Clinicopathologic analysis of oral dermoid and epidermoid cysts: a Brazilian multicenter study

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.

Mutagenicity in oral cells of individuals exposed to radiofrequency generated by different smartphones

Aim: This study aimed to investigate whether non-ionizing radiation emitted by smartphones is likely to cause genotoxic effects on oral epithelial cells. Methods: Thirty adults were distributed into two groups according to the mobile phone brand used, namely Samsung (Samsung, Seoul, South Korea) and Apple (Apple, California, USA). The material was collected with gentle swabbing of the right and left buccal mucosa using a cervical brush, then the micronucleus test was performed. Results: The Mann-Whitney test with a 5% significance level did not reveal statistically significant differences in micronuclei frequency between the exposed and non-exposed sides (p=0.251). The different brands do not seem to cause risks of inducing genetic damage because there were no statistically significant differences between them (p=0.47). Conclusion: Therefore, our results suggest no correlations of micronuclei frequency in the exposed buccal cells of mobile phone users at the exposure standard levels observed

Late Diagnosis of Oral Melanoma / Diagnóstico Tardío de Melanoma Oral

ABSTRACT: Oral melanoma (OM) is an extremely rare and aggressive malignancy. A 67-year-old patient presented with complains of a slightly symptomatic spot in the mouth since the past 2 years. Extraoral examination revealed left cervical lymphadenopathy, and intraoral examination a blue-black multinodular sessile mass, with irregular margins, involving the attached gingiva of teeth 27 and 28, extending to vestibular sulcus and hard palate, measuring approximately 3.5 cm. The lesion presented focal areas of ulceration. Panoramic radiograph did not show bone involvement. The main diagnostic hypothesis was oral melanoma. Microscopic findings of the incisional biopsy revealed a proliferation of densely pigmented pleomorphic cells, invading the subepithelial connective tissue in sheets or nests showing an organoid pattern. Immunopositivity for S-100, Melan-A and HMB-45 confirmed the diagnosis of melanoma. The patient was referred to an oncology hospital in which multiple metastases were detected, and the patient was subjected to palliative care. Herein we report an OM in advanced clinical stage, and discuss the clinical, morphological and immunohistochemical diagnostic criteria with emphasis on the importance of early diagnosis.

RESUMEN: El melanoma oral (MO) es una malignidad extremadamente rara y agresiva. Un paciente de 67 años acudió a consulta con la queja de una mancha intraoral ligeramente sintomática, presente desde hace dos años. Al examen clínico extraoral, se encontró adenopatía cervical del lado izquierdo, y al examen intraoral, se observó una masa sésil multinodular de color negro azulado, focalmente ulcerada, con bordes irregulares, afectando la encía de los dientes 27 y 28, extendiéndose hasta el surco vestibular y el paladar duro, midiendo aproximadamente 3,5 cm. La radiografía panorámica no mostró involucramiento óseo. La principal hipótesis diagnóstica fue MO. Los hallazgos microscópicos de la biopsia incisional revelaron una proliferación de células pleomórficas densamente pigmentadas, invadiendo difusamente el tejido conectivo en forma de sábanas o nidos con patrón organoide. La positividad inmunohistoquímica para S-100, Melan-A y HMB-45 confirmó el diagnóstico de melanoma. El paciente fue referido a un hospital oncológico, en el cual se le detectaron múltiples metástasis y fue sometido a cuidados paliativos. Este es el reporte de un caso de MO diagnosticado en estado avanzado, en el que se discuten los criterios clínicos, morfológicos e inmunohistoquímicos para su diagnóstico, haciendo énfasis en la importancia del diagnóstico temprano.

Plasma cell cheilitis: the diagnosis of a disorder mimicking lip cancer

Plasma cell cheilitis (PCC) is an inflammatory disorder of unknown etiology that affects the lip. It is characterized histologically by a dense infiltrate of plasma cells with a variety of clinical features. The response to different therapeutic modalities is controversial, especially regarding the effectiveness of corticosteroids. We present a case of a 56-year-old Caucasian man with a painful ulcerated and crusted area in the lower lip, resembling a squamous cell carcinoma or actinic cheilitis. Topical corticosteroid was used for one week, which resulted in partial regression and motivated a biopsy. The histological examination provided the diagnosis of PCC. The patient has been disease-free for six months. We also provide a discussion on the criteria of differential diagnosis and management of this rare condition.

