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Necrotizing Sialometaplasia: Case Report Focusing on Histological Stage And Histopathogenesis
ORAL AND MAXILLOFACIAL PATHOLOGY e174 Abstracts and fibro-osseous dysplasia for the lesion involving the premolars. Microscopically, the molar lesion showed fibrous connective tissue with a capsular aspect, hemorrhagic areas, trabecular bone, and some cells with round nuclei and other with fusiform nuclei. Histopathological evaluation confirmed a diagnosis of aneurysmal bone cyst associated with ossifying fibroma. Microscopically the premolar lesion had the deposition of bone matrix, some cells with round nuclei, and others with fusiform nuclei. Histopathological analysis established a diagnosis of ossifying fibroma. Supported by CNPq:133509/2012-5.
PE-217 - MULTIPLE HEPATIC ABSCESSES CAUSED BY ORAL INFECTION: CASE REPORT. RAFAELA MAIA CARDOSO ALMENDRA, VIVIANE ALMEIDA SARMENTO, PATRÍCIA LEITE RIBEIRO LAMBERTI, ANTONIO FERNANDO PEREIRA FALCÃO, VINÍCIUS RABELLO TORREGROSSA, VINÍCIUS DA COSTA VIEIRA, ANDRÉ LUCAS D’ALMEIDA LYRIO DOS SANTOS. UFBA. Abscesses in organs are rare and potentially fatal disorders, especially when caused by oral infections such as periodontitis through hematogenous spread. Immediate recognition of the main focus is important for early treatment of the underlying cause. Woman, 64, was admitted to the University Hospital with signs of abdominal distention, fever, and vomiting. The diagnosis was multiple hepatic abscesses based on cerebral and abdominal computed tomography, and severe periodontal disease, indicated by hepatic drainage and multiple extractions. Blood analysis and liver puncture revealed the presence of Pseudomonas aeruginosa, a bacterial organism found in the oral cavity of hospitalized patients with poor oral hygiene, representing a risk factor for the development of hepatic abscesses.
PE-218 - MULTIPLE ORAL LYMPHOEPITHELIAL CYSTS IN A HEALTHY PATIENT. STHEFANE GOMES FEITOSA, FILIPE NOBRE CHAVES, FRANCISCO SAMUEL RODRIGUES CARVALHO, ANA PAULA NEGREIROS NUNES ALVES, FABRÍCIO BITU SOUSA, FÁBIO WILDSON GURGEL COSTA, KARUZA MARIA ALVES PEREIRA. UNIVERSIDADE FEDERAL DO CEARÁ CAMPUS SOBRAL. Oral lymphoepithelial cyst (LEC) is a rare lesion that may develop in normal or accessory lymphoid tissue. Typically, it is characterized by a solitary, freely movable, dome-shaped, submucosal nodule, with a smooth, nonulcerated surface that is yellowish pink to white, with a cheeselike consistency when palpated. A rare case of multiple LEC on the tongue was reported. Woman, approximately 50, complained of three lesions in the oral cavity. Intraoral examination showed three yellowish nodules on the ventral surface of the tongue. Following biopsy, microscopic evaluation disclosed a diagnosis of LEC. After 1 year of followup, no evidence of recurrence was observed. This case addressed a rare presentation of oral LEC. To the best of our knowledge, there are no similar cases published in the English language literature.
PE-219 - MYOFIBROMA IN CHILDHOOD: CASE REPORT. MARCIA RODRIGUES GORISCH, ROSANA MARA GIORDANO DE BARROS, EDUARDO GIORDANO DE BARROS, SILVIA ROBERTA CIESLAK. FACULDADE DE ODONTOLOGIA DA UFMS. Considered to be a rare neoplasm of fusiform cells, myofibroma occurs more frequently during childhood at multiple sites such as bones, intestines, and soft tissues. Reportedly it has a discrete predilection for the head and neck regions. The jaw is the
OOOO February 2014 most common oral location, followed by the lips, cheeks, and tongue. Myofibroma can grow quickly and is painless. Child, 5, was brought to the Odontology Faculty/UFMS with a nodular lesion of the gingival mucosa whose color was apparently normal. Microscopic evaluation showed fusiform cells lying in order between collagen sheafs. Immunohistochemical reaction was positive to anti-actin antibody of smooth muscle. The treatment of choice is surgical excision; recurrence can occur in about 25% of cases. Although it is considered a benign fibrous neoplasm, solitary tumors located in the intestines carry a grim prognosis and a 76% mortality rate.
