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MALT LYMPHOMA OF THE SOFT PALATE: A CASE REPORT
OOOO Volume 129, Number 1 HIV was positive. Patient is on antiretroviral therapy and chemotherapy for sarcoma.
MYOFIBROMA IN PEDIATRIC PATIENTS: DIAGNOSIS AND TREATMENT OF A RARE LESION. CAMILA MELO MESQUITA, CARLA WELCH DA SILVA, GEORGE FERREIRA GOMES, JULIANA MARA OLIVEIRA SANTOS, ELIARDO SILVEIRA ^ SANTOS and, ANTONIO MOTALVERNE LOPES FILHO Myofibroma is a rare benign soft tissue neoplasm characterized by a large, growing, destructive mass. It shows predilection for the head and neck regions, the mandible being the most common oral location. Its biological behavior is unpredictable, presenting malignant lesions as differential diagnosis, and it is usually treated by surgical excision, despite reports of spontaneous regression. Patient E.T.S., 4 years old and female, was referred to our service with a chief complaint of showing "a lump in the chin." A swelling in the left mandible angle that was hard to palpation and associated to pain complaint with evolution of 6 months was observed. An incisional biopsy was performed, and the results revealed the diagnosis of myofibroma. The patient was referred to pediatrics for evaluation, the result being negative for others myofibromas. The treatment consisted of submandibular extraoral access for the excision of the tumor. The patient has 4 years of follow-up without signs of recurrence.
POLYOSTOTIC CRANIOMAXILLOFACIAL FIBROUS DYSPLASIA ASSOCIATED WITH ACROMEGALY: A CASE REPORT. CAMILA MELO MESQUITA, CARLA WELCH DA SILVA, GEORGE FERREIRA GOMES, ELIARDO SILVEIRA SANTOS, JEFERSON MARTINS PEREIRA LUCENA FRANCO, JOSE ITALO SOARES MOTA and, ROBERTO DIAS RE ^ GO McCune-Albright syndrome (MAS) is a complex congenital disorder due to mutations at the onset of embryonic activation of postzygotic somatic cells in the GNAS1 gene. The phenotype is heterogeneous and includes polyostotic/monostotic fibrous dysplasia, cafe-au-lait skin spots, and hyperfunctioning endocrinopathies including excess of growth hormone (GH). Similarly, acromegaly as a manifestation of endocrine hyperfunction is uncommon and affects about 20% of patients with MAS. Here, we describe a 31-year-old woman with severe facial involvement of polyostotic fibrous dysplasia, in association with acromegaly and McCune-Albright syndrome, in which it was satisfactorily managed by surgical recontouring, with no clinical signs of relapse at a 12-year follow-up. Patients with craniomaxillofacial fibrous dysplasia associated with acromegaly may present significant facial asymmetries, which can be satisfactorily solved by cosmetic treatment, especially in patients with psychological problems and problems of severe social acceptance.
USE OF THERMOGRAPHY FOR DIAGNOSIS OF ACTINIC CHEILITS AND LOWER LIP SQUAMOUS CELL CARCINOMA. INGRID MORGANA FERNANDES GONCALVES, ¸ ALANNE VANDREIA DA SILVA ALVES, KATIA ELIZABETE GALDINO, ROBSON PEQUENO DE SOUSA, DANIELA PITA DE MELO, CASSIANO FRANCISCO WEEGE NONAKA and, POLLIANNA MUNIZ ALVES
ABSTRACTS
e97
Lower lip squamous cell carcinoma (LLSCC) represents frequent lip malignant neoplasms, and the majority is preceded by actinic cheilitis (AC), a potentially malignant disorder. In this context, we report 3 cases of AC and 1 of LLSCC, emphasizing the importance of thermography as an auxiliary tool in diagnosis. In AC and LLSCC, thermography showed, respectively, whitish areas with higher heat emission and reddish circular area of irregular thermal distribution. After acquisition of thermography images, incisional biopsies were performed to evaluate microscopic alterations according to the criteria described by the World Health Organization (2017). Of the AC cases, 1 was diagnosed as mild epithelial dysplasia and 2 were moderate epithelial dysplasia. LLSCC was confirmed on anatomopathologic examination. As a result, we observed that thermography is not able to distinguish the different degrees of epithelial dysplasia found in AC, but it is a new imaging method useful in distinguishing AC from LLSCC.
