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DELAYED DIAGNOSIS OF ORAL SQUAMOUS CELL CARCINOMA IN TWO YOUNG PATIENTS
OOOO Volume 124, Number 2 CPP342 - DELAYED DIAGNOSIS OF ORAL SQUAMOUS CELL CARCINOMA IN TWO YOUNG PATIENTS. RODRIGO PORPINO MAFRA, LAUDENICE DE LUCENA PEREIRA, ANDRÉIA FERREIRA DO CARMO, DANYEL ELIAS PEREZ, VÍCTOR YURI NICOLAU, MÁRCIA CRISTINA DA COSTA MIGUEL, PAULO ROGÉRIO FERRETI BONAN. An increasing incidence of oral squamous cell carcinoma (OSCC) in individuals younger than 40 years has been observed. There are controversies in respect to the biologic behavior of the tumor in this age group. The present report describes 2 cases of OSCC in young patients with a fatal outcome. A female and a male patient, both 38 years old, tobacco and alcohol consumers, presented with extensive ulcerated lesions in tongue and gingiva, respectively. Regional lymph node metastases were found in both cases by extraoral inspection and CT. Incisional biopsies were performed in both patients and confirmed the diagnosis of OSCC. The patients underwent surgical resection, radiotherapy, and chemotherapy in a referral hospital. In both cases, the patients succumbed to the tumor in less than 1 year of follow-up, as a consequence of the advanced clinical stages at the time of diagnosis.
CPP343 - ORAL CARE AND SURVIVAL OF THE ONCOLOGY PATIENT. ELAINE CATARINA DE CAMARGO, ALICE ZELMANOWICZ. The oral health of cancer patients may compromise their survival. Ideally, oral evaluation should be conducted 1 month before cancer treatment to allow adequate time for recovery from invasive dental procedures. In this clinical case, dental infections were diagnosed in a hospitalized patient and the dentist had determined immediate chemical control of plaque, panoramic radiograph, and scheduling the surgery room. The medical team prepared medically and 2 dental surgeons performed the procedures (extractions, scaling, filling, adaptation of temporary denture of the upper arch and molding to denture adhesive), with local anesthesia and portable dental office. The laser therapy and cementation were performed with the patient at the infirmary and the case was completed in 72 hours. The patient was clinically and emotionally ready to receive the therapy outlined by the oncologist. It was concluded that specialized surgeon dentists in the multidisciplinary team, with the appropriate equipment, ensures resolution and prevention of oral complications.
CPP344 - SIMPLE BONE CYST: FOLLOWUP OR PRESERVATION?. HELITON GUSTAVO DE LIMA, CAMILA LOPES CARDOSO, RAFAEL ZETEHAKU ARAUJO, ANTHONY BENITES CONDEZO, CLÁUDIA CURRA, CARLOS CESAR DEANTONI, MARCOS MARTINS CURI. Simple bone cyst (SBC) is an intraosseous pseudocyst that primarily affects the mandible and is usually seen during routine radiographic examination. A 10-year-old female patient presented an asymptomatic multilocular radiolucent area in the anterior and left jaw, discovered in panoramic radiographs. CBCT showed extensive hypodense area in the affected region. Axial reconstruction showed moderate expansion of cortical. The diagnostic hypotheses were keratocystic odontogenic tumor and SBC. Facing the exuberance of the lesion and anxiety of parents, a surgical exploration of the area was planned to establish the final diagnosis. During surgery, an empty cavity was found, confirming SCB. After 3 years, the lesion was fully
ABSTRACTS Abstracts e121 repaired, corroborating with the literature regarding the treatment of SBC. In conclusion, this case illustrates an atypical SBC, by their great length and moderate bone expansion, and discusses the clinical decision for surgical exploration or to follow this condition.
