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Proliferative Osteomyelitis: Case Report
ORAL AND MAXILLOFACIAL PATHOLOGY e186 Abstracts composed of a mixture of glandular epithelium and myoepithelial cells within a mesenchyme-like background, confirming the diagnosis of PA. After 4 months of follow-up, complete healing and no sign of recurrence were observed.
PE-280 - PLEXIFORM SCHWANNOMA IN HARD PALATE: CASE REPORT. LARISSA ABBEHUSEN COUTO, JEAN NUNES DOS SANTOS, FLÁVIA CALÓ DE AQUINO XAVIER, LUCIANA MARIA PEDREIRA RAMALHO, LEONARDO DE ARAÚJO MELO, CLARISSA ARAÚJO SILVA GURGEL, ÁGUIDA CRISTINA GOMES HENRIQUES. UFBA. Schwannoma is a benign peripheral nerve sheath tumor that mostly affects young adults. It commonly affects cutaneous tissues of the head and neck region and is classified into four histopathological variants: conventional, cellular, plexiform, and melanotic. Young woman, 14, presented a nodular lesion in the hard palate of normal color that measured 3.0 cm. Pleomorphic adenoma was suspected. The incisional biopsy specimen revealed multiple round nodules demarcated with a fibrous capsule. The nodules mainly consisted of Antoni A tissue with spindle-shaped cells arranged in a nuclear palisade, along with well-developed Verocay bodies. Areas of Antoni B tissue were less frequently seen. Microscopic analysis was compatible with plexiform schwannoma (PS). Immunohistochemical analysis showed positive reactions for S-100 protein and vimentin in hypercellular and hypocellular areas. PS is extremely rare in the oral cavity. Peripheral nerve tumors are subject to frequent misdiagnosis, often mimicking neoplasms of different prognosis and treatment.
PE-281 - POLYMORPHOUS LOW-GRADE ADENOCARCINOMA MIMICKING CANALICULAR ADENOMA. MARION FARIAS GUIMARÃES, KALINY SOUZA FARIAS, DÉCIO DOS SANTOS PINTO JUNIOR, JULIANA VIANNA PEREIRA, MAX EDUARDO BARROSO DE AMORIM, NIKEILA CHACON DE OLIVEIRA CONDE, TATIANA NAYARA LIBÓRIO. UNIVERSIDADE FEDERAL DO AMAZONAS. Polymorphous low-grade adenocarcinoma (PLGA) and canalicular adenoma (CA) are relatively rare tumors of the minor salivary glands. PLGA is frequently found in the palate and CA in the upper lip. Histologically, PLGA presents diverse patterns of architecture, and low infiltrative growth and CA presents strands of columnar cells with occasionally cystic spaces. Man, 68, presented a 1-year history of an asymptomatic lesion in the upper lip mucosa. Oroscopy found a 0.7-cm floating mass of solid consistency, movable on palpation, that was covered by normal mucosa. After an excisional biopsy, microscopic examination revealed a monotonous pattern of long canals organized in cords of columnar epithelium with highly basophilic nuclei. The lesion mimicked canalicular adenoma both in location and histology. Immunohistochemistry revealed immunoreactivity for anti-AE1/ AE3, anti-CK7, and anti-vimentin. The definitive diagnosis of PLGA was established. The patient has had no recurrences over 6 months of follow-up.
¨ GREN’S SYNDROME: CASE PE-282 - PRIMARY SJO REPORT. JÉSSICA BRUNA CORRÊA LINDOSO, ELIZÂNGELA CRISTINA BARBOSA VIANA, NIKEILA CHACON DE OLIVEIRA CONDE, LUIZ FERNANDO SOUZA PASSOS, SANDRA LÚCIA EUZÉBIO RIBEIRO,
OOOO February 2014 JECONIAS CAMARA, TATIANA NAYARA LIBÓRIO. UNIVERIDADE FEDERAL DO AMAZONAS. Sjögren’s syndrome is a chronic, multisystem autoimmune disorder leading to dysfunction of the exocrine glands. Woman, 39, was referred to a dental school to assess symptoms of xerostomia, xerophthalmia, and swallowing difficulty. The patient had no history of systemic autoimmune disease but had a positive Schimmer test, attesting a decreased tearing, and a positive serological result for anti-Ro/SSA autoantibody. Oroscopy discovered dry lips and coated tongue. The patient underwent sialometry based on unstimulated and stimulated whole salivary flow, both detecting hyposalivation. A minor salivary gland biopsy was performed. Microscopic examination revealed focal lymphocytic sialoadenitis around the ducts and some degenerative acinar structure. Clinical and histological findings were compatible with the diagnosis of primary Sjögren’s syndrome. The patient was instructed to use artificial saliva and was referred to a rheumatologist and ophthalmologist for multidisciplinary treatment.
