BACKGROUND: Intraosseous xanthomas are rare benign lesions sometimes associated with excess lipid production. Xanthoma of the jaw bones (XJB) was first reported in 1964, and fewer than 50 cases have been reported in the English literature to date. The etiopathogenesis of XJB is highly suggestive of a reactive process or a metabolic condition.
METHODS: Seven cases of XJBs were retrieved from the archives of 4 oral and maxillofacial pathology services. Clinical, radiographic and histopathologic features of all these cases were retrospectively analyzed. Immunohistochemical (IHC) stains for S100 and CD68 were performed.
RESULTS: All seven cases involved the mandible. Patients\' age ranged between 13 and 69 years with an evenly distributed female to male ratio. One patient had a medical history of hyperlipidemia, but the medical and dental histories of the others were unremarkable. For most cases, XJB was an incidental finding discovered during routine radiographic examination. Swelling and cortical expansion were noted in a few cases. Radiographically, cases typically presented as either well-defined multilocular or unilocular lesions, which were either radiolucent or mixed radiolucent/radiopaque. All the lesions were treated with surgical curettage and no recurrence was observed during subsequent follow-ups. Each of the seven cases exhibited sheets of foamy macrophages. The diagnosis is established by exclusion of entities with overlapping microscopic features and involved correlation with the clinical, histological, radiographic and IHC profiles. Immunohistochemically, all the cases expressed diffuse positivity for CD68 and were negative for S100.
CONCLUSIONS: XJB is a rare lesion of unknown etiology, which may mimic other benign or reactive jaw lesions. Due to its rarity and the potential diagnostic challenges it presents, clinicians must remain vigilant and consider CXJ in their differential when assessing radiolucent jaw anomalies.

Introduction  An odontogenic keratocyst (OKC) is a benign intraosseous lesion with potential to demonstrate aggressive and invasive behavior. The aim of this retrospective study was to analyze the imaging features of the OKC using cone-beam computed tomography (CBCT) and to evaluate the association between the internal structure of the lesion and the effect of the lesion on surrounding structures. Methods Overall, 32 CBCT scans of histopathologically diagnosed cases of OKC were analyzed retrospectively. The following variables were analyzed: anatomic location of the lesions (mandible body (right/left), ramus (right/left), mandible body+ramus (right/left), maxilla (right/left), and both jaws), the internal structure of the lesion (unilocular/multilocular), and the effect of the lesion on the surrounding anatomical structures (involvement of the inferior alveolar nerve canal (IANC), displacement of the IANC, cortical expansion, displacement of the tooth, resorption of the root, associated impacted tooth, associated missing tooth). We also looked for the association between the internal structure and the effect of the lesion on anatomic structures. Results Out of 32 cases, 29 (90.6%) cases involved the mandible alone. Statistically significant association (p-value 0.005) was present between the internal structure and mean age of presentation as well as between the internal structure and impacted tooth (p-value 0.027). The association between the internal structure and other variables was statistically not significant. Conclusions The radiographic features of OKCs can be variable, and these lesions have a considerable effect on the tooth, IANC, and cortical bone. Significant association was found between the internal structure, age, and impacted tooth. Since OKCs have a high recurrence rate, CBCT is advised for evaluating the extent and location of any cortical perforations.

The odontogenic myxoma is a tumor of the jaws which arises from the mesenchymal portion of the tooth germ, either the dental papilla, the follicle, or the periodontal ligament. It is a slow-growing, painless, nonmetastasizing, central tumor of the jaws, chiefly the mandible. Radiographically, the classic presentation may vary from a unilocular radiolucency to a multilocular lesion with well-defined or diffuse margins. On histological study, it is composed of triangular or stellate connective cells, anastomosed by fine extensions, and embedded in abundant mucoid material.
UNASSIGNED: We present the unusual case of an odontogenic myxoma involving a 37-year-old female patient, which had acquired large dimensions and involved the right half of the mandible, including the ramus; the patient was treated with large resection surgery, with satisfying medium-term results.
UNASSIGNED: Early diagnosis of such lesions is very important, as the patient avoids extensive surgical procedures that involve losing a large part of the jawbones and their subsequent impact on the patient\'s quality of life.
UNASSIGNED: Although there is no fixed treatment plan for the management of odontogenic myxoma, treatment includes surgical management that may range from simple enucleation and curettage to surgical excision; wide surgical resection is appropriate for cases of large size to avoid recurrence.

Unicystic ameloblastoma (UCA) refers to cystic lesions that show gross features of a jaw cyst but on histologic examination show a typical ameloblastomatous epithelium lining part of the cyst cavity, with or without luminal and/or mural tumor growth. Even though the lesion is not as aggressive as the solid ameloblastoma, an accurate histopathologic diagnosis is essential for the treatment and prognosis. This case report illustrates a case of UCA of mural variant in the anterior region of the mandible crossing the midline, which is usually an unusual site of occurrence.

Bilateral multilocular huge epididymal cysts are a rare entity with few reports in the literature. Epididymal cysts are mostly found in middle-aged men with or without symptoms. We present the case of a 45-year-old man with asymptomatic bilateral scrotal swelling, which was clinically diagnosed as a right epididymal cyst with left hydrocele. However, an ultrasound of the scrotum revealed bilateral epididymal cysts with normal testes. Intraoperatively, it demonstrated bilateral huge epididymal cysts for which the patient underwent excision of bilateral epididymal cysts. Postoperatively, the patient is doing well on follow-up. Thus, it is concluded that when the epididymal cyst is larger than 10 mm or 1 cm and does not involute with time, surgery is indicated. In comparison, epididymal cysts smaller than 10 mm or 1 cm are managed conservatively.

