Influence of nicotine on progesterone and estradiol production of cultured human granulosa cells

A case of peripheral ameloblastoma in a 57-years-old woman is presented, along with a discussion of the clinical and histological characteristics of the lesion. After clinical and radiographic examinations, and with a differential diagnosis of pyogenic granuloma, an excisional biopsy was performed and the material collected was sent for histological examination. On the basis of the histopathological diagnosis, a second operation was performed with a wide safety margin, including bone tissue, which did not show any involvement with the odontogenic neoplasm.     

Nicotine excites cardiac vagal neurons via three sites of action

Clinicopathological data were collected for six children with ameloblastoma less than 16 years old. They were all treated initially by conservative surgery and satisfactory results without jaw deformities were finally attained. One of the histological characteristics of ameloblastoma in children is the prevalence of the plexiform type, which is thought to behave less aggressively than the follicular type. Conservative treatment is acceptable initial treatment of ameloblastoma in children who can be followed up in a precise, detailed manner.     

Desmoplastic ameloblastoma: correlative histopathology, radiology and CT-MR imaging

A desmoplastic variant of ameloblastoma with osteoplasia in the stroma is reported. This tumour presented in the canine/premolar region of the left maxilla of a 31-year-old woman. It was treated by partial hemimaxillectomy and immediate reconstruction with a non-vascularised iliac graft. The location of this lesion, its histology and radiological features differ from those of the conventional ameloblastoma. The behaviour and prognosis of the desmoplastic ameloblastoma (DA) cannot at this stage be predicted due to the small number of cases that have been reported and a lack of long-term follow-up. To our knowledge this is the first documentation of the CT and MRI features of desmoplastic ameloblastoma with pathologic correlation.     

Independence and statistical inference in clinical trial designs: a tutorial review

The identification of the proliferative activity in tumours may be useful to predict the biological behaviour of different lesions. Proliferating cell nuclear antigen (PCNA) has been used for the evaluation of the proliferative ability of many lesions. In this study 22 ameloblastomas (4 follicular, 5 plexiform, 4 acanthomatous, 5 unicystic, 4 recurrent), 12 odontogenic keratocysts (OKC), 8 dentigerous cysts (DC), and 12 radicular cysts (RC) were analysed. PCNA+ cells were present in all cyst types but the OKC contained the highest number of PCNA+ cells. In OKC the location of PCNA+ cells was mainly suprabasal. In ameloblastoma PCNA+ cells were located mainly in the peripheral portion of the tumour islands. Statistical analysis showed that ameloblastoma had higher PCNA+ cell counts than OKC (P < 0.0001); OKC had higher values than DC and RC (P < 0.0001). Recurrent ameloblastoma presented higher PCNA+ cell counts than other types of ameloblastoma, while unicystic ameloblastoma showed lower values than acanthomatous, plexiform and follicular ameloblastomas (in this latter case the difference was not statistically significant). These data could help to explain the different biological behaviour of these lesions.     

Calcifying odontogenic cyst: report of two cases and review of literature

The "Histological Typing of Odontogenic Tumours" (W.H.O., 1992) classified the Calcifying Odontogenic Cyst (C.O.C.) into two variants: the non-neoplastic cystic C.O.C. and the odontogenic ghost cell tumour, which is predominantly solid. We reported two cases of C.O.C.: a case with intraosseous development and another with extraosseous localisation, in the soft tissue of the alveolar area. The first case represents a cyst delimited by a squamous, non-keratinized epithelium, thickened in some areas through the accumulation of ghost cells (big pale-staining cells with a non-staining nuclear area). The connective tissue wall contains small ameloblastoma like islands. Dysplastic dentine islands, adjacente to the basal layer of the epithelium or in the connective tissue wall were also observed. The second case was a well-delimitated tumour consisting of ameloblastoma-like islands with numerous ghost cells inside. Islands of dysplastic dentine with psammomathous calcifications also exist. In certain histological sections microcystic aspects surrounded by ghost cells, dentinoid and ameloblastoma-like structures were noticed. The histochemical reaction for keratin and the immunohistochemical reaction for epithelial membrane antigen and for citokeratin were positive for ghost cells, suggesting their epithelial origin. Through this article we try to render pathologists sensitive with a particular and rare maxillary tumour.     

