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Central nervous system paracoccidioidomycosis: case report and review
Tristano,Antonio G; Chollet,María Eugenia; Willson,María; Perez,Julián; Troccoli,Marcos;
Investigación Clínica , 2004,
Abstract: abstract. paracoccidioidomycosis is a systemic infection caused by a dimorphic fungus (paracoccidioides brasiliensis). the most common lesions frequently occur in the bucopharinx mucosa. other lesions occur in the adrenal glands, liver, bone, gastrointestinal tract, lungs and nervous system. we report here a case of neuroparacoccidioidomycosis. the patient was a 49 year-old male, who consulted due to neurological symptoms (cephalalgia, speech difficulty and one tonic clonic seizure with urinary incontinence) of eight months duration. upon physical examination it was observed an emaciated male with nail clubbing, a skin ulcer with raised edges and a crusted bottom of 4 × 2 cm in diameter located in the right supraclavicular region and an ulcerated lesion in the left tonsil with edema. the rest of the physical examination reveled a discrete left side hemiparesis and pulmonary rales in the left hemitorax. the fungus was identified through direct examination of cerebrospinal fluid (csf). the histopathology of suprarenal, lungs, brain and skin showed multiple paracoccidioidal granulomas. to the best of our knowledge, this is the third case reported in the literature. we review the literature on the pathogenesis and prevalence of neuroparacoccidioidomycosis.
A Young man with an Ulcerated Lesion on the Right Ankle
Kamran Balighi,Khalil Farsinejad,Mohamadreza Barzegar,Zahra Naraghi
Acta Medica Iranica , 2010,
Abstract: We present a case of epitheloid sarcoma that was referred with a 2×3cm ulcerated lesion on the right ankle and edema of the lower leg. Foot drop of the right side was present that had caused walking difficulty. After a few months, he developed several sporthricoidal nodular lesions on the medial aspect of right thigh, inguinal lymphadenopathy, weight loss, anorexia and respiratory symptoms. Chest x-ray and HRCT showed pulmonary metastasis. Histopathological evaluation and immunohistochemical profile of both skin lesion and involved inguinal lymph node were consistent with epitheloid sarcoma. The case is interesting because as far as we know there has been no report of epitheloid sarcoma in literature presenting with foot drop and edema prior to obvious skin involvement.
Metastasis of Renal Cell Carcinoma to the Buccal Mucosa 19 Years after Radical Nephrectomy
Hernani Gil-Julio,Fernando Vázquez-Alonso,Antonio J. Fernández-Sánchez,Ignacio Puche-Sanz,José F. Flores-Martín,José M. Cózar
Case Reports in Oncological Medicine , 2012, DOI: 10.1155/2012/823042
Abstract: Renal cell carcinoma (RCC) has high metastatic potential, which requires early diagnosis to optimize the chance of cure. Metastasis of RCC to the head and neck region is less common and metastasis to the buccal mucosa is extremely rare. This phenomenon occurs mostly in patients with generalized dissemination, especially with lung metastases. In this article we report a case of buccal mucosa metastasis from RCC in a 65-year-old man who presented 19 years after undergoing a left radical nephrectomy for clear cell RCC. Surgical excision of the buccal lesion was performed without evidence of recurrence or new metastatic lesions after 6 years of followup. To our knowledge, this is the first case of metastasis to the buccal mucosa from a RCC reported in the literature.
