RESUMEN
We present a case of primary oral tuberculosis, affecting the maxillary gingiva and causing alveolar bone loss in a 34-year-old Colombian female patient. Definitive diagnosis was facilitated by polymerase chain reaction analysis, a useful modern tool for the diagnosis of infectious diseases. The location and clinical presentation of this lesion is unusual and underlines the importance of considering tuberculosis in the differential diagnosis of oral lesions that affect the gingiva and alveolar bone.
Asunto(s)
Mycobacterium tuberculosis/genética , Tuberculosis Bucal/diagnóstico , Adulto , Pérdida de Hueso Alveolar/microbiología , Técnicas de Tipificación Bacteriana , ADN Bacteriano/análisis , Femenino , Enfermedades de las Encías/microbiología , Humanos , Reacción en Cadena de la PolimerasaRESUMEN
Neurofibromatosis type 1 (NF1) is a relatively frequent mucocutaneous syndrome, which is transmitted as an autosomal dominant trait or which may represent neomutation. It is characterized by a variety of clinical manifestations, including multiple neurofibromas that are associated with a high risk of sarcomatous transformation. The aim of this report was to elucidate the orofacial manifestations observed in 6 pediatric patients (between 4 and 15 years of age) diagnosed with NF1. Physical, clinical, radiological, histological, and immunohistochemical studies were performed. Orofacial lesions were observed in all studied patients, located either in the soft tissues (4 cases) or centrally in the jaws (2 cases). All cases showed facial asymmetry, one of them exhibiting marked facial hemihypertrophy. All cases with soft tissue involvement were plexiform neurofibromas, while the intraosseous cases were diagnosed as solitary neurofibromas. Knowledge of the variability of presentation of orofacial soft tissue and bone manifestations of NF1 in children is necessary for prompt diagnosis.
Asunto(s)
Neoplasias Faciales/patología , Neoplasias de la Boca/patología , Neurofibromatosis 1/patología , Adolescente , Biopsia , Niño , Preescolar , Diagnóstico Diferencial , Asimetría Facial/diagnóstico por imagen , Asimetría Facial/patología , Neoplasias Faciales/diagnóstico por imagen , Femenino , Humanos , Inmunohistoquímica , Imagen por Resonancia Magnética , Masculino , Neoplasias Mandibulares/diagnóstico por imagen , Neoplasias Mandibulares/patología , Neoplasias Maxilares/diagnóstico por imagen , Neoplasias Maxilares/patología , Neoplasias de la Boca/diagnóstico por imagen , Neurofibroma/patología , Neurofibromatosis 1/diagnóstico por imagen , Radiografía Panorámica , Tomografía Computarizada por Rayos XRESUMEN
Overexpression and amplification of several genes (MDM2, CDK4 and SAS) located on chromosome 12q13-15 have been noted to occur in various human sarcomas. As a result, two major growth regulation pathways may be inhibited. MDM2 may down regulate the p53-mediated growth control and CDK4 may affect pRB-mediated events. To determine the frequency of alterations in these genes and their correlation with clinicopathologic features, we analyzed the MDM2 and CDK4 protein levels by immunohistochemistry and assessed MDM2, CDK4 and SAS amplification by real-time PCR in nine osteosarcomas of the jaws. Positive staining for CDK4 and MDM2 was observed in eight cases (88.8%) and five cases (55.5%), respectively. Intense CDK4 staining was noted in four cases (two high grade, one intermediate grade and one low grade). Intense MDM2 staining was observed in the same four previous cases, as well as, one additional high-grade tumor. Individual DNA amplification for CDK4, MDM2 and SAS was observed in six cases for each gene. Co-amplification was observed in five cases that showed CDK4 and MDM2 concomitant amplification and four cases that displayed amplification for all of the genes. In addition, among the five cases that presented CDK4 and MDM2 amplification, strong overexpression of CDK4 and MDM2 was observed in three and in four cases, respectively (three high grade and one intermediate grade). These results suggest that 12q13-15 genes are involved in neoplastic disease and concurrent amplification and overexpression of these genes might help to define high-grade tumors.