VASCULAR LEIOMYOMA MIMICKING A LIPOMA

OOOO Volume 129, Number 1 SUBGEMMAL NEUROGENOUS PLAQUE: REPORT OF 3 CASES. RENATA MENDONCA ¸ MORAES, BRUNA FERNANDES DO CARMO CARVALHO, JAQUELINE LEMES RIBEIRO, YASMIN RODARTE CARVALHO, ESTELA KAMINAGAKURA, VICTOR COSTA and, ANA LIA ANBINDER Subgemmal neurogenous plaque (SNP) is a neural structure present in the posterolateral border of the tongue, forming a morphophysiological complex with the taste buds. It was first described 20 years ago, and still now it is not well recognized by clinicians and pathologists. The aim of this study is to report 3 cases of SNP incidentally found after biopsies of posterior tongue lesions (lymphoepithelial cyst, lymphatic malformation, and mucoepidermoid carcinoma). The plexus usually exhibits a biphasic pattern, with bundle of fusiform wavy cells parallel to the epithelial surface, and a deepest portion composed of small nerve fascicles. The clinical findings of the SNP are unspecific, but several cases are symptomatic. The histologic pattern can be mistaken for soft tissue reactive or neoplastic neural lesions, which makes the recognition of the morphologic aspects of this anatomic structure very important.

CLEAR CELL CARCINOMA WITH INDOLENT COURSE: CASE REPORT AND IMMUNOHISTOCHEMICAL ANALYSIS. CAMILA DE OLIVEIRA BARBEIRO, HEITOR ALBERGONI DA SILVEIRA, DARCY FERNANDES, MARIA LETICIA DE ALMEIDA LAN¸CA, ROSE MARA ORTEGA, ANDREIA BUFALINO and, JORGE ESQUICHE LEON Clear cell carcinoma (CCC) is a low-grade salivary gland malignant neoplasm composed of neoplastic cells with clear cytoplasm, with or without hyalinized stroma, and presenting a squamoid phenotype. CCC commonly affects the palate and tongue. A 49-year-old female patient presented an uncomfortable swelling on the hard palate with 10 years of evolution. According to the patient, 2 previous biopsies presented inconclusive diagnosis. Intraorally, there was a swelling with ulcerated surface on the right side of the palate. Panoramic radiograph and computed tomography scans did not show alterations. Incisional biopsy was performed, and microscopic analysis revealed trabeculae and cords constituted by clear cells supported by vascularized and hyalinized stroma. Immunohistochemistry showed positivity for CK AE1/AE3, CK7, p40, and p63. Ki-67 was < 1%. The lesion was totally resected. This case report shows a relatively indolent course of CCC and emphasizes that inadequate biopsies can delay the diagnosis and treatment with impact on its prognosis.

VASCULAR LEIOMYOMA MIMICKING A LIPOMA. FABIO LUIZ CORACIN, VANESSA CHRISTINA DOS SANTOS PAVESI, PAULO  SERGIO SOUZA PINA, PAULO ANDRE DE ALMEIDA, EDUARDO VASQUES DA FONSECA, DANIEL FALBO MARTINS DE SOUZA and, DECIO DOS SANTOS PINTO JUNIOR Vascular leiomyoma is a benign solitary smooth muscle tumor that occurs more often in the lower extremity. A 21-yearold white woman presented a well-circumscribed, subcutaneous,

ABSTRACTS

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solitarym moveable, painless, soft swelling in left cheek for the last 3 years. Previous trauma and past medical and medication histories were noncontributory. No abnormalities in the overlying oral mucosa were seen. Initial diagnosis was lipoma, and other examinations were requested. The ultrasonography image revealed a mass compatible with an accessory parotid with signs suggestive of sialadenitis, and computed tomography revealed a lesion located below the hypodermis anterior to the masseter muscle and the left parotid gland, suggesting salivary gland tumor. Incisional biopsy showed vascular leiomyoma. Surgical extraoral approach included complete excision guided by the topography of the nodule and to reduce the probability of lesion of the buccal branch of the facial nerve. The initial diagnosis was confirmed, and the patient is free of recurrence.

POLYMORPHOUS ADENOCARCINOMA WITH PAPILLARY AND CRIBRIFORM PATTERNS. ELIS ANDRADE DE LIMA ZUTIN, RENATA MENDON¸CA MORAES, BRUNA FERNANDES DO CARMO CARVALHO, MILAGROS DEL VALLE EL ABRAS ANKHA, ESTELA KAMINAGAKURA TANGO, ANA LIA ANBINDER and, YASMIN RODARTE CARVALHO Polymorphous adenocarcinoma (PAC) is the second most common intraoral malignant salivary gland tumor. Although generally considered a low-grade tumor, when presenting a cribriform or papillary configuration there is a poorer prognosis. We report 2 PAC cases. Case 1: A 35-year-old man presented a pediculated nodule with reddish areas. Case 2: A 67-year-old woman presented with sessile nodule exhibiting telangiectatic areas. Both lesions occurred in the left hard palate, had smooth surface, measured approximately 3 cm, were painless, and at had least 4 years of evolution. Microscopically, both showed round isomorphic cells with indistinct cytoplasmic outlines and ovoid nuclei. Architectural pattern showed solid sheets, single files of cells, ducts with 1 cell layer, and papillary cystic formations. Perineural and minor salivary glands invasion were observed. The stroma is variably hyalinized and myxoid. In case 2, cribriform structures were also observed, indicating a higher probability of metastasis.

SQUAMOUS ODONTOGENIC TUMOR: REPORT OF A RARE CASE. CARLA MATOS VIEIRA BORGES, LARISSA DE OLIVEIRA KOCH, RAFAEL A. CAMPOS, VICTOR ANGELO  MARTINS MONTALLI, NEY SOARES DE ARAUJO, VERA  CAVALCANTI DE ARAUJO and, FABRICIO PASSADOR SANTOS A 51-year-old black woman sought care in a hospital because of an asymptomatic lesion involving the left anteroposterior region of the mandible identified in a routine panoramic radiograph. Intraoral physical examination revealed a small expansion of the region. Radiographic examination showed a multilocular radiolucent lesion with well-defined borders in the left side of the mandible, involving elements 31 to 35 and measuring approximately 5 cm in diameter. The treatment consisted of an excisional biopsy complemented with curettage. Histopathologic examination showed fragments of a benign odontogenic neoplasia presenting proliferation of polyhedral and cuboidal epithelial cells with eosinophilic cytoplasm, organized in nests,