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NASOPALATINE DUCT CYST: TREATMENT AND REHABILITATION
OOOO Volume 124, Number 2 being SLE the most common type. It affects many organs, nervous system and can also affect the oral mucosa. The cause is believed to be an environmental trigger, which results in misdirected immune response in people genetically susceptible. There is no cure for SLE. It is mainly treated with immunosuppressants, aiming to keep symptoms under control. Herein we report a case of a female patient who presented an erythematous ulcerative lesion surrounded by white threads in the palate. Incisional biopsy was made and microscopically was observed a lichenoid mucositis with a deep and perivascular inflammatory infiltrate. Also, basement membrane was clearly demonstrated by PAS-stained sections. The final diagnosis was systemic lupus erythematosus with oral involvement. SLE is uncommon and should be considered on the differential diagnosis of oral ulcerative lesion in women.
CPP289 - PERIPHERAL OSSIFYING FIBROMA INDUCED BY FOREIGN BODY IN PATIENT WITH SPECIAL NEEDS. GIEYSE NOGUEIRA DE OLIVEIRA, TIAGO NOVAES PINHEIRO, LIONEY NOBRE CABRAL, ANTÔNIO VASCONCELOS, II, ANA CARLA PIMENTEL, JÉSSICA BARBOSA. The peripheral ossifying fibroma (POF) is considered a borderline lesion from reactive to benign neoplastic nature. The present study aims to report a case of POF related to the presence of a strange body in a patient with intellectual disabilities. A 38year-old male patient, leucoderma, was referred to the oral medicine service presenting with a pediculated nodule associated with the inserted gingiva of tooth 21 with type II mobility. The lesion presented normal coloration, bleeding on touch, asymptomatic and well-defined borders. Excisional biopsy was performed, and during the procedure it was found a foreign body similar to a popcorn husk, interfacing the base of the lesion with the tooth cervical region. All tissue was submitted to histopathologic evaluation, concluding the diagnosis of POF. After 2 months of follow-up, the patient did not present recurrence. The association of the foreign body with the lesion reinforces the reactive nature of the POF.
CPP290 - PREMATURE EXFOLIATION OF BOTH DECIDOUS AND PERMANENT TEETH: A CASE REPORT. LILIANA APARECIDA PIMENTA DE BARROS, LUCIANA FARIA SANGLARD, MARIA HELENA MONTEIRO DE BARROS MIOTTO, MARCELO PEÇANHA, SÉRGIO LINS DE AZEVEDO VAZ, TÂNIA REGINA GRÃO VELLOSO, DANIELLE RESENDE CAMISASCA. A rare case of premature exfoliation of both deciduous and permanent dentitions is described. A 6-year-old white male patient presented at the Children Dental Clinic because of premature loss of deciduous teeth. His mother reported difficulties in social interaction. Body weight and height were compatible with his age. He had been evaluated by a geneticist who suggested aggressive periodontitis as a probable diagnosis. Biochemical analysis revealed minor alterations. A very thin mandibular arch was observed, with only the first molars erupted in both arches. Panoramic radiographs showed underdeveloped roots, narrow pulp chambers and absence of a few permanent teeth. Primary exfoliated teeth were sent to histopathologic analysis and revealed formation of abnormal dentin. Dentin dysplasia type I was the diagnosis established. A complete over denture was made under the guidance of prosthodontist. Diagnosis should
ABSTRACTS Abstracts e111 associate clinic, radiography and microscopy. Management of patients with dentinal dysplasia requires a multidisciplinary approach.