Gingival peripheral odontoma in a child: Case report of an uncommon lesion  [PDF]
Ji Hyun Kwon, Young Ah Cho, Hong Keun Hyun, Teo Jeon Shin, Young Jae Kim
Open Journal of Stomatology (OJST) , 2013, DOI: 10.4236/ojst.2013.31020
Abstract:
Odontomas are defined as hamartomas of odontogenic origin. They are composed of all dental tissues are represented, occurring in a more or less disorderly pattern. Intraosseous (central) odontomas are the odontogenic tumors of greatest incidence. Otherwise, odontomas arising in the extraosseous soft tissue, also known as peripheral odontoma, are extremely uncommon. This article presents a case of peripheral odontoma in a child referred to SNUDH for treatment. A 2-year-old girl was referred to The SNUDH regarding an asymptomatic nodule on the left maxillary buccal gingiva. Clinical examination revealed a 7 mm × 6 mm × 3 mm, sessile mucosal lesion on the buccal gingival between #62 and #63. The lesion was firm on palpation and covered with an intact non-ulcerated mucosa. There was no other mucosal pathology. Under N2O-O2 inhalation sedation, an excisional biopsy of the lesion was performed. The diagnosis was peripheral odontoma. Summary: Odontoma in an extraosseous location represents a challenge for diagnosis. This article reports a case of peripheral odontoma and its clinical presentation, histological evaluation and treatment. A 2-year-old girl reported a firm asymptomatic nodule on left maxillary buccal gingival. The procedures for diagnosis included intraoral examination, excisional biopsy and histological analysis. The diagnosis was peripheral odontoma. Peripheral odontoma is rare and the differential diagnosis with other gingival masses is rather difficult and must include inflammatory and reactive processes. The definitive diagnosis is based on microscopic features.
Metastasis of Renal Cell Carcinoma to the Buccal Mucosa 19 Years after Radical Nephrectomy  [PDF]
Hernani Gil-Julio,Fernando Vázquez-Alonso,Antonio J. Fernández-Sánchez,Ignacio Puche-Sanz,José F. Flores-Martín,José M. Cózar
Case Reports in Oncological Medicine , 2012, DOI: 10.1155/2012/823042
Abstract: Renal cell carcinoma (RCC) has high metastatic potential, which requires early diagnosis to optimize the chance of cure. Metastasis of RCC to the head and neck region is less common and metastasis to the buccal mucosa is extremely rare. This phenomenon occurs mostly in patients with generalized dissemination, especially with lung metastases. In this article we report a case of buccal mucosa metastasis from RCC in a 65-year-old man who presented 19 years after undergoing a left radical nephrectomy for clear cell RCC. Surgical excision of the buccal lesion was performed without evidence of recurrence or new metastatic lesions after 6 years of followup. To our knowledge, this is the first case of metastasis to the buccal mucosa from a RCC reported in the literature. 1. Introduction Metastasis of RCC to the buccal mucosa represents an extremely rare finding and is regarded to have very poor prognosis. The metastasis of RCC to the head and neck region is relatively uncommon and can be found in 8–16% of all cases [1–5], usually associated with lesions in other sites. The rich vascular structure of RCCs facilitates hematogenous extension and the development of distant metastases. The most important hematogenous extension route in RCC is the vena cava system, which leads to the lung. Metastatic tumours to the buccalmucosa generally present with nonspecific symptoms and signs. Surgical excision is considered the first line of treatment and the decision should be based on the evidence of other organs involvement, the patient’s general condition [2, 4, 6], and the use of radiotherapy [3, 5] or antiangiogenic therapy [7]. In this paper, we report a rare case of metastasis to the buccal mucosa from an RCC that occurred 19 years after left radical nephrectomy. 2. Case Report A65-year-old otherwise healthy male patient presented to clinic with a sensation of discomfort in his left cheek. His past history is significant for left radical nephrectomyperformed 19 years earlier for clear cell renal cellcarcinomawithrenalveinthrombosis (pT3aN0M0), and there were no other sites of disease evident upon current presentation. Computed Tomography scan detected a 10?mm 8?mm mass suggestive of malignant lesion in theleftbuccalmucosa (Figure 1) which was then surgically removed. Pathological examination showed metastaticclear cell renal cell carcinoma with clear excision margins. After 6 years of clinical followup and serial radiological controls, the patient showed no signs of local recurrence or new metastatic lesions. Figure 1: Head CT image showing a malignant lesion in the
Solitary mastocytoma: A rare presentation on the buccal mucosa  [PDF]
Bogahawatte S. M. Siriwardena, Ruwan Duminda Jayasinghe, Neelakanthi Ratnatunga, Wanninayake Mudiyanselage Tilakaratne
Case Reports in Clinical Medicine (CRCM) , 2013, DOI: 10.4236/crcm.2013.23062
Abstract:

Mastocytoma usually presents as a solitary lesion whereas mastocytosis is a rare skin condition which typically manifests with or without accompanied systemic symptoms. Although a few cases of solitary mastocytoma have been documented on mucosa (vulva), none has been reported on the oral mucosa in the English literature. The present case is an example of an exceptional rare presentation of solitary mastocytoma of the oral mucosa.

