Pathologic Quiz Case 1
Miriam I. Redleaf, MD, Robert A. Robinson, MD, PhD, Iowa City, Iowa
AN 85-YEAR-OLD woman presented with a 4-week history of a nontender "canker sore" that bled occasionally. Its size impaired her chewing. Her medical history was significant for a fracture of her left humerus 4 months before that had failed to heal.
On physical examination a submucosal pedunculated mass protruded from the left posterior mandibular alveolar ridge. Orthopedic evaluation identified fractures of the proximal and distal left humerus and of the proximal left radius (Figure 1). A chest roentgenogram identified a right clavicular fracture. Mandibular films were obtained (Figure 2).
An incisional biopsy specimen of the intraoral mass was examined with hematoxylin-eosin (Figure 3) and periodic acid–Schiff (Figure 4) stains. Vimentin immunocytochemical stain was positive in tumor cells. On electron microscopy microvilli were seen, and the cytoplasm contained numerous lipid vacuoles.
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