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Malignant Transformation of Giant Cell Tumor Affecting the Lower Lip
ORAL AND MAXILLOFACIAL PATHOLOGY e68 Abstracts of the mucosa, and resistant to palpation. The diagnostic hypothesis was papillary hyperplasia, but the histopathological examination indicated oral lymphoepithelial cyst. The clinical characteristics of oral lymphoepithelial cyst are nonspecific and can be confused with those of other intraoral lesions.
PCC-221 - NEUROFIBROMATOSIS TYPE 1 ASSOCIATED WITH RARE FACIAL CLEFT: A CASE REPORT. ELOÁ BORGES LUNA, LMS ALMEIDA, RAFAELA ELVIRA ROZZA DE MENEZES, PN ALMEIDA, TAIANA CAMPOS LEITE, FLÁVIA LIMA KLEINSORGEN MOTTA, KARIN SOARES GONÇALVES CUNHA. UNIVERSIDADE FEDERAL FLUMINENSE. Neurofibromatosis type 1 (NF1) is a dominant autosomal disease that can affect almost all organic systems and its manifestations include multiple neurofibromas, “cafe au lait” spots on the skin and bone alterations, such as sphenoid dysplasia and malformations of the jaws. Facial clefts are rare congenital abnormalities. We report a case of a 46-year-old female with NF1 and facial cleft classified as Tessier number 2e12, treated surgically during childhood. Ocular hypertelorism, deepening of the glabellar region, and a scar of the repaired cleft on the nose and upper lip were observed. Cone-beam computed tomography demonstrated a right bone cleft extending from the medial orbital region, extending laterally to the piriform opening and ending at the right maxilla. To our knowledge, this is the first reported case of Tessier facial cleft in association with NF1.
PCC-222 - MAXILLARY LEIOMYOSARCOMA MISDIAGNOSED AS DENTAL ABSCESS. CLAUDIA JOFFILY PARAHYBA, ANA CRISTINA FROELIC ALÓ NESRALLAH, MILENA CORREIA DE PINHO, CLAUDIA REGINA GOMES CARDIM DE OLIVEIRA, ANA CLAUDIA LUIZ, THAÍS BIANCA BRANDÃO, EDUARDO RODRIGUES FREGNANI. INSTITUTO DE ENSINO E PESQUISA HOSPITAL SÍRIO LIBANÊS. Leiomyosarcoma of the oral cavity is an uncommon malignant soft tissue tumor associated with aggressive clinical behavior and poor prognosis. A 43-year-old male had undergone extraction of tooth #27, diagnosed as abscess, 3 months before, with no scarring but with possible oroantral communication. The patient sought out our facility for a second opinion, because the initial treatment was unsuccessful. On physical examination, he presented significant left facial swelling in the posterior superior alveolar ridge and mobility of teeth #25 and #26. Imaging demonstrated a tumor-like lesion involving the left maxillary sinus and nasal cavity, as well as invading the retro-orbital space. An incisional biopsy was performed. Histopathological and immunohistochemical studies indicated a diagnosis of leiomyosarcoma. The lesions were initially treated with chemotherapy alone. However, metastases to the spine were identified and radiotherapy was added. Early diagnosis and aggressive initial treatment remain imperative for a better prognosis of leiomyosarcoma.
PCC-223 - MALIGNANT TRANSFORMATION OF GIANT CELL TUMOR AFFECTING THE LOWER LIP. JORGE ESQUICHE LEÓN, LUCIANA YAMAMOTO DE ALMEIDA, MARISOL MARTÍNEZ MARTÍNEZ, FERNANDA DOS SANTOS MOREIRA, ALÍCIA RUMAYOR PIÑA, RENATO ASSIS MACHADO. FACULDADE DE ODONTOLOGIA DE RIBEIRÃO PRETO e USP.
OOOO August 2015 Giant cell tumor of soft tissue (GCT-ST) is a relatively rare neoplasm that is clinically and microscopically indistinguishable from its counterpart in bone. The lesions are superficial and involve the lower extremities and trunk, being rare in the head and neck region. Although GCT-ST is predominantly a benign condition, its capacity to recur or evolve into a malignant lesion is well recognized. Here, we present a case affecting a 50-year-old female who presented with a nodular lesion on the lower lip and diagnosed as benign GCT-ST. After 1 year of follow-up, the patient returned with a larger lesion in the same location. The microscopic examination and immunohistochemical analysis confirmed the diagnosis of malignant transformation of GCT-ST. Malignant GCT-ST is composed of cytologically malignant mononuclear cells that lack definite lineage differentiation, together with osteoclast-like giant cells. To our knowledge, this is the first report of malignant GCT-ST affecting the lip.
