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UNUSUAL EPIDERMOID CYST IN THE HARD PALATE
OOOO Volume 124, Number 2 LETÍCIA DÁVILA PORTUGAL, CINTHIA XEREZ DE ALBUQUERQUE, PAULA REGINA KIMURA QUEIROZ, EVILÁZIO CUNHA CARDOSO, LUZIANA BRASIL. Herein we present the case of a 17-years-old female patient with acute lymphocytic leukemia in the induction phase of chemotherapy. She presented severe grade IV (WHO) critical oral mucositis, distributed all over the oral mucosa, associated with severe pain, drooling, halitosis, dysphagia, severely compromising oral ingestion. Treatment begun with low-level laser therapy, 780 nm of wave length, with continuous light applied with 6.2 J/ cm2. Ad-MucÒ cream (Chamomilla recutita extract) was applied to the lesions after laser therapy. Four sessions were performed at 24-hour interval, allowing the observation of significant progress during the applications. Full recovery was achieved after the laser therapy, with considerable regression of the legions, expressive general condition recovery, and reestablishment of progressive swallowing, contributing to the improvement of her nutrition state. The low-level laser therapy associated with Ad-MucÒ cream was an efficient alternative to the treatment of oral mucositis, considered non-traumatic, with low cost and with satisfactory results.
CPP269 - ORAL BASALOID SQUAMOUS CELL CARCINOMA IN AN INDIGENOUS PATIENT. PRISCILLA BARBOSA DINIZ, NAYARA DA SILVA BARAÚNA, FILIPE TORRES AMORIM OLIVEIRA, CAROLINA CALEGARI, MICHELLE AGOSTINI, BRUNO AUGUSTO BENEVENUTO DE ANDRADE, MÁRIO JOSÉ ROMAÑACH. Basaloid squamous cell carcinoma (BSCC) is a variant of oral squamous cell carcinoma with aggressive clinical behavior, usually occurring in the tongue and floor of the mouth of older patients. A 70-year-old indigenous male patient presented an exuberant swelling on the anterior alveolar ridge. Medical history included habits of chewing tobacco since he was 6 years old and alcohol consumption. Intraoral examination revealed a 4-cm reddish swelling covered by irregular and vascular surface, located on the anterior alveolar ridge of the mandible. Panoramic radiograph showed extensive superficial bone resorption with irregular borders. Microscopic evaluation revealed infiltrative tumor islands composed of basaloid epithelial cells with hyperchromatic pleomorphic nuclei, comedonecrosis, and focal areas of squamous differentiation. Final diagnosis was of BSCC of the alveolar ridge. The patient denied treatment because of religious beliefs; currently he is alive with the disease 1 year after diagnosis. Oral BSCC rarely affects the alveolar ridge of indigenous patients.
CPP270 - WHITE SPONGE NEVUS. PRISCILLA BARBOSA DINIZ, ÚRSULLA VAZ VIEIRA CAMPOS, RUBEM COSTA ARAÚJO, MICHELLE AGOSTINI, BRUNO AUGUSTO BENEVENUTO DE ANDRADE, MÁRIO JOSÉ ROMAÑACHOMAÑACH. White sponge nevus (WSN) is a rare autosomal-dominant disorder characterized by white symmetric diffuse corrugated or velvety plaques on the oral, esophageal, or genital mucosae. Oral lesions are benign, usually appear at birth or during childhood, and no treatment is required. A 7-year-old female patient was referred for evaluation of diffuse white verrucous plaques of smooth surface on the buccal mucosa bilaterally. Her mother reported initial presentation when the patient was 6 months old
ABSTRACTS Abstracts e107 and previous history of incisional biopsy performed 2 years before first consultation. Microscopic review revealed hyperplasic stratified squamous epithelium and hyperparakeratosis with extensive hydropic degeneration and keratinocytes exhibiting perinuclear eosinophilic condensation. The final diagnosis was of WSN. Orientation was offered to the patient’s family about the benign nature of oral lesions. WSN is uncommon and should be considered as a differential diagnosis of oral white lesions in infants.
