ABSTRACT
It is not clear whether the presence of human papillomavirus (HPV) in squamous cell carcinomas of the tongue (SCCT) is of etiopathogenic and clinical significance. This study was designed to establish the incidence of HPV in SCCT and to determine the influence of HPV detection on clinical parameters and the prognosis. Clinical and histopathological data of 64 patients with SCCT were collected. Thirty benign lesions of the tongue were analyzed in parallel, in order to compare the HPV incidence and genotypes in these lesions with those of SCCT. Paraffin blocks of all cases were collected and PCR was carried out using SPF10 primers and the INNO-LiPA genotyping methodology. HPV was detected in 26.2% of the patients. Hybridization results showed that all patients except one had high-risk (HR)-HPV. HPV56 was the most common (42.1%), followed by HPV18 (26.3%), HPV16 (10.5%), HPV66 (10.5%), HPV39 (5.3%), and HPV51 (5.3%). The odds ratio of HR-HPV infection in cases vs. controls was statistically significant (9.45, 95% confidence interval 1.18-75.46). Among the results of the univariate analysis correlating the presence of HR-HPV with different clinical parameters, only mortality showed a statistically significant correlation, being higher in HR-HPV patients (odds ratio 3.97, 95% confidence interval 1.07-14.7).
Subject(s)
Carcinoma, Squamous Cell/virology , Carcinoma/virology , Papillomaviridae/isolation & purification , Papillomavirus Infections/diagnosis , Tongue Neoplasms/virology , Adolescent , Adult , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/therapy , Female , Genotype , Humans , Incidence , Male , Middle Aged , Papillomavirus Infections/epidemiology , Polymerase Chain Reaction , Prognosis , Registries , Retrospective Studies , Risk Factors , Survival Rate , Tongue Neoplasms/therapyABSTRACT
El tumor fibroso solitario (TFS) es una neoplasia de partes blandascompuesta por células fusiformes, que principalmente se origina en lassuperficies mesoteliales. Generalmente tiene una localización intratorácica yla afectación de la cavidad oral es excepcional. Clínicamente el TFS intraoralsuele presentarse como una masa móvil, submucosa, no dolorosa, bien circunscrita,de lento crecimiento. El diagnóstico se obtiene mediante al análisishistopatológico e inmunohistoquímico. Histológicamente se caracterizapor una disposición variable de células fusiformes ovoides, generalmentepositivas para el marcador CD34. El tratamiento de elección es la extirpaciónquirúrgica de la lesión, recomendándose un seguimiento postoperatorio alargo plazo por la posibilidad de aparición de recurrencias y metástasis tardías.Presentamos un caso de TFS intraoral, localizado en el fondo del vestíbulomandibular. Un año después de la resección quirúrgica de la lesión, no haysignos de recidiva local o regional. Asimismo, realizamos una revisión de laliteratura(AU)
Solitary fibrous tumors (SFT) are spindle cell neoplasmsthat most often originate from mesothelial lined surfaces.Intrathoracic tumors are more common and oral mucosalinvolvement is uncommon. Clinically, intraoral SFT is usually apainless, well delimited, slow-growing, mobile submucosal mass.Diagnosis is based on immunohistochemical and histopathologicanalysis. Histologically, SFT is characterized by a variable provisionof spindle cells, which generally are CD34-positive. Resection is thetreatment of choice and long-term follow-up is recommended becauserecurrences and late metastases.We present a case of intraoral SFT of the mandibular vestibularsulcus. One year after surgical resection, there were no signs of localor regional recurrence. The literature was reviewed(AU)
Subject(s)
Humans , Male , Adult , Mouth Neoplasms/pathology , Solitary Fibrous Tumors/pathology , Mandibular Neoplasms/pathology , Immunohistochemistry/methods , Antigens, CD34/analysisABSTRACT
Los bifosfonatos constituyen un grupo de fármacos inhibidoresde la resorción ósea, utilizados en el tratamiento de numerosas patologíascomo la osteoporosis, la enfermedad de Paget, el mieloma múltiple,la hipercalcemia maligna y las metástasis óseas asociadas al cáncer de mamao de próstata. El principal efecto farmacológico de los bifosfonatos es lainhibición de la resorción ósea, mediante una disminución de la actividadde los osteoclastos, sin intervenir en la formación y mineralización del hueso.Son fármacos utilizados a nivel mundial con unos claros beneficios contrastadosclínicamente. Numerosas publicaciones durante los últimos tresaños, y debido a su utilización masiva, consideran que la osteonecrosisde los maxilares está asociada al tratamiento con bifosfonatos.Es importante que los pacientes sean informados del riesgo de presentarseesta complicación, para tener la oportunidad de someterse a procedimientosdentales previos al inicio del tratamiento. Las medidas preventivasdeben realizarse antes, durante y después del tratamiento con bifosfonatos.El tratamiento quirúrgico debe reservarse para aquellos pacientesque presenten síntomas. Son necesarias nuevas investigaciones que clarifiquenesta complicación(AU)
Bisphosphonates constitute a group of inhibitors of boneresorption that are used for treating many disor-ders such asosteoporosis, Pagets disease, multiple myeloma, malignanthypercalcemia and bone metas-tases associated with breast andprostate cancer. The main pharmacological effect of bisphosphonatesis the inhibition of bone resorption, mediated by a decreased functionof osteoclasts without interfering in bone formation andmineralization.These drugs are used worldwide, with clear and clinically provenbenefits. Several publications within the last three years considerosteonecrosis of the jaw to be associated with bisphosphonatetherapy as a result of their extensive use.It is important for patients to be informed of the risk of thiscomplication, so that they have the oppor-tunity to assess the needfor dental treatment before starting therapy. Preventive measuresmust be taken before, during, and after treatment withbisphosphonates. Surgical treatment should be reserved for thosepatients who are symptomatic. Further investigation is needed tocompletely elucidate this complication(AU)
Subject(s)
Humans , Osteonecrosis/chemically induced , Diphosphonates/adverse effects , Jaw , Risk Factors , Disease Prevention , Bone Resorption/drug therapyABSTRACT
La aparición de un neumomediastino asociado a enfisema subcutáneo cervical es una rara complicación en los pacientes a los que se practican cirugías de la región cérvicofacial. Se presentan 3 casos, cada uno de ellos con una causa diferente; en dos se desencadenó neumomediastino tras enfisema subcutáneo cervical, por vía descendente, y el otro se debió a barotrauma pulmonar intraoperatorio. Debido a que se trata de una causa potencial de complicaciones se recomienda cobertura antibiótica profiláctica. (AU)
