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LUPUS ERYTHEMATOSUS DIAGNOSED THROUGH ORAL MANIFESTATIONS
ABSTRACTS
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DIAGNOSES OF CASES SUBMITTED AS ORAL PRESENTATIONS IN THE BRAZILIAN CONGRESS OF ORAL MEDICINE AND PATHOLOGY. NATHALIA DE ALMEIDA FREIRE, ANA ^ A ROZA, KELLY TAMBASCO LUIZA OLIVEIRA CORRE BEZERRA, MICHELLE AGOSTINI, BRUNO AUGUSTO BENEVENUTO DE ANDRADE and, MARIO JOSE e ROMANACH The diagnoses of the cases submitted as oral presentations (OP) in the last 12 annual meetings of the Brazilian Society of Oral Medicine and Pathology (SOBEP) were retrieved from the abstracts available from 2006 to 2017. All diagnoses were classified in categories according to their etiology. There were 491 cases submitted as OP in the last 12 years; 210 cases collected from 5 Portugueselanguage abstracts and 281 cases collected from 7 English-language abstracts. The median number was of 41 OP cases per year, varying from 24 to 64 cases. The most common group was malignant tumors (140 cases, 28.5%), mainly lymphomas and leukemias (33 cases, 23.5%), sarcomas (30 cases, 21.4%), squamous cell carcinoma (25 cases, 17.8%), metastases (24 cases, 17.1%), malignant salivary gland tumors (18 cases, 12.8%), and malignant odontogenic tumors (10 cases, 7.1%). A descriptive analysis of the diagnoses of OP cases in the last 12 SOBEP meetings is offered.
DIFFUSE SCLEROSING OSTEOMYELITIS TREATED WITH METHOTREXATE: CASE REPORT. JULIANA CALEGARIO DE ANDRADE, RENATA LEMOS FERRARI, MARTA ACTIS LIMA, NATHALIA DE ALMEIDA FREIRE, MARIO JOSE e ROMANACH, SARAH APARECIDA ANTERO and, ^ e ISRAEL MONICA SIMOES Diffuse sclerosing osteomyelitis (DSO) affects adults, exhibits no gender predilection, and often occurs in the jawbone. A 20year-old male patient presented to our service with "facial pain" and mandibular asymmetry caused by a bone enlargement in the right side. Computerized tomography (CT) scanning showed large, mixed radiolucent and radiopaque areas associated with bone erosions from mandibular condyle to ipsilateral body. Culture and antibiogram analysis were negative. Histopathologic examination demonstrated unspecified bone inflammation signs. After review of the literature, the patient was referred to a rheumatologist and methotrexate in combination with folic acid was initiated on a weekly basis. The patient reports progressive reduction of pain although facial asymmetry still persists. Diagnosis of DSO may be challenging due to nonspecific findings and rarity of the disease. Fibrous dysplasia should be ruled out.
LUPUS ERYTHEMATOSUS DIAGNOSED THROUGH ORAL MANIFESTATIONS. MAYARA LEONEL DUARTE MEIRA, NATHALIA DE ALMEIDA FREIRE, WAGNER PINTO DAS CHAGAS, THAIS PIMENTEL DE SA BAHIA, BRUNO AUGUSTO BENEVENUTO DE ANDRADE, MARIO JOSE e ^ ROMANACH GONZALEZ SOBRINHO and, MONICA e ISRAEL SIMOES Systemic lupus erythematosus is a classic example of an immunologically mediated condition, which involves several systems, with a variety of cutaneous and oral manifestations. It’s a disease that is hard to diagnose, as it often presents in a
OOOO January 2020 nonspecific way, with periods of remission or inactivity of the disease. The final diagnosis depends on clinical, microscopic, and serologic associations. A male patient, 17 years of age, was referred to the stomatology clinic with a complaint of multiple lesions in the oral cavity. Extraoral clinical examination revealed hyperpigmented skin spots on the face, and intraoral examination revealed multiple ulcerated lesions, symptomatic, throughout the oral cavity, with an evolution time of approximately 13 years. An incisional biopsy was performed with a diagnosis of lupus erythematosus, along with laboratory exams including antinuclear antibody, anti double strand deoxyribonucleic acid antibodies, and anti-Smith antibodies, which aided in the diagnosis. The patient was referred to the dermatologist for treatment and is being followed up currently.
