Tumor glómico del espacio masticatorio que imita patología mandibular / Glomus tumour of the masticatory space mimicking oral mandibular pathology

El tumor glómico es una neoplasia mesenquimal derivada de la célula muscular lisa modificada del aparato glómico. Solo se han descrito 39 casos en la cavidad oral. Una mujer de 32 años presentó dolor intenso e hipoestesia en el área del nervio mandibular. El examen físico oral reveló un abultamiento suave sensible a la palpación. La ortopantomografía mostró una imagen radiolúcida y bien definida en la rama mandibular que sugiere un trastorno óseo. Sin embargo, el TC y el angio-TC mostraron una lesión hipervascular en el espacio masticatorio derecho. Se optó por un abordaje quirúrgico intraoral de la lesión. El análisis histopatológico mostró una positividad difusa y fuerte para la vimentina. La actina del músculo liso, la actina específica del músculo y la cadena pesada de miosina del músculo liso también fueron positivas, pero la inmunorreactividad para los marcadores varió en extensión e intensidad entre las diferentes áreas tumorales. Calponina mostró inmunotinción focal y débil. El índice de proliferación (Ki67-MIB1) fue inferior al 1 %.Basado en estos hallazgos morfológicos e inmunohistoquímicos, el tumor se diagnosticó como un tumor glómico (tipo sólido). Esta primera descripción de un tumor glómico en el espacio masticatorio nos hace incluirlo en el diagnóstico diferencial de las neoplasias en esta área. (AU)

Glomus tumour is a mesenchymal neoplasm from modified smooth muscle cell of the glomus apparatus. Only 39 cases have been reported in the oral cavity. A 32-year-old female presented with intense pain and hypoaestesia in the mandibular nerve area. Oral physical examination revealed a soft bulging tender to palpation. Orthopantomography showed a radiolucent, well-defined image in the mandibular ramus suggesting an osseous disorder. However, CT and angio-CT showed a hypervascular lesion in the right masticatory space. An intraoral surgical approach to the lesion was chosen. Histopathological analysis showed diffuse and strong positivity for vimentin. Smooth muscle actin, muscle specific actin, and smooth muscle myosin heavy-chain were also positive, but immunoreactivity for markers varied in extension and intensity between different tumour areas. Calponin showed focal and weak immunostaning. Proliferation index (Ki67-MIB1) was less than 1 %.Based on these morphological and immunohistochemical findings, the tumour was diagnosed as a glomus tumour (solid type). This first description of a glomus tumour in the masticatory space makes us include it in the differential diagnosis of neoplasms in this area. (AU)

Awareness of Oral Disorders Among Community-Dwelling Elderly Spaniards.

Introduction: Oral status has a clear impact on systemic health, a key component of successful aging. Awareness of oral disorders permits early diagnoses and treatments. This study investigates oral disorders awareness among community-dwelling elders. Methods: Community-based survey through face-to-face interviews undertaken in four cities at busy commercial and administrative areas. Results: A total of 789 people were recruited, mostly nonsmoker (60.3%) males (56.9%) with basic education (65.6%). The most frequently recalled disorder was bruxism, followed by periodontal diseases and ulcerations/aphthae. Caries was mentioned by 3.91%. Dentate participants were more aware of dental-related disorders, such as bruxism (p = .001) and periodontitis (p = .010), except for caries (p = .100). Caries awareness was related to educational level (p = .018) and smoking (p = .020), as was oral cancer (p = .019) with former smokers more aware of this neoplasm. Education was strongly related with periodontal awareness (p = .001). Conclusion: Awareness of the main oral disorders is worryingly poor among the elderly population and immediate action is required by taking advantage of the position of family nurses in the treatment of systemic chronic disorders and through educational interventions on this population subgroup to ease preventive behaviors, favor early diagnoses, and promote simpler, more effective treatments with a lower financial burden.