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COLON ADENOCARCINOMA METASTASIS TO THE MOUTH: A CASE REPORT
ABSTRACTS
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REQUIA MARTINS, BRUNA FERNANDES DO CARMO CARVALHO, ANA LIA ANBINDER, YASMIN RODARTE CARVALHO, SERGIO LUCIO PEREIRA DE CAST, RO LOPES and, JANETE DIAS ALMEIDA A 10-year-old boy was referred after orthodontic documentation because of maxillary lesions. On cone beam computed tomography scan, the right side lesion presented a volumetric increase with a ground-glass appearance, affecting the maxilla, zygomatic, sphenoid, squamous, and petrous portions of the temporal bones. The lesion on the left side presented a mixed, expansive aspect, with multilocular hypodense areas, containing internal hyperdense foci, similar to mineralized dental components, on the alveolar ridge, involving unerupted and displaced teeth. The right side lesion had a clinical diagnosis of craniofacial fibrous dysplasia. Incisional biopsy of the left lesion revealed an ameloblastic fibro-odontoma, which was surgically treated. After 4 years, no recurrence of the excised lesion was observed. Therefore, the patient remains in periodic follow-up. Craniofacial fibrous dysplasia presents a slight volumetric increase in the alveolar region. The authors did not find any report in the literature of coexistence of these lesions in the same patient.
PLEOMORPHIC ADENOMA IN THE LOWER LIP: CASE REPORT. BRUNA JUNGER, LEONARDO DE FREITAS SILVA, ERIK NEIVA e RIBEIRO DE CARVALHO REIS, JOAO PAULO BONARDI, CIRO DUAILIBE-DE-DEUS, IDELMO RANGEL GARCIAJR and, JOSE LINCOLN CARVALHO PARENTE Pleomorphic adenoma is the most common benign tumor of salivary glands; it usually occurs in major salivary glands, especially the parotid gland. Normally, it is seen as a firm nodule, painless with slow growth. Its most common locations are minor salivary glands, the soft and hard palate, and the upper lip, although it can be found in other regions less frequently. This lesion has slight preference for girls and women, and its treatment consists of surgical excision. The prognosis is good after the removal of benign lesions. The aim of this work is to report the case of a patient with the diagnosis of pleomorphic adenoma in the lower lip. The case was treated without complications, and a 1-year follow-up showed no recurrence, but longer follow-up is necessary to indicate the patient’s cure.
ACTINOMYCOSIS: EARLY DIAGNOSIS IN THE POST ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION: CASE REPORT. GABRIELA DE ASSIS RAMOS, BARBARA BARRETO PACHECO VALENTIM, CAMILA LOBO e BRANDAO, MARIA CLAUDIA MOREIRA, MARIA MIDORI MIURA PIRAGIBE, TAISA DOMINGUES BERNARDES SILVA and, HELITON SPINDOLA ANTUNES A 28-year-old Brazilian man was diagnosed with chronic myeloid leukemia and submitted to allogeneic hematopoietic stem cell transplant. This patient presented on D+210 in the right side of oral cavity painful, shallow, and irregular ulcers on the palate, buccal mucosa, retromolar area, and palatal gingiva and increase of the upper gingival thickness with fibrous consistency and dark red areas with necrosis. Examination results were the following:
OOOO January 2020 red blood cells: 2.89 uL, platelets: 12 k/uL, neutrophils: 4366 uL, IgA < 50.0 mg/dL, and IgG 603 mg/dL. Because of the clinical characteristics, an exfoliative cytology was performed, and the patient started the use of oral acyclovir 2 g/d and chlorhexidine 0.12% mouthwash. One day later the cytologic examination result suggested herpes virus, Actinomyces spp, and Candida spp. On the D+214, the patient was admitted to the hospital and treated with ampicillin/intravenously (IV)/8 g/d/21 days + acyclovir/IV 2 g/d/21 days + voriconazole/IV/400 mg/d/21 days. After hospital release, the patient continued treatment using amoxicillin 3 g/d/ 28 days, and at the end of the medication he was stable.
