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GRANULAR CELL TUMOR MIMICKING AN EOSINOPHILIC ULCER ON THE TONGUE
ABSTRACTS
e84
diagnosis when assessing malignant neoplasms affecting the maxilla. FAPESP (2016/11419-0 and 2017/02502-4).
ORAL METASTASIS OF GASTROINTESTINAL NEUROENDOCRINE TUMOR. CAIO ALMEIDA MOREIRA LOPES, SILVIA PAULA DE OLIVEIRA, NATHALIE HENRIQUES SILVA CANEDO, SANDRA REGINA TORRES, MICHELLE AGOSTINI, BRUNO AUGUSTO BENEVENUTO DE ANDRADE and, e MARIO JOSE ROMANACH Gastrointestinal neuroendocrine tumors (GI-NETs) are neoplasms derived from neuroendocrine cells interspersed within the gastrointestinal system. A 44-year-old woman under treatment for GI-NET was referred for evaluation of a 4 £ 3 cm reddish lobulated mass located in the lower posterior gingiva, which extended to the retromolar and buccal mucosae. A destructive and expansive lytic lesion in the left mandibular body was revealed by panoramic radiography and computerized tomography. Incisional biopsy was performed, and microscopic features included proliferation of neuroendocrine tumor cells with large amphophilic cytoplasm, round nuclei containing salt-and-pepper chromatin, and scant atypia, arranged in ribbons and trabeculae, some of which formed glandular spaces containing fresh hemorrhage in a sparse and edematous stroma. Tumor cells were positive for CK20 and chromogranin and negative for CK7. Ki-67 labeling index was 70%. The patient died 4 months later. Metastatic GI-NETs to the oral cavity are rare.
CHRONIC SUPPURATIVE OSTEOMYELITIS IN A PATIENT WITH AUTISM SPECTRUM DISORDER: CHALLENGES IN CLINICAL MANAGEMENT. PAULO VICTOR MENDES PENAFORT, ALESSANDRA VALLE SALINO, LIONEY NOBRE CABRAL and, TIAGO NOVAES PINHEIRO The present study reports the challenges faced during the diagnosis and treatment of chronic suppurative osteomyelitis in a patient with autism spectrum disorder (ASD). A 23-year-old woman intern in a special care institution attended the special care dental clinic of the authors with an unusual periodontal lesion involving tooth 47. Tooth extraction was performed with curettage of the surrounding structures for histopathologic examination. Microscopic examination diagnosed an aggressive juvenile periodontitis leading to suppurative osteomyelitis. Based on the pathologic report, a tomographic examination was performed and revealed the extension of the bone destruction as well as bone sequestrum. The patient was referred for surgical approach under general anesthesia to remove all necrotic and infected bone. After 1 year of the diagnosis the patient still under treatment without complete resolution of the lesion.
ORAL MELANOACANTHOMA ASSOCIATED WITH PSEUDOMELANOCYTIC NESTS: AN IMMUNOHISTOCHEMICAL STUDY. LUCAS RIBEIRO TEIXEIRA, JESSICA LUANA DOS SANTOS, RANDER MOREIRA MACEDO, ALFREDO RIBEIROSILVA, LUCIANA YAMAMOTO ALMEIDA, SILVIA ELENA YACARINI PAREDES and, JORGE ESQUICHE LEON Oral melanoacanthoma is an uncommon pigmented lesion of the oral mucosa characterized by the presence of acanthosis and
OOOO January 2020 dendritic pigment-laden melanocytes located in the prickle cell layer of the epithelium. Pseudomelanocytic nests (PNs) represent cellular aggregates of keratinocytes, macrophages, and melanocytes, usually located in close relationship with lichenoid inflammation, which if not recognized can be misdiagnosed as melanoma. A 41-year-old white woman was referred presenting a pigmented gingival lesion located between the left maxillary central and lateral incisors with 1 year of evolution. After excisional biopsy, microscopy showed typical melanoacanthoma associated with PNs. PNs and dendritic melanocytes were evidenced by Fontana-Masson stain. Immunohistochemistry revealed positivity for AE1/AE3, CD68, and CD163 in PNs, while HMB-45 and Melan-A highlighted dendritic melanocytes. SOX-10 positivity was observed in few melanocytes in basal location. To our knowledge, this is the first report of oral melanoacanthoma associated with PNs. FAPESP (2016/11419-0 and 2017/02502-4).
