Bulletin Board of Oral Pathology
Bulletin Board of Oral Pathology
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Forum for Clinical and Surgical Oral Pathology Case BBOPF 09-1 Dr. Bryan Whitaker (Northwest Medical Center, Springdale, Arkansas USA) invites your comments and suggestions for the ensuing case. Please send your comments in the window located below the images. This case will be posted from January 23-29, 2009. A summary of the responses will be posted in BBOP. Medical HistoryThe patient is a 78 year-old Caucasian male. Past medical history includes hypertension, gout, hypercholesterolemia and by-pass surgery. He was diagnosed with Alzheimer's in about 2004 after a series of seizures. They have not been able to ascertain the definitive etiology of his seizure disorder (possible TIA's) and he has had multiple recurrences over the years. He is in a nursing care facility. Medications include Dilantin (phenytoin) and Lamictal (lamotrigine) among others. Around a year ago, he had a hernia repair and has seemed to do fine since then. Recently, he started having difficulty maintaining his balance and fell a few times. He was taken to the ER and after a series of tests, CT's were ordered. The radiologists were kind enough to share the scans with me. Much to everyone's surprise, images depicted a lesion of the left TMJ area. Evidently he has no history of pain in the region, nor limited opening. He is essentially fully dentate and is able to chew well. I believe he is scheduled for more studies but I thought it an interesting case and obviously would appreciate other's opinions as to possible diagnoses. The lesion has not been biopsied to date. Thanks for your help Images(Larger images witll open in a new window or tab.) Case prepared by Dr. Alfredo Aguirre (BBOP Manager) and Daniel Emmer (Web Administrator, University at Buffalo School of Dental Medicine). |
