ABSTRACT
ABSTRACT Oral amyloidosis is a disease characterized by extracellular and irreversible deposition of amorphous and fibrillar proteins in the oral cavity, being strongly associated with Multiple Myeloma. The objective of this study is to report a case of a 62-year-old woman diagnosed with Multiple Myeloma who, approximately 2 years after starting treatment for the underlying disease, presented a lesion on the lateral border of the tongue with exophytic growth, pinkish color, vascularized, painless, measuring 3cm in its largest diameter. After histopathological analysis through incisional biopsy, a final diagnosis of amyloidosis was obtained. As a local treatment, we opted for complete excision of the lesion. The patient evolved to death due to Multiple Myeloma influenced by the diagnosis of systemic amyloidosis. Oral amyloidosis is usually associated with the systemic presentation of the disease, making it necessary to conduct a thorough investigation of other organs. Its diagnosis is important since the prognosis is directly related and can negatively influence survival rates and treatment of the underlying disease.
RESUMO A amiloidose oral é uma doença caracterizada pela deposição extracelular e irreversível de proteínas amorfas e fibrilares na cavidade bucal, sendo fortemente associada com Mieloma Múltiplo. O objetivo deste trabalho é relatar o caso de uma mulher com 62 anos de idade diagnosticada com Mieloma Múltiplo que, aproximadamente 2 anos após o início do tratamento para a doença de base, apresentou lesão em borda lateral de língua com crescimento exofítico, de coloração rósea, vascularizada, indolor, medindo 3 cm em seu maior diâmetro. Após análise histopatológica através de biópsia incisional, obteve-se diagnóstico final de amiloidose. Como tratamento local, optou-se pela exérese completa da lesão. A paciente evoluiu para óbito por consequência do Mieloma Múltiplo com complicações associadas à amiloidose sistêmica. A amiloidose oral geralmente está associada com a apresentação sistêmica da doença, tornando necessária uma investigação aprofundada nos demais órgãos. Seu diagnóstico é importante uma vez que pode influenciar diretamente no prognóstico e, consequentemente, negativamente nas taxas de sobrevida e no tratamento da doença de base.
ABSTRACT
Osteolipoma is a rarely reported histologic variant of lipoma that exhibits bone formation. To the best of our knowledge, only 13 well-documented case reports of osteolipoma in the oral cavity have been published in the English literature. This study presents the clinical, radiographic, and histologic features of an osteolipoma in the oral cavity and reviews the pertinent literature. The patient was a 29-year-old female, who presented with an 8-month history of a painless, progressively enlarging, well-defined, movable submucosal mass in the left posterior buccal mucosa. The lesion had a hard consistency. Imaging findings revealed a spherical radiopacity with an irregular trabecular pattern. The lesion was excised and the diagnosis of osteolipoma was established. No recurrence was observed after a 5-year follow-up.
Subject(s)
Lipoma/pathology , Mouth Mucosa/pathology , Mouth Neoplasms/pathology , Ossification, Heterotopic/pathology , Rare Diseases/pathology , Adult , Diagnosis, Differential , Female , Humans , Lipoma/surgery , Mouth Mucosa/surgery , Mouth Neoplasms/surgery , Ossification, Heterotopic/surgery , Rare Diseases/surgeryABSTRACT
BACKGROUND: Spindle cell lipoma (SCL) is an uncommon and histologically distinct variant of lipoma. It usually occurs as a solitary, subcutaneous, and well-circumscribed lesion in the posterior neck, shoulders, and back of older men. SCL of the oral cavity is rare. We present the clinical-pathologic features of the third case of SCL located on the hard palate and discuss the histological differential diagnosis with other fusiform neoplasms. CASE REPORT: A 56-year-old man was evaluated for an asymptomatic swelling on the right side of the hard palate. The intraoral examination showed a 25×20 mm sessile and circumscribed tumor, underlying an apparently healthy mucosa of normal color. The lesion revealed a floating consistency during palpation. Excisional biopsy was carried out based on a clinical diagnosis of lipoma or a benign minor salivary gland tumor. The histopathology demonstrated a well-circumscribed but unencapsulated proliferation of bland spindle cells admixed with mature adipocytes in a collagenous/myxoid stroma. The spindle cells were uniform, exhibiting elongated nuclei and narrow cytoplasmic processes without atypia. They were positive to CD34 and negative to factor VIII, alpha-smooth muscle actin, S100, cytokeratin, and actin. Mitotic activity was low, as confirmed by Ki-67 immunostaining. No lipoblastic activity was found. The diagnosis of SCL was therefore established. CONCLUSIONS: Oral spindle cell lipoma is a rare benign lipomatous tumor. The histologic picture shows a range of variations and the observation of morphological features is important to distinguish this lesion from other fusiform tumors. Immunohistochemistry should be helpful in this differentiation.