RP - RESEARCH POSTERS RP1 - THE ROLE OF KI-67, P16, CD34, BCL-2, AND CYCLOOXYGENASE-2 IN THE PATHOGENESIS OF PROLIFERATIVE VERRUCOUS LEUKOPLAKIA. RAGHU RADHAKRISHNAN. Background: Proliferative verrucous leukoplakia (PVL) is a highly persistent and aggressive oral pre-malignant lesion with an obscure etiopathogenesis and a malignant transformation rate of 70%e85%. Objective: It was assessed the role of Ki-67, p16, CD34, Bcl-2, cyclooxygenase-2 (COX-2) in the spectrum of PVL to ascertain their role in its etiopathogenesis. Study Design: A retrospective chart analysis on 7 confirmed cases of PVL, which were followed-up for 2 years, was immunohistochemically appraised using a panel related to cell proliferation, cell cycle regulation, angiogenesis, apoptosis and inflammation. The expression of these markers was correlated with patients’ clinicopathologic profile and analyzed. Results: The latest labeling index of Ki-67 in these cases ranged from 8.18 to 12.6; p16 was positive in 3/7 cases and Bcl-2 expression was moderately positive in 2/7 cases. All cases were intensely positive for COX-2 staining. Microvascular density assessed by CD34 ranged from 11 to 20/hpf. One case, which transformed into squamous cell carcinoma, demonstrated increased Ki-67, Bcl-2, COX-2, CD34 expression, but negative p16 and Bcl-2 expression. Conclusions: Application of these markers in PVL patients suggests an imbalance between the proliferation apoptosis dynamics, accompanied by an increase in inflammation and angiogenesis underlie the molecular pathogenesis of PVL.
RP2 - UNIT USING MOUTH CANCER SCREENING MOBILE DENTAL. CARLOS DEYVER DE SOUZA QUEIROZ, LIDIA MARIA REBOLHO BATISTA ARANTES, FABIANA DE LIMA VAZQUEZ, EDMUNDO CARVALHO MAUAD, ANDRÉ LOPES CARVALHO, RICARDO RIBEIRO GAMA, ADHEMAR LONGATTO FILHO. Oral cancer is one of the most serious public health problems, has a higher morbidity/mortality among head and neck cancers. According to INCA 2016, estimates will be 11,140 new cases of oral cavity cancer in men and women. This paper aims to show the importance of screening for oral cancer, through active pursuit of risk population, increasing the level of information on the risk factors and the achievement of an early diagnosis. Individuals of both genders, above 40 years of age, smoking and/or alcohol consumers, were subjected to clinical examination by a dentist. During the examination, in the identification of injury, a sample was subjected to biopsy for diagnosis. In the period of 22 months they assisted 5122 individuals of both genders; 1830 in the period from February to December 2014, and 3292 from January to December 2015, resulting in 328 biopsies whose pathology was positive for malignancy in 51 cases. Screening for oral cancer is important to raise awareness of the high-risk population and early diagnosis where the greatest chance of cure exists.
CPP343 - ORAL CARE AND SURVIVAL OF THE ONCOLOGY PATIENT. ELAINE CATARINA DE CAMARGO, ALICE ZELMANOWICZ. The oral health of cancer patients may compromise their survival. Ideally, oral evaluation should be conducted 1 month before cancer treatment to allow adequate time for recovery from invasive dental procedures. In this clinical case, dental infections were diagnosed in a hospitalized patient and the dentist had determined immediate chemical control of plaque, panoramic radiograph, and scheduling the surgery room. The medical team prepared medically and 2 dental surgeons performed the procedures (extractions, scaling, filling, adaptation of temporary denture of the upper arch and molding to denture adhesive), with local anesthesia and portable dental office. The laser therapy and cementation were performed with the patient at the infirmary and the case was completed in 72 hours. The patient was clinically and emotionally ready to receive the therapy outlined by the oncologist. It was concluded that specialized surgeon dentists in the multidisciplinary team, with the appropriate equipment, ensures resolution and prevention of oral complications.
