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INTRAORAL PLEOMORPHIC ADENOMA: A CLINICOPATHOLOGIC STUDY OF A CASE SERIES
ABSTRACTS
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ZAIRA GOMEZ-HERRERA and, RONELL BOLOGNAMOLINA Objective: To determine the immunoexpression of CD138, CK19 CD34, vascular endothelial growth factor (VEGF), BCL-2, p53, KI-67, mast cell tryptase, calretinina, and orosomucoid 1 in odontogenic myxomas (OMs). Study Design: Analytical and retrospective study was conducted. Immunohistochemistry was performed for 30 cases of OM. Results: Four CK19 and CD138 samples were positive, confirming the presence of odontogenic epithelium; also, CD138 was found in the extracellular matrix (moderated immunoexpression), and tumoral cells (high immunoexpression). Microvascular density (MVD) was measured with CD34 and VEGF expression, being 7.51 and 5.35 blood vessels, respectively. Orosomucoid 1 and mast cell tryptase showed a high immunoexpression in tumoral cells. Calretinin was negative in all the samples. KI67, BCL2 and p53 showed a low expression. Conclusions: The high immunopositivity found in orosomucoide 1, VEGF, and mast cell tryptase suggests a proangiogenic modulator among these proteins. The presence of CD138 in tumor cells and extracellular matrix suggests a relationship between this protein and extracellular components of OM, even though its role on this neoplastic process should be clarified.
INTRAORAL PLEOMORPHIC ADENOMA: A CLINICOPATHOLOGIC STUDY OF A CASE SERIES. MARIA EDUARDA PEREZ-DE OLIVEIRA, AUGUSTO CESAR LEAL DA SILVA LEONEL, ELAINE JUDITE DE AMORIM CARVALHO, JUREMA FREIRE LISBOA DE CASTRO, KAMILLA KARLA MAURICIO PASSOS, JOSE ERIVALDO DA SILVA MENDES and, DANYEL ELIAS DA CRUZ PEREZ Objective: The aim of this study was to describe the clinicopathologic features of 21 cases of intraoral pleomorphic adenoma (PA). Study Design: Between 2000 and 2016, all patients diagnosed with intraoral PA were retrieved and histopathologic slides stained with hematoxylin and eosin were reviewed. All tumors were classified histologically according to the Seifert et al. Results: The palate was the most common site (42.8%), with a slight predilection for females (52.4%) and a mean age of 36.68 years. Histopathologic analyses revealed a diversity of histologic patterns. Plasmacytoid (85.7%), fusiform (38.1%), epithelioid (9.5%), mucous (19%), and oncocytic (28.5%) cells were observed, as well as fibrous (95.2%), myxoid (66.7%), and chondromyxoid (28.6%) stroma. Most tumors were encapsulated (71.5%). Squamous (57.1%), adipose (47.6%), sebaceous (14.3%), and osseous (14.3%) metaplasias were found. A small group presented with pleomorphism (23.8%), increased mitotic activity (14.3%), necrotic areas (9.5%), and capsule infiltration (4.3%). According to the Seifert’s classification, most PAs were classified as subtype III (47.6%), followed by subtypes I and II (23.8%), and subtype IV (4.8%). Conclusions: These results confirm the morphologic diversity of PAs. The knowledge of these detailed microscopic features is essential to a correct diagnosis and adequate treatment.
OOOO January 2020 MALIGNANT PERIPHERAL NERVE SHEATH TUMOR: A BRAZILIAN COLLABORATIVE ^ STUDY OF 4 CASES. LENI VERONICA DE OLIVEIRA SILVA, JOSE ALCIDES ALMEIDA ARRUDA, LAUREN FRENZEL SCHUCH, ADRIANA APARECIDA e LUIZ GOMES CARNEIRO SILVA DA COSTA, JOAO MONTEIRO, ANA PAULA VERAS SOBRAL and, RICARDO ALVES MESQUITA Objective: Malignant peripheral nerve sheath tumor (MPNST) is an extremely rare malignancy in the oral cavity. It is derived from peripheral nerves and can display the differentiation of nerve sheath elements. This study investigated the frequency of MPNST that has been submitted for microscopic examination from 2 Brazilian oral and maxillofacial pathology services. Study Design: A retrospective study was conducted on biopsies obtained from 1954 to April 2018 at 2 Brazilian oral and maxillofacial pathology services. A total of 43,915 biopsy specimens were analyzed. Demographic data and histopathologic diagnosis were evaluated descriptively. Results: A total of 4 cases of MPNST were surveyed, representing 0.009% of the oral lesions at the centers studied. MPNST was diagnosed in 3 males and 1 female. The mean age § SD was 37.7 § 15.9 (range 16-61) years. Two of the 4 lesions occurred in the maxilla and the mean of evolution time was 10.2 months. Immunohistochemical analysis revealed positivity of neoplasms cells for S-100, vimentin, and glial fibrillary acidic protein (GFAP). Conclusions: This study has contributed to the improvement of the epidemiology, prognostic markers, and outcomes of this malignancy. The differential diagnosis of the MPNST may be facilitated by additional information obtained from immunohistochemistry findings. Support: FAPEMIG.
