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LATE RECURRENT LOW-GRADE MUCOEPIDERMOID CARCINOMA OF THE PALATE
ABSTRACTS
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lesion extensions with a 15-day interval between them. Subsequently, a peripheral ostectomy was done. Follow-up with no signs of recurrence was performed, presenting a good prognosis.
HISTOPATHOLOGIC FEATURES OF CENTRAL GIANT CELL GRANULOMA TREATED BY DENOSUMAB. FERNANDA DOS SANTOS MOREIRA, THIAGO BUENO DE OLIVEIRA, FELIPE D’ALMEIDA COSTA, FREDERICO LOUVEIRA AYRES, LUIZ PAULO KOWALSKI and, FABIO DE ABREU ALVES Central giant cell granulomas (CGCGs) are benign lesions of the jaws. Surgical management may cause significant morbidity, and noninvasive therapies such as intralesional corticoid, calcitonin, and, more recently, denosumab have been used as an option. The study aimed to describe histopathologic characteristics of CGCGs treated by denosumab. A 39-year-old man was referred to treat a CGCG. The imaginological examinations showed an extensive osteolytic lesion affecting the left maxilla. Tumor board evaluation proposed systemic therapy with denosumab. Four doses of denosumab (120 mg) were administered during the first month followed by 2 monthly doses (Thomas, 2010). After 3 months, there was facial edema, and the patient refused followup. Surgical treatment was performed, and the histopathologic examination showed a granulation tissue in a central region and a formation of mature bone trabeculae in the periphery. Typical areas of CGCG were not observed. This report shows that denosumab inhibits the giant cells of CGCG.
HISTIOCYTOSIS: CASE REPORT. WILKELLY ALVES DE LIMA, PABLYANNE TEREZA e LOUZADA GUEDES, GLAUCE GUIMARAES PEREIRA, LUCAS CARVALHAES PERES, ANA CAROLINA SANTIAGO DA SILVA, FLAVIA SIROTHEAU CORREA PONTES and, HELDER ANTONIO REBELO PONTES Histiocytosis is part of histiocyte-related proliferative diseases. The term histiocyte involves all types of macrophages and other dendritic cells (antigen-presenting cells: dermal dendrocytes, Langerhans cells (CL), and indeterminate cells). An 11year-old male patient presented with an initial complaint of dental pain. Intraoral examination revealed exophytic and ulcerated lesions associated with the left maxillary first and second premolar and with left mandibular first and second molar with a timecourse evolution of 2 months. An incisional biopsy was performed, and histopathologic examination revealed the presence of histiocytes with nuclei shaped like kidney beans, permeated by eosinophils. There also were lymphocytes and giant cells. Immunohistochemistry was positive for S-100, concluding the diagnosis of histiocytosis. The patient underwent chemotherapy, and there has been no recurrence after 2 years of follow-up.
LATE RECURRENT LOW-GRADE MUCOEPIDERMOID CARCINOMA OF THE PALATE. FERNANDA DOS SANTOS MOREIRA, ELISMAURO FRANCISCO DE MENDON¸CA, CLOVIS ANTONIO LOPES PINTO, LUIZ PAULO KOWALSKI and, FABIO DE ABREU ALVES Mucoepidermoid carcinoma (MEC) is the most common malignant neoplasm of the salivary glands, accounting for 10%
OOOO January 2020 to 15% of all salivary gland neoplasms. Histologically, it is classified into low-, intermediate-, and high-grade, and the prognosis is very dependent on tumor grade. The aim was to describe a late recurrence of MEC, which could be misdiagnosed as odontogenic lesion. A 28-year-old woman was diagnosed as having low-grade MEC of the palate and was treated with surgery. After 10 years of annual follow-up, the patient refers displacement of the upper second molar. The imaginological examinations showed a well-circumscribed osteolytic lesion involving teeth 27 and 28. According to these characteristics, our clinical hypotheses were recurrent MEC and odontogenic lesion. Incisional biopsy was performed, and low-grade MEC was confirmed. The patient was submitted to maxillectomy with microsurgical reconstruction. This report emphasizes that a rigorous clinical followup should be performed for a long period in cases of malignant salivary gland tumors.
