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Oral Metastasis of Breast Cancer: Rare Case Report
ORAL AND MAXILLOFACIAL PATHOLOGY e180 Abstracts varied manifestations of syphilis and establish the correct diagnosis.
PE-248 - ORAL MANIFESTATION OF SINONASAL UNDIFFERENTIATED CARCINOMA: REPORT OF TWO CASES. CAMILLA BORGES FERREIRA GOMES, KARINA MORAIS FARIA, LARA MARIA ALENCAR RAMOS INNOCENTINI, PABLO AGUSTIN VARGAS, OSLEI PAES DE ALMEIDA, MARCIO AJUDARTE LOPES, ALAN ROGER SANTOS-SILVA. FACULDADE DE ODONTOLOGIA DE PIRACICABA - FOP/UNICAMP. Sinonasal undifferentiated carcinoma (SNUC) is a rare, highly aggressive tumor arising in the nasal cavity or paranasal sinuses with an unclear pathogenesis. Clinical signs may include maxillary swelling, epistaxis, and nasal obstruction. The prognosis of SNUC is extremely poor, with high rates of local distant metastases. Additionally, local recurrences are quite common after surgery because of the complex anatomy of the sinonasal region. We describe the clinicopathologic, imaginological and immunohistochemical features of 2 cases of advanced SNUC diagnosed based on intraoral manifestations. Remarkably, both cases were previously misdiagnosed and treated as sinusitis in another service. Clinicians must be aware that SNUC may first manifest as an intraoral swelling or ulceration. Early diagnosis and prompt treatment of SNUC are key to providing better outcomes.
PE-249 - ORAL MANIFESTATIONS IN PATIENT WITH SICKLE CELL ANEMIA: CASE REPORT. DANIELLA VIEIRA ALVES, GABRIELA SAMPAIO ARAGÃO, HANNAH MENEZES LIRA, RAVENA DE MORAES ALVES, FLÁVIA CALÓ AQUINO XAVIER, ANTÔNIO FERNANDO PEREIRA FALCÃO, PATRÍCIA LEITE RIBEIRO LAMBERTI. UNIVERSIDADE FEDERAL DA BAHIA. Sickle cell anemia (SCA) is a hereditary hemolytic disease in which abnormal hemoglobin leads to morphological alterations in erythrocytes. Brunette-skinned woman, 51, was diagnosed with SCA and diabetes. She presented with dental pain and mobility. Intraoral examination, orthopantomography, and intraoral periapical radiography revealed a dentoalveolar abscess in the mandibular first molar and asymptomatic pulpal necrosis leading to a periapical reaction in the lateral incisor on the right side. Radiographic changes included a radiopaque area in the jaw bone that decreases in the trabecular pattern; bony trabeculae were also arranged horizontally. All these findings are compatible with SCA oral manifestations. The patient underwent dental treatment and is been followed up. Because SCA patients present special oral health findings, oral hygiene maintenance must be well-established. Moreover, the identification of bony micro- infarctions and the diagnosis and treatment of oral health problems are necessary to manage orofacial pain and infection in SCA patients.
OOOO February 2014 GVHD are lichenoid mucositis, xerostomia, ulcerated mucosa, and hyperkeratotic leukoplakia lesions that may be considered a potential risk factor for the development of oral cancer. White man, 27, presented extensive leukoplakia of the buccal mucosa 7 months after allogenic HSCT. Dark-skinned boy, 11, had multiple ulcerated lesions on the buccal mucosa, lip, and gingiva with pain and significant xerostomia 6 months after allogenic HSCT. Both patients received systemic treatment. Early diagnosis and treatment of oral manifestations of GVHD are complemented by vigilant follow-up and care under the supervision of oral health specialists to minimize morbidity and mortality and to improve living conditions.
PE-251 - ORAL MELANOMA: CASE REPORT AND LITERATURE REVIEW. ANA LUCIA NORONHA FRANCISCO, MARCUS VINICIUS FURLAN, CLÓVIS ANTÔNIO LOPES PINTO, MONICA LUCIA RODRIGUES, NATALIE KELNER, LUIZ PAULO KOWALSKI, MAURO KASUO IKEDA. DEPARTMENT OF HEAD AND NECK SURGERY AND OTORHINOLARYNGOLOGY, A.C. CAMARGO HOSPITAL. Mucosal melanoma is a rare, aggressive malignancy that accounts for about 2% of all head and neck cancers. Less than 1% of all melanomas occur in the oral mucosa. In the oral cavity the sites most often affected are the hard palate and maxillary gingiva. This neoplasia affects slightly more men than women in age 50 to 60 years. Asian man, 66, came for a medical consultation concerning a dark, painless, nodular, sessile lesion that involved the vestibular site but was indistinct in the upper gum left molar region. Biopsy confirmed invasive melanoma. Tests for disease staging showed no bone invasion or distant metastases. The patient underwent infrastructure resection and neck dissection at levels I to IV with microsurgical reconstruction using a forearm free flap. Postoperatively, radiotherapy was used for treatment.