CPP344 - SIMPLE BONE CYST: FOLLOWUP OR PRESERVATION?. HELITON GUSTAVO DE LIMA, CAMILA LOPES CARDOSO, RAFAEL ZETEHAKU ARAUJO, ANTHONY BENITES CONDEZO, CLÁUDIA CURRA, CARLOS CESAR DEANTONI, MARCOS MARTINS CURI. Simple bone cyst (SBC) is an intraosseous pseudocyst that primarily affects the mandible and is usually seen during routine radiographic examination. A 10-year-old female patient presented an asymptomatic multilocular radiolucent area in the anterior and left jaw, discovered in panoramic radiographs. CBCT showed extensive hypodense area in the affected region. Axial reconstruction showed moderate expansion of cortical. The diagnostic hypotheses were keratocystic odontogenic tumor and SBC. Facing the exuberance of the lesion and anxiety of parents, a surgical exploration of the area was planned to establish the final diagnosis. During surgery, an empty cavity was found, confirming SCB. After 3 years, the lesion was fully
ABSTRACTS Abstracts e121 repaired, corroborating with the literature regarding the treatment of SBC. In conclusion, this case illustrates an atypical SBC, by their great length and moderate bone expansion, and discusses the clinical decision for surgical exploration or to follow this condition.
RP - RESEARCH POSTERS RP1 - THE ROLE OF KI-67, P16, CD34, BCL-2, AND CYCLOOXYGENASE-2 IN THE PATHOGENESIS OF PROLIFERATIVE VERRUCOUS LEUKOPLAKIA. RAGHU RADHAKRISHNAN. Background: Proliferative verrucous leukoplakia (PVL) is a highly persistent and aggressive oral pre-malignant lesion with an obscure etiopathogenesis and a malignant transformation rate of 70%e85%. Objective: It was assessed the role of Ki-67, p16, CD34, Bcl-2, cyclooxygenase-2 (COX-2) in the spectrum of PVL to ascertain their role in its etiopathogenesis. Study Design: A retrospective chart analysis on 7 confirmed cases of PVL, which were followed-up for 2 years, was immunohistochemically appraised using a panel related to cell proliferation, cell cycle regulation, angiogenesis, apoptosis and inflammation. The expression of these markers was correlated with patients’ clinicopathologic profile and analyzed. Results: The latest labeling index of Ki-67 in these cases ranged from 8.18 to 12.6; p16 was positive in 3/7 cases and Bcl-2 expression was moderately positive in 2/7 cases. All cases were intensely positive for COX-2 staining. Microvascular density assessed by CD34 ranged from 11 to 20/hpf. One case, which transformed into squamous cell carcinoma, demonstrated increased Ki-67, Bcl-2, COX-2, CD34 expression, but negative p16 and Bcl-2 expression. Conclusions: Application of these markers in PVL patients suggests an imbalance between the proliferation apoptosis dynamics, accompanied by an increase in inflammation and angiogenesis underlie the molecular pathogenesis of PVL.
RP2 - UNIT USING MOUTH CANCER SCREENING MOBILE DENTAL. CARLOS DEYVER DE SOUZA QUEIROZ, LIDIA MARIA REBOLHO BATISTA ARANTES, FABIANA DE LIMA VAZQUEZ, EDMUNDO CARVALHO MAUAD, ANDRÉ LOPES CARVALHO, RICARDO RIBEIRO GAMA, ADHEMAR LONGATTO FILHO. Oral cancer is one of the most serious public health problems, has a higher morbidity/mortality among head and neck cancers. According to INCA 2016, estimates will be 11,140 new cases of oral cavity cancer in men and women. This paper aims to show the importance of screening for oral cancer, through active pursuit of risk population, increasing the level of information on the risk factors and the achievement of an early diagnosis. Individuals of both genders, above 40 years of age, smoking and/or alcohol consumers, were subjected to clinical examination by a dentist. During the examination, in the identification of injury, a sample was subjected to biopsy for diagnosis. In the period of 22 months they assisted 5122 individuals of both genders; 1830 in the period from February to December 2014, and 3292 from January to December 2015, resulting in 328 biopsies whose pathology was positive for malignancy in 51 cases. Screening for oral cancer is important to raise awareness of the high-risk population and early diagnosis where the greatest chance of cure exists.