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WEGENER’S GRANULOMATOSIS DIAGNOSIS FROM ORAL MANIFESTATIONS: A CASE REPORT
ORAL AND MAXILLOFACIAL PATHOLOGY e70 Abstracts showed a crescent bone destruction. There were radiopaque points, similar to bone tissue, inside the lesion. The diagnostic hypotheses were: chronic periodontitis, calcifying cystic odontogenic tumor, and calcifying epithelial odontogenic tumor. Tooth 45 was extracted and the material was sent for histopathologic analysis. The extracted tooth presented whitish fragments, with needled-shape, uneven surface, hard consistency, attached to the middle and apical third of the root, suggesting dental calculus. Pathologic examination showed loose connective tissue, cellularized with moderate inflammatory infiltrate, focal area of amorphous basophilic material. Associating the findings, the final diagnosis was chronic periodontitis with dental calculus within the lesion. Supported by FAPEMIG.
CPP78 - PLEOMORPHIC ADENOMA OF THE PALATE: A CASE REPORT. FLÁVIA FONSECA CARVALHO SOARES, FELIPE EDUARDO BAIRES CAMPOS, RICARDO SANTIAGO GOMEZ, CAROLINA CAVALIÉRI GOMES, WAGNER HENRIQUES CASTRO. A 34-year-old male patient presented with a 1-year history of tumoral growth in the left side of the hard palate. Clinical and imagiologic examination revealed an asymptomatic, sessile, ulcerated mass measuring about 4 cm. CT scan showed a hypodense mass with well-defined limits, round shape, affecting the left side of the hard palate, compatible with the diagnosis of salivary gland neoplasms. An incisional biopsy was performed and the histopathologic diagnosis was pleomorphic adenoma. The lesion was excised under general anesthesia and after 7 months of follow-up no signs of recurrence were observed. Supported by FAPEMIG.
CPP79 WEGENER’S GRANULOMATOSIS DIAGNOSIS FROM ORAL MANIFESTATIONS: A CASE REPORT. MAÍRA TAVARES DE FARIA, MARÍLIA HEFFER CANTISANO, FÁBIO RAMÔA PIRES, RUTH TRAMONTANI RAMOS, ANDREZA MARIA OLIVEIRA FILGUEIRAS, THIAGO MOREIRA PÊSSOA, GERALDO OLIVEIRA SILVA-JUNIOR. Wegener’s granulomatosis (WG) is a rare granulomatous disease characterized by the classic triad of necrotizing granulomas affecting respiratory tracts, disseminated vasculitis, and glomerulonephritis. It can also affect other sites, such as the oral cavity. Herein we report a case of WG with first manifestation in the oral cavity. A 19-year-old male patient had shown a general hyperplasic gingival growth, display of a granular surface, spontaneous bleeding; multiple granulomatous and necrotic ulcers, symptomatic and spontaneous bleeding located in multiple sites of oral mucosa. An incisional biopsy led to a diagnosis of WG, which was also confirmed by a c-ANCA reactivity. Nasal and maxillary sinus involvement can also be observed. The treatment received was: prednisone 40 mg in the morning and 20 mg at night. After the lesions had healed significantly, the prednisone dose was lowered on a weekly basis.
CPP80 - BUCCAL AND PALATAL EXOSTOSES CONCURRENT WITH TORI. PAMELA OLIVEIRA SANTOS, ANTONIO JORGE ARAÚJO DE VASCONCELOS, II, MARCO TÚLLIO BRAZÃO-SILVA, LIONEY NOBRE CABRAL, MARCELO DINIZ CARVALHO, TIAGO NOVAES PINHEIRO. Although exostoses are not a rare finding, relatively few reports on these structures are available. The information on the
OOOO August 2017 concurrence of tori with exostoses is very limited because of the scarcity of cases reported in the literature. Herein we report a case of multiple buccal and palatal exostosis concurrent with maxillary and mandible in a feoderma 37-year-old male patient. The case was successfully managed by multiple elective osteoplastic surgery and no recurrence was detected after 1 year of follow-up. The etiology of the coexistence of multiple exostoses and tori is not yet definitely established in the literature. The absence of local clinical factors, such as occlusal trauma or periodontal disease in this case, raise suspicions that multifactorial genetic and functional factors may be responsible for the development of this condition.
