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Oral manifestations of systemic lupus erythematosus: report of two cases
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e134
Abstracts
intraoral sites. The histological origin of this lesion remains unclear and so far no specific marker could elucidate this matter. We report a case of an eight-year-old girl, who presented a yellowish, painless, fibrous and single plaque on the right lateral border of the tongue discovered three months earlier. An excisional biopsy was performed and the histopathological findings showed no pseudoepitheliomatous hyperplasia while polygonal cells full of eosinophilic granular content and hyperchromatic nuclei were profusely detected from the mucosal epithelium to deep striated muscle bundles. This lesion was finally diagnosed as a granular cell tumor and no recurrence was detected after one-year follow-up.
LARGE OSSIFYING FIBROMA OF MAXILLA INVOLVING MAXILLARY SINUS Imada TSN1, Nogueira AS1, Alves APNN2, Soares ECS3, Medeiros JR3, Turatti E4, Santos PSS1 - 1BAURU SCHOOL OF DENTISTRY - UNIVERSITY OF SÃO PAULO - STOMATOLOGY, 2FEDERAL UNIVERSITY OF CEARÁ - STOMATOLOGY, 3FEDERAL UNIVERSITY OF CEARÁ, 4UNIVERSITY OF FORTALEZA Ossifying Fibromas has a definite female and maxilla predilection. We present a rare case of a large ossifying fibroma of the right posterior maxilla in a 38-year-old feoderm man. On intraoral examination, our patient showed a hard swelling expanding from vestibular plate to mid-line palate covered by subtle ischemic skin. The swelling started 10 years ago and increased gradually; initially it was asymptomatic but had become painful due to occlusion trauma. Panoramic radiograph and CBCT revealed a 4cmø large, well-defined mixed radiolucid and mainly radiopaque lesion extending from first pre-molar to tuber region of right maxilla in an edentulous area. Incisional biopsy was performed and the histopathologic features showed well-circumscribed fibrous connective tissue with mineralization areas, confirming Ossifying Fibroma diagnosis. Therefore, Le Fort I osteotomy technique was performed to access and remove the entirely lesion. Currently, the patient is on 3 years follow-up with no radiographic evidence of recurrence.
RESECTION OF CENTRAL GIANT CELL LESION IN THE JAW WITH GRAFT AND REHABILITATION WITH DENTAL IMPLANTS: 8-YEAR FOLLOW UP Oliveira TFL1, Figueiredo LMG2, Pontes C3, Carneiro Júnior B4, Lamberti PLR5, Sarmento VA5, Azevedo RA6 - 1FOB - USP - ESTOMATOLOGIA E RADIOLOGIA, 2UNIVERSIDADE FEDERAL DA BAHIA - UFBA, 3UNIVERSIDADE FEDERAL DA BAHIA - RESIDENTE EM CIRURGIA BUCOMAXILOFACIAL, 4 UNIVERSIDADE FEDERAL DA BAHIA - UFBA - CIRURGIA, 5UNIVERSIDADE FEDERAL DA BAHIA - UFBA ESTOMATOLOGIA E RADIOLOGIA, 6UNIVERSIDADE FEDERAL DA BAHIA - CIRURGIA Central giant cell lesion is an uncommon benign jaw lesion with uncertain etiology and variable clinical behavior. We hereby report a case of central giant cell lesion in a 27-year-old woman with an asymptomatic increased in the right region of the mandible and who had undergone previous surgery. Panoramic and computed tomography demonstrated the presence of a multilocular lesion in the basilar region of the mandible. The patient underwent an incisional biopsy and the histopathological diagnosis was central giant cell tumor. A partial resection of the mandible was performed with a bone graft from the iliac crest.
October 2012 After four months, osseointegrated implants were placed in the grafted bone to improve the patient’s appearance and rehabilitate her mastication ability; after 6 months, a fixed prosthesis was placed on the implants to permit the return of full mastication function. The patient was monitored for eight years without signs of recurrence.
ORAL MANIFESTATIONS OF SYSTEMIC LUPUS ERYTHEMATOSUS: REPORT OF TWO CASES Nóbrega TG1, Dillenburg CS2, Selbach BJ2, Dias LG2, Martins MAT2, Martins MD1, Munerato MC2 - 1UNIVERSIDADE FEDERAL DO RIO GRANDE DO SUL - PATOLOGIA BUCAL, 2UNIVERSIDADE FEDERAL DO RIO GRANDE DO SUL - HOSPITAL DE CLÍNICAS DE PORTO ALEGRE - ESTOMATOLOGIA Systemic lupus erythematosus (SLE) is a chronic autoimmune disease associated with significant morbidity and mortality. Different studies of oral lesions in the course of LE have shown a frequency varying from 9 to 45% in systemic disease. We described two cases of SLE with oral manifestation. Case 1 - A female patient, 32 years-old was diagnosed with SLE in 1997. The intraoral examination showed multiple ulcers located in soft and hard palate, buccal mucosa bilaterally and attached gingiva. Clobetasol propionate was prescribed associated with Nystatin 100,000 IU. Case 2- A female patient was diagnosed with SLE in 2011. The examination revealed a malar rash, arthralgias, and Cushing’s syndrome. During examination showed mucosal dehydrated, pale and intact. Both patients were treated with a combination of immunosuppressors with remission of oral manifestations. Careful examination of the oral cavity may reveal findings indicative of an underlying systemic condition as SLE.
