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TWO RARE CASES OF ADENOID CYSTIC CARCINOMA OF THE PAROTID GLAND PRESENTING AS A BONE LESION
OOOO Volume 129, Number 1 corticosteroids appears to be a successful option to control the relapses of PCC.
LATE RECURRENCE OF BURKITT LYMPHOMA IN THE JAW: NUMB CHIN SYNDROME AS THE ONLY SYMPTOM. BERNAR MONTEIRO BENITES, WANESSA MIRANDA-SILVA, FELIPE PAIVA FONSECA, ANDRE CAROLI ROCHA, CLAUDIA REGINA GOMES CARDIM MENDES DE OLIVEIRA, CELSO ARRAIS RODRIGUES and, EDUARDO RODRIGUES FREGNANI Late recurrence of Burkitt lymphoma (BL) is rare, especially in the oral region. A 58-year-old woman, treated 9 years ago for a BL in the tonsil, described a 2-week history of sensitive alteration and pain in the chin region. Physical examination revealed a complete paresthesia involving the bilateral chin and lower lip. No other alterations were found at cone beam computed tomography and at clinical examination. Through magnetic resonance exam, it was possible to identify an alteration in the mandibular body extending to the entire right side. An intraosseous biopsy was performed and the immunohistochemical profile revealed positivity to BCL-6, CD-10, CD-20, C-MYC, and PAX-5 demonstrating the presence of a mature B cell lineage, consistent with the diagnosis of BL. The in situ hybridization was negative for Epstein-Barr virus. The rescue chemotherapy treatment was initiated and the patient is under follow-up care.
AN ULCER AFFECTING THE GINGIVA AND HARD PALATE: AN INTERESTING CLINICAL PRESENTATION OF LANGERHANS CELL HISTIOCYTOSIS. JEFFERSON DA ROCHA TENORIO, MANUELA COLBECK GONCALVES ¸ CARVALHO, MARCOS CUSTODIO, FABIO DAUMAS NUNES and, KAREM LOPEZ ORTEGA A 37-year-old white female patient was referred for diagnosis of a lesion on alveolar ridge that extended to the hard palate. In reviewing her medical history, the patient reported headaches that led her to have a computed tomography (CT) scan performed. As a result, fibrous dysplasia of the ethmoidal sinus was diagnosed. Physical examination revealed an ulcerated lesion, with irregular contours, erythroplasic areas, partially covered by fibrin membrane, and without pain. Radiographic examination revealed the destructive character of the lesion, evidenced by the presence of bone loss between teeth 15 and 16. An incisional biopsy was performed and histopathologic examination revealed the presence of an intense proliferation of epithelioid histiocytic cells in addition to eosinophils and dispersed mononuclear cells. The diagnosis of Langerhans cell histiocytosis was established. The patient was referred to the oncologist for treatment.
METASTASIS OF RENAL CELL CARCINOMA TO MAXILLARY GINGIVA: A CASE REPORT. LUAN NATHIEL SANTANA KOVALSKI, VINICIUS COELHO CARRARD, JULIA TURRA RIBEIRO, MARINA GIRARDI SCHUEIGART, LUIS FERNANDO RIVERO, MARCIA GAIGER DE OLIVEIRA and, MARCO ^ ANTONIO TREVIZANI MARTINS A 63-year-old white male presented with maxillary gingival swelling for a 6-month duration. Medical history revealed
ABSTRACTS
e21
diabetes and hypertension. Extraoral examination was noncontributory. Intraoral exam showed a red bleeding lobulated nodule measuring 5.0 £ 3.0 cm in the left maxillary gingiva. The presumptive diagnosis was nonneoplastic reactive lesion. An incisional biopsy was performed and histopathologic diagnosis was unspecific malignant neoplasm. The initial immunohistochemical panel was inconclusive. The panoramic radiography showed extensive bone destruction in the left maxilla. Abdominal and chest computed tomography (CT) revealed lesions in the liver, kidney, and lung. Magnetic resonance imaging (MRI) of the central nervous system (CNS) showed nodules in left parietal lobe. An ultrasound-guided biopsy of the right kidney confirmed the diagnosis of clear cell renal carcinoma, with metastasis to the liver, lung, CNS, and oral cavity. The treatment combined surgery, palliative chemotherapy, and radiotherapy with partial remission of the lesions. The patient remains under treatment.
