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Treatment was established with AINES and muscle relaxants, as well as Michigan flat occlusal splint.
At 3 months, the patient came to the consultation showing an evident improvement of facial pain, although she referred bad night rest with frequent awakenings.
Upon examining the discharge splint, dark green staining-impregnation was observed, which recalled the gastric content (juice).
1.
With suspicion of gastroesophageal reflux, the patient was referred to the gastroenterologist who after performing the relevant tests (Ph-metry and endoscopy) confirmed the diagnosis.
The patient was treated with diet, postural measures and proton pump inhibitors (Omeprazole).
In the new review, at 6 months, the symptomatology had almost completely disappeared and the patient continued the treatment protocol for her myofascial syndrome.
A 49-year-old male patient underwent extraction of a third molar into a fourth quadrant and curettage of a large tissue at apical and distal level of the tooth.
The only personal history of interest is to highlight a smoking habit of 35ppaq.-year and an alcohol consumption of 150g/d.
As for family history highlights the death of his father for colon cancer.
The symptoms on physical examination were pain and inflammation in a region of 48 of several months of evolution that did not improve after extraction, also presenting a vestibular consistency of the fourth quadrant physical examination normal mucosa and upper quadrant.
1.
After analyzing the tissue extracted during tooth 48 extraction by the Pathological Anatomy Service, it is reported as Characterization Squamous with well differentiated cells.
A general extension study was carried out to determine clinical manifestations at head and neck level, where no neoformative destructive lesion was found in computerized tomography affecting the body and mandibular ramus and multiple cervical lymph nodes right distance.
The case is discussed in the Head and Neck Functional Unit (HCU) with chemotherapy and is catalogued as a T2N2bM0 and it is decided a radical surgical treatment together with a concomitant radiotherapy fields.
A segmental mandibulectomy is performed from tooth 43 to the right subcondylar region, modified radical cervical lymph node dissection, temporary colostomy and reconstruction by microvascular osteomyocutaneous graft.
Pathological anatomy classifies Squamous keratinizing carcinoma and affectation of 23 of the 35 nodes removed with extra invasion of the same nodes classified as pT2pN2
1.
3.5 months after surgery recurrence was observed after performing a new cervical CT for the appearance of cervical tumors compatible with massive recurrence in the form of multiple bilateral adenopathies.
We discuss the possibility of performing a new cycle of chemotherapy but it is discarded due to rapid massive recurrence, lack of response to treatment and low level of tolerance to chemotherapy by the patient.
The patient died 6.5 months after surgery due to local recurrence.
A 67-year-old patient smokes 6 cigarettes/day.
Previously diagnosed breast cancer (T2 N0 M0) treated by surgery associated with chemotherapy and radiotherapy.
Because of the metastatic progression of breast carcinoma, treatment with bisphosphonates (pamidronate 90 mg IV) was initiated.
20 cycles).
After the first 9 cycles of pamidronate it is when the patient is referred to our consultation of Oral and Maxillofacial Surgery by her oncologist presenting with a burning sensation and common gingival pain with a very painful lesion in the right hemigua.
The molar extraction associated with lingual lesion and other four non-viable teeth was indicated, appearing approximately one month after each extraction one month after the removal of the lesion by extra decubitus.
Limited debridement of bone necrosis was performed, supplemented with antibiotic therapy (amoxicillin-clavulanic, clarithromycin) and chlorhexidine gel.
The evolution was favorable in all areas except the mandibular molar, in which the exposure of the bone perpetuated the tongue position, requiring a second more aggressive ostectomy.
Although this exposure did not completely disappear, a correct control of the patient's pain was achieved when the lingual lesion disappeared.
We present the case of a 20-year-old patient who comes to the School of Dentistry of Sevilla derived by his orthodontist.
Inadequate position of the left lower canine (including in horizontal position), the temporal canine was used by the orthodontist during orthodontic treatment as permanent, not considering appropriate rescue of the definitive tooth.
The patient was informed about the existence of dental inclusion and the need for extraction or at least its surveillance.
