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Clinical Report

HUGE AMELOBLASTOMA OF JAW-A CASE REPORT

Subhalakshmi Mukhopadhyay1, Kalpana Raha2, Sambhu Charan Mondal1

1Assistant Professor Department of Pathology R G Kar Medical College Kolkata, 2Associate Professor Department of Pathology R G Kar Medical CollegeKolkata

CASE REPORTA 32-year-old male patient presented with a huge swellinginvolving lower jaw which was present for the last 7 years.The patient was a farmer by profession. The swelling graduallyincreased in size making it impossible for the patient to closehis mouth and to articulate properly. Some of the teeth of the

lower jaw were lost. Mandibular X-ray showed a huge roundradio opaque shadow without any evidence of multilocularradiolucency. Fine needle aspiraion cytology (FNAC) revealeddark brown fluid substance. Smears showed low cellularity.The cells were of benign characteristic, which were discrete,

ABSTRACT: Ameloblastoma is a tumor of odontogenic epithelium. It is a tumour of intermediatemalignant potential which lies in the gray zone between benign and malignant neoplasm. A huge

ameloblastoma revealing benign cytological features in FNAC is being reported.

Ameloblastoma arises from odontogenic epithelium. This tumor can occur at any age. Though traditionallydivided as solid and cystic, nearly all ameloblastomas show some cystic change. This tumor shows

invasive property and a remarkable tendency of recurrence. The cases showing distant metastasis are

recognized as malignant ameloblastoma. Ameloblastic carcinoma is a tumor with microscopic featuresof ameloblastoma that displays malignant features at cytological level.[2] It usually has aggressive course.

A case of large ameloblastoma with slow clinical course and benign cytological as well as histological

features is being reported.

Figure 1: Photograph of the patient showing the tumor.

Figure 2: Photograph of the patient after operation.

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Indian Journal of Otolaryngology and Head and Neck Surgery Vol. 57, No. 3, July - September 2005

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Clinical Report

FOREIGN BODY IN THE NASOPHARYNX OF A CHILD

Arunabha Sengupta1, Pinaki Saha2, Subhasish Chakrabarty3

ABSTRACT: Introduction of foreign body into the nasal cavity of the children by themselves is very

common, but lodgment of foreign body in the nasopharynx following introduction through mouth isunusual. Here a case is presented from the Otorhinolaryngology department of S.S.K.M. Hospital, Kolkata,

where a child was brought by their parents with history of introduction of a metallic foreign body in the

mouth of the child by himself and this foreign body was found to be lodged in the nasopharynx of thechild. The foreign body was removed orally in the out patient department. The patient returned home

without any complication.

1Assistant Professor, 2Junior Resident, 3Junior Resident, Department of Otorhinolaryngology, S.S.K.M. Hospital and I.P.G.M.E. & R., Kolkata

Incidence of foreign body being introduced into the nasalcavity of a child by himself or herself is very common, butlodgment of foreign body in the nasopharynx afterintroduction through mouth is very unusual. Here a case reportis given, where a metallic foreign body after being introducedinto the mouth of a child by himself ultimately had get lodgedin the nasopharynx. This was diagnosed clinically andradiologically. The foreign body was removed in the outpatient department orally and the patient was sent home

Key words: Laryngoscope, Luc’s forceps, Nasopharynx

without any complication with advice for oral antibiotic.

CASE REPORTThe child was playing with a thimble (a metallic hollowtruncated cone which tailors wear in their index finger duringstitching) and suddenly put it into his mouth. When noticedat around 7:30A.M., he was lying down with his mouth openand crying. His parents tried to bring it out by putting theirfingers in his mouth but could not localize the foreign body.

elongated or oval in shape with abundant cytoplasm. Someosteoblasts were also present in the smear. No giant cells weredetected. A provisional diagnosis of ameloblastoma was made.The swelling was resected out along with the mandible. [Table

2] The size of the mass was 25 cm. x15 cm.x10 cm. Histology

showed islands of epithelial cells with central loose network

of cells resembling stellate reticulum of ameloblastoma. [Table3]

DISCUSSIONDiagnosis of ameloblastoma depends upon appropriatehistological findings in proper clinical setting. Radiology oftenhelps in preoperative diagnosis. In this case diffuse opacity,possibly caused by extensive destruction of the mandible andcystic changes, gave rise to confusion. No specific FNACfinding of ameloblastoma was found in literature review Inthis case FNAC suggested a benign lesion. Absence ofmalignant cells was a significant finding in FNAC. Histologywas confirmatory. Such a huge size of a benign ameloblastomais rare in literature. FNAC may play significant role inpre-operative assessment of behavior of such tumor.

Figure 3: Microphotograph showing epithelial island with squamousmetaplasia. (x40)

REFERENCES1. Rosai J. Ackerman’s Surgical Pathology. Mosby, 1996;271-2.

2. Slootweg PJ, Muller H. Malignant ameloblastoma or ameloblastic

carcinoma. Oral Surg. Oral Med Oral Pathol 1984;57:168-76.

Address for correspondenceDr. Subhalakshmi Mukhopadhyay BB 41/8,Salt Lake CityKolkata -700064, E mail-sambuddhaghosh@hotmail.com

Huge ameloblastoma of jaw-A case report