentiation (weeks 5-6) result in formation of the conus tip and filum terminale. Defects in these early embryonic stages produce spinal dysraphism. Spinal dysraphism refers to the entire range of spinal column and neuraxis anomalies. 1 Open spina bifida /aperta includes myelocele, myelomeningocele ( Figure 1) and hemimyelomeningocele and hemimyelocele.Occult spinal dysraphism includes skin-covered masses suchas lipomyelomeningocele (Figure 2), skin-covered meningoceles or myelocystoceles and the group of spinal dysraphism without an associated mass. This group encompasses dorsal dermal sinus (Figure 3), spinal lipoma, tethered cord (tight filum terminale syndrome), and fibrolipoma of the filum terminale, diastematomyelia and anterior-sacral-meningocele.Prevalence: The estimated incidence of spinal dysraphism is about 1-3/1000 live births. 3 The prevalence of spinal dysraphism has been in decline the world over in the last ABSTRACT Background: Spinal dysraphism refers to the entire range of spinal column and neuraxis anomalies. The objective was to evaluate the role of magnetic resonance imaging (MRI) in characterizing the congenital and developmental disorders of spine. Methods: Fifty (50) patients with clinically suspected spinal dysraphism were included in the study. All the patients were made to undergo MRI spine using 1.5 Tesla MRI, manufactured by GE, SIGNA HDX MACHINE. The findings of MRI spine were assessed and analyzed. Results: Out of 50 patients included in the study; 24 were male (48%) and remaining 26 were female (52%). Congenital spinal lesions were more prevalent in the age group 0-20 years (70%). Lesions without subcutaneous masses (62%) were more common than the lesions with subcutaneous masses (38%). The commonest location for the congenital spinal lesions was lumbar region (54%). Congenital spinal lesions without spinal curvature abnormalities (58%) were more common than the lesions with spinal curvature abnormalities (42%). Vertebral anomalies (78%) were the commonest spinal anomalies in patients with congenital spinal lesions; spina bifida was the commonest (46%). Diastematomyelia was more prevalent in the age group 0-10 years (41.66%) and in female population (58.33%). Conclusion: Thus we conclude that Spinal dysraphism were common in young females, with commonest anomaly being vertebral anomaly (Spina bifida), commonest location is lumbar region, Diastematomyelia common in young aged female. Magnetic resonance imaging is an accurate, noninvasive, safe and advanced modality for evaluation of the congenital spinal disorders and help in better management of these patients with prompt and accurate diagnosis.
Objective:The objective of this study is to investigate the influence of flap design on visibility and accessibility during removal of impacted third molar and hematoma formation, wound gaping and healing of flap post-operatively.Study Design:The randomized prospective comparative study included 30 patients with impacted mandibular third molars. Two flap designs namely envelope flap (Koener's incision) and ‘triangular flap’ (Ward's incision) were used. After 7 days, sutures were removed and status of wound, periodontal health, and progress of healing was assessed. Patients were followed through 15 days to judge the incidence of post-operative complications in both groups.Results:No statistical differences were noted between the groups in terms of visibility, accessibility, excessive bleeding during surgery, healing of flap, sensitivity of adjacent teeth, and dry socket. A statistically significant difference was observed in post-operative hematoma, wound gaping, and distal pocket in adjacent tooth, which was significant in Ward's triangular incision group in comparison to Koeiner's envelope incision group.Conclusion:The selection of the flap design is dependent on needs of the case and preference of the operating surgeon and does not seem to have a significant influence on the health of tissues. In order to avoid wide area of exposure of bone, the operating surgeon should clinically and radiographically assess the designing of incision and mucoperiosteal flap, the clinical relevance is still debatable.
Synchronous malignant neoplasms in a single patient are well documented in the literature. It is also recognized that there is increasing incidence of synchronous non-neuroendocrine neoplasm in patients with neuroendocrine tumor (NET). We present a case, of a patient with synchronous colorectal cancer and pancreatic NET, both cancers presenting with liver metastasis. By using 18F-FDG PET and 68Ga-DOTATATE PET imaging, we showed 2 different tumor types within the liver, which was subsequently confirmed on liver biopsy. This case report shows the utility of molecular imaging using different PET peptides. These newer modalities are useful in understanding the biology of the NET and in determining the best patient management.
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