• Title/Summary/Keyword: diagnostic dilemma

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Localized Gingival Enlargement (임상가를 위한 특집 1 - 잇몸의 국소 증식 질환)

  • Ryu, Mi Heon
    • The Journal of the Korean dental association
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    • v.52 no.12
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    • pp.712-719
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    • 2014
  • Localized gingival enlargement is a common finding and tends to be reactive hyperplasia. Gingival reactive lesions are usually asymptomatic and respond to conservative treatment. However, a small entity of localized gingival enlargement is distinct from non-neoplastic growth, including developmental and neoplastic lesions. Since their clinical characteristics are similar with other lesions of gingiva, it can cause diagnostic dilemma, and is recommended to submit biopsy and confirm pathologic diagnosis. Their incidence of recurrence are different, therefore method of treatment should vary depending on the diagnosis. This review explains identification and treatment of localized gingival lesions.

Early recognition of high risk factors of acute abdominal pain in children (소아 급성 복통에서 고위험 인자의 조기 발견)

  • Hwang, Jin-Bok
    • Clinical and Experimental Pediatrics
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    • v.49 no.2
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    • pp.117-128
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    • 2006
  • Non-traumatic acute abdominal pain in children presents a diagnostic dilemma. Numerous disorders can cause abdominal pain. Although many etiologies are benign, some require a rapid diagnosis and treatment in order to minimize morbidity. This review concentrates on the clinical office evaluation of acute abdominal pain in infants and children and details the clinical guideline for the diagnostic approach to imaging and the salient clinical features of some of the conditions. The clinical outcomes of children presenting with acute abdominal pain and the risk factors of the high risk underlying diseases would be provided for the diagnostic algorithm.

Invasive sphenoid sinus aspergillosis with normal findings on initial diagnostic tests that mimics Tolosa-Hunt syndrome-a diagnostic dilemma: a case report

  • Yu Hun Jeong;Jongsuk Choi;Byung-Jo Kim;Hung Youl Seok
    • Journal of Yeungnam Medical Science
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    • v.40 no.2
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    • pp.198-201
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    • 2023
  • Invasive sphenoid sinus aspergillosis can mimic Tolosa-Hunt syndrome (THS), leading to frequent misdiagnoses and potentially fatal consequences. We report a case of invasive sphenoid sinus aspergillosis initially misdiagnosed as THS. A 79-year-old man presented with right periorbital pain, ophthalmoplegia, and loss of vision. Initial evaluations including magnetic resonance imaging (MRI), were normal. He was first diagnosed with THS based on clinical features. The disease progressed despite high-dose intravenous steroid treatment, and an enhancing mass-like lesion was found in the right orbital apex, cavernous sinus, and sphenoid sinus on follow-up MRI. Aspergillosis was eventually confirmed by sphenoid sinus biopsy. The patient developed cerebral infarction and finally died despite being treated with amphotericin B. Given that invasive sphenoid sinus aspergillosis may initially resemble THS, high suspicion and rapid histological examination are important for diagnosis.

A diagnostic dilemma in pediatric osteomyelitis: a case report

  • Mandrekar, Pooja Narendra;Gavhane, Sanket;Fernandes, Trishala Bhadauria;Dhupar, Vikas;Dhupar, Anita
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.2
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    • pp.117-121
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    • 2022
  • Infantile osteomyelitis is a rare disease that is infective in nature and may rapidly turn fatal, as the disease is often misdiagnosed due to its varied presenting signs. Early diagnosis may help in avoiding systemic involvement and permanent deformity. The disease presents with signs of orbital involvement, nasal congestion, and emesis, as well as other standard hallmarks of infection. Furthermore, the maxilla is a highly vascular and porous bone and the occurrence of osteomyelitis in an infant maxilla is highly uncommon. In addition, routine blood work is not suggestive of the presence of this disease. Thus, prompt diagnosis of this condition poses a challenge to surgeons due to the confusing array of symptoms combined with the rarity of the disease. One such case of osteomyelitis of the maxilla in a young child is presented. The dilemma encountered by the surgeon during the diagnosis and treatment of the disease is discussed.

