case of the
month
2022

COTM APRIL/MAY 2022

Case Credit- Tim Bracey and Amith Pinto (Royal Cornwall Hospital)

CLINICAL DETAILS

 

A 73 year old female patient presented on a two-week rule referral with a lump in the lower left 1,2 (incisor) region alveolar/gingival mucosa. This lump was completely asymptomatic and was noticed by the patient a few weeks prior. The area was initially aspirated by the dentist however no aspirate was obtained and radiographs were clear ruling out dental pathology. The patient had a history of carotid stenosis and was on Clopidogrel. Examination revealed a firm bosselated lump involving the gum/alveolar mucosa in the lower left incisor region. The clinical impression was that of a minor salivary gland neoplasm. 

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The patient underwent a biopsy of the lesion for histopathological analysis.

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COTM FEBRUARY/MARCH 2022

Case Credit- Alan Patterson (Rotheham, UK)

CLINICAL DETAILS

 

A 66 year old male patient presented with a large expansile lesion involving the lower left mandible. The patient had a history of previously extracted LL6. There was a history of slow but consistent increase in the size of the swelling with associated discomfort. Clinical examination showed a large lesion expanding both the buccal and lingual cortices of the mandible with a reddist brown appearance in places. There was no history of paresthesia.  The OPT radiograph showed soft tissue extension of lesion into the oral cavity (arrow).

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The patient underwent a biopsy of the lesion for histopathological analysis.

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COTM JANUARY 2022

Case Credit- Cristina Frezzini, Dan Brierley, Olive Allsobrook (Sheffield, UK)

CLINICAL DETAILS

 

A 56-year-old male presented with a 6-7 week history of a non-tender swelling involving the right junction between the hard and soft palate. Clinically, there was a 1.5 cm lesion involving the right palate with cemtral umbelication. The clinical impression was that the lesion was deeper and bigger than what was visible. On palpation, it was very firm. MRI scan showed an area of signal change in the right hard and soft palate region which was of indeterminate nature. It measured 2.3 cm in maximum anteroposterior dimension. Radiologically, it was not possible  to determine whether this was  a benign or malignant lesion. There was no evidence of lymphadenopathy or lesions elsewhere.

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The patient underwent a biopsy of the lesion for histopathological analysis.

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  Whole Slide Histology Image (H&E)

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Scroll to the right for details and diagnosis.