title: Progressive midfacial bone erosion and necrosis: case report and differential diagnosis.
abstract: A 31-year-old woman presented with a large oro-nasal communication (ONC), loss of vomer and significant nasal cartilage and nose deformity. Physical examination of the patient revealed a typical midline destructive lesion (MDL) with nasal septum and hard/soft palate perforation with a friable granular surface and a large amount of necrotic tissues. Medical history was unremarkable and the patient denied previous local trauma, including surgical procedures or drug assumption. Pathological examination revealed the presence of necrosis and chronic inflammation. MDLs have numerous etiologies. Signs and symptoms of MDLs can be similar and an accurate diagnosis may be elusive. We hereby present detailed clinicopathological findings.
authors.affiliation: Department of Surgical Sciences (Head: Prof. G. Ramieri), Maxillofacial Surgery Section, San Giovanni Battista Hospital, University of Turin, Corso A.M. Dogliotti 14, Turin 10126, Italy. Electronic address: p_f_bianchi@libero.it.
authors.forename: Francesca Antonella
authors.initials: FA
authors.lastname: Bianchi
authors.affiliation: Department of Surgical Sciences (Head: Prof. G. Ramieri), Maxillofacial Surgery Section, San Giovanni Battista Hospital, University of Turin, Corso A.M. Dogliotti 14, Turin 10126, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gerbino
authors.affiliation: Department of Surgical Sciences (Head: Prof. G. Ramieri), Maxillofacial Surgery Section, San Giovanni Battista Hospital, University of Turin, Corso A.M. Dogliotti 14, Turin 10126, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Tosco
authors.affiliation: Department of Surgical Sciences (Head: Prof. G. Ramieri), Maxillofacial Surgery Section, San Giovanni Battista Hospital, University of Turin, Corso A.M. Dogliotti 14, Turin 10126, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Tanteri
authors.affiliation: Department of Pathology (Head: Prof. G. Inghirami), San Giovanni Battista Hospital, University of Turin, Corso A.M. Dogliotti 14, Turin 10126, Italy.
authors.forename: Gaia
authors.initials: G
authors.lastname: Gatti
authors.affiliation: Department of Surgical Sciences (Head: Prof. G. Ramieri), Maxillofacial Surgery Section, San Giovanni Battista Hospital, University of Turin, Corso A.M. Dogliotti 14, Turin 10126, Italy.
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Ramieri
mesh_terms: D000328:Adult; D019970:Cocaine-Related Disorders / Q000175:diagnosis*; D003937:Diagnosis, Differential; D013293:Enterococcus faecalis / Q000302:isolation & purification; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis; D006801:Humans; D055171:Nasal Cartilages / Q000473:pathology*; D009667:Nose Deformities, Acquired / Q000175:diagnosis*; D009668:Nose Diseases / Q000175:diagnosis*; D016155:Oral Fistula / Q000175:diagnosis*; D010020:Osteonecrosis / Q000175:diagnosis; D021362:Palate, Hard / Q000473:pathology; D016156:Respiratory Tract Fistula / Q000175:diagnosis*; D013203:Staphylococcal Infections / Q000175:diagnosis; D055172:Vomer / Q000473:pathology*
keywords: Fascio-cutaneous forearm free flap; Midline destructive lesion; Oro-nasal communication