Intranasal tooth and associated rhinolith in a patient with cleft lip and palate

We report the case of a 9-year-old girl who presented with a complaint of a malodorous bloody discharge from the left naris. The patient had previously undergone a complete repair of left-sided cleft lip and palate. Clinical examination revealed hyperplasia of the nasal mucosa on the left side. X-ray examination of the nasal cavity demonstrated a radiopaque structure that resembled a tooth and a radiopaque mass similar to an odontoma that was adherent to the root of the suspected tooth. With the patient under general anesthesia, the structure was removed. On gross inspection, the structure was identified as a tooth with a rhinolith attached to the surface of its root. Microscopic examination revealed normal dentin and pulp tissue. A nonspecific inflammatory infiltrate was observed around the rhinolith, and areas of regular and irregular mineralization were seen. Some mineralized areas exhibited melanin-like brownish pigmentation. Areas of mucus with deposits of mineral salts were also observed. Rare cases of an intranasal tooth associated with a rhinolith have been described in the literature. We believe that this case represents only the second published report of an intranasal tooth associated with a rhinolith in a patient with cleft lip and palate

Peripheral compound odontoma erupting in the gingiva

Background: Peripheral odontoma arising in the extraosseous soft tissues is rare and if not removed early, may enlarge over time and eventually erupt in the oral cavity. Case presentation: A 15-year-old girl presented with “denticles on the gingiva”. During the intraoral examination, seven small tooth-like structures were found. These were exposed in the anterior left gingiva between the permanent maxillary lateral incisor and canine teeth, and the left first premolar was absent. Radiographic examination revealed irregular tooth-like structures without evidence of bone involvement. Conclusion: The lesion was surgically removed, and the specimens were analyzed histopathologically. The diagnosis of compound odontoma was established. Clinical significance: This is the twelfth reported case of peripheral odontoma in the gingiva and the first one that erupted in the oral cavity.

Garota de Mitilene

A proposta é uma abordagem de "Garota de Ipanema" de Jobim e Vinicius e de um poema de Safo, "Ode a Anactória" (século VII a.C.), que abriga um verso que diz, literalmente: "Esse modo de andar que desperta o desejo". E aí, aproveitando a deixa, desenvolvo um cotejo entre outros fragmentos de Safo e essa canção paradigmática da MPB, datada de 1962. Trata-se de um contraponto com 27 séculos de permeio e que - por maior que seja o cuidado em respeitar a historicidade do afeto (e não cometer anacronismos) - revela surpreendentes invariantes. Mas entre Safo e Jobim/Vinicius há Freud, ou melhor, Jensen, com a sua Gradiva - que tematiza, exatamente, o andar da mulher desejada. Por sua vez, o musicólogo Almir Chediak vê um paralelo entre o desenho melódico da partitura de "Garota de Ipanema" e as ondas do mar, no seu movimento de fluir e refluir; e no gráfico apresentado, de fato, delineia-se esse ritmo iconizado. Efetivamente, a onda, o passo ondulante, o ritmo, o tema, "o doce balanço, caminho do mar": tudo converge nessa brasileiríssima canção, que patenteia, no entanto, tão instigantes recorrências com a lírica grega arcaica.

Non-neoplastic bulky mediastinal mass presentation in an adolescent patient: a case report

Abstract : Introduction Mediastinal masses in pediatric patients are very heterogeneous in origin and etiology. In the first decade of life, 70% of the mediastinal masses are benign whereas malignant tumors are more frequent in the second decade of life. Among the mediastinal masses, lymph nodes are the most common involved structures and could be enlarged due to a lymphoma, leukemia, metastatic disease, or due to infectious diseases as sarcoidosis, tuberculosis and others. Case presentation. We report a case of a 13-year-old Caucasian girl who came to the emergency room with a history of intermittent fever, weight loss and night sweating for at least 1 month. A radiologic image work-up presented an anterior and posterior mediastinal mass. The 18F-fluorodeoxyglucose positron emission tomography presented a high maximum standard uptake value, which directed our decision for mediastinal biopsy for diagnostic elucidation. Histologic examination described the mass as granulomatous tuberculosis. The patient was treated with anti-tuberculosis therapy and developed a full clinical recovery. Conclusions . The present case report demonstrates that a bulky mediastinal lymphadenopathy detected on 18F-fluorodeoxyglucose positron emission tomography is not always a malignant lesion, and in countries where tuberculosis is endemic, this etiology should not be forgotten during clinical investigations. There is a need for more accurate cut-off values for this technology; meanwhile, the further investigation of patients with bulky mediastinal masses with procedures such as the open biopsy is indispensable.