Adenocarcinoma papilar de bajo grado de malignidad de glándulas salivares menores: a propósito de un caso clínico / Low-grade papillary adenocarcinoma of the minor salivary glands: a case report

El adenocarcinoma papilar de bajo grado de malignidad de glándulas salivales menores es un tumor poco frecuente que tiene predilección por la mucosa palatina, de todos los adenocarcinomas es el que tiene un comportamiento clínico más agresivo. Es de crecimiento lento y con tendencia a infiltrar estructuras vecinas, dando en un 25 por ciento de los casos metástasis. El propósito de este artículo es presentar un caso de un adenocarcinoma en mucosa yugal derecha, su forma de presentación y la evolución clínica del mismo (AU)

[Prevalence of oral lichen planus and oral leukoplakia in 112 patients with oral squamous cell carcinoma]. / Prevalencia de liquen plano oral y leucoplasia oral en 112 pacientes con carcinoma oral de células escamosas.

OBJECTIVE: To study the association existing between precancerous conditions, like oral lichen planus and oral leukoplakia into 112 patients with oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: We applied a protocol to 112 patients with OSCC in the "Servicio de Estomatología del Hospital General Universitario de Valencia". We made two groups: 1. patients with precancerous lesions and oral carcinoma, 2. patients with OSCC and no precancerous lesions. RESULTS: The average age was 61.4 years, 85 of them being men and 27 women. The tongue and floor of the mouth were the most common locations. 33.6% of the tumours presented stage TNM I, most of them being histologically well differentiated and the 55.8% were ulcerated. We found differences between two groups of the patients regarding alcohol and tobacco habits, location, size and clinical stage and histological differentiation of the malignant lesions.

Prevalencia de liquen plano oral y leucoplasia oral en 112 pacientes con carcinoma oral de células escamosas / Prevalence of oral lichen planus and oral leukoplakia in 112 patients with oral squamous cell carcinoma

Objetivo: Estudiar la asociación de las lesiones premalignas; liquen plano y leucoplasia en 112 pacientes con carcinoma oral de células escamosas (COCE). Material y método: Se aplicó un protocolo a 112 pacientes diagnosticados de COCE en el Servicio de Estomatología del Hospital General Universiario de Valencia. Se distinguieron dos grupos: 1º pacientes con lesiones precancerosas y cáncer oral, y 2º pacientes con COCE sin lesiones precancerosas. Resultados: La edad media, fue de 61,4 años, 85 eran hombres y 27 mujeres. La lengua y el suelo de boca eran las localizaciones más habituales. El 33,6 por ciento de los tumores se encontraban dentro del TNM estadio I siendo la mayoría de ellos histológicamente bien diferenciados y el 55,8 por ciento tenían forma ulcerada. Existían diferencias significativas entre ambos grupos de pacientes con respecto al consumo de alcohol y tabaco, la localización, el tamaño, el estadio clínico y la diferenciación histológica de las lesiones tumorales. Conclusiones: De los 112 pacientes estudiados 27 (24,10 por ciento) tenían lesiones precancerosas asociadas al cáncer oral. Estos últimos presentaban cierta predilección por el sexo femenino, tenían menor hábito tabáquico y alcohólico y la clínica e histología del tumor era menos agresiva (AU)

OBJECTIVE: To study the association existing between precancerous conditions, like oral lichen planus and oral leukoplakia into 112 patients with oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: We applied a protocol to 112 patients with OSCC in the "Servicio de Estomatología del Hospital General Universitario de Valencia". We made two groups: 1. patients with precancerous lesions and oral carcinoma, 2. patients with OSCC and no precancerous lesions. RESULTS: The average age was 61.4 years, 85 of them being men and 27 women. The tongue and floor of the mouth were the most common locations. 33.6% of the tumours presented stage TNM I, most of them being histologically well differentiated and the 55.8% were ulcerated. We found differences between two groups of the patients regarding alcohol and tobacco habits, location, size and clinical stage and histological differentiation of the malignant lesions (AU)

Hiperplasia epitelial focal. A propósito de dos casos clínicos / Focal epithelial hyperplasia