EXTRANODAL NATURAL KILLER/T-CELL LYMPHOMA, NASAL TYPE: CLINICOPATHOLOGIC ANALYSIS OF 3 CASES. SARA FERREIRA DOS SANTOS COSTA, LUCAS LACERDA DE SOUZA, OSLEI PAES DE ALMEIDA, ANDERSON MAURICIO PAIVA E COSTA, FLAVIA SIROTHEAU ^ A PONTES, FELIPE PAIVA FONSECA and, CORRE ^ HELDER ANTONIO REBELO PONTES Extranodal natural killer (NK)/T-cell lymphoma is an aggressive malignant neoplasia, and the nasal cavity is the most commonly involved site. We present the clinicopathologic features of 3 patients including 2 women and 1 man with age varying from 41 to 70 years. The patients exhibited painful, extensive, destructive lesions with large ulceration predominantly affecting the hard palate. They also revealed other complications such as nasal obstruction, facial asymmetry, fever, and weight loss. Microscopically, all cases revealed a diffuse lymphoid infiltrate composed of small-to-medium sized neoplastic cells with large areas of necrosis and the angiocentric and angiodestructive growth pattern. Positivity for LCA, CD3, CD43, CD56, and granzyme B was observed. A low Ki-67 labeling index and positivity for Epstein-Barr virus were also observed. Two patients died, and 1 remains alive under treatment. Extranodal nasal NK/T-cell lymphoma presents a poor prognosis, and its diagnosis can be challenging. Support: FAPEMIG.
MALT LYMPHOMA OF THE SOFT PALATE: A CASE REPORT. CINTHIA VERONICA BARDALEZ LOPEZ DE CACERES, OSLEI PAES DE ALMEIDA, PABLO AGUSTIN VARGAS, HELDER ^ ANTONIO REBELO PONTES, ANDERSON MAURICIO PAIVA E COSTA, LUCAS LACERDA DE SOUZA and, FELIPE PAIVA FONSECA The aim of this report is to describe an original case of extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma). A 63-year-old male patient was referred to our department because of a painless swelling in his soft palate observed 2 months ago. The intraoral examination confirmed the presence of a well-defined swelling in the soft palate, extending to the oropharynx, exhibiting a normal colored overlying mucosa. Microscopically, a diffuse proliferation of small-sized neoplastic cells, some of them showing abundant eosinophilic cytoplasm, and reactive plasma cells were observed.
ABSTRACTS
e98
Lymphoepithelial lesions were also present. Immunohistochemistry showed positivity for LCA and CD20. Negative reactions against CD3, CD10, CD23, CD43, and cyclin D1 were also seen. The proliferative index measured by Ki67 expression was very low. The clinical, microscopic, and immunohistochemical data led to the diagnosis of MALT lymphoma. The patient received surgical therapy and is free of lesions.
ORAL MANIFESTATION OF WEGENER GRANULOMATOSIS: CASE REPORT. GISELE ^A CORRE DE OLIVEIRA, FERNANDA BROCHIER CARDOSO, LUAN NATHIEL SANTANA KOVALSKI, VINICIUS COELHO CARRARD, MICHELLE ROXO GONCALVES, ¸ JULIANA ROMANINI and, MARCO ANTONIO TREVIZANI MARTINS An 86-year-old man was evaluated complaining a painful lesion situated in the tongue with 45-day duration. Medical history revealed anemia, heart disease, vasculitis, and glomerulitis associated with the previous diagnosis of Wegener granulomatosis. Positive reaction for antineutrophil cytoplasmic autoantibodies (ANCA) was reported. Intraoral examination revealed an asymptomatic ulceration on the dorsum of the tongue surrounded by a whitish area that measures its 2.0 £ 1.0 cm in its largest diameters. Clinical hypotheses were Wegener granulomatosis (GW), fungal infection, or bacterial infection. Incisional biopsy was performed, and the histopathologic diagnosis was an unspecific ulceration. The study of BAAR (alcohol - resistant acid bacillus) and fungal infection were negative. The treatment consisted of topical corticosteroids (clobetasol), oral hygiene guidelines, and photobiomodulation with the diode laser. Lesion completely regressed in 60 days.