GLANDULAR ODONTOGENIC CYST: A SERIES OF 17 NEW CASES. THAYANNE OLIVEIRA DE FREITAS GONCALVES, ¸ ANA ^ A ROZA, KELLY TAMBASCO LUIZA OLIVEIRA CORRE BEZERRA, BRUNO AUGUSTO BENEVENUTO DE ANDRADE, MICHELLE AGOSTINI and, MARIO JOSE e ROMANACH Objective: Our aim is to report a series of 17 new cases of glandular odontogenic cyst (GOC) diagnosed in a Brazilian laboratory of oral pathology in the last 7 years. Study Design: All clinical and radiographic features were retrieved from patients’ charts and the diagnosis of GOC was confirmed after microscopic evaluation following the current World Health Organization (WHO) criteria. Results: There were 13 women and 4 men, with a mean age of 46 years. Eleven cases involved the mandible and 6 cases involved the maxilla, particularly the anterior region (10 cases), as extensive well-defined unilocular radiolucencies with limited expansion of bone cortices. The most common histologic criteria observed were eosinophilic cuboidal cells, epithelial detachment, variable thickness, and mucous cells. Most cases were treated by surgical enucleation, with 1 case showing recurrence. Conclusions: GOC is an uncommon developmental cyst with features resembling glandular differentiation that may show large size with limited bone expansion.
e144
ZAIRA GOMEZ-HERRERA and, RONELL BOLOGNAMOLINA Objective: To determine the immunoexpression of CD138, CK19 CD34, vascular endothelial growth factor (VEGF), BCL-2, p53, KI-67, mast cell tryptase, calretinina, and orosomucoid 1 in odontogenic myxomas (OMs). Study Design: Analytical and retrospective study was conducted. Immunohistochemistry was performed for 30 cases of OM. Results: Four CK19 and CD138 samples were positive, confirming the presence of odontogenic epithelium; also, CD138 was found in the extracellular matrix (moderated immunoexpression), and tumoral cells (high immunoexpression). Microvascular density (MVD) was measured with CD34 and VEGF expression, being 7.51 and 5.35 blood vessels, respectively. Orosomucoid 1 and mast cell tryptase showed a high immunoexpression in tumoral cells. Calretinin was negative in all the samples. KI67, BCL2 and p53 showed a low expression. Conclusions: The high immunopositivity found in orosomucoide 1, VEGF, and mast cell tryptase suggests a proangiogenic modulator among these proteins. The presence of CD138 in tumor cells and extracellular matrix suggests a relationship between this protein and extracellular components of OM, even though its role on this neoplastic process should be clarified.
