Neurofibroma is a benign peripheral nerve sheath tumor and is the most frequent tumor of neural origin. Its presence is one of the clinical criteria for the diagnosis of neurofibromatosis type 1 (NF1; a common hereditary disease occurring in one out of every 3000 births). The diagnosis can sometimes be made at birth, while in others the diagnosis is made later in life after the appearance of additional clinical criteria. Majority of the solitary neurofibromas are sporadic, while a few are associated with NF1 syndrome. Oral hard and soft tissue are affected by the tumor; however, the tongue is the most affected site. Gingival neurofibroma is an uncommon oral manifestation of NF. Here, we report a rare case of gingival neurofibroma in NF1 patient. One of the most feared complications of NF1 is its transformation into neurofibrosarcoma, which bears a very poor prognosis. Treatment of neurofibroma is surgical resection.
Background: Diagnostic radiation is reported to cause significant damage in buccal cells, while the same effects after natural cell turn over cycle were not checked for in previous studies. The buccal cells were studied in patients exposed to computed tomography (CT) scans for evaluating the cells with micronuclei and cytotoxic changes, namely, pyknotic cells, karyorrhectic cells and karyolytic cells. The pre-exposure counts were compared with postexposure counts on 10 and 20 days corresponding to first and second cell turnover cycles. Aim: The aim of this study is to estimate the counts of micronucleus and cytotoxic changes in buccal cells post-exposure to CT scans and report on variance of the same with first and second buccal cell turnover cycles. Materials and Methods: This is an observational study, wherein the buccal smears of patients undergoing CT scans were made before and after CT scan exposures as needed. Papanicolaou (PAP) staining and analysis were performed as per standard criteria for micronuclear and cytotoxic changes, respectively. Statistical test used was paired t -tests. Results: The micronuclear counts revealed 0.4% positive cells before exposure and 1.4% positive cells post 10 days and 20 days of exposure were significant ( P < 0.005). The cytotoxic changes showed around 2.5% positive cells before and 5.7% positive cells 10 days after CT exposure ( P < 0.005). The cytotoxic cell values from baseline to 20 th day were not significant ( P < 0.25). Conclusion: CT scans have caused genotoxic effects notable after two cell turnover cycles but the cytotoxic changes have significantly decreased naturally after 2 nd cell turnover as per our study.
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with history of wound in mouth, causing nasal regurgitation of food for a period of 4 weeks. Examination revealed, a 3 × 3 cm oval ulcer at the junction of hard and soft palate in the midline, covered with extensive pseudomembrane and associated with foul smell. The ulcer was tender, with well-defined borders and everted margins [Figure 1]. Occlusal radiographs showed evidence of communication with the nasal cavity. Routine blood investigations along with serology (VDRL for syphilis and ELISA for HIV) were negative. Histopathology demonstrated candidal hyphae, while pus culture and antibiogram showed isolated methicillin-resistant Staphylococcus aureus (MRSA). Accordingly, local debridement was done, along with parenteral vancomycin 1 g/day administered 8 hourly and oral fluconazole 150 mg once daily for a week. The patient was referred for surgical management of the fistula after satisfactory healing.
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