UNASSIGNED: Enchondroma is a solitary, benign, intramedullary cartilaginous tumor commonly noticed in the phalanges of hands and feet with characteristic radiological features. Its occurrence in aberrant sites with atypical features lead to diagnostic dilemma. Enchondromas which are usually managed non-operatively can mimic other benign and malignant lesions, especially chondrosarcoma.
UNASSIGNED: We report the case of a 31-year-old farmer who presented with long standing inconspicuous pain in his left leg which turned out to be a diaphyseal enchondroma even though it demonstrated aggressive radiological features mimicking a chondrosarcoma. Incisional biopsy was done from the scalloped areas to obtain the correct histological diagnosis. He underwent thorough curettage of the lesion and remains asymptomatic 2 years after the procedure. We attempt to discuss the differentials which the orthopedic surgeon should keep in mind for diaphyseal lesions mimicking enchondroma.
UNASSIGNED: Though classically found in metaphysis, Enchondromas are not uncommon in diaphysis of long bones. Enchondromas are generally benign, but can cause diagnostic dilemma when they present with aggressive features at rare locations and surgeons should be wary of the differentials. Despite a size of more than 6 cm and evidence of cortical erosion and intramedullary widening, the lesion could still be benign. Early biopsy will help to differentiate Enchondroma from a malignant transformation or malignant tumor.

UNASSIGNED: Renal oncocytomas are benign epithelial tumors usually detected incidentally. They are typically solid,well-circumscribed,homogenous,mahoganybrown with a central stellate scar.Sometimes,they can have cystic degenerationand rarely present as a multilocular cyst which can be mistaken for other cystic renal carcinomas.
UNASSIGNED: We describe a case of incidentally detected multilocular cystic renal oncocytoma having an unusual gross appearance of multiloculation with perinephric fat invasion. The tumor exhibited tubulocystic architecture posed a diagnostic dilemma. Detailed study of multiple sections coupled with immunohisto chemistry helped elucidate the diagnosis. Till date, only eight cases of multicystic renal oncocytoma have been reported in the English literature.
UNASSIGNED: We emphasize the importance of awareness of this unusual morphologic variation to ensure correct diagnosis.

Liver transplantation (LT) is routinely performed for hepatocellular carcinoma (HCC) in cirrhosis without major vascular invasion. Although the adverse influence of microvascular invasion is recognized, its occurrence does not contraindicate LT. We retrospectively analyzed in our LT cohort the significance of microvascular invasion on survival and demonstrate bridging procedures. At our hospital, 346 patients were diagnosed with HCC, 171 patients were evaluated for LT, and 153 were listed at Eurotransplant during a period of 11 years. Among these, 112 patients received LT and were included in this study. Overall survival after 1, 3 and 5 years was 86.3%, 73.9%, and 67.9%, respectively. Microvascular invasion led to significantly reduced overall (p = 0.030) and disease-free survival (p = 0.002). Five-year disease-free survival with microvascular invasion was 10.5%. Multilocular tumor occurrence with simultaneous microvascular invasion revealed the worst prognosis. In our LT cohort, predominant bridging treatment was transarterial chemoembolization (TACE) and the number of TACE significantly correlated with poorer overall survival after LT (p = 0.028), which was confirmed in multiple Cox regression analysis for overall and disease-free survival (p = 0.015 and p = 0.011). Microvascular tumor invasion is significantly associated with reduced prognosis after LT, which is aggravated by simultaneous occurrence of multiple lesions. Therefore, indication strategies for LT should be reconsidered.

Thymic cysts are rare lesions, accounting approximately for 1% of all mediastinal masses. We report a case of a 36-year old woman who presented preoperatively with a calcified mass shadow found on a routine chest radiograph X-ray. After further investigation with chest computed tomography (CT), magnetic resonance imaging (MRI), and tests for Myasthenia gravis, a benign mediastinal cyst was diagnosed and the patient underwent median sternotomy and complete surgical excision of the lesion. The histological examination described a multilocular thymic cyst. Thymic cysts are usually associated with thymic epithelial tumors, such as thymomas, or multisystemic morbid conditions such as human immunodeficiency virus (HIV) infection, rheumatologic disease, and Myasthenia gravis. At all follow-up examinations to date, the patient remains healthy.

UNASSIGNED: The aim of this study was to evaluate the efficacy of topical application of 5-fluorouracil (5-FU) after peripheral ostectomy, and compare it with other treatment modalities in the management of odontogenic keratocyst (OKC).
UNASSIGNED: This prospective study was conducted in the OMFS department for last seven years, wherein twenty seven patients of OKC were included and randomly allocated to the three treatment groups. Nine were treated by enucleation followed by application of modified carnoy solution (CS), eleven by peripheral ostectomy followed by application of 5-FU and eleven by segmental resection (SR). Follow-up ranged from 2 to 4 years to assess bone healing and record any recurrence of lesion.
UNASSIGNED: Amongst twenty seven patients, eighteen were males and nine females, age range 20-66 years. The most common location of OKC was posterior mandible. Complications included nerve injury, swelling, infection, and recurrence (66.6% after modified CS). Functional and aesthetic compromise was seen in resection patients whereas application of 5-FU had minimal nerve injuries, infection, swelling, no recurrence with no compromise in aesthetics and function.
UNASSIGNED: Management of OKC by 5-FU is a novel surgical method having less morbidity, minimal recurrence, low cost, no functional or cosmetic deformity.