Severe craniofacial fibrous dysplasia associated with decreased visual acuity: a case report.

Fibrous dysplasia is a developmental abnormality characterized by the replacement of normal bone tissue by fibrous connective tissue with poorly organized bone trabeculae. This disorder rarely occurs in the craniofacial region, but in such cases it causes facial asymmetries and has severe clinical implications for the patient. This case report describes the treatment of an 18-year-old man who presented with complaints of facial deformity and decreased visual acuity. Cone beam computed tomography revealed a diffuse bone lesion affecting the region of the maxillary, frontal, and nasal bones on the left side of the face. After microscopic examination, the diagnosis of craniofacial fibrous dysplasia was made. The patient underwent a bilateral temporal craniotomy to perform decompression of the orbital apices and correct the loss of visual acuity. In addition, surgical cosmetic contouring of the facial bones was performed. The patient has been followed up by a multidisciplinary team; at his most recent examination, 18 months after the last surgical intervention, his clinical condition remained stable.

The challenging diagnosis of low-grade myofibroblastic sarcoma: A case report and literature update.

Low-Grade Myofibroblastic sarcoma (LGMS) is categorized as an extremely rare malignant neoplasia of myofibroblasts, which has only recently become more widely studied. Our patient was referred for evaluation of a nodule involving the palate. The histopathological analysis showed a mesenchymal tumor formed for stellate-shaped cells. Negativity for Laminin, Desmin, Collagen IV, CK pool, CD34, S100, and ALK1, discarded epithelial, endothelial, neural, and inflammatory origin. On the other hand, the positivity for Calponin and SMA demonstrated myofibroblastic and smooth muscle differentiation. The diagnosis of LGMS was endorsed and the patient was submitted for medical treatment. To date, only 18 cases describing patients diagnosed with intrabuccal LGMS have been reported in the scientific literature. Here, we introduce a rare report and for the first time, also provide an update of the literature and a clear review regarding the immunohistochemical panel to diagnose this entity, once the histopathological diagnosis is still challenging.

Etiologia do trauma facial: uma análise aprofundada entre 2016 e 2019 em Florianópolis/SC / Etiology of facial trauma: an in-depth analysis of cases occurred in Florianópolis, SC from 2016 to 2019

Introdução: Pensando em melhoria na saúde das populações, é indispensável para as equipes de CTBMF e gestores de saúde o conhecimento dos perfis epidemiológicos. O objetivo desse estudo foi estratificar etiologias, ossos mais afetados e possíveis padrões recorrentes entre 2016 e 2019, contabilizá los, analisá-los e então fundamentar sistemas de gestão e ferramentas de melhorias a fim de aumentar eficiência operacional da cadeia de saúde. Métodos: Trata-se de um estudo transversal descritivo que analisou 233 pacientes vitimados com trauma facial e necessitaram de abordagem cirúrgica entre dezembro de 2016 e dezembro de 2019 no Hospital Governador Celso Ramos. Resultados: Ao total de 447 fraturas, 85,83% ocorreram no sexo masculino. A média de idade foi 32,42 e o grupo etário mais acometido o de 21 aos 30 anos. Etiologia mais prevalente foi agressão física, representando 42% dos pacientes. Em comparação com os anos, houve uma tendência preocupante de ascensão nos índices. Conclusões: Os níveis de violência impressionam. Este trabalho direciona um alerta sobre danos graves evitáveis relacionados a agressões e acidentes de trânsito. É imperativo que as gestões públicas desenvolvam políticas no intuito de mitigar riscos e desperdício de recursos, assegurando tratamento, reabilitação e sobretudo prevenção eficaz... (AU)

Introduction: To think over population health improvement, it is all-important that OMFS teams and health managers have knowledge on epidemiological profiles. The aim of this study was to stratify etiologies, the most affected bones and possible recurrent patterns between 2016 and 2019, and based on the records and analyses of the cases, develop management systems and improvement tools to increase the healthcare chain operational efficiency. Methods: It is a cross-sectional study that examined 233 patients who suffered maxillofacial trauma and needed a surgical approach between December 2016 and December 2019 at the Hospital Governador Celso Ramos. Results: From a total of 447 fractures, 85.83% occurred in males. Mean age was 32.42 years, and the predominant injured individuals were between 21 and 30 years old. The most prevalent etiology was physical aggression, representing 42% of the patients. In the comparison of the years, there was a worrying upward trend in violence rates. Conclusions: The levels of violence are impressive, alarming. This work places red flag alert on serious preventable injuries caused by physical violence and traffic accidents. It is imperative that public administrations develop policies designed to mitigate risks and resource wastes, ensuring treatment, rehabilitation and, above all, effective prevention... (AU)

Hybrid ameloblastoma and central giant cell lesion: Challenge of early diagnosis.

Hybrid lesions encompass the occurrence of different entities in one lesion. A 67-year-old woman was referred to the Oral and Maxillofacial Surgery Service for treatment of mandibular Central Giant Cell Lesion (CGCL) previously diagnosed. Intraoral examination revealed edentulism and a painless swelling extending from the alveolar ridge to the buccal vestibule with hard consistency covered by normal mucosae, with unknown duration. Panoramic radiograph revealed a large, multilocular and well-defined radiolucent lesion extending from the region of left mandibular lateral incisor teeth to right mandibular first molar with no evidence of osseous perforation. Initially, a treatment with intralesional injection of corticosteroids was performed. After 18 months of treatment, an increase in size of the osteolytic lesion was noted. An incisional biopsy was carried out and the microscopic examination revealed a unicystic ameloblastoma associated to CGCL. It was performed marsupialization and later the enucleation of residual lesion. The follow-up remains being performed. Key words:Hybrid lesion, central giant cell lesion, ameloblastoma.

Primary intraosseous carcinoma of the maxilla arising from an odontogenic keratocyst: a case report and review of the literature.

A 47-year-old man was referred for treatment of a painful lesion of 5 months' duration located on the left side of the maxilla. A small perforation in the buccal cortex was observed during the intraoral examination. Cone beam computed tomography (CBCT) showed an extensive, well-delimited radiolucent lesion extending from the alveolar ridge to the nasal cavity. An incisional biopsy was performed, and a cystic lesion consistent with an odontogenic keratocyst (OKC) was observed microscopically. The initial treatment option was decompression to be followed by enucleation. However, 3 months after decompression of the lesion, the patient returned because there was a significant increase in the size of the perforation. A destructive lytic lesion that involved the left side of the maxilla and crossed the midline was evident in the CBCT. The examination of a second incisional biopsy specimen showed epithelial neoplasia comprising islands and projections toward the surface. There was abundant keratin deposition, resulting in the formation of pearls and plugs. A diagnosis of primary intraosseous carcinoma arising from an OKC was confirmed, and the patient underwent a maxillectomy. After 1 year of follow-up, there were no signs of recurrence.