PE-220 - NASOPALATINE CYST: CASE REPORT WITH SURGICAL MANAGEMENT. SERGIO EDUARDO MIGLIORINI, LUCIANO LAURIA DIB, DANIELA LATUFF CORTIZO, MARISA ALVAREZ CORAZZA MARQUES, LUIZ FERNANDO DUARTE, RENATA TUCCI, RICARDO SOUZA. UNIVERSIDADE PAULISTA-UNIP. Nasopalatine duct cyst is considered a nonodontogenic cyst of uncertain pathogenesis that affects individuals between the second and fifth decades of life, displaying slow, asymptomatic growth. Radiographically there is a radiolucent area in the anterior maxilla. Man, 24, came to the clinic of Stomatology Graduate Dentistry UNIP for the treatment of a radiolucent lesion, near the apices of the teeth #21, #22, and #23. The vitality test was positive in all dental elements. Computed tomography revealed a hypodense circular-shaped lesion with regular contour and interruption of the cortical bony palate, buccal area, and nasal cavity floor. Based on a clinical diagnosis of nasopalatine cyst, the patient underwent surgery. Histopathological analysis of the specimen was done by the service of Oral Pathology FOUNIP. The patient is free of symptoms. Bone formation is evaluated periodically by panoramic radiography.
PE-221 - NECROTIZING SIALOMETAPLASIA OF THE INFERIOR LIP: CASE REPORT AND CONSERVATIVE MANAGEMENT. ELOÁ BORGES LUNA, MARIA ELISA RANGEL JANINI, VALDIR MEIRELLES JUNIOR, JULIANA TRISTÃO WERNECK, RAPHAELLA POSTORIVO, JOSÉ ALEXANDRE DE ROCHA CURVELLO, MICHELLE AGOSTINI. FACULDADE DE ODONTOLOGIA DA UFRJ. Necrotizing sialometaplasia is a self-limited inflammatory condition that affects the minor salivary glands and rarely the lip region. Often the clinical appearance is similar to that of squamous cell carcinoma (SCC). Man, 65, was referred to the service with a lesion in the lip after trauma that did not heal for 15 days. Clinical examination revealed an ulcer on the right lower lip that was hard and well-defined, with a grey-white pseudomembrane and symptoms of burning. The differential diagnoses were lymphoma, SCC, and necrotizing sialometaplasia. Conservative treatment was undertaken with topical corticosteroids and cleansing with hydrogen peroxide. In 2 weeks the hardness completely disappeared; after 5 weeks of the same therapy, the lesion resolved totally. Because the necrotizing sialometaplasia is a self-limiting lesion, which heals after 6 to 10 weeks, we opted for conservative therapy rather than submit the patient to an unnecessary invasive procedure.
PE-222 - NECROTIZING SIALOMETAPLASIA: CASE REPORT FOCUSING ON HISTOLOGICAL STAGE AND HISTOPATHOGENESIS. JOABE DOS SANTOS PEREIRA, BÁRBARA VANESSA DE BRITO MONTEIRO, THÂMARA MANOELA MARINHO BEZERRA, ADRIANO ROCHA
OOOO Volume 117, Number 2 GERMANO, GIORDANO BRUNO PAIVA CAMPOS, ANA MIRYAM COSTA DE MEDEIROS, MÁRCIA CRISTINA DA COSTA MIGUEL. UNIVERSIDADE FEDERAL DO RIO GRANDE DO NORTE. Necrotizing sialometaplasia is a benign, self-limiting inflammatory condition first described in 1973. Its clinical and histologic features mimic those of a malignant neoplasm, mainly mucoepidermoid carcinoma or squamous cell carcinoma. A case description focused on histologic stage and histopathogenesis of the lesion. Man, 26, presented an ulcerated mass in the soft palate. The lesion had appeared 40 days previously and was reddish, firm, and painless, measuring 0.5 cm in diameter. No secondary signals or lymphadenopathy was present. The clinical diagnosis was traumatic ulcer. Histopathological examination revealed scarce necrosis of the glandular acini, squamous metaplasia of the salivary ductal epithelium, pseudoepitheliomatous hyperplasia of the overlying epithelium, and an associated inflammatory response. This case demonstrates principally the reparative histological stage proposed by Anneroth and Hasen (1982): metaplastic change of ducts, fibrosis, and chronic inflammatory infiltrate. Pathophysiology of this lesion is related to ischemic events. Its accurate recognition avoids inappropriate treatment.