Radiological examination (orthopantomography) showed the inclusion of the left lower canine in a horizontal position under the apex of contralateral premolars and lower canines (Mupparation pattern 8).
Location of evidence of canine transmigation indicates its extraction.
If we continue to control the case, when approaching the included tooth to the chin hole, the risks of the intervention would be unnecessarily increased, as well as the inferior tooth irritation due to the nerve would occur (9 very safely).
1.
Extraction was performed through a partial Neuman incision, with discharge at left lateral level.
No discharge was performed in the fourth quadrant due to the proximity of the mental foramen, identifying and protecting the right chin nerve during the intervention.
The tooth was extracted by coronal osteotomy and double odontosection, also eliminating the pericoronary sac.
1.
Finally, the wound was sutured and analgesic treatment was prescribed during the postoperative period, without prescription (acidbuprofen 600 mg, 1 with p. / 8 hours for one week) and antibiotic (Amoxicillin 875 mg).
The stitches were removed after ten days.
The evolution was favorable without detecting any complication.
A nine-year-old pediatric patient with no relevant clinical history was referred to the Children's Maxillofacial Surgery Unit for dental inclusion.
The radiological study showed inclusion of left lower canine, with a radiolucent area around 33, entering for surgical correction, with a preoperative diagnosis of follicular cyst.
The surgical treatment consisted of removal of the "follicular cyst" with curettage of the bone cavity and extraction of the canine included, with subsequent filling with "Bio-oss" bone, with satisfactory outcome.
The surgical specimen obtained through the curettage comprised several irregular fragments of greyish color and low consistency that grouped median 0.8 x 0.7 cms and a canine (0.9 x 0.5 cms) product of the surgical specimen
The histological study showed an unaltered dental structure, accompanied by tissue within which numerous odontogenic epithelial nests were observed within odontogenic solid formations arranged in fibrotic solid arranged elements arranged in a compacted micro cellular arrangement.
The elements that formed these structures were basaloid, with monomorphous, oval or fusiform nuclei, somewhat hyperchromatic, although without evidence of divisional activity.
Mixed with structures appeared glansuliform formations, sometimes tubular in appearance, with a lining of cylinical cells, homogeneous and nuclei often polarized to their base.
At the intercellular and dispersed level, small calcified basophilic spherules appeared, as well as areas with irregular contour of amorphous and hyaline deposits, with positive polar light against resistant diastase.
These data led to the diagnosis of follicular adenomatoid odontogenic tumor associated with canine dental structure retention.
1.
From the resected soft tissue material, an immunohistochemical study was carried out, which showed in the first place a reactivity of the proliferative elements, both in nodular and adenomatous areas of keratins compared to adenomatoid.
A nuclear positivity was also observed for p63 protein (marker of stem cells or progenitors) and this nuclear reactivity was present in both glansuliform areas and fusiform cells rounded nests.
1.
Ki-67 proliferation marker marks only 2-3% of the constituent cells of the tumor lesion, often appearing the grouped positivity to some fusiform cell nodules.
The detection of the markers of melanic differentiation HMB45 and Melan-A was negative as well as the hormonal receptors of estrogens (ER) and progesterone (RPg) and beta-2-microglobulin.
A 42-year-old female patient, with no personal history of interest, who came to the outpatient clinic of Oral and Maxillofacial Surgery of the Virgen de las Nieves University Hospital in Granada, presented with 15 lesions.
The intraoral examination of the patient also shows the presence of a tongue of appearance and authenticity.
Under local anesthesia and in two surgical times, complete excision of the lesions is performed.
The anatomopathological study of them typifies the lesions as fibropapillomas.
1.
Due to the characteristic stalked appearance of mucosal lesions, accompanied by the systemic examination of cutaneous trichilemomas in acral regions, the long time of evolution of these lesions, and the presence of a direct family history of papillary neoplasia proposed other
1.