Subject(s)
Lipoma/diagnosis , Mouth Mucosa/pathology , Mouth Neoplasms/diagnosis , Biopsy , Diagnosis, Differential , Humans , Male , Middle AgedABSTRACT
BACKGROUND: Osteolipoma located in the oral cavity and pharyngeal region is rare. CASE REPORT: The current case presents the clinical-ultrasonographic-radiographic-histopathological features of the diagnosis and management of osteolipoma of the mandibular buccal mucosa. DISCUSSION: A literature review of the osteolipoma of the oral cavity and pharyngeal region is also presented. In this localization study, 14 well-documented cases could be found in English-language literature, in which the mean age of patients was 50.6 years, and slight predilection for male gender could be identified. The majority of cases appeared in the oral cavity (67 %). The data demonstrated that osteolipoma of the oral cavity and pharyngeal region is an asymptomatic (80 %) lesion without bone attachment (80 %). The size of the lesions ranged from 8 to 90 mm in diameter (mean = 36 mm), with an evolution time ranging from 1 to 35 years (mean = 7.7 years). Similar to the present case, no recurrence could be identified in works which reported on the follow-up period.
ABSTRACT
Aim. To evaluate the efficacy of Brazilian green propolis in comparison to miconazole gel in the treatment of Candida-associated denture stomatitis. Methods. Forty-five denture stomatitis patients, with palatal mucosa erythema levels classified according to Newtons's criteria and with positive culture to Candida spp., were randomly divided into three treatment groups: 15 received miconazole gel 2%, 15 received propolis gel 2,5%, and 15 received propolis 24% for mouthwash. After four daily use lasting two weeks, they were reexamined for the denture stomatitis degree and for a second culture of Candida. The Wilcoxon's test was applied to compare the results of clinical classification of the denture stomatitis and the Candida spp. colonies numbers, before and after each treatment. The Kruskall-Wallis's test was used to compare efficacy among the three treatment groups. Results. There were a significant reduction or complete remission of denture stomatitis (P < 0.05) and a significant decrease of Candida colonies for the three groups (P < 0.05). There was no difference in the efficacy among the treatment groups (P > 0.05). Conclusion. Brazilian green propolis has a similar effect as miconazole in the treatment of Candida-associated denture stomatitis being an alternative in the therapeutics of this condition.
ABSTRACT
Despite high cure rates, approximately 20% of patients with acute lymphoblastic leukemia (ALL) have disease relapse. Isolated recurrence in oral cavity is extremely unusual. The aim of this paper is to report a case of an isolated relapse occurred in a child with T-lineage ALL. Clinical picture included swelling and pain in the right upper gingiva of the oral cavity, with no other clinical or hematological alterations. Diagnosis was confirmed by biopsy and immunohistochemical staining. Bone marrow aspiration was normal. Five months later leukemic infiltration of the bone marrow was detected and systemic chemotherapy was reintroduced. This case report highlights the relevance of dental care during and after chemotherapy, not only to treat lesions in the oral cavity resulting from the disease itself or from treatment side effects, but also to detect unusual sites of ALL relapse.
Subject(s)
Gingival Neoplasms/diagnosis , Neoplasm Recurrence, Local/diagnosis , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Antineoplastic Agents/therapeutic use , Biopsy , Bone Marrow Examination , Child, Preschool , Dental Care for Chronically Ill , Diagnosis, Differential , Follow-Up Studies , Gingival Neoplasms/pathology , Humans , Immunohistochemistry , Leukemia, T-Cell/diagnosis , Leukemia, T-Cell/pathology , Leukemic Infiltration , Male , Neoplasm Recurrence, Local/pathology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology , Remission InductionABSTRACT
Despite high cure rates, approximately 20% of patients with acute lymphoblastic leukemia (ALL) have disease relapse. Isolated recurrence in oral cavity is extremely unusual. The aim of this paper is to report a case of an isolated relapse occurred in a child with T-lineage ALL. Clinical picture included swelling and pain in the right upper gingiva of the oral cavity, with no other clinical or hematological alterations. Diagnosis was confirmed by biopsy and immunohistochemical staining. Bone marrow aspiration was normal. Five months later leukemic infiltration of the bone marrow was detected and systemic chemotherapy was reintroduced. This case report highlights the relevance of dental care during and after chemotherapy, not only to treat lesions in the oral cavity resulting from the disease itself or from treatment side effects, but also to detect unusual sites of ALL relapse.
