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Squamous Cell Carcinoma: Delayed Diagnosis
ORAL AND MAXILLOFACIAL PATHOLOGY e66 Abstracts PCC-211 - A RARE CASE OF ORAL SPINDLE CELL (SARCOMATOID) CARCINOMA: DIAGNOSIS AND IMMUNOHISTOCHEMICAL PROFILE. MARIA LUIZA DINIZ DE SOUSA LOPES, LÉLIA BATISTA DE SOUZA, MÁRCIA CRISTINA DA COSTA MIGUEL, ALEXANDRE DE OLIVEIRA SALES, CARLOS CÉSAR DE OLIVEIRA RAMOS, MARIA DE LOURDES SILVA ARRUDA DE MORAIS, ÉRICKA JANINE DANTAS DA SILVEIRA. UNIVERSIDADE FEDERAL DO RIO GRANDE DO NORTE. Oral spindle cell carcinoma is an aggressive and rare variant of squamous cell carcinoma. A 36-year-old male was referred to our facility 2 months after removal of a lesion from the upper lip at another facility, with a diagnosis of spindle cell lesion to be elucidated. Extraoral examination revealed a slight elevation of the right side of the nose. Intraorally, there was a slight asymptomatic swelling, normally colored and hard on palpation, of the upper lip. After an incisional biopsy, microscopic examination showed proliferation of poorly differentiated epidermoid cells and a mesenchymal component with spindle cells arranged in a fascicular, storiform pattern, with muscle and perineural invasion. Immunostaining revealed strong positivity for AE1/AE3, a-SMA; focal positivity for S100, CK7, p53; and negative reaction for p63, CK8/18, EMA, CD10, CD99, CD34, TLE-1, desmin, and caldesmon. The final diagnosis was oral spindle cell (sarcomatoid) carcinoma. The patient underwent 3-dimensional resection, reconstruction, and radiotherapy.
PCC-212 - MAXILLARY SINUS CARCINOMA: A CASE REPORT. DANIELLA MORAES ANTUNES, DOUGLAS MAGNO GUIMARÃES, RENATO TUFFY, DÉCIO DOS SANTOS PINTO JÚNIOR, FABIO DAUMAS NUNES. FACULDADE DE ODONTOLOGIA DA UNIVERSIDADE DE SÃO PAULO. Maxillary sinus carcinoma is a rare neoplasm whose etiology is still under debate. It usually affects patients between the fifth and sixth decades of life. In most cases, it is diagnosed in advanced stages and the prognosis is therefore poor. A 26-yearold male presented with a swelling in the buccal region of the first molar that had first appeared 3 months earlier. Radiographic examination revealed cortical bone destruction. The lesion was symptomatic and bleeding on palpation. The diagnostic hypothesis was central giant cell granuloma. Histological examination revealed fragments of an epithelial malignancy with proliferating cells forming islands, sometimes with central necrotic areas (comedo necrosis). The neoplastic cells showed changes in the nucleus/cytoplasm ratio, as well as cellular pleomorphism and hyperchromatic nuclei. Clear cells were also observed, mainly in the central areas of the neoplastic islands. The final diagnosis was carcinoma of the maxillary sinus.
PCC-213 - PRIMARY INTRAOSSEOUS CARCINOMA OF MANDIBLE: A CASE REPORT. SILVIA CRISTINA OLIVEIRA BRANDÃO, JULIANA MARIA OLIVEIRA, MARCO ANTÔNIO CRUZ ROCHA, TATIANA NAYARA LIBÓRIO KIMURA, NAÍZA MENEZES MEDEIROS ABRAHIM, LUCILEIDE CASTRO DE OLIVEIRA, JECONIAS CÂMARA. UNIVERSIDADE FEDERAL DO AMAZONAS. Primary intraosseous carcinoma (PIOC) is considered a rare lesion, characterized by a squamous cell carcinoma arising within the jaws, having no initial connection with oral mucosa and,
OOOO August 2015 presumably, developing from remnants of odontogenic epithelium. A 68-year-old male was referred to a school of dentistry for evaluation of a lesion on the anterior mandible. Intraoral examination revealed a swelling in the mandible and mobility of the anterior teeth, with a small, painful ulcer. Radiographic examination showed an irregular pattern of bone destruction with illdefined margins. An incisional biopsy was performed with the hypothesis of squamous cell carcinoma. Microscopic examination revealed proliferation of malignant islands and nests of atypical epithelioid cells, apparently not arising from oral epithelial lining, in a dense stroma. The diagnosis of PIOC was established by correlating clinical and histopathological findings. The patient was referred to an oncology center and is currently undergoing radiotherapy and chemotherapy.