AMELOBLASTIC CARCINOMA OF THE MAXILLA IN A YOUNG WOMAN: FROM DIAGNOSIS TO REHABILITATION. CAROLINA DUMMEL, FERNANDA BROCHIER CARDOSO, LUIS FERNANDO RIVERO, MANOELA DOMINGUES MARTINS, RENATA DE ALMEIDA ZIEGER, JULIA TURRA RIBEIRO and, MARCO ANTONIO TREVIZANI MARTINS A 23-year-old woman was referred with maxillary swelling for a 6-month duration. In her medical history, the patient revealed a surgery for ameloblastoma 8 years earlier. Extraoral examination revealed a swelling over the right side of face, lifting her lip and nose. Intraorally, a firm, reddish, nodular swelling involving the right maxilla was observed. Computed tomography (CT) showed a hypodense image invading the right maxilla, maxillary sinus, and nasal fossa. An incisional biopsy was performed, followed by histopathologic examination and immunohistochemical panel, which led to the diagnosis of ameloblastic carcinoma. The patient underwent a total resection of the lesion and an immediate obturator prosthesis was placed. Four months after the surgery, the patient was rehabilitated with a temporary obturator and no recurrence was detected.
TWO RARE CASES OF ADENOID CYSTIC CARCINOMA OF THE PAROTID GLAND PRESENTING AS A BONE LESION. DIEGO ^ ANTONIO COSTA ARANTES, ALEXANDRE BELLOTTI, ALINE CARVALHO BATISTA, REJANE FARIA RIBEIROROTTA, ROBSON RODRIGUES GARCIA and, ENEIDA FRANCO VENCIO Adenoid cystic carcinoma (ACC) is a relatively rare salivary gland malignancy, exhibiting a lethal clinical course often several years after initial diagnosis. It is rarely found outside major or minor salivary glands especially as a bone lesion. Here, 2 rare clinical conditions of ACC arising from the parotid gland and spreading into the mandible are presented. A 50-year-old woman and 49-year-old man presented with pain and paresthesia in the left face. A swelling was observed and computed tomography detected an osteolytic lesion with irregular margins in the mandible. Clinical diagnosis included osteomyelitis and sarcoma. Tumors presented as solid masses with few ductiform structures and exhibited perineurial invasion in the inferior alveolar nerve and high-grade transformation. Challenges in the diagnosis of ACC highlight the need for meticulous clinical management in
ABSTRACTS
e22
an effort to allow for early detection of the primary tumor and initiation of the appropriate therapy.
€ IS SJOGREN’S SYNDROME ANOTHER POSSIBLE AUTOIMMUNE COMPLICATION OF CHIKUNGUNYA FEVER?. LUIZ ALCINO MONTEIRO GUEIROS, ALESSANDRA CARVALHO, JAIR e CARNEIRO LEAO, AYSA PINHEIRO, PAULA TOCHE and, ANGELA DUARTE Chikungunya (CHIK) fever is a tropical arbovirosis characterized by sudden fever, headache, rash, and severe arthralgia. The disease has been suggested to act as a trigger for several autoimmune disorders, especially rheumatoid arthritis. This abstract reports 2 cases of Sj€ ogren syndrome (SS) following CHIK infection. Both patients were female and presented with fever, arthralgia, rash, and arthritis during CHIK outbreak in Recife, Brazil. After several months, they developed severe sicca symptoms and 1 of them presented with parotid enlargement. Clinical salivary gland biopsy and serologic examination rendered the diagnosis of SS for both patients. No systemic features of SS were noted. New evidence has pointed to the development of autoimmune inflammatory musculoskeletal diseases following CHIK fever, such as rheumatoid arthritis, spondylitis, and systemic lupus as a sequel of the infection. Nevertheless, SS has rarely been associated with CHIK and this association should be better evaluated.
