ABSTRACT
Background: Nodular Fasciitis (NF) is characterized as a benign, fast-growing lesion with proliferation of fibroblasts and myofibroblasts. The use of immunohistochemistry is important for the diagnostic definition and if its findings are not clear, the differential diagnosis will be challenging, even more when the clinical findings do not correspond with the histopathological characteristics. Objective:Here, we reported a case of dermal Nodular Fasciitis affecting zygomatic region of a 64 years old male who complained of swelling in the right side of the face for 3 months, which appeared after an ox-horn trauma. Literature review: We reviewed the literature for all Nodular Fasciitis cases in the zygomatic region. Furthermore, we discussed the relationship of trauma as an etiological factor, main differential diagnoses and immunohistochemical markers for Nodular Fasciitis. Case report: Incisional biopsy was done which revealed benign neoplasm of mesenchymal origin characterized by the fusocellular proliferation. Immunohistochemistry revealed positivity for VIM and SMA, being negative for S-100, CKs, CD34, and p53. The Ki-67 index was low. Due to the clinical, histopathological and immunohistochemical findings, the diagnosis of dermal NF was established. Conclusion: This case consists of Nodular Fasciitis, which must be microscopically differentiated from dermatofibroma, solitary fibrous tumor, low-grade myofibroblastic sarcoma and atypical fibroxanthoma. Immunohistochemistry should always be performed to elucidate the nature of tumor cells and thus contribute to the correct diagnosis and treatment. Nodular Fasciitis appears to be uncommon in the zygomatic region.
Introdução: A Fasciíte Nodular (FN) é caracterizada como uma lesão benigna, de crescimento rápido, com proliferação de fibroblastos e miofibroblastos. O uso da imunoistoquímica é importante para a definição diagnóstica e se seus achados não forem claros, odiagnóstico diferencial será desafiador, ainda mais quando os achados clínicos não corresponderem às características histopatológicas. Objetivo: Relatar um caso de Fasciíte Nodular dérmica acometendo a região zigomática de um homem de 64 anos que se queixava de inchaço no lado direito da face há 3 meses, que surgiu após trauma ocasionado por chifre de boi. Revisão da literatura: A literatura foi revisada para todos os casos de Fasciíte Nodular na região zigomática. Além disso, discutiu-se a relação do trauma como fator etiológico, principais diagnósticos diferenciais e marcadores imunoistoquímicos para Fasciíte Nodular. Relato de caso: Foi realizada biópsia incisional que revelou neoplasia benigna de origem mesenquimal caracterizada pela proliferação fusocelular. A imunoistoquímica revelou positividade para VIM e AML, sendo negativa para S-100, CKs, CD34 e p53. O índice Ki-67 foi baixo. Devido aos achados clínicos, histopatológicos e imunoistoquímicos, foi estabelecido o diagnóstico de Fasciíte Nodular dérmica. Conclusão:Este caso consiste em Fasciíte Nodular, que deve ser diferenciada microscopicamente de dermatofibroma, tumor fibroso solitário, sarcoma miofibroblástico de baixo grau e fibroxantoma atípico. A imunoistoquímica deve sempre ser realizada para elucidar a natureza das células tumorais e assim contribuir para o correto diagnóstico e tratamento. A Fasciíte Nodular parece ser incomum na região zigomática
ABSTRACT
Background: Patients undergoing dialysis treatment have a worse quality of life and have higher rates of malnutrition, inflammation and hospitalization than the general population. Objective: This study aimed to evaluate the influence of dental treatment on the quality of life and self-esteem of hemodialysis-therapy patients. Materials and Methods: An interventional study was developed with 27 patients undergoing hemodialysis in Diamantina, Brazil. Initially, patients received a clinical evaluation of a dentist and responded to questionnaires to estimate the quality of life (Medical Outcomes Study 36-Item Short Form Health Questionnaire (SF-36) and Oral Health Impact Profile (OHIP) version 14) and self-esteem (Scale Self-Esteem of Rosenberg). After 45 days, the questionnaires were reapplied, and the patients received dental treatment to adapt the oral environment. After the treatment, 45 days were awaited to reapply the questionnaires. Descriptive analyzes were performed, Wilcoxon and Friedman tests were done. The level of significance was set at 5% (p <0.05). Results: Twenty-seven low-income and educated individuals participated in the study, most of whom were men. Hypertension and diabetes were not widely reported systemic diseases. There was statistical significance in SF-36 and OHIP-14 dimensions and improvement of self-esteem. Conclusion: Dental treatment interfered positively with the quality of life and self-esteem of patients undergoing hemodialysis.