A comparative analysis of oral and maxillofacial pathology over a 16-year period, in the north of Portugal.

OBJECTIVES: To determine the frequency and spectrum of oral and maxillofacial lesions biopsied in a hospital population in the northern region of Portugal. METHODS: We conducted descriptive analyses of pathology reports from biopsies of oral and maxillofacial lesions performed between 1990 and 2006, in Oporto Hospital Center. Information on gender and age of patient, location of the lesions and the histopathological diagnosis were analysed. RESULTS: The analyses revealed that 1,520 (47.7%) patients were male and 1,666 (52.3%) were female. They had a mean age ± standard deviation of 47.8 ± 18.6 years. The site most frequently biopsied was the labial mucosa (17.5%). A non-neoplastic diagnosis was established in 2,162 (63.3%) cases, potentially malignant disorders in 163 (5.1%) and neoplasms in 886 (27.6%) (403 benign and 483 malignant). The most commonly reported diagnosis was fibroepithelial polyp (n = 186; 15.9%), followed by squamous cell carcinoma (SCC) (n = 158; 13.6%). SCC was the lesion most commonly found in male patients (n = 279; 18.4%) whilst fibroepithelial polyp was the lesion most commonly found in female patients (n = 268; 16.1%). The most common lesion in patients 0-17 years of age was a follicular cyst (n = 25; 12.8%), whereas in patients 18-64 years of age it was a fibroepithelial polyp (n = 299; 13%). SCC was the most common type of lesion found in patients ≥ 65 years of age (n = 160; 24.6%). CONCLUSION: This large sample provides useful information about the incidence and distribution of oral biopsies over a period of 16 years, allowing valuable comparison with other countries. Non-neoplastic lesions were the types of lesion most commonly reported, with fibroepithelial polyp being most frequent. SCC was the second most common diagnosis.

Incidence and clinical significance of lesions presenting as a scalp mass in adult patients.

BACKGROUND: Lesions initially presenting as a scalp mass are quite common entities with a wide spectrum of causes. They may be directly related to the scalp itself or may be secondary stigmata of an underlying process in the skull. The rate and clinical significance of the differential diagnosis of these lesions are not well studied in the adult population. METHODS: Three hundred sixty patients were operated on for scalp masses at our hospital between January 2011 and February 2014. The patients were defined retrospectively by using the hospital coding system for scalp lesions. Among these patients, 15 were excluded for being younger than 16 years old. RESULTS: A total of 345 patients, consisting of 172 females (49.9 %) and 173 males (50.1 %), were included in the study. The mean age at diagnosis was 44.3 (16-89). There were no mortalities during the follow-up period (mean 17.99 months). Mean numbers of scalp lesions and surgeries were 1.25 and 1.18, respectively. There were 32 distinct histopathological diagnoses, the 5 most common being trichilemmal cyst, epidermal cyst, lipoma, nevus and sebaceous cyst in order of frequency. The rate of "clinically significant" pathologies, meaning malignancies or those needing follow-up, was around 7.8 %. The incidence of correct preoperative diagnosis with respect to the departments was 13-27 %. CONCLUSIONS: Our series indicated that generally scalp masses were underestimated and detailed preoperative diagnostic workup or interdisciplinary consultations were not performed regularly. The overall incidence of clinically significant lesions warrants a high degree of vigilance for accurate diagnosis and management of these lesions, because their etiology can be so variable and challenging.

Does exogenous progesterone and oestradiol treatment from the mid-luteal phase induce follicular cysts in goats?

The purpose of the present study was to investigate the effects of exogenous ovarian steroid treatment, which is known to induce follicular cyst experimentally in cows, on ovarian activity in goats. Eleven female Shiba goats with the length of the normal oestrous cycle (approximately 21 days) received subcutaneously either 1 ml of ethanol (control group, n=4) or 4 mg of progesterone and 2mg of oestradiol (treatment group, n=7) daily for 7 days beginning on day 14 of the oestrous cycle (day 0=ovulation). Ultrasonographic images of the ovary and blood samples were collected daily to monitor the ovarian activity. Ovulation was observed before 1 day after the end of treatment in the control group. In the treatment group, no detectable structures of follicles or corpus luteum (static ovarian condition) were found for 6.0+/-1.4 days (mean+/-S.D.) after the end of treatment. Then, detectable follicles appeared and ovulation was observed in all animals of the treatment group. There was no significant difference in the maximum diameter of the ovulatory follicle between the control and treatment group (4.7+/-0.4mm versus 5.1+/-0.7 mm). The large non-ovulatory follicles, which grew more than 10mm in diameter were observed after the static ovarian condition in one goat of the treatment group, whereas no turnover of the cystic follicular structures was found. The length of the inter-ovulatory intervals in the treatment group was significantly longer than that in the control group (38.4+/-7.4 days versus 20.3+/-0.5 days, P<0.05). The present results demonstrated that the exogenous treatment of progesterone and oestradiol, which was adapted from the follicular cyst model in cows, did not induce follicular cysts in goats, suggesting that there is/are different mechanism(s) mediating the occurrence of follicular cysts between cows and goats.

Prevalence of differentiated thyroid cancer in 810 cases of surgically treated goiter in Yemen.