ORAL SQUAMOUS CELL CARCINOMA AFTER HEMATOPOIETIC STEM CELL TRANSPLANTATION: 2 CASES IN PATIENTS WITH FANCONI ANEMIA. FERNANDA GON¸CALVES SALUM, KAREN CHERUBINI, LILIANE SOARES YURGEL and, MARIA ANTONIA ZANCANARO DE FIGUEIREDO Fanconi anemia (FA) is an autosomal recessive disorder with the following important features: (1) progressive bone marrow failure and (2) development of malignancies. We report 2 cases of oral squamous cell carcinoma in male patients with FA who underwent hematopoietic stem cell transplantation. Both patients presented with oral lichenoid lesions, compatible with chronic graft vs host disease. In the first case, a 16-year-old patient presented with an extensive infiltrative and necrotic lesion on the border of the tongue. After biopsy, the diagnosis of squamous cell carcinoma was confirmed. The patient received chemotherapy and radiotherapy but died 4 months later. In the second case, a 26-year-old patient presented with an irregular white plaque on the border of the tongue. After histopathologic diagnosis confirmation, the carcinoma was surgically resected and the patient is under follow-up evaluation. Patients with FA have a high risk for oral cancer and their systematic follow-up is essential.
EPSTEIN-BARR POSITIVE ULCERS OF THE ORAL CAVITY ASSOCIATED WITH IMMUNOSUPPRESSION IN A PATIENT WITH CANCER. VANESSA TONETTO MARQUES, ADRIANO TADEU MARANGONI, ANA RAPHAELA DEZAN CURVO, LEANDRO DORIGAN DE MACEDO and, LARA MARIA ALENCAR RAMOS INNOCENTINI A 24-year-old man with synovial sarcoma was hospitalized for neutropenic fever after chemotherapy, complaining of
OOOO January 2020 gingival pain for 1 day. No lymph node involvement was detected during neck palpation. Intraoral exam revealed a purple lesion involving the attached gingiva on the maxilla and mandible, of increased size and with a detachable overlying white plaque. There was rapid evolution to ulcerated lesions, causing an inability to feed. We performed an incisional biopsy and referred the patient for anatomopathologic examination, polymerase chain reaction (PCR), and culture for fungi and bacteria, a prescription of chlorhexidine 0.12%, and empiric fluconazole and acyclovir. PCR was positive for Epstein-Barr virus (EBV) with 1095 copies, so the patient was maintained on acyclovir for 15 days. The patient had significant improvement in pain and the oral lesions regressed after this period. This case demonstrated that EBV commonly occurs in immunosuppressed patients and underscores the importance of dentists in the diagnosis and control of oral complications in the multiprofessional hospital team.
CENTRAL HEMANGIOMA OF THE ANTERIOR MANDIBLE WITH AGGRESSIVE CLINICAL APPEARANCE. MATEUS DUTRA SANTANA, GUSTAVO BARROSO MELLO ALVES, BRUNO COSTA FERREIRA, LEONEL PORTO DE CARVALHO, ALEXANDRE MAURITY DE PAULA AFONSO, BRUNO AUGUSTO BENEVENUTO DE e ANDRADE and, MARIO JOSE ROMANACH Central hemangioma (CH) of the jaws is a rare benign vascular neoplasm of variable radiographic appearance. A 32-yearold man was referred for evaluation of an ulcerated mass on the anterior mandible causing facial asymmetry for the last 6 months. The patient reported progressive growth and bleeding episodes. Intraoral examination revealed an erythematous and necrotic swelling in the lower anterior gingiva. Computerized tomography revealed a well-defined multilocular hypodense lesion involving the mandibular symphysis, containing hyperdense foci, with expansion and destruction of the buccal cortical bone, and teeth displacement and mobility. High blood content was detected during aspiration and surgical enucleation was performed after tumor embolization. Microscopically, large arterial blood vessels of variable sizes were observed, some of them containing intravascular concentric calcifications, confirming the diagnosis of CH. During a follow-up period of 6 months, the patient had no recurrence. CH of the jaws may show an aggressive clinical appearance, mimicking malignancy.
