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NONCHARACTERIZED ODONTOGENIC LESION ENCOMPASSED BY PRIMORDIAL ODONTOGENIC TUMOR AND ADENOMATOID ODONTOGENIC HAMARTOMA
OOOO Volume 129, Number 1
ABSTRACTS
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region. Tumor resection was done. The results of the pathology report were, "Pleomorphic and poorly differentiated embryonal rhabdomyosarcoma, 4 cm in its largest diameter, necrosis and infiltration of surrounding soft tissue. Surgical limits in contact with tumor in various locations and osseous surgical limits without tumorous lesions." The patient continues to remain in stable condition and she is still receiving chemotherapy.
VARIABLE EXPRESSIVITY AND NOVEL PTEN GENE MUTATIONS IN COWDEN SYNDROME. RENATO ASSIS MACHADO, LIVIA MARIS RIBEIRO PARANAIBA, BRENO AMARAL ROCHA, GERALDO DE OLIVEIRA SILVA JUNIOR, THAYS TEIXEIRA DE SOUZA, FABIO RAMOA PIRES and, RICARDO DELLA COLETTA Cowden syndrome (CS) is a PTEN gene associated condition characterized by multiple mucocutaneous hamartomas and an increased risk of malignancies. We reported an isolated case and 1 family with several individuals affected by CS. The isolated case showed typical features including fibrocystic breast disease, benign thyroid nodules, and multiple papillomatous lesions in the face and oral cavity and was caused by a novel nonsense mutation (c.940 G>T) in the PTEN gene. In the family, the proband showed erythema nodosum, duodenal ulcer, intestinal polyps, cervical lipoma, renal cysts, and glaucoma, whereas her family revealed multiple members with intestinal polyps and a sister with breast cancer diagnosed at early age. An intronic mutation was found (c.1026+32 T>G) in this family, with in silico analysis revealing the creation of a new donor splice site. This study confirms the involvement of the PTEN gene in CS and reinforces the variable clinical expressivity of disease.
NONCHARACTERIZED ODONTOGENIC LESION ENCOMPASSED BY PRIMORDIAL ODONTOGENIC TUMOR AND ADENOMATOID ODONTOGENIC HAMARTOMA. L.A.E.C. RAMIRO FRANKLIN BERNAL FARO, FRANKLIN BERNAL, VANIA ARIAS MENDEZ and, VANIA ARIAS-M. F We are reporting a clinical case of the complex histology of an oral sample from an 8-year-old girl. The histology analysis shares characteristics of a primordial odontogenic tumor (POT) and adenomatoid odontogenic hamartoma (AOH). The clinical evaluation reveals a left submandibular soreness and the presence of 1 cm in diameter radiolucent image in the region of the mandibular third molar with expanded and thin cortical bone. After enucleation, we obtained a white soft mass, showing on histology an ameloblastic epithelium and a stellate reticulum enveloping hypercellular myxoid connective tissue. On another field, the cells morphologically resembled odontoblasts; nevertheless the duct-like structures were absent. Some odontogenic tumors are lesions that are difficult to diagnose because of their histologic complexity and, in many of these cases, they are considered as unclassifiable hybrid or collision tumors. In summary, this rare and interesting case report should be characterized by a consensus of oral pathology experts.
ORAL PSEUDOLYMPHOMA: A DIAGNOS TIC CHALLENGE. TULIO MORANDIN BARROS DE OLIVEIRA, FERRISSE, ANALU LAIS DE BARROS PINTO GRIFONI,
HEITOR
ALBERGONI DA SILVEIRA, ANA THAIS BAGATINI, ANDREIA BUFALINO and, JORGE ESQUICHE LEON Pseudolymphoma (PL) is a benign reactive lymphoproliferative disease secondary to known or unknown stimuli mimicking a lymphomatous-appearing picture with potential misdiagnosis of overt lymphoma. A 64-year-old white man was referred for evaluation of ulceration on the left side of the buccal mucosa with 1 week of duration. The medical history revealed Alzheimer disease treated with donepezil and vildagliptin. Regional lymphadenopathy was absent and computerized tomography (CT) scans did not show alterations. An incisional biopsy was performed and microscopic analysis showed foci of angiocentric and perivascular lymphoid infiltrate containing atypical cells surrounded by fibrous stroma. Immunohistochemical analysis revealed positivity for CD3, CD4, CD25, and FOXP3. There was weak positivity for CD10 and BCL2. Almost all atypical cells were Ki-67 positive. Epstein-Barr virus-encoded RNA 1 and 2 (EBER1, EBER2) was negative. Complete blood counts and serology for herpes simplex virus 1 and 2 (HSV1, HSV2), cytomegalovirus (CMV), and Epstein-Barr virus (EBV) were noncontributory. Four weeks after biopsy, the lesion disappeared, without treatment or modification or discontinuation of medications. A diagnosis of idiopathic PL was made.
