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Background Odontogenic keratocysts (OKC) are cystic lesions appearing in the jaws, usually asymptomatic with a progressive growth into the bone. Many of them are diagnosed by a routine radiological examination. Material and methods This study reports a 12-year-old girl that presented an asymptomatic large radiolucent unilocular lesion associated to the crown of 3.8 that caused displacement of the molar and the inferior alveolar canal. Differential diagnosis included OKC, unicystic ameloblastoma, ameloblastic fibroma, dentigerous cyst and orthokeratinized odontogenic cyst. Two surgical interventions were performed; first, a marsupialization, and 10 months after, the third molar extraction plus cyst enucleation, mucosa excision and the application of Carnoy's solution. Results The anatomopathological exam confirmed diagnosis of OKC. There was no evidence of recurrence after 2 years of follow-up. Conclusions Marsupialization followed by surgical enucleation with mucosa excision and Carnoy's solution can help manage treatment of OKC, a lesion characterized by an aggressive behavior. Key words:Odontogenic keratocyst, mucosa excision, carnoy solution, third molar, tooth extraction.

Metformin is currently used to improve pregnancy outcome in women affected by polycystic ovary syndrome (PCOS) or diabetes. However, metformin may also be useful in pregnancies at risk of intrauterine growth restriction (IUGR) since it improves placental efficiency and the fetuses&rsquo, developmental competence. There is no data on the duration of the effect of this treatment from the prenatal up to the postnatal stages. Therefore, the present trial aimed at determining the impact of metformin treatment on the offspring neonatal traits and early postnatal development (i.e., during lactation) using an in vivo swine model. The results support that maternal metformin treatment during pregnancy induces protective changes in body shape and composition of the progeny (i.e., larger head size and body length at birth and higher total viscera weight at weaning). However, there were also major effects of the offspring sex (smaller corpulence in females and lower relative weight of main viscerae in males), which should be considered for further preclinical studies and when even the current clinical application in women affected by PCOS or diabetes is implemented.

Background. A solitary bone cyst or simple bone cyst is a nonneoplastic osseous lesion, with no epithelial lining, also considered as a pseudocyst. These lesions, with an intact bony wall and fluid-filled, are frequently discovered by chance in radiological studies. The etiopathogenesis has not been studied in depth, and the management remains controversial. Case Presentation. We present a clinical case of a 15-year-old boy who underwent an orthopantomography to assess the development and position of the third molars during a routine postorthodontic check-up. By chance, the X-ray identified an asymptomatic radiolucent image in the left jaw, measuring 12.0 mm×17.8 mm and compatible with a solitary bone cyst involving teeth 35 and 36. We describe our technique for performing minimally invasive decompression of the lesion using a microperforated catheter. We describe the entire course of the follow-up, both clinical and radiological, until complete cure. Conclusions. This straightforward continuous decompression technique poses no problems for the patient, has a low risk of sequelae, and is clearly cost-effective. In view of the highly satisfactory evolution, whenever possible, we favor this minimally invasive technique for the treatment of solitary bone cysts in the jaw.

Background Dentigerous cyst appears surrounding the crown of an included tooth. On the radiographic exam, a radiolucent rounded well-defined lesion can be observed. Material and methods This study reports a clinical case of a 34-years old man with a pericoronal radiolucent lesion associated to an impacted lower third molar with the presence of radiopaque material inside. The radiological differential diagnosis was calcifying odontogenic tumor, adenomatoid odontogenic tumor and dentigerous cyst. The impacted third molar was removed and the lesion was sent for the histopathological exam. Results The histopathological diagnosis was dentigerous cyst with capsular calcifications. Specifically, parietal calcifications on its connective wall and a piece of cemento-osseous tissue inside. Conclusions Non-neoplastic lesions such as dentigerous cysts could develop radiopacities inside the radiolucent pericoronal area. Key words:Dentigerous cyst, calcifications, third molar, differential diagnosis.

Dentigerous cysts are one of the most common odontogenic cysts of the oral cavity. Odontogenic cysts can give rise to a variety of neoplasms. Carcinoma arising in a dentigerous cyst is extremely rare, with a review of literature showing near 30 cases. The present report describes 2 cases of primary intraosseous squamous cell carcinoma originated from a dentigerous cyst. The first one refers to a 57-year old female with a persistent lesion in the left retromolarregion and diagnosed with squamous cell carcinoma originated fromthe incomplete excision of the lower third molar follicle during its surgical extraction. The second case describes the case of an 18-year old male with an impacted upper canine with previous history of infection and swelling of the oral cavity. The histopathological study revealed the malignization of the follicle surrounding the dental crown. These two cases confirmed the importance of the histopathological study of all the tissue samples obtained from surgical procedures. Although the development of a malignant lesion from a dentigerous cyst is rare and its clinical-radiological features are apparently innocuous, this entity should be considered as a differential diagnosis. Key words:Dentigerous cyst, odontogenic cyst, squamous cell carcinoma, primary intraosseous squamous cell carcinoma, odontogenic carcinoma.

