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LOW-GRADE OSTEOSARCOMA OF THE MANDIBLE: A CASE REPORT
ABSTRACTS
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BORGES ALVES, VALERIA SOUZA FREITAS, JENER GONCALVES ¸ DE FARIAS, MARIA EMILIA SANTOS PEREIRA RAMOS, BRUNO CUNHA PIRES and, MARCIO CAMPOS OLIVEIRA Papillary squamous cell carcinoma is uncommon in the oral cavity and when it occurs, it usually presents as a single ulcerative-vegetative lesion. We report a case of a 73-year-old man who sought care for inflammation in the mouth for 3 months and asked for a biopsy. This patient was edentulous, without comorbidities, and without history of smoking or alcohol use. On examination, left lymph node enlargement (level 1B) measuring 4 £ 3 cm and 2 ulcerated lesions, 1 in the retromolar region and other at the alveolar ridge and floor of the mouth interface, both on left side, were identified. Incisional biopsies and histopathologic examination were performed, the first lesion was diagnosed as carcinoma in situ and the second one as papillary squamous cell carcinoma, represented by the proliferation of malignant cells in basaloid morphology and arranged in papillary projections. The tumor was classified as T3 N2 aM0, stage III-B and the patient underwent chemotherapy and radiotherapy, along with close monitoring by a team of specialists.
MASSIVE EXTRUSION OF CALCIUM HYDROXIDE PASTE CONTAINING BARIUM SULFATE DURING ENDODONTIC TREAT ^ CA, NATALIA MENT. JESSICA MONTENEGRO FONSE RANGEL PALMIER, GLEYSON KLEBER DO AMARALSILVA, LADY PAOLA ARISTIZABAL ARBOLEDA, PABLO AGUSTIN VARGAS, MARCIO AJUDARTE LOPES and, ALAN ROGER SANTOS-SILVA A 31-year-old woman was referred for evaluation of persistent numbness on the left side of the lower lip, which began during endodontic treatment of the left mandibular first molar. Imaging exams showed a large amount of a radiopaque or hyperdense throughout the left mandibular body in close proximity to the lower alveolar nerve. Histologic analyses identified birefringent crystalloid foreign bodies widespread through soft tissue and bone leading to an inflammatory foreign body reaction, eventually demonstrated to be rich in barium and sulfur by the means of scanning electron microscopy coupled with energy dispersive x-ray detection. This scenario led to the diagnosis of lower alveolar nerve injury due to accidental extrusion of intracanal dressing material composed of calcium hydroxide (CaOH2) paste incorporated with BaSO4. The paresthesia was treated with the combination of citoneurin and prednisone, but no improvement in nerve sensitivity was noticed after 12 months of follow-up examination.
THE RISK OF FACIAL FILLINGS DURING AESTHETIC PROCEDURES: A CASE REPORT. ELIANDRO DE SOUZA FREITAS, DANIEL FROTA DE SOUZA, LARISSA LUZIA DA SILVA ARAUJO and, TIAGO NOVAES PINHEIRO Facial cosmetic procedures are increasing in demand for plastic surgeons and dental professionals nowadays. This study highlights some of the risks related to such procedures, reporting a case of a painful, fluctuating nodule in the midline of the vestibular sulcus, extending to the upper lip. The patient, a 32-yearold man, showed a normochromic swelling of the affected region with 2 years’ history of evolution. The patient stated that he
OOOO January 2020 underwent a rhinoplasty procedure 5 years earlier. An excisional biopsy was performed and the lesion was diagnosed as a foreign body granuloma caused by methylmethacrylate. A wide morphologic investigation with polarized light and fluorescence microscopy was applied in order to confirm the filling material. Multiple splintered synthetic spherules were noted; these spherules were surrounded by foreign body giant cells circumscribed by a thin fibrous capsule and infiltrated by lymphocytes. The clinical follow-up was uneventful after 7 months.
