Solitary cecal ulcer - case report and treatment options according to literature review

Introduction. Solitary cecal ulcer is a benign and extremely rare disease, as less than 300 cases have been reported so far. The etiology is unknown, and it can be diagnosed by pathohistological examination. Often presented as an acute abdomen and rectal bleeding, it can mock various important and urgent conditions. Treatment protocol is not defined. Extensive and radical surgeries are often performed due to this benign disease mimic. Our aim was to indicate this disease, present the treatment of this rare condition, and to facilitate the treatment plan for this disease. Case outline. Female, aged 67, was admitted to the Emergency Department with a clinical manifestation of acute appendicitis. Emergency surgery was indicated after following diagnostic tests. The intraoperative finding revealed an ulcer on the cecum, which was sutured. The patient fully recovered, and subsequent colonoscopy and pathohistological findings indicated a solitary ulcer. Conclusion. It is possible to treat this condition by retaining the organ and avoiding major surgery. Therefore, it is our opinion that it might provide significant assistance to clinicians in a similar situation. Hence, it is undoubtedly an interesting case for archiving, especially since such a case has not been recorded in our country yet.

Traumatic ulcerative granuloma with stromal eosinophilia: a series of four cases with review of literature

Most of the oral ulcers are traumatic in origin due to sharp tooth and self bite. Traumatic ulcerative granuloma with stromal eosinophilia is a chronic benign lesion of the oral mucosa with uncertain histogenesis. Trauma was proposed to be an inciting factor. A series of four cases of Traumatic Ulcerative Granuloma with Stromal Eosinophilia in the lateral borders of the tongue were analyzed regarding oral hygiene, sharp tooth, clinical presentation, histology, and follow-up. The lesion manifests as a small solitary ulcer with induration in the oral mucosa mimicking malignancy. Histology revealed ulcers with exudate and granulation tissue with dense polymorphous infiltrate rich in eosinophils. Infiltrate extends down in between the skeletal muscle fibers and salivary gland lobules. A sharp tooth was found to be the inciting factor in a proportion of cases. Histopathological examination is mandatory to confirm the diagnosis and to exclude malignancy and other eosinophil rich disorders.

Extranodal diffuse large B cell lymphoma of maxillary sinus presenting as a palatal ulcer

A multitude of disease processes ranging from periodontitis to malignancies can lead to formation of solitary ulcer on the palate. Hence solitary ulcers of palate can often be a challenging one to diagnose. We report an interesting case of a diffuse large B cell lymphoma of the maxillary sinus which perforated the palatal bone and presented clinically as a palatal ulcer. Initially the lesion manifested as a small ill-defined swelling in the posterior palatal slope in relation to 24and25 which were mobile and hence was erroneously diagnosed as chronic periodontal abscess. This paper is intended to stress the relevance of including non-Hodgkin’s lymphoma in the differential diagnosis of solitary palatal ulcers as it may be often misdiagnosed as more common reactive or inflammatory lesions.

Ulcerative Granular Cell Tumor: A Clinicopathological and Immunohistochemical Study

Granular cell tumor (GCT) is uncommonly presented with cutaneous ulcer. We examined the clinicopathological and immunohistochemical features of this ulcerative form in fourteen cases that may raise the awareness of this variant. The study included 11 males and 3 females with a mean age 31.5 ± 7.42 years. All cases were presented with large solitary ulcer with indurated base, elevated border, skin colored margin, and necrotic floor. Twelve lesions were located on the extremities and two lesions on the genital region. Histologically, the lesions showed dermal infiltrate composed of large polygonal cells with granular cytoplasm and characteristic infiltration of the dermal muscles in all cases. Immunostaining showed positive reaction for S100 (14/14), NSE (14/14), CD68 (5/14), and Vimentin (7/14) while HMB45, CK, EMA, and Desmin were negative. We hope that this paper increases the awareness of ulcerative GCT and consider it in the differential diagnosis of ulcerative lesions.