Jaw Swelling Back with Vengeance
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CLINICAL REPORT
Jaw Swelling Back with Vengeance Neeti Swarup1 • Zoya Chowdhary2
•
Meghanand T. Nayak3 • Swati Shami4
Received: 23 July 2020 / Accepted: 17 August 2020 Ó Association of Otolaryngologists of India 2020
Abstract Rhabdomyosarcoma (RMS) is a highly aggressive lesion and is commonly seen in children below the age of 10 years. The survival rate is not very high as an early diagnosis is often difficult. However, the treatment involves mainly surgery followed by chemotherapy and sometimes radiotherapy. Keywords Intraosseous Radiotherapy Rhabdomyosarcoma Soft tissue sarcoma
develops from skeletal (striated) muscle cells which have failed to fully differentiate [3]. The incidence of RMS is approximately 4.5 case per 1 million children [4]. An accurate and early diagnosis is often difficult because of the heterogeneity and a lack of strong genetic markers of the disease [4]. However, its treatment involves a combination of surgery, chemotherapy, and radiation but the patient outcome varies considerably.
Introduction
Case Report
Rhabdomyosarcoma (RMS) was first described by Weber [1], but was classified by Stout [2]. It is a malignant and highly aggressive lesion seen commonly in childhood that
A 11-year-old female reported to the department of oral and maxillofacial surgery for evaluation of swelling in right lower jaw. The swelling was present since 1 month. Clinical evaluation revealed diffuse, erythematous sessile swelling of the mandible. The radiographic evaluation revealed a diffuse radiolucency involving primary first and second molar within the mandible (Fig. 1a). The lesion was excised and submitted for biopsy. The histopathological evaluation revealed islands of round cells within the connective tissue stroma (Fig. 1b), the immunohistochemical evaluation for vimentin, desmin, S-100, Pan CK, LCA revealed no reactivity for the antibodies. The patient reported back within 15 days of the procedure with the swelling of similar size (Fig. 1c) and was later referred to higher center which the patient failed to report. The patient reported to the department a month later again with an aggressive lesion involving almost entire mandible crossing the midline (Fig. 2a). MRI was conducted and revealed a solid, expansile, fairly defined lesion with cystic & hemorrhagic areas causing destruction of buccal and lingual cortical plates and displacement of soft tissues (Fig. 2b). Patient was referred to higher center and second biopsy was done which revealed numerous atypical round cells (with cellular and nuclear pleomorphism),
& Zoya Chowdhary [email protected] Neeti Swarup [email protected] Meghanand T. Nayak [email protected] Swati Shami [email protected] 1
Department of Oral Pathology, School of Dentistry, Seoul National University, Seoul, South Korea
2
Department of Periodontology, Indira Gandhi Government Dental College and Hospital, Jammu University, Jammu, J&K 180005, India
3
Department of Oral Pathology and Microbiology, Teerthanker Mahaveer Dental College and Resear
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