ABSTRACT
El épulis congénito es una patología neonatal muy rara. Se trata de un tumor benigno pediculado de la mucosa de los maxilares, más frecuentemente localizado en maxilar superior en relación 2-3/1. Se describe el caso de un recién nacido de sexo femenino, de término, adecuado, vigoroso. Se constata al nacimiento la presencia de un épulis congénito que causa alteraciones de la succión. Se realiza intervención quirúrgica temprana, con resolución de la patología sin complicaciones.
Congenital epulis is a very rare neonatal pathology. It is a benign pedunculated tumor of the jaw mucosa, most frequently located in the upper jaw in a 2-3 / 1 ratio. The case of a newborn, female, term, adequate, vigorous is described. Noting at birth a congenital Epulis that causes suction alterations. Early surgical intervention is perfomed with resolution of the pathology without complications.
A epúlide congênita é uma patologia neonatal muito rara. É um tumor pedunculado benigno da mucosa dos maxilares, mais frequentemente localizado no maxilar superior na proporção de 2-3/1. Descreve-se o caso de um recém-nascido, do sexo feminino, a termo, adequado, vigoroso. Verificando ao nascimento uma Epúlide congênita que causa alterações na sucção. A intervenção cirúrgica precoce é realizada com resolução da patologia sem complicações.
Subject(s)
Humans , Male , Infant, Newborn , Gingival Neoplasms/surgery , Gingival Neoplasms/diagnosis , Gingival Neoplasms/pathologyABSTRACT
Background: Reconstruction of anterior segmental mandibulectomy still remains a challenge. Osteocutaneous free flap remains the ideal choice of reconstruction because it restores cosmesis and function. The use of other locoregional flaps compromises cosmesis and function. Here, we have introduced a unique technique of reconstruction with lingual cortex mandibular plate as an alternate choice for free flap. Method: Six patients aged 12–62 years underwent oncological resection for oral cancer which involved the anterior segment of the mandible. Following resection, they underwent lingual cortex mandibular plating with pectoralis major myocutaneous flap reconstruction. Adjuvant radiotherapy was delivered to all patients. Results: The mean bony defect was 9.2 cm. There were no significant perioperative events related to the surgery. None required tracheostomy and all were safely extubated with no post-surgical complications. The cosmetic and functional outcomes were acceptable. Following the completion of radiotherapy with a median follow-up of 11 months, Plate exposure occurred in one patient. Conclusion: The technique is cheap, quick and simple, and can be effectively applied in resource-constrained and demanding situations. It is possible to consider this as an alternative treatment strategy for osteocutaneous free flap in anterior segmental defects
ABSTRACT
El linfoma difuso de células B grandes (LDCBG) es el linfoma más frecuente. La presentación clínica puede ser nodal o extranodal y sus síntomas dependen de la localización tumoral; en la mayoría de los casos están asociados a algún tipo de inmunodeficiencia. Referiremos un caso de LDCBG de presentación atípica en una localización muy infrecuente. Es importante tener en cuenta estas situaciones, ya que pueden simular otros procesos patológicos, retrasando así su correcto diagnóstico y por lo tanto un adecuado tratamiento. (AU)
Diffuse large cell lymphoma B (LDCBG) is the most common type of lymphoma. It´s clinical presentation can be nodal or extranodal and it's symptoms depend where the tumor is located and whether is associated or not with an immunodeficiency disease. We present an atypical presentation of a LDCBG in a very unusual location. It´s important to consider these kind of appearance, as they can mimic other oral pathological processes, delaying their correct diagnosis and therefore an appropriate treatment. (AU)
Subject(s)
Humans , Male , Aged , Lymphoma, Non-Hodgkin/diagnosis , Gingival Neoplasms/diagnostic imaging , Lymphoma, Large B-Cell, Diffuse/diagnosis , Lymphoma, Non-Hodgkin/classification , Lymphoma, Non-Hodgkin/etiology , Mouth Neoplasms/diagnosis , Lymphoma, Large B-Cell, Diffuse/therapy , Lymphoma, Large B-Cell, Diffuse/diagnostic imaging , HIV Seronegativity/immunology , Herpesvirus 4, Human/immunology , Oral Ulcer/pathology , Mouth Mucosa/pathologyABSTRACT
El Fibroma Odontogénico Periférico fue definido por la OMS en el año 2005 como una neoplasia benigna rara constituida por tejido fibroso maduro y una cantidad variable de epitelio odontogénico inactivo. Dada su presentación clínica, localización y baja prevalencia suele ser mal diagnosticado como una lesión reaccional. Se presenta un caso clínico de fibroma odontogénico periférico tratado mediante remoción quirúrgica y se realiza una revisión de la bibliografía respecto a la patología con el propósito de esclarecer algunos aspectos de esta lesión, además de incluirla dentro de los posibles diagnósticos diferenciales de lesiones reaccionales gingivales. El objetivo del siguiente artículo es presentar un caso clínico de FOP tratado mediante remoción quirúrgica y aportar en el diagnóstico diferencial de las lesiones reaccionales gingivales.