CPP81 - PERIPHERAL GIANT CELLS LESION IN A CHILD: CASE REPORT. KAROLINE ARAUJO LIMA VALBER, BARBOSA MARTINS, MARCELO VINÍCIUS DE OLIVEIRA, FLÁVIO TENDOLO FAYAD, GUSTAVO CAVALCANTI DE ALBUQUERQUE, JECONIAS CÂMARA, JOEL MOTTA-JUNIOR. Herein we report on a peripheral giant cells lesion case affecting a male patient, 6 years old, complaining of intraoral swelling, spontaneous bleeding, and difficulty chewing for 1 year. Clinical examination found extensive exophytic, pediculated pink-purplish, ulcerated surface in the posterior region of mandibular alveolar ridge and precarious conditions of oral hygiene. Radiographic analysis noted small reabsorption on marginal crestal bone and tooth 34 floating. Incisional biopsy was performed with histopathology confirming peripheral giant cell lesion. Surgical excision of the lesion was performed, taking care to remove the entire base and the extraction of the associated tooth. The excised lesion was stored in 10% formalin and sent for histopathologic examination, which again confirmed the previous diagnosis. The patient has been in follow-up for 7 months without signs or symptoms of recurrence.
CPP82 - IMMUNOHISTOCHEMICAL CHARACTERIZATION OF PSEUDOLYMPHOMATOUS REACTION IN HERPES LABIALIS: A POTENTIAL DIAGNOSTIC PITFALL. DAPHINE CAXIAS TRAVASSOS, ANA CAROLINA FRAGOSO MOTTA, ANDREIA BUFALINO, ALFREDO RIBEIRO DA SILVA, FERNANDO CHAHUD, LUCIANA YAMAMOTO DE ALMEIDA, JORGE ESQUICHE LEÓN. Pseudolymphomas represent a reactive/benign T- or B-cell lymphoproliferative process that clinically and/or histopathologically simulate overt lymphomas. Interestingly, some viral infections may histopathologically mimic lymphomas, requiring urgent differential diagnosis because of completely different management. A 42-year-old female patient was referred presenting with multiple ulcerative, vesicular, and bullous lesions over both vermilion borders of 5 days’ duration. The patient related the onset prior to a dental appointment. Exfoliative cytology was suggestive of viral infection, whereas biopsy revealed an exuberant lymphoid proliferation that, on immunohistochemistry, showed positivity for T-cell cytotoxic markers, besides CD30 expression, admixed with numerous CD123+ plasmacytoid dendritic cells. Ki-67 proliferative index was >60%. Blood tests showed normal cell count values and HIV test was negative. Clinicopathologic correlation favored pseudolymphomatous reaction to herpes labialis. The patient had complete resolution of the lesions. When assessing biopsy of herpes labialis, clinicopathologic and immunohistochemical (remarkably CD30 and CD123 expression) correlations are necessary to differentiate it from overt lymphomas.
CPP78 - PLEOMORPHIC ADENOMA OF THE PALATE: A CASE REPORT. FLÁVIA FONSECA CARVALHO SOARES, FELIPE EDUARDO BAIRES CAMPOS, RICARDO SANTIAGO GOMEZ, CAROLINA CAVALIÉRI GOMES, WAGNER HENRIQUES CASTRO. A 34-year-old male patient presented with a 1-year history of tumoral growth in the left side of the hard palate. Clinical and imagiologic examination revealed an asymptomatic, sessile, ulcerated mass measuring about 4 cm. CT scan showed a hypodense mass with well-defined limits, round shape, affecting the left side of the hard palate, compatible with the diagnosis of salivary gland neoplasms. An incisional biopsy was performed and the histopathologic diagnosis was pleomorphic adenoma. The lesion was excised under general anesthesia and after 7 months of follow-up no signs of recurrence were observed. Supported by FAPEMIG.
CPP79 WEGENER’S GRANULOMATOSIS DIAGNOSIS FROM ORAL MANIFESTATIONS: A CASE REPORT. MAÍRA TAVARES DE FARIA, MARÍLIA HEFFER CANTISANO, FÁBIO RAMÔA PIRES, RUTH TRAMONTANI RAMOS, ANDREZA MARIA OLIVEIRA FILGUEIRAS, THIAGO MOREIRA PÊSSOA, GERALDO OLIVEIRA SILVA-JUNIOR. Wegener’s granulomatosis (WG) is a rare granulomatous disease characterized by the classic triad of necrotizing granulomas affecting respiratory tracts, disseminated vasculitis, and glomerulonephritis. It can also affect other sites, such as the oral cavity. Herein we report a case of WG with first manifestation in the oral cavity. A 19-year-old male patient had shown a general hyperplasic gingival growth, display of a granular surface, spontaneous bleeding; multiple granulomatous and necrotic ulcers, symptomatic and spontaneous bleeding located in multiple sites of oral mucosa. An incisional biopsy led to a diagnosis of WG, which was also confirmed by a c-ANCA reactivity. Nasal and maxillary sinus involvement can also be observed. The treatment received was: prednisone 40 mg in the morning and 20 mg at night. After the lesions had healed significantly, the prednisone dose was lowered on a weekly basis.