ORAL NEUROFIBROMA IN FEMALE TEENAGER: CLINICAL, HISTOLOGIC, AND IMMUNOHISTOCHEMICAL ASPECTS. THIAGO MACEDO MARQUES, LIVIA BINO MARQUES, ADRIANA TEREZINHA NEVES NOVELLINO ALVES, SIMONE DE QUEIROZ CHAVES LOURENCO, ¸ LUCIANA WERNERSBACH PINTO, ANA FLAVIA SCHUELER DE e LEITE and, JOSIANE COSTA RODRIGUES ASSUMPC ¸ AO DE SA A 19-year-old white woman was referred to the community health center with asymptomatic "tumor tongue" related. Anamnesis revealed that the patients mother had undiagnosed congenital disease with multiple facial nodules. On general examination, cafe au lait macules on the neck and abdomen and a soft nodule in right forearm were observed. Intraoral examination revealed sessile nodular swelling in the dorsal surface of the tongue, involving middle and posterior thirds, with defined limits and purplish color, which was fibrous to palpation, about 6 cm in its largest diameter, and asymptomatic with evolution of approximately 3 years. Diagnostic hypothesis was neurofibroma related to neurofibromatosis. Incisional biopsy was performed on the tongue lesion. The histopathologic report and immunohistochemical study were conclusive for neurofibroma. Clinical and laboratory findings are suggestive of neurofibromatosis. Medical evaluation should be performed to confirm and define the type of neurofibromatosis. Neurofibromatosis is a frequent genetic condition with relevant oral manifestations in dental care.
GRANULAR CELL TUMOR MIMICKING AN EOSINOPHILIC ULCER ON THE TONGUE. LORENA PASSONI VERVLOET, MARCIO AJUDARTE LOPES, PABLO AGUSTIN VARGAS, GLEYSON KLEBER DO AMARAL-SILVA, DIEGO TETZNER FERNANDES, ALAN ROGER SANTOS-SILVA and, PATRICIA MARIA FERNANDES Granular cell tumor (GCT) is an uncommon benign neoplasia of soft tissue that possibly arises from neural cells, especially Schwann cells. In the oral cavity, the most frequent site is the tongue. Usually, the clinical appearance is a solitary submucosal nodule, painless and nonulcerated, located in the dorsum of the tongue. Women have twice more predilection than men, and mean age ranges from fourth to sixth decades. This case report
OOOO Volume 129, Number 1 consists in a 56-year-old man referred for evaluation of a 6month evolution of an ulcerated lesion in the right lateral border of tongue. Clinically, a discoid ulceration with elevated erythematous center and whiteness halo was observed. The clinical hypothesis was an eosinophilic ulcer. After excisional biopsy and histologic processes, a predominant group of eosinophilic cells with granular cytoplasm raised from connective tissue to ulcerated surface could be visualized. S100 immunohistochemical reaction was made, and a strong staining of these cells confirmed the final diagnosis of GCT.
NEUROFIBROMATOSIS TYPE I (VON RECKLINGHAUSEN DISEASE OF THE SKIN): CASE REPORT. PRISCILA THAIS RODRIGUES DE ^ ABREU, SICILIA REZENDE OLIVEIRA, LENI VERONICA DE OLIVEIRA SILVA, ALINE FERNANDA CRUZ, RICARDO ALVES DE MESQUITA, TARCILIA APARECIDA DA SILVA and, FELIPE PAIVA FONSECA Patient J.J.G., a 59-year-old man, was referred for evaluation of an oral lesion with more than 20 years of evolution. The patient was related by previous diagnosis of neurofibromatosis. The physical examination was performed by multiple consecutive head and neck segments, showing the hands, arms, and the iris of the left eye with gray opacity, suggesting optic glioma. Intraoral examination revealed pedunculated tumor, softened in consistency with mucosa-like color on the left hard palate, besides minor lesions affecting the tongue and a diffuse lesion on the right hard palate. Aspiration puncture of the lesion was performed on the right palate, which revealed bloody content, and an excision by diode laser of the left palate tumor was performed. Histopathologic analysis revealed a characteristic neurofibroma showing delicate spindle cells and wavy nuclei interspersed with irregular neuritis and interlaced collagen fibers. The patient was referred for dental treatment at Hospital das Clınicas and currently is under follow-up.
