PMC10098463_01
(a) Pre-operative photograph showing discolored upper left central Incisor. (b) Pre-operative CBCT showing hypo dense lesion labial to the cervical third with embedded bony spicule /filling material. (c) The lesion was identified with partial envelope of bone after raising a mucoperiosteal flap. (d) Excision of the lesion. (e) Surgical bed after excision, aggressive curettage and peripheral ostectomy. (f) Clinical picture at 3 week follow up
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F1
A 38 years old male patient reported to the Endodontic clinic with a discoloured maxillary front tooth (Fig. 1a). A hypodense lesion labial to the cervical third with an embedded bony spicule /filling material labial to the maxillary left central incisor was seen (Fig. 1b) on the cone beam computed tomography (CBCT) scan. (Carestream Dental CS 8100SC3D: 90kv: 4.00mA: 150 voxel size: FOV-5x5cm). The lesion was identified with a partial envelope of thinned out bone (Fig. 1c). The lesion was excised, aggressive curettage and peripheral ostectomy was performed (Fig. 1d, e). Three weeks post-operative examination revealed satisfactory healing (Fig. 1f).
(a) Histopathology showed a mucosa covered tissue with underlying fibrocollagenous tissue infiltrated by moderately differentiated adenocarcinoma with extracellular mucin. (b) Immunohistochemistry showing positivity for Cytokeratin 7(CK7) and S100. (c, d) CBCT at 12-month follow up showing no recurrence. (e) Clinical picture at 12-month follow up
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F2
Individual cells had a moderate amount of eosinophilic cytoplasm and hyperchromatic nuclei (Fig. 2a). The findings were suggestive of mucinous adenocarcinoma favouring a primary mucosal origin (Fig. 2b). CBCT at 12-month follow up showed no recurrence (Fig. 2c, d) and the clinical picture was also satisfactory (Fig. 2e).