Hyperplastic parathyroiditis--a new autoimmune disease?

A case of parathyroiditis with epithelial hyperplasia is reported in which the histological features suggest an autoimmune process analogous to Hashimoto's disease.     

Surgery for primary hyperparathyroidism 1962-1996: indications and outcomes

Twenty-two cases of ameloblastoma and ten cases of adenomatoid odontogenic tumour (AOT) were analyzed comparatively by the AgNOR technique. Ameloblastomas were distributed into three groups according to their clinical behaviour: primary lesions without recurrences (PLWTR), 5 cases; primary lesions with recurrences (PLWR), 4 cases; and recurrences, 13 cases. The cases were also regrouped according to their histological pattern: follicular (9 cases), plexiform (7 cases), acanthomatous (4 cases) and unicystic (2 cases). Considering histological patterns, there was a significant statistical difference only between follicular and plexiform types. There were no significant differences between the group of ameloblastomas and the group of AOTs or between the three groups of ameloblastomas with different clinical behaviour. Our results strongly suggest that the distinct clinical behaviour of ameloblastomas and AOT is not correlated with their cellular proliferation ratio. Thus, the infiltrative ability of the ameloblastomas is probably not related to the cellular proliferation index of these tumours.     

Prolonged survival in a patient with sinonasal teratocarcinosarcoma with cranial extension. Case report

Sinonasal teratocarcinosarcoma is a rare malignant neoplasm characterized by the combined histological features of carcinosarcoma and teratoma. The primary symptoms of this tumor are usually nasal obstruction and epistaxis, and a nasal cavity mass is the most common clinical finding. The authors describe an exceptionally rare case in which the patient presented with massive intracranial extension and exhibited confusion as an initial symptom. He subsequently underwent combined radical surgery and radiation therapy and has remained free of disease for 31 months. The surgical approach to the lesion, histological features, and clinical course are detailed.     

Using exercise to tackle postnatal depression

A case of obstructive jaundice secondary to a neurofibroma in the common hepatic duct is presented. The histological appearance was that of a plexiform neurofibroma. The clinicopathological features are discussed.     

Haemangiopericytoma of the parotid salivary gland: report of a case with literature review

Haemangiopericytoma is a rare, soft tissue, tumour with unpredictable biological behaviour. A case of haemangiopericytoma of the parotid salivary gland is reported. The clinical, surgical and histological features are described.     

Lichen sclerosus et atrophicus in a band-like arrangement

We report a case of lichen sclerosus et atrophicus (LSA) in a band-like arrangement. The patient had a white atrophic plaque on the left breast which showed the typical histological features of LSA. One month later, the patient had developed multiple, brown-colored plaques from the right breast to the right upper arm following the distribution of the peripheral nerve. These plaques showed the mild histological changes indicative of LSA. This band-like arrangement of LSA appears to be unique.     

Ameloblastic carcinoma of the mandible

BACKGROUND: Ameloblastic carcinoma is a rare, aggressive odontogenic neoplasm of the jaws in which the epithelial cells exhibit cytologic features of recognizable ameloblastoma and malignancy. Cases with metastasis have been infrequently reported. METHODS: A case of a 64-year-old white woman with mandibular ameloblastic carcinoma with documented distant metastasis is presented. The patient's presenting symptoms included facial asymmetry of the right jaw over 2 months and the development of moderate trismus. Clinical manifestations, pathology, treatment, and biologic behavior are discussed. The nomenclature and classification of odontogenic carcinomas are reviewed, including entities that should be considered in the differential diagnosis. RESULTS: The patient underwent surgical resection consisting of mandibulectomy, parotidectomy, and modified radical neck dissection followed by radiation to both necks and tumor bed. Postsurgically, the patient developed pulmonary metastasis at 11 months and expired with widespread metastatic disease at 28 months. CONCLUSIONS: This case demonstrated an unusual behavior pattern in that local recurrence and regional metastasis did not occur. Distant metastasis occurred despite apparent adequate control of the primary mandibular tumor. The ameloblastic carcinoma is a highly malignant neoplasm which requires aggressive therapy. Prognosis is poor. Further reporting of ameloblastic carcinoma is encouraged.     

