• Archives of Craniofacial Surgery
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• v.25 no.3
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• pp.150-154
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• 2024

This case report describes a rare occurrence of pyogenic granuloma (PG) in the hard palate deviating from its typical gingival location that led to the formation of an alveolar cleft. The aggressive growth pattern of the lesion, with atypical progression from a pedunculated nodule to an alveolar cleft, raised concern. The diagnosis was based on magnetic resonance imaging and computed tomography findings, which revealed a tadpole-shaped lesion originating from the midline hard palate. The differential diagnosis included a minor salivary gland tumor. Surgical excision was performed under general anesthesia and resulted in a mucosal defect without nasolabial fistula formation or bone exposure. The palatal defect was packed with oxidized regenerated cellulose and closed with Vicryl Rapide sutures, both of which contributed to the patient's successful outcomes. Our comprehensive approach, extending across the stages of surgical planning, execution, and postoperative care, demonstrated the advantages of a multidisciplinary strategy for the accurate diagnosis and effective treatment of palatal PGs. This report makes a meaningful contribution to the existing literature on common oral lesions by emphasizing the importance of a broad differential diagnosis and a systematic approach to oral pathologies. It also raises clinical awareness of PGs with atypical presentations and the diagnostic challenge that they pose.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.4
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• pp.223-227
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• 2023

A midline or median cleft lip is rare, and a midline cleft associated with a unilateral cleft and a proboscis-like structure is rarer still. We present a case managed at our center in which a 5-year-old male had a median cleft of the upper lip with an associated 'proboscis' and a microform unilateral cleft lip.

• Korean Journal of Head & Neck Oncology
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• v.33 no.1
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• pp.31-34
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• 2017

First branchial cleft anomaly is a very rare disease and exhibits various clinical presentations. Therefore, the diagnosis of first branchial cleft anomaly may be difficult; the condition is often misdiagnosed and mismanaged. Accurate diagnosis is very important, because if not diagnosed correctly, patients with first branchial cleft anomaly would be treated with local incision and drainage repeatedly. We report two cases of first branchial cleft anomaly. The first patient visited for recurrent swell and discharge in the infra-auricular area with a history of previous incision and drainage. The other patient showed a cystic mass in the infra-auricular area and all of them were misdiagnosed initially by their treating specialists elsewhere. The objective of this study is to share our experiences of first branchial cleft anomaly, and emphasize its various clinical patterns and the significance of accurate diagnosis.

• Archives of Craniofacial Surgery
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• v.20 no.2
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• pp.139-143
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• 2019

Here we report a case of a focal atypical proliferative nodule (PN) arising from a congenital melanocytic nevus (CMN). Diagnosis was challenging because it had both benign and malignant clinical features. Unusual histopathology, immunohistochemistry, and intraoperative findings of this atypical PN are discussed. A 5-year-old girl was admitted for a congenital $5{\times}5cm$ sized scalp mass. This hemangioma-like soft mass showed biphasic characteristics such as a slow, gradual, and benign increase in size but worrisome dural invasion with cranial bone defect. We removed the scalp mass with clear resection margins. Interoperatively, we found that the cranial bone defect had already filled. Histopathologic examination showed CMN with focal atypical PN. The nodule showed sharp demarcation and cellular pleomorphism. However, in immunohistochemical study, Ki-67 proliferation index and expression levels of protein S-100 and Melan-A were very low. These were unusual findings of atypical PNs. Despite her worrisome preoperative radiologic features, she showed an indolent clinical course compatible with previously reported biologic behavior. The patient underwent follow-up inspection with magnetic resonance imaging every 6 months for up to 3 years. The nodule appeared to be stationary at the last visit.

• Korean Journal of Head & Neck Oncology
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• v.24 no.1
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• pp.53-56
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• 2008

Objectives：The purpose of this study was to evaluate the variable sonographic features in addition to classic findings and to find the helpful characteristic findings for diagnosis of branchial cleft cysts. Subjects and Methods：We retrospectively analyzed the sonographic finding of 16 histopathologically proven branchial cleft cysts. Assessment involved the following variables : location related to carotid artery, size, cyst wall, border, margin, shape, internal echotexture, post echoic enhancement, orientation of longitudinal axis relative to the long axis of the neck, and tapering edge. Results：Most branchial cleft cysts were seen as well defined(15/16), oval shape(13/16), smooth inner (12/16) and outer margin(13/16), and post echoic enhancement(16/16). Their diameter varied from 1 to 6cm (mean 3.3cm). The branchial cleft cysts showed variable internal echopatterns；hyperechogenicity or pseudosolid appearance(1/16), heterogeneous echogenicity(4/16) in addition to classic form of anechoic(5/16) or hypoechoic internal echogenicity(6/16). Longitudinal axis of most branchial cleft cysts were arranged in the direction of the long axis of the neck(13/16) and some branchial cleft cysts had tapering edge(6/16). Conclusion：If both atypical sonographic findings and location are showed, longitudinal arrangement of long axis and tapering edge of branchial cleft cysts are helpful findings for differential diagnosis.