In our hospital's emergency department, the patient is diagnosed with bilateral fibrocystic breast carcinoma and left-sided stage ductal carcinoma GII, which requires postoperative tumorectomy plus axillary chemotherapy homo collateral therapy and treatment.
The clinical diagnosis of genodermatosis of multiple hamartomas (the patient presents a pathognomonic lesion, a major criterion and three minor criteria), begins a complete process of systemic tumor screening.
The patient is evaluated in the Digestive Service, where the presence of asymptomatic thyroidism in the rectal mucosa and colonic mucosa is detected, after which she is referred to the Department of Endocrinology for progressive hyperthyroid evaluation.
After ruling out malignancy by cytohistological study, the patient is operated by the Endocrine Surgery Service performing total thyroidectomy.
The conclusive pathological result diagnosed the lesion as multinodular colloid goiter.
Five months after thyroid surgery, a mass in the right kidney was detected, which after studying with Computerized Tomography showed malignancy.
Associated to the Urology Department, it was decided to perform right radical nephrectomy plus supracaval lymphadenectomy.
The histological study of the surgical specimen diagnosed the lesion as renal carcinoma of clear and granular cells of fundamentally tubular component.
No postsurgical treatments are required.
At present the patient presents progressive decrease of visual acuity not affiliated in study by the Ophthalmology Service.
All neoplasic processes diagnosed and treated were detected in early stages.
At present the patient is in complete remission of all diagnosed and treated tumor pathology.
Despite having a clear clinical diagnosis almost from the beginning, the patient has been studied in the National Center of Oncological Research [Department of Human Genetics] confirming in a definitive way that the cGEN gene carrier is confirmed.
The study has been extended to other first-degree relatives to perform an appropriate screening and initiate close clinical follow-up if necessary.
We report the case of a 22-year-old man, asthenic, pale and thin, who repeatedly visited our health center during the last month for postprandial epigastric pain associated with vomiting.
The episodes have been present for 7 years, reason why he has consulted the emergency services on multiple occasions, without ever having found acute pathology.
He was admitted 3 years ago for one of these episodes, performing gastroscopy with gastric biopsy which was positive for H. pylori. He was treated with erradication with current triple therapy (meprazole, alien and clarithromycin).
Due to persistence of symptoms, treatment with antiemetics and multiple proton pump inhibitors was instituted, with no long-term response.
Upon admission, the patient was assessed by the Mental Health Service, since the symptoms of acute pain persisted and he was on vomiting, being diagnosed with anxiety-depressive syndrome with poor follow-up and therapeutic non-compliance.
She had no food or drug allergies.
Currently, the pain was in a genupectoral position and with cannabis consumption.
On examination we found a patient with stable constants, with a BMI of 17.7.
The abdomen is lying flat, tympanic, blanding and slightly tender for deep fixation, without palpable masses, adenopathies or enlargement.
Analytical analysis showed no alterations; absence of anemia, negative markers of inflammatory response, without liver alterations or electrolyte disturbances, total proteins 5.8 g/dl (normal value of 6.4 to 8.3 g/dL).
Abdominal X-ray showed no signs of intestinal obstruction.
In our consultation, a total abdominal ultrasound was performed in the supine position, with no evidence of relevant findings. In 8 cases, we consulted the gastroenterology service for continuous compression i.e., continuous compression i.e. slowing of the distal segment.
Because of this finding, an abdominal CT angiography was performed, resulting in a vascular clamp that produced compression of the duodenum in its third portion.
The pinch mes affected the duodenum and the left renal vein, producing pre- and post-compression compression and dilatation.
A 68-year-old male smoker of one pack a day for the past 40 years, without known drug allergies.
He is not hypertensive, diabetic, or has dyslipidemia.
Cataract surgery.
Our patient began to be studied in internal medicine one year before due to sciatica and edema in the lower limbs of a month of evolution.
In the clinical examination, two hard and painless masses were discovered incidentally in both parotid glands, reason why ultrasound of these glands and FNA of the lesions detected were requested.
His family doctor assumed both techniques (ultrasound and FNA).