DESMOPLASTIC AMELOBLASTOMA IN THE MAXILLA: A CASE REPORT. ANA CAROLINA LEMOS PIMENTEL, ANDREA LYRA, ALENA PEIXOTO MEDRADO, MIGUEL GUSTAVO SETUBAL, LIVIA PRATES SOARES ZERBINATI, JEAN NUNES DOS ^ SANTOS and, ANTONIO MARCIO TEIXEIRA MARCHIONNI Desmoplastic ameloblastoma is a rare variant with unknown biologic behavior. The purpose of this work is to report a case of a male patient, 17 years old, for whom the incisional biopsy was conclusive for desmoplastic ameloblastoma. Computed tomography and prototype were part of the surgical planning. Partial maxillectomy with a 0.5-cm margin was performed, involving 2.1 through 1.6 tooth, the border of the nasal cavity, and less them 3 mm below the infraorbital foramen. The maxillary structure was reconstructed with a 2.0 titanium system screen, to minimize communication between the mouth and maxillary sinus while maintaining the maxillary projection and the space to be reconstructed later. The tumor was send for histopathologic exam. The patient had a 1-year follow-up without recurrence, using a partial removable denture, to enable him to return to his daily routine.
THE USE OF PHOTOBIOMODULATION IN ORAL LESIONS IN A PATIENT WITH STEVENS-JOHNSON SYNDROME. HELENA DE CAMPOS ZINET, LETICIA RODRIGUES DE OLIVEIRA, AMANDA KIMURA LUCCHESI REIS, ISADORA DOURADO CARDOSO ALVES, MARCELO IVANDER ANDRADE WANDERLEY, MARIA PAULA SIQUEIRA DE MELO PERES and, JULIANA BERTOLDI FRANCO Stevens-Johnson syndrome (SJS) is a delayed-type hypersensitivity reaction that typically involves the skin and the mucous membranes with high morbidity and mortality rates. Photobiomodulation therapy (PBMT) stands out as an alternative treatment for SJS since it improves tissue repair and helps pain control. A female patient, 28 years of age, developed SJS after
ABSTRACTS
e23
region. Tumor resection was done. The results of the pathology report were, "Pleomorphic and poorly differentiated embryonal rhabdomyosarcoma, 4 cm in its largest diameter, necrosis and infiltration of surrounding soft tissue. Surgical limits in contact with tumor in various locations and osseous surgical limits without tumorous lesions." The patient continues to remain in stable condition and she is still receiving chemotherapy.
VARIABLE EXPRESSIVITY AND NOVEL PTEN GENE MUTATIONS IN COWDEN SYNDROME. RENATO ASSIS MACHADO, LIVIA MARIS RIBEIRO PARANAIBA, BRENO AMARAL ROCHA, GERALDO DE OLIVEIRA SILVA JUNIOR, THAYS TEIXEIRA DE SOUZA, FABIO RAMOA PIRES and, RICARDO DELLA COLETTA Cowden syndrome (CS) is a PTEN gene associated condition characterized by multiple mucocutaneous hamartomas and an increased risk of malignancies. We reported an isolated case and 1 family with several individuals affected by CS. The isolated case showed typical features including fibrocystic breast disease, benign thyroid nodules, and multiple papillomatous lesions in the face and oral cavity and was caused by a novel nonsense mutation (c.940 G>T) in the PTEN gene. In the family, the proband showed erythema nodosum, duodenal ulcer, intestinal polyps, cervical lipoma, renal cysts, and glaucoma, whereas her family revealed multiple members with intestinal polyps and a sister with breast cancer diagnosed at early age. An intronic mutation was found (c.1026+32 T>G) in this family, with in silico analysis revealing the creation of a new donor splice site. This study confirms the involvement of the PTEN gene in CS and reinforces the variable clinical expressivity of disease.