La hiperplasia epitelial local o enfermedad de Heck es una afección asintomática, benigna y proliferativa que aparece como pápulas en la mucosa labial inferior, aunque también se pueden encontrar en otras localizaciones. Presentamos dos casos clínicos de pacientes con lesiones papulares en número variable irregularmente distribuidas, circunscritas, blandas al tacto, redondas u ovoideas y de unos milímetros de diámetro. Histológicamente la lesiones corresponden a una hiperplasia papilomatosa asociada a infección con HPV y existe una displasia celular leve. Los pacientes padecen inmunodepresión asociada a la infección por HIV, lo cual supone un factor predisponente para la infección oral con HPV inusuales tales como 13 y 32 (AU)

Highly aggressive brown tumour of the maxilla as first manifestation of primary hyperparathyroidism.

A case is presented of a 62-year-old man with a right maxillary swelling for the previous three months. The lesion was expansive and osteolytic, with invasion of the adjacent maxillary sinus, nasal and pterygomaxillary fossae and floor of the orbit. Histology revealed the presence of an intrabony giant cell lesion. Blood tests demonstrated elevations in calcium (16.2 mg/dl) and parathyroid hormone (PTH) concentrations (841 pg/ml). This suggested the diagnosis of hyperparathyroidism initially manifesting as a brown tumour of the maxilla. Posterior explorations confirmed the existence of an underlying ectopic parathyroid adenoma as the cause of the condition.

[Oral lichen planus plaques and homogeneous leukoplasia: comparative results of treatment with CO2 laser]. / Liquen plano oral en placas y leucoplasia oral homogénea: resultados comparativos tras el tratamiento de estas lesiones con láser CO2.

OBJECTIVE: To determine the efficacy of CO2 laser therapy in plaque-like oral lichen planus and homogeneous oral leukoplakia. MATERIAL AND METHODS: We studied two groups of patients; one comprised 29 cases of plaque-like oral lichen planus (group 1) and the other one included 34 cases of homogeneous oral leukoplasia (group 2). After histological study, all the lesions were treated by CO2 laser evaporation at 10 W. We analyzed the results following one month, three months and one year after the treatment. RESULTS: In group 1, 19 lesions (65.5%) were revoluted enterally in one month. Patients reported a slight to moderate pain in 16 cases (55.2%), while 4 (13.8%) showed recurrences after three months and 12 (41.4%) at the end of the following time (one year). In group 2 we found a complete healing after one month in 28 cases (82.4%), with a slight to moderate pain in 22 cases (64.7%). Three months after the treatment we found 7 recurrences (20.6%) and 8 (25.8%) one year after. CONCLUSIONS: We found lower rate of recurrences in homogeneous oral leukoplakias than in plaque-like oral lichen planus after treatment with carbon dioxide laser therapy.

[Sinus aspergillosis after an endodontic treatment. Presentation of a clinical case]. / Aspergilosis sinusal a partir de un tratamiento odontológico. Presentación de un caso clínico.

Aspergillosis is an opportunistic deep mycosis that occurs in immunocompromised patients, often in the paranasal sinuses. However, it sometimes occurs in healthy subjects, producing symptoms similar to those of a chronic sinusitis that is unresponsive to conventional treatment. A possible entry point for Aspergillus is the oroantral communication originated by perforation of the dental root cavity during root canal of a molar with penetration of material. We report the clinical case of a patient with symptoms of chronic sinusitis who was diagnosed as sinus aspergillosis after radiological and histological study. The origin may have been a third upper molar in which a root canal was performed.

[Oral histiocytosis X with severe upper maxillary destruction]. / Histiocitosis X oral con severa destrucción del maxilar superior.

Histiocytosis X is a group of disorders of the reticuloendothelial system that have different clinical features and common histological characteristics, including abnormal proliferation of Langerhans cells. Eosinophilic granuloma is a localized form of histiocytosis affecting one or more bones. A case report is made of a patient diagnosed as histiocytosis X whose first manifestation was the appearance of an orosinusal communication. The lesions were located in the maxillary bones and produced large osteolytic lesions. No other bones were affected. In spite of surgery and radiotherapy, the disease recurred at 12 months.