PLEOMORPHIC ADENOMA IN THE HARD PALATE WITH 5 YEARS OF EVOLUTION: CASE REPORT. PRISCILA THAIS RODRIGUES DE ABREU, EDUARDO MORATO DE OLIVEIRA, EVANDRO NEVES ABDO, MARIA CASSIA FERREIRA DE AGUIAR, TARCILIA APARECIDA DA SILVA and, FELIPE PAIVA FONSECA Patient C.C.F.S., a 39-year-old woman, went to the pathology and stomatology center for an evaluation of a lesion in the palate with more than 5 years of evolution. The anamnesis and intraoral examination revealed a well-defined tumor, fibrous consistency, and ulcerated surface in the posterior region of the hard palate on the left side. Ulceration resulted from the drainage attempt by the physician who referred it supposing to be an odontogenic lesion. An incisional biopsy was performed. Histopathologic evaluation revealed capsular tissue surrounding the periphery; neoplastic cells arranged in cords and nests, and ductal structures filled by mucoid content interspersed by hyalinized connective tissue. Treatment consisted of surgical excision and use of an acetate plate in the postoperative period because of the risk of bucosinusal communication evidenced by the tomography. The staining of the edges of the surgical specimen showed that they were free of neoplastic cells. The patient has been followed up for 8 months.
ABSTRACTS
e85
LANGERHANS CELL HISTIOCYTOSIS. RUBIA DA ROCHA VIEIRA, KARINE RASERA and, PAULA LUCE BOHRER Langerhans cell histiocytosis (LCH) is a rare condition of uncertain etiology resulting from a clonal proliferation of Langerhans cells, which mainly affects children. In March 2018, parents of a 1-year-old male patient reported a volume increasing on the right side of the child’s jaw. The imaging tests revealed a lytic lesion with aggressive aspect in the mandible. In view of this, it was decided to perform an incisional biopsy of the affected area and subsequent histopathologic examination. The histologic slices showed a diffuse infiltration of large monocyte cell resembling histiocytes, numerous plasma cells, lymphocytes, and eosinophils. It was concluded that it was an undifferentiated malignant neoplasm. To confirm the diagnosis, immunohistochemical examination was required, which was positive for vimentin (V9), Ki67 (20% of cells), S100, and CD-1 a. Morphologic and immunohistochemical findings were consistent with Langerhans cell histiocytosis. After the diagnosis the patient underwent chemotherapy for a minimum of 6 months. Currently, the patient is undergoing treatment and progressing well.
EARLY DIAGNOSIS AND MULTIPLE FACES OF ORAL SQUAMOUS CELL CARCINOMA. BRUNA FERNANDES DO CARMO CARVALHO, VICTOR COSTA, CESAR AUGUSTO CARDOSO, ANA LIA ANBINDER, ESTELA KAMINAGAKURA, JANETE DIAS ALMEIDA and, ANA SUELI RODRIGUES CAVALCANTE This is a case report of an unusual clinical presentation of squamous cell carcinoma (SCC). A 60-year-old man was referred for evaluation of pain in the posterior border of the tongue. The patient reported a previous biopsy in the same region, about 2 years ago, which was diagnosed as lichenoid dysplasia. Intraoral examination revealed a 5-mm reddish nodule of firm consistency and smooth surface with a painful symptomatology in the right side of the posterior border of the tongue. The diagnosis hypotheses were subgemmal neurogenous plaque, neurofibroma, or SCC. The histopathologic examination revealed superficially invasive SCC. The surgical treatment included the radical neck dissection, and lymph node metastases were found in the levels II and IV. The patient started radiotherapy and is under followup. This case emphasizes the importance of early diagnosis since SCC can present different patterns and, despite the small size, have the potential to metastasize.
CONDYLE SALIVARY GLAND DEFECT (STAFNE DEFECT) MIMICKING AN ODONTOGENIC CYST. CAMILA ZORASKI DE FREITAS, PAULA LUCE BOHRER and, RUBIA DA ROCHA VIEIRA Stafne bone defect consists of an asymptomatic, anatomic condition of uncertain origin and rare evolvement, often discovered at random in routine radiographic examinations. It is usually consisted on mandibular salivary gland inclusion as a developmental anomaly represented by a bone concavity usually containing submandibular gland tissue. A 39-year-old woman presented a hypodense lesion in the condyle of the left side of the jaw, discovered randomly. Because of the fact that the lesion mimics a cyst of odontogenic origin, excisional biopsy and later histopathologic
e84
diagnosis when assessing malignant neoplasms affecting the maxilla. FAPESP (2016/11419-0 and 2017/02502-4).