LOSS OF HETEROZYGOSITY IN REGIONS OF TUMOR SUPPRESSOR GENES IN ORAL LEUKOPLAKIA FonsecaSilva T1, Galvão CF1, Gomez RS1, Gomes CC2 - 1UNIVERSIDADE FEDERAL DE MINAS GERAIS, BELO HORIZONTE, BRAZIL - DEPARTMENT OF ORAL SURGERY AND PATHOLOGY; SCHOOL OF DENTISTRY, 2UNIVERSIDADE FEDERAL DE MINAS GERAIS, BELO HORIZONTE, BRAZIL - DEPARTMENT OF PATHOLOGY; INSTITUTE OF BIOLOGICAL SCIENCES Objectives: The objective of this study was to investigate loss of heterozygosity (LOH) in regions of tumor suppressor genes in oral leukoplakia samples and its association with histological grading. Study design: LOH was assessed using microsatellite markers (D3S1029, D3S1293, D9S157, D9S162, D9S171, D11S1369, D11S1883, AFM238WF2 and P53).The 18 patients were previously submitted to two biopsies in the same lesion site with a minimal of 6 months of intervals, resulting in a total of 36 samples. These samples included 22 mild dysplasias, 9 moderate, 2 severe and 3 showed oral squamous cell carcinomas. Results: LOH was detected in 32 samples in at least one marker and the frequency of allelic loss was associated with histological grading of dyplasia and with some cytological abnormalities. Conclusions: The results show that LOH in regions of tumor suppressor genes in oral leukoplakias represent a frequent event and are associated with architectural and cytological alterations. Support: CAPES, CNPq, FAPEMIG.
e134
Abstracts
intraoral sites. The histological origin of this lesion remains unclear and so far no specific marker could elucidate this matter. We report a case of an eight-year-old girl, who presented a yellowish, painless, fibrous and single plaque on the right lateral border of the tongue discovered three months earlier. An excisional biopsy was performed and the histopathological findings showed no pseudoepitheliomatous hyperplasia while polygonal cells full of eosinophilic granular content and hyperchromatic nuclei were profusely detected from the mucosal epithelium to deep striated muscle bundles. This lesion was finally diagnosed as a granular cell tumor and no recurrence was detected after one-year follow-up.
LARGE OSSIFYING FIBROMA OF MAXILLA INVOLVING MAXILLARY SINUS Imada TSN1, Nogueira AS1, Alves APNN2, Soares ECS3, Medeiros JR3, Turatti E4, Santos PSS1 - 1BAURU SCHOOL OF DENTISTRY - UNIVERSITY OF SÃO PAULO - STOMATOLOGY, 2FEDERAL UNIVERSITY OF CEARÁ - STOMATOLOGY, 3FEDERAL UNIVERSITY OF CEARÁ, 4UNIVERSITY OF FORTALEZA Ossifying Fibromas has a definite female and maxilla predilection. We present a rare case of a large ossifying fibroma of the right posterior maxilla in a 38-year-old feoderm man. On intraoral examination, our patient showed a hard swelling expanding from vestibular plate to mid-line palate covered by subtle ischemic skin. The swelling started 10 years ago and increased gradually; initially it was asymptomatic but had become painful due to occlusion trauma. Panoramic radiograph and CBCT revealed a 4cmø large, well-defined mixed radiolucid and mainly radiopaque lesion extending from first pre-molar to tuber region of right maxilla in an edentulous area. Incisional biopsy was performed and the histopathologic features showed well-circumscribed fibrous connective tissue with mineralization areas, confirming Ossifying Fibroma diagnosis. Therefore, Le Fort I osteotomy technique was performed to access and remove the entirely lesion. Currently, the patient is on 3 years follow-up with no radiographic evidence of recurrence.