INTRAORAL PLEOMORPHIC ADENOMA: A CLINICOPATHOLOGIC STUDY OF A CASE SERIES. MARIA EDUARDA PEREZ-DE OLIVEIRA, AUGUSTO CESAR LEAL DA SILVA LEONEL, ELAINE JUDITE DE AMORIM CARVALHO, JUREMA FREIRE LISBOA DE CASTRO, KAMILLA KARLA MAURICIO PASSOS, JOSE ERIVALDO DA SILVA MENDES and, DANYEL ELIAS DA CRUZ PEREZ Objective: The aim of this study was to describe the clinicopathologic features of 21 cases of intraoral pleomorphic adenoma (PA). Study Design: Between 2000 and 2016, all patients diagnosed with intraoral PA were retrieved and histopathologic slides stained with hematoxylin and eosin were reviewed. All tumors were classified histologically according to the Seifert et al. Results: The palate was the most common site (42.8%), with a slight predilection for females (52.4%) and a mean age of 36.68 years. Histopathologic analyses revealed a diversity of histologic patterns. Plasmacytoid (85.7%), fusiform (38.1%), epithelioid (9.5%), mucous (19%), and oncocytic (28.5%) cells were observed, as well as fibrous (95.2%), myxoid (66.7%), and chondromyxoid (28.6%) stroma. Most tumors were encapsulated (71.5%). Squamous (57.1%), adipose (47.6%), sebaceous (14.3%), and osseous (14.3%) metaplasias were found. A small group presented with pleomorphism (23.8%), increased mitotic activity (14.3%), necrotic areas (9.5%), and capsule infiltration (4.3%). According to the Seifert’s classification, most PAs were classified as subtype III (47.6%), followed by subtypes I and II (23.8%), and subtype IV (4.8%). Conclusions: These results confirm the morphologic diversity of PAs. The knowledge of these detailed microscopic features is essential to a correct diagnosis and adequate treatment.
OOOO January 2020 MALIGNANT PERIPHERAL NERVE SHEATH TUMOR: A BRAZILIAN COLLABORATIVE ^ STUDY OF 4 CASES. LENI VERONICA DE OLIVEIRA SILVA, JOSE ALCIDES ALMEIDA ARRUDA, LAUREN FRENZEL SCHUCH, ADRIANA APARECIDA e LUIZ GOMES CARNEIRO SILVA DA COSTA, JOAO MONTEIRO, ANA PAULA VERAS SOBRAL and, RICARDO ALVES MESQUITA Objective: Malignant peripheral nerve sheath tumor (MPNST) is an extremely rare malignancy in the oral cavity. It is derived from peripheral nerves and can display the differentiation of nerve sheath elements. This study investigated the frequency of MPNST that has been submitted for microscopic examination from 2 Brazilian oral and maxillofacial pathology services. Study Design: A retrospective study was conducted on biopsies obtained from 1954 to April 2018 at 2 Brazilian oral and maxillofacial pathology services. A total of 43,915 biopsy specimens were analyzed. Demographic data and histopathologic diagnosis were evaluated descriptively. Results: A total of 4 cases of MPNST were surveyed, representing 0.009% of the oral lesions at the centers studied. MPNST was diagnosed in 3 males and 1 female. The mean age § SD was 37.7 § 15.9 (range 16-61) years. Two of the 4 lesions occurred in the maxilla and the mean of evolution time was 10.2 months. Immunohistochemical analysis revealed positivity of neoplasms cells for S-100, vimentin, and glial fibrillary acidic protein (GFAP). Conclusions: This study has contributed to the improvement of the epidemiology, prognostic markers, and outcomes of this malignancy. The differential diagnosis of the MPNST may be facilitated by additional information obtained from immunohistochemistry findings. Support: FAPEMIG.
GLANDULAR ODONTOGENIC CYST: A SERIES OF 17 NEW CASES. THAYANNE OLIVEIRA DE FREITAS GONCALVES, ¸ ANA ^ A ROZA, KELLY TAMBASCO LUIZA OLIVEIRA CORRE BEZERRA, BRUNO AUGUSTO BENEVENUTO DE ANDRADE, MICHELLE AGOSTINI and, MARIO JOSE e ROMANACH Objective: Our aim is to report a series of 17 new cases of glandular odontogenic cyst (GOC) diagnosed in a Brazilian laboratory of oral pathology in the last 7 years. Study Design: All clinical and radiographic features were retrieved from patients’ charts and the diagnosis of GOC was confirmed after microscopic evaluation following the current World Health Organization (WHO) criteria. Results: There were 13 women and 4 men, with a mean age of 46 years. Eleven cases involved the mandible and 6 cases involved the maxilla, particularly the anterior region (10 cases), as extensive well-defined unilocular radiolucencies with limited expansion of bone cortices. The most common histologic criteria observed were eosinophilic cuboidal cells, epithelial detachment, variable thickness, and mucous cells. Most cases were treated by surgical enucleation, with 1 case showing recurrence. Conclusions: GOC is an uncommon developmental cyst with features resembling glandular differentiation that may show large size with limited bone expansion.