Carcinoma de células escamosas de boca: relação entre graduação histopatológica e características clínicas da neoplasia / Oral squamous cell carcinoma: relation between histopathologic graduation and clinical features of the neoplasia

As características histopatológicas do carcinoma de células escamosas de boca (CCEB) têm sido utilizadas para previsão do comportamento clínico desta neoplasia. Objetivo: Descrever as características de uma amostra de CCEB e verificar a relação da graduação histopatológica com características do indivíduo e da lesão, procurando identificar associações relacionadas com o comportamento agressivo desta neoplasia. Métodos: O protocolo foi aprovado pelo Comitê de Ética em Pesquisa da UFMG. Todos os casos selecionados foram de CCEB diagnosticados no serviço de Patologia Bucal da Faculdade de Odontologia da UFMG e no serviço de Estomatologia do Hospital Municipal Odilon Behrens. A amostra compreendeu 72 casos de CCEB, sendo 56 homens e 16 mulheres. Os indivíduos foram submetidos a questionários quanto aos seus hábitos tabagista e etilista, tempo de evolução da lesão e sintomatologia. Foram realizados exames clínicos, e os fragmentos tumorais foram revisados e graduados através do método proposto por Bryne et al. (1989). Os dados foram analisados, pelo teste do Qui-quadrado, no software SPSS 12.0 (p menor que 0,05). Resultados: Os tumores foram graduados como 23 bem diferenciados (32%), 23 moderadamente diferenciados (32%) e 26 mal diferenciados (36%). Neoplasias histologicamente mais agressivas foram mais frequentemente localizadas em língua ou assoalho bucal, sem, entretanto diferença estatisticamente significante (p maior que 0,05). A maioria das lesões mal diferenciadas (15 / 71,4%) exibiu metástase regional e o envolvimento linfonodal mostrou associação com tamanho da lesão (p menor que 0,05). Conclusão: Os resultados sugerem que algumas características da neoplasia, tais como, tamanho do tumor, sua localização (língua e/ou assoalho bucal), bem como a ocorrência de metástases para linfonodos locais, podem estar relacionados com a agressividade histológica do CCEB.

The histopathological characteristics of oral squamous cell carcinoma (OSCC) have been used to predict the clinical behavior of this neoplasia. Purpose: The aim of this study was describe the characteristics of an OSCC sample and verify the relation between histological grading and characteristics of the subjects and the tumor, identifying associations with the aggressive behavior of this lesion. Method: The protocol of this study was approved by the Research Ethics Committee from Universidade Federal de Minas Gerais (COEP-UFMG). OSCC cases selected were diagnosed in Oral Diagnosis Service at the Dentistry School of UFMG and in Odilon Behrens Hospital. ). The sample consisted of 72 patients with OSCC, been 56 men and 16 women. The patients were submitted to a questionnaire about tobacco and alcohol habits, evolution time and symptomatology. Clinical examinations were performed and tumor fragments were reviewed and graded in accordance to the criteria proposed by Bryne et al. (1989). The data were analyzed in SPSS (Statistic Package for Social Sciences) 12.0 for Windows (p less than 0,05). Results: Twenty-three tumors were graded histologically as well differentiated (32%), 23 moderately differentiated (32%) and 26 poorly differentiated (36%). Neoplasms histologically more aggressive were often located in tongue and floor of mouth, however, without statistical significance (p greater than 0,05). The majority of the well differentiated lesions (71,4%) exhibited regional metastasis and the lymph node involvement showed association with tumor's size (p less than 0,05). Conclusion: The results suggest that histological aggressiveness could be associated with size and regional dissemination in OSCC and that tumors located in tongue and floor of mouth may exhibit more aggressive behavior.