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9-Year Follow-up of Postoperative Ameloblastic Fibroma: Case Report
ORAL AND MAXILLOFACIAL PATHOLOGY e128 Abstracts GERALDO NASCIMENTO, GRAZIELLA CHAGAS JAGUAR, JOSÉ DIVALDO PRADO, FÁBIO DE ABREU ALVES. HOSPITAL AC CAMARGO. Girl, 2, was referred for evaluation of a facial deformity consisting of asymptomatic swelling of both the maxilla and mandible bilaterally. The first signs were noted 1 year previously. Imaging showed expansive osteogenic lesions with areas of calcification as well as thinning and rupture of the cortical bone of the primary teeth. Frozen biopsy was done, then, under general anesthesia, tumor resection was performed in two different surgical procedures. Microscopic analysis of surgical specimens revealed homogenous epithelial proliferation with irregularly formed dystrophic calcifications and dentin-like hard tissue resembling an adenomatoid odontogenic tumor (AOT). Remarkably, epithelial sheets formed of cuboidal cells produced areas with a glandular appearance and scant evidence of the tubular arrangement typical of classical AOT. This less complex cellular organization compared to classical AOT may represent a hitherto less welldefined odontogenic tumor entity. The patient has been followed up for 3 years with no signs of local recurrence.
AO-39 - NEURILEMMOMA OF THE HARD PALATE IN AN 18-YEAR-OLD WOMAN: CASE REPORT. GABRIEL FUKUNAGA KATO, ANA MARIA HOYOS CADAVID, ANNA TORREZANI, FABIANA MARTINS E MARTINS, MARILIA TRIERVEILER MARTINS, FABIO DAUMAS NUNES, SUZANA CANTANHEDE ORSINI MACHADO DE SOUZA. FACULDADE DE ODONTOLOGIA DA UNIVERSIDADE DE SÃO PAULO. Woman, 18, was referred for assessment of an asymptomatic nodule in the hard palate. At the School of Dentistry of USP, the lesion was described as a 3-cm solid nodule exhibiting telangiectasia. According to the patient, the lesion had been growing for 2 years. An incisional biopsy was immediately performed, with findings suggesting mucoepidermoid carcinoma. Histopathological analysis with eosin-hematoxylin staining and immunohistochemical reaction showed proliferating Schwann cells, sometimes arranged in palisades around acellular zones (Verocay bodies). The Schwann cells were positive for S100 protein. These features were compatible with the diagnosis of neurilemmoma, so the patient was referred to an oral and maxillofacial surgery service for appropriate surgical treatment.
AO-40 - 9-YEAR FOLLOW-UP OF POSTOPERATIVE AMELOBLASTIC FIBROMA: CASE REPORT. JOÃO NUNES NOGUEIRA NETO, JEAN NUNES DOS SANTOS, ARLEI CERQUEIRA, SANDRA DE CÁSSIA SANTANA SARDINHA. UNIVERSIDADE FEDERAL DA BAHIA. Ameloblastic fibroma is an unusual odontogenic tumor found predominantly in young patients, with no gender predilection. The posterior jaw is affected most often and lesions are associated with impacted teeth. Usually asymptomatic, larger lesions with cortical extension may be painful. Characteristics include a soft tissue mass with a smooth surface with or without a well-defined capsule. Radiographs reveal a unilocular or multilocular radiolucent area with well-defined borders. Histopathologically there may be odontogenic cubic or columnar epithelial cells and ovoid and stellate mesenchymal cells. Boy, 6, had painful swelling in the posterior area of the jaw diagnosed as ameloblastic fibroma. Assessing an ameloblastic fibroma can be difficult at first because of its nonspecific features. Conservative treatment can be sufficient for early tumors; extensive excisions are required for large or
OOOO February 2014 relapsing lesions. Patients should be followed up long-term because of the possibility of relapse and malignant transformation.
