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Erosive Lichen Planus: Malignant Potential And Case Report
OOOO Volume 117, Number 2 connective tissue composed of scattered strands of irregular, amphophilic fibers of variable size, thickness, and shape. Histochemical analysis confirmed the presence of elastic fibers admixed with collagenous fibers, consistent with oral elastofibromatous lesion. The patient is being followed-up with no signs of local recurrence.
PE-117 - ENCEPHALOTRIGEMINAL ANGIOMATOSIS: REPORT OF TWO CASES. NATHALIA DE ALMEIDA FREIRE, FLÁVIA SOUZA PEREIRA DE JESUS ALMEIDA, THAÍS PIMENTEL, SARAH APARECIDA ANTERO, MARCELO FIGUEREIDO, ROSEMIRO DE MENEZES MACIEL, MÔNICA ISRAEL. UERJ. Encephalotrigeminal angiomatosis, also known as SturgeWeber syndrome, is a congenital neurocutaneous disorder characterized by vascular malformation associated with leptomeningeal angiomas overlaid on ipsilateral cerebral cortex. Clinically there is a unilateral port-wine stain distributed over the trigeminal nerve. This study presents two case reports, both involving female patients, whose hemifacial hemangioma was diagnosed as a non-hereditary developmental condition. The purpose is detail clinicopathological features and discuss appropriate therapy.
PE-118 - EPITHELIAL ISLANDS ASSOCIATED WITH MANDIBULAR NERVES IN THE SURGICAL SPECIMEN. FERNANDA DOS SANTOS MOREIRA, LUCIANA YAMAMOTO DE ALMEIDA, ALEXANDRE ELIAS TRIVELLATO, CASSIO EDVARD SVERZUT, JORGE ESQUICHE LEÓN. FACULDADE DE ODONTOLOGIA DE PIRACICABA-UNICAMP; FACULDADE DE ODONTOLOGIA DE RIBEIRÃO PRETO-FORP/USP. Perineural involvement by epithelial tissue is usually observed in malignant neoplasms, especially carcinomas. However, it can also be seen in benign neoplasms such as melanocytic nevi, capillary hemangiomas, and granular cell tumors. Intraosseous odontogenic epithelial rests of Malassez, dental lamina, and remnants of nasopalatine ductal epithelium have been found intraneurally. These may be misinterpreted as neural invasion by neoplastic epithelial cells if the cytologic details are not carefully considered. Man, 33, was diagnosed with ameloblastoma affecting the body of the mandible. Microscopic examination of the medial surgical margin showed epithelial rests adjacent to and within the nerve bundles. The histomorphologic examination of the epithelial nests was entirely consistent with odontogenic rests, excluding the possibility of compromised surgical margin by ameloblastoma. This benign occurrence may be misinterpreted microscopically as neural invasion by an odontogenic or malignant neoplasm.
PE-119 - EPITHELIOID HEMANGIOMA LOCATED IN THE BUCCAL MUCOSA: CASE REPORT. MANUELA TORRES ANDION VIDAL, CLARISSA ARAÚJO GURGEL, ÁGUIDA CRISTINA GOMES HENRIQUES LEITÃO, EDUARDO ARAÚJO GONÇALVES RAMOS, FLÁVIA CALÓ DE AQUINO XAVIER, LUCIANA MARIA PEDREIRA RAMALHO, JEAN NUNES DOS SANTOS. FACULDADE DE ODONTOLOGIA DA UNIVERSIDADE FEDERAL DA BAHIA. Epithelioid hemangioma (EH) is an uncommon vasoproliferative benign neoplasm that usually occurs in middle-aged adults as multiple red nodules. Man, 52, presented a nodular lesion measuring 3 cm in the left buccal mucosa that had
ABSTRACTS Abstracts e155 developed over the course of 1 year. The clinical hypothesis was lipoma. A specimen obtained through excisional biopsy showed a circumscribed lesion composed of lobules of vessels with or without perceptible or poor lumina associated with a prominent inflammatory infiltrate consisting of eosinophils, histiocytes, and chronic inflammatory cells. The endothelial cells that compose the lesion showed epithelioid morphology, with abundant eosinophilic cytoplasm. Immunohistochemical reactions were tested for CD34, factor VIII, laminin, actin, and mast cells along with histochemical staining for Weigert van Gieson factor. Vascular proliferations of soft tissues are a diverse and morphologically complex group of lesions that can cause diagnostic difficulty. This study reports an oral EH, highlighting relevant immunohistochemical features that could help distinguish EH from other neoplasms.