ORAL METASTASIS OF GASTROINTESTINAL NEUROENDOCRINE TUMOR. CAIO ALMEIDA MOREIRA LOPES, SILVIA PAULA DE OLIVEIRA, NATHALIE HENRIQUES SILVA CANEDO, SANDRA REGINA TORRES, MICHELLE AGOSTINI, BRUNO AUGUSTO BENEVENUTO DE ANDRADE and, e MARIO JOSE ROMANACH Gastrointestinal neuroendocrine tumors (GI-NETs) are neoplasms derived from neuroendocrine cells interspersed within the gastrointestinal system. A 44-year-old woman under treatment for GI-NET was referred for evaluation of a 4 £ 3 cm reddish lobulated mass located in the lower posterior gingiva, which extended to the retromolar and buccal mucosae. A destructive and expansive lytic lesion in the left mandibular body was revealed by panoramic radiography and computerized tomography. Incisional biopsy was performed, and microscopic features included proliferation of neuroendocrine tumor cells with large amphophilic cytoplasm, round nuclei containing salt-and-pepper chromatin, and scant atypia, arranged in ribbons and trabeculae, some of which formed glandular spaces containing fresh hemorrhage in a sparse and edematous stroma. Tumor cells were positive for CK20 and chromogranin and negative for CK7. Ki-67 labeling index was 70%. The patient died 4 months later. Metastatic GI-NETs to the oral cavity are rare.
CHRONIC SUPPURATIVE OSTEOMYELITIS IN A PATIENT WITH AUTISM SPECTRUM DISORDER: CHALLENGES IN CLINICAL MANAGEMENT. PAULO VICTOR MENDES PENAFORT, ALESSANDRA VALLE SALINO, LIONEY NOBRE CABRAL and, TIAGO NOVAES PINHEIRO The present study reports the challenges faced during the diagnosis and treatment of chronic suppurative osteomyelitis in a patient with autism spectrum disorder (ASD). A 23-year-old woman intern in a special care institution attended the special care dental clinic of the authors with an unusual periodontal lesion involving tooth 47. Tooth extraction was performed with curettage of the surrounding structures for histopathologic examination. Microscopic examination diagnosed an aggressive juvenile periodontitis leading to suppurative osteomyelitis. Based on the pathologic report, a tomographic examination was performed and revealed the extension of the bone destruction as well as bone sequestrum. The patient was referred for surgical approach under general anesthesia to remove all necrotic and infected bone. After 1 year of the diagnosis the patient still under treatment without complete resolution of the lesion.
ORAL MELANOACANTHOMA ASSOCIATED WITH PSEUDOMELANOCYTIC NESTS: AN IMMUNOHISTOCHEMICAL STUDY. LUCAS RIBEIRO TEIXEIRA, JESSICA LUANA DOS SANTOS, RANDER MOREIRA MACEDO, ALFREDO RIBEIROSILVA, LUCIANA YAMAMOTO ALMEIDA, SILVIA ELENA YACARINI PAREDES and, JORGE ESQUICHE LEON Oral melanoacanthoma is an uncommon pigmented lesion of the oral mucosa characterized by the presence of acanthosis and
OOOO January 2020 dendritic pigment-laden melanocytes located in the prickle cell layer of the epithelium. Pseudomelanocytic nests (PNs) represent cellular aggregates of keratinocytes, macrophages, and melanocytes, usually located in close relationship with lichenoid inflammation, which if not recognized can be misdiagnosed as melanoma. A 41-year-old white woman was referred presenting a pigmented gingival lesion located between the left maxillary central and lateral incisors with 1 year of evolution. After excisional biopsy, microscopy showed typical melanoacanthoma associated with PNs. PNs and dendritic melanocytes were evidenced by Fontana-Masson stain. Immunohistochemistry revealed positivity for AE1/AE3, CD68, and CD163 in PNs, while HMB-45 and Melan-A highlighted dendritic melanocytes. SOX-10 positivity was observed in few melanocytes in basal location. To our knowledge, this is the first report of oral melanoacanthoma associated with PNs. FAPESP (2016/11419-0 and 2017/02502-4).
