Greta Yordanova

Background/Introduction: Cutaneous mixed tumor is a rare benign neoplasm that exhibits a wide range of metaplastic changes and differentiation in the epithelial, myoepithelial, and stromal components, which is often confused with various other skin lesions. Case report: We present an unusual case of a 58-year-old woman with a mixed tumor of the upper lip, previously misdiagnosed as adnexal carcinoma on a preoperative biopsy. The excision biopsy shows a well-circumscribed lesion composed of various cells and structures featuring folliculo–sebaceous differentiation embedded in a prominent chondromyxoid stroma. The immunohistochemical study proves the various lineages of differentiation and classifies the neoplasm as the less common eccrine subtype of cutaneous mixed tumor. Discussion: The common embryologic origin of the folliculo–sebaceous apocrine complex leads to a great histological variety of cellular components of mixed tumors and the formation of structures that resemble established types of adnexal neoplasms, which could be a diagnostic pitfall, especially on a small incision biopsy.

In interceptive treatments in which impacted teeth (incisor or first permanent molar) should be included into the dental arch, the main clinical problem is the provision of an anchorage area and a suitable appliance. The use of a laser-sintered metal orthodontic printed dento-alveolar anchorage (PDaA), designed and printed digitally, has expanded the boundaries of orthodontic treatment, especially in its interceptive phase. Our aim is to describe a laser-sintered metal appliance to provide anchorage during orthodontic surgical traction of impacted teeth in the mixed dentition period. The presented clinical cases were treated with digitally projected and printed metal PDaA. In the described clinical cases, individually designed anchorage systems were used. They were created through design software and, after that, the metal appliances were printed. The devices were placed in the oral area and did not disturb the aesthetics of the patient. The advantages of individual designed metal PDaA allow the accommodation of the morphology of the hard palate and alveolar bone. This makes the PDaA comfortable for the patient and rigid enough to perform orthodontic traction at the same time. The PDaA is applicable in mixed dentition and, in complicated clinical cases, in permanent dentition. Their individuality allows for segmental treatments or treatments in cases requiring additional anchorage further away from the active force.