case_images: PMC10957724_01
case_images: PMC10957724_02
case_images: intra-oral photographs: presence of a medium-sized, round to irregular, bucco-lingual gingival swelling measuring about 2.5 x 1.5 cm having an erythematous overlying surface with a central dark area, extending from the distal aspect of the permanent right mandibular central to lateral incisor
case_images: PAMJ-47-14-g001.jpg
case_images: PMC10957724_02_PAMJ-47-14-g001.jpg
case_images: F1
case_images: Clinical findings: the patient presented with a medium-sized, soft to firm, round to irregular gingival (bucco-lingual) swelling having an erythematous surface with a central dark area, measuring about 2.5 x 1.5 cm, involving the mandibular right central and lateral incisor with concomitant mobility of the regional tooth (Figure 1).
case_images: cone-beam computed tomography scan: peri-apical pathosis measuring about 12.3 x 6.2 mm with evidence of a bucco-lingual intra-bony osteolytic ill-defined area in relation to 41 and 42; presence of thin labial cortical plate was also noted
case_images: PAMJ-47-14-g002.jpg
case_images: PMC10957724_02_PAMJ-47-14-g002.jpg
case_images: F2
case_images: Diagnostic assessment: cone-beam computed tomography revealed: peri-apical pathosis measuring about 12.3 x 6.2 mm with a bucco-lingual intra-bony osteolytic ill-defined area in relation to 41 and 42 along with thinning of labial cortical plate (Figure 2).
case_images: histopathological photomicrograph: multiple, glandular epithelial rests arranged in irregular strands having hyperchromatic nucleus and pleomorphism with tumour cell clusters floating in mucous-filled cystic cavities separated by connective fibrous strands [hematoxylin-Eosin staining x400 magnification]
case_images: PAMJ-47-14-g003.jpg
case_images: PMC10957724_02_PAMJ-47-14-g003.jpg
case_images: F3
case_images: Biopsy and histopathology sections revealed multiple, glandular epithelial rests arranged in irregular strands having a hyperchromatic nucleus and pleomorphism with tumour cell clusters floating in mucous-filled cystic cavities separated by connective fibrous strands (Figure 3) suggesting: malignant salivary gland neoplasm favouring Adenocarcinoma.
case_images: (A) positive immunohistochemistry (IHC) photomicrograph for CK 7; (B) positive for ER; (C) positive for mammoglobin; (D) focally positive for CEA (all slides at x400 magnification)
case_images: PAMJ-47-14-g004.jpg
case_images: PMC10957724_02_PAMJ-47-14-g004.jpg
case_images: F4
case_images: Immunohistochemistry showed cytokeratin 7 (CK7) positive (Figure 4A), cytokeratin 20 (CK20) negative, estrogen receptor (ER) positive (Figure 4B), mammoglobin positive (Figure 4C), positive (focal) for gross cystic disease fluid protein 15 and carcinoembryonic antigen (Figure 4D).