Aggressive oral granular cell tumor with unusual periorbital involvement
Journal name: Journal of Indian Society of Periodontology
Original article title: Aggressive oral granular cell tumor with periorbital involvement: An unusual case
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Original source:
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Rajiv Garg, Gunjan Rana, Siddharth Madan, Anita Nangia, Rekha Yadav
Journal of Indian Society of Periodontology:
(A bimonthly open-access journal)
Full text available for: Aggressive oral granular cell tumor with periorbital involvement: An unusual case
Year: 2021 | Doi: 10.4103/jisp.jisp_435
Copyright (license): CC BY-NC-SA
Summary of article contents:
Introduction
Granular cell tumor (GCT) is a rare benign neoplasm frequently observed in the head-and-neck region. Though it can affect various body parts, its occurrence in the oral cavity, particularly in the retromolar area, is exceedingly uncommon. This case report documents a 65-year-old male patient who developed an unusual ulceroproliferative mass in the periorbital region, arising post-trauma, which initially presented a diagnostic challenge for both clinicians and radiologists. Although GCTs can cause a range of ocular symptoms, their atypical presentation can lead to misdiagnosis and complicate treatment approaches.
Importance of Multidisciplinary Evaluation
The case emphasizes the necessity of a multidisciplinary approach when evaluating unusual presentations of GCT, particularly those affecting regions in proximity, such as the oral cavity, orbit, and paranasal sinuses. Despite the initial assumption of a chronic osteomyelitis with secondary infection, histopathological analysis ultimately confirmed GCT, which can exhibit aggressive local behavior by invading adjacent structures and eroding bone. The findings underscore the importance of thorough clinical examination and imaging, along with immunohistochemistry, for accurate diagnosis and appropriate management. Furthermore, this case indicates that dental professionals and ophthalmologists should be aware of the possibility of GCTs in atypical presentations to ensure timely diagnosis and intervention.
Conclusion
In conclusion, the presented case illustrates the rarity and complexity of GCT, particularly when it manifests in atypical locations such as the periorbital region due to underlying conditions in the oral cavity. The close anatomical relationship between the eye, nasal cavity, and oral structures necessitates a comprehensive evaluation of all related areas in cases of unusual tumors. Understanding the interconnectivity of these anatomical sites is essential for both diagnosis and treatment, reinforcing the need for collaborative care among dental, ophthalmic, and oncology professionals to effectively manage such challenging clinical scenarios.
FAQ section (important questions/answers):
What is a granular cell tumor (GCT)?
Granular cell tumors (GCTs) are rare benign neoplasms most commonly found in the head and neck region. They typically arise from Schwann cells of the neural crest and can occur in various tissues, including the oral cavity and orbit.
What symptoms did the patient with GCT experience?
The 65-year-old male patient presented with a progressively increasing nodular mass on his left cheek, which ulcerated and produced blood-stained discharge. He also reported pain, redness, purulent discharge from multiple sinus tracts, and deterioration in vision.
How is a granular cell tumor diagnosed?
Diagnosis of GCT is established through histopathological examination and immunohistochemistry of biopsy specimens. Histology reveals well-circumscribed cells with abundant granular cytoplasm, often staining positive for S100 and CD68, indicating their neural origin.
What were the imaging findings for the patient with GCT?
Radiographs and CT scans showed chronic osteomyelitis signs and an ill-defined soft-tissue mass eroding bone. The mass extended into the maxillary sinus and surrounding structures, prompting further evaluation and biopsies for diagnosis.
What is the treatment approach for granular cell tumors?
Treatment usually involves surgical excision of the tumor, potentially followed by radiotherapy for residual masses. For malignant variants or cases with extensive local destruction, comprehensive management including oncology referrals may be necessary, although chemotherapy efficacy is uncertain.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Aggressive oral granular cell tumor with unusual periorbital involvement”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Table:
In clinical research, the term 'Table' often refers to a structured representation of data, summarizing findings such as patient demographics, treatment outcomes, or statistical analyses. Tables facilitate quick reference and comparison, allowing researchers, clinicians, and readers to understand key points of the study effectively at a glance.
2) Relative:
The term 'Relative' can signify a familial connection among individuals, which can be pertinent in discussing hereditary conditions or genetic predispositions in medical cases. Moreover, it may refer to the comparative severity or incidence of a condition in relation to other diseases, enhancing understanding of its impact.
3) Arrow:
In medical diagrams or figures, arrows typically indicate directionality or movement, aiding in the visualization of anatomical structures, treatment pathways, or progressions of diseases. This visual aspect is particularly beneficial for illustrating complex interactions within the body, thus enhancing communication among healthcare professionals.
4) Radiotherapy:
Radiotherapy is a treatment modality that utilizes high-energy radiation to target and destroy malignant cells. Its relevance lies in its application for various cancers, often complementing surgical or chemotherapeutic approaches. Understanding radiotherapy includes assessing potential side effects and planning treatment schedules for optimal patient outcomes.
5) Surrounding:
The word 'Surrounding' relates to the structures or tissues adjacent to a pathological site. In medical contexts, evaluating surrounding areas is crucial to understand the extent of disease, potential invasiveness, and influence on treatment decisions, notably in conditions like tumors or infections affecting adjacent anatomical regions.