EMBRYONAL RHABDOMYOSARCOMA. JOSE FRANCISCO TORRES ANGUIANO, ISRAEL VIVANCO PEREZ, OSMAR ADAN CARCAMO IDIAQUEZ, DIEGO ACEVEDO CANTORAN, CARLOS MANUEL ROA ENCARNACION, ADOLFO NAVARRO ZARATE and, NANCY TRUJILLO GARCIA A 7-month-old female infant was sent to the clinic diagnosed by the oncology unit with embryonal rhabdomyosarcoma. The disease was detected at the time of her birth. She showed an increase in volume in the nasolabial region that was treated as a hemangioma without response to treatment. Diagnosis was established through a Tru-Cut (MeritMedical, South Jordan, UT) biopsy and it was confirmed with immunohistochemistry. The treatment was established with chemotherapy, then, she was sent to our clinical unit for assessment and surgical treatment. The contrasted tomography suggested tumor of the nasogenian
LATE RECURRENCE OF BURKITT LYMPHOMA IN THE JAW: NUMB CHIN SYNDROME AS THE ONLY SYMPTOM. BERNAR MONTEIRO BENITES, WANESSA MIRANDA-SILVA, FELIPE PAIVA FONSECA, ANDRE CAROLI ROCHA, CLAUDIA REGINA GOMES CARDIM MENDES DE OLIVEIRA, CELSO ARRAIS RODRIGUES and, EDUARDO RODRIGUES FREGNANI Late recurrence of Burkitt lymphoma (BL) is rare, especially in the oral region. A 58-year-old woman, treated 9 years ago for a BL in the tonsil, described a 2-week history of sensitive alteration and pain in the chin region. Physical examination revealed a complete paresthesia involving the bilateral chin and lower lip. No other alterations were found at cone beam computed tomography and at clinical examination. Through magnetic resonance exam, it was possible to identify an alteration in the mandibular body extending to the entire right side. An intraosseous biopsy was performed and the immunohistochemical profile revealed positivity to BCL-6, CD-10, CD-20, C-MYC, and PAX-5 demonstrating the presence of a mature B cell lineage, consistent with the diagnosis of BL. The in situ hybridization was negative for Epstein-Barr virus. The rescue chemotherapy treatment was initiated and the patient is under follow-up care.
AN ULCER AFFECTING THE GINGIVA AND HARD PALATE: AN INTERESTING CLINICAL PRESENTATION OF LANGERHANS CELL HISTIOCYTOSIS. JEFFERSON DA ROCHA TENORIO, MANUELA COLBECK GONCALVES ¸ CARVALHO, MARCOS CUSTODIO, FABIO DAUMAS NUNES and, KAREM LOPEZ ORTEGA A 37-year-old white female patient was referred for diagnosis of a lesion on alveolar ridge that extended to the hard palate. In reviewing her medical history, the patient reported headaches that led her to have a computed tomography (CT) scan performed. As a result, fibrous dysplasia of the ethmoidal sinus was diagnosed. Physical examination revealed an ulcerated lesion, with irregular contours, erythroplasic areas, partially covered by fibrin membrane, and without pain. Radiographic examination revealed the destructive character of the lesion, evidenced by the presence of bone loss between teeth 15 and 16. An incisional biopsy was performed and histopathologic examination revealed the presence of an intense proliferation of epithelioid histiocytic cells in addition to eosinophils and dispersed mononuclear cells. The diagnosis of Langerhans cell histiocytosis was established. The patient was referred to the oncologist for treatment.
METASTASIS OF RENAL CELL CARCINOMA TO MAXILLARY GINGIVA: A CASE REPORT. LUAN NATHIEL SANTANA KOVALSKI, VINICIUS COELHO CARRARD, JULIA TURRA RIBEIRO, MARINA GIRARDI SCHUEIGART, LUIS FERNANDO RIVERO, MARCIA GAIGER DE OLIVEIRA and, MARCO ^ ANTONIO TREVIZANI MARTINS A 63-year-old white male presented with maxillary gingival swelling for a 6-month duration. Medical history revealed
ABSTRACTS
e21
diabetes and hypertension. Extraoral examination was noncontributory. Intraoral exam showed a red bleeding lobulated nodule measuring 5.0 £ 3.0 cm in the left maxillary gingiva. The presumptive diagnosis was nonneoplastic reactive lesion. An incisional biopsy was performed and histopathologic diagnosis was unspecific malignant neoplasm. The initial immunohistochemical panel was inconclusive. The panoramic radiography showed extensive bone destruction in the left maxilla. Abdominal and chest computed tomography (CT) revealed lesions in the liver, kidney, and lung. Magnetic resonance imaging (MRI) of the central nervous system (CNS) showed nodules in left parietal lobe. An ultrasound-guided biopsy of the right kidney confirmed the diagnosis of clear cell renal carcinoma, with metastasis to the liver, lung, CNS, and oral cavity. The treatment combined surgery, palliative chemotherapy, and radiotherapy with partial remission of the lesions. The patient remains under treatment.