Submitted by José Pereira (jro.pereira@gmail.com) on 2018-07-12T11:16:05Z No. of bitstreams: 1 Umbilical Cord Hemangioma.pdf: 918142 bytes, checksum: 811dc55c343fd0da79c2b75652e1220f (MD5) Made available in DSpace on 2018-07-12T11:16:05Z (GMT). No. of bitstreams: 1 Umbilical Cord Hemangioma.pdf: 918142 bytes, checksum: 811dc55c343fd0da79c2b75652e1220f (MD5) Previous issue date: 2017-09-29 info:eu-repo/semantics/publishedVersion

The aim of this study was to systematically review scientific literature in orderto describe the characteristics and prognosis of malignant entities developing from odontogenic cysts. A search in Pubmed (MEDLINE) and Cochrane databases was conducted. The inclusion criteria were articles published in English related to the malignisation of odontogenic cysts in humans. The exclusion criteria were articles that do not specify the type of odontogenic cyst, malignisation of parakeratinised keratocysts, the presence of an ameloblastic carcinoma and metastasis from distant primary tumours. The selected articles were classified according to Strength of Recommendation Taxonomy criteria. Statistical analysis of the data was carried out using statistical package software SPSS version 22.0. From the 1,237 articles initially obtained, the authors included 3 case series and 45 case reports in the end. Descriptive analysis showed that men have a disposition for malignisation from odontogenic cysts and they frequently appear at the posterior mandible, with pain and swelling being the most frequent signs and symptoms. Follicular cysts were the entities that underwent the most malignant changes with well differentiated squamous cell carcinomas being the most prevalent type of malignancy. The real prognosis of this malignancy is not known because of the heterogeneity of available studies. Key words:Odontogenic cysts, squamous cell carcinoma, neoplastic cell transformation, oral cancer.

PURPOSE: To evaluate the effectiveness, recurrence rate, and complications of carbon-dioxide laser vaporization in the treatment of Bartholin's gland cysts. METHODS: A retrospective study including 127 patients with symptomatic Bartholin' gland cysts submitted to carbon-dioxide laser vaporization at our institution from January 2005 to June 2011. Patients with Bartholin's gland abscesses and those suspected of having neoplasia were excluded. All procedures were performed in an outpatient setting under local anaesthesia. Clinical records were reviewed for demographic characteristics, anatomic parameters, intraoperative and postoperative complications, and follow-up data. Data were stored and analyzed in Microsoft Excel® 2007 software. A descriptive statistical analysis was performed, and its results were expressed as frequency (percentage) or mean±standard deviation. Complication, recurrence, and cure rates were calculated. RESULTS: The mean age of the patients was 37.3±9.5 years-old (range from 18 to 61 years-old). Seventy percent (n=85) of them were multiparous. The most common symptom was pain and 47.2% (n=60) of patients had a history of previous medical and/or surgical treatment for Bartholin's gland abscesses. Mean cyst size was 2.7±0.9 cm. There were three (2.4%) cases of minor intraoperative bleeding. Overall, there were 17 (13.4%) recurrences within a mean of 14.6 months (range from 1 to 56 months): ten Bartholin's gland abscesses and seven recurrent cysts requiring reintervention. The cure rate after single laser treatment was 86.6%. Among the five patients with recurrent disease that had a second laser procedure, the cure rate was 100%. CONCLUSIONS: At this institution, carbon-dioxide laser vaporization seems to be a safe and effective procedure for the treatment of Bartholin's gland cysts. OBJETIVO: Avaliar a eficácia, a taxa de recorrência e as complicações da vaporização laser com CO2 no tratamento dos cistos da glândula de Bartholin. MÉTODOS: Estudo retrospectivo com 127 pacientes que apresentavam cistos sintomáticos da glândula de Bartholin submetidas à vaporização laser CO2 na nossa instituição de janeiro de 2005 a junho de 2011. Foram excluídas todas as pacientes com abcessos da glândula de Bartholin ou com suspeita de câncer. Todos os procedimentos foram realizados em regime ambulatorial, sob anestesia local. A coleta dos dados foi feita com base na consulta do processo clínico, tendo-se procedido à análise das características demográficas, dos parâmetros anatômicos, das complicações intra e pós-operatórias e dos dados de acompanhamento. Os dados foram armazenados e analisados no software Microsoft Excel® 2007, e os resultados foram apresentados como frequência (porcentagem) ou média±desvio padrão. As taxas de complicações, recorrência e cura foram calculadas. RESULTADOS: A idade média das pacientes foi de 37,3±9,5 anos (variando entre 18 e 61 anos). Setenta por cento (n=85) delas eram multíparas. A queixa mais frequente foi dor e 47,2% (n=60) das pacientes tinham antecedentes de tratamento médico e/ou cirúrgico por abcesso da glândula de Bartholin. A dimensão média dos cistos foi de 2,7±0,9 cm. Foram verificados três (2,4%) casos de hemorragia intraoperatória ligeira e 17 (13,4%) recorrências durante um período médio de 14,6 meses (variando entre 1 e 56 meses): dez abscessos da glândula de Bartholin e sete cistos recorrentes, que precisavam de uma nova intervenção cirúrgica. A taxa de cura após um único tratamento à laser foi de 86,6%. Dentre as cinco pacientes com doença recorrente que foram submetidas a um segundo procedimento com laser, a taxa de cura foi de 100%. CONCLUSÕES: Na presente instituição, a vaporização laser com CO2 parece ser uma opção terapêutica segura e eficaz no tratamento dos cistos da glândula de Bartholin.

