Neurofibrosarcoma of the mandible derived from neurofibromatosis

Neurofibrosarcoma is a rare malignant neoplasm of the head and neck region and accounts for 8% to 16% of all cases. Its origin is varied and may stem from cells of the peripheral nerves, develop de novo, or result from malignant transformation of preexisting neurofibromas. Because the features of neurofibrosarcomas are heterogeneous, the data retrieved during clinical examinations are of great aid for diagnosis. In this case, owing to clinical features and the fact that the patient had neurofibromatosis type 1, the hypothesis of neurofibrosarcoma was promptly established. The final diagnosis was confirmed by associating clinical, imaging, and pathological data. After the treatment, the patient has been followed up for 10 years, with no evidence of recurrence.

Lesões orais da agranulocitose pelo uso de metimazol em pacientes com doença de Graves / Oral lesions of methimazole-induced agranulocytosis in a patient with graves desease

A agranulocitose é uma reação adversa rara atribuída ao uso de medicamentos, caracterizada pela redução acentuada de número de leucócitos. Apresenta manifestações sistêmicas gerais sendo que as lesões iniciais podem ocorrer em cavidade oral e orofaringe. Este artigo relata o caso de uma paciente que desenvolveu um quadro de agranulocitose com lesões bucais devido ao uso de Metimazol, droga geralmente prescrita no tratamento do hiperparatireoidismo, o objetivo deste relato é alertar o cirurgião-dentista para a identificação precoce das lesões da agranulocitose, bem como reforçar a importância da anamnese na rotina diária.

The agranulocytosis is a rare adverse reation attributed to the use of some therapeutic drugs, characterized by a decrease of leukocytes counts. It presents systemic manifestations and the first lesions may accur on the oral and oropharynx region. This case report of patient who developed an agranulocytosis with oral lesions induced by the use of Methimazole, a drug usually prescribed to hypertiroidism treatement. The objective of thus report is to alert the dentist to make a prompt identification of the agranulocytosis lesions and to emphasize the importance of anamnesis on the daily routine.