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LEIOMYOMA OF THE ORAL CAVITY: A SERIES OF 8 CASES
OOOO Volume 129, Number 1 ROCHA, MARIA LETICIA DE ALMEIDA LANCA ¸ and, CLAUDIA MARIA NAVARRO Squamous cell carcinoma (SCC) is the most frequent type of oral cancer. Lip SCC is associated with UV exposure during occupational activities. The objective of this study is to present 1 case of second primary SCC and 1 case of dysplasia after previous SCC on the lower lip. Case 1: A 29-year-old male patient was diagnosed with SCC in the lower lip and was referred to the oncologist. After 4 and a half years, he returned with a moderate dysplasia. Case 2: A 63 year-old-male patient was diagnosed with SCC of the lip and received treatment. After 3 years, he returned with a new primary SCC on the opposite side of the lip. Usually patients with SCC on the lips present actinic cheilitis, which need to be periodically followed up to diagnose early potential new areas of SCC or dysplasia as illustrated in these reports.
DESMOPLASTIC FIBROMA. AUGUSTO CESAR LEAL DA SILVA LEONEL, STEFANNY TORRES DOS SANTOS, ELAINE JUDITE DE AMORIM CARVALHO, JUREMA FREIRE LISBOA DE CASTRO, FLAVIA MARIA DE MORAES RAMOS-PEREZ, MARIA LUIZA DOS ANJOS PONTUAL and, DANYEL ELIAS DA CRUZ PEREZ This report describes a case of desmoplastic fibroma (DF) in the right maxilla. A 35-year-old female patient was referred for diagnosis of a painless lesion located in the right maxilla with 4 years of duration. Intraorally, the lesion appeared as a welldelimited swelling, extending from the hard palate to the maxillary vestibule. Computed tomography revealed a large expansive lesion, which caused enlargement and thinning of the buccal and palatine cortical bone. Radiopaque foci within the lesion were also observed. The main diagnostic hypothesis was cementoossifying fibroma. The microscopic analysis revealed scarce spindle-shaped cells, some of them of starry aspect, immersed in a collagen-rich fibrous tissue. No cellular atypia was observed. The cells were positive for vimentin and negative for S-100 protein and CD34. Based on these features, the diagnosis of DF was established. The patient was submitted to surgical resection. No recurrence was observed after 8 months.
ONCOCITIC VARIANT OF CENTRAL MUCOEPIDERMOID CARCINOMA: A RARE CASE REPORT. PEDRO HENRIQUE CHAVES ISAIAS, MARIA ELISA QUEZADO LIMA VERDE, BARBARA BETTY DE LIMA, EDUARDO COSTA STUDART SOARES, FABRICIO BITU SOUSA, ANA PAULA NEGREIROS NUNES ALVES and, MARIO ROGERIO LIMA MOTA Mucoepidermoid carcinoma (MC) constitutes a heterogeneous lesion and may present histologic variations that make the diagnosis difficult to establish. A 45-year-old women presented to a referral center complaining of a 10-year increase of volume in the left posterior mandible, associated with dental displacement, with no sign of oral mucosal involvement. Computed tomography evidenced a large hypodense area, with well-defined limits, cortical bone thinning, and a discrete area of solution of continuity. Incisional biopsy was performed with diagnostic hypothesis of dentigerous cyst or ameloblastoma. Histopathologic analysis revealed a malignant neoplasia with glandular
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differentiation, presenting a prominent component of large oncocytoid polygonal cells, such as cells with squamous, basaloid, columnar, and mucous aspects. Multiple cystic and ductiform spaces, sometimes containing basophilic mucoid-like material, were observed. Histochemical and immunohistochemical reactions were also performed, and the diagnosis of oncocytic MC was established. Tumor resection and mandibular reconstruction with microsurgical fibular graft were considered for treatment.
