RESUMO
O carcinoma de células escamosas papilar é um tumor que acomete o trato aerodigestivo superior e raramente afeta a cavidade oral. O objetivo do presente estudo foi relatar um caso de carcinoma de células escamosas papilar em cavidade oral e revisar a literatura a respeito. Paciente, sexo masculino, 73 anos, apresentando duas lesões intraorais com 3 meses de evolução. Havia uma lesão exofítica, úlcero-vegetativa, medindo 1,5 cm em rebordo alveolar (assoalho bucal) do lado esquerdo e uma lesão ulcerada na região retromolar esquerda medindo 1 cm. Além disso, havia um linfonodo endurecido e sintomático no nível 1B do lado esquerdo, medindo 4 cm x 3 cm. As duas lesões intraorais foram biopsiadas e a que acometia o rebordo alveolar (assoalho bucal) foi diagnosticada como carcinoma de células escamosas papilar composto por células atípicas, basaloides e em disposição papilar. No momento do estadiamento, o tumor apresentava 4 cm x 6 cm, sendo estadiado como T3N2aM0 (IV-A) e o tratamento empregado foi quimioterapia associada à radioterapia. Após 2 anos de acompanhamento, o paciente encontra-se vivo, sem evidência de doença, metástase em linfonodos ou a distância. Conclui- se, portanto, que carcinoma de células escamosas papilar é um tumor raro na cavidade oral, com poucos casos relatados. O presente relato destaca a importância do exame histopatológico para o diagnóstico preciso e seu papel na determinação de tratamentos e prognósticos adequados.
Papillary squamous cell carcinoma is a tumor that affects the upper aerodigestive tract, but rarely the oral cavity. The aim of this study is to report a case of oral papillary squamous cell carcinoma and to review the available literature. We present a case of a 73-year-old man patient with two intraoral lesions with three-month evolution. An ulcerated exophytic lesion measuring 1.5 cm was detected in the left alveolar ridge region/mouth floor and an ulcerated lesion in the left retromolar region measuring 1 cm. Moreover, we identified a symptomatic hardened lymph node on the level 1B of the left side, measuring 4×3 cm. Both intraoral lesions were biopsied and the one in the alveolar ridge/mouth floor was diagnosed as papillary squamous cell carcinoma composed of atypical cells, basaloids and in papillary disposition. At the time of staging, the tumor had 4×6 cm being staged as T3N2aM0 (IV-A) and the employed treatment was chemotherapy associated with radiotherapy. After two years of follow-up, the patient is alive and without evidence of the disease, lymph node or distant metastases. Therefore, the papillary squamous cell carcinoma is a rare tumor in the oral cavity with few reported cases. This case report emphasizes the importance of histopathological examination for the accurate diagnosis and its role in determining appropriate treatments and prognosis.
RESUMO
Introducción: El liquen plano pigmentoso es una lesión autoinmune de etiología desconocida, aunque tiene mayor incidencia en mujeres de mediana edad, a las que afecta principalmente la cara y el cuello y, en menor medida, la cavidad oral. Objetivo: Describir las características clínicas e histopatológicas de un caso de liquen plano pigmentoso en la cavidad oral. Presentación del caso: Mujer de 21 años, negra, que acudió al servicio quejándose de una mancha en la cavidad oral. Las lesiones presentaban un mes de evolución, crecimiento radial y sin síntomas dolorosos. Consistían en placas ennegrecidas de contorno regular con estrías blanquecinas en su periferia, forma redondeada, bordes afilados, en mucosa yugal bilateral, que medían aproximadamente 25 mm en el derecho y 13 mm en el lado izquierdo. Después de la biopsia incisional y el análisis histopatológico, se confirmó la sospecha de liquen plano pigmentoso oral. El tratamiento propuesto para las lesiones fue conservador mediante un estricto seguimiento clínico. Conclusiones: El diagnóstico del liquen plano pigmentoso, debido a su baja ocurrencia en la cavidad oral y sus características clínicas atípicas y semejantes a otras lesiones orales, es complejo. En este contexto, se ratifica la relevancia del examen histopatológico y se destaca la necesidad de otros estudios para aclarar los factores etiológicos involucrados en esta lesión(AU)
Introduction: Pigment lichen planus is an autoimmune lesion of unknown etiology, with preference for middle-aged women, which mainly affects the face and neck, being rare in the oral cavity. Objective: To report a case of pigment lichen planus in the oral cavity, with emphasis on its clinical and histopathological characteristics. Case report: 21 years old woman, black, who came to the service complaining about a spot in the oral cavity. The lesions presented a month of evolution, radial growth and no painful symptoms. They consisted of blackened plates of regular contour with whitish stretch marks on their periphery, rounded shape, sharp edges, on bilateral jugular mucosa, which measured approximately 13 mm on the left side and 25 mm on the right. After the incisional biopsy and histopathological analysis, the suspicion of oral pigment lichen planus was confirmed. The proposed treatment for the lesions was conservative through strict clinical follow-up. Conclusion: The importance and difficulty of the diagnosis of pigment lichen planus is emphasized, especially due to its low occurrence in the oral cavity and its atypical clinical characteristics and similar to other oral lesions. In this context, the relevance of the histopathological examination is ratified and the need for further studies to clarify the etiological factors involved in this pathology is highlighted(AU)