Oral Disease: Case Studies of Difficult Diagnoses, 1st Edition

Section 1: Developmental Conditions/Syndromes
1. Acro-osteolysis syndrome
2. Gardner syndrome
3. Oligodontia misdiagnosed as ectodermal dysplasia
4. Plasminogen deficiency
5. White sponge nevus
Section 2: Dental Conditions
6. Fluorosis
7. Erosion secondary to bulimia
Section 3: Environmental and Trauma-Related Conditions
8. Toothbrush trauma
9. Petechial hemorrhage caused by fellatio
10. Oxycontin insufflation injury
11. Abrading the fibrin covering a non-specific ulcer
12. Traumatic ulcers related to xerostomia and candida
13. Burn caused by inhaling hashish ember
14. Graphite tattoo
15. Factitial oro-antral fistula
16. Lip burns caused by crack pipe
17. Mucosal sloughing caused by tartar-control toothpaste
Section 4: Salivary Gland – Reactive
18. Necrotizing sialometaplasia
Section 5: Infections – Bacterial
19. Syphilis – secondary, presenting as lymphadenopathy
20. Syphilis – secondary, presenting as leukoplakia
Section 6: Infections - Fungal
21. Candidiasis – mucosal presentations and their management
22. Candidiasis – severe cheilitis/lip balms
23. Candidiasis – perioral, due to petroleum jelly application
24. Candidiasis – invasive in uncontrolled diabetic with oral ulcer
25. Aspergillosis – patient being treated for leukemia
Section 7: Infections – Viral
26. Hand, foot and mouth disease mistaken for erythema multiforme
27. Oral HSV-1 in a leukemia patient
28. Oral primary herpes affecting a teenager
29. Herpes - recurrent intraoral infection
Section 8: Oral Manifestations of HIV Infection
30. Oral Kaposi sarcoma mistaken for Crohn disease
31. Recurrent candidiasis and Kaposi sarcoma in a previously undiagnosed HIV patient
32. HSV causing a persistent tongue ulcer
33. Oral lymphoma mimicking a pyogenic granuloma
34. Oral aphthous ulcers in HIV-positive patients
35. Oral histoplasmosis in AIDS patients
36. HIV-positive man with squamous cell carcinoma
37. Behcet syndrome in an HIV-positive man
38. HIV-positive man with gingival ulceration
39. HIV-positive man with a vascular anomaly of his lip
Section 9: Oral Precancerous Conditions – Leukoplakia and Erythroplaki
40. Precancerous oral lesions - three different presentations
41. Erythroplakia of the floor of the mouth, treated with radiation
42. Erythro-leukoplakia of young man’s tongue
Section 10: Oral Precancerous Conditions – Proliferative Verrucous Leukoplaki
43. A woman with palatal erythroplakia and pharyngeal “polyps”
44. PVL of the mandibular ridge
45. PVL of a young woman’s tongue
46. PVL of the lateral tongue of a nurse, treated as lichen planus
47. PVL, lichenoid, in a middle-aged man
48. PVL, slowly progressive in an older man
49. PVL, erosive, but eventually leukoplakia and carcinoma
50. PVL, young woman with lichenoid tongue lesions
51. PVL eventually transforming to verrucous carcinoma
Section 11: Oral Squamous Cell Carcinoma (SCCa)
52. Poorly differentiated Ca of buccal mucosa in a young woman
53. SCCa of tongue treated as denture sore
54. SCCa of gingiva arising in “lichen planus”
55. SCCa of gingiva mistaken for cyclosporine hyperplasia
56. SCCa of the lower lip in BMT patient, treated as infection
57. SCCa of dorsal tongue, treated as candidiasis
58. SCCa, large and destructive of the buccal mucosa
59. SCCa, due to betel quid and cigarette use in an Indian man
60. SCCa of the dorsal tongue. Mild dysplasia 10 years earlier.
61. SCCa of the tongue treated as infection over several months
62. SCCa of tongue thought to be due to a foreign body
63. SCCa, massive lesion of the lower lip. Non-treatable.
64. SCCa of the gingiva. Prior biopsy suggested dysplasia.
65. SCCa of tongue in a 36-year-old woman
66. SCCa mistaken for abscess in a 19-year-old male
67. SCCa of the cheek in a man who used alternative treatments
68. Verrucous Ca is managed with radiation in an older man
69. Verrucous Ca is seen in the initial incisional biopsy…
Section 12: Melanoma
70. Oral melanoma in an edentulous man
Section 13: Malignancies of Osseous Differentiation
71. Osteosarcoma affecting a woman with Turner syndrome
72. Osteosarcoma, massive, of a woman’s mandible
73. Osteosarcoma, referred by the woman’s dentist
Section 14: Hematopoietic Malignancies
74. Lymphoma causing palatal swelling
75. Lymphoma causing a posterior maxillary mass
76. Granulocytic sarcoma in an older man and a teenager
77. Multiple myeloma – presenting as tongue and eyelid nodules of amyloid
78. Multiple myeloma in a man with tongue and neck swelling
Section 15: Other Mesenchymal Malignancies
79. Synovial sarcoma in a woman treated as TMJ dysfunction
Section 16: Salivary Gland Malignancies
80. Mucoepidermoid carcinoma misdiagnosed as a tattoo
81. Mucoepidermoid carcinoma presenting as a tongue nodule
82. Secretory carcinoma seen as a nodule in the buccal vestibule
Section 17: Metastatic Disease
83. Metastatic adenocarcinoma of the colon in a denture patient
84. Metastatic lung carcinoma presenting as a tongue nodule
85. Metastatic nasopharyngeal Ca involving the brain and gingiva
86. Metastatic prostate carcinoma treated endodontically
87. Metastatic renal cell Ca presenting as a large jaw swelling
88. Metastatic malignant peripheral nerve sheath tumor in a boy
Section 18: Vesiculobullous Disease
89. Pemphigus vulgaris affecting a 15-year-old boy
90. Mucous membrane pemphigoid leading to blindness
91. Paraneoplastic pemphigoid caused by burn pit exposure
92. Paraneoplastic pemphigus affecting a man with lymphoma
Section 19: Immune-Mediated Disease
93. Geographic tongue affecting a young woman
94. Herpetiform aphthae and coated tongue in a young woman
95. Lichenoid and granulomatous stomatitis in an elderly man
96. Behcet syndrome in a woman with oral sores for months
97. Pyostomatitis vegetans presenting as painful gingival lesions
98. Crohn disease in a man with gingival swelling
99. Crohn disease in a young woman with gingival swelling
100. Cheilitis granulomatosa for years in a young woman
101. Cinnamon reaction of t

Carl M. Allen, DDS, MSD, Division of Oral and Maxillofacial Pathology and Radiology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA