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GIANT EPIGNATHUS TERATOMA: A CASE REPORT
OOOO Volume 124, Number 2 lesion in each case was performed, being diagnosed as JSGH. In both cases, the lesions had recurrence. Hence, cryotherapy sessions in all lesions over 8 weeks were performed. After 3-month follow-up, meaningful lesional regression and restoration of gingival texture were observed. In conclusion, cryotherapy appears to be successful in JSGH, with good tolerance by pediatric patients.
OP21 - GINGIVAL LEUKEMIC INFILTRATION AS THE FIRST MANIFESTATION OF ACUTE MYELOID LEUKEMIA. KARIN SÁ FERNANDES, MARINA GALLOTTINI, YARA ANDREA PIRES AFONSO REINA, TALITA CASTRO, MAURICIO FLAMINIO AMATO, PAULO HENRIQUE BRAZ DA SILVA. The leukemic infiltration of the gingival tissue associated or not with gingival enlargement could be the first manifestation of acute leukemia, and it has rarely been reported in the literature. A 10-year-old female patient presented with a 1-month history of an asymptomatic, firm and pinkish red generalized gingival overgrowth. The panoramic x-ray of the jaw was performed and showed no evidence of periodontal resorption. The incisional biopsy of the gingival tissue was performed, and histopathologic exam revealed a mucosa fragment in which the connective tissue showed a diffuse and hypercellular infiltrate of monocytoid cells. The patient was referred to a hematologist and underwent a bone marrow biopsy that was conclusive for acute myeloid leukemia diagnosis. The patient was treated with chemotherapy and after 4 weeks there was a great improvement of gingival aspect.
OP22 - ORAL LESIONS IN PATIENT WITH LEPROMATOUS LEPROSY AND LUCIO’S PHENOMENON. GIOVANI ANTONIO RODRIGUES, NAIARA PRISCILA QUALIO, FERNANDA ANDRÉ MARTINS CRUZ PERECIN, JOÃO CARLOS LOPES SIMÃO, LARA MARIA ALENCAR RAMOS INNOCENTINI, MARCO ANDREY CIPRIANI FRADE, ANA CAROLINA FRAGOSO MOTTA. Lucio’s phenomenon is a variant of erythema nodosum leprosum characterized by serious cutaneous necrotizing reaction. Herein we report on a 46-year-old male patient complaining of multiple purpuric skin lesions and fever for 3 days. Medical history revealed previous clinical diagnosis of lepromatous leprosy (LL) and Lucio’s phenomenon. Dermatologic examination showed nodular infiltration of face, madarosis, erythematous macules, and necrotic ulcerations on the upper and lower limbs. Oral examination revealed multiple ulcers on the upper lip and tongue. Skin biopsy showed necrotizing vasculitis, and tongue biopsy revealed hyperplastic epithelium with submucosa infiltrated by many foamy macrophages with intact bacilli and globi. Mycobacterium leprae DNA was identified by PCR. Final diagnosis was LL and Lucio’s phenomenon, and the patient started multidrug therapy for LL, prednisone and thalidomide for the Lucio’s phenomenon. This case demonstrates that LL and Lucio’s phenomenon can affect the oral cavity, underscoring the importance of evaluating oral mucosa for the diagnosis.
OP23 - A MISINTERPRETATION OF THE PROGRESSION TIME OF A TONGUE LESION. CARLA RENATA SANOMIYA IKUTA, PAULO SÉRGIO DA SILVA SANTOS, RENATO YASUTAKA DE FARIA YAEDU, CLEVERSON TEIXEIRA SOARES, JOSÉ HUMBERTO DAMANTE.
ABSTRACTS Abstracts e51 A14-year-old female patient complained of a tongue lesion of 4 days of evolution. The lesion was realized the day after a hysteric episode during a musical concert. On clinical examination there was an asymptomatic swelling in the left side of “V” region of the dorsum. A lightly erythematous mucosa recovered the lesion that was resilient and rounded, 3-cm in diameter. The patient’s general health was perfect and the presumptive diagnosis was traumatic inflammation. After 4 days’ follow-up the lesion did not change despite 21 mg/day of prednisone. An ultrasonography examination showed a hypoechoic tumor of high vascularization. The patient was then submitted to a fine needle aspiration biopsy and the diagnosis was a “well differentiated mesenchymal neoplasm.” An incisional biopsy was performed and morphologic diagnosis was “alveolar soft part sarcoma.” Immunohistochemical examination confirmed this final diagnosis. A surgical resection was performed and the patient is under chemotherapy.
OP24 - GIANT EPIGNATHUS TERATOMA: A CASE REPORT. AMANDA KATARINNY GOES GONZAGA, CYNTIA HELENA PEREIRA DE CARVALHO, CASSIANO FRANCISCO WEEGE NONAKA, CASSANDRA TEIXEIRA VALLE ELIAS, RITA DE CASSIA SIMÕES MATHEUS, LÉLIA BATISTA DE SOUZA, LEÃO PEREIRA PINTO. Teratomas are tumors composed of tissues derived from the 3 germ cell layers, and they are relatively uncommon in the head and neck. The term epignathus has been applied to teratomas arising from the oropharynx. A newborn male patient presented with a polypoid tumor mass exteriorizing through the mouth over a length of 9 cm. Computed tomography showed that the mass arose deep in the left hemiface. Alpha-fetoprotein (AFP) levels were elevated to 31,600.00 ng/ml. Surgery was performed and microscopic analysis confirmed the diagnosis of mature teratoma. Because of residual tumor and high AFP levels, the patient was submitted to chemotherapy, resulting in complete lesion regression and normalization of AFP levels. Surgical repair of a cleft palate was performed at 5 years of age. At 7 years of age, the patient was in good general health and showed no clinical signs of recurrence.
OP25 - ORAL LESION COMPATIBLE WITH HPV WITH POSTERIOR SQUAMOUS CELL CARCINOMA. JOSE FERREIRA MENEZES FILHO, VIVIANE SILVA SIQUEIRA, ANELISE RIBEIRO PEIXOTO ALENCAR, FABRÍCIO PASSADOR SANTOS, ANDRESA BORGES SOARES, RUFINO KLUG. HPV has been described in the pathogenesis of benign warty lesions and their participation in the development of oral carcinoma is seldom reported. A 34-year-old male patient, married, was complaining of 2 wounds on the palate without symptoms, with a 4 months history of evolution. Clinical examination revealed 2 round and verrucous lesions, not bleeding and asymptomatic, measuring the smallest 0.5 1.0 cm and the largest 1.51.5 cm, located in the soft palate and hard palate, respectively. Incisional biopsies were performed and histologic examination revealed a squamous cell papilloma for the smallest lesion and squamous cell carcinoma for the biggest. The patient continues for 2 years without seeking treatment and lesions evolved into a single verrucous plaque. At present, vegetating lesions were seen in the right nasal cavity. The patient was referred to the oncology center for evaluation and establishment of therapeutic approaches but again abandoned treatment.
OP21 - GINGIVAL LEUKEMIC INFILTRATION AS THE FIRST MANIFESTATION OF ACUTE MYELOID LEUKEMIA. KARIN SÁ FERNANDES, MARINA GALLOTTINI, YARA ANDREA PIRES AFONSO REINA, TALITA CASTRO, MAURICIO FLAMINIO AMATO, PAULO HENRIQUE BRAZ DA SILVA. The leukemic infiltration of the gingival tissue associated or not with gingival enlargement could be the first manifestation of acute leukemia, and it has rarely been reported in the literature. A 10-year-old female patient presented with a 1-month history of an asymptomatic, firm and pinkish red generalized gingival overgrowth. The panoramic x-ray of the jaw was performed and showed no evidence of periodontal resorption. The incisional biopsy of the gingival tissue was performed, and histopathologic exam revealed a mucosa fragment in which the connective tissue showed a diffuse and hypercellular infiltrate of monocytoid cells. The patient was referred to a hematologist and underwent a bone marrow biopsy that was conclusive for acute myeloid leukemia diagnosis. The patient was treated with chemotherapy and after 4 weeks there was a great improvement of gingival aspect.
OP22 - ORAL LESIONS IN PATIENT WITH LEPROMATOUS LEPROSY AND LUCIO’S PHENOMENON. GIOVANI ANTONIO RODRIGUES, NAIARA PRISCILA QUALIO, FERNANDA ANDRÉ MARTINS CRUZ PERECIN, JOÃO CARLOS LOPES SIMÃO, LARA MARIA ALENCAR RAMOS INNOCENTINI, MARCO ANDREY CIPRIANI FRADE, ANA CAROLINA FRAGOSO MOTTA. Lucio’s phenomenon is a variant of erythema nodosum leprosum characterized by serious cutaneous necrotizing reaction. Herein we report on a 46-year-old male patient complaining of multiple purpuric skin lesions and fever for 3 days. Medical history revealed previous clinical diagnosis of lepromatous leprosy (LL) and Lucio’s phenomenon. Dermatologic examination showed nodular infiltration of face, madarosis, erythematous macules, and necrotic ulcerations on the upper and lower limbs. Oral examination revealed multiple ulcers on the upper lip and tongue. Skin biopsy showed necrotizing vasculitis, and tongue biopsy revealed hyperplastic epithelium with submucosa infiltrated by many foamy macrophages with intact bacilli and globi. Mycobacterium leprae DNA was identified by PCR. Final diagnosis was LL and Lucio’s phenomenon, and the patient started multidrug therapy for LL, prednisone and thalidomide for the Lucio’s phenomenon. This case demonstrates that LL and Lucio’s phenomenon can affect the oral cavity, underscoring the importance of evaluating oral mucosa for the diagnosis.