AMELOBLASTIC CARCINOMA OF THE MAXILLA IN A YOUNG WOMAN: FROM DIAGNOSIS TO REHABILITATION. CAROLINA DUMMEL, FERNANDA BROCHIER CARDOSO, LUIS FERNANDO RIVERO, MANOELA DOMINGUES MARTINS, RENATA DE ALMEIDA ZIEGER, JULIA TURRA RIBEIRO and, MARCO ANTONIO TREVIZANI MARTINS A 23-year-old woman was referred with maxillary swelling for a 6-month duration. In her medical history, the patient revealed a surgery for ameloblastoma 8 years earlier. Extraoral examination revealed a swelling over the right side of face, lifting her lip and nose. Intraorally, a firm, reddish, nodular swelling involving the right maxilla was observed. Computed tomography (CT) showed a hypodense image invading the right maxilla, maxillary sinus, and nasal fossa. An incisional biopsy was performed, followed by histopathologic examination and immunohistochemical panel, which led to the diagnosis of ameloblastic carcinoma. The patient underwent a total resection of the lesion and an immediate obturator prosthesis was placed. Four months after the surgery, the patient was rehabilitated with a temporary obturator and no recurrence was detected.
TWO RARE CASES OF ADENOID CYSTIC CARCINOMA OF THE PAROTID GLAND PRESENTING AS A BONE LESION. DIEGO ^ ANTONIO COSTA ARANTES, ALEXANDRE BELLOTTI, ALINE CARVALHO BATISTA, REJANE FARIA RIBEIROROTTA, ROBSON RODRIGUES GARCIA and, ENEIDA FRANCO VENCIO Adenoid cystic carcinoma (ACC) is a relatively rare salivary gland malignancy, exhibiting a lethal clinical course often several years after initial diagnosis. It is rarely found outside major or minor salivary glands especially as a bone lesion. Here, 2 rare clinical conditions of ACC arising from the parotid gland and spreading into the mandible are presented. A 50-year-old woman and 49-year-old man presented with pain and paresthesia in the left face. A swelling was observed and computed tomography detected an osteolytic lesion with irregular margins in the mandible. Clinical diagnosis included osteomyelitis and sarcoma. Tumors presented as solid masses with few ductiform structures and exhibited perineurial invasion in the inferior alveolar nerve and high-grade transformation. Challenges in the diagnosis of ACC highlight the need for meticulous clinical management in
ABSTRACTS
e22
an effort to allow for early detection of the primary tumor and initiation of the appropriate therapy.
€ IS SJOGREN’S SYNDROME ANOTHER POSSIBLE AUTOIMMUNE COMPLICATION OF CHIKUNGUNYA FEVER?. LUIZ ALCINO MONTEIRO GUEIROS, ALESSANDRA CARVALHO, JAIR e CARNEIRO LEAO, AYSA PINHEIRO, PAULA TOCHE and, ANGELA DUARTE Chikungunya (CHIK) fever is a tropical arbovirosis characterized by sudden fever, headache, rash, and severe arthralgia. The disease has been suggested to act as a trigger for several autoimmune disorders, especially rheumatoid arthritis. This abstract reports 2 cases of Sj€ ogren syndrome (SS) following CHIK infection. Both patients were female and presented with fever, arthralgia, rash, and arthritis during CHIK outbreak in Recife, Brazil. After several months, they developed severe sicca symptoms and 1 of them presented with parotid enlargement. Clinical salivary gland biopsy and serologic examination rendered the diagnosis of SS for both patients. No systemic features of SS were noted. New evidence has pointed to the development of autoimmune inflammatory musculoskeletal diseases following CHIK fever, such as rheumatoid arthritis, spondylitis, and systemic lupus as a sequel of the infection. Nevertheless, SS has rarely been associated with CHIK and this association should be better evaluated.
ORAL SQUAMOUS CELL CARCINOMA AFTER HEMATOPOIETIC STEM CELL TRANSPLANTATION: 2 CASES IN PATIENTS WITH FANCONI ANEMIA. FERNANDA GON¸CALVES SALUM, KAREN CHERUBINI, LILIANE SOARES YURGEL and, MARIA ANTONIA ZANCANARO DE FIGUEIREDO Fanconi anemia (FA) is an autosomal recessive disorder with the following important features: (1) progressive bone marrow failure and (2) development of malignancies. We report 2 cases of oral squamous cell carcinoma in male patients with FA who underwent hematopoietic stem cell transplantation. Both patients presented with oral lichenoid lesions, compatible with chronic graft vs host disease. In the first case, a 16-year-old patient presented with an extensive infiltrative and necrotic lesion on the border of the tongue. After biopsy, the diagnosis of squamous cell carcinoma was confirmed. The patient received chemotherapy and radiotherapy but died 4 months later. In the second case, a 26-year-old patient presented with an irregular white plaque on the border of the tongue. After histopathologic diagnosis confirmation, the carcinoma was surgically resected and the patient is under follow-up evaluation. Patients with FA have a high risk for oral cancer and their systematic follow-up is essential.
