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Oral lesions of granuloma inguinale
172
Journal of Dentistry,
Three cases of lung malignancy
metastasizing
to the jaws are described. Case I: A 70-year-old white man had a large parenchymal mass of the left lung for which he refused treatment. However, the diagnosis was established by biopsy as an oat cell carcinoma. He experienced pain in 3 and the pulp was removed and the canal dressed. Two weeks later he presented with non-fluctuant non-tender swellings of the tissues both buccally and lingually. An X-ray showed periapical bone destruction and biopsy demonstrated an oat cell carcinoma. Palliative radiotherapy was given with some relief of the pain. Case 2: A 49-year-old white man had a peripheral density in the upper lobe of the right lung and enlarged mediastinal nodes. A node biopsy showed a poorly differentiated squamous ceil carcinoma which was treated by radiotherapy. Six months later the patient presented with a 4-cm nodule in the right mandibular buccal sulcus adjacent to visible retained roots. An X-ray demonstrated bone destruction related to a premolar root tip. The root was extracted and a biopsy taken which confirmed metastatic squamous cell carcinoma. Case 3: A SO-year-old
white
man had had a
right upper lobectomy for tuberculosis 9 and 6 months before years previously, admission a chest X-ray had shown no disease. On the present occasion his complaint was of pain from a l-week-old k socket. On examination there was heapedup tissue at this socket and at that of the i9 which had been extracted elsewhere 3 months before. His general health was poor with enlargement of the liver, ascites and ankle swelling. Biopsies showed undifferentiated carcinoma, probably metastatic from the lungs. In each case the proper management followed from a critical consideration of the detailed history. The mode of spread of the turnouts and the differential diagnosis are discussed. Development of metastases in wounds is recognized and the possibility that inflamed areas may be favoured is considered. G. R. Seward SUBBA RAO M., KAMESWARI V. FL, RAMULU C. and REDDY C. FL R. M. Oral lesions of granuloma inguinale, J. Oral Surg. 34 (1976) 1112-1114.
Over
a S-year
period
from
1969,
13 160
cases of venereal disease were seen in King George Hospital, Visakhapatnam, India. Of these, 865 cases were granuloma inguinale, 3 of which had oral lesions. Case 1 was a 35-year-old woman. Six year previously she had had an ulcer on the fourchette which was treated and healed. On the present occasion she reported that over a period of 4 months she had developed an ulcer which extended to affect both the upper and lower gingivae and the left fauces. There was a granulomatous and hypertrophied lesion of the gingivae, scrapings from which showed typical Donovan bodies. Treatment with tetracycline was successful. Case 2 was a 25year-old man who had had an ulcer of the penis 4 years earlier and now had a granulomatous ulcer of the gingivae which extended on to the palate and had been present for 6 months. Case 3 was a 30-year-old man with ulcers of the penis, cheek and gingivae which had been present for 11 months. Scrapings revealed Donovan bodies and the lesions healed with tetracycline. Because in the first 2 cases the oral lesions appeared long after the genital ulcers they could have been fresh, primary oral lesions. G. Ft. Seward
ORAL
SURGERY
WEBSTER M. H. C. and REID W. H. Problems following cryotherapy for oral cancer, Br. J. Oral Surg. 14 (1976) 72-75. Cryosurgery has obvious advantages as a form of treatment for oral cancer, but has the disadvantage that no pathological specimen is provided, nor is there an indication of the degree to which the tumour has been removed. An edentulous woman aged 63 was treated by the application of a cryoprobe at 6-week intervals to a small carcinoma in the lower anterior ridge. The lesion disappeared from the ridge but extended into the lip, requiring excision of the lip and bilateral neck dissection. A man aged 66 had a squamous cell carcinoma under his tongue treated over 9 months with a ctyoprobe, but it persisted and subsequently required hemiglossectomy. A woman of 70 years had a carcinoma of the tongue. It was treated