espanolCasos clinicos: Presentamos una paciente de 43 anos con historia clinica de dolor sacro incapacitante 8/10 en la escala de EVA de 8 meses de evolucion. No se apreciaban alteraciones sensitivas ni perdida del control de esfinteres. Realizo consulta en multiples hospitales. Se le practicaron una tomografia computadorizada (TC) lumbar que puso de relieve un hemangioma en L5, una resonancia magnetica (RM) de pelvis en la que se evidencio rotura muscular grado I del gluteo mayor izquierdo y una lesion quistica en el sacro que se interpreto como quiste de Tarlov. Recibio tratamiento analgesico y antiinflamatorio sin mejoria. Se le realizaron dos bloqueos facetarios e incluso un bloqueo del musculo piriforme izquierdo, todo ello sin resultados. En nuestro centro se practico una RM lumbo-sacra que puso de relieve la lesion quistica de localizacion central y lateral derecha en canal espinal sacro a la altura de la transicion S2-S3. Era de alta senal en T2 y de baja senal en T1. Segun la clasificacion de Nabors correspondia a un meningocele intrasacro oculto. Discusion: El meningocele intrasacro oculto (quiste meningeo extradural tipo lB de la clasificacion de Nabors) es una entidad poco frecuente que se presenta generalmente entre la tercera y cuarta decada de la vida, como un cuadro clinico insidioso de dolor en extremidades inferiores, con o sin sintomas radiculares, disfuncion de esfinteres y alteraciones sensitivas. El tratamiento habitual de este tipo de lesiones es la intervencion quirurgica. En nuestro caso se realizo puncion y evacuacion del quiste sacro guiado por TC obteniendose unos 2 cc de un liquido sero-hematico. La evolucion posterior fue de mejoria notable del dolor sacro que paso a ser de 3/10 en la escala de EVA. En la revision de la literatura que hemos efectuado este es el primer caso en que se trata un meningocele intrasacro oculto doloroso mediante puncion evacuadora guiada por TC. EnglishCase reports: We report a 43-year old patient with a history of disabling pain sacrum 8/10 on the VAS of 8 months. No sensory disturbances were noted or loss of bowel control. Consultation conducted in multiple hospitals. She underwent a computed tomography (CT) lumbar that highlighted a hemangioma in L5, a magnetic resonance imaging (MRI) of the pelvis which showed muscle breakdown grade I of the left maximus gluteus, and a cystic lesion in the sacrum, which was interpreted as a Tarlov cyst. She received analgesic and anti-inflammatory treatment with no improvement. She also goes through two facet blocks and even a lock in the left piriformis, all without results. In our center we practised a lumbosacral MRI which highlighted a cystic lesion localized in central and right lateral sacral spinal canal at the level of S2-S3 transition. It was high signal on T2 and low signal on T1. Discussion: According to Nabors classification, this lesion corresponds to a hidden intrasacro meningocele. The hidden intrasacro meningocele (extradural meningeal cyst type classification LB Nabors) is a rare entity that usually develops between the third and fourth decade of life, as an insidious clinical lower extremity pain, with or without radicular symptoms, bowel dysfunction and sensory disturbances. The usual treatment of these lesions is surgical intervention. In our case puncture and evacuation guided by CT of the sacral cyst was performed, yielding about 2 cc of a sero-hematic fluid. The postoperative course was a remarkable improvement, and the sacral pain happened to be 3/10 on the VAS. In the literature that we have reviewed, this is the first case in which a hidden painful intrasacro meningocele is evacuated by CT-guided puncture.

