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Clinical Pathology Conference Seminar II
Transcript of Clinical Pathology Conference Seminar II
CPC 622- 2nd Semester -2014-2015.
History of Present illness:
Left posterior body of the mandible in the area between teeth #s 18-20
3.Squamous cell carcinoma
This is an 83-year-old female who presented to the dental clinic with gingival swelling and pain in the left posterior mandibular alveolar ridge between teeth #s 18 and 20; tooth # 19 was missing (Figure 1). The patient stated that the area was painful, especially when biting down. The area had been sensitive for several weeks and had been swollen for a few months.
Figure 1 Photograph taken at first clinical.
Note the pink, sessile swelling between teeth #s 18 & 20. Tooth # 19 is missing. The mucosa is intact and shows no evidence of ulceration.
Figure 2 Panoramic radiograph demonstrating bone resorption, left posterior mandible in the area of teeth #s 18-20. This radiograph reveals an ill-defined radiolucency with reactive bone at the inferior margin.
The patient’s past medical history is significant for:
Congestive heart failure.
Sick sinus syndrome.
Past Medical History:
1.Reactive Gingival Swelling
Site and location:
Size and Shape:
Outline and periphery:
I'll-defined radiolucency with reactive bone at the inferior margin.
Effect on surrounding structures:
Lisinopril 15mg PO qday.
ASA 81 mg PO daily.
Doxazosin 4mg PO qhs.
Lasix 20mg PO daily.
Small to medium, Approximately 2x3 cm Oval extended from tooth #18 to #20.
Most probable diagnosis
Bundgaard T, S Bentzen, et al. Histopathologic, stereologic, Epidemiologic, and clinical parameters in the prognostic evaluation of squamous cell carcinoma of the oral cavity. Head & Neck. 18:142-152 (1996).
Barasch A, DE Morse, et al. Smoking, gender, and age as risk factors for site-specific intraoral squamous cell carcinoma. Cancer 73:509-513 (1994).
Syrjanen SM, KJ Syrjanen et al. Human papillomavirus (HPV) DNA sequences in oral precancerous lesions and squamous cell carcinoma demonstrated by in situ hybridization. J Oral Pathol. 17:273 (1988).
Akhtar K, Laghari NA, Haq AU, Anees M, Rehman SU, Alam MI. Multiple myeloma in younger age.. J Coll Physicians Surg Pak. 2009 Jan;19(1):62-3
Canger EM, Celenk P, Alkan A, Günhan O. Mandibular involvement of solitary plasmocytoma: a case report. Med Oral Patol Oral Cir Bucal. 2007 Jan 1;12(1):E7-9.
Souza LN, Farias LC, Santos LA, Mesquita RA, Martelli H Jr, De-Paula AM. Asymptomatic expansile lesion of the posterior mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Jan;103(1):4-7. Epub 2006 Oct 16.
Hudson TM, Bertoni F, Enneking WF. Scintigraphy of aggressive fibromatosis. Skeletal Radiol. 1985;13 (1): 26-32
* Satish Kumar, Saravanan Ram. Multicentric peripheral ossifying fibroma
*Bundgaard T, S Bentzen, et al. Histopathologic, stereologic, Epidemiologic, and clinical parameters in the prognostic evaluation of squamous cell carcinoma of the oral cavity. Head & Neck. 18:142-152 (1996)
*Akhtar K, Laghari NA, Haq AU, Anees M, Rehman SU, Alam MI. Multiple myeloma in younger age.. J Coll Physicians Surg Pak. 2009 Jan;19(1):62-3
*Hudson TM, Bertoni F, Enneking WF. Scintigraphy of aggressive fibromatosis. Skeletal Radiol. 1985;13 (1): 26-32