Vol. ~/NO. 2
Journal of Dentistry,
Three cases of lung malignancy
metastasizing
to the jaws are described. Case I: A 70-year-old white man had a large parenchymal mass of the left lung for which he refused treatment. However, the diagnosis was established by biopsy as an oat cell carcinoma. He experienced pain in 3 and the pulp was removed and the canal dressed. Two weeks later he presented with non-fluctuant non-tender swellings of the tissues both buccally and lingually. An X-ray showed periapical bone destruction and biopsy demonstrated an oat cell carcinoma. Palliative radiotherapy was given with some relief of the pain. Case 2: A 49-year-old white man had a peripheral density in the upper lobe of the right lung and enlarged mediastinal nodes. A node biopsy showed a poorly differentiated squamous ceil carcinoma which was treated by radiotherapy. Six months later the patient presented with a 4-cm nodule in the right mandibular buccal sulcus adjacent to visible retained roots. An X-ray demonstrated bone destruction related to a premolar root tip. The root was extracted and a biopsy taken which confirmed metastatic squamous cell carcinoma. Case 3: A SO-year-old
white
man had had a
right upper lobectomy for tuberculosis 9 and 6 months before years previously, admission a chest X-ray had shown no disease. On the present occasion his complaint was of pain from a l-week-old k socket. On examination there was heapedup tissue at this socket and at that of the i9 which had been extracted elsewhere 3 months before. His general health was poor with enlargement of the liver, ascites and ankle swelling. Biopsies showed undifferentiated carcinoma, probably metastatic from the lungs. In each case the proper management followed from a critical consideration of the detailed history. The mode of spread of the turnouts and the differential diagnosis are discussed. Development of metastases in wounds is recognized and the possibility that inflamed areas may be favoured is considered. G. R. Seward SUBBA RAO M., KAMESWARI V. FL, RAMULU C. and REDDY C. FL R. M. Oral lesions of granuloma inguinale, J. Oral Surg. 34 (1976) 1112-1114.
Over
a S-year
period
from
1969,
13 160
cases of venereal disease were seen in King George Hospital, Visakhapatnam, India. Of these, 865 cases were granuloma inguinale, 3 of which had oral lesions. Case 1 was a 35-year-old woman. Six year previously she had had an ulcer on the fourchette which was treated and healed. On the present occasion she reported that over a period of 4 months she had developed an ulcer which extended to affect both the upper and lower gingivae and the left fauces. There was a granulomatous and hypertrophied lesion of the gingivae, scrapings from which showed typical Donovan bodies. Treatment with tetracycline was successful. Case 2 was a 25year-old man who had had an ulcer of the penis 4 years earlier and now had a granulomatous ulcer of the gingivae which extended on to the palate and had been present for 6 months. Case 3 was a 30-year-old man with ulcers of the penis, cheek and gingivae which had been present for 11 months. Scrapings revealed Donovan bodies and the lesions healed with tetracycline. Because in the first 2 cases the oral lesions appeared long after the genital ulcers they could have been fresh, primary oral lesions. G. Ft. Seward
ORAL
SURGERY
WEBSTER M. H. C. and REID W. H. Problems following cryotherapy for oral cancer, Br. J. Oral Surg. 14 (1976) 72-75. Cryosurgery has obvious advantages as a form of treatment for oral cancer, but has the disadvantage that no pathological specimen is provided, nor is there an indication of the degree to which the tumour has been removed. An edentulous woman aged 63 was treated by the application of a cryoprobe at 6-week intervals to a small carcinoma in the lower anterior ridge. The lesion disappeared from the ridge but extended into the lip, requiring excision of the lip and bilateral neck dissection. A man aged 66 had a squamous cell carcinoma under his tongue treated over 9 months with a ctyoprobe, but it persisted and subsequently required hemiglossectomy. A woman of 70 years had a carcinoma of the tongue. It was treated
Vol. ~/NO. 2