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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

Resected specimens. (a) Frontal plane section. (b) Sagittal section. (c) Horizontal section.
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fig11: Resected specimens. (a) Frontal plane section. (b) Sagittal section. (c) Horizontal section.

Mentions: The patient underwent partial maxillectomy and a split-thickness skin graft under general anesthesia in late February 2013 in the Division of Oral and Maxillofacial Surgery, Tokyo Medical and Dental University. The margin was located 0.8 cm from the tumor on the palate (Figure 9). The anterior wall of the maxilla was cut at the level of the middle meatus to open the maxillary sinus. The maxillary sinus membrane was edematously thickened, but there was no tumor exposure in the sinus. The maxillary sinus membrane was detached and collected on the floor of the sinus, and subsequently osteotomy was performed from the lateral wall to the posterior wall of the maxilla at almost the same level. Then, the alveolar process was cut in the left maxillary first premolar area and the palate bone was separated at almost the same level as the incision line of the membrane. The maxilla was downfractured to separate the pterygoid process and cut the internal pterygoid muscle, in order to isolate them with the maxilla (Figures 10, 11(a), 11(b), and 11(c)). Collected STS was grafted in the pterygoid region. After the sulcular incision in the anterior lip was sutured, tetracycline hydrochloride carboxymethyl cellulose ointment dressing gauze was put into the surgical cavity. Finally, the wound was closed and surgery was completed.


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)

Resected specimens. (a) Frontal plane section. (b) Sagittal section. (c) Horizontal section.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig11: Resected specimens. (a) Frontal plane section. (b) Sagittal section. (c) Horizontal section.
Mentions: The patient underwent partial maxillectomy and a split-thickness skin graft under general anesthesia in late February 2013 in the Division of Oral and Maxillofacial Surgery, Tokyo Medical and Dental University. The margin was located 0.8 cm from the tumor on the palate (Figure 9). The anterior wall of the maxilla was cut at the level of the middle meatus to open the maxillary sinus. The maxillary sinus membrane was edematously thickened, but there was no tumor exposure in the sinus. The maxillary sinus membrane was detached and collected on the floor of the sinus, and subsequently osteotomy was performed from the lateral wall to the posterior wall of the maxilla at almost the same level. Then, the alveolar process was cut in the left maxillary first premolar area and the palate bone was separated at almost the same level as the incision line of the membrane. The maxilla was downfractured to separate the pterygoid process and cut the internal pterygoid muscle, in order to isolate them with the maxilla (Figures 10, 11(a), 11(b), and 11(c)). Collected STS was grafted in the pterygoid region. After the sulcular incision in the anterior lip was sutured, tetracycline hydrochloride carboxymethyl cellulose ointment dressing gauze was put into the surgical cavity. Finally, the wound was closed and surgery was completed.

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