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Massive Neurilemoma of the Hard Plate in Which Preoperative Diagnosis Was Difficult.

Kudoh M, Harada H, Matsumoto K, Sato Y, Omura K, Ishii Y - Case Rep Surg (2015)

Bottom Line: The mass was a solid tumor associated with resorption of surrounding bone and expansion of the greater palatine canal.The histopathological diagnosis was a suspected malignant neurogenic tumor.No recurrence was noted 29 months after the operation.

View Article: PubMed Central - PubMed

Affiliation: Division of Oral and Maxillofacial Surgery, Ebina General Hospital, 1320 Kawaraguchi, Ebina City, Kanagawa 243-0433, Japan ; Oral and Maxillofacial Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, Japan.

ABSTRACT
The patient was an 84-year-old man who was referred to our hospital in mid-December 2012 for a close examination of a mass arising from the left side of the hard palate that was found by a local dentist. The initial examination revealed the presence of a 3.0-cm elastic soft, dome-shaped mass in the left hard palate. CE-CT showed a lesion of size 1.8 × 1.4 cm in the right hard palate, which extended upward and invaded the nasal cavity. The mass was a solid tumor associated with resorption of surrounding bone and expansion of the greater palatine canal. CE-MRI indicated that the mass extended upward and invaded the nasal cavity, and the mass showed hypointensity on T1-weighted images, hyperintensity on T2-weighted images, and an irregular margin with internal enhancement. Abnormal uptake of FDG on PET-CT (SUVmax = 5.2) was observed in the left hard palate. The biopsy site lesion rapidly increased in size and biopsy was performed again in January 2013 due to suspicion of a malignant tumor. The histopathological diagnosis was a suspected malignant neurogenic tumor. Therefore, the patient underwent partial maxillectomy and a split-thickness skin graft in late February 2013. No recurrence was noted 29 months after the operation.

No MeSH data available.


Related in: MedlinePlus

CT images. (a) Frontal plane CE-CT image showing the presence of a 1.8 × 1.4 cm mass in the left hard palate, which extended upward and invaded the nasal cavity (arrow). (b) Horizontal image showing hyperplasia localized in bone (arrow) observed upward and backward to the maxillary sinus. No bone destruction was observed.
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fig2: CT images. (a) Frontal plane CE-CT image showing the presence of a 1.8 × 1.4 cm mass in the left hard palate, which extended upward and invaded the nasal cavity (arrow). (b) Horizontal image showing hyperplasia localized in bone (arrow) observed upward and backward to the maxillary sinus. No bone destruction was observed.

Mentions: Initial oral findings showed a 3.0-cm elastic soft, dome-shaped mass in the right hard palate (Figure 1). CE-CT showed a lesion of size 1.8 × 1.4 cm in the right hard palate, which extended upward and invaded the nasal cavity (Figure 2(a)). The mass was a solid tumor associated with resorption of surrounding bone and an enlarged greater palatine canal (Figure 2(b)). CE-MRI indicated that the mass extended upward and invaded the nasal cavity, and the mass showed hypointensity on T1-weighted images, hyperintensity on T2-weighted images, and an irregular margin with internal enhancement (Figure 3(a)). Dynamic MRI revealed a plateau type lesion that was suspected to be a malignant tumor (Figure 3(b)). Abnormal uptake of FDG in PET-CT (SUVmax = 5.2) was observed in the left hard palate (Figure 4). Based on these findings, the patient was diagnosed with a malignant tumor in the left hard palate.


Massive Neurilemoma of the Hard Plate in Which Preoperative Diagnosis Was Difficult.

Kudoh M, Harada H, Matsumoto K, Sato Y, Omura K, Ishii Y - Case Rep Surg (2015)

CT images. (a) Frontal plane CE-CT image showing the presence of a 1.8 × 1.4 cm mass in the left hard palate, which extended upward and invaded the nasal cavity (arrow). (b) Horizontal image showing hyperplasia localized in bone (arrow) observed upward and backward to the maxillary sinus. No bone destruction was observed.
© Copyright Policy - open-access
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4537717&req=5

fig2: CT images. (a) Frontal plane CE-CT image showing the presence of a 1.8 × 1.4 cm mass in the left hard palate, which extended upward and invaded the nasal cavity (arrow). (b) Horizontal image showing hyperplasia localized in bone (arrow) observed upward and backward to the maxillary sinus. No bone destruction was observed.
Mentions: Initial oral findings showed a 3.0-cm elastic soft, dome-shaped mass in the right hard palate (Figure 1). CE-CT showed a lesion of size 1.8 × 1.4 cm in the right hard palate, which extended upward and invaded the nasal cavity (Figure 2(a)). The mass was a solid tumor associated with resorption of surrounding bone and an enlarged greater palatine canal (Figure 2(b)). CE-MRI indicated that the mass extended upward and invaded the nasal cavity, and the mass showed hypointensity on T1-weighted images, hyperintensity on T2-weighted images, and an irregular margin with internal enhancement (Figure 3(a)). Dynamic MRI revealed a plateau type lesion that was suspected to be a malignant tumor (Figure 3(b)). Abnormal uptake of FDG in PET-CT (SUVmax = 5.2) was observed in the left hard palate (Figure 4). Based on these findings, the patient was diagnosed with a malignant tumor in the left hard palate.

Bottom Line: The mass was a solid tumor associated with resorption of surrounding bone and expansion of the greater palatine canal.The histopathological diagnosis was a suspected malignant neurogenic tumor.No recurrence was noted 29 months after the operation.

View Article: PubMed Central - PubMed

Affiliation: Division of Oral and Maxillofacial Surgery, Ebina General Hospital, 1320 Kawaraguchi, Ebina City, Kanagawa 243-0433, Japan ; Oral and Maxillofacial Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, Japan.

ABSTRACT
The patient was an 84-year-old man who was referred to our hospital in mid-December 2012 for a close examination of a mass arising from the left side of the hard palate that was found by a local dentist. The initial examination revealed the presence of a 3.0-cm elastic soft, dome-shaped mass in the left hard palate. CE-CT showed a lesion of size 1.8 × 1.4 cm in the right hard palate, which extended upward and invaded the nasal cavity. The mass was a solid tumor associated with resorption of surrounding bone and expansion of the greater palatine canal. CE-MRI indicated that the mass extended upward and invaded the nasal cavity, and the mass showed hypointensity on T1-weighted images, hyperintensity on T2-weighted images, and an irregular margin with internal enhancement. Abnormal uptake of FDG on PET-CT (SUVmax = 5.2) was observed in the left hard palate. The biopsy site lesion rapidly increased in size and biopsy was performed again in January 2013 due to suspicion of a malignant tumor. The histopathological diagnosis was a suspected malignant neurogenic tumor. Therefore, the patient underwent partial maxillectomy and a split-thickness skin graft in late February 2013. No recurrence was noted 29 months after the operation.

No MeSH data available.


Related in: MedlinePlus