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LINGUAL LYMPHANGIOMA TREATED WITH DIODE LASER
OOOO Volume 129, Number 1 CECCHETI, NEVICOLINO ¸ PEREIRA DE CARVALHO FILHO and, ALAN ROGER DOS SANTOS SILVA Central giant cell granulomas (CGCGs) are locally aggressive nonneoplastic lesions, which mainly affect the jaws of young patients. Microscopically, CGCGs are characterized by the proliferation of multinucleated giant cells in a fibrous and hemorrhagic stroma. Optimal treatment includes surgical and nonsurgical approaches. The latter encompass the use of subcutaneous denosumab due to its ability to inhibit osteoclast metabolism. Herein, we report 2 cases of aggressive CGCL treated with subcutaneous denosumab. Case 1: A 9-year-old girl with a maxillary CGCG causing nasal expansion and tooth displacement and mobility, which was recalcitrant to intralesional corticosteroid therapy, was treated with subcutaneous denosumab during 1 year (120 mg/mo), leading to complete calcification of the CGCG. Case 2: A 23-year-old woman with a diffuse maxillary enlargement diagnosed as CGCG by incisional biopsy was treated with subcutaneous denosumab for 5 months (120 mg/mo), leading to calcification of the CGCG, which was complementary managed with osteoplasty.
MUCORMYCOSIS IN THE IMMUNOCOMPROMISED HOST: A CASE REPORT. ALINE ^ FERNANDA CRUZ, LIVIA SAMARA FRANCIELLE DE SOUZA PINTO, JULIO CESAR TANOS DE LACERDA, ISABELA FERNANDES DOS SANTOS, SERGIO HENRIQUE BENFENATTI BOTELHO, FELIPE PAIVA FONSECA and, RENATA GONCALVES ¸ RESENDE Mucormycosis is an aggressive and highly lethal pathology caused by an opportunistic fungus of the Mucorales order. Mucormycosis occurs particularly in patients with an impaired immune response. A 57-year-old woman with uncontrolled diabetes presented with palatal necrosis and hardening of the subcutaneous tissue at the level of the maxillary sinus associated with otalgia and myalgia. The patient was receiving antibiotic and antifungal therapy. The computed tomography (CT) exam showed gas bubbles in the left pterygopalatine fossa, originating from the extensive necrotic lesion of the palate and communication between these areas. The diagnostic hypotheses were squamous cells carcinoma and deep fungal infection, so the patient underwent incisional biopsy of the palatal lesion. The anatomopathologic exam revealed the presence of large nonseptate hyphae and intense infiltration of mixed inflammatory cells that were compatible with mucormycosis. The patient received amphotericin B therapy and was submitted to surgical resection of left hemiface and remains under follow-up. Support: FAPEMIG.
LIP HEMANGIOMA IN A YOUNG PATIENT: AN AESTHETIC CHALLENGE MANAGED BY AN ASSOCIATION OF TREATMENT TECHNIQUES. DIEGO TETZNER FERNANDES, PATRICIA MARIA e CURIOSO, FERNANDES, PEDRO AUGUSTO BULHOES ROGERIO DE ANDRADE ELIAS, PABLO AGUSTIN VARGAS, ALAN ROGER SANTOS-SILVA and, MARCIO AJUDARTE LOPES Treatment of benign lip vascular anomalies can be an aesthetic challenge even though several techniques are available to manage these lesions. A difficult case treated with an association of techniques is presented. A 12-year-old boy with an extensive
ABSTRACTS
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congenital hemangioma in the upper lip was referred with an aesthetic complaint and past history of treatment failures. Sclerotherapy with 5% ethanolamine oleate was proposed. Intriguingly, after 6 sessions of sclerotherapy, the size and the consistency of the lesion remained almost the same, although some color improvement was observed. Therefore, an aesthetic surgery was considered and the patient was referred to a vascular surgeon. After arteriography, 3 sessions of percutaneous embolization with 3% polidocanol foam was performed. Afterward, the patient underwent 2 surgical interventions using diode highpotential laser achieving a satisfactory result. Although uncommon, a refractory vascular lesion may occur and an association of different techniques may be necessary.
