Huge ameloblastoma of jaw a case report
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Huge ameloblastoma of jaw a case report

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    Huge ameloblastoma of jaw a case report Huge ameloblastoma of jaw a case report Document Transcript

    • 247 Clinical Report HUGE AMELOBLASTOMA OF JAW-A CASE REPORT Subhalakshmi Mukhopadhyay1, Kalpana Raha2, Sambhu Charan Mondal1 ABSTRACT: Ameloblastoma is a tumor of odontogenic epithelium. It is a tumour of intermediate malignant potential which lies in the gray zone between benign and malignant neoplasm. A huge ameloblastoma revealing benign cytological features in FNAC is being reported. Ameloblastoma arises from odontogenic epithelium. This tumor can occur at any age. Though traditionally divided as solid and cystic, nearly all ameloblastomas show some cystic change. This tumor shows invasive property and a remarkable tendency of recurrence. The cases showing distant metastasis are recognized as malignant ameloblastoma. Ameloblastic carcinoma is a tumor with microscopic features of ameloblastoma that displays malignant features at cytological level. [2] It usually has aggressive course. A case of large ameloblastoma with slow clinical course and benign cytological as well as histological features is being reported.CASE REPORTA 32-year-old male patient presented with a huge swellinginvolving lower jaw which was present for the last 7 years.The patient was a farmer by profession. The swelling graduallyincreased in size making it impossible for the patient to closehis mouth and to articulate properly. Some of the teeth of the Figure 2: Photograph of the patient after operation. lower jaw were lost. Mandibular X-ray showed a huge round radio opaque shadow without any evidence of multilocular radiolucency. Fine needle aspiraion cytology (FNAC) revealed dark brown fluid substance. Smears showed low cellularity.Figure 1: Photograph of the patient showing the tumor. The cells were of benign characteristic, which were discrete,1 Assistant Professor Department of Pathology R G Kar Medical College Kolkata, 2Associate Professor Department of Pathology R G Kar Medical CollegeKolkata Indian Journal of Otolaryngology and Head and Neck Surgery Vol. 57, No. 3, July-September 2005 247 CMYK
    • 248 Huge ameloblastoma of jaw-A case reportelongated or oval in shape with abundant cytoplasm. Someosteoblasts were also present in the smear. No giant cells weredetected. A provisional diagnosis of ameloblastoma was made.The swelling was resected out along with the mandible. [Table2] The size of the mass was 25 cm. x15 cm.x10 cm. Histologyshowed islands of epithelial cells with central loose networkof cells resembling stellate reticulum of ameloblastoma. [Table3]DISCUSSIONDiagnosis of ameloblastoma depends upon appropriate Figure 3: Microphotograph showing epithelial island with squamoushistological findings in proper clinical setting. Radiology often metaplasia. (x40)helps in preoperative diagnosis. In this case diffuse opacity,possibly caused by extensive destruction of the mandible and REFERENCEScystic changes, gave rise to confusion. No specific FNAC 1. Rosai J. Ackerman’s Surgical Pathology. Mosby, 1996;271-2.finding of ameloblastoma was found in literature review In 2. Slootweg PJ, Muller H. Malignant ameloblastoma or ameloblasticthis case FNAC suggested a benign lesion. Absence of carcinoma. Oral Surg. Oral Med Oral Pathol 1984;57:168-76.malignant cells was a significant finding in FNAC. Histologywas confirmatory. Such a huge size of a benign ameloblastoma Address for correspondenceis rare in literature. FNAC may play significant role in Dr. Subhalakshmi Mukhopadhyay BB 41/8,Salt Lake Citypre-operative assessment of behavior of such tumor. Kolkata -700064, E mail-sambuddhaghosh@hotmail.com Clinical Report FOREIGN BODY IN THE NASOPHARYNX OF A CHILD Arunabha Sengupta1, Pinaki Saha2, Subhasish Chakrabarty3 ABSTRACT: Introduction of foreign body into the nasal cavity of the children by themselves is very common, but lodgment of foreign body in the nasopharynx following introduction through mouth is unusual. Here a case is presented from the Otorhinolaryngology department of S.S.K.M. Hospital, Kolkata, where a child was brought by their parents with history of introduction of a metallic foreign body in the mouth of the child by himself and this foreign body was found to be lodged in the nasopharynx of the child. The foreign body was removed orally in the out patient department. The patient returned home without any complication. Key words: Laryngoscope, Luc’s forceps, NasopharynxIncidence of foreign body being introduced into the nasal without any complication with advice for oral antibiotic.cavity of a child by himself or herself is very common, butlodgment of foreign body in the nasopharynx after CASE REPORTintroduction through mouth is very unusual. Here a case report The child was playing with a thimble (a metallic hollowis given, where a metallic foreign body after being introduced truncated cone which tailors wear in their index finger duringinto the mouth of a child by himself ultimately had get lodged stitching) and suddenly put it into his mouth. When noticedin the nasopharynx. This was diagnosed clinically and at around 7:30A.M., he was lying down with his mouth openradiologically. The foreign body was removed in the out and crying. His parents tried to bring it out by putting theirpatient department orally and the patient was sent home fingers in his mouth but could not localize the foreign body.1 Assistant Professor, 2Junior Resident, 3Junior Resident, Department of Otorhinolaryngology, S.S.K.M. Hospital and I.P.G.M.E. & R., KolkataIndian Journal of Otolaryngology and Head and Neck Surgery Vol. 57, No. 3, July - September 2005248 CMYK