CPP291 - ORAL CONDITIONS OF CANCER PATIENTS ASSOCIATED WITH DIABETES AND ARTERIAL HYPERTENSION: CASE REPORT. ERICA DA SILVA CARVALHO, GIULY MAIARA BARBOSA ARIZA, ANGELA MONTEIRO, BARBARA MOURA VIGAS, LIA MIZOBE ONO, EDUARDO J.S. HONORATO, LIONEI NOBRE CABRAL. A 68-year-old female patient, with vitiligo, attended to the hospital for breast cancer treatment. Also presented hypertension and diabetes. During the clinical oral exam ICU were observed dark stains in the dorsum of the tongue, lingual fissures and lip-dryness. Also diagnosed has drug pigmentation with organic material. The treatment consist in oral sanitation with 0.12% digluconate chlorhexidine, followed by tongues crape with small spoon to remove the crust. In the fissures were used manipulated paste containing: VEGELIP, triamcinolone 10%/1g, associated with the use of laser with low intensity. Was used artificial saliva to xerostomia and dexpantenol to the lip-dryness. The treatment was finished in 5 days, 2 sessions with an interval of 12 hours resulting in regression of the case. Between the other 2 diseases, the hypertension influence more in a negative way the CA treatment
CPP292 - ORAL SYPHILIS IN A YOUNG PATIENT: A CASE REPORT. INGRID DA SILVA SANTOS, VITOR BONETTI VALENTE, SOLANGE PIRES D’ÁVILA, KELLEN CRISTINE TJIOE, ÉDER RICARDO BIASOLI, GLAUCO ISSAMU MIYAHARA, DANIEL GALERA BERNABÉ. Syphilis is a sexually transmitted disease caused by Treponema pallidum. A 23-year-old female patient was referred to the clinic with multiple oral lesions 2 months ago. Her medical history revealed that initially oral lesions were treated as pharyngitis by otolaryngologist with no favorable improvement of lesions. She also presented skin lesions, which were diagnosed as pityriasis by dermatologist. Intraoral examination showed erosive lesions and mucous patches on the bilateral lip commissures, palate and border of the tongue. Initially, immuno-mediated diseases were suspected, but hematologic tests were negative. However, non-treponemic test Venereal Disease Research Laboratory (VDRL) was reagent, therefore, syphilis was hypothesized. Biopsy was performed and histopathologic aspects were suggestive of syphilis. Treponemic test fluorescent treponemal antibody-absorption (FTA-ABS) was positive and secondary syphilis was confirmed. The treatment consisted of penicillin G benzathine for 3 weeks. After 6 months of follow-up, clinical and serological exams did not show any sign of the disease.
CPP293 - NASOPALATINE DUCT CYST: TREATMENT AND REHABILITATION. EVELYN ESTEFANI CRISTALDO, NELSON LUIS BARBOSA REBELLATO, PAOLA FERNANDA COTAIT DE LUCAS CORSO, RICARDO PASQUINI FILHO, RAFAELA CRISTINA COSTA CARLOS, DELSON JOÃO DA COSTA. The nasopalatine duct cyst is a non-odontogenic cyst originated from the reminiscents of the nasopalatine duct, which is most common in young adults. The aim of this case report will be to show the case of a 41-year-old female patient that presented a
ORAL AND MAXILLOFACIAL PATHOLOGY e112 Abstracts
OOOO August 2017
radiographic image of a radiolucent area in the region between the incisors. Vitality tests were performed on the involved teeth and the diagnostic hypothesis were nasopalatine duct cyst. First, incisional biopsy and enucleation of the cyst were conducted. The sample was sent for pathologic examination, confirming the diagnostic of nasopalatine duct cyst. Finally, the cyst was excised and this procedure was followed by autogenous bone graft and implant installation. The patient have been followed-up for 10 years and currently is prosthetically rehabilitated and without local recurrence of the lesion.
CPP294 - ORAL MANIFESTATION OF CHIKUNGUNYA FEVER: CASE REPORT. JAIR CARNEIRO LEAO, MARIANA BITU RAMOS PINTO, JAIR CARNEIRO LEÃO FILHO, ANDREZA BARKOKEBAS, LUIZ ALCINO GUEIROS, ALESSANDRA TAVARES CARVALHO, STEPHEN PORTER. The emerging arboviruses in Latin America, including Chikungunya infect patients usually presenting with mild illness. However, there is now great concern about the associations and manifestations of arboviruses, because of the widespread epidemic recently described. The aim of the present report is to detail the features of a 34-year-old female patient with fever, rash, myalgia, arthralgia associated with vomiting and an oral ulceration in the lower lip. Based upon the clinical characteristics, a diagnosis of Chikungunya was established. The patient was treated with Tramadol 100 mg. To knowledge, this is the first report associating oral ulceration with Chikungunya.