AO-41 - NON-EXPOSED BISPHOSPHONATE OSTEONECROSIS OF THE MANDIBLE: A CRITICAL OVERVIEW OF DEFINITION, STAGING, AND TREATMENT. MARCOS MARTINS CURI, DANIEL HENRIQUE KOGA, CAMILA LOPES CARDOSO, CRISTINA ZARDETTO, SÉRGIO ROCHA ARAÚJO. HOSPITAL SANTA CATARINA, SÃO PAULO. Non-exposed bisphosphonate-related osteonecrosis of the jaws is a newly reported complication arising from bisphosphonate therapy characterized by atypical symptoms and no apparent mucosal fenestration or exposure of necrotic bone. We present a case that could not be classified into any proposed stage because it had findings associated with stages 0 and 3. Woman, 66, had a history of intravenous bisphosphonate therapy over the past 6 months and implant surgery 2 months previously. She developed non-exposed osteonecrosis of the mandible. Clinical examination revealed an intact oral mucosa around the implants with signs of fistulae or bone exposure. Computed tomography scans showed pathologic fracture of the mandible involving one of the implants. Treatment consisted of bone resection and fixation with the mandibular reconstruction plate with platelet-rich plasma. The patient’s bone/mucosal healing allowed her to resume wearing the implant-supported prostheses 4 months after surgery.
AO-42 - ORAL AND MAXILLOFACIAL CONSIDERATIONS IN GARDNER’S SYNDROME: REPORT OF TWO CASES. PAULO ANDRÉ GONÇALVES DE CARVALHO, DEBORA LIMA PEREIRA, DANIEL CAMPANHÃ, RODRIGO NASCIMENTO LOPES, FABIO DE ABREU ALVES, ANDRÉ CAROLI ROCHA. A C CAMARGO CANCER CENTER. Gardner syndrome (GS) is an autosomal dominant genetic disorder characterized by intestinal polyps, multiple osteomas, and soft tissue tumors. Dental abnormalities such as impacted or unerupted teeth, congenitally missing teeth, supernumerary teeth, hypercementosis, and compound odontomas are present in 30% to 75%, and osteomas in 68% to 82% of GS patients. This study described the stomatological manifestation of GS in two patients. In addition, the important role of the dentist in its diagnosis is emphasized. The first patient, a woman, 49, had supernumerary teeth in both of jaws and osteomas on the right side of the mandible and right condyle. The second patient, a woman, 20, had multiple osteomas on the right side of the mandible and was later diagnosed with GS. Surgical excision of the osteomas on the right side of the mandible was performed. In conclusion, the ability to diagnose this disease in its early stage allows an excellent prognosis and avoids the malignant transformation of colonic polyposis.
AO-43 - ORAL HERPES SIMPLEX VIRUS INFECTION IN HEMATOLOGY PATIENT. GRAZIELLA CHAGAS JAGUAR, ANA CLÁUDIA LUIZ, ADRIELE FERREIRA GOUVEA VASCONCELLOS, ARISTILIA KEMP, MARCELO BELLESSO, THAIS BIANCA BRANDÃO. INSTITUTO DO CÂNCER DO ESTADO DE SÃO PAULOeICESP. Oral herpes simplex virus (HSV) infection is a common complication in patients with hematological malignancies who are undergoing chemotherapy. Although frequent, HSV in these patients often has atypical characteristics and can remain unrecognized or be misdiagnosed. The authors report an atypical case of HSV with a complicated diagnosis and management. Woman,
AO-39 - NEURILEMMOMA OF THE HARD PALATE IN AN 18-YEAR-OLD WOMAN: CASE REPORT. GABRIEL FUKUNAGA KATO, ANA MARIA HOYOS CADAVID, ANNA TORREZANI, FABIANA MARTINS E MARTINS, MARILIA TRIERVEILER MARTINS, FABIO DAUMAS NUNES, SUZANA CANTANHEDE ORSINI MACHADO DE SOUZA. FACULDADE DE ODONTOLOGIA DA UNIVERSIDADE DE SÃO PAULO. Woman, 18, was referred for assessment of an asymptomatic nodule in the hard palate. At the School of Dentistry of USP, the lesion was described as a 3-cm solid nodule exhibiting telangiectasia. According to the patient, the lesion had been growing for 2 years. An incisional biopsy was immediately performed, with findings suggesting mucoepidermoid carcinoma. Histopathological analysis with eosin-hematoxylin staining and immunohistochemical reaction showed proliferating Schwann cells, sometimes arranged in palisades around acellular zones (Verocay bodies). The Schwann cells were positive for S100 protein. These features were compatible with the diagnosis of neurilemmoma, so the patient was referred to an oral and maxillofacial surgery service for appropriate surgical treatment.