CPP271 - UNUSUAL EPIDERMOID CYST IN THE HARD PALATE. ONDINA KARLA MOUSINHO DA SILVA ROCHA, HUGO COSTA-NETO, ANDRÉIA FERREIRA DO CARMO, LUIZ ARTHUR BARBOSA DA SILVA, ÉRICKA JANINE DANTAS DA SILVEIRA, HÉBEL CAVALCANTI GALVÃO. Epidermoid cysts are ectoderm-derived benign malformations and represent approximately 7% of all head and neck cysts, although they are rare in the oral cavity, which represents less than 0.01% of all known cysts. They are usually located in the floor of the mouth’s middle line in children and young adults. Herein we report the case of a 56-year-old male patient, melanoderma, presenting with a lesion in the palate middle line, nodular, exophytic, sessile, staining slightly reddened, softened consistency, asymptomatic, with duration of 2 years. The radiographic data showed no alterations associated with the lesion. An excisional biopsy was performed and the histopathologic exam showed pathologic cavity coated with keratinized squamous stratified epithelium and subsequent capsule composed by dense fibrous connective tissue, not showing cutaneous annexes. In this case report, it is discussed the origin, the localization and the differential diagnosis for oral cavity epidermoid cysts.
CPP272 - PLASMABLASTIC LYMPHOMA IN THE ORAL CAVITY IN PATIENTS WITH SEROLOGIES UNKNOWN FOR HIV: CASE REPORT. ANDREZA MARIA DE OLIVEIRA FILGUEIRAS, THIAGO MOREIRA PESSÔA, GERALDO OLIVEIRA SILVA-JUNIOR, RUTH TRAMONTANI RAMOS, MARÍLIA HEFFER CANTISANO, FÁBIO RAMOA PIRES. Plasmablastic lymphoma (PL) is an unusual aggressive nonHodgkin’s lymphoma derived from B cells and mostly associated with human immunodeficiency virus (HIV) infection. The aim of this study was to report a case of PL involving the oral cavity in a 35-year-old male patient with unknown HIV serology. FMSJ, male, leucoderma, presented to the Stomatology Service with pain in the anterior maxilla, 5 months of evolution, with constant fever, weight loss, and lack of appetite. Intraoral exam noted an ulcerated lesion with hardened edges and with extensive necrotic areas, fetid odor, painful on palpation, located in the pre-maxilla extending to the upper lip mucosa. An incisional biopsy of the area was performed and submitted for histopathologic examination and later immunohistochemistry, which was conclusive for B lymphoma of high-grade plasmablastic type, with positive result for CD138, plasma cell, KI67 >90%, and negative for CD20, CD56, CD3, and CD68. Complementary exams revealed that the patient had HIV 1- and 2-positive serology. The patient was referred to Oncology and Infectology for treatment. Oral PL and large associated of HIV-positive patients is important information for the differential diagnosis. The importance of complementary exams, especially when the person with AIDS is unaware of HIV
CPP269 - ORAL BASALOID SQUAMOUS CELL CARCINOMA IN AN INDIGENOUS PATIENT. PRISCILLA BARBOSA DINIZ, NAYARA DA SILVA BARAÚNA, FILIPE TORRES AMORIM OLIVEIRA, CAROLINA CALEGARI, MICHELLE AGOSTINI, BRUNO AUGUSTO BENEVENUTO DE ANDRADE, MÁRIO JOSÉ ROMAÑACH. Basaloid squamous cell carcinoma (BSCC) is a variant of oral squamous cell carcinoma with aggressive clinical behavior, usually occurring in the tongue and floor of the mouth of older patients. A 70-year-old indigenous male patient presented an exuberant swelling on the anterior alveolar ridge. Medical history included habits of chewing tobacco since he was 6 years old and alcohol consumption. Intraoral examination revealed a 4-cm reddish swelling covered by irregular and vascular surface, located on the anterior alveolar ridge of the mandible. Panoramic radiograph showed extensive superficial bone resorption with irregular borders. Microscopic evaluation revealed infiltrative tumor islands composed of basaloid epithelial cells with hyperchromatic pleomorphic nuclei, comedonecrosis, and focal areas of squamous differentiation. Final diagnosis was of BSCC of the alveolar ridge. The patient denied treatment because of religious beliefs; currently he is alive with the disease 1 year after diagnosis. Oral BSCC rarely affects the alveolar ridge of indigenous patients.