OSTEOSARCOMA OF THE JAWS: CLINICOPATHOLOGIC STUDY OF 3 CASES. ANDRE MYLLER BARBOSA SILVA, OSLEI PAES DE ALMEIDA, PABLO AGUSTIN VARGAS, LUCAS LACERDA DE SOUZA, FLAVIA SIROTHEAU CORREA ^ PONTES, HELDER ANTONIO REBELO PONTES and, FELIPE PAIVA FONSECA Osteosarcoma is the most frequent primary malignant bone tumor, but osteosarcomas of the jaws are uncommon and account for only 2% to 10% of all cases diagnosed. The aim of this study is to present 3 new cases of osteosarcoma affecting the gnathic bones. The mandible was affected in 2 cases, whereas the maxilla was involved in 1. Age ranged from 10 to 25 years, and all patients were female. An asymptomatic expansive swelling was the chief complaint in all cases. Microscopically, a diffuse proliferation of pleomorphic cells with presence of osteoid material and variable number of atypical mitotic features were observed. Ki67 staining showed a proliferative index of approximately 15%, and positivity for D2-40 and CDK4 were also observed. All patients are currently under oncological treatment. Support: FAPEMIG.
MANAGEMENT OF PREGNANT PATIENT WITH MANDIBULAR INJURY. EVA AGUIAR ALMEIDA CAMPOS CASTRO TORRIANI, LUISA BERLATO, VICTOR DE MELLO PALMA and, CRISTIANE CADEMARTORI DANESI The management of pregnant women in dentistry is a challenge that requires attention and interdisciplinary care. This study
OOOO January 2020 reports the case of mandibular intraosseous lesion in pregnant women, addressing tomographic dose, type of anesthetic procedure, moment of intervention, and outcome of treatment. The patient is 44 years old with complaint of lack of sensitivity in the mental region. She was on the third gestational month, and had done cone beam tomography. Clinical examination revealed a slight increase in mandibular volume, absence of decayed teeth, or periodontal pocket in the involved teeth. After contact with the attending physician, an incisional biopsy was performed with 2% lidocaine with epinephrine, with diagnostic hypotheses of Central giant cell granuloma (CGCG), ameloblastoma, and aneurysmal bone cyst. After definitive diagnosis of CGCG, we chose to perform surgical treatment after childbirth. The patient returned 1 year later, and the lesion spontaneously regressed. After 2 years, computed tomography showed total wound healing.
DIFFUSE LARGE B-CELL LYMPHOMA IN THE e UPPER LIP: CASE REPORT. GEORGE JOAO FERREIRA DO NASCIMENTO, INGRIDY CRISTINY DE SOUSA MOREIRA, MARIA DE FATIMA, MARIA DE FATIMA VIEIRA ALVES, ANA PAULA VERAS SOBRAL, LEORIK PEREIRA DA SILVA, KEILA MARTHA AMORIM BARROSO and, CYNTIA HELENA PEREIRA DE CARVALHO Diffuse large B-cell lymphomas (DLBCLs) are uncommon in the mouth; however, they are the commonest type of nonHodgkin lymphomas at this site. Preferentially, they affect tonsils and their occurrence in the upper lip is rare. This work reports a case of DLBCL arising in the left upper lip of a 73year-old white woman that was recently diagnosed as having advanced breast cancer besides being a carrier of Parkinson and Alzheimer diseases. The mucosal surface of the upper lip displayed a solitary, fast-growing, painful, ulcerated, reddish, and sessile 4-cm-sized swelling without cervical lymph node involvement at presentation. After incisional biopsy, the microscopic analysis showed a lymphoid cell malignant neoplasm presenting great amounts of large-to-medium sized cells resembling centroblasts losing cell cohesion. Immunohistochemical profile was intensely positive for CD20 and Ki-67, diffusely positive for CD3, and negative for pan-cytokeratins. Unfortunately, the patient died 2 weeks after our clinical care before receiving her final diagnosis.