AO-40 - 9-YEAR FOLLOW-UP OF POSTOPERATIVE AMELOBLASTIC FIBROMA: CASE REPORT. JOÃO NUNES NOGUEIRA NETO, JEAN NUNES DOS SANTOS, ARLEI CERQUEIRA, SANDRA DE CÁSSIA SANTANA SARDINHA. UNIVERSIDADE FEDERAL DA BAHIA. Ameloblastic fibroma is an unusual odontogenic tumor found predominantly in young patients, with no gender predilection. The posterior jaw is affected most often and lesions are associated with impacted teeth. Usually asymptomatic, larger lesions with cortical extension may be painful. Characteristics include a soft tissue mass with a smooth surface with or without a well-defined capsule. Radiographs reveal a unilocular or multilocular radiolucent area with well-defined borders. Histopathologically there may be odontogenic cubic or columnar epithelial cells and ovoid and stellate mesenchymal cells. Boy, 6, had painful swelling in the posterior area of the jaw diagnosed as ameloblastic fibroma. Assessing an ameloblastic fibroma can be difficult at first because of its nonspecific features. Conservative treatment can be sufficient for early tumors; extensive excisions are required for large or
OOOO February 2014 relapsing lesions. Patients should be followed up long-term because of the possibility of relapse and malignant transformation.
AO-41 - NON-EXPOSED BISPHOSPHONATE OSTEONECROSIS OF THE MANDIBLE: A CRITICAL OVERVIEW OF DEFINITION, STAGING, AND TREATMENT. MARCOS MARTINS CURI, DANIEL HENRIQUE KOGA, CAMILA LOPES CARDOSO, CRISTINA ZARDETTO, SÉRGIO ROCHA ARAÚJO. HOSPITAL SANTA CATARINA, SÃO PAULO. Non-exposed bisphosphonate-related osteonecrosis of the jaws is a newly reported complication arising from bisphosphonate therapy characterized by atypical symptoms and no apparent mucosal fenestration or exposure of necrotic bone. We present a case that could not be classified into any proposed stage because it had findings associated with stages 0 and 3. Woman, 66, had a history of intravenous bisphosphonate therapy over the past 6 months and implant surgery 2 months previously. She developed non-exposed osteonecrosis of the mandible. Clinical examination revealed an intact oral mucosa around the implants with signs of fistulae or bone exposure. Computed tomography scans showed pathologic fracture of the mandible involving one of the implants. Treatment consisted of bone resection and fixation with the mandibular reconstruction plate with platelet-rich plasma. The patient’s bone/mucosal healing allowed her to resume wearing the implant-supported prostheses 4 months after surgery.
AO-42 - ORAL AND MAXILLOFACIAL CONSIDERATIONS IN GARDNER’S SYNDROME: REPORT OF TWO CASES. PAULO ANDRÉ GONÇALVES DE CARVALHO, DEBORA LIMA PEREIRA, DANIEL CAMPANHÃ, RODRIGO NASCIMENTO LOPES, FABIO DE ABREU ALVES, ANDRÉ CAROLI ROCHA. A C CAMARGO CANCER CENTER. Gardner syndrome (GS) is an autosomal dominant genetic disorder characterized by intestinal polyps, multiple osteomas, and soft tissue tumors. Dental abnormalities such as impacted or unerupted teeth, congenitally missing teeth, supernumerary teeth, hypercementosis, and compound odontomas are present in 30% to 75%, and osteomas in 68% to 82% of GS patients. This study described the stomatological manifestation of GS in two patients. In addition, the important role of the dentist in its diagnosis is emphasized. The first patient, a woman, 49, had supernumerary teeth in both of jaws and osteomas on the right side of the mandible and right condyle. The second patient, a woman, 20, had multiple osteomas on the right side of the mandible and was later diagnosed with GS. Surgical excision of the osteomas on the right side of the mandible was performed. In conclusion, the ability to diagnose this disease in its early stage allows an excellent prognosis and avoids the malignant transformation of colonic polyposis.
AO-43 - ORAL HERPES SIMPLEX VIRUS INFECTION IN HEMATOLOGY PATIENT. GRAZIELLA CHAGAS JAGUAR, ANA CLÁUDIA LUIZ, ADRIELE FERREIRA GOUVEA VASCONCELLOS, ARISTILIA KEMP, MARCELO BELLESSO, THAIS BIANCA BRANDÃO. INSTITUTO DO CÂNCER DO ESTADO DE SÃO PAULOeICESP. Oral herpes simplex virus (HSV) infection is a common complication in patients with hematological malignancies who are undergoing chemotherapy. Although frequent, HSV in these patients often has atypical characteristics and can remain unrecognized or be misdiagnosed. The authors report an atypical case of HSV with a complicated diagnosis and management. Woman,