• Archives of Plastic Surgery
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• v.33 no.2
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• pp.144-148
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• 2006

The velopharyngeal dysfunction usually occurs in patients with previous operation of the cleft palate or with submucosal cleft palate. In case of velopharyngeal dysfunction without cleft palate, no study has been made when it comes to operative method and postoperative results. Here, we would like to present the operative methods and the postoperative results with the cases we've experienced. This study is based on seven cases of velopharyngeal dysfunction without cleft palate from 1999 to 2004. Analysis of age, sex, etiology, operative methods, satisfaction rate and speech evaluation was done. The patients were 3 males and 4 females, with an age ranged from 10 to 28 at the time of surgery. The follow-up period was more than six months. One case had bifid uvula, another had atypical anomaly in palate, and five cases had no anatomical abnormality. The palatal lengthening was done on one patient, the levator muscle repositioning on another patient and to the rest of them, the superiorly based posterior pharyngeal flap was done. It was difficult to determine the etiology of the velopharyngeal dysfunction without cleft palate. The speech improvement and the satisfaction rate of the patients and parents were diverse. Although the authors had a problem with statistical analysis between the operative age and the speech improvement, it was reasonable to perform a surgical operation because postoperative speech improvement was observed in most cases regardless of age. There is little statistical correlation, but significantly higher outcomes were observed in palatal lengthening and levator muscle repositioning than in pharyngeal flap.

• Archives of Craniofacial Surgery
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• v.17 no.3
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• pp.169-172
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• 2016

Dermal fillers are generally accepted as safe and well-tolerable cosmetic tools. However, adverse reactions have been reported in the literature. Here, we present a case of atypical facial filler granuloma and compare its histologic features with those of the classic paraffinoma.

• Archives of Craniofacial Surgery
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• v.15 no.2
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• pp.102-104
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• 2014

Spindle cell lipoma, a rare variant of lipoma, is a benign tumor found in the posterior neck and shoulder. A 24-year-old man with a close family history of malignant lymphoma had presented with a large, firm, nodular mass found in the right supraclavicular area. Excision of the deeply located mass revealed a pale yellow, rubbery nodule which grossly resembled an enlarged lymph node, with a variant of lymphoma as a primary suspect. However, pathological studies revealed the lesion to be a spindle cell lipoma. Although atypical in location, spindle cell lipoma should always be kept in differential diagnosis of a newly-noted soft tissue mass, as this entity may be easily cured by simple excision.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.3
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• pp.388-393
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• 2000

Cleft lip and palate is one of the most common congenital defects in oro-maxillo-facial region. Because most patients undergo surgical repair in early life, the sagittal jaw relationships used to be deteriorated gradually from palate surgery up to adulthood. Also, the maxillary lateral incisor may be absent or atypical-shaped in the cleft site and may not erupt or erupt ectopically, so multidisciplinary dental cares are needed for cleft lip and palate patients. The effects of the cleft lip and alveolus seem to be limited to that part of the dentofacial complex that surrounds the cleft area. In the maxillary arch, the anterior part of the non cleft segment has a tendency to be rotated forward. On the other hand, the cleft segment has a tendency to rotated slightly medially ; hence, the tendency for canines to be edge-to-edge and sometimes in crossbite. Lip and alveolus surgery adequetely correct these problems, with little untoward effect on the skeletal maxillary-mandible relationships. In this report, the patient has a repaired lip and cleft alveolus on the left side with congenital missing on '62, '22, oronasal fistula, and skeletal class III malocclusion which is not affected by lip surgery. Dental treatments for this patient including orthodontic(space supervision, functional regulator in mixed dentition, fixed therapy in permanent dentition) and prosthodontic(removable obturator with key and keyway attachment and Konus crown) therapy were performed to improve the patient's functions and esthetics.

• The Korean Journal of Cytopathology
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• v.15 no.1
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• pp.56-59
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• 2004

Development of an invasive squamous cell carcinoma within a branchial cleft cyst (branchiogenic carcinoma) is very rare and this case is the first description of cytologic findings in Korea. A 62-year-old man presented with a 5-month history of an enlarged right neck mass. Fine needle aspiration cytology of the mass showed low cellularity and the background containing proteinaceous debris, inflammatory cells, and histiocytes suggested a cystic nature. Abundant lymphocytes, a few anucleated squames, and rare atypical squamous cells with pyknotic nuclei and abnormal keratinization were also noted. After excision of the mass, histologic findings were consistent with a branchiogenic carcinoma. We recommend to raise the possibility of carcinoma (primary or metastatic) when we observe a few dyskeratotic cells in a cystic mass within the neck area, especially in an old male.