ORAL MANIFESTATIONS OF SCLERODERMA - CASE REPORT. FABIANE MARQUES DOS SANTOS FREIRE, KELLY TAMBASCO BEZERRA, NATHALIA SCHETTINI SETUBAL FERME, VALDIR MEIRELLES JUNIOR, MARCIA GRILLO CABRAL, JOSE ALEXANDRE DA ROCHA CURVELO and, MARIA ELISA RANGEL JANINI Scleroderma is a rare autoimmune disease of unknown etiology characterized by the acumination of collagen in the tissues, which can be divided into localized and systemic. The localized one occurs more in the skin and rarely intraorally. Patient M.S. O., 45 years old and white, was referred to the stomatology clinic presenting painful symptomatology on the left side palate. In her anamnesis, she reported fibromyalgia. Intraoral examination revealed leukoplastic plaques on the palate in a "saber-throb" pattern and the tongue. Use of Omcilon-A orabase was indicated without regression of the condition. Prescription prednisone 20 mg, 1 tablet/d was applied. After 3 days, regression of 80% of
MYOFIBROMA IN PEDIATRIC PATIENTS: DIAGNOSIS AND TREATMENT OF A RARE LESION. CAMILA MELO MESQUITA, CARLA WELCH DA SILVA, GEORGE FERREIRA GOMES, JULIANA MARA OLIVEIRA SANTOS, ELIARDO SILVEIRA ^ SANTOS and, ANTONIO MOTALVERNE LOPES FILHO Myofibroma is a rare benign soft tissue neoplasm characterized by a large, growing, destructive mass. It shows predilection for the head and neck regions, the mandible being the most common oral location. Its biological behavior is unpredictable, presenting malignant lesions as differential diagnosis, and it is usually treated by surgical excision, despite reports of spontaneous regression. Patient E.T.S., 4 years old and female, was referred to our service with a chief complaint of showing "a lump in the chin." A swelling in the left mandible angle that was hard to palpation and associated to pain complaint with evolution of 6 months was observed. An incisional biopsy was performed, and the results revealed the diagnosis of myofibroma. The patient was referred to pediatrics for evaluation, the result being negative for others myofibromas. The treatment consisted of submandibular extraoral access for the excision of the tumor. The patient has 4 years of follow-up without signs of recurrence.
POLYOSTOTIC CRANIOMAXILLOFACIAL FIBROUS DYSPLASIA ASSOCIATED WITH ACROMEGALY: A CASE REPORT. CAMILA MELO MESQUITA, CARLA WELCH DA SILVA, GEORGE FERREIRA GOMES, ELIARDO SILVEIRA SANTOS, JEFERSON MARTINS PEREIRA LUCENA FRANCO, JOSE ITALO SOARES MOTA and, ROBERTO DIAS RE ^ GO McCune-Albright syndrome (MAS) is a complex congenital disorder due to mutations at the onset of embryonic activation of postzygotic somatic cells in the GNAS1 gene. The phenotype is heterogeneous and includes polyostotic/monostotic fibrous dysplasia, cafe-au-lait skin spots, and hyperfunctioning endocrinopathies including excess of growth hormone (GH). Similarly, acromegaly as a manifestation of endocrine hyperfunction is uncommon and affects about 20% of patients with MAS. Here, we describe a 31-year-old woman with severe facial involvement of polyostotic fibrous dysplasia, in association with acromegaly and McCune-Albright syndrome, in which it was satisfactorily managed by surgical recontouring, with no clinical signs of relapse at a 12-year follow-up. Patients with craniomaxillofacial fibrous dysplasia associated with acromegaly may present significant facial asymmetries, which can be satisfactorily solved by cosmetic treatment, especially in patients with psychological problems and problems of severe social acceptance.
USE OF THERMOGRAPHY FOR DIAGNOSIS OF ACTINIC CHEILITS AND LOWER LIP SQUAMOUS CELL CARCINOMA. INGRID MORGANA FERNANDES GONCALVES, ¸ ALANNE VANDREIA DA SILVA ALVES, KATIA ELIZABETE GALDINO, ROBSON PEQUENO DE SOUSA, DANIELA PITA DE MELO, CASSIANO FRANCISCO WEEGE NONAKA and, POLLIANNA MUNIZ ALVES
ABSTRACTS
e97
Lower lip squamous cell carcinoma (LLSCC) represents frequent lip malignant neoplasms, and the majority is preceded by actinic cheilitis (AC), a potentially malignant disorder. In this context, we report 3 cases of AC and 1 of LLSCC, emphasizing the importance of thermography as an auxiliary tool in diagnosis. In AC and LLSCC, thermography showed, respectively, whitish areas with higher heat emission and reddish circular area of irregular thermal distribution. After acquisition of thermography images, incisional biopsies were performed to evaluate microscopic alterations according to the criteria described by the World Health Organization (2017). Of the AC cases, 1 was diagnosed as mild epithelial dysplasia and 2 were moderate epithelial dysplasia. LLSCC was confirmed on anatomopathologic examination. As a result, we observed that thermography is not able to distinguish the different degrees of epithelial dysplasia found in AC, but it is a new imaging method useful in distinguishing AC from LLSCC.