EPSTEIN-BARR POSITIVE ULCERS OF THE ORAL CAVITY ASSOCIATED WITH IMMUNOSUPPRESSION IN A PATIENT WITH CANCER. VANESSA TONETTO MARQUES, ADRIANO TADEU MARANGONI, ANA RAPHAELA DEZAN CURVO, LEANDRO DORIGAN DE MACEDO and, LARA MARIA ALENCAR RAMOS INNOCENTINI A 24-year-old man with synovial sarcoma was hospitalized for neutropenic fever after chemotherapy, complaining of
OOOO January 2020 gingival pain for 1 day. No lymph node involvement was detected during neck palpation. Intraoral exam revealed a purple lesion involving the attached gingiva on the maxilla and mandible, of increased size and with a detachable overlying white plaque. There was rapid evolution to ulcerated lesions, causing an inability to feed. We performed an incisional biopsy and referred the patient for anatomopathologic examination, polymerase chain reaction (PCR), and culture for fungi and bacteria, a prescription of chlorhexidine 0.12%, and empiric fluconazole and acyclovir. PCR was positive for Epstein-Barr virus (EBV) with 1095 copies, so the patient was maintained on acyclovir for 15 days. The patient had significant improvement in pain and the oral lesions regressed after this period. This case demonstrated that EBV commonly occurs in immunosuppressed patients and underscores the importance of dentists in the diagnosis and control of oral complications in the multiprofessional hospital team.
CENTRAL HEMANGIOMA OF THE ANTERIOR MANDIBLE WITH AGGRESSIVE CLINICAL APPEARANCE. MATEUS DUTRA SANTANA, GUSTAVO BARROSO MELLO ALVES, BRUNO COSTA FERREIRA, LEONEL PORTO DE CARVALHO, ALEXANDRE MAURITY DE PAULA AFONSO, BRUNO AUGUSTO BENEVENUTO DE e ANDRADE and, MARIO JOSE ROMANACH Central hemangioma (CH) of the jaws is a rare benign vascular neoplasm of variable radiographic appearance. A 32-yearold man was referred for evaluation of an ulcerated mass on the anterior mandible causing facial asymmetry for the last 6 months. The patient reported progressive growth and bleeding episodes. Intraoral examination revealed an erythematous and necrotic swelling in the lower anterior gingiva. Computerized tomography revealed a well-defined multilocular hypodense lesion involving the mandibular symphysis, containing hyperdense foci, with expansion and destruction of the buccal cortical bone, and teeth displacement and mobility. High blood content was detected during aspiration and surgical enucleation was performed after tumor embolization. Microscopically, large arterial blood vessels of variable sizes were observed, some of them containing intravascular concentric calcifications, confirming the diagnosis of CH. During a follow-up period of 6 months, the patient had no recurrence. CH of the jaws may show an aggressive clinical appearance, mimicking malignancy.
EMBRYONAL RHABDOMYOSARCOMA. JOSE FRANCISCO TORRES ANGUIANO, ISRAEL VIVANCO PEREZ, OSMAR ADAN CARCAMO IDIAQUEZ, DIEGO ACEVEDO CANTORAN, CARLOS MANUEL ROA ENCARNACION, ADOLFO NAVARRO ZARATE and, NANCY TRUJILLO GARCIA A 7-month-old female infant was sent to the clinic diagnosed by the oncology unit with embryonal rhabdomyosarcoma. The disease was detected at the time of her birth. She showed an increase in volume in the nasolabial region that was treated as a hemangioma without response to treatment. Diagnosis was established through a Tru-Cut (MeritMedical, South Jordan, UT) biopsy and it was confirmed with immunohistochemistry. The treatment was established with chemotherapy, then, she was sent to our clinical unit for assessment and surgical treatment. The contrasted tomography suggested tumor of the nasogenian