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Dermatologic diseases are often associated with oral manifestations and sometimes the oral lesions are the sole presenting features of the disease. Diagnosing a dermatologic disease based on its oral manifestations is a challenge, especially in the absence of associated cutaneous lesions. Lichen planus is a common dermatologic disease that affects the oral mucosa in the adult population. While some patients have concomitant oral and cutaneous lesions, the oral lesions are persistent and seen for years together even after the cutaneous lesions have healed. Herein, we present two cases of oral lichen planus seen as an ulcerated lesion on the lower lip which is an uncommon manifestation of this otherwise common disease.

Malignancy is characterized by anaplasia, invasiveness, and metastasis. Primary oral squamous cell carcinoma is the most prevalent oral malignancy, but secondary malignancy from distant sites have also been reported. Hepatocellular carcinoma (HCC) is a common primary liver malignancy that frequently metastasizes during the course of the disease, but < 1% of cases show oral involvement. Such secondary neoplasms do not have any pathognomonic clinical or radiologic findings, and therefore they pose a diagnostic challenge. Hence, in the differential diagnosis of malignant tumors of the oral cavity, it is essential to consider the occurrence of both primary as well as metastatic tumors despite the low incidence of the latter. A rare case of HCC metastasizing to both the maxilla and mandible is presented, in which the patient succumbed to the disease as a result of the delay in diagnosis.

Central giant cell granuloma (CGCG) of the jaw bones is a rare benign intraosseous lesions that is commonly seen as indolent lesions in the mandible anterior to the first molar. It is a localized osteolytic lesion with the varied biologic behavior of aggression which affects the jaw bones. There is much controversy regarding it arising as a result of trauma and its connection with the giant cell lesion seen in the long bones. Since the lesion is uncommon, does not possess any characteristic clinical or radiologic features, and resembles neoplasms, the diagnosis is initially some odontogenic or non-odontogenic neoplasm till a definitive histologic diagnosis of CGCG is made. CGCG is divided into a rare aggressive variant and a common nonaggressive variant based on the clinical and radiographic features. The present case is a rare aggressive CGCG seen in the posterior mandible associated with mandibular swelling, rapid growth, pain, paraesthesia, and cortical bone perforation.

Ameloblastomas are rare histologically benign, locally aggressive tumors arising from the oral ectoderm that occasionally reach a gigantic size. Giant ameloblastomas are a rarity these days with the advent of panoramic radiography in routine dental practice. Furthermore, the granular cell variant is an uncommon histological subtype of ameloblastoma where the central stellate reticulum like cells in tumor follicles is replaced by granular cells. Although granular cell ameloblastoma (GCA) is considered to be a destructive tumor with a high recurrence rate, the significance of granular cells in predicting its biologic behavior is debatable. However, we present a rare case of giant GCA of remarkable histomorphology showing extensive craniofacial involvement and dural extension that rendered a good prognosis following treatment.

Paget disease of bone (PDB) is a chronic progressive disease of the bone of uncertain etiology, characterized initially by an increase in bone resorption, followed by a disorganized and excessive formation of bone, leading to pain, fractures, and deformities. It can manifest as a monostotic or polyostotic disease. The prevalence of PDB is common in the Anglo-Saxon population, but relatively rare in India. The disease is often asymptomatic and commonly seen in an aging population. The diagnosis of the disease is mostly based on radiological examination and on biochemical markers of bone turnover. Markedly elevated serum alkaline phosphatase (SAP) is a constant feature while calcium and phosphate levels are typically within normal limits. It is being successfully treated by biphosphonates, a group of anti-resorptive drugs, thereby decreasing the morbidity and mortality associated with the disease. We report a classic case of PDB with craniofacial involvement resulting in Leontiasis Ossea (lion like face), cotton wool appearance of the skull and elevated SAP.

In a dental hospital, patients reporting with exposed bone in the palate/maxilla with or without pus discharging sinuses are generally clinically diagnosed as osteomyelitis which can occur as a complication of odontogenic bacterial infections, traumatic injuries, herpes zoster infection, aspergillosis, mucormycosis or iatrogenic infections. We present a series of four cases, all of which were initially clinically diagnosed as osteomyelitis and later confirmed to be mucormycosis following histopathological examination. Although rare, the common form of this opportunistic fungal infection is seen in the rhinomaxillary region and in people with an underlying systemic disease like diabetes mellitus (DM). This case series of rhinomaxillary mucormycosis is being reported to increase awareness among dental surgeons to regard the occurrence of osteomyelitis in the maxilla occurring in a immunocompromised patient especially with poorly controlled DM, with suspicion of an aggressive, fulminant, fatal fungal infection so as to ensure an early diagnosis and prompt treatment thereby reducing the morbidity and mortality associated with this disease.

Chondrosarcoma (CS) is a malignant neoplasm that results in abnormal bone and cartilage growth. Although CS is rare, it is the second most common primary bone malignancy. Mesenchymal chondrosarcoma (MC) is a rare histological variant of CS that accounts for only about 1 % of all CS and has high predilection for the head and neck region. It is usually seen in younger age group compared to conventional CS and the maxillary alveolus is the most common site. The tumor is unique because of its aggressive growth with a high tendency for late recurrence and delayed metastasis- We present two cases of MC, one case involving the mandibular condyle and the second, a metastatic CS with the primary in the clavicle.

Neurofbromatosis (NF) is an autosomal dominant disorder that affects the bone, the nervous system, soft tissue and the skin. NF is a neurocutaneous condition that can involve almost any organ system existing in two subtypes. NF1 is the most common subtype and is referred to as peripheral NF. Plexiform neurofibromas are diffuse, elongated fibromas coursing along the nerves. These lesions frequently involve the trigeminal or upper cervical nerves- Though plexiform neurofibroma occurs in only 5% of patients with NF 1, it is considered pathognomonic feature of NF1. We present a case of plexiform neurofibroma in the left side of the face in a 13-year-old girl with NF1.

Calcifying epithelial odontogenic tumor (CEOT) is a rare and benign odontogenic neoplasm that affects the jaws. It is certainly an atypical instance to find this tumor in children. Here, we present two case reports of CEOT presenting in mandible of a 12- and 13-year-old female child, respectively. CEOT have been reported to show features of malignant transformation also.