PE-223 - NEUROFIBROMA IN THE TONGUE: CASE REPORT. JOSÉ NARCISO ROSA ASSUNÇÃO JUNIOR, JOSÉ NARCISO ROSA ASSUNÇÃO JUNIOR, JORGE DE SÁ BARBOSA, HAROLDO ARID SOARES, NELISE ALEXANDRE DA SILVA LASCANE, DECIO DOS SANTOS PINTO JUNIOR, CELSO AUGUSTO LEMOS JUNIOR. UNIVERSIDADE METROPOLITANA DE SANTOS/FACULDADE DE ODONTOLOGIA DA USP. Caucasian woman, 64, demonstrated a tongue lesion that had developed over 8 months. She reported local trauma with asymptomatic slow growth of a nodule. Intraoral examination showed an encapsulated submucosal nodule, measuring 1 cm in diameter, which was asymptomatic on palpation; the surface mucosa was reddish and smooth. The clinical diagnosis was neuroma X lipoma. After the excisional biopsy, histological examination revealed a mucosal fragment lined by stratified squamous epithelium and a parakeratinized area of dense connective tissue showing thick bundles of collagen fibers distributed parallel to the epithelium, with a proliferation of bundles of spindle cells in various directions, often with corrugated nuclei. There were also various stromal cells with eosinophilic cytoplasm resembling mast cells. The result suggested neurofibroma. The patient remains asymptomatic with no signs of recurrence after 1 year of follow-up.
PE-224 - NON-FAMILIAL CHERUBISM ASSOCIATED WITH CONGENITAL CARDIOPATHY: DIFFERENTIAL DIAGNOSIS WITH NOONAN SYNDROME AND TURNER SYNDROME. ARTHUR PIAS SALGUEIRO, RONAIRO ZAIOSC TURCHIELLO, MICHELE RORATO SAGRILLO, MÁRCIA RODRIGUES PAYERAS, LEANDRO BERNI OSÓRIO, KÍVIA LINHARES FERRAZZO. FRANCISCAN UNIVERSITY CENTER - UNIFRA - SANTA MARIA/ RS, BRAZIL. Cherubism is a rare disease that usually manifests in childhood. A case of cherubism was reported and the clinical, radiographic, and laboratory findings noted, focusing on the differential diagnosis. Girl, 10, was brought for dental care with a medical history of pulmonary valve stenosis, short stature, and bilateral convergent strabismus. Physical examination, imaging
ABSTRACTS Abstracts e175 findings, laboratory tests, and histology suggested the diagnosis of cherubism. Given the heart disease, a differential diagnosis of cherubism with Noonan syndrome (NS) and Turner syndrome (TS) was postulated. After normal cytogenetic examination, TS was ruled out. Based on the clinical diagnostic criteria proposed by Van der Burgt et al (1994), the diagnosis of NS was not possible. For the differential diagnosis of cherubism, it is necessary to unite medical history, physical evaluation, radiographic findings, and laboratory tests. Although clinical criteria are useful in the diagnosis of NS, genetic tests are essential to establish the definitive diagnosis of this disease.