CPP270 - WHITE SPONGE NEVUS. PRISCILLA BARBOSA DINIZ, ÚRSULLA VAZ VIEIRA CAMPOS, RUBEM COSTA ARAÚJO, MICHELLE AGOSTINI, BRUNO AUGUSTO BENEVENUTO DE ANDRADE, MÁRIO JOSÉ ROMAÑACHOMAÑACH. White sponge nevus (WSN) is a rare autosomal-dominant disorder characterized by white symmetric diffuse corrugated or velvety plaques on the oral, esophageal, or genital mucosae. Oral lesions are benign, usually appear at birth or during childhood, and no treatment is required. A 7-year-old female patient was referred for evaluation of diffuse white verrucous plaques of smooth surface on the buccal mucosa bilaterally. Her mother reported initial presentation when the patient was 6 months old
ABSTRACTS Abstracts e107 and previous history of incisional biopsy performed 2 years before first consultation. Microscopic review revealed hyperplasic stratified squamous epithelium and hyperparakeratosis with extensive hydropic degeneration and keratinocytes exhibiting perinuclear eosinophilic condensation. The final diagnosis was of WSN. Orientation was offered to the patient’s family about the benign nature of oral lesions. WSN is uncommon and should be considered as a differential diagnosis of oral white lesions in infants.
CPP271 - UNUSUAL EPIDERMOID CYST IN THE HARD PALATE. ONDINA KARLA MOUSINHO DA SILVA ROCHA, HUGO COSTA-NETO, ANDRÉIA FERREIRA DO CARMO, LUIZ ARTHUR BARBOSA DA SILVA, ÉRICKA JANINE DANTAS DA SILVEIRA, HÉBEL CAVALCANTI GALVÃO. Epidermoid cysts are ectoderm-derived benign malformations and represent approximately 7% of all head and neck cysts, although they are rare in the oral cavity, which represents less than 0.01% of all known cysts. They are usually located in the floor of the mouth’s middle line in children and young adults. Herein we report the case of a 56-year-old male patient, melanoderma, presenting with a lesion in the palate middle line, nodular, exophytic, sessile, staining slightly reddened, softened consistency, asymptomatic, with duration of 2 years. The radiographic data showed no alterations associated with the lesion. An excisional biopsy was performed and the histopathologic exam showed pathologic cavity coated with keratinized squamous stratified epithelium and subsequent capsule composed by dense fibrous connective tissue, not showing cutaneous annexes. In this case report, it is discussed the origin, the localization and the differential diagnosis for oral cavity epidermoid cysts.
CPP272 - PLASMABLASTIC LYMPHOMA IN THE ORAL CAVITY IN PATIENTS WITH SEROLOGIES UNKNOWN FOR HIV: CASE REPORT. ANDREZA MARIA DE OLIVEIRA FILGUEIRAS, THIAGO MOREIRA PESSÔA, GERALDO OLIVEIRA SILVA-JUNIOR, RUTH TRAMONTANI RAMOS, MARÍLIA HEFFER CANTISANO, FÁBIO RAMOA PIRES. Plasmablastic lymphoma (PL) is an unusual aggressive nonHodgkin’s lymphoma derived from B cells and mostly associated with human immunodeficiency virus (HIV) infection. The aim of this study was to report a case of PL involving the oral cavity in a 35-year-old male patient with unknown HIV serology. FMSJ, male, leucoderma, presented to the Stomatology Service with pain in the anterior maxilla, 5 months of evolution, with constant fever, weight loss, and lack of appetite. Intraoral exam noted an ulcerated lesion with hardened edges and with extensive necrotic areas, fetid odor, painful on palpation, located in the pre-maxilla extending to the upper lip mucosa. An incisional biopsy of the area was performed and submitted for histopathologic examination and later immunohistochemistry, which was conclusive for B lymphoma of high-grade plasmablastic type, with positive result for CD138, plasma cell, KI67 >90%, and negative for CD20, CD56, CD3, and CD68. Complementary exams revealed that the patient had HIV 1- and 2-positive serology. The patient was referred to Oncology and Infectology for treatment. Oral PL and large associated of HIV-positive patients is important information for the differential diagnosis. The importance of complementary exams, especially when the person with AIDS is unaware of HIV