Dilemmas of Oral Cancer Screening: An Update

  • Kujan, Omar;Sloan, Philip
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.3369-3373
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    • 2013
  • Oral cancer is a global health burden with high mortality and morbidity. Advances in treatment have failed to improve the relatively poor survival rate due to late-stage diagnosis. Early detection and screening have been shown to be effective in reducing mortality and morbidity of most common cancers. Several studies have evaluated the effectiveness of oral cancer screening programs but clear results were not obtained. This narrative commentary aimed to give a critical insight into the dilemma of oral cancer screening and to suggest recommendations for future trends. Conventional oral examination still constitutes the gold standard screening tool for potentially malignant oral lesions and cancer. Interestingly, the findings of the most lasting (15-year) randomized controlled trial on oral cancer screening using visual examination (Kerala) supported the introduction of a screening program in high-risk individuals. Several screening adjuncts exist but are still not at the introduction stage. Further research to find an appropriate adjunct reliable tool for oral cancer screening is needed. In conclusion, oral cancer fulfills most of the essential principles of cancer screening but still many points need to be clarified. Therefore, there is a striking need to establish a global consortium on oral cancer screening that will oversee research and provide recommendations for health authorities at regular intervals.

Hydrocephalus as a Presenting Manifestation of Neurosarcoidosis : Easy to Misdiagnose as Tuberculosis

  • Lee, Chang-Hyun;Jung, Young-Sub;Lee, Sang-Hyung
    • Journal of Korean Neurosurgical Society
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    • v.48 no.1
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    • pp.79-81
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    • 2010
  • We present a case of hydrocephalus as the primary manifestation of neurosarcoidosis. Sarcoidosis is a rare disease in Korea and its incidence is much lower than that of tuberculosis. Diagnosis is made by pathologic findings and by exclusion of other granulomatous disorders. Neurosarcoidosis is observed in approximately 5% of sarcoidosis. Its common manifestations are facial palsy (50% of patients with neurosarcoidosis) and optic neuritis. Hydrocephalus is a very uncommon reported finding. Although the typical presentation of sarcoidosis such as facial palsy is not a diagnostic dilemma, more atypical presentations such as hydrocephalus with altered mentality in a tuberculosis patient can lead to a misdiagnosis.

A Case of Pelvic Actinomycosis Superimposed in IUD Carrier (자궁내 피임장치와 동반된 골반방선균증 1례)

  • Kang, Jung-Woon;Kim, Won-Cheol;Park, Yeun-Hee;Park, Gee-Hong;Shin, Meun-Woo
    • Clinical and Experimental Reproductive Medicine
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    • v.20 no.2
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    • pp.183-186
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    • 1993
  • Pelvic actinomyces, usually a complication of an intrauterine device, is uncommon and may present a diagnostic dilemma because of an atypical clinical presentation. This organism is very difficult to culture, and most actinomyces is actually identified by histologic feature in pathologic specimens. Authors have experienced a case of pelvic actinomycosis associated with an intrauterine device and reported with a review of literatures.

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Sinonasal sarcoidosis of the maxillary sinus and infraorbital nerve: a case report

  • Joseph, Benny;Vyloppilli, Suresh;Sayd, Shermil;Ummer, Niyas
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.4
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    • pp.217-221
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    • 2015
  • Sinonasal sarcoidosis in the head and neck region is infrequent. Its occurrence can be either isolated in combination with other systems. The literature reveals that the occurrence of sinonasal sarcoidosis without lung involvement is rare. In general, sarcoidosis is a chronic non-caseating granulomatous disease of unknown origin, often identified after biopsy. In this article, we report on a benign tumor of the face that produced a diagnostic dilemma, necessitating refinement of the surgical access and in toto removal of the benign tumor.