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A RARE CASE OF ORAL SARCOMA: CLINICAL AND HISTOPATHOLOGIC CHALLENGE
OOOO Volume 129, Number 1 of multiple myeloma. This report emphasizes the importance of dentists in the diagnoses of systemic conditions, such as primary amyloidosis due to multiple myeloma.
ATYPICAL FIBROUS DYSPLASIA—CASE REPORT. MARIANA CAMPELLO NUNES, FABIANE MARQUES DOS SANTOS FREIRE, JOYCE BARBOSA, CARLOS HENRIQUE COSTA BAPTISTA DE MELLO, VALDIR MEIRELLES and, MARIA ELISA RANGEL JANINI MJC, 56-year-old woman with melanoderma, attended the clinic of stomatology to evaluate the increase of volume in the jaw discovered in routine examination. The intraoral examination found a volume increase in mandible body region of molars in the lingual face, which was painless and covered by an integrated and normochromic mucosa. The diagnostic hypotheses were fibro-osseous lesion and osteoma. A cone beam computed tomography was performed, where a mixed-aspect image with expansion and preservation of the cortical bone was observed. It was also possible to observe that the base of bone implantation of the lesion was pediculated. An incisional biopsy was performed with osteoplasty. The fragments were sent for histopathologic examination. The report was of fibrous dysplasia, with an extremely atypical clinical and radiographic aspect. The patient continues to be clinically and radiographically asymptomatic, with no complaints, signs of exacerbation of the condition, or involvement of other skeletal bones.
ORAL METASTASIS OF RENAL CELL CARCINOMA. BARBARA BARRETO PACHECO VALENTIM, GUILHERME LIMA, ALINE e ^ A ABRAHAO, CORRE NATHALIE HENRIQUES SILVA CANEDO, BRUNO AUGUSTO BENEVENUTO DE ANDRADE, MICHELLE AGOSTINI and, MARIO JOSE e ROMANACH Renal cell carcinoma (RCC) is the third most common neoplasm to metastasize to the oral cavity, eventually as the first manifestation of the disease. An otherwise healthy 76-year-old man was referred for evaluation of a 5 £ 4 cm reddish, lobulated, and ulcerated mass located in the upper posterior gingiva. A well-defined lytic lesion in the left maxilla was revealed by computerized tomography. Microscopic examination revealed sheets of neoplastic clear cells arranged in an alveolar pattern, with many central blood vessels. Tumor cells were positive for CD10 and epithelial membrane antigen and negative for CK7, CK20, and vimentin. The final diagnosis was oral metastasis of RCC. The patient was referred to an oncologist for clinical and imaging check-up, which showed uptake in the liver and kidney. RCC was confirmed after incisional biopsy of the kidney. Gingival metastasis of RCC may present as a clear cell tumor in patients who are unaware of their cancer.
A RARE CASE OF ORAL SARCOMA: CLINICAL AND HISTOPATHOLOGIC CHALLENGE. THAIS GIMENEZ MINIELLO, RENNAN LUIZ OLIVEIRA DOS SANTOS, ROSANE TRONCHIN GALLO, LARA CRISTINA OLIVER GIMENEZ, FABIO DAUMAS NUNES, ANDRE CAROLI ROCHA and, NORBERTO NOBUO SUGAYA
ABSTRACTS
e105
A 75-year-old woman presented to the clinic complaining of a progressive, painless, nodular growth in the right anterior portion of her mandible with 1-year duration. Diabetes was the only remark in her medical history. The extraoral examination perceived growth was palpable intraorally showing rubbery consistency, no pain, and no changes in mucosal lining. Radiographs showed no bone damage. A working diagnosis of myofibroblastic tumor was inconclusive on morphologic and immunohistochemical basis. Second biopsy results allowed a suggestion of an ossifying fibromyxoid tumor. Nevertheless, the patient presented pain and a new overgrowth leading to a hospital referral. A wider surgical intervention showed an infiltrative behavior of the tumor, and another microscopic study concluded it was a highgrade osteoblastic sarcoma. The patient underwent hemimandibular resection and radiotherapy. She is currently under clinical and radiographic monitoring.