TREATMENT OF A LARGE LOW-FLOW VASCULAR LESION IN THE LOWER LIP BY SCLEROSIS IN A PEDIATRIC PATIENT. IURY DE CARVALHO MARTINS, CAMILLA JOHNSON NASCIMENTO FURTADO, OSVALDO XAVIER MAIA NETO, NAELKA SARMENTO, LIONEY NOBRE CABRAL and, TIAGO NOVAES PINHEIRO Low-flow vascular lesions consist in a blood vessel’s abnormal development, with clinical appearance at the birth, commonly affecting lips, tongue, and oral mucosa. Herein, we report a treatment case of a large low-flow vascular lesion in the lower lip by sclerosis in a pediatric patient. A female patient, 5 years old with light brown skin color, presenting purple lesion on the lower lip with softened consistency and approximately 35-mm diameter, with history of unsuccessful sclerosis attempt history, was referred to the authors’ oral medicine service. Clinical diagnosis was established, and the treatment started after blood examination confirms normal limits. The sclerosing agent of choice was monoethanolamine oleate. After 3 periodical infiltrations of 0.5 mL, 0.8 mL, and 1 mL, the lesion disappeared. No signs of recurrence on the lesion were found during the followup period of 6 months, and the patient was then released.
LEIOMYOMA OF THE ORAL CAVITY: A SERIES OF 8 CASES. SARA FERREIRA DOS SANTOS COSTA, CINTHIA VERONICA BARDALEZ LOPEZ DE CACERES, RAMIRO ALEJANDRO TOMASI, RUTH SALOME FERREYRA DE PRATO, PABLO AGUSTIN VARGAS, RICARDO ALVES MESQUITA and, FELIPE PAIVA FONSECA Leiomyomas are benign smooth muscle tumors that are uncommon in the oral cavity. The purpose of this study was to present the clinicopathologic features of a series of 8 cases of oral leiomyomas from 2 Brazilian and 1 Argentinian oral pathology service. The patients’ age at diagnosis varied from 28 to 67 years, and similar frequency in male and female patients was observed (1:1). The most commonly involved sites were lip and palate. The tumors manifested as slow-growing, asymptomatic, solitary swelling. Microscopic analysis revealed similar pattern in all cases with bundles or fascicles of spindle-shaped cells. The most common histologic subtype was angioleiomyoma. Immunohistochemical evaluation revealed positivity for smooth muscle markers. All patients underwent excision of the tumor, and no recurrence was observed. Although diagnosis is usually done on histologic analysis, immunohistochemistry is a useful tool to differentiate oral leiomyomas from other spindle cell lesions. Support: FAPEMIG.
A RARE CASE REPORT OF CRANIOFACIAL FIBROUS DYSPLASIA AND AMELOBLASTIC FIBRO-ODONTOMA IN THE MAXILLA. ^ MONICA GHISLAINE OLIVEIRA ALVES, ANA PAULA
DESMOPLASTIC FIBROMA. AUGUSTO CESAR LEAL DA SILVA LEONEL, STEFANNY TORRES DOS SANTOS, ELAINE JUDITE DE AMORIM CARVALHO, JUREMA FREIRE LISBOA DE CASTRO, FLAVIA MARIA DE MORAES RAMOS-PEREZ, MARIA LUIZA DOS ANJOS PONTUAL and, DANYEL ELIAS DA CRUZ PEREZ This report describes a case of desmoplastic fibroma (DF) in the right maxilla. A 35-year-old female patient was referred for diagnosis of a painless lesion located in the right maxilla with 4 years of duration. Intraorally, the lesion appeared as a welldelimited swelling, extending from the hard palate to the maxillary vestibule. Computed tomography revealed a large expansive lesion, which caused enlargement and thinning of the buccal and palatine cortical bone. Radiopaque foci within the lesion were also observed. The main diagnostic hypothesis was cementoossifying fibroma. The microscopic analysis revealed scarce spindle-shaped cells, some of them of starry aspect, immersed in a collagen-rich fibrous tissue. No cellular atypia was observed. The cells were positive for vimentin and negative for S-100 protein and CD34. Based on these features, the diagnosis of DF was established. The patient was submitted to surgical resection. No recurrence was observed after 8 months.