Apesar dos altos índices de cura, cerca de 20% dos pacientes com leucemia linfóide aguda (LLA) apresentam recidiva da doença. Recidiva isolada na cavidade oral é extremamente incomum. O objetivo deste trabalho é relatar um caso de recidiva isolada em criança com LLA de linhagem T. A apresentação clínica foi quadro de edema e dor na cavidade oral, na região superior da gengiva à direita, sem outras alterações clínicas ou hematológicas. O diagnóstico foi confirmado por meio de biópsia e imuno-histoquímica. O mielograma era normal. Cinco meses após a manifestação inicial na cavidade oral, foi detectada infiltração leucêmica na medula óssea. O tratamento com quimioterapia sistêmica foi reintroduzido. Este relato de caso ressalta a importância do acompanhamento clínico e odontológico durante e após o tratamento quimioterápico, não somente com o objetivo de tratar as alterações na cavidade oral decorrentes da própria doença ou dos efeitos adversos do tratamento, mas para que sejam detectadas apresentações incomuns de recidiva na LLA.
Subject(s)
Child, Preschool , Humans , Male , Gingival Neoplasms/diagnosis , Neoplasm Recurrence, Local/diagnosis , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Antineoplastic Agents/therapeutic use , Biopsy , Bone Marrow Examination , Dental Care for Chronically Ill , Diagnosis, Differential , Follow-Up Studies , Gingival Neoplasms/pathology , Immunohistochemistry , Leukemic Infiltration , Leukemia, T-Cell/diagnosis , Leukemia, T-Cell/pathology , Neoplasm Recurrence, Local/pathology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology , Remission InductionABSTRACT
The aim of this study was to report a case of periapical cemental dysplasia affecting the mandibular incisors in 38-year-old twin sisters. The major concern is failure to recognize the nature of the lesion, which may result in unnecessary root canal treatment or extractions on the assumption that the lesion represents inflammatory periapical pathosis.
Subject(s)
Cementoma/genetics , Diseases in Twins , Incisor/pathology , Mandibular Neoplasms/genetics , Adult , Diagnosis, Differential , Female , Humans , Radiography, BitewingABSTRACT
Este estudo procurou avaliar a realidade institucional do câncer bucal em um hospital de atendimento geral. Foram analisados os registros hospitalares de câncer (RHC) do Hospital Ibiapaba, Barbacena (MG) entre 1992 e 2001 para estabelecer a prevalência de câncer bucal e obter dados sobre variáveis relacionadas ao portador e à doença. O câncer bucal representou 3 por cento de todos os tipos de neoplasias malignas registradas no período; 83,3 por cento dos portadores eram do sexo masculino; 87,5 por cento tinham 40 ou mais anos de idade e 79,2 por cento chegaram ao hospital com diagnóstico e sem terem recebido nenhuma forma de tratamento. A principal localização foi na língua (37,5 por cento). O diagnóstico histológico foi de carcinoma de células escamosas em 91,7 por cento dos casos. Para 66,7 por cento dos portadores o diagnóstico foi tardio. Hábitos de tabagismo e/ou etilismo foram relatados por 33,3 por cento dos doentes. Todas as biópsias para diagnóstico foram feitas por médicos (100 por cento dos casos). Os resultados encontrados dão suporte ao programa de saúde bucal do município, sugerindo medidas para a prevenção e diagnóstico precoce do câncer bucal.
Subject(s)
Mouth Neoplasms/classification , Mouth Neoplasms/etiologyABSTRACT
Os autores propöe apresentar um levantamento das biópsias encaminhadas ao Laboratório de Patologia Bucal da Faculdade de Odontologia da Universidade Federal de Minas Gerais entre os períodos de 1981 a 1990. A partir da análise das fichas de biópsias e do diagnóstico histopatológico, cada amostra examinada foi classificada em 11 diferentes grupos de acordo com a sua natureza, origem tecidual ou localizaçäo anatômica. Os resultados demonstraram grande predomínio do grupo das lesöes proliferativas näo neoplásicas. A hiperplasia fibrosa inflamatória representou a entidade mais comum verificada no levantamento. Importantes consideraçöes em torno da prática da estomatologia säo feitas em relaçäo aos resultados obtidos no estudo