CPP295 - SURGICAL TREATMENT OF CENTRAL GIANT CELL GRANULOMA: A CASE REPORT. THIAGO FONTANELLA CESTARI, MATHEUS CAVALCANTE TOMAZ BEZERRA, TÂNIA CRISTINA CHICRE ALCÂNTARA DE BRITO, LIA MIZOBE ONO, JECONIAS CÂMARA, JOSÉ EDUARDO GOMES DOMINGUES. The central giant cell granuloma is considered a nonneoplastic lesion that affects mainly women and approximately 70% arise with preference for the jaw. The aim of this paper is to report a central giant cell granuloma case of a male patient, 11year-old, who attended the service with tumor volume history of rapid evolution, painless, in the right maxillary region. The clinical examination revealed a tumor of approximately 2 cm in diameter, firm consistency, with bluish-red coloration in the region between the dental elements 13 and 14. The imaging examination showed diffuse radiolucent image. An excisional biopsy of the lesion was performed and a piece of about 3 cm in largest diameter was obtained. Histopathologic analysis confirmed the diagnosis of central giant cell granuloma. After more than 2 months of surgery, patient showed significant bone formation seen by occlusal radiograph. Patient recovered uneventfully.
CPP296 - PERIPHERAL OSSIFYING FIBROMA TREATMENT: A CASE REPORT. THIAGO FONTANELLA CESTARI, VICTOR MAQUES COELHO.
HUGO
IFR female patient, 33 years old, feoderma, who attended the service with a complaining of volume in gingival tissue, located in the alveolar region of the left jaw. The clinical examination showed lesion of approximately 2 cm in diameter, nodular, pedunculated, slightly reddish, smooth and firm consistency. According to the report, the lesion began 1 year before and had
slowly increase of volume. On radiographic examination of the lesion, no abnormalities were found. An excisional biopsy of the lesion was performed, the parts were preserved in container with 10% formalin and sent for histopathologic analysis. On microscopic examination was observed lesion characterized by development of a tumor of mesenchymal origin with production of large amounts of calcified material of osteoid nature. It was defined as diagnosis of peripheral ossifying fibroma injury. Surgical removal should be the treatment of choice for this type of injury, having a low recurrence rate. Patient recovered uneventfully.
CPP297 - BASALOID SQUAMOUS CELL CARCINOMA OF THE LOWER LIP: A CASE REPORT. LUIS ALBERTO NUNES DE SOUSA CRUZ, GILBERTO AMARAL DIAS NETO, NATALY PANTOJA LEITE, CAMILA TATYANNE SANTOS DE FREITAS, JOACY DA SILVA AZEVEDO, JECONIAS CÂMARA, NAÍZA MENEZES MEDEIROS ABRAHIM. Basaloid squamous cell carcinoma (BSCC) is a rare, highgrade, aggressive variant of squamous cell carcinoma. A 90-yearold female patient presenting with a lesion in lower lip with a history of high tobacco and alcohol consumption since adolescence. Clinical examination revealed a large ulcerated lesion on of the lower lip vermilion in the right side of the face, with indurated borders. An excisional biopsy was performed and histologic examination showed tissue fragments exhibiting proliferation of cells forming nests, with pleomorphism, hyperchromatic, volume increase; in some areas its was noticed the presence of basaloid tumor cells and atypical mitosis and formation of keratin’s pearls and the stroma was permeated by inflammatory infiltrate. The diagnosis was compatible with basaloid squamous cell carcinoma. The patient is on follow-up of 2 months with signs of healing of surgical site. The optimal treatment of BSCC of the skin involves complete surgical resection followed by postoperative.
CPP298 - PERIPHERAL GIANT CELL GRANULOMA (PERIPHERAL GIANT CELL LESION): CASE REPORT. BRENDO VINICIUS RODRIGUES LOUREDO, HELLEN FERREIRA DE SOUZA SOBRINHO, TÂNIA CRISTINA CHICRE ALCÂNTARA DE BRITO, NIKEILA CHACON DE OLIVEIRA CONDE, JECONIAS CÂMARA, JOSÉ EDUARDO GOMES DOMINGUES. The peripheral giant cell granuloma (PGCG) has a similar growth as the tumor and are relatively common in the oral cavity. The present clinical case is of a black female patient, 43 years old, who attended the service of stomatology complaining of a “cyst” in her tooth. The intraoral examination noticed a gingival growth in the region of element 43 of approximately 2 cm, without bleeding, painful, pedicellate, non-ulcerated and the presence of purulent secretion. Initially was held the scraping supra and subgingival of the elements in the lower right hemiarcade. The excisional biopsy was realized, the specimen was sent to pathology service for histopathologic analysis and the result revealed multinucleated giant cells in the midst of a fibroelastic connective tissue with lymphoplasmacytic infiltration, with presence of multiple Russell bodies and areas of hemorrhage, confirming the diagnosis of PGCG. Six months after treatment, the patient showed no recurrence of the lesion.