NONCHARACTERIZED ODONTOGENIC LESION ENCOMPASSED BY PRIMORDIAL ODONTOGENIC TUMOR AND ADENOMATOID ODONTOGENIC HAMARTOMA. L.A.E.C. RAMIRO FRANKLIN BERNAL FARO, FRANKLIN BERNAL, VANIA ARIAS MENDEZ and, VANIA ARIAS-M. F We are reporting a clinical case of the complex histology of an oral sample from an 8-year-old girl. The histology analysis shares characteristics of a primordial odontogenic tumor (POT) and adenomatoid odontogenic hamartoma (AOH). The clinical evaluation reveals a left submandibular soreness and the presence of 1 cm in diameter radiolucent image in the region of the mandibular third molar with expanded and thin cortical bone. After enucleation, we obtained a white soft mass, showing on histology an ameloblastic epithelium and a stellate reticulum enveloping hypercellular myxoid connective tissue. On another field, the cells morphologically resembled odontoblasts; nevertheless the duct-like structures were absent. Some odontogenic tumors are lesions that are difficult to diagnose because of their histologic complexity and, in many of these cases, they are considered as unclassifiable hybrid or collision tumors. In summary, this rare and interesting case report should be characterized by a consensus of oral pathology experts.
ORAL PSEUDOLYMPHOMA: A DIAGNOS TIC CHALLENGE. TULIO MORANDIN BARROS DE OLIVEIRA, FERRISSE, ANALU LAIS DE BARROS PINTO GRIFONI,
HEITOR
ALBERGONI DA SILVEIRA, ANA THAIS BAGATINI, ANDREIA BUFALINO and, JORGE ESQUICHE LEON Pseudolymphoma (PL) is a benign reactive lymphoproliferative disease secondary to known or unknown stimuli mimicking a lymphomatous-appearing picture with potential misdiagnosis of overt lymphoma. A 64-year-old white man was referred for evaluation of ulceration on the left side of the buccal mucosa with 1 week of duration. The medical history revealed Alzheimer disease treated with donepezil and vildagliptin. Regional lymphadenopathy was absent and computerized tomography (CT) scans did not show alterations. An incisional biopsy was performed and microscopic analysis showed foci of angiocentric and perivascular lymphoid infiltrate containing atypical cells surrounded by fibrous stroma. Immunohistochemical analysis revealed positivity for CD3, CD4, CD25, and FOXP3. There was weak positivity for CD10 and BCL2. Almost all atypical cells were Ki-67 positive. Epstein-Barr virus-encoded RNA 1 and 2 (EBER1, EBER2) was negative. Complete blood counts and serology for herpes simplex virus 1 and 2 (HSV1, HSV2), cytomegalovirus (CMV), and Epstein-Barr virus (EBV) were noncontributory. Four weeks after biopsy, the lesion disappeared, without treatment or modification or discontinuation of medications. A diagnosis of idiopathic PL was made.
DESMOPLASTIC AMELOBLASTOMA IN THE MAXILLA: A CASE REPORT. ANA CAROLINA LEMOS PIMENTEL, ANDREA LYRA, ALENA PEIXOTO MEDRADO, MIGUEL GUSTAVO SETUBAL, LIVIA PRATES SOARES ZERBINATI, JEAN NUNES DOS ^ SANTOS and, ANTONIO MARCIO TEIXEIRA MARCHIONNI Desmoplastic ameloblastoma is a rare variant with unknown biologic behavior. The purpose of this work is to report a case of a male patient, 17 years old, for whom the incisional biopsy was conclusive for desmoplastic ameloblastoma. Computed tomography and prototype were part of the surgical planning. Partial maxillectomy with a 0.5-cm margin was performed, involving 2.1 through 1.6 tooth, the border of the nasal cavity, and less them 3 mm below the infraorbital foramen. The maxillary structure was reconstructed with a 2.0 titanium system screen, to minimize communication between the mouth and maxillary sinus while maintaining the maxillary projection and the space to be reconstructed later. The tumor was send for histopathologic exam. The patient had a 1-year follow-up without recurrence, using a partial removable denture, to enable him to return to his daily routine.
THE USE OF PHOTOBIOMODULATION IN ORAL LESIONS IN A PATIENT WITH STEVENS-JOHNSON SYNDROME. HELENA DE CAMPOS ZINET, LETICIA RODRIGUES DE OLIVEIRA, AMANDA KIMURA LUCCHESI REIS, ISADORA DOURADO CARDOSO ALVES, MARCELO IVANDER ANDRADE WANDERLEY, MARIA PAULA SIQUEIRA DE MELO PERES and, JULIANA BERTOLDI FRANCO Stevens-Johnson syndrome (SJS) is a delayed-type hypersensitivity reaction that typically involves the skin and the mucous membranes with high morbidity and mortality rates. Photobiomodulation therapy (PBMT) stands out as an alternative treatment for SJS since it improves tissue repair and helps pain control. A female patient, 28 years of age, developed SJS after