case_images: PMC8387074_01
case_images: Photomicrographs of the biopsied soft tissue lesion: A - stratified squamous para-keratinized epithelium overlying a fibro-cellular connective tissue stroma predominantly comprising of blood vessels, neural tissue, smooth muscle bundles and forming hyaline cartilage in deeper stroma (H&E, 10X); B - Masson trichrome stain used to differentiate the smooth muscle cells (stained pink) from dense collagen fibres (stained blue) (10X).
case_images: autopsy-11-e2021315-g01.jpg
case_images: PMC8387074_01_autopsy-11-e2021315-g01.jpg
case_images: gf01
case_images: The stroma consisted of loosely arranged collagen fibers, loosely arranged bundles of differentiated smooth muscle fibers, nerve fascicles, thick-walled blood vessels and ectopic cartilaginous tissue (Figure 1A). The Masson Trichrome special stain was used to delineate the different connective tissue components (Figure 1B).
case_images: Clinical examination: A - showing soft tissue swelling over the alveolar mucosa (arrow head), abnormal frenal attachment, midline diastema, median alveolar cleft, mesio-labial rotation of the right central incisor, pseudo cleft of the lower lip (yellow dotted line), milia (arrows); B - Philtrum pits (arrowhead), milia (arrows); C - Low set ears; D - Thin scanty hair.
case_images: autopsy-11-e2021315-g02.jpg
case_images: PMC8387074_01_autopsy-11-e2021315-g02.jpg
case_images: gf02
case_images: Extra-orally, micrognathia, pseudo-clefting of the lower lip, two midline pits in the labial philtrum and low set ears were evident (Figure 2A-C). The skin of patient was dry with thin scanty hair, crops of milia were noted on the nose, along the nasolabial folds and chin (Figure 2A, B, D).
case_images: Tomographic examination of maxilla showing median alveolar cleft. A - 3D reconstruction; B - Axial view.
case_images: autopsy-11-e2021315-g03.jpg
case_images: PMC8387074_01_autopsy-11-e2021315-g03.jpg
case_images: gf03
case_images: The CBCT (Figure 3A, B) and the OPG confirmed the presence of a median alveolar cleft of the maxilla, while the abdominal ultrasound was unremarkable.