Peripheral odontogenic fibroma was described by the World Health Organization (WHO) in 2005, as a rare benign tumor containing mature fibrous connective tissue with a varying amount of inactive odontogenic epithelium. Though its clinical presentation, localization and low prevalence, it tends to be misdiagnosed as a reactive lesion. We present a case report of a Peripheral Odontogenic Fibroma treated by surgical resection and a narrative review of the literature with the purpose of clarifying different aspects of this lesion besides considering it as a possible differential diagnosis of reactive gingival lesions. The purpose of this article is to present a case report of peripheral odontogenic fibroma treated by surgical resection. Also to contribute to the differential diagnosis of gingival reactive lesions.
Subject(s)
Humans , Female , Middle Aged , Gingival Neoplasms/surgery , Gingival Neoplasms/diagnosis , Odontogenic Tumors/surgery , Odontogenic Tumors/diagnosis , Tooth Resorption/etiology , Gingival Neoplasms/pathology , Odontogenic Tumors/pathology , Diagnosis, Differential , FibromaABSTRACT
Congenital epulis is an uncommon benign lesion that affects the oral cavity of newborns, and presents histological features which are similar to those of granular cell tumor. The origin of this lesion has not been fully elucidated, and many hypotheses are considered due to the large variety of cell types observed in histological sections. Epulis development occurs further in the prenatal period, and is more common in newborn females, frequently in the maxilla. This lesion usually is presentend as a nodule covered by normal oral mucosa, which in some cases, interferes with baby's breathing and feeding. This report describes the case of a two-month-old male baby who presented a pedunculated intraoral lesion in the mandibular alveolar ridge. Histological sections revealed presence of mucosal fragments with atrophic squamous stratified epithelium, and fibrous connective tissue composed of cells with granular and eosinophilic cytoplasm. A few days after initial exam, the lesion detached from alveolar ridge, and healed spontaneously.
A epúlide congênita é uma lesão benigna rara que acomete a cavidade oral de recém-nascidos e apresenta características histológicas semelhantes às do tumor de células granulares. A origem da lesão ainda não foi completamente elucidada, e as muitas hipóteses a respeito de sua histogênese baseiam-se na grande variedade de tipos celulares observados nos cortes histológicos. A epúlide desenvolve-se ainda no período pré-natal, e é mais comum em recém-nascidos do sexo feminino, ocorrendo com mais freqüência na maxila. Esta lesão costuma apresentar-se como um nódulo coberto por mucosa oral normal que, em alguns casos, interfere na respiração e na alimentação do bebê. Esse artigo descreve o caso de um bebê do gênero masculino, leucoderma, de dois meses de idade, que apresentava lesão intra-oral pediculada com implantação débil na região alveolar da mandíbula. Cortes histológicos revelaram a presença de fragmento de mucosa revestido por epitélio pavimentoso estratificado atrófico, e de tecido conjuntivo fibroso composto de células com citoplasma granular e eosinofílico abundante. Alguns dias após o exame inicial, a lesão desprendeu-se do rebordo alveolar, sofrendo resolução espontânea.
ABSTRACT
Introducción. El épulis del recién nacido es un tumor de células granulares originado en la mucosa de la cresta alveolar dental. Se presenta como una masa de tejido blando pedunculado, que puede ser lobular o multinodular. Es más habitual en mujeres que en hombres (8:1), debido, quizás, a factores hormonales en su génesis. Puede acompañarse de otras malformaciones congénitas. El manejo anestésico se basa en su potencial dificultad para la intubación y el riesgo de sangrado. Objetivos. Presentar el caso de un recién nacido con épulis congénito y hacer revisión de esta entidad y de su manejo anestésico. Métodos y resultados. Presentación de este caso clínico. Conclusiones. Hay descritos varios tipos de anestesia, dependiendo, entre otros factores, del tamaño del tumor y de los profesionales que intervienen en su exéresis. En nuestro caso, y dadas las características del tumor, optamos por una sedación inhalatoria con O2 /aire / sevofluorane, posición en decúbito lateral e infiltración local en la base del implantación. El éxito de la intervención debe basarse en una buena colaboración quirúrgico-anestésica.