CPP289 - PERIPHERAL OSSIFYING FIBROMA INDUCED BY FOREIGN BODY IN PATIENT WITH SPECIAL NEEDS. GIEYSE NOGUEIRA DE OLIVEIRA, TIAGO NOVAES PINHEIRO, LIONEY NOBRE CABRAL, ANTÔNIO VASCONCELOS, II, ANA CARLA PIMENTEL, JÉSSICA BARBOSA. The peripheral ossifying fibroma (POF) is considered a borderline lesion from reactive to benign neoplastic nature. The present study aims to report a case of POF related to the presence of a strange body in a patient with intellectual disabilities. A 38year-old male patient, leucoderma, was referred to the oral medicine service presenting with a pediculated nodule associated with the inserted gingiva of tooth 21 with type II mobility. The lesion presented normal coloration, bleeding on touch, asymptomatic and well-defined borders. Excisional biopsy was performed, and during the procedure it was found a foreign body similar to a popcorn husk, interfacing the base of the lesion with the tooth cervical region. All tissue was submitted to histopathologic evaluation, concluding the diagnosis of POF. After 2 months of follow-up, the patient did not present recurrence. The association of the foreign body with the lesion reinforces the reactive nature of the POF.
CPP290 - PREMATURE EXFOLIATION OF BOTH DECIDOUS AND PERMANENT TEETH: A CASE REPORT. LILIANA APARECIDA PIMENTA DE BARROS, LUCIANA FARIA SANGLARD, MARIA HELENA MONTEIRO DE BARROS MIOTTO, MARCELO PEÇANHA, SÉRGIO LINS DE AZEVEDO VAZ, TÂNIA REGINA GRÃO VELLOSO, DANIELLE RESENDE CAMISASCA. A rare case of premature exfoliation of both deciduous and permanent dentitions is described. A 6-year-old white male patient presented at the Children Dental Clinic because of premature loss of deciduous teeth. His mother reported difficulties in social interaction. Body weight and height were compatible with his age. He had been evaluated by a geneticist who suggested aggressive periodontitis as a probable diagnosis. Biochemical analysis revealed minor alterations. A very thin mandibular arch was observed, with only the first molars erupted in both arches. Panoramic radiographs showed underdeveloped roots, narrow pulp chambers and absence of a few permanent teeth. Primary exfoliated teeth were sent to histopathologic analysis and revealed formation of abnormal dentin. Dentin dysplasia type I was the diagnosis established. A complete over denture was made under the guidance of prosthodontist. Diagnosis should
ABSTRACTS Abstracts e111 associate clinic, radiography and microscopy. Management of patients with dentinal dysplasia requires a multidisciplinary approach.