Objectives: To determine the relative incidence of odontogenic cysts and to identify the main clinicopathological features among patients treated in the Oral Surgery Department of the Dental Clinic of the University of Barcelona (Spain). Study design: A retrospective observational study was made of 418 odontogenic cysts diagnosed in 380 patients included in the database of 1235 histopathological diagnoses. The subjects were treated in the Master degree program of Oral Surgery and Implantology of the University of Barcelona in the period 1997-2006. The following variables were recorded: gender, age, clinical characteristics of the lesions (size and location), radiological features, duration, treatment, complications and relapses. A descriptive analysis was made of the study variables, using the SPSS version 15.0. Results: The incidence of odontogenic cysts was 33.8%. The mean patient age at appearance of the lesion was 42 years (range 7-83). The cysts were slightly more prevalent in males (58.4%). The lesion size ranged from 2-60 mm, with a mean size of 18.4 mm. The most frequent diagnosis was radicular cyst (50.2%). The most common location of the odontogenic cysts was in the mandible (61.5%), particularly the lower third molar region (36.8%). Conclusions: The most frequently diagnosed lesion was the radicular cyst. Odontogenic cysts were seen to be slightly more prevalent in males, and showed a high mandibular incidence. Knowledge of the biological and histological behavior of odontogenic cysts and their frequency are key aspects for ensuring early detection and adequate treatment.

Epidermoid cysts are a rare entity in the oral cavity and are even less frequent in the floor of the mouth, representing less than 0.01% of all the cases. We present the case of a 3-year-old girl with a growth in the floor of the mouth with 2 months of evolution and without changes since it was discovered by her parents. The lesion was asymptomatic; it did not cause dysphagia, dyspnea, or any other alteration. A CT scan with contrast was done which revealed the location and exact size of the lesion, allowing an intraoral approach for its excision. The histological examination confirmed the clinical speculation of an epidermoid cyst.

Summary Intraventricular schwannoma is an exceedingly rare tumour with only 6 cases described in the literature. One case of a cystic intraventricular schwannoma operated on at our Institution is analized and the other cases reported in the literature are reviewed. Complete removal was achieved and no reccurrence was noted after a follow-up period of 10 years. Intraventricular schwannomas are rare tumours that are amenable to complete surgical removal, having a good prognosis without the need of adjuvant therapy.

The squamous odontogenic tumour is a rare benign neoplasm whose aetiology remains unknown. It usually appears in the jaw and its origin could be related to the ephitelial remnants of Malassez. Histologically comprises numerous islets of squamous, non-keratinized, well-differentiated and rounded epithelial cells a fibrous stroma without signs of atypical cells. There is a non-neoplastic lesion with the same histological pattern than the squamous odontogenic tumour. This entity is characterized by squamous odontogenic tumour proliferations isolated into the cyst wall of an odontogenic cyst. It is rare and has a benign behavior. It has been suggested that these epithelial proliferations could be the former expression of the neoplastic form. It is very important to carry out clinical and radiological controls periodically. So far it has not been documented any change towards a squamous odontogenic tumour nor toward malignancy in a squamous odontogenic tumour like proliferation. Key words:Radicular cyst, squamous odontogenic tumour.

A 61-year-old woman was followed for multifocal motor neuropathy (MMN) with conduction block since young adulthood. She had bilateral clinical and neurophysiologic involvement of both median and ulnar nerves, as also the right peroneal nerve. In a recent reevaluation, we decided to complete her investigation with a brachial plexus magnetic resonance imaging (MRI) that, besides diffuse thickening of the right brachial plexus trunks, showed a round hyperintense cyst that compressed several branches distally (Figure). Brachial plexus MRI may be important [...]

Cysts of the median raphe are uncommon. We describe a 43-year-old man with an asymptomatic nodule on the glans penis. Excision of the lesion was performed followed by histological and immunohistochemical studies. Histopathological examination revealed a solitary unilocular cystic cavity in the corium, lined by a pseudostratified columnar epithelium, among which mucinous cells where identified. Hints of decapitation secretion occurred at the apex of the luminal layer. An immunohistochemical study using a standard avidin-biotin peroxidase method disclosed CK7 and CK13 reactivity in the columnar cells. Epithelial membrane antigen (EMA) and carcinoembryonic (CEA) antigen immunoreactivity occurred at the apical border of the luminal cells. No staining was obtained with anti-CK20, human milk fat globulin 1 (HMFG1) and anti- S100 protein. The study supports its histogenetic relationship with the urothelium.

A patient with chronic liver disease was treated with large doses of mebendazole for a hepatic hydatid cyst. Eighteen days after beginning treatment he developed marrow aplasia which reverted to normal after the drug was stopped. This is the marrow aplasia which reverted to normal after the drug was stopped. This is the sixth patient described as developing marrow aplasia when treated with large doses of mebendazole. We suggest that the aplasia is related to the dose of the drug, and that the patient's chronic liver disease was an important factor in its genesis. Patients treated with large doses of mebendazole should have their blood counts monitored during treatment.