Introduction. epulis of the newborn is agranular cell tumor arising in the mucosa of the dental ridge. It presents as a pedunculated soft tissue mass that can be lobular or multinodular.It is more common in females than inmales (8:1) perhaps due to hormonal factors. It may be accompanied by other congenital malformations. Anesthetic management is based on a potentially difficult intubation and the risk of bleeding. Objectives. To present the case of a newborn with congenital epulis and to review this pathologyand its anesthetic management.Methods and Results Clinical case presentation. Conclusions. Several types of anesthesia havebeen described depending, among other factors, on tumor size and on the professionals involved in excising the lesion. In our case, and given the characteristics of the tumor, we chose inhalation sedation with O2 / air / sevoflurane, lateral decubitus position and local infiltration at the base of implantation. Good collaboration between the surgeon and the anesthetist is critical for success.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Anesthesia , Congenital Abnormalities , Gingival Neoplasms , Granular Cell Tumor , Laryngoscopy , Anesthesia , LaryngoscopyABSTRACT
Purpose: To describe a case of congenital epulis with multiple lesions, which was treated combining surgical resection of the largest tumor and monitoring of the smaller lesions. Case description: A white female newborn showed a large (2.4x1.8x1.1cm), pinkish-red, nodular formation on the left side of the maxillary alveolar ridge, which was preventing mouth closure and causing feeding difficulties. Other small polyps were present on the left side of the mandibular ridge. Excisional biopsy under general anesthesia allowed for the complete removal of the irregular, bilobed maxillary tumor. The diagnostic hypothesis of congenital epulis of the newborn was confirmed based on both the anatomic details and immunohistochemical profile of the lesion. The smaller mandibular tumors were not resected; complete spontaneous remission occurred within 6 months. After surgery, the patient showed substantial clinical improvement, with complete functional and esthetic rehabilitation. No recurrence was observed. Conclusion: Treatment allowed the reestablishment of vital functions and normal neonatal development. The surgical approach improved the infant's quality of life and restored the parents' confidence and emotional stability.
Objetivo: Descrever um caso de epúlide congênita com lesões múltiplas, onde foi realizada a exérese total do tumor maior e o monitoramento dos tumores menores. Descrição do caso: Um sujeito neonato do gênero feminino apresentava uma formação nodular grande (2,4x1,8x1,1cm), vermelha-rosada, no lado esquerdo do rebordo alveolar superior, a qual estava dificultando o fechamento bucal e causando dificuldades de alimentação. Outros pólipos menores estavam presentes no lado esquerdo do rebordo mandibular. A biópsia excisional sob anestesia geral permitiu a remoção complete do tumor superior, com aspecto irregular e bilobulado. A hipótese diagnóstica de épulis congênita do recém-nascido foi confirmada com base nos detalhes anatômicos e no perfil imunoistoquímico da lesão. Os tumores mandibulares menores não foram excisionados; a remissão espontânea completa ocorreu dentro de seis meses. Após a cirurgia, a paciente mostrou melhora clínica significativa com completa reabilitação funcional e estética. Não houve recorrência nas visitas subseqüentes. Conclusão: O tratamento permitiu o restabelecimento das funções vitais e do desenvolvimento normal do neonato. A abordagem cirúrgica melhorou a qualidade de vida da criança e devolveu confiança e estabilidade emocional aos pais.
Subject(s)
Humans , Female , Infant, Newborn , Gingival Neoplasms/surgeryABSTRACT
Metastatic tumors to the jaw bones are uncommon. The most common metastatic tumors to the jaw bones are the breast, lung and kidney. In the jaw bones, the common location of the lesions is the mandible, and the posterior area of the mandible is more commonly affected. The radiographic appearance is quite variable. In this report, a very rare case of metastatic gastric adenocarcinoma to the mandible is presented. The patient had undergone a gastrectomy 3 years ago.