PCC-214 - SQUAMOUS CELL CARCINOMA: DELAYED DIAGNOSIS. FELIPE BAARS DE MIRANDA, GERALDO OLIVEIRA SILVA JUNIOR, THIAGO MOREIRA PESSOA, FELIPE SOUZA LIMA ALENCAR, BIANCA OLIVEIRA DE ALMEIDA BARBOSA, TUANNY LIMA RANGEL, MARILIA HEFFER CANTISANO. UNIVERSIDADE DO ESTADO DO RIO DE JANEIRO. Despite efforts to promote the early diagnosis of mouth cancer, some cases are still detected only in the advanced stages, with no chance of cure. The profile of patients with such lesions often reveals that they live in regions with a low human development index. A 59-year-old black male, who was a rural worker, alcoholic, and pipe smoker, sought treatment at our stomatology clinic with volume increases of the gingiva and tongue. Clinical examination revealed a tumor-like lesion in the sublingual region extending to the mentum region, including the mucosa and semimucosa of the lower lip. Radiographic examination revealed a classic “moth-eaten” image. Differential diagnoses included paracoccidioidomycosis and histoplasmosis. The histopathological analysis revealed a squamous cell carcinoma. The patient is under palliative care at a referral hospital, because the lesion is compressing adjacent structures. The focus in primary care should continue to be on the early diagnosis of such lesions.
PCC-215 - TONGUE SQUAMOUS CELL CARCINOMA IN A 39-YEAR-OLD FEMALE: A CASE REPORT. LIA MIZOBE ONO, ERICK SOUZA PEDRAÇA, JULIANA MARIA SOUZA DE OLIVEIRA, TANIA CRISTINA CHICRE ALCÂNTARA DE BRITO, NIKEILA CHACON DE OLIVEIRA CONDE, LUCIANA BOTINELLY MENDONÇA FUJIMOTO, TATIANA NAYARA LIBÓRIO KIMURA. UNIVERSIDADE FEDERAL DO AMAZONAS. Squamous cell carcinoma is the most common malignancy of the oral cavity, usually affecting individuals over 50 years of age. A 39-year-old female, who was a non-smoker and non-drinker, was referred to our school of dentistry for evaluation of a white plaque, on the tongue, that had initially been painless and had increased in size, with hard lesions. Intraoral examination revealed lesions of multiple aspects on the right ventral surface of the tongue; some were yellowish papules, whereas others presented elevated borders. A minor fissure with an irregular white plaque, on the right lateral border of the tongue, was also observed. Physical examination revealed no impairment, and no lymph nodes were detected in the cervical region. A biopsy was performed, and the histopathology showed invasive islands of
PCC-212 - MAXILLARY SINUS CARCINOMA: A CASE REPORT. DANIELLA MORAES ANTUNES, DOUGLAS MAGNO GUIMARÃES, RENATO TUFFY, DÉCIO DOS SANTOS PINTO JÚNIOR, FABIO DAUMAS NUNES. FACULDADE DE ODONTOLOGIA DA UNIVERSIDADE DE SÃO PAULO. Maxillary sinus carcinoma is a rare neoplasm whose etiology is still under debate. It usually affects patients between the fifth and sixth decades of life. In most cases, it is diagnosed in advanced stages and the prognosis is therefore poor. A 26-yearold male presented with a swelling in the buccal region of the first molar that had first appeared 3 months earlier. Radiographic examination revealed cortical bone destruction. The lesion was symptomatic and bleeding on palpation. The diagnostic hypothesis was central giant cell granuloma. Histological examination revealed fragments of an epithelial malignancy with proliferating cells forming islands, sometimes with central necrotic areas (comedo necrosis). The neoplastic cells showed changes in the nucleus/cytoplasm ratio, as well as cellular pleomorphism and hyperchromatic nuclei. Clear cells were also observed, mainly in the central areas of the neoplastic islands. The final diagnosis was carcinoma of the maxillary sinus.