LINGUAL LYMPHANGIOMA TREATED WITH DIODE LASER. CAMILA DE NAZARE ALVES DE OLIVEIRA KATO, AMANDA VIEIRA ^ AIRES, ISADORA PEREIRA GOMES, SAMILA ^ GONCALVES ¸ BARRA, TANIA MARA PIMENTA DO AMARAL, FELIPE PAIVA FONSECA and, RICARDO ALVES MESQUITA Lymphangioma is a congenital vascular malformation, which affects lymphatic vessels. This case report describes a lymphangioma in a 9-year-old boy treated by ablation with diode laser. The patient’s mother reported the presence of the lesion since his birth, with periods of growth and complaints of pain. Intraoral exam showed multiples transparent and erythematous vesicles in dorsum of the tongue, affecting an area of approximately 30 mm. Blood tests and Doppler ultrasonography were required. After clinical and image exams, the diagnosis was lingual lymphangioma. The ablation with diode laser was performed under local infiltrative anesthesia. The parameters of the laser were continuous mode and power of 2500 mW. The lesion was treated in 2 sessions with a 14-day interval. Rigorous oral hygiene was required and need of antibiotic therapy both preablation and postablation. There was clinical healing of the lesion after 30 days. The follow-up examination at 8 months showed no recurrence. Support: FAPEMIG.
LIP OSTEOLIPOMA, CLINICAL AND SURGICAL MANAGEMENT OF AN INFREQUENT DISEASE. JUAN IGNACIO PANICO, LEONARDI and, RENE GERARDO GILLIGAN, NICOLAS LUIS PANICO Lipomas are relatively infrequent mesenchymal benign neoplasms of oral soft tissues. A wide range of subtypes of lipomas have been previously described, including fibrolipoma, angiolipoma, pleomorphic lipoma, and osteolipoma. The aim of this study is to present a clinical case of an 83-year-old man with a painless labial mass of 20-year duration with a remarkable increase in the size of the lesion in the last 2 years. Oral examination revealed a yellowish and sessile mass located in the lower labial mucosa. The provisional diagnosis was a lipoma, but during its surgical excision, a cartilaginouslike tissue was noticed generating some doubts about our previous diagnosis. The histopathologic findings revealed mature adipocytes surrounding bone tissue and the final diagnosis was osteolipoma. The presence of bony calcifications within this tumor could be related to metaplastic changes during the evolution of the lesion. This rare presentation was previously reported with different oral locations.
MUCORMYCOSIS IN THE IMMUNOCOMPROMISED HOST: A CASE REPORT. ALINE ^ FERNANDA CRUZ, LIVIA SAMARA FRANCIELLE DE SOUZA PINTO, JULIO CESAR TANOS DE LACERDA, ISABELA FERNANDES DOS SANTOS, SERGIO HENRIQUE BENFENATTI BOTELHO, FELIPE PAIVA FONSECA and, RENATA GONCALVES ¸ RESENDE Mucormycosis is an aggressive and highly lethal pathology caused by an opportunistic fungus of the Mucorales order. Mucormycosis occurs particularly in patients with an impaired immune response. A 57-year-old woman with uncontrolled diabetes presented with palatal necrosis and hardening of the subcutaneous tissue at the level of the maxillary sinus associated with otalgia and myalgia. The patient was receiving antibiotic and antifungal therapy. The computed tomography (CT) exam showed gas bubbles in the left pterygopalatine fossa, originating from the extensive necrotic lesion of the palate and communication between these areas. The diagnostic hypotheses were squamous cells carcinoma and deep fungal infection, so the patient underwent incisional biopsy of the palatal lesion. The anatomopathologic exam revealed the presence of large nonseptate hyphae and intense infiltration of mixed inflammatory cells that were compatible with mucormycosis. The patient received amphotericin B therapy and was submitted to surgical resection of left hemiface and remains under follow-up. Support: FAPEMIG.