OP23 - A MISINTERPRETATION OF THE PROGRESSION TIME OF A TONGUE LESION. CARLA RENATA SANOMIYA IKUTA, PAULO SÉRGIO DA SILVA SANTOS, RENATO YASUTAKA DE FARIA YAEDU, CLEVERSON TEIXEIRA SOARES, JOSÉ HUMBERTO DAMANTE.
ABSTRACTS Abstracts e51 A14-year-old female patient complained of a tongue lesion of 4 days of evolution. The lesion was realized the day after a hysteric episode during a musical concert. On clinical examination there was an asymptomatic swelling in the left side of “V” region of the dorsum. A lightly erythematous mucosa recovered the lesion that was resilient and rounded, 3-cm in diameter. The patient’s general health was perfect and the presumptive diagnosis was traumatic inflammation. After 4 days’ follow-up the lesion did not change despite 21 mg/day of prednisone. An ultrasonography examination showed a hypoechoic tumor of high vascularization. The patient was then submitted to a fine needle aspiration biopsy and the diagnosis was a “well differentiated mesenchymal neoplasm.” An incisional biopsy was performed and morphologic diagnosis was “alveolar soft part sarcoma.” Immunohistochemical examination confirmed this final diagnosis. A surgical resection was performed and the patient is under chemotherapy.
OP24 - GIANT EPIGNATHUS TERATOMA: A CASE REPORT. AMANDA KATARINNY GOES GONZAGA, CYNTIA HELENA PEREIRA DE CARVALHO, CASSIANO FRANCISCO WEEGE NONAKA, CASSANDRA TEIXEIRA VALLE ELIAS, RITA DE CASSIA SIMÕES MATHEUS, LÉLIA BATISTA DE SOUZA, LEÃO PEREIRA PINTO. Teratomas are tumors composed of tissues derived from the 3 germ cell layers, and they are relatively uncommon in the head and neck. The term epignathus has been applied to teratomas arising from the oropharynx. A newborn male patient presented with a polypoid tumor mass exteriorizing through the mouth over a length of 9 cm. Computed tomography showed that the mass arose deep in the left hemiface. Alpha-fetoprotein (AFP) levels were elevated to 31,600.00 ng/ml. Surgery was performed and microscopic analysis confirmed the diagnosis of mature teratoma. Because of residual tumor and high AFP levels, the patient was submitted to chemotherapy, resulting in complete lesion regression and normalization of AFP levels. Surgical repair of a cleft palate was performed at 5 years of age. At 7 years of age, the patient was in good general health and showed no clinical signs of recurrence.
OP25 - ORAL LESION COMPATIBLE WITH HPV WITH POSTERIOR SQUAMOUS CELL CARCINOMA. JOSE FERREIRA MENEZES FILHO, VIVIANE SILVA SIQUEIRA, ANELISE RIBEIRO PEIXOTO ALENCAR, FABRÍCIO PASSADOR SANTOS, ANDRESA BORGES SOARES, RUFINO KLUG. HPV has been described in the pathogenesis of benign warty lesions and their participation in the development of oral carcinoma is seldom reported. A 34-year-old male patient, married, was complaining of 2 wounds on the palate without symptoms, with a 4 months history of evolution. Clinical examination revealed 2 round and verrucous lesions, not bleeding and asymptomatic, measuring the smallest 0.5 1.0 cm and the largest 1.51.5 cm, located in the soft palate and hard palate, respectively. Incisional biopsies were performed and histologic examination revealed a squamous cell papilloma for the smallest lesion and squamous cell carcinoma for the biggest. The patient continues for 2 years without seeking treatment and lesions evolved into a single verrucous plaque. At present, vegetating lesions were seen in the right nasal cavity. The patient was referred to the oncology center for evaluation and establishment of therapeutic approaches but again abandoned treatment.