6) Antibiotic (Antibacterial):
Antibiotics are medications that combat bacterial infections and are fundamental in various therapeutic regimens, particularly for infections with identified pathogens, like Methicillin-resistant Staphylococcus aureus (MRSA). Their importance includes preventing and treating infections, understanding resistance patterns, and formulating guidelines for appropriate use among healthcare providers.
7) Activity:
In medical discussions, 'Activity' may refer to the biological processes or responses of an organism, such as immune responses or tumor growth dynamics. Assessing activity levels can be crucial for evaluating treatment efficacy, understanding disease progression, or during rehabilitation and recovery phases in patients.
8) Wall:
In anatomy and medical imaging, 'Wall' commonly describes the structural boundaries of organs or cavities, such as walls of blood vessels, sinuses, or tumors. A wall's integrity is significant in diagnosing and managing conditions, as disruptions may suggest pathological processes or complications requiring intervention.
9) Chemotherapy:
Chemotherapy involves the use of chemical agents to treat cancer, aiming to inhibit cell division and tumor growth. Its relevance stems from its role as a cornerstone in oncologic therapy, necessitating an understanding of side effects, resistance mechanisms, and the importance of individualized treatment plans for patient safety.
10) Disease:
The term 'Disease' represents a pathological state characterized by specific signs and symptoms, often resulting from infectious agents, genetic factors, or environmental influences. Understanding disease processes is vital for diagnosis, management, and prevention strategies, thereby influencing clinical practices and public health policies.
11) Blood:
Blood is a vital bodily fluid that plays crucial roles in transporting oxygen and nutrients, regulating temperature, and protecting against infections. In clinical settings, blood analysis provides insights into numerous health conditions, thereby facilitating diagnosis, monitoring treatment efficacy, and guiding therapeutic decisions based on hematological findings.
12) Male:
The classification of 'Male' signifies one of the two primary biological sexes, important in medical studies for understanding gender-specific health issues, response to treatments, and disease prevalence. Male-specific conditions and prevention strategies significantly influence clinical approaches in various health care settings.
13) Accumulation (Accumulating, Accumulate):
In health contexts, 'Accumulation' often describes the buildup of substances, such as fluids or cells, in tissues which may indicate underlying health issues. Recognizing accumulation patterns can guide diagnostics and treatment, revealing insights into conditions like infections, tumors, or metabolic disorders affecting patient outcomes.
14) Observation:
Observation in medicine refers to the act of monitoring a patient's condition over time to assess changes or responses to treatment. It is a critical step in diagnosing and managing health issues, ensuring timely interventions are made based on observed clinical signs or patient-reported outcomes.
15) Discussion:
Discussion in a medical context pertains to the interpretative conversation surrounding clinical findings, including rationale behind diagnoses, treatment options, and potential outcomes. Engaging in thorough discussions improves understanding among healthcare professionals and enhances shared decision-making in patient care, ultimately aiming for optimal treatment results.
16) Suffering:
Suffering reflects the physical, emotional, or psychological distress experienced by patients due to illness, injury, or treatment effects. Recognizing suffering is crucial for healthcare providers, as it fosters empathy and informs holistic treatment approaches aiming to improve quality of life and patient-centered care.
17) Hygiene (Hygienic):
Hygiene refers to practices that maintain health and prevent disease, primarily through cleanliness. In clinical settings, hygiene is essential, particularly in managing infections and promoting patient safety. Understanding hygiene protocols can significantly reduce nosocomial infections and improve overall health outcomes in healthcare environments.
18) Aureus:
In microbiology, 'Aureus' commonly refers to Staphylococcus aureus, a bacterium significant in clinical settings due to its role in various infections. Its relevance extends to discussions about antibiotic resistance, preventative measures, and treatment protocols necessary for managing infections, particularly in hospitalized patients or immunocompromised individuals.
19) Nature:
The term 'Nature' in medical texts can encompass the inherent characteristics of a condition, such as its progression, symptoms, or treatment response. Understanding the nature of disease processes is foundational to developing effective management strategies and informs clinician-patient communications regarding expectations and lifestyle adaptations.
20) Farmer:
The term 'Farmer' may denote an individual's occupation, which can be relevant in healthcare for discussing occupational exposures, health risks associated with agricultural work, and specific health needs. Understanding demographic backgrounds can inform health education and targeted interventions for populations engaged in farming and related activities.
21) Field:
In a medical context, 'Field' can refer to an area of study or practice, such as a medical specialty. Understanding various fields in healthcare is essential for multidisciplinary collaboration, ensuring comprehensive patient care and advancing medical knowledge through the integration of diverse expertise and perspectives.
22) Visit:
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23) Food:
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24) Pain:
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25) Drug:
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Other Health Sciences Concepts:
Discover the significance of concepts within the article: ‘Aggressive oral granular cell tumor with unusual periorbital involvement’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:
Final Diagnosis, Oral cavity, Histopathological examination, Vital signs, Computed tomography scan, Diagnostic challenge, Immunohistochemistry, Hematoxylin and Eosin stain, Benign neoplasm, Chronic osteomyelitis, Ocular motility, Ocular manifestation, Ocular adnexa, Biopsy specimen, Pseudophakic, Reactive lymphadenitis, Surgical debulking, Immunoreactivity, Diagnostic workup, Eosinophilic cytoplasm, Tissue section.