EXTRANODAL NATURAL KILLER/T-CELL LYMPHOMA, NASAL TYPE: CLINICOPATHOLOGIC ANALYSIS OF 3 CASES. SARA FERREIRA DOS SANTOS COSTA, LUCAS LACERDA DE SOUZA, OSLEI PAES DE ALMEIDA, ANDERSON MAURICIO PAIVA E COSTA, FLAVIA SIROTHEAU ^ A PONTES, FELIPE PAIVA FONSECA and, CORRE ^ HELDER ANTONIO REBELO PONTES Extranodal natural killer (NK)/T-cell lymphoma is an aggressive malignant neoplasia, and the nasal cavity is the most commonly involved site. We present the clinicopathologic features of 3 patients including 2 women and 1 man with age varying from 41 to 70 years. The patients exhibited painful, extensive, destructive lesions with large ulceration predominantly affecting the hard palate. They also revealed other complications such as nasal obstruction, facial asymmetry, fever, and weight loss. Microscopically, all cases revealed a diffuse lymphoid infiltrate composed of small-to-medium sized neoplastic cells with large areas of necrosis and the angiocentric and angiodestructive growth pattern. Positivity for LCA, CD3, CD43, CD56, and granzyme B was observed. A low Ki-67 labeling index and positivity for Epstein-Barr virus were also observed. Two patients died, and 1 remains alive under treatment. Extranodal nasal NK/T-cell lymphoma presents a poor prognosis, and its diagnosis can be challenging. Support: FAPEMIG.
MALT LYMPHOMA OF THE SOFT PALATE: A CASE REPORT. CINTHIA VERONICA BARDALEZ LOPEZ DE CACERES, OSLEI PAES DE ALMEIDA, PABLO AGUSTIN VARGAS, HELDER ^ ANTONIO REBELO PONTES, ANDERSON MAURICIO PAIVA E COSTA, LUCAS LACERDA DE SOUZA and, FELIPE PAIVA FONSECA The aim of this report is to describe an original case of extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma). A 63-year-old male patient was referred to our department because of a painless swelling in his soft palate observed 2 months ago. The intraoral examination confirmed the presence of a well-defined swelling in the soft palate, extending to the oropharynx, exhibiting a normal colored overlying mucosa. Microscopically, a diffuse proliferation of small-sized neoplastic cells, some of them showing abundant eosinophilic cytoplasm, and reactive plasma cells were observed.
ABSTRACTS
e98
Lymphoepithelial lesions were also present. Immunohistochemistry showed positivity for LCA and CD20. Negative reactions against CD3, CD10, CD23, CD43, and cyclin D1 were also seen. The proliferative index measured by Ki67 expression was very low. The clinical, microscopic, and immunohistochemical data led to the diagnosis of MALT lymphoma. The patient received surgical therapy and is free of lesions.
ORAL MANIFESTATION OF WEGENER GRANULOMATOSIS: CASE REPORT. GISELE ^A CORRE DE OLIVEIRA, FERNANDA BROCHIER CARDOSO, LUAN NATHIEL SANTANA KOVALSKI, VINICIUS COELHO CARRARD, MICHELLE ROXO GONCALVES, ¸ JULIANA ROMANINI and, MARCO ANTONIO TREVIZANI MARTINS An 86-year-old man was evaluated complaining a painful lesion situated in the tongue with 45-day duration. Medical history revealed anemia, heart disease, vasculitis, and glomerulitis associated with the previous diagnosis of Wegener granulomatosis. Positive reaction for antineutrophil cytoplasmic autoantibodies (ANCA) was reported. Intraoral examination revealed an asymptomatic ulceration on the dorsum of the tongue surrounded by a whitish area that measures its 2.0 £ 1.0 cm in its largest diameters. Clinical hypotheses were Wegener granulomatosis (GW), fungal infection, or bacterial infection. Incisional biopsy was performed, and the histopathologic diagnosis was an unspecific ulceration. The study of BAAR (alcohol - resistant acid bacillus) and fungal infection were negative. The treatment consisted of topical corticosteroids (clobetasol), oral hygiene guidelines, and photobiomodulation with the diode laser. Lesion completely regressed in 60 days.