ONCOCITIC VARIANT OF CENTRAL MUCOEPIDERMOID CARCINOMA: A RARE CASE REPORT. PEDRO HENRIQUE CHAVES ISAIAS, MARIA ELISA QUEZADO LIMA VERDE, BARBARA BETTY DE LIMA, EDUARDO COSTA STUDART SOARES, FABRICIO BITU SOUSA, ANA PAULA NEGREIROS NUNES ALVES and, MARIO ROGERIO LIMA MOTA Mucoepidermoid carcinoma (MC) constitutes a heterogeneous lesion and may present histologic variations that make the diagnosis difficult to establish. A 45-year-old women presented to a referral center complaining of a 10-year increase of volume in the left posterior mandible, associated with dental displacement, with no sign of oral mucosal involvement. Computed tomography evidenced a large hypodense area, with well-defined limits, cortical bone thinning, and a discrete area of solution of continuity. Incisional biopsy was performed with diagnostic hypothesis of dentigerous cyst or ameloblastoma. Histopathologic analysis revealed a malignant neoplasia with glandular
ABSTRACTS
e63
differentiation, presenting a prominent component of large oncocytoid polygonal cells, such as cells with squamous, basaloid, columnar, and mucous aspects. Multiple cystic and ductiform spaces, sometimes containing basophilic mucoid-like material, were observed. Histochemical and immunohistochemical reactions were also performed, and the diagnosis of oncocytic MC was established. Tumor resection and mandibular reconstruction with microsurgical fibular graft were considered for treatment.
TREATMENT OF A LARGE LOW-FLOW VASCULAR LESION IN THE LOWER LIP BY SCLEROSIS IN A PEDIATRIC PATIENT. IURY DE CARVALHO MARTINS, CAMILLA JOHNSON NASCIMENTO FURTADO, OSVALDO XAVIER MAIA NETO, NAELKA SARMENTO, LIONEY NOBRE CABRAL and, TIAGO NOVAES PINHEIRO Low-flow vascular lesions consist in a blood vessel’s abnormal development, with clinical appearance at the birth, commonly affecting lips, tongue, and oral mucosa. Herein, we report a treatment case of a large low-flow vascular lesion in the lower lip by sclerosis in a pediatric patient. A female patient, 5 years old with light brown skin color, presenting purple lesion on the lower lip with softened consistency and approximately 35-mm diameter, with history of unsuccessful sclerosis attempt history, was referred to the authors’ oral medicine service. Clinical diagnosis was established, and the treatment started after blood examination confirms normal limits. The sclerosing agent of choice was monoethanolamine oleate. After 3 periodical infiltrations of 0.5 mL, 0.8 mL, and 1 mL, the lesion disappeared. No signs of recurrence on the lesion were found during the followup period of 6 months, and the patient was then released.
LEIOMYOMA OF THE ORAL CAVITY: A SERIES OF 8 CASES. SARA FERREIRA DOS SANTOS COSTA, CINTHIA VERONICA BARDALEZ LOPEZ DE CACERES, RAMIRO ALEJANDRO TOMASI, RUTH SALOME FERREYRA DE PRATO, PABLO AGUSTIN VARGAS, RICARDO ALVES MESQUITA and, FELIPE PAIVA FONSECA Leiomyomas are benign smooth muscle tumors that are uncommon in the oral cavity. The purpose of this study was to present the clinicopathologic features of a series of 8 cases of oral leiomyomas from 2 Brazilian and 1 Argentinian oral pathology service. The patients’ age at diagnosis varied from 28 to 67 years, and similar frequency in male and female patients was observed (1:1). The most commonly involved sites were lip and palate. The tumors manifested as slow-growing, asymptomatic, solitary swelling. Microscopic analysis revealed similar pattern in all cases with bundles or fascicles of spindle-shaped cells. The most common histologic subtype was angioleiomyoma. Immunohistochemical evaluation revealed positivity for smooth muscle markers. All patients underwent excision of the tumor, and no recurrence was observed. Although diagnosis is usually done on histologic analysis, immunohistochemistry is a useful tool to differentiate oral leiomyomas from other spindle cell lesions. Support: FAPEMIG.
A RARE CASE REPORT OF CRANIOFACIAL FIBROUS DYSPLASIA AND AMELOBLASTIC FIBRO-ODONTOMA IN THE MAXILLA. ^ MONICA GHISLAINE OLIVEIRA ALVES, ANA PAULA