BACKGROUND: In 1990, the World Health Organization (WHO) suggested that severe iodine deficiency exists in Yemen. Therefore, we looked at the prevalence of differentiated thyroid goiter in 810 cases consecutively treated by surgery for goiter. METHODS: This was a retrospective study of 810 surgically operated cases of goiter over a 5-year period (1999-2003). All cases were evaluated on H&E stained sections from embedded, 10% buffered formalin fixed tissue blocks. Special stains and immunohistochemical analysis were done in Yemen and abroad. Most patients were older than 20 years of age and were from the high altitude areas (2000 to 2600 meters above sea level), where iodine deficiency disorders (IDD) are well documented. RESULTS: In the 810 cases, 729 (90%) were females and the remaining 81 (10%) were males, with female-to-male ratio of 9:1. Differentiated thyroid cancer (DTC) was found in 170 (21%) cases, including 148 (86.4%) females and 22 (13.6%) males. Nearly 60% of the cases were in the age group of 21-40 years. Papillary carcinoma was the most common type of DTC (164 cases, 96.5%). CONCLUSIONS: In a Yemeni population, which has a high prevalence of iodine deficiency, 21% of patients operated on for nodular goiter without pre-operative fine needle aspiration biopsy had thyroid cancer, mostly of the papillary type. In this study, males and elderly patients with goiter had a higher chance of having malignancy.

Serous cysts are a benign component of the cyclic ovary in the guinea pig with an incidence dependent upon inhibin bioactivity.

Ovaries were collected from normal cycling female guinea pigs on each day of the estrous cycle (n = 5 per day) for histological analysis of ovarian morphology. Three types of ovarian cysts were observed: serous cysts, follicular cysts and parovarian cysts. The most common were serous cysts (cystic rete ovarii), which were present throughout the estrous cycle with an overall incidence of 63.5% (54 out of 85 animals). Follicular cysts occurred in 22.4% of guinea pigs overall (19 out of 85). Only one parovarian cyst (1 out of 85) was observed in the present experiment. Follicular cysts always coincided with serous cysts and were less common during diestrus. The incidence of serous cysts did not vary significantly across the estrous cycle. In a second experiment, cycling female guinea pigs were arrested in a prolonged luteal phase by a progesterone implant in order to achieve ovarian synchrony. They were then treated with inhibin antiserum (0.5 or 1 ml per animal i.v.; n = 6 per group) or normal goat serum (controls; n = 6 per group). There was a dose dependent increase in the incidence of serous ovarian cysts following passive immunization against the inhibin alpha-subunit. These results suggest that serous cysts are a normal component of the cyclic guinea pig ovary and that alterations in the inhibin-follicle-stimulating hormone system appear to modulate the incidence of serous ovarian cysts in this species.

A survey of oral biopsies in Brazilian pediatric patients.

This paper presents a review of 1018 oral biopsies in pediatric patients from the Oral Pathology Service, Minas Gerais Federal University, Brazil. The lesions were divided into ten main categories. The most common oral lesions in this study were follicular cyst in the maxillary anterior region, followed by inflammatory fibrous hyperplasia in the same region, and mucocele in the lower lip. Cysts of the jaws and oral soft tissues comprised 26.1 percent of total oral biopsies. The importance of these findings in oral diagnosis is discussed.

Incidence of ovarian dysfunction in post partum dairy cows and the effectiveness of its clinical diagnosis and treatment.

Ovarian function was assessed from milk progesterone profiles in 236 cows that were presented for clinical examination after parturition and in 227 unexamined herdmates. By 30 days after calving, 81 per cent of the cows had ovulated and by 42 days 92 per cent had resumed cycling. On average milk samples were taken for 155 days, and during this period 67 luteal cysts or cystic corpora lutea and 24 follicular cysts were recorded, and 88 cows were anoestrus for more than 30 days. Luteal cysts, follicular cysts and prolonged anoestrus all occurred twice as frequently in the cows which were clinically examined as in those which were not examined. Progesterone profiles indicated that at the time of clinical examination 72.4 per cent of the cows examined were cycling normally, 11.3 per cent were anoestrus, 6.7 per cent had follicular cysts, 8.0 per cent had luteal cysts and 1.6 per cent were pregnant. Rectal palpation correctly identified ovarian function in only 63.5 per cent of examinations, with 29.8 per cent of cows that were cycling normally, 58.1 per cent that were anoestrus, 70.3 per cent with follicular cysts and 25 per cent with luteal cysts being incorrectly diagnosed. Progesterone profiles confirmed normal oestrous cyclicity in 81.9 per cent of these cows diagnosed as cycling normally by the clinician. The clinical treatments administered included prostaglandin, gonadotrophin-releasing hormone (GnRH), progesterone (PRID) and the physical expression of ovarian structures. Cows diagnosed as cycling normally were left untreated. At the time of treatment, 28.8 per cent of prostaglandin-treated cows had low progesterone concentrations indicating that no luteal tissue was present.(ABSTRACT TRUNCATED AT 250 WORDS)

Hair matrix differentiation. Occurrence in lesions other than pilomatricoma.

The formation of structures resembling hair matrices is the least common form of follicular differentiation and only occurs with any frequency in pilomatricoma. Rarely, follicular cysts and both benign and malignant adnexal tumors can show areas of pilomatricoma-like change, or hair matrix differentiation. Examples of focal hair matrix differentiation in a follicular cyst, a cutaneous mixed tumor, and an adnexal carcinoma are presented. Each of these cases also demonstrates the presence of limited differentiation toward structures of the inner root sheath.