PURSE 1998

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Browsing PURSE 1998 by Author "Attygalla, A. M."

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    A case of juvenile active or aggressive ossifying fibroma(JAOF) in relation to the maxilla
    (University of Peradeniya, 1998-11-07) Prabaharan, P. J.; Mendis, B. R. R. N.; Attygalla, A. M.
    In the view of many pathologists and surgeons, the group of fibro-osseous lesions (FOL) occur by the replacement of the normal bone by fibrous tissue. Thereafter there is the formation of a new form of calcifying mass by the process of mataplasia. The FOL comprise of a diverse, interesting and challenging group of lesions that pose difficulty in classification and management. The FOL of the jaws may vary from asymptomatic lesions discovered by accident in routine radiographs to extensive, cosmetically and functionally disturbing lesions. Proper diagnosis of these lesions depend on a good correlation of the history, clinical findings, radiographic characteristics, and the histopathological appearances. Microscopically the lesion consists plump osteoblast like cells, surrounding areas of osteoid. The patient is a 18 years old male, from Vavuniya. He first reported to the Kandy General Hospital (Centre for sight), with a gradually progressing right sided proptosis and swelling in relation to the right eye. He had no pain but reduced vision on the right eye. He later reported to the Dental Hospital, Peradeniya with the same symptoms and an initial diagnosis of fibrous-dysplasia of bone was made. Further investigations such as like C.T Scans and histopathological observations reveals the diagnosis of Juvenile Active or Aggressive Ossifying Fibroma. Discussion A. JAOF is most often seen in the maxilla and the patients are in the first or second decade of life. This tumour is more cellular than any other fibro-osseous lesion. Some of these cells produce streams of osteoid that may bear some resemblance to the osteogenic sarcoma. B. According to the Johnson (1967) these lesions are aggressive and extend into antrum and approach the nasal septum and medial wall of the obit, causing proptosis and exopthalamos. Some of these lesions become osteogenic sarcomas while others mature into ossifying fibromas. JAOF may have an ancestral relationship to osteoblastoma because of the overlapping histological features of both lesions. Reed and Hagy (1965) also consider the JAOF and osteoblastoma to be the identical lesion.
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    A case of recurrent Central Giant Cell Granuloma in relation of the Maxilla
    (University of Peradeniya, 1998-11-07) Attygalla, A. M.; Amaratunge, N. A. De S.; Mendis, A. R. R. N.
    Central giant cell granuloma ( CGCG) of the jaws is an uncommon lesion which accounts for less than 7 percent of all benign lesions of the jaws. The CGCG is defined by the WHO as 'an intra osseous lesion consisting of a more or less cellular fibrous tissue containing multiple foci of haemorrhage, focal aggregations of multinuclear giant cells, and sometimes trabeculae of woven bone formation within the septa of more mature fibrous tissue that may traverse the lesion. The aetiology of the CGCG is unknown and its biological behaviour is poorly understood. In 1953, Jaffe identified these lesions as "giant cell reparative granulomas" to distinguish them from the giant cell turnours that are usually found in the epiphysial regions of the long bones. There are reports in the literature of CGCG behaving as slow growing neoplasms. The features of such lesions are gross bone destruction, displacement of teeth, enveloping and often erosion of roots, perforation of the cortex and also pathological fractures. A case of central giant cell granuloma of a 26-year-old Sinhalese woman is presented. The lesion was in relation to the left maxilla, involving the hard palate and extending from ~ crossing the midline. The occipitomental radiograph showed a mixed radiolucent lesion involving the left maxilla with ill-defined margins. The CT scan revealed a lobulated expanded lesion arising from the left maxilla which extends in to L nasal cavity, L maxillary and ethmoidal sinuses, L nasopharynx and infero medial aspect of L orbit. The management of this lesion and the difficulty of differentiating it from central giant cell tumour of bone are discussed. The comparisons of the CGCG and the Central Giant Cell tumour of Bone are given below. Detailed diagram is availble in the pdf