Challenging Cases

KMUOP-Case 1 KMUOP-Case 2
KMUOP-Case 3 KMUOP-Case 4
KMUOP-Case 5 　


KMUOP - Case 1
What is your diagnosis for these multiple nodules on dorsal tongue?
Clinical   History Histologic   Examination
Please select the most likely answer from the following three choices
(A) Fibroma ---  Submit
(B) Amyloidosis ---  Submit
(C) Hemangiolymphangioma  ---  Submit                                           

 

KMUOP - Case 2
Please study carefully the clinical history, panorex findings, and histologic pictures provided below.
Clinical  history (above left):
A 42 y/o female patient complained pain over left mandibular posterior teeth.
Oral examination revealed mild buccal & lingual bony expansion over tooth 37 and retromolar area with a normal covering mucosa.

　

 Panorex findings (above right):
There was a well-defined multilocular ovoid-shaped radiolucence with a sclerotic margin around the root of tooth 38 extending from retromolar area down to the inferior border of left mandible with vertical expansion, & from mesial aspect of tooth 38 to left mandibular angle, measuring about 3.0 × 6.0 cm in diameter.
Histologic   Picture (1)                 Histologic   Picture (2)
Please provide the most likely answers for the following four questions
(1) What is your differential diagnosis for this mandibular lesion?
(2) Does any special stain(s) should be done to confirm your diagnosis?
(3) What is the most likely diagnosis for this mandibular lesion?
(4) How to treat this mandibular lesion?            Answers submitted                     


KMUOP - Case 3
Please study carefully the clinical history, panorex and CT findings as well as the histologic pictures provided below.
Extraoral findings (Fig. 1A):
Swelling over right mandibular body-angle to submandibular area
1. Size: 5×3 cm
2. Consistency: fixed and hard
3. Pain: (+)
4. Paresthesia over right lower lip and   gingiva

　

 Intraoral findings (Fig. 1B):
A swelling mass from teeth 47, 48, to retromolar area with shallow vestibule.
1. Size: 5×2.8 cm
2. Surface: smooth
3. Color: pink
4. Consistency: bony hard
5. Pain: (+)
6. Right lower lip and gingiva paresthesia
　
Histologic   Picture (1)                 Histologic   Picture (2)
Please provide the most likely answers for the following four questions
(1) What is your most likely differential diagnosis for this lesion?
(2) Does any special stain(s) should be done to confirm your diagnosis?
(3) How to treat this mandibular lesion?
(4)  What further examination(s) would you suggest for this patient?
       Answers submitted                                                                                            


KMUOP - Case 4
Please study carefully the clinical history, panorex and CT findings as well as the histologic pictures provided below.
Clinical history
This 43 y/o male suffered from left facial swelling for one month.

Intraoral findings (above left):
Area of teeth 25-27 swelling with buccol-lingual bone expansion.
Percussion pain of teeth 25, 27 (+)

 Panorex finding (above right)
An ill-defined radiolucence over left posterior maxilla.


CT finding (above right):
After CT scanning, a lesion over left maxillary sinus was found.

Histologic   Picture              　
Please provide the most likely answers for the following four questions
(1) What is your differential diagnosis for this lesion?
(2) What is your most likely diagnosis for this lesion?
(3) What immunohistochemical stainings have to be done to confirm the pathologic 
     diagnosis?
(4)  How to treat this patient?          Answers    submitted                                     

　

KMUOP - Case 5
Please study carefully the clinical history, panorex and  the histologic pictures provided below.

Clinical history
This 62 y/o female suffered from a swelling mass over right posterior maxilla for 2 weeks.

Intraoral findings (above left):
A tender, painful, reddish bony hard irregular shaped swelling without flutuation over buccal and palatal gingiva from tooth14 distal to tuberosity , measured 4×2.5 cm in diameter.

 Panorex finding (above right)
A radiopaque (apical 14-16) mixed with radioluce (17-tuberosity) lesion extended
from tooth 14 apical to tuberosity from alveolar crest to sinus floor, measured about 4.5×2.0 cm in diameter.
Histologic   Pictures              　
Please provide the most likely answers for the following four questions
(1) What is your differential diagnosis for this lesion?
(2) What is your most likely diagnosis for this lesion?
(3) What immunohistochemical stainings have to be done to confirm the pathologic 
     diagnosis?
(4)  How to treat this patient?          Answers    submitted