PE-225 - NON-HODGKIN’S LYMPHOMA IN THE SUBMANDIBULAR REGION. LEONARDO AMARAL DOS REIS, ALÍCIA RUMAYOR PIÑA, MARISOL MARTINEZ MARTINEZ, NÁDIA LAGES LIMA, JOÃO LUIZ DE MIRANDA, OSLEI PAES DE ALMEIDA, ANA TEREZINHA MARQUES MESQUITA. UNIVERSIDADE FEDERAL DOS VALES DO JEQUITINHONHA E MUCURI. The diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin’s lymphoma and is more frequent in the head and neck region. Man, 58, had swelling in the right submandibular region that had developed over 4 months. His medical history was uneventful. Extraoral examination revealed a nodular lesion, normal in color, with ill-defined borders, that was adhering to the underlying tissues. Intraoral examination and panoramic radiograph showed normal features. Histopathological analysis revealed malignancy of lymphocytic origin and demonstrated cells of varied morphologies, some large cells with polymorphic nuclei, and atypical mitosis. Immunohistochemical analysis showed the atypical cells were positive for LCA, CD20, CD43, CD45RO, and CD79a, but negative for CD3, CD138, kappa, and lambda. Ki-67 proliferation index was 60%. The definitive diagnosis was diffuse large B-cell lymphoma. The patient was referred for treatment and is under follow-up.
PE-226 - NOONAN SYNDROME AND ITS DENTOFACIAL ACCOMPANIMENTS: REPORT OF TWO CLINICAL CASES. CAROLINE FARIAS LEMOS, LUCIANA DUARTE CALDAS, BERNARDO FERREIRA BRASILEIRO, MARTA RABELLO PIVA. UNIVERSIDADE FEDERAL DE SERGIPE. Noonan syndrome (NS) is an autosomal dominant genetic syndrome that affects both genders, with an incidence estimated between 1:1000 and 1:2500. NS is an important differential diagnosis in patients with short stature, facial dysmorphism, delayed puberty, and cryptorchidism. Among the facial changes typical of NS carriers are hypertelorism of the eye, eyelid ptosis, palpebral fissure externally diverted down with low attachment, incomplete rotation of the ear, mandibular micrognathia, short and webbed neck, and a triangularly shaped face. Changes produced include dental maxillary atresia, making an adequate tongue position and triggering, usually a posterior cross-bite and eventually an anterior open bite. By virtue of mandibular micrognathia, such patients have malocclusions of type Class II malocclusion. Two patients with NS demonstrated similarities in dentofacial changes and the therapeutic procedures employed.
PE-227 - OCCURRENCE OF ORAL SQUAMOUS CELL CARCINOMA IN A YOUNG PATIENT: CASE REPORT. MATEUS BARROS CAVALCANTE, CAMILA MARIA BEDER RIBEIRO, SONIA MARIA SOARES
PE-217 - MULTIPLE HEPATIC ABSCESSES CAUSED BY ORAL INFECTION: CASE REPORT. RAFAELA MAIA CARDOSO ALMENDRA, VIVIANE ALMEIDA SARMENTO, PATRÍCIA LEITE RIBEIRO LAMBERTI, ANTONIO FERNANDO PEREIRA FALCÃO, VINÍCIUS RABELLO TORREGROSSA, VINÍCIUS DA COSTA VIEIRA, ANDRÉ LUCAS D’ALMEIDA LYRIO DOS SANTOS. UFBA. Abscesses in organs are rare and potentially fatal disorders, especially when caused by oral infections such as periodontitis through hematogenous spread. Immediate recognition of the main focus is important for early treatment of the underlying cause. Woman, 64, was admitted to the University Hospital with signs of abdominal distention, fever, and vomiting. The diagnosis was multiple hepatic abscesses based on cerebral and abdominal computed tomography, and severe periodontal disease, indicated by hepatic drainage and multiple extractions. Blood analysis and liver puncture revealed the presence of Pseudomonas aeruginosa, a bacterial organism found in the oral cavity of hospitalized patients with poor oral hygiene, representing a risk factor for the development of hepatic abscesses.