ODONTOGENIC KERATOCYST OF THE BUCCAL MUCOSA. EDUARDO MORATO DE OLIVEIRA, PATRICIA CARLOS CALDEIRA, RICARDO ALVES MESQUITA, KARINE DUARTE DA SILVA, EVANDRO NEVES ABDO and, MARIA CASSIA FERREIRA DE AGUIAR A 64-year-old male patient presented an asymptomatic, long-lasting, submucosal enlargement at the right buccal mucosa. The lesion had a nodular appearance, was well circumscribed, was mobile, had a firm consistency, and was covered by clinically healthy mucosa. Ultrasonography revealed a hypoechoic, hypovascular, lobulated, and partially circumscribed lesion measuring 4.5 £ 2.1 cm. The diagnostic hypotheses were epidermoid cyst or lipoma. The lesion was surgically excised under local anesthesia. During the excision, a dark-brown liquid drained out of the lesion. Histopathologic examination revealed a cystic lesion lined by a uniform, thin, parakeratinized epithelium with corrugated surface. The basal cell layer was hyperchromatic with nuclei palisade. The diagnosis was of odontogenic keratocyst. Panoramic radiograph revealed no bone involvement, and the patient showed no signs of Gorlin-Goltz syndrome. The patient is disease-free after 12 months of follow-up. Support: FAPEMIG.
GLANDULAR ODONTOGENIC CYST: CONSERVATIVE SURGICAL APPROACH OF A RARE ENTITY. MARIA ELISA RANGEL JANINI, GUSTAVO DE SOUZA VIEIRA, RAFAEL NETTO, MARIANA CAMPELLO NUNES, FABIANE MARQUES DOS SANTOS FREIRE, VALDIR MEIRELLES JUNIOR and, JOSE ALEXANDRE DE ROCHA CURVELO Glandular odontogenic cyst is a rare jaw lesion that is thought to arise from rests of the dental lamina with unpredictable and potentially aggressive behavior. A white 17-year-old female adolescent complained of pain in the posterior region of the mandible beginning about 1 year ago, which increased after the indirect dental restoration of tooth #46 that was submitted to root canal treatment about 8 years ago. Intraoral examination showed swelling of vestibular region between teeth #45 and #47 and cortical perforation of the same lingual region of the mandible, which was painless on palpation. Orthopantomogram revealed a well-defined, large, radiolucent, and unilocular lesion in the periapical region of teeth #45, #46, and #47. Diagnostic
e128
lesion extensions with a 15-day interval between them. Subsequently, a peripheral ostectomy was done. Follow-up with no signs of recurrence was performed, presenting a good prognosis.
HISTOPATHOLOGIC FEATURES OF CENTRAL GIANT CELL GRANULOMA TREATED BY DENOSUMAB. FERNANDA DOS SANTOS MOREIRA, THIAGO BUENO DE OLIVEIRA, FELIPE D’ALMEIDA COSTA, FREDERICO LOUVEIRA AYRES, LUIZ PAULO KOWALSKI and, FABIO DE ABREU ALVES Central giant cell granulomas (CGCGs) are benign lesions of the jaws. Surgical management may cause significant morbidity, and noninvasive therapies such as intralesional corticoid, calcitonin, and, more recently, denosumab have been used as an option. The study aimed to describe histopathologic characteristics of CGCGs treated by denosumab. A 39-year-old man was referred to treat a CGCG. The imaginological examinations showed an extensive osteolytic lesion affecting the left maxilla. Tumor board evaluation proposed systemic therapy with denosumab. Four doses of denosumab (120 mg) were administered during the first month followed by 2 monthly doses (Thomas, 2010). After 3 months, there was facial edema, and the patient refused followup. Surgical treatment was performed, and the histopathologic examination showed a granulation tissue in a central region and a formation of mature bone trabeculae in the periphery. Typical areas of CGCG were not observed. This report shows that denosumab inhibits the giant cells of CGCG.
HISTIOCYTOSIS: CASE REPORT. WILKELLY ALVES DE LIMA, PABLYANNE TEREZA e LOUZADA GUEDES, GLAUCE GUIMARAES PEREIRA, LUCAS CARVALHAES PERES, ANA CAROLINA SANTIAGO DA SILVA, FLAVIA SIROTHEAU CORREA PONTES and, HELDER ANTONIO REBELO PONTES Histiocytosis is part of histiocyte-related proliferative diseases. The term histiocyte involves all types of macrophages and other dendritic cells (antigen-presenting cells: dermal dendrocytes, Langerhans cells (CL), and indeterminate cells). An 11year-old male patient presented with an initial complaint of dental pain. Intraoral examination revealed exophytic and ulcerated lesions associated with the left maxillary first and second premolar and with left mandibular first and second molar with a timecourse evolution of 2 months. An incisional biopsy was performed, and histopathologic examination revealed the presence of histiocytes with nuclei shaped like kidney beans, permeated by eosinophils. There also were lymphocytes and giant cells. Immunohistochemistry was positive for S-100, concluding the diagnosis of histiocytosis. The patient underwent chemotherapy, and there has been no recurrence after 2 years of follow-up.