CPP80 - BUCCAL AND PALATAL EXOSTOSES CONCURRENT WITH TORI. PAMELA OLIVEIRA SANTOS, ANTONIO JORGE ARAÚJO DE VASCONCELOS, II, MARCO TÚLLIO BRAZÃO-SILVA, LIONEY NOBRE CABRAL, MARCELO DINIZ CARVALHO, TIAGO NOVAES PINHEIRO. Although exostoses are not a rare finding, relatively few reports on these structures are available. The information on the
OOOO August 2017 concurrence of tori with exostoses is very limited because of the scarcity of cases reported in the literature. Herein we report a case of multiple buccal and palatal exostosis concurrent with maxillary and mandible in a feoderma 37-year-old male patient. The case was successfully managed by multiple elective osteoplastic surgery and no recurrence was detected after 1 year of follow-up. The etiology of the coexistence of multiple exostoses and tori is not yet definitely established in the literature. The absence of local clinical factors, such as occlusal trauma or periodontal disease in this case, raise suspicions that multifactorial genetic and functional factors may be responsible for the development of this condition.
CPP81 - PERIPHERAL GIANT CELLS LESION IN A CHILD: CASE REPORT. KAROLINE ARAUJO LIMA VALBER, BARBOSA MARTINS, MARCELO VINÍCIUS DE OLIVEIRA, FLÁVIO TENDOLO FAYAD, GUSTAVO CAVALCANTI DE ALBUQUERQUE, JECONIAS CÂMARA, JOEL MOTTA-JUNIOR. Herein we report on a peripheral giant cells lesion case affecting a male patient, 6 years old, complaining of intraoral swelling, spontaneous bleeding, and difficulty chewing for 1 year. Clinical examination found extensive exophytic, pediculated pink-purplish, ulcerated surface in the posterior region of mandibular alveolar ridge and precarious conditions of oral hygiene. Radiographic analysis noted small reabsorption on marginal crestal bone and tooth 34 floating. Incisional biopsy was performed with histopathology confirming peripheral giant cell lesion. Surgical excision of the lesion was performed, taking care to remove the entire base and the extraction of the associated tooth. The excised lesion was stored in 10% formalin and sent for histopathologic examination, which again confirmed the previous diagnosis. The patient has been in follow-up for 7 months without signs or symptoms of recurrence.
CPP82 - IMMUNOHISTOCHEMICAL CHARACTERIZATION OF PSEUDOLYMPHOMATOUS REACTION IN HERPES LABIALIS: A POTENTIAL DIAGNOSTIC PITFALL. DAPHINE CAXIAS TRAVASSOS, ANA CAROLINA FRAGOSO MOTTA, ANDREIA BUFALINO, ALFREDO RIBEIRO DA SILVA, FERNANDO CHAHUD, LUCIANA YAMAMOTO DE ALMEIDA, JORGE ESQUICHE LEÓN. Pseudolymphomas represent a reactive/benign T- or B-cell lymphoproliferative process that clinically and/or histopathologically simulate overt lymphomas. Interestingly, some viral infections may histopathologically mimic lymphomas, requiring urgent differential diagnosis because of completely different management. A 42-year-old female patient was referred presenting with multiple ulcerative, vesicular, and bullous lesions over both vermilion borders of 5 days’ duration. The patient related the onset prior to a dental appointment. Exfoliative cytology was suggestive of viral infection, whereas biopsy revealed an exuberant lymphoid proliferation that, on immunohistochemistry, showed positivity for T-cell cytotoxic markers, besides CD30 expression, admixed with numerous CD123+ plasmacytoid dendritic cells. Ki-67 proliferative index was >60%. Blood tests showed normal cell count values and HIV test was negative. Clinicopathologic correlation favored pseudolymphomatous reaction to herpes labialis. The patient had complete resolution of the lesions. When assessing biopsy of herpes labialis, clinicopathologic and immunohistochemical (remarkably CD30 and CD123 expression) correlations are necessary to differentiate it from overt lymphomas.