Odontogenic tumours in children and adolescents: a collaborative study of 431 cases.

This study describes the oral and maxillofacial pathological characteristics of a series of odontogenic tumours in children and adolescents from three Brazilian reference centres. The records were reviewed for all odontogenic tumours in patients up to 18 years old based on criteria proposed by the World Health Organization (WHO) in 2005. Data concerning sex, age, skin colour and tumour location were collected and plotted. Four hundred and thirty one odontogenic tumours in children and adolescents were found, accounting for 37.5% of the total number of odontogenic tumours diagnosed. Benign tumours were predominant (99.8% of the cases), and odontoma was the most frequent type (41.4%), followed by keratocystic odontogenic tumours (25.5%) and ameloblastoma (14.6%). Odontogenic tumours were rarely detected in early childhood, and their prevalence increased with age. An almost equal distribution was observed with respect to sex and the site of the lesions. This study is the largest reported retrospective analysis describing odontogenic tumours in children and adolescents to date. The authors detected some variation in the relative frequency of odontogenic tumours compared with similar reports. Additional studies should be conducted based on the new WHO classification and predetermined age parameters to enable comparative analysis among different worldwide populations.

A rare case of sclerosing mucoepidermoid carcinoma arising in minor salivary glands with immunohistochemical evaluation.

Mucoepidermoid carcinomas (MECs) are the most common malignancy of the salivary glands demonstrating a wide range of histologic variants and behavior. However, the sclerosing mucoepidermoid carcinoma (SMEC), a morphologic variant of this tumor is extremely rare and has been described almost exclusively in the major glands. The prominent sclerosis observed may obscure its typical morphological feature resulting in a diagnostic challenge. We describe herein a case of SMEC in a 43-year-old-woman, occurring in the minor salivary glands of palate. To our knowledge only 13 cases have been reported until this moment, being only 2 in minor salivary glands. We also performed the immunohistochemical evaluation of c-erbB-2 and Ki-67, searching for an association with the histopathological findings and behavior.

Inflammatory myofibroblastic tumor of the alveolar mucosa of the mandible.

Inflammatory myofibroblastic tumor is a rare lesion composed of myofibroblastic spindle cells accompanied by inflammatory infiltrate. The objective of this paper is to report an uncommon case of inflammatory myofibroblastic tumor located in the alveolar mucosa of the mandible. A 33-year-old male presented an asymptomatic tumoral lesion, firm, pedunculated, pink-colored, covered by smooth mucosa, with focal ulceration, measuring 30x20x20 mm, located in the left posterior alveolar mucosa. Clinical diagnosis was soft tissue tumor. An excisional biopsy was made. Microscopic examination showed compact fascicular spindle cells proliferation with a diffuse inflammatory infiltrate of plasma cells, lymphocytes, and eosinophils. Large ganglion-like cells were observed. The lesional cells were immunopos-itive to vimentin, a-smooth muscle actin, muscle specific actin, and CD68. Negative immunostain was observed to S-100, Bcl-2, Ki-67, desmin, CD34, and cytokeratin. A diagnosis of inflammatory myofibroblastic tumor was performed. After 28 months of follow-up there was no recurrence. Although no evidence of oral inflammatory myofibroblastic tumor recurrence or malignant transformation has been reported, it has been observed that in inflammatory myofibroblastic tumor of other regions a prolonged follow-up is necessary after surgical excision.

Retrospective analysis of peripheral odontogenic fibroma (WHO-type) in Brazilians.

AIM: The purpose of this study is to present data on a series of peripheral odontogenic fibroma, WHO (World Health Organization)-type (POF), in Brazilians and to compare the results with previously reported studies. METHODS: The study sample was made from the number of POF cases and its synonymies diagnosed from 1950 to 2004 at the Oral Pathology Service of the Federal University of Minas Gerais. The cases were reviewed in hematoxylin-eosin stain and the histological features were evaluated in accordance with the classification WHO. Patient's data about gender, age and race and the lesion's clinical data were obtained from the biopsy request forms, after the definite diagnosis of POF. RESULTS: Seventeen diagnoses of POF were found. Data showed that POF has a higher prevalence in females (88.2%), occurring in the second and fourth decades of life (29.4% each), and in Caucasians (64.7%). The most common location was the posterior region of the mandible (41.1%). It was an asymptomatic lesion (23.5%) with an average size of 1.1 to 2.0 cm (35.2%). The histological findings were: 1) fibroblastic tissue high cellularity (58.8%); 2) scarce odontogenic epithelium (64.7%); 3) inflammation (94.1%) and 4) absence of calcification (58.8%). CONCLUSIONS: Clinical and histological data of POF in Brazilians showed important characteristcs for its diagnosis. This epidemiological data will generate a substantial contribution to the clinical, histological diagnosis and behavior of this lesion.

GLUT-1 in oral benign vascular lesions.