PE-252 - ORAL METASTASIS OF BREAST CANCER: RARE CASE REPORT. SILAS ANTONIO JUVENCIO DE FREITAS FILHO, ROBERTA REZENDE ROSA, TAMIRIS RODRIGUES SABRINA, PEDRO HENRIQUE REZENDE SPINI, CARLA SILVA SIQUEIRA, TÚLIO HUMBERTO SPINI, SÉRGIO VITORINO CARDOSO. UNIVERSIDADE FEDERAL DE UBERLÂNDIA.
PE-250 - ORAL MANIFESTATIONS OF CHRONIC GRAFT-VERSUS-HOST DISEASE: REPORT OF TWO CASES. CAROLINE ALVES DE CASTRO, EDUARDO REZENDE ARANTES, LORRANY CANDIDO DA SILVA, GEISA BADAUY LAURIA SILVA. HOSPITAL ARAÚJO JORGE.
Metastatic tumors to the oral cavity may occur in the jawbones, soft tissues, or salivary glands, but represent less than 1% of all malignant oral lesions. Woman, 53, had a mass in her oral cavity. The patient reported having had breast carcinoma that was treated with chemotherapy and radiation 2 years previously. Oral examination showed a painful mass in the left posterior maxilla (soft palate and alveolar ridge) with yellowish coloration and ulcerative surface. After incisional biopsy, histopathological analysis revealed nests of malignant cells and deposits of eosinophilic and clear cells permeated by ductal structures that suggested the origin was the breast. The specimen was positive for cytokeratins 7, 8, and HMW, progesterone receptor, and estrogen. The diagnosis of metastatic carcinoma of breast origin was established. The patient was referred to an oncology center for further investigation and treatment.
Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative modality in nonmalignant and neoplastic diseases. Allogeneic HSCT is frequently complicated by graft-versus-host disease (GVHD). The clinical manifestations of oral chronic
PE-253 ORAL PARACOCCIDIOIDOMYCOSIS: REPORT OF TWO CASES. KARINE CASSIA BATISTA LUCIO E SILVA, ELIANE PEDRA DIAS, VANESSA DE
PE-248 - ORAL MANIFESTATION OF SINONASAL UNDIFFERENTIATED CARCINOMA: REPORT OF TWO CASES. CAMILLA BORGES FERREIRA GOMES, KARINA MORAIS FARIA, LARA MARIA ALENCAR RAMOS INNOCENTINI, PABLO AGUSTIN VARGAS, OSLEI PAES DE ALMEIDA, MARCIO AJUDARTE LOPES, ALAN ROGER SANTOS-SILVA. FACULDADE DE ODONTOLOGIA DE PIRACICABA - FOP/UNICAMP. Sinonasal undifferentiated carcinoma (SNUC) is a rare, highly aggressive tumor arising in the nasal cavity or paranasal sinuses with an unclear pathogenesis. Clinical signs may include maxillary swelling, epistaxis, and nasal obstruction. The prognosis of SNUC is extremely poor, with high rates of local distant metastases. Additionally, local recurrences are quite common after surgery because of the complex anatomy of the sinonasal region. We describe the clinicopathologic, imaginological and immunohistochemical features of 2 cases of advanced SNUC diagnosed based on intraoral manifestations. Remarkably, both cases were previously misdiagnosed and treated as sinusitis in another service. Clinicians must be aware that SNUC may first manifest as an intraoral swelling or ulceration. Early diagnosis and prompt treatment of SNUC are key to providing better outcomes.
PE-249 - ORAL MANIFESTATIONS IN PATIENT WITH SICKLE CELL ANEMIA: CASE REPORT. DANIELLA VIEIRA ALVES, GABRIELA SAMPAIO ARAGÃO, HANNAH MENEZES LIRA, RAVENA DE MORAES ALVES, FLÁVIA CALÓ AQUINO XAVIER, ANTÔNIO FERNANDO PEREIRA FALCÃO, PATRÍCIA LEITE RIBEIRO LAMBERTI. UNIVERSIDADE FEDERAL DA BAHIA. Sickle cell anemia (SCA) is a hereditary hemolytic disease in which abnormal hemoglobin leads to morphological alterations in erythrocytes. Brunette-skinned woman, 51, was diagnosed with SCA and diabetes. She presented with dental pain and mobility. Intraoral examination, orthopantomography, and intraoral periapical radiography revealed a dentoalveolar abscess in the mandibular first molar and asymptomatic pulpal necrosis leading to a periapical reaction in the lateral incisor on the right side. Radiographic changes included a radiopaque area in the jaw bone that decreases in the trabecular pattern; bony trabeculae were also arranged horizontally. All these findings are compatible with SCA oral manifestations. The patient underwent dental treatment and is been followed up. Because SCA patients present special oral health findings, oral hygiene maintenance must be well-established. Moreover, the identification of bony micro- infarctions and the diagnosis and treatment of oral health problems are necessary to manage orofacial pain and infection in SCA patients.
