Benign osteoblastoma is a rarely seen tumor of the facial bones. The authors present a case of a 30-year-old man with a tumor of the mandibular body and ramus. The histopathological diagnosis was one of osteoblastoma. Postoperative recurrence with soft tissue infiltration suggested an osteosarcoma radiologically, but the histological examination again revealed the presence of an osteoblastoma. A second recurrence occured in the pharyngo-glossal region and this time the tumor was histologically diagnosed as an osteoblastoma, but with foci of well-differentiated osteosarcoma. The patient was given a course of radiotherapy, but clinical and radiological examination 8 months later revealed lung metastases and chemotherapy was started. Unfortunately, the patient died months later. While osteoblastomas are rare, and their sarcomatous change even rarer, our experience with this case lead us to suggest that a therapeutic preventative approach, involving both chemotherapy and total excision of the tumor, is the regime to adopt with osteoblastomas which involve soft tissues and have radiological features suggesting malignancy.
Despite the negative impact of immunosuppressive drugs on the process of bone healing, it is possible to treat organ transplant patients with intraosseous titanium implants. The key to success is the observance of appropriate treatment procedures and proper hygienic routines. An alteration of medication regimen that currently makes use of immunosuppressive drugs of much lower toxicity is also extremely significant.
This paper presents a rare case of facial soft tissue infection caused by the bacterial strain of Rothia mucilaginosa. Odontogenic background of infection and initial clinical presentation suggested the presence of typical bacterial flora and uncomplicated course of treatment. However, despite surgical intervention and broad-spectrum antibiotic therapy, the expected improvement of a clinical status was not achieved. Only detailed bacteriological examination allowed to establish a bacterial pathogen and start a targeted antibiotic therapy. The unusual clinical course was monitored by imaging CT examination and further surgical interventions. A significant improvement was obtained in the third week of hospitalization and further antibiotic therapy was continued by means of outpatient treatment. Rothia mucilaginosa infection together with dental intervention is a rare case, since most of the reports in the literature concern the patients with decreased immunity. In such patients, the most common areas of infection were: the peritoneum, lung tissue and meningeal spaces of the brain and the presence of a foreign body.
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