ENT - ORL

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  Femme de 40 ans, se plaignant d'une lésion polypoïde du palais, de consistance ferme, bien circonscrite.   40 yo female, complaining of a polypoïde mass of the palate, firm in consistancy, well circumscribed.  
  Resection chirurgicale   Surgical excision:  
     
     
     
     
  Alcian Blue   Alcian Blue - Hyaluronidase  
     
  Alcian Blue   Alcian Blue - Hyaluronidase  
     
  Alcian Blue   Alcian Blue - Hyaluronidase  
 

Diagnostic proposé

 

 

 

 

 

 

 

Mucinose orale focale

 

Proposed diagnosis

 

 

 

 

 

 

 

Focal Oral Mucinosis

 
  Arguments      
 

dans le texte ci-dessous

 

In the highlighted text below

 
         
 

Pathology & Genetics of Head and Neck Tumours

(WHO Classification of tumours, 2005)

 
 

Definition
Focal oral mucinosis (FOM) is the oral counterpart of focal cutaneous mucinosis and cutaneous myxoid cyst. It is postulated that FOM develops as the result of a fibroblastic overproduction of hyaluronic acid due to an unknown cause.

 
 

Epidemiology
Today, fewer than fifty cases have been reported. The lesion may occur at all
ages, but it is rare in children. There is no distinct sex predilection.

 
 

Clinical features
The clinical presentation is usually that of an otherwise asymptomatic fibrous or cystic-like lesion. The most common site is the gingiva; less common sites include the palate, cheek mucosa and tongue. The consistency may vary from soft elastic to firm.

   
 

Histopathology
The histopathology is characterized by a well-circumscribed area of myxomatous tissue in which fusiform or stellate fibroblasts are present. Reticular fibres are sparse or absent. The mucinous material shows alcianophilia at pH 2.5. The histologic differential diagnosis includes soft-tissue myxoma, myxomatous change in fibrous lesions, nerve sheath myxoma, and mucous retention phenomenon. The lack of reticular fibres and the sharp delineation distinguishes FOM both from soft-tissue myxoma and from myxomatous changes in fibrouslesions. Nerve sheath myxoma usually shows a lobular architecture and, conspicuously, contains numerous mast
cells. The mucous retention phenomenon is surrounded by a wall of granulation tissue or an epithelium-lined wall, while the mucoid material contains histiocytic cells; such features are lacking in FOM.

 
 

Prognosis and predictive factors
The lesion is treated by conservative surgical excision and has no tendency to recur.