PE-218 - MULTIPLE ORAL LYMPHOEPITHELIAL CYSTS IN A HEALTHY PATIENT. STHEFANE GOMES FEITOSA, FILIPE NOBRE CHAVES, FRANCISCO SAMUEL RODRIGUES CARVALHO, ANA PAULA NEGREIROS NUNES ALVES, FABRÍCIO BITU SOUSA, FÁBIO WILDSON GURGEL COSTA, KARUZA MARIA ALVES PEREIRA. UNIVERSIDADE FEDERAL DO CEARÁ CAMPUS SOBRAL. Oral lymphoepithelial cyst (LEC) is a rare lesion that may develop in normal or accessory lymphoid tissue. Typically, it is characterized by a solitary, freely movable, dome-shaped, submucosal nodule, with a smooth, nonulcerated surface that is yellowish pink to white, with a cheeselike consistency when palpated. A rare case of multiple LEC on the tongue was reported. Woman, approximately 50, complained of three lesions in the oral cavity. Intraoral examination showed three yellowish nodules on the ventral surface of the tongue. Following biopsy, microscopic evaluation disclosed a diagnosis of LEC. After 1 year of followup, no evidence of recurrence was observed. This case addressed a rare presentation of oral LEC. To the best of our knowledge, there are no similar cases published in the English language literature.
PE-219 - MYOFIBROMA IN CHILDHOOD: CASE REPORT. MARCIA RODRIGUES GORISCH, ROSANA MARA GIORDANO DE BARROS, EDUARDO GIORDANO DE BARROS, SILVIA ROBERTA CIESLAK. FACULDADE DE ODONTOLOGIA DA UFMS. Considered to be a rare neoplasm of fusiform cells, myofibroma occurs more frequently during childhood at multiple sites such as bones, intestines, and soft tissues. Reportedly it has a discrete predilection for the head and neck regions. The jaw is the
OOOO February 2014 most common oral location, followed by the lips, cheeks, and tongue. Myofibroma can grow quickly and is painless. Child, 5, was brought to the Odontology Faculty/UFMS with a nodular lesion of the gingival mucosa whose color was apparently normal. Microscopic evaluation showed fusiform cells lying in order between collagen sheafs. Immunohistochemical reaction was positive to anti-actin antibody of smooth muscle. The treatment of choice is surgical excision; recurrence can occur in about 25% of cases. Although it is considered a benign fibrous neoplasm, solitary tumors located in the intestines carry a grim prognosis and a 76% mortality rate.
PE-220 - NASOPALATINE CYST: CASE REPORT WITH SURGICAL MANAGEMENT. SERGIO EDUARDO MIGLIORINI, LUCIANO LAURIA DIB, DANIELA LATUFF CORTIZO, MARISA ALVAREZ CORAZZA MARQUES, LUIZ FERNANDO DUARTE, RENATA TUCCI, RICARDO SOUZA. UNIVERSIDADE PAULISTA-UNIP. Nasopalatine duct cyst is considered a nonodontogenic cyst of uncertain pathogenesis that affects individuals between the second and fifth decades of life, displaying slow, asymptomatic growth. Radiographically there is a radiolucent area in the anterior maxilla. Man, 24, came to the clinic of Stomatology Graduate Dentistry UNIP for the treatment of a radiolucent lesion, near the apices of the teeth #21, #22, and #23. The vitality test was positive in all dental elements. Computed tomography revealed a hypodense circular-shaped lesion with regular contour and interruption of the cortical bony palate, buccal area, and nasal cavity floor. Based on a clinical diagnosis of nasopalatine cyst, the patient underwent surgery. Histopathological analysis of the specimen was done by the service of Oral Pathology FOUNIP. The patient is free of symptoms. Bone formation is evaluated periodically by panoramic radiography.
PE-221 - NECROTIZING SIALOMETAPLASIA OF THE INFERIOR LIP: CASE REPORT AND CONSERVATIVE MANAGEMENT. ELOÁ BORGES LUNA, MARIA ELISA RANGEL JANINI, VALDIR MEIRELLES JUNIOR, JULIANA TRISTÃO WERNECK, RAPHAELLA POSTORIVO, JOSÉ ALEXANDRE DE ROCHA CURVELLO, MICHELLE AGOSTINI. FACULDADE DE ODONTOLOGIA DA UFRJ. Necrotizing sialometaplasia is a self-limited inflammatory condition that affects the minor salivary glands and rarely the lip region. Often the clinical appearance is similar to that of squamous cell carcinoma (SCC). Man, 65, was referred to the service with a lesion in the lip after trauma that did not heal for 15 days. Clinical examination revealed an ulcer on the right lower lip that was hard and well-defined, with a grey-white pseudomembrane and symptoms of burning. The differential diagnoses were lymphoma, SCC, and necrotizing sialometaplasia. Conservative treatment was undertaken with topical corticosteroids and cleansing with hydrogen peroxide. In 2 weeks the hardness completely disappeared; after 5 weeks of the same therapy, the lesion resolved totally. Because the necrotizing sialometaplasia is a self-limiting lesion, which heals after 6 to 10 weeks, we opted for conservative therapy rather than submit the patient to an unnecessary invasive procedure.
