Gingival calcifying epithelial odontogenic tumor: case report and review of the literature comprising a period of 44 years

Calcifying epithelial odontogenic tumors are rare odontogenic neoplasms that account for approximately 1% of all odontogenic tumors. The extraosseous variant is extremely rare, with only few cases being described in the literature. To our knowledge, only 22 cases have been reported over a period of 44 years. Therefore, the aim of this study was to present a critical literature review comprising the period from 1966 to 2010. In addition, we discuss the clinical presentation, diagnosis, and subsequent treatment of a patient with a gingival calcifying epithelial odontogenic tumor in the anterior mandible. This study shows that even though being an extremely rare neoplasm the gingival calcifying epithelial odontogenic tumor should be included in the differential diagnosis by general dentists of gingival lesions due to its clinical similarity to other oral hyperplastic or reactive lesions. A conservative surgical approach can be adopted in view of the nonaggressive behavior of this tumor. Recurrence is low and the prognosis is excellen

Adenoid cystic carcinoma of the tongue : Case report and literature review

Adenoid cystic carcinoma is a common malignant neoplasm originated from salivary glands. The clinical and pathological findings typical of this tumor include slow growth, perineural invasion, and potential local recurrence. It accounts for nearly 2% to 4% of head and neck area tumors. In minor salivary glands it usually affects the palate. We described herein the case of a patient who presented a posterior tongue lesion, which was treated with surgery and radiotherapy as additional treatment. We also carried out a brief literature review on the subject

Prevalence of carotid artery calcifications among 2,500 digital panoramic radiographs of an adult Brazilian population

The aim of the present study was to analyze the epidemiological data of digital panoramic radiographs revealing suggestive images of carotid artery calcifications (CAC) from a Northeast Brazilian population. A cross-sectional retrospective study was conducted with 2,500 digital panoramic radiographs obtained from a single imaging reference center in Northeast Brazil. Images from individuals of both sexes and older than 18 years were included and those that did not cover the region of cervical vertebrae or presented low radiographic quality were excluded. Data were analyzed regarding prevalence, location (bilateral, right or left), sex, and age using the Chi-square test at the significance level of 5%. An amount of 96 (4%) patients presented suggestive images of CAC. The female sex (p=0.003) and individuals aged up to 70 years (p=0.002) were statically significant. 40.4% were found bilaterally, 37.6% on the right side (p<0.001) and 22% on the left side. In conclusion, this study showed a low prevalence of suggestive images of CAC in digital panoramic radiographs from a Northeast Brazilian population. It was observed a higher prevalence of CAC associated with female sex, older patients, and right side location

Is immunohistochemistry more sensitive than hematoxylin-eosin staining for identifying perineural or lymphovascular invasion in oral squamous cell carcinoma? A systematic review and meta-analysis

This study aimed to analyze whether immunohistochemistry (IHC) is more sensitive than hematoxylin-eosin (H&E) staining for identifying perineural invasion (PNI) or lymphovascular invasion (LVI) in oral squamous cell carcinoma (OSCC). In this systematic review and meta-analysis (Prospective Register of Systematic Reviews ? CRD 42021256515), data were obtained from six databases (PubMed, Scopus, LILACS, Web of Science, EBSCO, LIVIVO, Embase) and the grey literature. Cross-sectional observational studies of the diagnostic sensitivity of IHC for PNI and LVI were included. Studies were selected in two phases: first collection and reference retrieval. The Quality Assessment of Diagnostic Accuracy Studies-2 tool assessed study quality, while the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach assessed evidence quality. The meta-analysis (random effects model) was performed using MedCalc 18.2.1 software (MedCalc®) (p<0.05). Four studies (560 patients with 295 biopsies) were analyzed. The combined sensitivity was 76% (95% confidence interval [CI], 44.30?97.19%) and specificity was 42% (95% CI, 23.40?62.02%). The positive predictive value (PPV) and negative predictive value (NPV) were 61% (95% CI, 49.78?71.53%) and 70% (95% CI, 37.63?94.43%). The overall accuracy was 58% (95% CI, 45.17?70.65%). The risk of bias was low, and GRADE analysis showed a very low certainty of evidence. Our data suggest that IHC staining to highlight PNI/LVI may be useful in cases in which H&E analysis results in a negative decrease in the prevalence of false-negative cases and underestimated treatment