CASE REPORT: KAPOSI SARCOMA IN AN HIV-POSITIVE PATIENT. RACHEL LAMARCK, ANDERSON MAURICIO PAIVA E COSTA, RAIRA DE BRITO SILVA, SAMEH BRGLAH, LIGIA AKIKO NINOKATA MIYAHARA, PRISCILLA FLORES SILVA ^ GONCALVES ¸ and, DR. HELDER ANTONIO REBELO PONTES Kaposi sarcoma (KS) is a malignant vascular neoplasia with occurrence in 15% to 20% of patients with AIDS. It presents multiple macules and purple papules on the skin. Treatment depends on subtype and disease stage, with variable prognosis. Oral lesions are rare. A 31-year-old male patient was attended with a 6-month painless, erythematous, exophytic, bleeding lesion with variable surface texture located in the hard palate, soft palate, and alveolar ridge. He also presented skin patches, left eye lesion, and weight loss of 20 kg in 2 months. The diagnosis was confirmed through histopathologic examination and blood test. The patient was HIV-positive but unaware of it. Treatment was made with antiretroviral medication and 12 sessions of chemotherapy with great improvement in lesion size and weight gain. The diagnosis and treatment of this lesion depends on the immune state of the patient; therefore, a systemic approach is essential for a better understanding of oral pathologies.
ORAL LEUKOPLAKIA: A DIFFERENT CASE REPORT. HERIKA CRISTINA SILVA DE SOUZA, BRUNO AUGUSTO BENEVENUTO e DE ANDRADE, MARIO JOSE ROMANACH GONZALEZ SOBRINHO, BIANCA ZACHARIAS FORTUNATO, SILVIA PAULA DE OLIVEIRA, ALESSANDRA OLIVEIRA FERRARI GOMES and, LUISA AGUIRRE BUEXM Oral leukoplakia is a potentially malignant lesion characterized by plaques or white patches that cannot be rubbed off. It presents higher prevalence in men, those older than 40 years, and smokers. Surgical treatment must be performed when moderate to intense epithelial dysplasia is present. A male patient who was 87 years old and a nonsmoker sought dental care complaining of "discomfort caused by prosthesis." Intraoral examination showed a poorly adapted upper prosthesis. There was in the upper right buccal vestibule, extending to buccal mucosa, a heterogeneous white plaque, asymptomatic and unique, which could not be scraped off. The toluidine blue test was performed, which guided the site of incisional biopsy. Hypothesis of clinical diagnosis was
ATYPICAL FIBROUS DYSPLASIA—CASE REPORT. MARIANA CAMPELLO NUNES, FABIANE MARQUES DOS SANTOS FREIRE, JOYCE BARBOSA, CARLOS HENRIQUE COSTA BAPTISTA DE MELLO, VALDIR MEIRELLES and, MARIA ELISA RANGEL JANINI MJC, 56-year-old woman with melanoderma, attended the clinic of stomatology to evaluate the increase of volume in the jaw discovered in routine examination. The intraoral examination found a volume increase in mandible body region of molars in the lingual face, which was painless and covered by an integrated and normochromic mucosa. The diagnostic hypotheses were fibro-osseous lesion and osteoma. A cone beam computed tomography was performed, where a mixed-aspect image with expansion and preservation of the cortical bone was observed. It was also possible to observe that the base of bone implantation of the lesion was pediculated. An incisional biopsy was performed with osteoplasty. The fragments were sent for histopathologic examination. The report was of fibrous dysplasia, with an extremely atypical clinical and radiographic aspect. The patient continues to be clinically and radiographically asymptomatic, with no complaints, signs of exacerbation of the condition, or involvement of other skeletal bones.
ORAL METASTASIS OF RENAL CELL CARCINOMA. BARBARA BARRETO PACHECO VALENTIM, GUILHERME LIMA, ALINE e ^ A ABRAHAO, CORRE NATHALIE HENRIQUES SILVA CANEDO, BRUNO AUGUSTO BENEVENUTO DE ANDRADE, MICHELLE AGOSTINI and, MARIO JOSE e ROMANACH Renal cell carcinoma (RCC) is the third most common neoplasm to metastasize to the oral cavity, eventually as the first manifestation of the disease. An otherwise healthy 76-year-old man was referred for evaluation of a 5 £ 4 cm reddish, lobulated, and ulcerated mass located in the upper posterior gingiva. A well-defined lytic lesion in the left maxilla was revealed by computerized tomography. Microscopic examination revealed sheets of neoplastic clear cells arranged in an alveolar pattern, with many central blood vessels. Tumor cells were positive for CD10 and epithelial membrane antigen and negative for CK7, CK20, and vimentin. The final diagnosis was oral metastasis of RCC. The patient was referred to an oncologist for clinical and imaging check-up, which showed uptake in the liver and kidney. RCC was confirmed after incisional biopsy of the kidney. Gingival metastasis of RCC may present as a clear cell tumor in patients who are unaware of their cancer.
