A case of external dental fistula which diagnosis was difficult

Abstract

The case was a 48 year-old-woman, and the chief complaint was swelling of the right submandibular part. She noticed the swelling since around Oct. 2002 and on Nov. 27, 2002 the case was introduced to our department by a dentist for a checkup. Palpating indicated hard mass at a size of 28×20mm in front of the submandibular gland. An inflammatory mass was suspected from the test result and image findings, and the patient was scheduled for follow up. It was resected for diagnosis on Mar. 19, 2003 due to an enlarged phyma. A histopathology diagnosis of an abscess and granulat ed tissue formation was reported. Because the same locus had enlarged further when seen on Oct. 6, 2003, external dental fistula was suspected. It was reported to the dentist that the possibility of external dental fistula was low. Because stoma formed in the mandibular direction, which was confirmed on Dec. 16, 2003 when we inserted conductor, we presented the case to the dentist again. The tooth was extracted and there has been no recurrence to date.