PCC-224 - ORAL MUCOSAL MELANOMA: A CASE REPORT. ELISANDRA SILVA DO CARMO, ALÍCIA RUMAYOR PIÑA, ANNA CAROLINA OMENA VASCONCELLOS LE CAMPION, OSLEI PAES DE ALMEIDA, STEFÂNIA JERONIMO FERREIRA, CAMILA MARIA BEDER RIBEIRO, SONIA MARIA SOARES FERREIRA. CENTRO UNIVERSITÁRIO CESMAC. Oral mucosal melanoma is a rare aggressive lesion of melanocytic origin but unknown etiology that affects individuals in the sixth to eighth decades of life. A 60-year-old black female sought treatment at our stomatology clinic, complaining of a lesion in the oral cavity that evolved over the course of 1 year. Clinical examination revealed a disseminated, hyperchromic, infiltrative, sessile lesion, on the palate and upper alveolar ridges, with a soft consistency and smooth surface. The diagnostic hypothesis was melanoma. After incisional biopsy, histopathological analysis revealed proliferation of atypical melanocytes. Immunohistochemistry showed positivity for S-100, HMB-45 and Melan-A. These findings confirmed the diagnosis of melanoma. The patient was referred for treatment and remains under close follow-up. This case report shows that the dentist plays an important role in identifying such oral lesions, which can exhibit infiltrative growth and need to be biopsied in order to confirm or exclude malignancy.
PCC-225 - ORAL PLASMABLASTIC LYMPHOMA ASSOCIATED WITH AIDS. VIVIAN PETERSEN WAGNER, MARCO ANTONIO TREVIZANI MARTINS, HELENA PEREIRA RODRIGUES DA SILVA, BRUNA JALFIM MARASCHIN, VINÍCIUS COELHO CARRARD, LUISE MEURER, MANOELA DOMINGUES MARTINS. UNIVERSIDADE FEDERAL DO RIO GRANDE DO SUL. Non-Hodgkin’s lymphoma (NHL) represents the second most common HIV-associated malignancy, occurring 60 times more at HIV-infected individuals than in the healthy population. Plasmablastic lymphoma (PL) is a rare form of NHL with plasma cell differentiation. A 33-year-old HIV-infected female presented a painless and locally ulcerated lesion located at the mandibular buccal and lingual vestibule, extending from the second right premolar to first right molar, which had appeared 20 days earlier. The teeth adjacent to the lesion showed severe mobility. A single submandibular lymph node was increased in size. The patient reported having stopped her antiretroviral therapy for the last 4 months, because of nausea. An incisional biopsy of the intraoral
PCC-221 - NEUROFIBROMATOSIS TYPE 1 ASSOCIATED WITH RARE FACIAL CLEFT: A CASE REPORT. ELOÁ BORGES LUNA, LMS ALMEIDA, RAFAELA ELVIRA ROZZA DE MENEZES, PN ALMEIDA, TAIANA CAMPOS LEITE, FLÁVIA LIMA KLEINSORGEN MOTTA, KARIN SOARES GONÇALVES CUNHA. UNIVERSIDADE FEDERAL FLUMINENSE. Neurofibromatosis type 1 (NF1) is a dominant autosomal disease that can affect almost all organic systems and its manifestations include multiple neurofibromas, “cafe au lait” spots on the skin and bone alterations, such as sphenoid dysplasia and malformations of the jaws. Facial clefts are rare congenital abnormalities. We report a case of a 46-year-old female with NF1 and facial cleft classified as Tessier number 2e12, treated surgically during childhood. Ocular hypertelorism, deepening of the glabellar region, and a scar of the repaired cleft on the nose and upper lip were observed. Cone-beam computed tomography demonstrated a right bone cleft extending from the medial orbital region, extending laterally to the piriform opening and ending at the right maxilla. To our knowledge, this is the first reported case of Tessier facial cleft in association with NF1.
PCC-222 - MAXILLARY LEIOMYOSARCOMA MISDIAGNOSED AS DENTAL ABSCESS. CLAUDIA JOFFILY PARAHYBA, ANA CRISTINA FROELIC ALÓ NESRALLAH, MILENA CORREIA DE PINHO, CLAUDIA REGINA GOMES CARDIM DE OLIVEIRA, ANA CLAUDIA LUIZ, THAÍS BIANCA BRANDÃO, EDUARDO RODRIGUES FREGNANI. INSTITUTO DE ENSINO E PESQUISA HOSPITAL SÍRIO LIBANÊS. Leiomyosarcoma of the oral cavity is an uncommon malignant soft tissue tumor associated with aggressive clinical behavior and poor prognosis. A 43-year-old male had undergone extraction of tooth #27, diagnosed as abscess, 3 months before, with no scarring but with possible oroantral communication. The patient sought out our facility for a second opinion, because the initial treatment was unsuccessful. On physical examination, he presented significant left facial swelling in the posterior superior alveolar ridge and mobility of teeth #25 and #26. Imaging demonstrated a tumor-like lesion involving the left maxillary sinus and nasal cavity, as well as invading the retro-orbital space. An incisional biopsy was performed. Histopathological and immunohistochemical studies indicated a diagnosis of leiomyosarcoma. The lesions were initially treated with chemotherapy alone. However, metastases to the spine were identified and radiotherapy was added. Early diagnosis and aggressive initial treatment remain imperative for a better prognosis of leiomyosarcoma.