PE-120 - EROSIVE LICHEN PLANUS: MALIGNANT POTENTIAL AND CASE REPORT. KAROLINE DE SOUZA CHINASSO TULIO, ANA PAULA RIBEIRO BRAOSI. UNIVERSIDADE POSITIVO. Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous disease of unknown etiology, whose onset and progression are influenced by many factors. Its current clinical classification comprises reticular and atrophic-erosive forms with erythematous, ulcerated, and painful areas. This study presents a clinical case of erosive OLP that illustrates its malignant potential. Man, 37, was referred to the Stomatology Center in Universidade Positivo complaining of pain and burning in the mouth. On examination, reticular and erythematous ulcerative areas were seen in the oral mucosa and gingiva. After incisional biopsy, histopathological analysis confirmed the clinical impression. Simultaneously, the dermatologist requested serological tests aiming to detect other autoimmune diseases. The lesion and pain regressed after a week of using topical/systemic corticosteroids. However, due to erosive etiology, follow-up is essential. Stomatodermatological lesions with autoimmune characteristics require rapid diagnosis and a multidisciplinary treatment approach to control the disease and symptoms.
PE-121 - EROSIVE ORAL LICHEN PLANUS: DIAGNOSIS AND TREATMENT: CASE REPORT. THAÍSE GOMES E NÓBREGA, VIVIANE PALMEIRA DA SILVA, ARTUR CUNHA VASCONCELOS, FERNANDA VISIOLI, LAURA CAMPOS HILDEBRAND, MANOEL SANT’ANA FILHO, MÁRCIA GAIGER DE OLIVEIRA. UFRGS - UNIVERSIDADE FEDERAL DO RIO GRANDE DO SUL. Oral lichen planus is an autoimmune disease of unknown etiology and varying clinical manifestations. Erosive lichen planus (ELP) is more painful and debilitating than the nonerosive types and is characterized by multifocal white lines with erosive or ulcerated areas. This clinical manifestation is rarer than other types and causes diagnostic difficulty. In addition, ELP requires topical or systemic treatment for healing and pain control. Woman, 43, complained of oral lesions that compromised food intake and phonetic function. Oral examination revealed extensive, painful ulcers with reticular keratotic components in different areas of the oral mucosa. The patient had previously been diagnosed with chronic inflammation caused by dental prosthesis trauma. Incisional biopsy allowed a definitive diagnosis of ELP and proper treatment following a topical corticosteroid protocol. After 2 months, the ulcers were healed. This case report discusses better management
PE-117 - ENCEPHALOTRIGEMINAL ANGIOMATOSIS: REPORT OF TWO CASES. NATHALIA DE ALMEIDA FREIRE, FLÁVIA SOUZA PEREIRA DE JESUS ALMEIDA, THAÍS PIMENTEL, SARAH APARECIDA ANTERO, MARCELO FIGUEREIDO, ROSEMIRO DE MENEZES MACIEL, MÔNICA ISRAEL. UERJ. Encephalotrigeminal angiomatosis, also known as SturgeWeber syndrome, is a congenital neurocutaneous disorder characterized by vascular malformation associated with leptomeningeal angiomas overlaid on ipsilateral cerebral cortex. Clinically there is a unilateral port-wine stain distributed over the trigeminal nerve. This study presents two case reports, both involving female patients, whose hemifacial hemangioma was diagnosed as a non-hereditary developmental condition. The purpose is detail clinicopathological features and discuss appropriate therapy.
PE-118 - EPITHELIAL ISLANDS ASSOCIATED WITH MANDIBULAR NERVES IN THE SURGICAL SPECIMEN. FERNANDA DOS SANTOS MOREIRA, LUCIANA YAMAMOTO DE ALMEIDA, ALEXANDRE ELIAS TRIVELLATO, CASSIO EDVARD SVERZUT, JORGE ESQUICHE LEÓN. FACULDADE DE ODONTOLOGIA DE PIRACICABA-UNICAMP; FACULDADE DE ODONTOLOGIA DE RIBEIRÃO PRETO-FORP/USP. Perineural involvement by epithelial tissue is usually observed in malignant neoplasms, especially carcinomas. However, it can also be seen in benign neoplasms such as melanocytic nevi, capillary hemangiomas, and granular cell tumors. Intraosseous odontogenic epithelial rests of Malassez, dental lamina, and remnants of nasopalatine ductal epithelium have been found intraneurally. These may be misinterpreted as neural invasion by neoplastic epithelial cells if the cytologic details are not carefully considered. Man, 33, was diagnosed with ameloblastoma affecting the body of the mandible. Microscopic examination of the medial surgical margin showed epithelial rests adjacent to and within the nerve bundles. The histomorphologic examination of the epithelial nests was entirely consistent with odontogenic rests, excluding the possibility of compromised surgical margin by ameloblastoma. This benign occurrence may be misinterpreted microscopically as neural invasion by an odontogenic or malignant neoplasm.