RESECTION OF CENTRAL GIANT CELL LESION IN THE JAW WITH GRAFT AND REHABILITATION WITH DENTAL IMPLANTS: 8-YEAR FOLLOW UP Oliveira TFL1, Figueiredo LMG2, Pontes C3, Carneiro Júnior B4, Lamberti PLR5, Sarmento VA5, Azevedo RA6 - 1FOB - USP - ESTOMATOLOGIA E RADIOLOGIA, 2UNIVERSIDADE FEDERAL DA BAHIA - UFBA, 3UNIVERSIDADE FEDERAL DA BAHIA - RESIDENTE EM CIRURGIA BUCOMAXILOFACIAL, 4 UNIVERSIDADE FEDERAL DA BAHIA - UFBA - CIRURGIA, 5UNIVERSIDADE FEDERAL DA BAHIA - UFBA ESTOMATOLOGIA E RADIOLOGIA, 6UNIVERSIDADE FEDERAL DA BAHIA - CIRURGIA Central giant cell lesion is an uncommon benign jaw lesion with uncertain etiology and variable clinical behavior. We hereby report a case of central giant cell lesion in a 27-year-old woman with an asymptomatic increased in the right region of the mandible and who had undergone previous surgery. Panoramic and computed tomography demonstrated the presence of a multilocular lesion in the basilar region of the mandible. The patient underwent an incisional biopsy and the histopathological diagnosis was central giant cell tumor. A partial resection of the mandible was performed with a bone graft from the iliac crest.
October 2012 After four months, osseointegrated implants were placed in the grafted bone to improve the patient’s appearance and rehabilitate her mastication ability; after 6 months, a fixed prosthesis was placed on the implants to permit the return of full mastication function. The patient was monitored for eight years without signs of recurrence.
ORAL MANIFESTATIONS OF SYSTEMIC LUPUS ERYTHEMATOSUS: REPORT OF TWO CASES Nóbrega TG1, Dillenburg CS2, Selbach BJ2, Dias LG2, Martins MAT2, Martins MD1, Munerato MC2 - 1UNIVERSIDADE FEDERAL DO RIO GRANDE DO SUL - PATOLOGIA BUCAL, 2UNIVERSIDADE FEDERAL DO RIO GRANDE DO SUL - HOSPITAL DE CLÍNICAS DE PORTO ALEGRE - ESTOMATOLOGIA Systemic lupus erythematosus (SLE) is a chronic autoimmune disease associated with significant morbidity and mortality. Different studies of oral lesions in the course of LE have shown a frequency varying from 9 to 45% in systemic disease. We described two cases of SLE with oral manifestation. Case 1 - A female patient, 32 years-old was diagnosed with SLE in 1997. The intraoral examination showed multiple ulcers located in soft and hard palate, buccal mucosa bilaterally and attached gingiva. Clobetasol propionate was prescribed associated with Nystatin 100,000 IU. Case 2- A female patient was diagnosed with SLE in 2011. The examination revealed a malar rash, arthralgias, and Cushing’s syndrome. During examination showed mucosal dehydrated, pale and intact. Both patients were treated with a combination of immunosuppressors with remission of oral manifestations. Careful examination of the oral cavity may reveal findings indicative of an underlying systemic condition as SLE.
LOSS OF HETEROZYGOSITY IN REGIONS OF TUMOR SUPPRESSOR GENES IN ORAL LEUKOPLAKIA FonsecaSilva T1, Galvão CF1, Gomez RS1, Gomes CC2 - 1UNIVERSIDADE FEDERAL DE MINAS GERAIS, BELO HORIZONTE, BRAZIL - DEPARTMENT OF ORAL SURGERY AND PATHOLOGY; SCHOOL OF DENTISTRY, 2UNIVERSIDADE FEDERAL DE MINAS GERAIS, BELO HORIZONTE, BRAZIL - DEPARTMENT OF PATHOLOGY; INSTITUTE OF BIOLOGICAL SCIENCES Objectives: The objective of this study was to investigate loss of heterozygosity (LOH) in regions of tumor suppressor genes in oral leukoplakia samples and its association with histological grading. Study design: LOH was assessed using microsatellite markers (D3S1029, D3S1293, D9S157, D9S162, D9S171, D11S1369, D11S1883, AFM238WF2 and P53).The 18 patients were previously submitted to two biopsies in the same lesion site with a minimal of 6 months of intervals, resulting in a total of 36 samples. These samples included 22 mild dysplasias, 9 moderate, 2 severe and 3 showed oral squamous cell carcinomas. Results: LOH was detected in 32 samples in at least one marker and the frequency of allelic loss was associated with histological grading of dyplasia and with some cytological abnormalities. Conclusions: The results show that LOH in regions of tumor suppressor genes in oral leukoplakias represent a frequent event and are associated with architectural and cytological alterations. Support: CAPES, CNPq, FAPEMIG.