ORAL NEUROFIBROMA IN FEMALE TEENAGER: CLINICAL, HISTOLOGIC, AND IMMUNOHISTOCHEMICAL ASPECTS. THIAGO MACEDO MARQUES, LIVIA BINO MARQUES, ADRIANA TEREZINHA NEVES NOVELLINO ALVES, SIMONE DE QUEIROZ CHAVES LOURENCO, ¸ LUCIANA WERNERSBACH PINTO, ANA FLAVIA SCHUELER DE e LEITE and, JOSIANE COSTA RODRIGUES ASSUMPC ¸ AO DE SA A 19-year-old white woman was referred to the community health center with asymptomatic "tumor tongue" related. Anamnesis revealed that the patients mother had undiagnosed congenital disease with multiple facial nodules. On general examination, cafe au lait macules on the neck and abdomen and a soft nodule in right forearm were observed. Intraoral examination revealed sessile nodular swelling in the dorsal surface of the tongue, involving middle and posterior thirds, with defined limits and purplish color, which was fibrous to palpation, about 6 cm in its largest diameter, and asymptomatic with evolution of approximately 3 years. Diagnostic hypothesis was neurofibroma related to neurofibromatosis. Incisional biopsy was performed on the tongue lesion. The histopathologic report and immunohistochemical study were conclusive for neurofibroma. Clinical and laboratory findings are suggestive of neurofibromatosis. Medical evaluation should be performed to confirm and define the type of neurofibromatosis. Neurofibromatosis is a frequent genetic condition with relevant oral manifestations in dental care.
GRANULAR CELL TUMOR MIMICKING AN EOSINOPHILIC ULCER ON THE TONGUE. LORENA PASSONI VERVLOET, MARCIO AJUDARTE LOPES, PABLO AGUSTIN VARGAS, GLEYSON KLEBER DO AMARAL-SILVA, DIEGO TETZNER FERNANDES, ALAN ROGER SANTOS-SILVA and, PATRICIA MARIA FERNANDES Granular cell tumor (GCT) is an uncommon benign neoplasia of soft tissue that possibly arises from neural cells, especially Schwann cells. In the oral cavity, the most frequent site is the tongue. Usually, the clinical appearance is a solitary submucosal nodule, painless and nonulcerated, located in the dorsum of the tongue. Women have twice more predilection than men, and mean age ranges from fourth to sixth decades. This case report
OOOO Volume 129, Number 1 consists in a 56-year-old man referred for evaluation of a 6month evolution of an ulcerated lesion in the right lateral border of tongue. Clinically, a discoid ulceration with elevated erythematous center and whiteness halo was observed. The clinical hypothesis was an eosinophilic ulcer. After excisional biopsy and histologic processes, a predominant group of eosinophilic cells with granular cytoplasm raised from connective tissue to ulcerated surface could be visualized. S100 immunohistochemical reaction was made, and a strong staining of these cells confirmed the final diagnosis of GCT.
NEUROFIBROMATOSIS TYPE I (VON RECKLINGHAUSEN DISEASE OF THE SKIN): CASE REPORT. PRISCILA THAIS RODRIGUES DE ^ ABREU, SICILIA REZENDE OLIVEIRA, LENI VERONICA DE OLIVEIRA SILVA, ALINE FERNANDA CRUZ, RICARDO ALVES DE MESQUITA, TARCILIA APARECIDA DA SILVA and, FELIPE PAIVA FONSECA Patient J.J.G., a 59-year-old man, was referred for evaluation of an oral lesion with more than 20 years of evolution. The patient was related by previous diagnosis of neurofibromatosis. The physical examination was performed by multiple consecutive head and neck segments, showing the hands, arms, and the iris of the left eye with gray opacity, suggesting optic glioma. Intraoral examination revealed pedunculated tumor, softened in consistency with mucosa-like color on the left hard palate, besides minor lesions affecting the tongue and a diffuse lesion on the right hard palate. Aspiration puncture of the lesion was performed on the right palate, which revealed bloody content, and an excision by diode laser of the left palate tumor was performed. Histopathologic analysis revealed a characteristic neurofibroma showing delicate spindle cells and wavy nuclei interspersed with irregular neuritis and interlaced collagen fibers. The patient was referred for dental treatment at Hospital das Clınicas and currently is under follow-up.
