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Solitary fibrous tumors （SFTs） were reported in 1931 as tumors derived from mesenchymal tissue. They occur mainly in the pleura and peritoneum and rarely in the oral and maxillary regions. This report presents the case of a 48-year-old woman with a tumor in the left buccal mucosa. We suspected a salivary gland tumor or hemangioma. Excision was performed under general anesthesia. The lesion was removed as a single mass. Histopathological and immunohistochemical analyses led to the diagnosis of SFT. We report this case based on a literature review.

A definitive diagnosis of salivary gland tumors is extremely difficult to make without evaluating the entire tumor and conducting immunohistochemical examinations. In this study, we aimed to examine and compare the expression patterns of the tumor protein （TP） D52 family, including TPD52, TPD53, and TPD54, in salivary gland tumor cells by using immunohistochemical staining. Among over 30 benign and malignant salivary gland tumors with extensive and diverse morphological features and overlapping histological similarities, we selected Warthin’s tumor and pleomorphic adenoma to represent benign salivary gland tumors and mucoepidermoid carcinoma to represent malignant ones. Tumor samples were fixed in 10％ buffered formalin and embedded in paraffin. Then, immunohistochemical staining was performed using antibodies against TPD52, TPD53, and TPD54. Neither the benign salivary gland tumors nor mucoepidermoid carcinoma stained for TPD52. However, the intensity of TPD53 and TPD54 staining was found to be low in the benign salivary gland tumors and high in mucoepidermoid carcinoma. TPD54 may serve as a pathological indicator of benign salivary gland tumors and mucoepidermoid carcinoma.

Necrotizing sialometaplasia is a benign lesion affecting the minor salivary glands of the hard palate. This lesion may be clinically and histopathologically confused with malignant lesions. A case of a 47-year-old man who presented with necrotizing sialometaplasia on the left side of the hard palate is herein reported. A biopsy was performed, and the condition was diagnosed based on immunohistochemistry. The lesion receded following treatment with tranexamic acid and sodium azulene sulfonate. The symptom of painful swelling on the hard palate subsided within 10 days. The palatal lesion had disappeared completely 4 months later.

A case of delayed epistaxis from the mucosa behind the right side of the inferior nasal mucosa 11 days after orthognathic surgery by Le Fort I osteotomy is presented. The patient was a 31-year-old man who underwent orthognathic surgery under general anesthesia. No abnormal findings were found during or after the operation. The patient was discharged from the hospital 10 days postoperatively. However, bleeding from the right nasal cavity occurred suddenly on the night after discharge, and he presented to our hospital again. The epistaxis was stopped once by nasal packing containing 0.001% epinephrine and systemic infusion of carbazochrome sulfonic acid and tranexamic acid. However, when the nasal packing was removed the next day, right nasal epistaxis was observed again. Curvature of the nasal septum and thickening of the inferior turbinate mucosa were seen on inspection; although, no active bleeding point was identified. Decreased nasal mucosa thickening and bleeding were observed after nasal packing containing 0.02% epinephrine. When the inside of the nasal cavity was observed endoscopically, an approximately 2 mm laceration was found in the mucosa behind the side wall of the right inferior nasal mucosa, and bleeding from the same part was confirmed. After endoscopic cauterization for hemostasis of the nasal mucosa, no rebleeding was observed. Although delayed epistaxis after Le Fort I osteotomy are often performed CT angiography to confirm the bleeding site, endoscopic cauterization would be primarily useful because of less invasiveness.

Additional file 1. Supplementary methods.

The prevalence of nonsuicidal self-injury (NSSI) in adults is lower than that in adolescents and it is more prevalent in patients with psychiatric disorders. Sleep disturbances such as nightmares are associated with NSSI after accounting for depression; thus, persons with major NSSI sometimes present at medical institutions during the night seeking emergency treatment. Gingival tissues comprise the most frequent target of self-injury of the oral cavity using oral hygiene tools. Most NSSI in the oral cavity is minor because such tools are blunt. Major NSSI such as autoamputation of the tongue is rare. We describe two patients who partially autoamputated the apex of their own tongues using edged tools. Case 1 was a 55-year-old female with depression who had defaulted from psychiatric intervention. She had cut off her tongue using a Japanese kitchen knife and presented with the dry, necrotic amputated portion and blood oozing from the remainder of her tongue. We debrided and sutured the remainder of the tongue without reattaching the amputated portion. Her postoperative course was uneventful, and she was free of adverse events such as functional disability and wound infection. Case 2 was a 69-year-old female with schizophrenia who had defaulted from psychiatric intervention and had cut off her tongue using scissors. The amputated portion of the tongue was lost and the remainder, which was oozing blood, was debrided and sutured. She defaulted on a follow-up appointment. Neither of these patients had suicidal intent. The prevalence of NSSI across all age groups has recently increased, and the risk that self-injury will become normalized has become a concern. Thus, dentists as well as oral and maxillofacial surgeons should be aware of the possibility that patients will present with major NSSI requiring emergency treatment.