Document Detail

Aggressive destructive midfacial lesion from cocaine abuse.
MedLine Citation:
PMID:  12374921     Owner:  NLM     Status:  MEDLINE    
Since the first reported case in 1912 of cocaine-induced perforation of the palate, an additional 7 cases have been reported describing extensive palatal destruction. The clinical presentation shares similarities with nasal-type natural killer/T-cell lymphoma, Wegener's granulomatosis, and infectious diseases. We describe a 50-year-old woman with a progressively destructive midfacial process that initially appeared as a small, localized palatal defect. Over time, the lesion caused bilateral deformity of the ala, extensive loss of the palate, maxillary and sinonasal complexes, ethmoids, and ulceration of adjacent tissue. Clinical laboratory tests showed elevated cytoplasmic-antineutrophil cytoplasmic antibodies, but the histopathology did not support the diagnosis of Wegener's granulomatosis. Special stains and cultures were negative for infectious organisms. Flow cytometry and T-cell gene rearrangement studies ruled out lymphoma. Because of the inability to diagnose this worrisome process, the presence of polarizable foreign material in the original biopsy, and the patient's admission to past cocaine use, a urine drug screen was performed, which was positive for cocaine and marijuana.
Bradley A Seyer; William Grist; Susan Muller
Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics     Volume:  94     ISSN:  1079-2104     ISO Abbreviation:  Oral Surg Oral Med Oral Pathol Oral Radiol Endod     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-10-10     Completed Date:  2003-01-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9508562     Medline TA:  Oral Surg Oral Med Oral Pathol Oral Radiol Endod     Country:  United States    
Other Details:
Languages:  eng     Pagination:  465-70     Citation Subset:  D; IM    
Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA.
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MeSH Terms
Cocaine-Related Disorders / complications*,  diagnosis
Diagnosis, Differential
Ethmoid Sinus / pathology
Lymphoma, T-Cell / diagnosis
Maxillary Diseases / etiology*
Maxillary Sinus / pathology
Middle Aged
Nasal Cavity / pathology
Nasal Septum / pathology
Nose Diseases / etiology*
Osteonecrosis / etiology
Palate / pathology*
Paranasal Sinus Diseases / etiology*
Wegener Granulomatosis / diagnosis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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