AIM: To investigate the accuracy of histological diagnosis of oral hemangioma, oral vascular malformation and oral pyogenic granuloma according to immunohistochemical evaluation of the human erythrocyte-type glucose transporter protein (GLUT-1), and to observe the immunoexpression of this protein in oral varix. MATERIALS AND METHODS: Immunohistochemistry for GLUT-1 was performed in 93 histologically diagnosed cases of oral benign vascular lesions: 17 vascular malformations, 19 hemangiomas, nine varix, and 48 pyogenic granulomas. Descriptive analyses were performed. RESULTS: None of the cases of the oral benign vascular lesions evaluated were immunopositive to GLUT-1. The 19 cases histologically diagnosed as oral hemangioma that showed negative staining to GLUT-1 were reclassified as oral pyogenic granuloma or oral vascular malformations. The histological evaluation itself is not enough to obtain the correct diagnosis of oral HEM as none of the sample cases were true hemangioma. All sample cases with initial vascular malformation or pyogenic granulomas classification were negative to GLUT-1, demonstrating the accuracy of histological diagnosis of these lesions itself. Oral varix showed negative staining to GLUT-1 in blood vessels. CONCLUSIONS: GLUT-1 is an useful, effective and important auxiliary marker for the diagnosis of oral benign vascular lesions. CLINICAL RELEVANCE: This study showed that histological diagnosis alone is not sufficient to correct diagnoses of oral hemangioma. Moreover, immunohistochemistry to GLUT-1 is a useful and easy diagnostic method that may be used to avoid such misdiagnosis. Accurate diagnosis of these oral lesions has an important clinical relevance allowing: (1) correct management, (2) adequate communication among the multidisciplinary team (dentist, dermatologist, pediatrist, radiologist, pathologist, and surgeon), (3) understanding of the biological behavior of the lesions, and (4) facilitate the development of new therapeutic modalities. Thus, supporting the use of this marker in medical and dentistry communities is warranted.

Oral candidiasis treatment with Brazilian ethanol propolis extract.

The Brazilian commercial ethanol propolis extract, also formulated to ensure physical and chemical stability, was found to inhibit oral candidiasis in 12 denture-bearing patients with prosthesis stomatitis candidiasis association.

Apoptosis in epithelial cells of apical radicular cysts.

AIM: To investigate the occurrence of apoptotic cell death in the epithelium of radicular cysts and to compare its frequency in lesions presenting a distinct functional state. METHODOLOGY: Twenty radicular cysts were selected and arranged into two groups with 10 lesions in each group: atrophic (quiescent) and hyperplastic (active) epithelium. Morphologic investigations of apoptosis were conducted by means of optic microscopy in haematoxylin and eosin slides. Immunohistochemical techniques to detect the bcl-2 protein were carried out by streptavidin-biotin-peroxidase assay. In both instances, 30 sequential high-power microscopic fields were observed to determine apoptotic (AI) and bcl-2 immunostaining (bcl-2I) indexes. The presence of AI and bcl-2I within the two groups was compared using the t-test. Correlation between the AI and the bcl-2I was investigated using the Spearman test. RESULTS: Apoptosis was detected in the epithelium of all cysts. Higher AI levels were found in lesions with an atrophic (0.17 +/- 0.19) rather than a hyperplastic (0.10 +/- 0.10) epithelium. The same was found for the bcl-2I levels (0.06 +/- 0.03 vs. 0.04 +/- 0.01, respectively). However, these differences were not statistically significant. A positive and significant correlation was found between AI and bcl-2I. CONCLUSIONS: Apoptosis was always present in the epithelium of the lesions and was more frequent in lesions with atrophic (quiescent) epithelium.

Nasolabial cyst with radiographic contrast medium: report of two cases.

Two cases are presented of a nasolabial cyst (NC) on which a radiographic contrast medium was used in order to define the real extension of the lesion. Use of contrast is important for visualizing the definite extensions of NC primarily in cases when plain radiographs may not show any detectable changes and CT can not be used.

Prevalence of oral mucosal alterations in children from 0 to 12 years old.

BACKGROUND: As the exact prevalence of oral alterations in children is still not known and the findings are controversial, other studies about this subject are necessary. METHODS: A cross-sectional survey was carried out on 1211 Brazilian children divided in two age groups: 0-4 and 5-12 years. The patients were economically classified and data of medical history were obtained from medical records. RESULTS: The frequency of children presenting alterations was 27.0%, and it was higher in older children. The most common lesions were geographic tongue, cheek biting, and melanotic macule. Candidiasis was associated with antibiotic therapy and use of pacifiers. Fissured tongue was associated with congenital anomalies, allergy; age from 5 to 12 years. There was a lack of association of patient's economic status and prevalence of oral mucosal alterations. CONCLUSIONS: The frequency of mucosal alterations in children is high and increases with age, and some of them are associated with habits and medical history of the patients.