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  • Publicado : 14 de septiembre de 2012
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Bilateral multiple spindle cell lipomas of the tongue

Lipomas are the most frequent benign soft tissue tumors, occurring as a slowly enlarging, painless mass formation. They commonly AFFECT THE UPPER BACK and shoulder, but also accur in the oral cavity in lower rates, predominantly the buccal mucosa, followed by the lip and the tongue . multiple involvement is known as benign symmetricallipomatosis (BSL; Madelung´s disease), and characterized by the diffuse growth of non encapsulated lipomas. Multiple tongue lipomas, particularly symmetric tumor formation, is called symmetric lipomatosis of the tongue.
Histologically, lipomas are classified into various subtypes, including simple lipomas, fibrolipomas, angiolipomas, myxoid lipomas, pleomorphic lipomas, and spindle celllipomas. Spindle cell lipomas (SCL), an uncommon variant first reported by Enzinger and Harvey in 1975, is composed of mature fat cells, collagen-forming spindle cells, and sparse mast cells. SCL typically occurs in elderly men as a solitary lesion in the posterior neck and back.

Resection and immediate reconstruction of a pediatric vascular malformation in the mandible: Case report

Centralarteriovenous malformation (AVM) of the jaws are rare and potentially life-threatening entities that can present as innocuous episodes of gingival bleeding, slow growing expansile masses, or severe hemorrhage. Treatment may be surgical or nonsurgical. The latter includes intravascular embolization with colis, and/or sclerosing solutions. Surgical resection is reserved for lesions that are extensiveand/or refractory to endovascular therapy.

MINIMALLY INVASIVE THERAPY, such as endovascular obliteration, are generally preferred for the treatment of vascular lesions.
Teeth are exposed to daily physiologic stress from mastication and this micro trauma may be sufficient to induce bleeding.
Vascular malformation are caused by a failure of blood vessel morphogenesis during the late stage ofangiogenesis, i,e., during the truncal stage of embryonic development. These abnormal vessels that are fed by smaller tributary vessels. The type of vessels that comprise the malformation will determine the extent of blood flow that the central area will receive.
These lesions are divided into low-and high-flow varieties. Capillary, venous, or lymphatic malformations are considered to be low-flowmalformations and arterial and arteriovenous network are considered high-flown malformations. The combination of numerous.
Feeding vessels, the delivery of blood at arterial pressure, and an inherent structural weakness in the vessel walls will cause the central channel to enlarge while simultaneously recruiting more feeding vessels.
Consequently, as more blood flows through the malformation, thelikelihood increases that significant acute hemorrhage might occur.
Vascular anomalies in general are uncommon but tend to occur most frequently in the head and neck.
The most common age group for the first detection of an AVM is birth to infancy, but initial onset has been described in patients as old as 74 years. There is an equal, male to female ration when the initial presentation is atbirth, but there is female predominance when presentation is during or after puberty.
In contrast to hemangiomas, malformations do not involute spontaneously. The presence of signs and symptoms are largely dependent on the location of the lesion. Patients may present with vague complaints such as awelling, pain, pressure, toothache, earache, pulsation, and ocular paint. Vascular malformations at thealveolar level may present with gingival bleeding, mobile teeth, and depressible teeth, and occlusal abnormalities. Lesions that extend superficially toward the skin may produce swelling, neurosensory dificits, and mimic vascular nevi.

The tongues is the most commonly affected intraoral site, followed by the lip, palate and gingival.

Successful Reconstruction Of...
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