A RARE CASE OF ORAL SARCOMA: CLINICAL AND HISTOPATHOLOGIC CHALLENGE. THAIS GIMENEZ MINIELLO, RENNAN LUIZ OLIVEIRA DOS SANTOS, ROSANE TRONCHIN GALLO, LARA CRISTINA OLIVER GIMENEZ, FABIO DAUMAS NUNES, ANDRE CAROLI ROCHA and, NORBERTO NOBUO SUGAYA
ABSTRACTS
e105
A 75-year-old woman presented to the clinic complaining of a progressive, painless, nodular growth in the right anterior portion of her mandible with 1-year duration. Diabetes was the only remark in her medical history. The extraoral examination perceived growth was palpable intraorally showing rubbery consistency, no pain, and no changes in mucosal lining. Radiographs showed no bone damage. A working diagnosis of myofibroblastic tumor was inconclusive on morphologic and immunohistochemical basis. Second biopsy results allowed a suggestion of an ossifying fibromyxoid tumor. Nevertheless, the patient presented pain and a new overgrowth leading to a hospital referral. A wider surgical intervention showed an infiltrative behavior of the tumor, and another microscopic study concluded it was a highgrade osteoblastic sarcoma. The patient underwent hemimandibular resection and radiotherapy. She is currently under clinical and radiographic monitoring.
CASE REPORT: KAPOSI SARCOMA IN AN HIV-POSITIVE PATIENT. RACHEL LAMARCK, ANDERSON MAURICIO PAIVA E COSTA, RAIRA DE BRITO SILVA, SAMEH BRGLAH, LIGIA AKIKO NINOKATA MIYAHARA, PRISCILLA FLORES SILVA ^ GONCALVES ¸ and, DR. HELDER ANTONIO REBELO PONTES Kaposi sarcoma (KS) is a malignant vascular neoplasia with occurrence in 15% to 20% of patients with AIDS. It presents multiple macules and purple papules on the skin. Treatment depends on subtype and disease stage, with variable prognosis. Oral lesions are rare. A 31-year-old male patient was attended with a 6-month painless, erythematous, exophytic, bleeding lesion with variable surface texture located in the hard palate, soft palate, and alveolar ridge. He also presented skin patches, left eye lesion, and weight loss of 20 kg in 2 months. The diagnosis was confirmed through histopathologic examination and blood test. The patient was HIV-positive but unaware of it. Treatment was made with antiretroviral medication and 12 sessions of chemotherapy with great improvement in lesion size and weight gain. The diagnosis and treatment of this lesion depends on the immune state of the patient; therefore, a systemic approach is essential for a better understanding of oral pathologies.
ORAL LEUKOPLAKIA: A DIFFERENT CASE REPORT. HERIKA CRISTINA SILVA DE SOUZA, BRUNO AUGUSTO BENEVENUTO e DE ANDRADE, MARIO JOSE ROMANACH GONZALEZ SOBRINHO, BIANCA ZACHARIAS FORTUNATO, SILVIA PAULA DE OLIVEIRA, ALESSANDRA OLIVEIRA FERRARI GOMES and, LUISA AGUIRRE BUEXM Oral leukoplakia is a potentially malignant lesion characterized by plaques or white patches that cannot be rubbed off. It presents higher prevalence in men, those older than 40 years, and smokers. Surgical treatment must be performed when moderate to intense epithelial dysplasia is present. A male patient who was 87 years old and a nonsmoker sought dental care complaining of "discomfort caused by prosthesis." Intraoral examination showed a poorly adapted upper prosthesis. There was in the upper right buccal vestibule, extending to buccal mucosa, a heterogeneous white plaque, asymptomatic and unique, which could not be scraped off. The toluidine blue test was performed, which guided the site of incisional biopsy. Hypothesis of clinical diagnosis was