Buccal Mucosa Urethroplasty for Bulbar Urethral Strictures
V Pansadoro, P Emiliozzi, P Scarpone, M Gaffi, G Sabatini, M Pizzo, G Federico, M Martin, A Pansadoro
African Journal of Urology , 2004,
Abstract: Objectives: Urethroplasty with the buccal mucosa graft is an excellent option for the treatment of urethral stricture disease. The authors report their 10-year experience with buccal mucosa graft urethroplasty by the dorsal and ventral approach. Patients and Methods: From June 1994 to May 2003, 67 patients with bulbar urethral stricture underwent buccal mucosa urethroplasty. A free graft of buccal mucosa was used as an onlay; ten patients were operated by the ventral approach and the remaining 57 by the dorsal approach. After the bulbar urethra is exposed, we perform a dorsal endoscopic cold knife urethrotomy until the urethra is fully opened. After measurement of the defect, the graft is harvested from the lower lip and sutured to the urethra and to the corpora cavernosa. A transurethral grooved catheter and suprapubic drainage are left for 7 and 14 days, respectively. Results: The median follow-up was 58 months (range 12 – 110). Recurrence of the stricture occurred in 4% (3/67) of the patients with a recurrence rate of 2/10 (20%) and 1/57 (2%) for the ventral and dorsal onlay patients, respectively. The overall complication rate was 9/67 (13%). Conclusions: Buccal mucosa urethroplasty provides a high long-term success rate for the treatment of bulbar urethral strictures. The dorsal onlay may be superior to the ventral onlay approach. L\'utilisation de muqueuse buccale dans le traitement des sténoses de l\'urètre bulbaire Objectifs: L\'urètroplastie par greffe de muqueuse buccale est une excellente option pour le traitement des sténoses urétrales. Les auteurs rapportent 10 ans d\'expérience dans l\'approche dorsale et ventrale de la greffe de muqueuse buccale dans l'urètroplastie. Patients et Méthodes: De juin 1994 à mai 2003, 67 patients présentant une sténose de l\'urètre bulbaire ont subi une urètroplastie utilisant la muqueuse buccale. Un onlay est réalisé par un greffon de muqueuse buccale libre; dix patients ont été opérés par l\'approche ventrale et les 57 restants par l\'approche dorsale. Après exposition de l\'urètre bulbaire, nous réalisons une urètrotomie interne endoscopique dorsale jusqu\'à ce que l\'urètre soit complètement ouvert. Après mesure du défècte, le greffon est prélevé au niveau de la lèvre inférieure et est suturé à l\'urètre et aux corps caverneux. Un drainage transurètral et suspubien est gardé respectivement 7 et 14 jours. Résultats: La médiane du suivi était de 58 mois (de 12 à 110). Une récidive de la sténose est constatée dans 4% (3/67) des patients avec un taux respectif de récidives de 2/10 (20%) et 1/57 (2%) patients pour l\'onlay ventral et dorsal. Le taux de complications total était de 9/67 patients (13%). Conclusions: L\'utilisation de muqueuse buccale dans le traitement des sténoses de l\'urètre bulbaire donne à long terme un taux de succès élevé. L\'onlay dorsal parait donner de meilleurs résultats que l\'approche ventrale African Journal of Urology Vol.10(3) 2004: 208-211
Micronucleus level in exfoliated buccal mucosa cells of cancer patients
Nersesyan Armen K.,Vardazaryan Nina S.,Gevorgyan Ani L.,Arutyunyan Rouben M.
Archive of Oncology , 2002, DOI: 10.2298/aoo0201035n
Abstract: Micronucleus levels in exfoliated buccal mucosa cells of patients with primary breast, lung, cervix uteri cancer, and patients with Hodgkin's disease were studied (n=59). Significantly increased number of micronuclei in cells of cancer patients was observed compared with healthy persons (n=45). The evaluation of micronuclei number in buccal mucosa cells shows genomic instability in somatic cells of humans.