OSTEOSARCOMA OF THE JAWS: CLINICOPATHOLOGIC STUDY OF 3 CASES. ANDRE MYLLER BARBOSA SILVA, OSLEI PAES DE ALMEIDA, PABLO AGUSTIN VARGAS, LUCAS LACERDA DE SOUZA, FLAVIA SIROTHEAU CORREA ^ PONTES, HELDER ANTONIO REBELO PONTES and, FELIPE PAIVA FONSECA Osteosarcoma is the most frequent primary malignant bone tumor, but osteosarcomas of the jaws are uncommon and account for only 2% to 10% of all cases diagnosed. The aim of this study is to present 3 new cases of osteosarcoma affecting the gnathic bones. The mandible was affected in 2 cases, whereas the maxilla was involved in 1. Age ranged from 10 to 25 years, and all patients were female. An asymptomatic expansive swelling was the chief complaint in all cases. Microscopically, a diffuse proliferation of pleomorphic cells with presence of osteoid material and variable number of atypical mitotic features were observed. Ki67 staining showed a proliferative index of approximately 15%, and positivity for D2-40 and CDK4 were also observed. All patients are currently under oncological treatment. Support: FAPEMIG.
MANAGEMENT OF PREGNANT PATIENT WITH MANDIBULAR INJURY. EVA AGUIAR ALMEIDA CAMPOS CASTRO TORRIANI, LUISA BERLATO, VICTOR DE MELLO PALMA and, CRISTIANE CADEMARTORI DANESI The management of pregnant women in dentistry is a challenge that requires attention and interdisciplinary care. This study
OOOO January 2020 reports the case of mandibular intraosseous lesion in pregnant women, addressing tomographic dose, type of anesthetic procedure, moment of intervention, and outcome of treatment. The patient is 44 years old with complaint of lack of sensitivity in the mental region. She was on the third gestational month, and had done cone beam tomography. Clinical examination revealed a slight increase in mandibular volume, absence of decayed teeth, or periodontal pocket in the involved teeth. After contact with the attending physician, an incisional biopsy was performed with 2% lidocaine with epinephrine, with diagnostic hypotheses of Central giant cell granuloma (CGCG), ameloblastoma, and aneurysmal bone cyst. After definitive diagnosis of CGCG, we chose to perform surgical treatment after childbirth. The patient returned 1 year later, and the lesion spontaneously regressed. After 2 years, computed tomography showed total wound healing.
DIFFUSE LARGE B-CELL LYMPHOMA IN THE e UPPER LIP: CASE REPORT. GEORGE JOAO FERREIRA DO NASCIMENTO, INGRIDY CRISTINY DE SOUSA MOREIRA, MARIA DE FATIMA, MARIA DE FATIMA VIEIRA ALVES, ANA PAULA VERAS SOBRAL, LEORIK PEREIRA DA SILVA, KEILA MARTHA AMORIM BARROSO and, CYNTIA HELENA PEREIRA DE CARVALHO Diffuse large B-cell lymphomas (DLBCLs) are uncommon in the mouth; however, they are the commonest type of nonHodgkin lymphomas at this site. Preferentially, they affect tonsils and their occurrence in the upper lip is rare. This work reports a case of DLBCL arising in the left upper lip of a 73year-old white woman that was recently diagnosed as having advanced breast cancer besides being a carrier of Parkinson and Alzheimer diseases. The mucosal surface of the upper lip displayed a solitary, fast-growing, painful, ulcerated, reddish, and sessile 4-cm-sized swelling without cervical lymph node involvement at presentation. After incisional biopsy, the microscopic analysis showed a lymphoid cell malignant neoplasm presenting great amounts of large-to-medium sized cells resembling centroblasts losing cell cohesion. Immunohistochemical profile was intensely positive for CD20 and Ki-67, diffusely positive for CD3, and negative for pan-cytokeratins. Unfortunately, the patient died 2 weeks after our clinical care before receiving her final diagnosis.
ORAL MANIFESTATIONS OF SCLERODERMA - CASE REPORT. FABIANE MARQUES DOS SANTOS FREIRE, KELLY TAMBASCO BEZERRA, NATHALIA SCHETTINI SETUBAL FERME, VALDIR MEIRELLES JUNIOR, MARCIA GRILLO CABRAL, JOSE ALEXANDRE DA ROCHA CURVELO and, MARIA ELISA RANGEL JANINI Scleroderma is a rare autoimmune disease of unknown etiology characterized by the acumination of collagen in the tissues, which can be divided into localized and systemic. The localized one occurs more in the skin and rarely intraorally. Patient M.S. O., 45 years old and white, was referred to the stomatology clinic presenting painful symptomatology on the left side palate. In her anamnesis, she reported fibromyalgia. Intraoral examination revealed leukoplastic plaques on the palate in a "saber-throb" pattern and the tongue. Use of Omcilon-A orabase was indicated without regression of the condition. Prescription prednisone 20 mg, 1 tablet/d was applied. After 3 days, regression of 80% of