THE IMPORTANCE OF CLINICAL-PATHOLOGIC MONITORING IN THE EVOLUTION OF LEUCOPLASTIC AREAS IN ACTINIC CHEILITIS. AUDREY FOSTER LEFORT ROCHA, MARIA LETICIA DE ALMEIDA LANCA, ¸ LARISSA NATIELE MIOTO, TULIO MORANDIN FERRISSE, MIRIAN APARECIDA ONOFRE, CLEVERTON ROBERTO DE ANDRADE and, ELAINE MARIA SGAVIOLI MASSUCATO Actinic cheilitis is a potentially malignant lesion that occurs by chronic exposure of the lips to ultraviolet rays, which are the main etiologic agent of squamous cell carcinoma affecting the lower lip. A 67-year-old male patient with a complaint of multiple white stains in this region with 2-months evolution time was selected. Clinical examination revealed loss of delimitation of vermillion border of the lower lip and presence of white, nonscratch plaques with a rough and diffuse surface. The biopsy revealed presence of grade II dysplasia; then the treatment of vermilionectomy in the lower lip was chosen and confirmed the diagnosis of squamous cell carcinoma. The patient was referred to the oncologist. The report confirmed the malignancy of the lesion and supports the conclusion that the dentist should closely monitor cases of potentially malignant disorders in view of the early diagnosis of possible malignant neoplasms.
COLON ADENOCARCINOMA METASTASIS TO THE MOUTH: A CASE REPORT. RENATA MENDONCA ¸ MORAES, ESTELA ^ KAMINAGAKURA, EURICO CANDIDO DE OLIVEIRA, CARLOS MATHEUS LESCURA, JANETE DIAS ALMEIDA, YASMIN RODARTE CARVALHO and, ANA LIA ANBINDER Metastatic dissemination to the mouth is uncommon, representing nearly 1% of all oral cavity malignant neoplasms. We present a case of oral metastasis as the initial presentation of colon adenocarcinoma in an 80-year-old man with a 4-cm ulcerated nodule in the left palate. The clinical hypotheses were squamous cell carcinoma, pyogenic granuloma, and metastatic lesion. Incisional biopsy was performed, and a malignant neoplasm composed by glandular structures lined by simple or stratified epithelium with polarized basal cells and papillary or cribriform pattern was found. Endoscopy and colonoscopy showed several lesions in the gut with similar histologic aspects to the oral lesion, which was diagnosed as metastatic colon adenocarcinoma. The patient started chemotherapy but unfortunately died several months after the diagnosis. Although rare in mouth, metastatic lesions should be included in the differential diagnosis and can be the first sign of a distant malignant neoplasm.
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REQUIA MARTINS, BRUNA FERNANDES DO CARMO CARVALHO, ANA LIA ANBINDER, YASMIN RODARTE CARVALHO, SERGIO LUCIO PEREIRA DE CAST, RO LOPES and, JANETE DIAS ALMEIDA A 10-year-old boy was referred after orthodontic documentation because of maxillary lesions. On cone beam computed tomography scan, the right side lesion presented a volumetric increase with a ground-glass appearance, affecting the maxilla, zygomatic, sphenoid, squamous, and petrous portions of the temporal bones. The lesion on the left side presented a mixed, expansive aspect, with multilocular hypodense areas, containing internal hyperdense foci, similar to mineralized dental components, on the alveolar ridge, involving unerupted and displaced teeth. The right side lesion had a clinical diagnosis of craniofacial fibrous dysplasia. Incisional biopsy of the left lesion revealed an ameloblastic fibro-odontoma, which was surgically treated. After 4 years, no recurrence of the excised lesion was observed. Therefore, the patient remains in periodic follow-up. Craniofacial fibrous dysplasia presents a slight volumetric increase in the alveolar region. The authors did not find any report in the literature of coexistence of these lesions in the same patient.
PLEOMORPHIC ADENOMA IN THE LOWER LIP: CASE REPORT. BRUNA JUNGER, LEONARDO DE FREITAS SILVA, ERIK NEIVA e RIBEIRO DE CARVALHO REIS, JOAO PAULO BONARDI, CIRO DUAILIBE-DE-DEUS, IDELMO RANGEL GARCIAJR and, JOSE LINCOLN CARVALHO PARENTE Pleomorphic adenoma is the most common benign tumor of salivary glands; it usually occurs in major salivary glands, especially the parotid gland. Normally, it is seen as a firm nodule, painless with slow growth. Its most common locations are minor salivary glands, the soft and hard palate, and the upper lip, although it can be found in other regions less frequently. This lesion has slight preference for girls and women, and its treatment consists of surgical excision. The prognosis is good after the removal of benign lesions. The aim of this work is to report the case of a patient with the diagnosis of pleomorphic adenoma in the lower lip. The case was treated without complications, and a 1-year follow-up showed no recurrence, but longer follow-up is necessary to indicate the patient’s cure.