PLEOMORPHIC ADENOMA IN THE HARD PALATE WITH 5 YEARS OF EVOLUTION: CASE REPORT. PRISCILA THAIS RODRIGUES DE ABREU, EDUARDO MORATO DE OLIVEIRA, EVANDRO NEVES ABDO, MARIA CASSIA FERREIRA DE AGUIAR, TARCILIA APARECIDA DA SILVA and, FELIPE PAIVA FONSECA Patient C.C.F.S., a 39-year-old woman, went to the pathology and stomatology center for an evaluation of a lesion in the palate with more than 5 years of evolution. The anamnesis and intraoral examination revealed a well-defined tumor, fibrous consistency, and ulcerated surface in the posterior region of the hard palate on the left side. Ulceration resulted from the drainage attempt by the physician who referred it supposing to be an odontogenic lesion. An incisional biopsy was performed. Histopathologic evaluation revealed capsular tissue surrounding the periphery; neoplastic cells arranged in cords and nests, and ductal structures filled by mucoid content interspersed by hyalinized connective tissue. Treatment consisted of surgical excision and use of an acetate plate in the postoperative period because of the risk of bucosinusal communication evidenced by the tomography. The staining of the edges of the surgical specimen showed that they were free of neoplastic cells. The patient has been followed up for 8 months.
ABSTRACTS
e85
LANGERHANS CELL HISTIOCYTOSIS. RUBIA DA ROCHA VIEIRA, KARINE RASERA and, PAULA LUCE BOHRER Langerhans cell histiocytosis (LCH) is a rare condition of uncertain etiology resulting from a clonal proliferation of Langerhans cells, which mainly affects children. In March 2018, parents of a 1-year-old male patient reported a volume increasing on the right side of the child’s jaw. The imaging tests revealed a lytic lesion with aggressive aspect in the mandible. In view of this, it was decided to perform an incisional biopsy of the affected area and subsequent histopathologic examination. The histologic slices showed a diffuse infiltration of large monocyte cell resembling histiocytes, numerous plasma cells, lymphocytes, and eosinophils. It was concluded that it was an undifferentiated malignant neoplasm. To confirm the diagnosis, immunohistochemical examination was required, which was positive for vimentin (V9), Ki67 (20% of cells), S100, and CD-1 a. Morphologic and immunohistochemical findings were consistent with Langerhans cell histiocytosis. After the diagnosis the patient underwent chemotherapy for a minimum of 6 months. Currently, the patient is undergoing treatment and progressing well.
EARLY DIAGNOSIS AND MULTIPLE FACES OF ORAL SQUAMOUS CELL CARCINOMA. BRUNA FERNANDES DO CARMO CARVALHO, VICTOR COSTA, CESAR AUGUSTO CARDOSO, ANA LIA ANBINDER, ESTELA KAMINAGAKURA, JANETE DIAS ALMEIDA and, ANA SUELI RODRIGUES CAVALCANTE This is a case report of an unusual clinical presentation of squamous cell carcinoma (SCC). A 60-year-old man was referred for evaluation of pain in the posterior border of the tongue. The patient reported a previous biopsy in the same region, about 2 years ago, which was diagnosed as lichenoid dysplasia. Intraoral examination revealed a 5-mm reddish nodule of firm consistency and smooth surface with a painful symptomatology in the right side of the posterior border of the tongue. The diagnosis hypotheses were subgemmal neurogenous plaque, neurofibroma, or SCC. The histopathologic examination revealed superficially invasive SCC. The surgical treatment included the radical neck dissection, and lymph node metastases were found in the levels II and IV. The patient started radiotherapy and is under followup. This case emphasizes the importance of early diagnosis since SCC can present different patterns and, despite the small size, have the potential to metastasize.
CONDYLE SALIVARY GLAND DEFECT (STAFNE DEFECT) MIMICKING AN ODONTOGENIC CYST. CAMILA ZORASKI DE FREITAS, PAULA LUCE BOHRER and, RUBIA DA ROCHA VIEIRA Stafne bone defect consists of an asymptomatic, anatomic condition of uncertain origin and rare evolvement, often discovered at random in routine radiographic examinations. It is usually consisted on mandibular salivary gland inclusion as a developmental anomaly represented by a bone concavity usually containing submandibular gland tissue. A 39-year-old woman presented a hypodense lesion in the condyle of the left side of the jaw, discovered randomly. Because of the fact that the lesion mimics a cyst of odontogenic origin, excisional biopsy and later histopathologic