OOOO February 2014 GVHD are lichenoid mucositis, xerostomia, ulcerated mucosa, and hyperkeratotic leukoplakia lesions that may be considered a potential risk factor for the development of oral cancer. White man, 27, presented extensive leukoplakia of the buccal mucosa 7 months after allogenic HSCT. Dark-skinned boy, 11, had multiple ulcerated lesions on the buccal mucosa, lip, and gingiva with pain and significant xerostomia 6 months after allogenic HSCT. Both patients received systemic treatment. Early diagnosis and treatment of oral manifestations of GVHD are complemented by vigilant follow-up and care under the supervision of oral health specialists to minimize morbidity and mortality and to improve living conditions.
PE-251 - ORAL MELANOMA: CASE REPORT AND LITERATURE REVIEW. ANA LUCIA NORONHA FRANCISCO, MARCUS VINICIUS FURLAN, CLÓVIS ANTÔNIO LOPES PINTO, MONICA LUCIA RODRIGUES, NATALIE KELNER, LUIZ PAULO KOWALSKI, MAURO KASUO IKEDA. DEPARTMENT OF HEAD AND NECK SURGERY AND OTORHINOLARYNGOLOGY, A.C. CAMARGO HOSPITAL. Mucosal melanoma is a rare, aggressive malignancy that accounts for about 2% of all head and neck cancers. Less than 1% of all melanomas occur in the oral mucosa. In the oral cavity the sites most often affected are the hard palate and maxillary gingiva. This neoplasia affects slightly more men than women in age 50 to 60 years. Asian man, 66, came for a medical consultation concerning a dark, painless, nodular, sessile lesion that involved the vestibular site but was indistinct in the upper gum left molar region. Biopsy confirmed invasive melanoma. Tests for disease staging showed no bone invasion or distant metastases. The patient underwent infrastructure resection and neck dissection at levels I to IV with microsurgical reconstruction using a forearm free flap. Postoperatively, radiotherapy was used for treatment.
PE-252 - ORAL METASTASIS OF BREAST CANCER: RARE CASE REPORT. SILAS ANTONIO JUVENCIO DE FREITAS FILHO, ROBERTA REZENDE ROSA, TAMIRIS RODRIGUES SABRINA, PEDRO HENRIQUE REZENDE SPINI, CARLA SILVA SIQUEIRA, TÚLIO HUMBERTO SPINI, SÉRGIO VITORINO CARDOSO. UNIVERSIDADE FEDERAL DE UBERLÂNDIA.
PE-250 - ORAL MANIFESTATIONS OF CHRONIC GRAFT-VERSUS-HOST DISEASE: REPORT OF TWO CASES. CAROLINE ALVES DE CASTRO, EDUARDO REZENDE ARANTES, LORRANY CANDIDO DA SILVA, GEISA BADAUY LAURIA SILVA. HOSPITAL ARAÚJO JORGE.
Metastatic tumors to the oral cavity may occur in the jawbones, soft tissues, or salivary glands, but represent less than 1% of all malignant oral lesions. Woman, 53, had a mass in her oral cavity. The patient reported having had breast carcinoma that was treated with chemotherapy and radiation 2 years previously. Oral examination showed a painful mass in the left posterior maxilla (soft palate and alveolar ridge) with yellowish coloration and ulcerative surface. After incisional biopsy, histopathological analysis revealed nests of malignant cells and deposits of eosinophilic and clear cells permeated by ductal structures that suggested the origin was the breast. The specimen was positive for cytokeratins 7, 8, and HMW, progesterone receptor, and estrogen. The diagnosis of metastatic carcinoma of breast origin was established. The patient was referred to an oncology center for further investigation and treatment.
Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative modality in nonmalignant and neoplastic diseases. Allogeneic HSCT is frequently complicated by graft-versus-host disease (GVHD). The clinical manifestations of oral chronic
PE-253 ORAL PARACOCCIDIOIDOMYCOSIS: REPORT OF TWO CASES. KARINE CASSIA BATISTA LUCIO E SILVA, ELIANE PEDRA DIAS, VANESSA DE