ABSTRACT
Abstract The aim of this study was to describe the prevalence, clinicopathological, and prognostic features of acinic cell carcinoma (AciCC) of the oral and maxillofacial region. AciCC cases were retrospectively retrieved from 11 pathology centers of three different countries. Medical records were examined to extract demographic, clinical, pathologic, and follow-up information. A total of 75 cases were included. Females (65.33%) with a mean age of 45.51 years were mostly affected. The lesions usually presented as an asymptomatic (64.28%) nodule (95.66%) in the parotid gland (70.68%). The association of two histopathological patterns was the most common finding (48.93%) and the tumors presented mainly conventional histopathological grades (86.11%). Surgical treatment was performed in the majority of the cases (59.19%). Local recurrence was observed in 20% of the informed cases, regional metastasis in 30.43%, and distant metastasis in 12.50%. The statistical analysis showed that the cases with a solid histopathological pattern (p=0.01), high-grade transformation (p=0.008), recurrence (p=0.007), and regional metastasis (p=0.03) were associated with poor survival. In conclusion, high histopathological transformation, presence of nodal metastasis, and recurrence were prognostic factors for AciCC of the oral and maxillofacial region.
ABSTRACT
Abstract Dermoid cysts (DCs) and epidermoid cysts (ECs) are uncommon developmental cysts affecting the oral cavity. This study aims to evaluate patients with oral DCs and ECs and their demographic and clinicopathologic features. A retrospective descriptive cross-sectional study was performed. A total of 105,077 biopsy records of oral and maxillofacial lesions from seven Brazilian oral pathology centers were analyzed. All cases diagnosed as oral DCs and ECs were reviewed, and clinical, demographic, and histopathological data were collected. The series comprised 32 DCs (31.4%) and 70 ECs (68.6%). Most of the DCs occurred on the floor of the mouth (n = 14; 45.2%) of women (n = 17; 53.1%) with a mean age of 34.6 ± 21.6 years. All DCs were lined partially or entirely by stratified squamous epithelium (100%). Chronic inflammatory cells, melanin pigmentation, multinucleated giant cell reaction, and cholesterol clefts were observed in the fibrous capsule . Most of the ECs affected the labial mucosa (n = 20; 31.7%) of men (n = 39; 56.5%) with a mean age of 48.0±19.8 years. Microscopically, most ECs (n = 68; 97.1%) were lined entirely by stratified squamous epithelium. Two cysts (2.9%) showed areas of respiratory metaplasia. Chronic inflammatory cells, melanin pigmentation, multinucleated giant cell reaction, and cholesterol clefts were also observed in the fibrous capsule. Conservative surgical excision was the treatment of choice in all cases. Oral DCs and ECs are uncommon and often clinically misdiagnosed lesions. Clinicians should consider DCs and ECs in the differential diagnosis of soft tissue lesions in the oral cavity, mainly located on the floor of the mouth and labial mucosa.
ABSTRACT
Abstract This study aimed to evaluate the contribution of oral and maxillofacial pathology laboratories (OMPLs) in Brazilian public universities to the diagnosis of lip, oral cavity, and oropharyngeal squamous cell carcinoma (SCC). A cross-sectional study was performed using biopsy records from a consortium of sixteen public OMPLs from all regions of Brazil (North, Northeast, Central-West, Southeast, and South). Clinical and demographic data of patients diagnosed with lip, oral cavity, and oropharyngeal SCC between 2010 and 2019 were collected from the patients' histopathological records. Of the 120,010 oral and maxillofacial biopsies (2010-2019), 6.9% (8,321 cases) were diagnosed as lip (0.8%, 951 cases), oral cavity (4.9%, 5,971 cases), and oropharyngeal (1.2%, 1,399 cases) SCCs. Most cases were from Brazil's Southeast (64.5%), where six of the OMPLs analyzed are located. The predominant profile of patients with lip and oral cavity SCC was Caucasian men, with a mean age over 60 years, low schooling level, and a previous history of heavy tobacco consumption. In the oropharyngeal group, the majority were non-Caucasian men, with a mean age under 60 years, had a low education level, and were former/current tobacco and alcohol users. According to data from the Brazilian National Cancer Institute, approximately 9.9% of the total lip, oral cavity, and oropharyngeal SCCs reported over the last decade in Brazil may have been diagnosed at the OMPLs included in the current study. Therefore, this data confirms the contribution of public OMPLs with respect to the important diagnostic support they provide to the oral healthcare services extended by the Brazilian Public Health System.
ABSTRACT
Introdução: Odontoma é o tumor odontogênico mais frequente e é diagnosticado durante as primeiras décadas de vida, devido ao atraso na erupção de um dente ou por meio de exame radiográfico de rotina. As características radiográficas e microscópicas são úteis para sua classificação em complexo ou composto. Odontomas em pacientes adultos são incomuns e podem ser complexos de tratar. Objetivo: O objetivo deste trabalho foi relatar a complexidade de tratamento de um odontoma composto em paciente adulto. Material e Método: o presente artigo é do tipo relato de caso. Resultados: Paciente do sexo feminino, 32 anos, compareceu ao cirurgião-dentista para avaliação clínica de rotina. Durante o exame clínico foi observada a ausência do dente 43, exames radiográficos demonstraram lesão mista, bem delimitada, com estruturas semelhantes a dentículos, localizada na região anterior de mandíbula do lado direito, entre as raízes dos dentes 42 e 44, promovendo deslocamento do dente 43 para a base da mandíbula. Devido à localização da lesão e seus efeitos no dente 43, a paciente foi submetida à ressecção da lesão sob anestesia geral. Foi realizada osteotomia na tábua óssea vestibular da mandíbula, remoção de múltiplas estruturas semelhantes a dentes, instalação de placa de reconstrução mandibular sistema 2.4 com cinco parafusos do mesmo sistema e enxerto ósseo com biomaterial aloplástico. O dente 13 foi extraído. As radiografias de controle pós-operatório evidenciaram bom posicionamento do material. O controle pós-operatório indica que a paciente encontra-se bem e sem ausência de sinais de recidiva ou complicações cirúrgicas. Conclusão: O diagnóstico tardio de odontomas associado ao deslocamento dentário ocasionado pelo tumor podem tornar o seu tratamento mais complexo.
Introduction: The most common odontogenic tumor is Odontoma, and is diagnosed during the first decades of life, due to a delayed eruption of a tooth, or through routine radiographic examination. From the radiographic and microscopic characteristics is classified into complex or compound. Odontomas in adult patients are uncommon and can have a complex treatment. Aim: The aim of this study was to report the complexity of treating a compound odontoma in an adult patient. Material and Methods: the present research is a case report. Results: A 32-year-old female patient attended the dental surgeon for routine evaluation. During the clinical examination, the absence of tooth 43 was observed, image exams revealed a well-defined mixed lesion consisting of denticles, located in the anterior region of the right mandible, between the roots of the teeth 42 and 44, the lesion promoted displacement of tooth 43. Due to the location and its effects on tooth 43, the patient underwent resection of the lesion under general anesthesia. Surgery proceeded with buccal plate osteotomy, removal of multiple tooth-like structures, installation of mandibular reconstruction plates 2.4 with five screws and bone graft with alloplastic biomaterial. Tooth 13 was extracted. Postoperative control radiographs showed good positioning of the material. Postoperative control show that patient does not have recurrence signal or complications due to surgery. Conclusion: Late diagnosis of odontomas associated with tooth displacement caused by the tumor may make its treatment more complex.