PE-283 - PROGRESSIVE FACIAL HEMIATROPHY: CASE REPORT. THAÍSE GOMES E NÓBREGA, MARCO ANTÔNIO TREVISAN MARTINS, FERNANDA VISIOLI, MANOEL SANT’ANA FILHO, LAURA CAMPOS HILDEBRAND, MANOELA DOMINGUES MARTINS, MARIA CRISTINA MUNERATO. UFRGS - UNIVERSIDADE FEDERAL DO RIO GRANDE DO SUL. Progressive facial hemiatrophy (PFH) (Parry-Romberg syndrome) is a rare degenerative disease of unknown origin with a heterogenic spectrum of associated neurological and cutaneous complications. The main clinical features are a slow, progressive atrophy, generally unilateral, of the facial tissues, including muscles, bones, and skin. It affects both the aesthetic aspects and the functionality of the hemiface. Patient, 45, had progressive facial asymmetry over the previous 25 years that affected the lower third of the left side without crossing the facial median line. Panoramic radiographs did not reveal any bone alterations. Local alopecia, 9 degrees of myopia with ocular degeneration, and paresthesia were detected. The diagnosis supported by all these clinical features. PFH remains a poorly understood condition and exhibits very limited medical management.
PE-284 - PROLIFERATIVE OSTEOMYELITIS: CASE REPORT. CLÁUDIA ANDRÉA CORRÊA GARCIA SIMÕES, CRISTIANO DE BRITO MATOS, LIONEY NOBRE CABRAL, TIAGO NOVAES PINHEIRO, TÂNIA CRISTINA CHICRE ALCÂNTARA DE BRITO, VILMA MELO. UNIVERSIDADE ESTADUAL DO AMAZONAS. Proliferative osteomyelitis associated with periostitis ossificans or Garrès osteomyelitis is a type of chronic nonsuppurative osteomyelitis that mostly affects the mandible of children and young adults in molar regions. It is usually related to dental caries and periapical lesions. The lesion is characterized by a periosteal reaction caused by persistent low-grade infection and is radiographically similar to a lamellar “onion skin” pattern. Girl, 12, had an extensive carious lesion on tooth #36, facial asymmetry, and a slightly characteristic radiographic appearance. Extraction and curettage of the compromised region were done. Follow-up and diagnostic maneuvers essential for the correct diagnosis constitute a major factor in managing similar cases.
PE-280 - PLEXIFORM SCHWANNOMA IN HARD PALATE: CASE REPORT. LARISSA ABBEHUSEN COUTO, JEAN NUNES DOS SANTOS, FLÁVIA CALÓ DE AQUINO XAVIER, LUCIANA MARIA PEDREIRA RAMALHO, LEONARDO DE ARAÚJO MELO, CLARISSA ARAÚJO SILVA GURGEL, ÁGUIDA CRISTINA GOMES HENRIQUES. UFBA. Schwannoma is a benign peripheral nerve sheath tumor that mostly affects young adults. It commonly affects cutaneous tissues of the head and neck region and is classified into four histopathological variants: conventional, cellular, plexiform, and melanotic. Young woman, 14, presented a nodular lesion in the hard palate of normal color that measured 3.0 cm. Pleomorphic adenoma was suspected. The incisional biopsy specimen revealed multiple round nodules demarcated with a fibrous capsule. The nodules mainly consisted of Antoni A tissue with spindle-shaped cells arranged in a nuclear palisade, along with well-developed Verocay bodies. Areas of Antoni B tissue were less frequently seen. Microscopic analysis was compatible with plexiform schwannoma (PS). Immunohistochemical analysis showed positive reactions for S-100 protein and vimentin in hypercellular and hypocellular areas. PS is extremely rare in the oral cavity. Peripheral nerve tumors are subject to frequent misdiagnosis, often mimicking neoplasms of different prognosis and treatment.
