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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

After re-biopsy, the lesion size rapidly increased and a malignant tumor was strongly suspected.
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fig7: After re-biopsy, the lesion size rapidly increased and a malignant tumor was strongly suspected.

Mentions: Biopsy was performed twice and the tumor was confirmed histopathologically to be neurilemoma (Figures 5, 6(a), and 6(b)). However, the biopsy site lesion showed aggressive rapid growth (Figure 7), and therefore rebiopsy was performed in January 2013 due to suspicion of a malignant tumor. Histopathological specimens indicated that the lesion consisted of tumor cells containing atypical glands and a spindle nucleus, with fibrous tissues in the submucosa, which proliferated in a fascicular pattern. Mitoses and proliferation of atypical cells were also present (Figure 8(a)). In immunostaining, the Ki-67 positive rate exceeded 5% and the tumor cells were S-100 positive and strongly p63 positive. Based on these findings and the disease progression, the lesion was histopathologically diagnosed as a suspected malignant neurogenic tumor (Figures 8(b), 8(c), and 8(d)).


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)

After re-biopsy, the lesion size rapidly increased and a malignant tumor was strongly suspected.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4537717&req=5

fig7: After re-biopsy, the lesion size rapidly increased and a malignant tumor was strongly suspected.
Mentions: Biopsy was performed twice and the tumor was confirmed histopathologically to be neurilemoma (Figures 5, 6(a), and 6(b)). However, the biopsy site lesion showed aggressive rapid growth (Figure 7), and therefore rebiopsy was performed in January 2013 due to suspicion of a malignant tumor. Histopathological specimens indicated that the lesion consisted of tumor cells containing atypical glands and a spindle nucleus, with fibrous tissues in the submucosa, which proliferated in a fascicular pattern. Mitoses and proliferation of atypical cells were also present (Figure 8(a)). In immunostaining, the Ki-67 positive rate exceeded 5% and the tumor cells were S-100 positive and strongly p63 positive. Based on these findings and the disease progression, the lesion was histopathologically diagnosed as a suspected malignant neurogenic tumor (Figures 8(b), 8(c), and 8(d)).

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