LATE RECURRENT LOW-GRADE MUCOEPIDERMOID CARCINOMA OF THE PALATE. FERNANDA DOS SANTOS MOREIRA, ELISMAURO FRANCISCO DE MENDON¸CA, CLOVIS ANTONIO LOPES PINTO, LUIZ PAULO KOWALSKI and, FABIO DE ABREU ALVES Mucoepidermoid carcinoma (MEC) is the most common malignant neoplasm of the salivary glands, accounting for 10%
OOOO January 2020 to 15% of all salivary gland neoplasms. Histologically, it is classified into low-, intermediate-, and high-grade, and the prognosis is very dependent on tumor grade. The aim was to describe a late recurrence of MEC, which could be misdiagnosed as odontogenic lesion. A 28-year-old woman was diagnosed as having low-grade MEC of the palate and was treated with surgery. After 10 years of annual follow-up, the patient refers displacement of the upper second molar. The imaginological examinations showed a well-circumscribed osteolytic lesion involving teeth 27 and 28. According to these characteristics, our clinical hypotheses were recurrent MEC and odontogenic lesion. Incisional biopsy was performed, and low-grade MEC was confirmed. The patient was submitted to maxillectomy with microsurgical reconstruction. This report emphasizes that a rigorous clinical followup should be performed for a long period in cases of malignant salivary gland tumors.
ODONTOGENIC KERATOCYST OF THE BUCCAL MUCOSA. EDUARDO MORATO DE OLIVEIRA, PATRICIA CARLOS CALDEIRA, RICARDO ALVES MESQUITA, KARINE DUARTE DA SILVA, EVANDRO NEVES ABDO and, MARIA CASSIA FERREIRA DE AGUIAR A 64-year-old male patient presented an asymptomatic, long-lasting, submucosal enlargement at the right buccal mucosa. The lesion had a nodular appearance, was well circumscribed, was mobile, had a firm consistency, and was covered by clinically healthy mucosa. Ultrasonography revealed a hypoechoic, hypovascular, lobulated, and partially circumscribed lesion measuring 4.5 £ 2.1 cm. The diagnostic hypotheses were epidermoid cyst or lipoma. The lesion was surgically excised under local anesthesia. During the excision, a dark-brown liquid drained out of the lesion. Histopathologic examination revealed a cystic lesion lined by a uniform, thin, parakeratinized epithelium with corrugated surface. The basal cell layer was hyperchromatic with nuclei palisade. The diagnosis was of odontogenic keratocyst. Panoramic radiograph revealed no bone involvement, and the patient showed no signs of Gorlin-Goltz syndrome. The patient is disease-free after 12 months of follow-up. Support: FAPEMIG.
GLANDULAR ODONTOGENIC CYST: CONSERVATIVE SURGICAL APPROACH OF A RARE ENTITY. MARIA ELISA RANGEL JANINI, GUSTAVO DE SOUZA VIEIRA, RAFAEL NETTO, MARIANA CAMPELLO NUNES, FABIANE MARQUES DOS SANTOS FREIRE, VALDIR MEIRELLES JUNIOR and, JOSE ALEXANDRE DE ROCHA CURVELO Glandular odontogenic cyst is a rare jaw lesion that is thought to arise from rests of the dental lamina with unpredictable and potentially aggressive behavior. A white 17-year-old female adolescent complained of pain in the posterior region of the mandible beginning about 1 year ago, which increased after the indirect dental restoration of tooth #46 that was submitted to root canal treatment about 8 years ago. Intraoral examination showed swelling of vestibular region between teeth #45 and #47 and cortical perforation of the same lingual region of the mandible, which was painless on palpation. Orthopantomogram revealed a well-defined, large, radiolucent, and unilocular lesion in the periapical region of teeth #45, #46, and #47. Diagnostic