LIP HEMANGIOMA IN A YOUNG PATIENT: AN AESTHETIC CHALLENGE MANAGED BY AN ASSOCIATION OF TREATMENT TECHNIQUES. DIEGO TETZNER FERNANDES, PATRICIA MARIA e CURIOSO, FERNANDES, PEDRO AUGUSTO BULHOES ROGERIO DE ANDRADE ELIAS, PABLO AGUSTIN VARGAS, ALAN ROGER SANTOS-SILVA and, MARCIO AJUDARTE LOPES Treatment of benign lip vascular anomalies can be an aesthetic challenge even though several techniques are available to manage these lesions. A difficult case treated with an association of techniques is presented. A 12-year-old boy with an extensive
ABSTRACTS
e19
congenital hemangioma in the upper lip was referred with an aesthetic complaint and past history of treatment failures. Sclerotherapy with 5% ethanolamine oleate was proposed. Intriguingly, after 6 sessions of sclerotherapy, the size and the consistency of the lesion remained almost the same, although some color improvement was observed. Therefore, an aesthetic surgery was considered and the patient was referred to a vascular surgeon. After arteriography, 3 sessions of percutaneous embolization with 3% polidocanol foam was performed. Afterward, the patient underwent 2 surgical interventions using diode highpotential laser achieving a satisfactory result. Although uncommon, a refractory vascular lesion may occur and an association of different techniques may be necessary.
LINGUAL LYMPHANGIOMA TREATED WITH DIODE LASER. CAMILA DE NAZARE ALVES DE OLIVEIRA KATO, AMANDA VIEIRA ^ AIRES, ISADORA PEREIRA GOMES, SAMILA ^ GONCALVES ¸ BARRA, TANIA MARA PIMENTA DO AMARAL, FELIPE PAIVA FONSECA and, RICARDO ALVES MESQUITA Lymphangioma is a congenital vascular malformation, which affects lymphatic vessels. This case report describes a lymphangioma in a 9-year-old boy treated by ablation with diode laser. The patient’s mother reported the presence of the lesion since his birth, with periods of growth and complaints of pain. Intraoral exam showed multiples transparent and erythematous vesicles in dorsum of the tongue, affecting an area of approximately 30 mm. Blood tests and Doppler ultrasonography were required. After clinical and image exams, the diagnosis was lingual lymphangioma. The ablation with diode laser was performed under local infiltrative anesthesia. The parameters of the laser were continuous mode and power of 2500 mW. The lesion was treated in 2 sessions with a 14-day interval. Rigorous oral hygiene was required and need of antibiotic therapy both preablation and postablation. There was clinical healing of the lesion after 30 days. The follow-up examination at 8 months showed no recurrence. Support: FAPEMIG.
LIP OSTEOLIPOMA, CLINICAL AND SURGICAL MANAGEMENT OF AN INFREQUENT DISEASE. JUAN IGNACIO PANICO, LEONARDI and, RENE GERARDO GILLIGAN, NICOLAS LUIS PANICO Lipomas are relatively infrequent mesenchymal benign neoplasms of oral soft tissues. A wide range of subtypes of lipomas have been previously described, including fibrolipoma, angiolipoma, pleomorphic lipoma, and osteolipoma. The aim of this study is to present a clinical case of an 83-year-old man with a painless labial mass of 20-year duration with a remarkable increase in the size of the lesion in the last 2 years. Oral examination revealed a yellowish and sessile mass located in the lower labial mucosa. The provisional diagnosis was a lipoma, but during its surgical excision, a cartilaginouslike tissue was noticed generating some doubts about our previous diagnosis. The histopathologic findings revealed mature adipocytes surrounding bone tissue and the final diagnosis was osteolipoma. The presence of bony calcifications within this tumor could be related to metaplastic changes during the evolution of the lesion. This rare presentation was previously reported with different oral locations.