CPP291 - ORAL CONDITIONS OF CANCER PATIENTS ASSOCIATED WITH DIABETES AND ARTERIAL HYPERTENSION: CASE REPORT. ERICA DA SILVA CARVALHO, GIULY MAIARA BARBOSA ARIZA, ANGELA MONTEIRO, BARBARA MOURA VIGAS, LIA MIZOBE ONO, EDUARDO J.S. HONORATO, LIONEI NOBRE CABRAL. A 68-year-old female patient, with vitiligo, attended to the hospital for breast cancer treatment. Also presented hypertension and diabetes. During the clinical oral exam ICU were observed dark stains in the dorsum of the tongue, lingual fissures and lip-dryness. Also diagnosed has drug pigmentation with organic material. The treatment consist in oral sanitation with 0.12% digluconate chlorhexidine, followed by tongues crape with small spoon to remove the crust. In the fissures were used manipulated paste containing: VEGELIP, triamcinolone 10%/1g, associated with the use of laser with low intensity. Was used artificial saliva to xerostomia and dexpantenol to the lip-dryness. The treatment was finished in 5 days, 2 sessions with an interval of 12 hours resulting in regression of the case. Between the other 2 diseases, the hypertension influence more in a negative way the CA treatment
CPP292 - ORAL SYPHILIS IN A YOUNG PATIENT: A CASE REPORT. INGRID DA SILVA SANTOS, VITOR BONETTI VALENTE, SOLANGE PIRES D’ÁVILA, KELLEN CRISTINE TJIOE, ÉDER RICARDO BIASOLI, GLAUCO ISSAMU MIYAHARA, DANIEL GALERA BERNABÉ. Syphilis is a sexually transmitted disease caused by Treponema pallidum. A 23-year-old female patient was referred to the clinic with multiple oral lesions 2 months ago. Her medical history revealed that initially oral lesions were treated as pharyngitis by otolaryngologist with no favorable improvement of lesions. She also presented skin lesions, which were diagnosed as pityriasis by dermatologist. Intraoral examination showed erosive lesions and mucous patches on the bilateral lip commissures, palate and border of the tongue. Initially, immuno-mediated diseases were suspected, but hematologic tests were negative. However, non-treponemic test Venereal Disease Research Laboratory (VDRL) was reagent, therefore, syphilis was hypothesized. Biopsy was performed and histopathologic aspects were suggestive of syphilis. Treponemic test fluorescent treponemal antibody-absorption (FTA-ABS) was positive and secondary syphilis was confirmed. The treatment consisted of penicillin G benzathine for 3 weeks. After 6 months of follow-up, clinical and serological exams did not show any sign of the disease.
CPP293 - NASOPALATINE DUCT CYST: TREATMENT AND REHABILITATION. EVELYN ESTEFANI CRISTALDO, NELSON LUIS BARBOSA REBELLATO, PAOLA FERNANDA COTAIT DE LUCAS CORSO, RICARDO PASQUINI FILHO, RAFAELA CRISTINA COSTA CARLOS, DELSON JOÃO DA COSTA. The nasopalatine duct cyst is a non-odontogenic cyst originated from the reminiscents of the nasopalatine duct, which is most common in young adults. The aim of this case report will be to show the case of a 41-year-old female patient that presented a
ORAL AND MAXILLOFACIAL PATHOLOGY e112 Abstracts
OOOO August 2017
radiographic image of a radiolucent area in the region between the incisors. Vitality tests were performed on the involved teeth and the diagnostic hypothesis were nasopalatine duct cyst. First, incisional biopsy and enucleation of the cyst were conducted. The sample was sent for pathologic examination, confirming the diagnostic of nasopalatine duct cyst. Finally, the cyst was excised and this procedure was followed by autogenous bone graft and implant installation. The patient have been followed-up for 10 years and currently is prosthetically rehabilitated and without local recurrence of the lesion.
CPP294 - ORAL MANIFESTATION OF CHIKUNGUNYA FEVER: CASE REPORT. JAIR CARNEIRO LEAO, MARIANA BITU RAMOS PINTO, JAIR CARNEIRO LEÃO FILHO, ANDREZA BARKOKEBAS, LUIZ ALCINO GUEIROS, ALESSANDRA TAVARES CARVALHO, STEPHEN PORTER. The emerging arboviruses in Latin America, including Chikungunya infect patients usually presenting with mild illness. However, there is now great concern about the associations and manifestations of arboviruses, because of the widespread epidemic recently described. The aim of the present report is to detail the features of a 34-year-old female patient with fever, rash, myalgia, arthralgia associated with vomiting and an oral ulceration in the lower lip. Based upon the clinical characteristics, a diagnosis of Chikungunya was established. The patient was treated with Tramadol 100 mg. To knowledge, this is the first report associating oral ulceration with Chikungunya.
CPP295 - SURGICAL TREATMENT OF CENTRAL GIANT CELL GRANULOMA: A CASE REPORT. THIAGO FONTANELLA CESTARI, MATHEUS CAVALCANTE TOMAZ BEZERRA, TÂNIA CRISTINA CHICRE ALCÂNTARA DE BRITO, LIA MIZOBE ONO, JECONIAS CÂMARA, JOSÉ EDUARDO GOMES DOMINGUES. The central giant cell granuloma is considered a nonneoplastic lesion that affects mainly women and approximately 70% arise with preference for the jaw. The aim of this paper is to report a central giant cell granuloma case of a male patient, 11year-old, who attended the service with tumor volume history of rapid evolution, painless, in the right maxillary region. The clinical examination revealed a tumor of approximately 2 cm in diameter, firm consistency, with bluish-red coloration in the region between the dental elements 13 and 14. The imaging examination showed diffuse radiolucent image. An excisional biopsy of the lesion was performed and a piece of about 3 cm in largest diameter was obtained. Histopathologic analysis confirmed the diagnosis of central giant cell granuloma. After more than 2 months of surgery, patient showed significant bone formation seen by occlusal radiograph. Patient recovered uneventfully.
