Myiasis in maxillofacial region: series of three cases

Introduction: Myiasis is a disease caused by larvae of flies in organs and tissues of man or other vertebrate animals, where they install and evolve as parasites. The human myiasis is common in tropical countries, most frequently affecting rural people, immunocompromised patients and those with psychiatric disorders. It has great destructive potential and needs adequate prevention and treatment for resolution or non-occurrence of this manifestation. Objective: This paper aims to report a series of three cases of patients with presence of myiasis in face: 1) firearm injury postoperative complication in the mandible in a drug user patient; 2) wound after trauma in the region of the upper lip in a patient using illicit drugs; and 3) complication due to poor oral hygiene of a patient with neurological and motor deficits. Case report: The care required by these patients is different because this complication is easily prevented by basic and personal health care, although it represents a complicating factor for surgical procedures and/or dental care. Conclusion: The role of health professionals in patients with special needs and/or drug addiction become sometimes a challenge for dental practice, requiring individualized attention to each patient.

Linfoma De Burkitt / Burkitt's Lymphoma

Introdução: o linfoma pertence ao grupo dos linfomas não-Hodgkin, apresentando condições malignas heterogêneas que surgem de células muito diversificadas do sistema imunológico, tendo origem no linfócito B. Acomete principalmente crianças. Relato de Caso: paciente masculino, com cinco anos de indade, caucasiano, apresentou-se com aumento de volume em hemiface esquerda com trinta dias de evolução, indolor de crescimento rápido. Não foram notadas alterações dentárias. Observou-se abaulamento em hemiface esquerda. A tomografia computadorizada mostrou uma lesão destrutiva de aspecto sólido, acometendo a porção alveolar da mandíbula bilateralmente e as paredes de ambos os seios maxilares, invadindo os antros. A análise cromossômica mostrou o linfoma de Burkitt. O tratamento foi quimioterápico, observando-se redução da lesão após a vigésima sessão. O paciente permanece sem sinal de doença, decorridos cinco anos do início do tratamento. Discussão: esse tipo de linfoma é de crescimento rápido, etiologia incerta, mas com provável envolvimento do vírus Epstein-Barr e origem genética. A lesão tem uma predominância em crianças, com ocorrência maior em meninos. Apresenta duas subclasses, a forma endêmica ou africana e a forma não endêmica ou amaericana; alguns autores citam uma terceira subclasse que seria associada com imunodeficiência adquirida. No entanto, todos esses subtipos são idênticos histologicamente, diferenciando-se apenas nas características epidemiológicas e biológicas.

Introduction: burkitt's lymphoma belongs to the group of the Non-Hodgkin's lymphomas. It presents heterogenic malignant conditions that usually stem from highly diversified cells of the immune system, having their origin in B lymphocytes. Case report: a male Caucasian 5-year-old patient presented a painless growth on his left hemiface for 30 days. No dental disorders were found. The extraoral exam showed a lump in his left hemiface. The computed tomography showed a solid-looking destructive lesion in the alveolar region of the mandible (bilaterally), left mandibular ramus, maxilla (bilaterally), and the walls of both maxillary sinuses, reaching the antra. The Burktt's lymphoma diagnosis was confirmed through the chromosome analysis. The treatment consisted of 20 sessions of chemotherapy, with tumor reduction. The patient remains disease-free after 5 years from the begining of the treatment. Discussion: this kind of lymphoma is a fast-growing tumor whose etiology is uncertain, but which may have association with the Epstein-Barr virus, and/or with genetic conditions. It is a childhood tumor afflicting mainly the boys. It has 2 subclasses, the endemic (or African) form, and the non-endemic (or American) one. Some authors claim that there is a third subclass which would be associated to acquired immunodeficiency. Despite that, all subtypes present identical histology with different epidemiologic and biologic features.