- Email: [email protected]
Chondroblastic osteosarcoma in a pregnant patient – the difficulties of a rapid diagnosis
OOOO
e126
Abstracts
posed bone tissue in the right front maxilla region caused by a physical trauma. Patient is a smoker, does not use any kind of medication and has no significant systemic alterations. Clinical examination showed extensive areas of necrotic bone, with a purulent liquid draining and teeth involved (11 to 14) with mobility. Radiographic examination showed a diffuse bone destruction on the maxilla. Based on clinical and radiographic findings, the suggested diagnosis was chronic suppurative osteomyelitis. Patient was medicated properly and then submitted to surgery. The surgery, performed under local anesthesia, removed the whole lesion of necrotic bone and also the teeth 11 to 15. Microscopic analysis of the removed material identified necrotic bone, Haversian canals, and microbial colonies; aspects that confirm the clinical diagnosis of chronic suppurative osteomyelitis. (Financial support: FAPEMIG).
MALIGNANT ODONTOGENIC TUMORS: CLINICOPATHOLOGICAL AND IMMUNOHISTOCHEMICAL STUDY OF 25 CASES Martínez MM1, Mosqueda-Taylor A2, Carlos-Bregni R3, Rumayor-Piña A4, Paes de Almeida O4 1 FOP-UNICAMP - PATOLOGÍA, 2UNIVERSIDAD AUTÓNOMA METROPOLITANA XOCHIMILCO, MÉXICO. CIENCIAS CLINICAS, 3CENTRO CLÍNICO DE CABEZA Y CUELLO/HOSPITAL HERRERA LLERANDI, GUATEMALA. - PATOLOGIA ORAL, 4FOP-UNICAMP - PATOLOGIA Background/Objectives: Malignant odontogenic tumors (MOT) are uncommon, comprise less than 7% of all odontogenic tumors (OT). Its etiology is unknown, representing the malignant counterpart of benign lesions, malignant transformation of odontogenic cyst epithelium or de novo development. The aim of this study was to analyze histopathological features of MOT. Study design: We studied 2140 OT, from 1979 to 2011, of which 25 (1. 16%) were MOT. Results/Conclusion: It preferably affected mandible posterior region of male patients with a mean age of 43.3 years. Seven cases were ameloblastic carcinoma, 6 ameloblastic fibrosarcomas, 5 primary intraosseous squamous carcinomas, 3 clear cell odontogenic carcinomas, 3 ghost cell odontogenic carcinomas and 1 case of metastasizing ameloblastoma. Immunoprofile features were positive for CK5 and 14. Almost all cases were positive for CD138, E-cadherin and B-catenin with variable lost expression. Ki-67, p53 and p63 labeling index showed values compatible to the aggressive behavior of the tumors.
CHONDROBLASTIC OSTEOSARCOMA IN A PREGNANT PATIENT – THE DIFFICULTIES OF A RAPID DIAGNOSIS Lima MHA1, Soares BMV1, Ferreira SMS1, Dos Santos VCB2, Dias EP2, Cabús B3 - 1CENTRO UNIVERSITÁRIO CESMAC, 2UNIVERSIDADE FEDERAL FLUMINENSE - DEPARTAMENTO DE PATOLOGIA ORAL, 3 SCAN - CENTRO DE DIAGNÓSTICO DA FACE Osteosarcoma is a malignant tumor derived from mesenchymal cells, capable of producing immature bone. This is a case report of chondroblastic osteosarcoma (CO) of the mandible affecting a 38-year-old pregnant woman, illustrating the difficulties of a rapid diagnosis. Reporting the lesion has been present for five months, the patient presents with jaw pain and earache. The patient reports a history of a lesion removed from the same area without histopathologic diagnosis. Extraoral examination showed mandibular left facial asymmetry. The lesion was located on the
October 2012 right mandibular alveolar ridge, measuring 3x3x2cm, normal mucosal color, but firm and painful to palpation. Clinical diagnosis was central giant cell lesion. CT scan showed bone destruction and hyperdense images adjacent to a previous extraction site. Preliminary histopathologic diagnosis was myxoma. After referral to the University Pathology Department, a definitive diagnosis of Chondroblastic Osteosarcoma was reached.