PE-222 - NECROTIZING SIALOMETAPLASIA: CASE REPORT FOCUSING ON HISTOLOGICAL STAGE AND HISTOPATHOGENESIS. JOABE DOS SANTOS PEREIRA, BÁRBARA VANESSA DE BRITO MONTEIRO, THÂMARA MANOELA MARINHO BEZERRA, ADRIANO ROCHA
OOOO Volume 117, Number 2 GERMANO, GIORDANO BRUNO PAIVA CAMPOS, ANA MIRYAM COSTA DE MEDEIROS, MÁRCIA CRISTINA DA COSTA MIGUEL. UNIVERSIDADE FEDERAL DO RIO GRANDE DO NORTE. Necrotizing sialometaplasia is a benign, self-limiting inflammatory condition first described in 1973. Its clinical and histologic features mimic those of a malignant neoplasm, mainly mucoepidermoid carcinoma or squamous cell carcinoma. A case description focused on histologic stage and histopathogenesis of the lesion. Man, 26, presented an ulcerated mass in the soft palate. The lesion had appeared 40 days previously and was reddish, firm, and painless, measuring 0.5 cm in diameter. No secondary signals or lymphadenopathy was present. The clinical diagnosis was traumatic ulcer. Histopathological examination revealed scarce necrosis of the glandular acini, squamous metaplasia of the salivary ductal epithelium, pseudoepitheliomatous hyperplasia of the overlying epithelium, and an associated inflammatory response. This case demonstrates principally the reparative histological stage proposed by Anneroth and Hasen (1982): metaplastic change of ducts, fibrosis, and chronic inflammatory infiltrate. Pathophysiology of this lesion is related to ischemic events. Its accurate recognition avoids inappropriate treatment.
PE-223 - NEUROFIBROMA IN THE TONGUE: CASE REPORT. JOSÉ NARCISO ROSA ASSUNÇÃO JUNIOR, JOSÉ NARCISO ROSA ASSUNÇÃO JUNIOR, JORGE DE SÁ BARBOSA, HAROLDO ARID SOARES, NELISE ALEXANDRE DA SILVA LASCANE, DECIO DOS SANTOS PINTO JUNIOR, CELSO AUGUSTO LEMOS JUNIOR. UNIVERSIDADE METROPOLITANA DE SANTOS/FACULDADE DE ODONTOLOGIA DA USP. Caucasian woman, 64, demonstrated a tongue lesion that had developed over 8 months. She reported local trauma with asymptomatic slow growth of a nodule. Intraoral examination showed an encapsulated submucosal nodule, measuring 1 cm in diameter, which was asymptomatic on palpation; the surface mucosa was reddish and smooth. The clinical diagnosis was neuroma X lipoma. After the excisional biopsy, histological examination revealed a mucosal fragment lined by stratified squamous epithelium and a parakeratinized area of dense connective tissue showing thick bundles of collagen fibers distributed parallel to the epithelium, with a proliferation of bundles of spindle cells in various directions, often with corrugated nuclei. There were also various stromal cells with eosinophilic cytoplasm resembling mast cells. The result suggested neurofibroma. The patient remains asymptomatic with no signs of recurrence after 1 year of follow-up.