PE-281 - POLYMORPHOUS LOW-GRADE ADENOCARCINOMA MIMICKING CANALICULAR ADENOMA. MARION FARIAS GUIMARÃES, KALINY SOUZA FARIAS, DÉCIO DOS SANTOS PINTO JUNIOR, JULIANA VIANNA PEREIRA, MAX EDUARDO BARROSO DE AMORIM, NIKEILA CHACON DE OLIVEIRA CONDE, TATIANA NAYARA LIBÓRIO. UNIVERSIDADE FEDERAL DO AMAZONAS. Polymorphous low-grade adenocarcinoma (PLGA) and canalicular adenoma (CA) are relatively rare tumors of the minor salivary glands. PLGA is frequently found in the palate and CA in the upper lip. Histologically, PLGA presents diverse patterns of architecture, and low infiltrative growth and CA presents strands of columnar cells with occasionally cystic spaces. Man, 68, presented a 1-year history of an asymptomatic lesion in the upper lip mucosa. Oroscopy found a 0.7-cm floating mass of solid consistency, movable on palpation, that was covered by normal mucosa. After an excisional biopsy, microscopic examination revealed a monotonous pattern of long canals organized in cords of columnar epithelium with highly basophilic nuclei. The lesion mimicked canalicular adenoma both in location and histology. Immunohistochemistry revealed immunoreactivity for anti-AE1/ AE3, anti-CK7, and anti-vimentin. The definitive diagnosis of PLGA was established. The patient has had no recurrences over 6 months of follow-up.
¨ GREN’S SYNDROME: CASE PE-282 - PRIMARY SJO REPORT. JÉSSICA BRUNA CORRÊA LINDOSO, ELIZÂNGELA CRISTINA BARBOSA VIANA, NIKEILA CHACON DE OLIVEIRA CONDE, LUIZ FERNANDO SOUZA PASSOS, SANDRA LÚCIA EUZÉBIO RIBEIRO,
OOOO February 2014 JECONIAS CAMARA, TATIANA NAYARA LIBÓRIO. UNIVERIDADE FEDERAL DO AMAZONAS. Sjögren’s syndrome is a chronic, multisystem autoimmune disorder leading to dysfunction of the exocrine glands. Woman, 39, was referred to a dental school to assess symptoms of xerostomia, xerophthalmia, and swallowing difficulty. The patient had no history of systemic autoimmune disease but had a positive Schimmer test, attesting a decreased tearing, and a positive serological result for anti-Ro/SSA autoantibody. Oroscopy discovered dry lips and coated tongue. The patient underwent sialometry based on unstimulated and stimulated whole salivary flow, both detecting hyposalivation. A minor salivary gland biopsy was performed. Microscopic examination revealed focal lymphocytic sialoadenitis around the ducts and some degenerative acinar structure. Clinical and histological findings were compatible with the diagnosis of primary Sjögren’s syndrome. The patient was instructed to use artificial saliva and was referred to a rheumatologist and ophthalmologist for multidisciplinary treatment.
PE-283 - PROGRESSIVE FACIAL HEMIATROPHY: CASE REPORT. THAÍSE GOMES E NÓBREGA, MARCO ANTÔNIO TREVISAN MARTINS, FERNANDA VISIOLI, MANOEL SANT’ANA FILHO, LAURA CAMPOS HILDEBRAND, MANOELA DOMINGUES MARTINS, MARIA CRISTINA MUNERATO. UFRGS - UNIVERSIDADE FEDERAL DO RIO GRANDE DO SUL. Progressive facial hemiatrophy (PFH) (Parry-Romberg syndrome) is a rare degenerative disease of unknown origin with a heterogenic spectrum of associated neurological and cutaneous complications. The main clinical features are a slow, progressive atrophy, generally unilateral, of the facial tissues, including muscles, bones, and skin. It affects both the aesthetic aspects and the functionality of the hemiface. Patient, 45, had progressive facial asymmetry over the previous 25 years that affected the lower third of the left side without crossing the facial median line. Panoramic radiographs did not reveal any bone alterations. Local alopecia, 9 degrees of myopia with ocular degeneration, and paresthesia were detected. The diagnosis supported by all these clinical features. PFH remains a poorly understood condition and exhibits very limited medical management.
PE-284 - PROLIFERATIVE OSTEOMYELITIS: CASE REPORT. CLÁUDIA ANDRÉA CORRÊA GARCIA SIMÕES, CRISTIANO DE BRITO MATOS, LIONEY NOBRE CABRAL, TIAGO NOVAES PINHEIRO, TÂNIA CRISTINA CHICRE ALCÂNTARA DE BRITO, VILMA MELO. UNIVERSIDADE ESTADUAL DO AMAZONAS. Proliferative osteomyelitis associated with periostitis ossificans or Garrès osteomyelitis is a type of chronic nonsuppurative osteomyelitis that mostly affects the mandible of children and young adults in molar regions. It is usually related to dental caries and periapical lesions. The lesion is characterized by a periosteal reaction caused by persistent low-grade infection and is radiographically similar to a lamellar “onion skin” pattern. Girl, 12, had an extensive carious lesion on tooth #36, facial asymmetry, and a slightly characteristic radiographic appearance. Extraction and curettage of the compromised region were done. Follow-up and diagnostic maneuvers essential for the correct diagnosis constitute a major factor in managing similar cases.