Central nervous system paracoccidioidomycosis: case report and review
Antonio G Tristano,María Eugenia Chollet,María Willson,Julián Perez
Investigación Clínica , 2004,
Abstract: . Paracoccidioidomycosis is a systemic infection caused by a dimorphic fungus (Paracoccidioides brasiliensis). The most common lesions frequently occur in the bucopharinx mucosa. Other lesions occur in the adrenal glands, liver, bone, gastrointestinal tract, lungs and nervous system. We report here a case of neuroparacoccidioidomycosis. The patient was a 49 year-old male, who consulted due to neurological symptoms (cephalalgia, speech difficulty and one tonic clonic seizure with urinary incontinence) of eight months duration. Upon physical examination it was observed an emaciated male with nail clubbing, a skin ulcer with raised edges and a crusted bottom of 4 × 2 cm in diameter located in the right supraclavicular region and an ulcerated lesion in the left tonsil with edema. The rest of the physical examination reveled a discrete left side hemiparesis and pulmonary rales in the left hemitorax. The fungus was identified through direct examination of cerebrospinal fluid (CSF). The histopathology of suprarenal, lungs, brain and skin showed multiple paracoccidioidal granulomas. To the best of our knowledge, this is the third case reported in the literature. We review the literature on the pathogenesis and prevalence of neuroparacoccidioidomycosis. Resumen. La Paracoccidioidomicosis es una infección sistémica causada por un hongo dimorfo (Paracoccidioides brasiliensis). Las lesiones más comunes frecuentemente ocurren en la mucosa bucofaríngea. Otras lesiones ocurren en la glándula adrenal, hígado, hueso, tracto gastrointestinal, pulmones y sistema nervioso. Se presenta un paciente masculino de 49 a os de edad, quién consultó con historia de ocho meses de duración caracterizada por síntomas neurológicos (cefalea, dificultad para hablar, un episodio de convulsión tónico-clónica generalizada con relajación del esfínter vesical). Al examen físico se encontró un paciente emaciado con dedos en palillo de tambor y una úlcera de bordes elevados y fondo costroso de 4 × 2 cm de diámetro en la región supraclavicular derecha. Además, se apreció una lesión ulcerada en la amigdala izquierda con edema. El resto del examen físico reveló una hemiparesia izquierda y crepitantes en el hemitorax izquierdo. Nosotros reportamos un caso de neuroparacoccidiodomicosis donde el hongo fue identificado a través del examen directo del líquido cefalorraquídeo. Este es el tercer caso reportado en la literatura. La histopatología de las suprarrenales, pulmones, cerebro y piel mostró múltiples granulomas paracoccidioidales. Hacemos una revisión de la literatura sobre la patogénesis
Histopathological evaluation of urethroplasty with dorsal buccal mucosa: an experimental study in rabbits
Souza, Geovanne F.;Calado, Adriano A.;Delcelo, Rosana;Ortiz, Valdemar;MacedoJr., Antonio;
International braz j urol , 2008, DOI: 10.1590/S1677-55382008000300012
Abstract: purpose: buccal mucosa is a widely accepted tissue for urethroplasty. the exact healing and tissue integration process, mainly the histological characteristics of dorsal buccal mucosa graft urethroplasty when used dorsally to reconstruct the urethral plate has not previously been assessed, and thus we developed an experimental model to address this question. materials and methods: in 12 new zealand rabbits (weight 2.5 kg) we surgically created a dorsal penile urethral defect. a buccal mucosa graft was sutured to the corpora and tunica albuginea, and the ventral urethra anastomosed to this new urethral plate. the animals were divided in three groups and sacrificed 1, 3 and 6 weeks after surgery (groups 1, 2 and 3). a retrograde urethrogram was obtained at autopsy in the last group and the penis analyzed histologically with hematoxylin-eosin and masson's staining. results: the urethrograms showed no evidence of fistula or stricture. in group 1 the histopathological analysis showed submucosal lymph-mononuclear inflammatory edema, numerous eosinophils and squamous epithelium integrated into the adjacent urothelium. in group 2 there was no evidence of an inflammatory response but rather complete subepithelial hyaline healing, which was more marked in group 3. conclusion: healing of buccal mucosa grafts to reconstruct the urethral plate can be achieved by total integration of the squamous epithelium with the urothelium, maintaining the original histological properties of the graft with no fibrosis or retraction.
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