PE-224 - NON-FAMILIAL CHERUBISM ASSOCIATED WITH CONGENITAL CARDIOPATHY: DIFFERENTIAL DIAGNOSIS WITH NOONAN SYNDROME AND TURNER SYNDROME. ARTHUR PIAS SALGUEIRO, RONAIRO ZAIOSC TURCHIELLO, MICHELE RORATO SAGRILLO, MÁRCIA RODRIGUES PAYERAS, LEANDRO BERNI OSÓRIO, KÍVIA LINHARES FERRAZZO. FRANCISCAN UNIVERSITY CENTER - UNIFRA - SANTA MARIA/ RS, BRAZIL. Cherubism is a rare disease that usually manifests in childhood. A case of cherubism was reported and the clinical, radiographic, and laboratory findings noted, focusing on the differential diagnosis. Girl, 10, was brought for dental care with a medical history of pulmonary valve stenosis, short stature, and bilateral convergent strabismus. Physical examination, imaging
ABSTRACTS Abstracts e175 findings, laboratory tests, and histology suggested the diagnosis of cherubism. Given the heart disease, a differential diagnosis of cherubism with Noonan syndrome (NS) and Turner syndrome (TS) was postulated. After normal cytogenetic examination, TS was ruled out. Based on the clinical diagnostic criteria proposed by Van der Burgt et al (1994), the diagnosis of NS was not possible. For the differential diagnosis of cherubism, it is necessary to unite medical history, physical evaluation, radiographic findings, and laboratory tests. Although clinical criteria are useful in the diagnosis of NS, genetic tests are essential to establish the definitive diagnosis of this disease.
PE-225 - NON-HODGKIN’S LYMPHOMA IN THE SUBMANDIBULAR REGION. LEONARDO AMARAL DOS REIS, ALÍCIA RUMAYOR PIÑA, MARISOL MARTINEZ MARTINEZ, NÁDIA LAGES LIMA, JOÃO LUIZ DE MIRANDA, OSLEI PAES DE ALMEIDA, ANA TEREZINHA MARQUES MESQUITA. UNIVERSIDADE FEDERAL DOS VALES DO JEQUITINHONHA E MUCURI. The diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin’s lymphoma and is more frequent in the head and neck region. Man, 58, had swelling in the right submandibular region that had developed over 4 months. His medical history was uneventful. Extraoral examination revealed a nodular lesion, normal in color, with ill-defined borders, that was adhering to the underlying tissues. Intraoral examination and panoramic radiograph showed normal features. Histopathological analysis revealed malignancy of lymphocytic origin and demonstrated cells of varied morphologies, some large cells with polymorphic nuclei, and atypical mitosis. Immunohistochemical analysis showed the atypical cells were positive for LCA, CD20, CD43, CD45RO, and CD79a, but negative for CD3, CD138, kappa, and lambda. Ki-67 proliferation index was 60%. The definitive diagnosis was diffuse large B-cell lymphoma. The patient was referred for treatment and is under follow-up.
PE-226 - NOONAN SYNDROME AND ITS DENTOFACIAL ACCOMPANIMENTS: REPORT OF TWO CLINICAL CASES. CAROLINE FARIAS LEMOS, LUCIANA DUARTE CALDAS, BERNARDO FERREIRA BRASILEIRO, MARTA RABELLO PIVA. UNIVERSIDADE FEDERAL DE SERGIPE. Noonan syndrome (NS) is an autosomal dominant genetic syndrome that affects both genders, with an incidence estimated between 1:1000 and 1:2500. NS is an important differential diagnosis in patients with short stature, facial dysmorphism, delayed puberty, and cryptorchidism. Among the facial changes typical of NS carriers are hypertelorism of the eye, eyelid ptosis, palpebral fissure externally diverted down with low attachment, incomplete rotation of the ear, mandibular micrognathia, short and webbed neck, and a triangularly shaped face. Changes produced include dental maxillary atresia, making an adequate tongue position and triggering, usually a posterior cross-bite and eventually an anterior open bite. By virtue of mandibular micrognathia, such patients have malocclusions of type Class II malocclusion. Two patients with NS demonstrated similarities in dentofacial changes and the therapeutic procedures employed.
PE-227 - OCCURRENCE OF ORAL SQUAMOUS CELL CARCINOMA IN A YOUNG PATIENT: CASE REPORT. MATEUS BARROS CAVALCANTE, CAMILA MARIA BEDER RIBEIRO, SONIA MARIA SOARES