LOW-GRADE OSTEOSARCOMA OF THE MANDIBLE: A CASE REPORT. RUBIA ^ TEODORO STUEPP, LISIANE CANDIDO and, ROGERIO GONDAK Osteosarcoma of the jaws is a rare and aggressive malignant mesenchymal tumor characterized by the formation of osteoid tissue. A 32-year-old male patient reported a complaint of a painless, slow swelling on the right side of the mandible and paresthesia of the lower lip. Intraoral examination revealed a smooth nodular mass in the lower right alveolar ridge and dental mobility of the lower second molar. Computed tomography showed a mixed density lesion of the right body of the mandible with irregular margins and cortical erosions. There was a widened periodontal ligament space of the first and second lower molars. After incisional biopsy, the histologic sections revealed areas of mineralization and proliferation of stellate and spindle cells in a myxoid matrix. The cells showed moderate nuclear pleomorphism and minimal mitotic activity. A diagnosis of a low-grade osteosarcoma was given. The patient underwent surgical resection. There have been no signs of recurrence after 2 years of follow-up care.
CALCIFYING EPITHELIAL ODONTOGENIC TUMOR: A CASE REPORT. RUBIA TEODORO STUEPP, ANDRE LUIS BIM, FILIPE ^ S MEURER and, MODOLO SIQUEIRA, MARIA INE ROGERIO GONDAK Calcifying epithelial odontogenic tumor (CEOT) is a rare, benign odontogenic neoplasm with aggressive biologic behavior. A 29-year-old woman presented at the university hospital with a complaint of a painless swelling in the right mandibular region that was fibrous in consistency on palpation. Computed tomography (CT) revealed a well-defined radiolucency (3.5 £ 2.8 £ 2.0 cm) in the mandibular body, permeated by foci of calcification, associated with the crown of an unerupted molar. Cortical expansion and focal areas of perforation were identified. Based on CT, the differential diagnosis included: calcifying cystic odontogenic tumor, calcifying epithelial odontogenic tumor, ameloblastic fibro-odontoma and adenomatoid odontogenic tumor. The microscopic examination revealed sheets of polyhedral, neoplastic, odontogenic epithelial cells with prominent cellular outlines and intercellular bridges. Calcified areas and eosinophilic amyloidlike material were identified. The diagnosis of CEOT was given. Mandibular segmental resection and reconstruction with titanium plate was performed with no recurrence after 3 years’ follow-up.
A SYNCHRONOUS PARACOCCIDIOIDOMYCOSIS AND SQUAMOUS CELL CARCINOMA: A CASE REPORT. PATRICIA DE SOUSA FILGUEIRAS, FABRICIO PASSADOR-SANTOS, VICTOR ANGELO MARTINS MONTALLI, ARTHUR
e48
BORGES ALVES, VALERIA SOUZA FREITAS, JENER GONCALVES ¸ DE FARIAS, MARIA EMILIA SANTOS PEREIRA RAMOS, BRUNO CUNHA PIRES and, MARCIO CAMPOS OLIVEIRA Papillary squamous cell carcinoma is uncommon in the oral cavity and when it occurs, it usually presents as a single ulcerative-vegetative lesion. We report a case of a 73-year-old man who sought care for inflammation in the mouth for 3 months and asked for a biopsy. This patient was edentulous, without comorbidities, and without history of smoking or alcohol use. On examination, left lymph node enlargement (level 1B) measuring 4 £ 3 cm and 2 ulcerated lesions, 1 in the retromolar region and other at the alveolar ridge and floor of the mouth interface, both on left side, were identified. Incisional biopsies and histopathologic examination were performed, the first lesion was diagnosed as carcinoma in situ and the second one as papillary squamous cell carcinoma, represented by the proliferation of malignant cells in basaloid morphology and arranged in papillary projections. The tumor was classified as T3 N2 aM0, stage III-B and the patient underwent chemotherapy and radiotherapy, along with close monitoring by a team of specialists.
MASSIVE EXTRUSION OF CALCIUM HYDROXIDE PASTE CONTAINING BARIUM SULFATE DURING ENDODONTIC TREAT ^ CA, NATALIA MENT. JESSICA MONTENEGRO FONSE RANGEL PALMIER, GLEYSON KLEBER DO AMARALSILVA, LADY PAOLA ARISTIZABAL ARBOLEDA, PABLO AGUSTIN VARGAS, MARCIO AJUDARTE LOPES and, ALAN ROGER SANTOS-SILVA A 31-year-old woman was referred for evaluation of persistent numbness on the left side of the lower lip, which began during endodontic treatment of the left mandibular first molar. Imaging exams showed a large amount of a radiopaque or hyperdense throughout the left mandibular body in close proximity to the lower alveolar nerve. Histologic analyses identified birefringent crystalloid foreign bodies widespread through soft tissue and bone leading to an inflammatory foreign body reaction, eventually demonstrated to be rich in barium and sulfur by the means of scanning electron microscopy coupled with energy dispersive x-ray detection. This scenario led to the diagnosis of lower alveolar nerve injury due to accidental extrusion of intracanal dressing material composed of calcium hydroxide (CaOH2) paste incorporated with BaSO4. The paresthesia was treated with the combination of citoneurin and prednisone, but no improvement in nerve sensitivity was noticed after 12 months of follow-up examination.