The underlying cause of polyhydramnios determines prematurity

A case of metastatic granulosa cell tumour of the ovary is reported. Investigations revealed a secondary tumour in segment VI and VII of the liver. Right hepatic resection was performed. Microscopic findings revealed a tumour with histological features identical to that removed eleven years before.     

Recurrent ameloblastoma in an autogenous bone graft after 28 years: a case report

The growth characteristics of ameloblastoma is such that recurrence can occur regardless of treatment method, although recurrence rates following a block resection are considerably less than that following enucleation and curettage. A small number of recurrences in autogenous bone grafts have been reported in the literature. This report describes a recurrent ameloblastoma in an autogenous bone graft occurring 28 years following resection and reconstruction.     

Anatomic classification of intraosseous ameloblastoma as a guide to surgical management

This paper discusses current knowledge of the growth characteristics and biologic behaviour of the solid-multicystic ameloblastoma (classic intraosseous ameloblastoma). The clinical prognostic factors that could influence surgical treatment planning are highlighted. An anatomic classification that may serve as a guide to surgical management is proposed. We advocate that strict adherence to these surgico-therapeutic guidelines and a uniform anatomic classification would allow meaningful comparison of treatment outcomes reported by surgeons from different parts of the world.     

Eccrine-nevus (author''s transl)

The eccrine nevus is an exceptional entity, formed by well-differentiated adnexa which can be classified as hamartoma or organoid nevus. It is characterized by a high degree of structural maturation. The authors report a case of eccrine nevus observed in a 32-year-old woman and compare clinical and histological features of the lesion with literature data.     

Anaphylactic shock and its implication for nurses

We report the case of a voluminous melanotic neuroectodermic tumor, also termed melanotic progonoma, which developed in a 5 month old infant, recalling the main aspects of such uncommon non-odontogenic tumors with characteristic histological features. The large size of the tumor can hinder feeding in infants. Surgical cure is generally easy and outcome quite satisfactory without recurrence.     

Odontogenic fibroma in Sprague-Dawley rats: a report of 2 cases

Two cases of odontogenic fibroma occurring in aged Sprague-Dawley rats are described. Both neoplasms were associated with a maxillary incisor and had identical histomorphological features. They were composed of solid proliferations of primitive, dental pulp-like mesenchyme separated by areas of collagenization. Small strands and islands of mainly undifferentiated odontogenic epithelium immunostaining for keratins were scattered throughout both tumours. As a further characteristic, the lesions contained small foci of mineralization which were either cementum-like or resembled dysplastic dentin. The odontogenic fibroma represents a further type of odontogenic tumour in rats, which due to its typical histomorphology, can easily be differentiated from other odontogenic tumours such as ameloblastic odontoma or ameloblastoma.     

Induction of osteodentin and abortive enamel in adenomatoid odontogenic tumor

Adenomatoid odontogenic tumor (AOT) with induction of calcified dentin with or without concomitant formation of enamel is exceedingly rare. This paper reports a case of AOT showing induction of osteodentin and abortive enamel. The patient was a 15-year-old male with a well-circumscribed intraosseous lesion containing the crown of the embedded left maxillary canine. Histologically, induction of osteodentin and abortive enamel was seen, in addition to characteristic histological features of AOT. The review of the English literature yields that the present case is the second AOT with induction of both dentin and enamel.