CRITICAL APPRAISAL OF ORAL SQUAMOUS CELL CARCINOMA MANAGE MENT—A CASE REPORT. NATALIA BATISTA DAROIT, MONIQUE SANTANA CANDREVA, SARAH APARECIDA ANTERO, WAGNER PINTO DAS CHAGAS, ROSEMIRO DE MENEZES MACIEL, NATALIA DE ^ e ALMEIDA FREIRE and, MONICA SIMOES ISRAEL Squamous cell carcinoma is the most frequent oral malignant neoplasm. Early diagnosis is key in successful treatment of this neoplasia. The aims of this study are to report a case of an aggressive squamous cell carcinoma, to discuss the factors involved in the late diagnosis of an advanced lesion, and to make a critical appraisal of the Brazilian health system and the difficulties found in referring these patients. A male patient, 50 years of age with a history of chronic alcoholism and tobacco use, presented with a proliferative ulcer with an indurated, raised margin, involving the left palate, the lower gingiva, and the buccal mucosa extending and overlying the skin. The extraoral incisional biopsy confirmed the diagnosis of squamous cell carcinoma and the patient was referred to an oncologist. The factors that delay this diagnosis are: misinformation, self-care negligence, and socioeconomic patient aspects; inappropriate oral mucosa examination; unfamiliarity with oral diseases; and difficulties with referral for oncologic treatment. The diagnostic delay results in greater morbidity and mortality due to the disease.
DIAGNOSTIC CHALLENGE OF BENIGN FIBROUS HISTIOCYTOMA—A CASE REPORT. NATALIA BATISTA DAROIT, BIANCA DE BEM PRUNES, ANA LUISA SARAIVA HOMEM DE CARVALHO, FABIO DEL MORO MAITO and, PANTELIS VARVAKI RADOS In many cases, the microscopic analysis of soft tissue tumors is complex. The final accurate diagnosis usually involves morphology and immunohistochemical characteristics that should be coupled with clinical findings. A 77-year-old female patient presented with an asymptomatic purplish sessile nodule in the hard palate. Serologic examination results showed normal limits. Tomographic image disclosed a well-circumscribed exophytic mass associated with discrete bone reabsorption of floor of the nasal fossa. Histopathologic examination revealed histiocytoid and spindle cell proliferation with multiple pericytomalike vessels in a fibrous connective tissue. An immunohistochemical panel showed a positive stain for CD10, vimentin, CD163,
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DIAGNOSES OF CASES SUBMITTED AS ORAL PRESENTATIONS IN THE BRAZILIAN CONGRESS OF ORAL MEDICINE AND PATHOLOGY. NATHALIA DE ALMEIDA FREIRE, ANA ^ A ROZA, KELLY TAMBASCO LUIZA OLIVEIRA CORRE BEZERRA, MICHELLE AGOSTINI, BRUNO AUGUSTO BENEVENUTO DE ANDRADE and, MARIO JOSE e ROMANACH The diagnoses of the cases submitted as oral presentations (OP) in the last 12 annual meetings of the Brazilian Society of Oral Medicine and Pathology (SOBEP) were retrieved from the abstracts available from 2006 to 2017. All diagnoses were classified in categories according to their etiology. There were 491 cases submitted as OP in the last 12 years; 210 cases collected from 5 Portugueselanguage abstracts and 281 cases collected from 7 English-language abstracts. The median number was of 41 OP cases per year, varying from 24 to 64 cases. The most common group was malignant tumors (140 cases, 28.5%), mainly lymphomas and leukemias (33 cases, 23.5%), sarcomas (30 cases, 21.4%), squamous cell carcinoma (25 cases, 17.8%), metastases (24 cases, 17.1%), malignant salivary gland tumors (18 cases, 12.8%), and malignant odontogenic tumors (10 cases, 7.1%). A descriptive analysis of the diagnoses of OP cases in the last 12 SOBEP meetings is offered.
DIFFUSE SCLEROSING OSTEOMYELITIS TREATED WITH METHOTREXATE: CASE REPORT. JULIANA CALEGARIO DE ANDRADE, RENATA LEMOS FERRARI, MARTA ACTIS LIMA, NATHALIA DE ALMEIDA FREIRE, MARIO JOSE e ROMANACH, SARAH APARECIDA ANTERO and, ^ e ISRAEL MONICA SIMOES Diffuse sclerosing osteomyelitis (DSO) affects adults, exhibits no gender predilection, and often occurs in the jawbone. A 20year-old male patient presented to our service with "facial pain" and mandibular asymmetry caused by a bone enlargement in the right side. Computerized tomography (CT) scanning showed large, mixed radiolucent and radiopaque areas associated with bone erosions from mandibular condyle to ipsilateral body. Culture and antibiogram analysis were negative. Histopathologic examination demonstrated unspecified bone inflammation signs. After review of the literature, the patient was referred to a rheumatologist and methotrexate in combination with folic acid was initiated on a weekly basis. The patient reports progressive reduction of pain although facial asymmetry still persists. Diagnosis of DSO may be challenging due to nonspecific findings and rarity of the disease. Fibrous dysplasia should be ruled out.
