In situ carcinoma developed over oral lichen planus: a case report with analysis of BUB3, p16, p53, Ki67 and SOX4 expression

AbstractOral lichen planus (OLP) represents a common mucocutaneous disease. Various authors have suggested that OLP has malignant potential; however, the mechanisms involved in malignant transformation have not yet been elucidated. A 79-year-old man presented a white lesion for five months in the buccal mucosa diagnosed as OLP. After two months using 0.05% clobetasol ointment for treatment, the lesion became ulcerated. A new biopsy of the same lesion was performed, and histological analysis showed an in situ oral carcinoma (ISOC). An immunohistochemistry panel was performed, and p16 expression was negative in OLP, however, it showed weak cytoplasmic staining in ISOC. There was strong nuclear BUB3 staining in both OLP and ISOC areas. p53 showed less intense nuclear staining in both regions. Ki67 was negative in OLP area, but showed nuclear staining in the ISOC. SOX4 was negative in both studied areas. BUB3 expression, first reported in this case, and the p16 expression may suggest some influence of these genes on pathogenesis or malignant potential of OLP.

Relato de caso raro de extenso xantoma verruciforme no palato / A rare case of giant verruciform xanthoma in the palate

Verruciform xanthoma represents a rare disease of unknown etiology that typically affects the oral mucosa. In most cases, it is asymptomatic and characterized by a well demarcated elevation with irregular or papillary surface. The gums are the most affected oral site, and the lesion is usually less than 2 cm in diameter. The aim of this study is to report a rare case of an extensive verruciform xanthoma in the hard palate and gums of a 55-year-old male. Clinically, the well delimitated, reddish, elastic lesion measuring approximately 2.8 X 1.5 cm had a slightly granular surface. Histopathological analysis found proliferative epithelial activity with evident papillomatosis, parakeratosis, and large epithelial ridges. Xanthomatous cells with clear, vacuolated cytoplasm were detected in the lamina propria. The patient has been disease free for 18 months. According to an extensive research in the PubMed, MEDLINE, and Lilacs databases, this paper describes one of the most extensive cases of verruciform xanthoma reported in the literature.

O xantoma verruciforme ? uma les?o rara de etiologia n?o determinada, que acomete, principalmente, a mucosa oral. Na maioria das vezes ? assintom?tica, caracterizando-se por uma eleva??o bem-delimitada, de superf?cie rugosa ou papilar, e sua principal localiza??o na boca ? agengiva. Com rela??o ao tamanho, a maioria das les?es n?o ultrapassa 2 cm no seu maior di?metro. O objetivo do presente trabalho ? relatar um caso raro de extenso xantoma verruciforme em paciente do g?nero masculino, de 55 anos, apresentando les?o localizada no palato duroe na gengiva palatina. Clinicamente, a les?o possu?a bordas bem-destacadas, de superf?cie levemente granular e colora??o avermelhada, com consist?ncia el?stica, medindo aproximadamente 2,8 X 1,5cm. O exame histopatol?gico demonstrou a presen?a de prolifera??o do epit?liode revestimento, exibindo papilomatose, paraceratose e alongamento das cristas epiteliais. Na l?mina pr?pria, c?lulas xantomatosas com citoplasma claro e vacuolado puderam ser observadas. O paciente encontra-se livre de recidivas ap?s 18 meses de acompanhamento cl?nico. De acordo com extensa pesquisa em bases de dados (pubmed, medline, lilacs), o presente caso representa uma das maiores les?es do tipo xantoma verruciforme j? relatadas na literatura.

Ameloblastomas: avaliaçäo do tratamento executado nos pacientes do Hospital Universitário Pedro Ernesto - UERJ, entre 1990 e 1997 / Ameloblastomas appreciation of the pacientes treated st Pedro Ernesto University Hospital - UERJ, from 1990 to 1997

O ameloblastomas é o segundo tumor odontogênico mais comumente encontrado. O presente artigo traz, além de uma revisäo da literatura, a avaliaçäo do tratamento executado em 12 pacientes do Serviço de Cirurgia Buco-Maxilo-Facial do Hupe/UERJ, no período entre 1190 e 1997. Foram diagnosticados 10 ameloblastomas do tipo multicístico e 2 do tipo unicístico. Os ameloblastomas multicísticos foram tratados por curetagem (2 casos), ressecçäo marginal (6 casos) e ressecçäo segmentar (2 casos), enquanto que os do tipo unicístico foram tratados por curetagem. Somente 2 casos de ameloblastoma multicístico onde optou-se pela curetagem apresentaram recidivas. Conclui-se que a curetagem, embora eficaz no tratamento dos ameloblastomas unicísticos, näo é eficiente para o ameloblastoma multicístico; as ressecçöes marginal e segmentar säo eficazes no tratamento do ameloblastoma multicístico, mas deve-se considerar o risco de fratura da mandíbula e as dificuldades de reconstruçäo após a remoçäo do tumor