CPP296 - PERIPHERAL OSSIFYING FIBROMA TREATMENT: A CASE REPORT. THIAGO FONTANELLA CESTARI, VICTOR MAQUES COELHO.
HUGO
IFR female patient, 33 years old, feoderma, who attended the service with a complaining of volume in gingival tissue, located in the alveolar region of the left jaw. The clinical examination showed lesion of approximately 2 cm in diameter, nodular, pedunculated, slightly reddish, smooth and firm consistency. According to the report, the lesion began 1 year before and had
slowly increase of volume. On radiographic examination of the lesion, no abnormalities were found. An excisional biopsy of the lesion was performed, the parts were preserved in container with 10% formalin and sent for histopathologic analysis. On microscopic examination was observed lesion characterized by development of a tumor of mesenchymal origin with production of large amounts of calcified material of osteoid nature. It was defined as diagnosis of peripheral ossifying fibroma injury. Surgical removal should be the treatment of choice for this type of injury, having a low recurrence rate. Patient recovered uneventfully.
CPP297 - BASALOID SQUAMOUS CELL CARCINOMA OF THE LOWER LIP: A CASE REPORT. LUIS ALBERTO NUNES DE SOUSA CRUZ, GILBERTO AMARAL DIAS NETO, NATALY PANTOJA LEITE, CAMILA TATYANNE SANTOS DE FREITAS, JOACY DA SILVA AZEVEDO, JECONIAS CÂMARA, NAÍZA MENEZES MEDEIROS ABRAHIM. Basaloid squamous cell carcinoma (BSCC) is a rare, highgrade, aggressive variant of squamous cell carcinoma. A 90-yearold female patient presenting with a lesion in lower lip with a history of high tobacco and alcohol consumption since adolescence. Clinical examination revealed a large ulcerated lesion on of the lower lip vermilion in the right side of the face, with indurated borders. An excisional biopsy was performed and histologic examination showed tissue fragments exhibiting proliferation of cells forming nests, with pleomorphism, hyperchromatic, volume increase; in some areas its was noticed the presence of basaloid tumor cells and atypical mitosis and formation of keratin’s pearls and the stroma was permeated by inflammatory infiltrate. The diagnosis was compatible with basaloid squamous cell carcinoma. The patient is on follow-up of 2 months with signs of healing of surgical site. The optimal treatment of BSCC of the skin involves complete surgical resection followed by postoperative.
CPP298 - PERIPHERAL GIANT CELL GRANULOMA (PERIPHERAL GIANT CELL LESION): CASE REPORT. BRENDO VINICIUS RODRIGUES LOUREDO, HELLEN FERREIRA DE SOUZA SOBRINHO, TÂNIA CRISTINA CHICRE ALCÂNTARA DE BRITO, NIKEILA CHACON DE OLIVEIRA CONDE, JECONIAS CÂMARA, JOSÉ EDUARDO GOMES DOMINGUES. The peripheral giant cell granuloma (PGCG) has a similar growth as the tumor and are relatively common in the oral cavity. The present clinical case is of a black female patient, 43 years old, who attended the service of stomatology complaining of a “cyst” in her tooth. The intraoral examination noticed a gingival growth in the region of element 43 of approximately 2 cm, without bleeding, painful, pedicellate, non-ulcerated and the presence of purulent secretion. Initially was held the scraping supra and subgingival of the elements in the lower right hemiarcade. The excisional biopsy was realized, the specimen was sent to pathology service for histopathologic analysis and the result revealed multinucleated giant cells in the midst of a fibroelastic connective tissue with lymphoplasmacytic infiltration, with presence of multiple Russell bodies and areas of hemorrhage, confirming the diagnosis of PGCG. Six months after treatment, the patient showed no recurrence of the lesion.