RECURRENT ORAL INTRAMUSCULAR LIPOMA Lawall MA1, Pareira EM2, Araújo RR3, Naves-Neto VA3, BugarinJúnior JG4 - 1UNIVERSIDADE PAULISTA (UNIP); INSTITUTO FLORENCE DE ENSINO - DEPARTAMENTO DE PATOLOGIA, 2UNIVERSIDADE FEDERAL DO MARANHÃO - DE ODONTOLOGIA II, 3UNIVERSIDADE PAULISTA UNIP, 4UNIVERSIDADE PAULISTA UNIP CIRURGIA Lipomas are benign soft tissue neoplasms of mature adipose tissue. They are infrequent tumors in the oral cavity, in particular those of intramuscular subtype. Oral intramuscular lipoma generally presents as an asymptomatic not-well-circumscribed nodule characterized by infiltrating adipose tissue and muscle atrophy. The recurrence rate of these lesions is infrequent. We herein report a case of a 54-years-old man that was referred to GAAAC Oral Surgery Service with complaints of a recurrent, painless, not well circumscribed mass in the buccal mucosa. The patient reported a previous surgery for removal of a lipomatous lesion. An incisional biopsy was performed and the histopathologic examination showed an unencapsulated lipomatous tumor composed of mature adipocytes diffusely infiltrating muscles. A surgery was performed and the lesion was removed. After six months, there was a local recurrence and a less conservative surgery was performed. The patient is without evidence of recurrence at a 12-month follow-up period.
A RARE ODONTOGENIC TUMOUR: CENTRAL ODONTOGENIC FIBROMA Tekkesin MS1, Cakarer S2, Olgac V1 1 ISTANBUL UNIVERSITY, INSTITUTE OF ONCOLOGY DEPARTMENT OF TUMOUR PATHOLOGY, 2ISTANBUL UNIVERSITY, FACULTY OF DENTISTRY - DEPARTMENT OF ORAL & MAXILLOFACIAL SURGERY The odontogenic fibroma is a rare, benign odontogenic neoplasm derived from the dental mesenchymal tissues. Two variants of odontogenic fibroma can be distinguished: the central and peripheral types. Central odontogenic fibroma is a slow persistent growing tumour. A 14-year old male patient was referred to the clinic presenting a swelling in the premolar site of mandible. Radiologically, a unilocular radiolucency with sclerotic borders between the lateral roots of the right mandibular canine and first premolar teeth were observed. The lesion was treated by conservative curettage. Histopathological examination revealed the non-encapsulated tumour consisting of fibroblast cells with wavy cytoplasm. A few nest of odontogenic epithelium and foci of calcified material were shown in some areas. Eight months of follow-up has not shown any signs of recurrence. Long-term follow-up studies are not enough so it is suggested that the patients should follow at least 5 years after surgical intervention.
THE FATTY ACID SYNTHASE INHIBITOR ORLISTAT REDUCES TUMOR GROWTH AND LYMPH NODE METASTASIS IN AN ORTHOTOPIC MURINE MODEL OF ORAL
e126
Abstracts
posed bone tissue in the right front maxilla region caused by a physical trauma. Patient is a smoker, does not use any kind of medication and has no significant systemic alterations. Clinical examination showed extensive areas of necrotic bone, with a purulent liquid draining and teeth involved (11 to 14) with mobility. Radiographic examination showed a diffuse bone destruction on the maxilla. Based on clinical and radiographic findings, the suggested diagnosis was chronic suppurative osteomyelitis. Patient was medicated properly and then submitted to surgery. The surgery, performed under local anesthesia, removed the whole lesion of necrotic bone and also the teeth 11 to 15. Microscopic analysis of the removed material identified necrotic bone, Haversian canals, and microbial colonies; aspects that confirm the clinical diagnosis of chronic suppurative osteomyelitis. (Financial support: FAPEMIG).
MALIGNANT ODONTOGENIC TUMORS: CLINICOPATHOLOGICAL AND IMMUNOHISTOCHEMICAL STUDY OF 25 CASES Martínez MM1, Mosqueda-Taylor A2, Carlos-Bregni R3, Rumayor-Piña A4, Paes de Almeida O4 1 FOP-UNICAMP - PATOLOGÍA, 2UNIVERSIDAD AUTÓNOMA METROPOLITANA XOCHIMILCO, MÉXICO. CIENCIAS CLINICAS, 3CENTRO CLÍNICO DE CABEZA Y CUELLO/HOSPITAL HERRERA LLERANDI, GUATEMALA. - PATOLOGIA ORAL, 4FOP-UNICAMP - PATOLOGIA Background/Objectives: Malignant odontogenic tumors (MOT) are uncommon, comprise less than 7% of all odontogenic tumors (OT). Its etiology is unknown, representing the malignant counterpart of benign lesions, malignant transformation of odontogenic cyst epithelium or de novo development. The aim of this study was to analyze histopathological features of MOT. Study design: We studied 2140 OT, from 1979 to 2011, of which 25 (1. 16%) were MOT. Results/Conclusion: It preferably affected mandible posterior region of male patients with a mean age of 43.3 years. Seven cases were ameloblastic carcinoma, 6 ameloblastic fibrosarcomas, 5 primary intraosseous squamous carcinomas, 3 clear cell odontogenic carcinomas, 3 ghost cell odontogenic carcinomas and 1 case of metastasizing ameloblastoma. Immunoprofile features were positive for CK5 and 14. Almost all cases were positive for CD138, E-cadherin and B-catenin with variable lost expression. Ki-67, p53 and p63 labeling index showed values compatible to the aggressive behavior of the tumors.
