RESUMO
Epstein-Barr virus-positive mucocutaneous ulcer (EBVMCU) is a recently recognized clinicopathological entity. It presents as an ulcerative lesion with lymphoma-like histologic features and is clinically associated with various types of immunosuppression. EBVMCU lesions respond well to conservative measures aimed at correcting the underlying immunosuppression. The case described clearly demonstrates the importance of appropriately completing biopsy submission forms with a detailed clinical history, thus aiding the histopathologist in reaching the correct diagnosis, particularly in pathologic conditions that have similar or overlapping histopathological features. Failure to do so may lead to incorrect diagnosis and management.
Assuntos
Antimetabólitos Antineoplásicos/efeitos adversos , Infecções por Vírus Epstein-Barr/patologia , Herpesvirus Humano 4 , Hospedeiro Imunocomprometido , Imunossupressores/efeitos adversos , Anamnese , Metotrexato/efeitos adversos , Úlceras Orais/patologia , Úlceras Orais/virologia , Idoso de 80 Anos ou mais , Biópsia , Neoplasias da Mama/tratamento farmacológico , DNA Viral/análise , DNA Viral/genética , Diagnóstico Diferencial , Infecções por Vírus Epstein-Barr/imunologia , Feminino , Herpesvirus Humano 4/isolamento & purificação , Humanos , Úlceras Orais/imunologiaRESUMO
A case of Collet-Sicard Syndrome caused by skull base metastasis of probable breast adenocarcinoma is reported. A 79-year-old lady presented to the Oral and Maxillofacial Surgery Department with progressive left-sided tongue symptoms that she described as swelling. This was initially attributed to local disease, and a biopsy showed the patient was suffering from Necrotizing Sialometaplasia. However, her symptoms rapidly evolved into cranial nerve palsies affecting IX-XII, not initially diagnosed. Subsequent imaging revealed the cause of her worsening symptoms to be a metastatic lesion at her left skull base. Cranial nerve palsies due to metastases to the skull base are rare, and the authors would advise clinicians to adopt a high-index of suspicion in ruling out cranial nerve pathology at the skull base when encountering unusual signs and symptoms in the head and neck region.