PE-119 - EPITHELIOID HEMANGIOMA LOCATED IN THE BUCCAL MUCOSA: CASE REPORT. MANUELA TORRES ANDION VIDAL, CLARISSA ARAÚJO GURGEL, ÁGUIDA CRISTINA GOMES HENRIQUES LEITÃO, EDUARDO ARAÚJO GONÇALVES RAMOS, FLÁVIA CALÓ DE AQUINO XAVIER, LUCIANA MARIA PEDREIRA RAMALHO, JEAN NUNES DOS SANTOS. FACULDADE DE ODONTOLOGIA DA UNIVERSIDADE FEDERAL DA BAHIA. Epithelioid hemangioma (EH) is an uncommon vasoproliferative benign neoplasm that usually occurs in middle-aged adults as multiple red nodules. Man, 52, presented a nodular lesion measuring 3 cm in the left buccal mucosa that had
ABSTRACTS Abstracts e155 developed over the course of 1 year. The clinical hypothesis was lipoma. A specimen obtained through excisional biopsy showed a circumscribed lesion composed of lobules of vessels with or without perceptible or poor lumina associated with a prominent inflammatory infiltrate consisting of eosinophils, histiocytes, and chronic inflammatory cells. The endothelial cells that compose the lesion showed epithelioid morphology, with abundant eosinophilic cytoplasm. Immunohistochemical reactions were tested for CD34, factor VIII, laminin, actin, and mast cells along with histochemical staining for Weigert van Gieson factor. Vascular proliferations of soft tissues are a diverse and morphologically complex group of lesions that can cause diagnostic difficulty. This study reports an oral EH, highlighting relevant immunohistochemical features that could help distinguish EH from other neoplasms.
PE-120 - EROSIVE LICHEN PLANUS: MALIGNANT POTENTIAL AND CASE REPORT. KAROLINE DE SOUZA CHINASSO TULIO, ANA PAULA RIBEIRO BRAOSI. UNIVERSIDADE POSITIVO. Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous disease of unknown etiology, whose onset and progression are influenced by many factors. Its current clinical classification comprises reticular and atrophic-erosive forms with erythematous, ulcerated, and painful areas. This study presents a clinical case of erosive OLP that illustrates its malignant potential. Man, 37, was referred to the Stomatology Center in Universidade Positivo complaining of pain and burning in the mouth. On examination, reticular and erythematous ulcerative areas were seen in the oral mucosa and gingiva. After incisional biopsy, histopathological analysis confirmed the clinical impression. Simultaneously, the dermatologist requested serological tests aiming to detect other autoimmune diseases. The lesion and pain regressed after a week of using topical/systemic corticosteroids. However, due to erosive etiology, follow-up is essential. Stomatodermatological lesions with autoimmune characteristics require rapid diagnosis and a multidisciplinary treatment approach to control the disease and symptoms.
PE-121 - EROSIVE ORAL LICHEN PLANUS: DIAGNOSIS AND TREATMENT: CASE REPORT. THAÍSE GOMES E NÓBREGA, VIVIANE PALMEIRA DA SILVA, ARTUR CUNHA VASCONCELOS, FERNANDA VISIOLI, LAURA CAMPOS HILDEBRAND, MANOEL SANT’ANA FILHO, MÁRCIA GAIGER DE OLIVEIRA. UFRGS - UNIVERSIDADE FEDERAL DO RIO GRANDE DO SUL. Oral lichen planus is an autoimmune disease of unknown etiology and varying clinical manifestations. Erosive lichen planus (ELP) is more painful and debilitating than the nonerosive types and is characterized by multifocal white lines with erosive or ulcerated areas. This clinical manifestation is rarer than other types and causes diagnostic difficulty. In addition, ELP requires topical or systemic treatment for healing and pain control. Woman, 43, complained of oral lesions that compromised food intake and phonetic function. Oral examination revealed extensive, painful ulcers with reticular keratotic components in different areas of the oral mucosa. The patient had previously been diagnosed with chronic inflammation caused by dental prosthesis trauma. Incisional biopsy allowed a definitive diagnosis of ELP and proper treatment following a topical corticosteroid protocol. After 2 months, the ulcers were healed. This case report discusses better management