PCC-223 - MALIGNANT TRANSFORMATION OF GIANT CELL TUMOR AFFECTING THE LOWER LIP. JORGE ESQUICHE LEÓN, LUCIANA YAMAMOTO DE ALMEIDA, MARISOL MARTÍNEZ MARTÍNEZ, FERNANDA DOS SANTOS MOREIRA, ALÍCIA RUMAYOR PIÑA, RENATO ASSIS MACHADO. FACULDADE DE ODONTOLOGIA DE RIBEIRÃO PRETO e USP.
OOOO August 2015 Giant cell tumor of soft tissue (GCT-ST) is a relatively rare neoplasm that is clinically and microscopically indistinguishable from its counterpart in bone. The lesions are superficial and involve the lower extremities and trunk, being rare in the head and neck region. Although GCT-ST is predominantly a benign condition, its capacity to recur or evolve into a malignant lesion is well recognized. Here, we present a case affecting a 50-year-old female who presented with a nodular lesion on the lower lip and diagnosed as benign GCT-ST. After 1 year of follow-up, the patient returned with a larger lesion in the same location. The microscopic examination and immunohistochemical analysis confirmed the diagnosis of malignant transformation of GCT-ST. Malignant GCT-ST is composed of cytologically malignant mononuclear cells that lack definite lineage differentiation, together with osteoclast-like giant cells. To our knowledge, this is the first report of malignant GCT-ST affecting the lip.
PCC-224 - ORAL MUCOSAL MELANOMA: A CASE REPORT. ELISANDRA SILVA DO CARMO, ALÍCIA RUMAYOR PIÑA, ANNA CAROLINA OMENA VASCONCELLOS LE CAMPION, OSLEI PAES DE ALMEIDA, STEFÂNIA JERONIMO FERREIRA, CAMILA MARIA BEDER RIBEIRO, SONIA MARIA SOARES FERREIRA. CENTRO UNIVERSITÁRIO CESMAC. Oral mucosal melanoma is a rare aggressive lesion of melanocytic origin but unknown etiology that affects individuals in the sixth to eighth decades of life. A 60-year-old black female sought treatment at our stomatology clinic, complaining of a lesion in the oral cavity that evolved over the course of 1 year. Clinical examination revealed a disseminated, hyperchromic, infiltrative, sessile lesion, on the palate and upper alveolar ridges, with a soft consistency and smooth surface. The diagnostic hypothesis was melanoma. After incisional biopsy, histopathological analysis revealed proliferation of atypical melanocytes. Immunohistochemistry showed positivity for S-100, HMB-45 and Melan-A. These findings confirmed the diagnosis of melanoma. The patient was referred for treatment and remains under close follow-up. This case report shows that the dentist plays an important role in identifying such oral lesions, which can exhibit infiltrative growth and need to be biopsied in order to confirm or exclude malignancy.
PCC-225 - ORAL PLASMABLASTIC LYMPHOMA ASSOCIATED WITH AIDS. VIVIAN PETERSEN WAGNER, MARCO ANTONIO TREVIZANI MARTINS, HELENA PEREIRA RODRIGUES DA SILVA, BRUNA JALFIM MARASCHIN, VINÍCIUS COELHO CARRARD, LUISE MEURER, MANOELA DOMINGUES MARTINS. UNIVERSIDADE FEDERAL DO RIO GRANDE DO SUL. Non-Hodgkin’s lymphoma (NHL) represents the second most common HIV-associated malignancy, occurring 60 times more at HIV-infected individuals than in the healthy population. Plasmablastic lymphoma (PL) is a rare form of NHL with plasma cell differentiation. A 33-year-old HIV-infected female presented a painless and locally ulcerated lesion located at the mandibular buccal and lingual vestibule, extending from the second right premolar to first right molar, which had appeared 20 days earlier. The teeth adjacent to the lesion showed severe mobility. A single submandibular lymph node was increased in size. The patient reported having stopped her antiretroviral therapy for the last 4 months, because of nausea. An incisional biopsy of the intraoral