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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.

The mandible is a complex osteological structure composed of distinct units integrated into a single bone around the director axis of the mandibular nerve. In this study of the mandibular development, we use a method that synthesizes the contributions of each sub-unit, using the mandibular canal as reference system. This novel approach results in new informations and confirms the leading role of the mandibular nerve and of its curve in mandibular development. It would seem to be possible to explain a major part of mandibular development by the role of the nerve as guide.

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.

-Psoriasis is a chronic cutaneous inflammatory disease. We describe the case of a 60-year-old woman presenting both general psoriasis and oral erythemato-erosive lesions. History and histopathology of the lesions tend to prouve a link with her general psoriasis. Local applications of betamethasone provides rapid improvement of the symptomatology. Oral lesions of psoriasis are rare and controversial. There is some evidences that fissurated or geographic tongue present a statistical correlation with skin psoriasis. Our case present unusual features which were never described so far and that could be source of misdiagnosis.

Assistant hospitalier universitaire, Service de chirurgie buccale, CHU Nancy. Pierre BRAVETTI

278Actualités Odonto-Stomatologiques -n° 251 -septembre 2010 Description du cas