LUPUS ERYTHEMATOSUS DIAGNOSED THROUGH ORAL MANIFESTATIONS. MAYARA LEONEL DUARTE MEIRA, NATHALIA DE ALMEIDA FREIRE, WAGNER PINTO DAS CHAGAS, THAIS PIMENTEL DE SA BAHIA, BRUNO AUGUSTO BENEVENUTO DE ANDRADE, MARIO JOSE e ^ ROMANACH GONZALEZ SOBRINHO and, MONICA e ISRAEL SIMOES Systemic lupus erythematosus is a classic example of an immunologically mediated condition, which involves several systems, with a variety of cutaneous and oral manifestations. It’s a disease that is hard to diagnose, as it often presents in a
OOOO January 2020 nonspecific way, with periods of remission or inactivity of the disease. The final diagnosis depends on clinical, microscopic, and serologic associations. A male patient, 17 years of age, was referred to the stomatology clinic with a complaint of multiple lesions in the oral cavity. Extraoral clinical examination revealed hyperpigmented skin spots on the face, and intraoral examination revealed multiple ulcerated lesions, symptomatic, throughout the oral cavity, with an evolution time of approximately 13 years. An incisional biopsy was performed with a diagnosis of lupus erythematosus, along with laboratory exams including antinuclear antibody, anti double strand deoxyribonucleic acid antibodies, and anti-Smith antibodies, which aided in the diagnosis. The patient was referred to the dermatologist for treatment and is being followed up currently.
CRITICAL APPRAISAL OF ORAL SQUAMOUS CELL CARCINOMA MANAGE MENT—A CASE REPORT. NATALIA BATISTA DAROIT, MONIQUE SANTANA CANDREVA, SARAH APARECIDA ANTERO, WAGNER PINTO DAS CHAGAS, ROSEMIRO DE MENEZES MACIEL, NATALIA DE ^ e ALMEIDA FREIRE and, MONICA SIMOES ISRAEL Squamous cell carcinoma is the most frequent oral malignant neoplasm. Early diagnosis is key in successful treatment of this neoplasia. The aims of this study are to report a case of an aggressive squamous cell carcinoma, to discuss the factors involved in the late diagnosis of an advanced lesion, and to make a critical appraisal of the Brazilian health system and the difficulties found in referring these patients. A male patient, 50 years of age with a history of chronic alcoholism and tobacco use, presented with a proliferative ulcer with an indurated, raised margin, involving the left palate, the lower gingiva, and the buccal mucosa extending and overlying the skin. The extraoral incisional biopsy confirmed the diagnosis of squamous cell carcinoma and the patient was referred to an oncologist. The factors that delay this diagnosis are: misinformation, self-care negligence, and socioeconomic patient aspects; inappropriate oral mucosa examination; unfamiliarity with oral diseases; and difficulties with referral for oncologic treatment. The diagnostic delay results in greater morbidity and mortality due to the disease.
DIAGNOSTIC CHALLENGE OF BENIGN FIBROUS HISTIOCYTOMA—A CASE REPORT. NATALIA BATISTA DAROIT, BIANCA DE BEM PRUNES, ANA LUISA SARAIVA HOMEM DE CARVALHO, FABIO DEL MORO MAITO and, PANTELIS VARVAKI RADOS In many cases, the microscopic analysis of soft tissue tumors is complex. The final accurate diagnosis usually involves morphology and immunohistochemical characteristics that should be coupled with clinical findings. A 77-year-old female patient presented with an asymptomatic purplish sessile nodule in the hard palate. Serologic examination results showed normal limits. Tomographic image disclosed a well-circumscribed exophytic mass associated with discrete bone reabsorption of floor of the nasal fossa. Histopathologic examination revealed histiocytoid and spindle cell proliferation with multiple pericytomalike vessels in a fibrous connective tissue. An immunohistochemical panel showed a positive stain for CD10, vimentin, CD163,