Case Challenge #17

An 85-year-old Caucasian male was referred to the oral and maxillofacial department complaining of a loose upper denture and extrusion of ‘sharp fragments’ bilaterally from his gums. He also gave a recent history of recurrent nasal discharge.

On examination the patient was edentulous, but had evidence of bony protrusions:  cc17

The report of the CT indicated the appearances were highly suggestive of a diffuse malignant process although an extensive erosive or inflammatory process could not be excluded from the differential diagnosis.

In order to relieve his symptoms and reach a diagnosis, partial debridement of the area (including removal of the bony sequestra) was undertaken and the tissue was sent for histological examination. The histology report showed the following:

Casechallenge 17