ACTINOMYCOSIS: EARLY DIAGNOSIS IN THE POST ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION: CASE REPORT. GABRIELA DE ASSIS RAMOS, BARBARA BARRETO PACHECO VALENTIM, CAMILA LOBO e BRANDAO, MARIA CLAUDIA MOREIRA, MARIA MIDORI MIURA PIRAGIBE, TAISA DOMINGUES BERNARDES SILVA and, HELITON SPINDOLA ANTUNES A 28-year-old Brazilian man was diagnosed with chronic myeloid leukemia and submitted to allogeneic hematopoietic stem cell transplant. This patient presented on D+210 in the right side of oral cavity painful, shallow, and irregular ulcers on the palate, buccal mucosa, retromolar area, and palatal gingiva and increase of the upper gingival thickness with fibrous consistency and dark red areas with necrosis. Examination results were the following:
OOOO January 2020 red blood cells: 2.89 uL, platelets: 12 k/uL, neutrophils: 4366 uL, IgA < 50.0 mg/dL, and IgG 603 mg/dL. Because of the clinical characteristics, an exfoliative cytology was performed, and the patient started the use of oral acyclovir 2 g/d and chlorhexidine 0.12% mouthwash. One day later the cytologic examination result suggested herpes virus, Actinomyces spp, and Candida spp. On the D+214, the patient was admitted to the hospital and treated with ampicillin/intravenously (IV)/8 g/d/21 days + acyclovir/IV 2 g/d/21 days + voriconazole/IV/400 mg/d/21 days. After hospital release, the patient continued treatment using amoxicillin 3 g/d/ 28 days, and at the end of the medication he was stable.
THE IMPORTANCE OF CLINICAL-PATHOLOGIC MONITORING IN THE EVOLUTION OF LEUCOPLASTIC AREAS IN ACTINIC CHEILITIS. AUDREY FOSTER LEFORT ROCHA, MARIA LETICIA DE ALMEIDA LANCA, ¸ LARISSA NATIELE MIOTO, TULIO MORANDIN FERRISSE, MIRIAN APARECIDA ONOFRE, CLEVERTON ROBERTO DE ANDRADE and, ELAINE MARIA SGAVIOLI MASSUCATO Actinic cheilitis is a potentially malignant lesion that occurs by chronic exposure of the lips to ultraviolet rays, which are the main etiologic agent of squamous cell carcinoma affecting the lower lip. A 67-year-old male patient with a complaint of multiple white stains in this region with 2-months evolution time was selected. Clinical examination revealed loss of delimitation of vermillion border of the lower lip and presence of white, nonscratch plaques with a rough and diffuse surface. The biopsy revealed presence of grade II dysplasia; then the treatment of vermilionectomy in the lower lip was chosen and confirmed the diagnosis of squamous cell carcinoma. The patient was referred to the oncologist. The report confirmed the malignancy of the lesion and supports the conclusion that the dentist should closely monitor cases of potentially malignant disorders in view of the early diagnosis of possible malignant neoplasms.
COLON ADENOCARCINOMA METASTASIS TO THE MOUTH: A CASE REPORT. RENATA MENDONCA ¸ MORAES, ESTELA ^ KAMINAGAKURA, EURICO CANDIDO DE OLIVEIRA, CARLOS MATHEUS LESCURA, JANETE DIAS ALMEIDA, YASMIN RODARTE CARVALHO and, ANA LIA ANBINDER Metastatic dissemination to the mouth is uncommon, representing nearly 1% of all oral cavity malignant neoplasms. We present a case of oral metastasis as the initial presentation of colon adenocarcinoma in an 80-year-old man with a 4-cm ulcerated nodule in the left palate. The clinical hypotheses were squamous cell carcinoma, pyogenic granuloma, and metastatic lesion. Incisional biopsy was performed, and a malignant neoplasm composed by glandular structures lined by simple or stratified epithelium with polarized basal cells and papillary or cribriform pattern was found. Endoscopy and colonoscopy showed several lesions in the gut with similar histologic aspects to the oral lesion, which was diagnosed as metastatic colon adenocarcinoma. The patient started chemotherapy but unfortunately died several months after the diagnosis. Although rare in mouth, metastatic lesions should be included in the differential diagnosis and can be the first sign of a distant malignant neoplasm.