Purpose of the Study: To understand the reasons for charm needle insertions, chemical constituents of charm needles and their significance to magnetic resonance imaging. Materials and Methods: Confidential interviews were used to collect information from charm needle wearers. Two attempts at surgical removal of charm needles were carried out. Charm needle samples were chemically analyzed using EPMA method. A review of literature on the possible complications of charm needles in relation to MRI was made. Results: Patients had varied reasons for wearing charm needles including to be physically attractive, to overcome personal problems and for protection. Charm needles were made of gold alloy consisting of gold (85.2%-88.6%), copper (9.3%-10.8%) and trace elements of aluminium and silver. As such, MRI may not be a hazard to charm needle wearers given the fact that gold is non-ferromagnetic. However, artefacts may potentially distort the MR imaging. Conclusion: A tactful manner in handling these patients may be to ignore the needles unless a clinical need warrants intervention. The surgical removal of these needles may be a straightforward procedure, but the localization is usually a challenging task. At present, the pertinent literature does not contain carefully controlled studies that demonstrate the absolute safety of charm needle exposure to powerful magnetic fields.
Pleomorphic adenoma is a benign tumour with variable cytomorphological and architectural elements. It is the most common salivary gland tumour in children and adults. We report a case of a 32-year-old Malay woman who presented with a slow-growing, painless, firm, and mobile nodule of 1 cm x 1 cm in size at the angle of her mandible on the right side which could be palpated bimanually. Intraorally, this nodule could be palpated at the retromolar area. On excisional biopsy, this nodule was reported as a pleomorphic adenoma with predominant chondroid stromal elements and a large area of bone formation in the stroma. We discuss the possible pathogenesis, differential diagnosis, and clinical significance of this exceptionally rare phenomenon of bone formation in pleomorphic adenoma in minor salivary glands with the literature review. The clinical significance and relevance on treatment outcome for pleomorphic adenoma with bone formation is currently uncertain as there are only a few cases reported in the literature. A good follow-up study is recommended to assess the clinical significance of pleomorphic adenoma with extensive bone formation.
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