PCC-213 - PRIMARY INTRAOSSEOUS CARCINOMA OF MANDIBLE: A CASE REPORT. SILVIA CRISTINA OLIVEIRA BRANDÃO, JULIANA MARIA OLIVEIRA, MARCO ANTÔNIO CRUZ ROCHA, TATIANA NAYARA LIBÓRIO KIMURA, NAÍZA MENEZES MEDEIROS ABRAHIM, LUCILEIDE CASTRO DE OLIVEIRA, JECONIAS CÂMARA. UNIVERSIDADE FEDERAL DO AMAZONAS. Primary intraosseous carcinoma (PIOC) is considered a rare lesion, characterized by a squamous cell carcinoma arising within the jaws, having no initial connection with oral mucosa and,
OOOO August 2015 presumably, developing from remnants of odontogenic epithelium. A 68-year-old male was referred to a school of dentistry for evaluation of a lesion on the anterior mandible. Intraoral examination revealed a swelling in the mandible and mobility of the anterior teeth, with a small, painful ulcer. Radiographic examination showed an irregular pattern of bone destruction with illdefined margins. An incisional biopsy was performed with the hypothesis of squamous cell carcinoma. Microscopic examination revealed proliferation of malignant islands and nests of atypical epithelioid cells, apparently not arising from oral epithelial lining, in a dense stroma. The diagnosis of PIOC was established by correlating clinical and histopathological findings. The patient was referred to an oncology center and is currently undergoing radiotherapy and chemotherapy.
PCC-214 - SQUAMOUS CELL CARCINOMA: DELAYED DIAGNOSIS. FELIPE BAARS DE MIRANDA, GERALDO OLIVEIRA SILVA JUNIOR, THIAGO MOREIRA PESSOA, FELIPE SOUZA LIMA ALENCAR, BIANCA OLIVEIRA DE ALMEIDA BARBOSA, TUANNY LIMA RANGEL, MARILIA HEFFER CANTISANO. UNIVERSIDADE DO ESTADO DO RIO DE JANEIRO. Despite efforts to promote the early diagnosis of mouth cancer, some cases are still detected only in the advanced stages, with no chance of cure. The profile of patients with such lesions often reveals that they live in regions with a low human development index. A 59-year-old black male, who was a rural worker, alcoholic, and pipe smoker, sought treatment at our stomatology clinic with volume increases of the gingiva and tongue. Clinical examination revealed a tumor-like lesion in the sublingual region extending to the mentum region, including the mucosa and semimucosa of the lower lip. Radiographic examination revealed a classic “moth-eaten” image. Differential diagnoses included paracoccidioidomycosis and histoplasmosis. The histopathological analysis revealed a squamous cell carcinoma. The patient is under palliative care at a referral hospital, because the lesion is compressing adjacent structures. The focus in primary care should continue to be on the early diagnosis of such lesions.
PCC-215 - TONGUE SQUAMOUS CELL CARCINOMA IN A 39-YEAR-OLD FEMALE: A CASE REPORT. LIA MIZOBE ONO, ERICK SOUZA PEDRAÇA, JULIANA MARIA SOUZA DE OLIVEIRA, TANIA CRISTINA CHICRE ALCÂNTARA DE BRITO, NIKEILA CHACON DE OLIVEIRA CONDE, LUCIANA BOTINELLY MENDONÇA FUJIMOTO, TATIANA NAYARA LIBÓRIO KIMURA. UNIVERSIDADE FEDERAL DO AMAZONAS. Squamous cell carcinoma is the most common malignancy of the oral cavity, usually affecting individuals over 50 years of age. A 39-year-old female, who was a non-smoker and non-drinker, was referred to our school of dentistry for evaluation of a white plaque, on the tongue, that had initially been painless and had increased in size, with hard lesions. Intraoral examination revealed lesions of multiple aspects on the right ventral surface of the tongue; some were yellowish papules, whereas others presented elevated borders. A minor fissure with an irregular white plaque, on the right lateral border of the tongue, was also observed. Physical examination revealed no impairment, and no lymph nodes were detected in the cervical region. A biopsy was performed, and the histopathology showed invasive islands of