THE RISK OF FACIAL FILLINGS DURING AESTHETIC PROCEDURES: A CASE REPORT. ELIANDRO DE SOUZA FREITAS, DANIEL FROTA DE SOUZA, LARISSA LUZIA DA SILVA ARAUJO and, TIAGO NOVAES PINHEIRO Facial cosmetic procedures are increasing in demand for plastic surgeons and dental professionals nowadays. This study highlights some of the risks related to such procedures, reporting a case of a painful, fluctuating nodule in the midline of the vestibular sulcus, extending to the upper lip. The patient, a 32-yearold man, showed a normochromic swelling of the affected region with 2 years’ history of evolution. The patient stated that he
OOOO January 2020 underwent a rhinoplasty procedure 5 years earlier. An excisional biopsy was performed and the lesion was diagnosed as a foreign body granuloma caused by methylmethacrylate. A wide morphologic investigation with polarized light and fluorescence microscopy was applied in order to confirm the filling material. Multiple splintered synthetic spherules were noted; these spherules were surrounded by foreign body giant cells circumscribed by a thin fibrous capsule and infiltrated by lymphocytes. The clinical follow-up was uneventful after 7 months.
LOW-GRADE OSTEOSARCOMA OF THE MANDIBLE: A CASE REPORT. RUBIA ^ TEODORO STUEPP, LISIANE CANDIDO and, ROGERIO GONDAK Osteosarcoma of the jaws is a rare and aggressive malignant mesenchymal tumor characterized by the formation of osteoid tissue. A 32-year-old male patient reported a complaint of a painless, slow swelling on the right side of the mandible and paresthesia of the lower lip. Intraoral examination revealed a smooth nodular mass in the lower right alveolar ridge and dental mobility of the lower second molar. Computed tomography showed a mixed density lesion of the right body of the mandible with irregular margins and cortical erosions. There was a widened periodontal ligament space of the first and second lower molars. After incisional biopsy, the histologic sections revealed areas of mineralization and proliferation of stellate and spindle cells in a myxoid matrix. The cells showed moderate nuclear pleomorphism and minimal mitotic activity. A diagnosis of a low-grade osteosarcoma was given. The patient underwent surgical resection. There have been no signs of recurrence after 2 years of follow-up care.
CALCIFYING EPITHELIAL ODONTOGENIC TUMOR: A CASE REPORT. RUBIA TEODORO STUEPP, ANDRE LUIS BIM, FILIPE ^ S MEURER and, MODOLO SIQUEIRA, MARIA INE ROGERIO GONDAK Calcifying epithelial odontogenic tumor (CEOT) is a rare, benign odontogenic neoplasm with aggressive biologic behavior. A 29-year-old woman presented at the university hospital with a complaint of a painless swelling in the right mandibular region that was fibrous in consistency on palpation. Computed tomography (CT) revealed a well-defined radiolucency (3.5 £ 2.8 £ 2.0 cm) in the mandibular body, permeated by foci of calcification, associated with the crown of an unerupted molar. Cortical expansion and focal areas of perforation were identified. Based on CT, the differential diagnosis included: calcifying cystic odontogenic tumor, calcifying epithelial odontogenic tumor, ameloblastic fibro-odontoma and adenomatoid odontogenic tumor. The microscopic examination revealed sheets of polyhedral, neoplastic, odontogenic epithelial cells with prominent cellular outlines and intercellular bridges. Calcified areas and eosinophilic amyloidlike material were identified. The diagnosis of CEOT was given. Mandibular segmental resection and reconstruction with titanium plate was performed with no recurrence after 3 years’ follow-up.
A SYNCHRONOUS PARACOCCIDIOIDOMYCOSIS AND SQUAMOUS CELL CARCINOMA: A CASE REPORT. PATRICIA DE SOUSA FILGUEIRAS, FABRICIO PASSADOR-SANTOS, VICTOR ANGELO MARTINS MONTALLI, ARTHUR