CHONDROBLASTIC OSTEOSARCOMA IN A PREGNANT PATIENT – THE DIFFICULTIES OF A RAPID DIAGNOSIS Lima MHA1, Soares BMV1, Ferreira SMS1, Dos Santos VCB2, Dias EP2, Cabús B3 - 1CENTRO UNIVERSITÁRIO CESMAC, 2UNIVERSIDADE FEDERAL FLUMINENSE - DEPARTAMENTO DE PATOLOGIA ORAL, 3 SCAN - CENTRO DE DIAGNÓSTICO DA FACE Osteosarcoma is a malignant tumor derived from mesenchymal cells, capable of producing immature bone. This is a case report of chondroblastic osteosarcoma (CO) of the mandible affecting a 38-year-old pregnant woman, illustrating the difficulties of a rapid diagnosis. Reporting the lesion has been present for five months, the patient presents with jaw pain and earache. The patient reports a history of a lesion removed from the same area without histopathologic diagnosis. Extraoral examination showed mandibular left facial asymmetry. The lesion was located on the
October 2012 right mandibular alveolar ridge, measuring 3x3x2cm, normal mucosal color, but firm and painful to palpation. Clinical diagnosis was central giant cell lesion. CT scan showed bone destruction and hyperdense images adjacent to a previous extraction site. Preliminary histopathologic diagnosis was myxoma. After referral to the University Pathology Department, a definitive diagnosis of Chondroblastic Osteosarcoma was reached.
RECURRENT ORAL INTRAMUSCULAR LIPOMA Lawall MA1, Pareira EM2, Araújo RR3, Naves-Neto VA3, BugarinJúnior JG4 - 1UNIVERSIDADE PAULISTA (UNIP); INSTITUTO FLORENCE DE ENSINO - DEPARTAMENTO DE PATOLOGIA, 2UNIVERSIDADE FEDERAL DO MARANHÃO - DE ODONTOLOGIA II, 3UNIVERSIDADE PAULISTA UNIP, 4UNIVERSIDADE PAULISTA UNIP CIRURGIA Lipomas are benign soft tissue neoplasms of mature adipose tissue. They are infrequent tumors in the oral cavity, in particular those of intramuscular subtype. Oral intramuscular lipoma generally presents as an asymptomatic not-well-circumscribed nodule characterized by infiltrating adipose tissue and muscle atrophy. The recurrence rate of these lesions is infrequent. We herein report a case of a 54-years-old man that was referred to GAAAC Oral Surgery Service with complaints of a recurrent, painless, not well circumscribed mass in the buccal mucosa. The patient reported a previous surgery for removal of a lipomatous lesion. An incisional biopsy was performed and the histopathologic examination showed an unencapsulated lipomatous tumor composed of mature adipocytes diffusely infiltrating muscles. A surgery was performed and the lesion was removed. After six months, there was a local recurrence and a less conservative surgery was performed. The patient is without evidence of recurrence at a 12-month follow-up period.
A RARE ODONTOGENIC TUMOUR: CENTRAL ODONTOGENIC FIBROMA Tekkesin MS1, Cakarer S2, Olgac V1 1 ISTANBUL UNIVERSITY, INSTITUTE OF ONCOLOGY DEPARTMENT OF TUMOUR PATHOLOGY, 2ISTANBUL UNIVERSITY, FACULTY OF DENTISTRY - DEPARTMENT OF ORAL & MAXILLOFACIAL SURGERY The odontogenic fibroma is a rare, benign odontogenic neoplasm derived from the dental mesenchymal tissues. Two variants of odontogenic fibroma can be distinguished: the central and peripheral types. Central odontogenic fibroma is a slow persistent growing tumour. A 14-year old male patient was referred to the clinic presenting a swelling in the premolar site of mandible. Radiologically, a unilocular radiolucency with sclerotic borders between the lateral roots of the right mandibular canine and first premolar teeth were observed. The lesion was treated by conservative curettage. Histopathological examination revealed the non-encapsulated tumour consisting of fibroblast cells with wavy cytoplasm. A few nest of odontogenic epithelium and foci of calcified material were shown in some areas. Eight months of follow-up has not shown any signs of recurrence. Long-term follow-up studies are not enough so it is suggested that the patients should follow at least 5 years after surgical intervention.
THE FATTY ACID SYNTHASE INHIBITOR ORLISTAT REDUCES TUMOR GROWTH AND LYMPH NODE METASTASIS IN AN ORTHOTOPIC MURINE MODEL OF ORAL