Oral granular cell tumor: a study of twelve cases in a Brazilian population

Objectives: Analyze clinic and epidemiological aspects of all Oral Granular cell tumor (GCT) during a 5-year period in a Brazilian population. Study design: clinical and treatment outcome data of patients with oral GCT seen at the Division of Stomatology, School of Dentistry, Federal University of Ceara, Brazil, between January 2001 and December 2005 were reviewed. Results: during the analyzed period, 6231 oral lesions were collected from files of different anatomo-pathology laboratories situated in the state of Ceara, Brazil. Of all cases, only 12 of GCT were diagnosed. The lesion was more common in female patients, with a mean age of 40.8 years, occurring mainly in tongue. Conclusion: Oral GCT is a rare and infrequent lesion in this population, and affects more female in the third, fourth a fifth decade of life. Clinical significance: Although it is a rare occurrence in the oral cavity, the clinician must know about its occurrence and should include GCT in the differential diagnose of certain lesions especially when situated in tongu

TNF-alpha expression, evaluation of collagen, and TUNEL of Matricaria recutita L. extract and triamcinolone on oral ulcer in diabetic rats

Diabetes mellitus (DM) is a disease associated with delayed wound healing of oral ulcers by increased expression of proinflammatory cytokines and cellular apoptosis. Objective to evaluate the influence of Tumor Necrosis Factor alpha (TNF-α) and apoptosis in rats with DM treated with chamomile extract or triamcinolone. Material and Methods Wistar male rats (210.0±4.2 g) were divided into five groups: negative control group (NCG) without diabetes; positive control group (PCG) with DM (alloxan, 45 mg/kg); and groups treated with chamomile extract (normoglycemic= NCG group and diabetic= DCG group) and with triamcinolone (TG). Traumatic ulcers were performed on all animals that received topical triamcinolone, chamomile extract or saline 12/12 hours for ten days. Results On days five and ten the animals were euthanized and the ulcers were analyzed by light microscopy, TUNEL assay, and immunohistochemically (TNF-α). The NCG (p=0.0062), PCG (p=0.0285), NCG (p=0.0041), and DCG (

Interleukin-17 plays a role in dental pulp inflammation mediated by zoledronic acid: a mechanism unrelated to the Th17 immune response?

Objective: To evaluate the influence of RORγT inhibition by digoxin on inflammatory changes related to interleukin-17 (IL-17) in the pulp of rats treated with zoledronate (ZOL). Methodology: Forty male Wistar rats were divided into a negative control group (NCG) treated with saline solution, a positive control group (PCG) treated with ZOL (0.20 mg/kg), and three groups treated with ZOL and co-treated with digoxin 1, 2, or 4 mg/kg (DG1, 2, and 4). After four intravenous administrations of ZOL or saline solution in a 70-day protocol, the right molars were evaluated by histomorphometry (number of blood vessels, blood vessels/µm2, cells/µm2, total blood vessel area, and average blood vessel area) and immunohistochemistry (IL-17, TNF-α, IL-6, and TGF-β). The Kruskal-Wallis/Dunn test was used for statistical analysis. Results: PCG showed an increase in total blood vessel area (p=0.008) and average blood vessel area (p=0.014), and digoxin treatment reversed these changes. DG4 showed a reduction in blood vessels/µm2 (p&lt;0.001). In PCG odontoblasts, there was an increase in IL-17 (p=0.002) and TNF-α (p=0.002) immunostaining, and in DG4, these changes were reversed. Odontoblasts in the digoxin-treated groups also showed an increase in IL-6 immunostaining (p&lt;0.001) and a reduction in TGF-β immunostaining (p=0.002), and all ZOL-treated groups showed an increase in IL-17 (p=0.011) and TNF-α (p=0.017) in non-odontoblasts cells. Conclusion: ZOL induces TNF-α- and IL-17-dependent vasodilation and ectasia, and the classical Th17 response activation pathway does not seem to participate in this process

A ten-year retrospective study of the clinical, sociodemographic, and survival characteristics of patients with oral and pharyngeal squamous cell carcinomas/ Estudo retrospectivo de dez anos das características clínicas, sociodemográficas e de sobrevida de pacientes com carcinomas epidermóides orais e faríngeos

Objective: This study evaluated the epidemiological profile of patients diagnosed with squamous cell carcinoma, as well compared oral and pharyngeal lesions regarding the survival of these patients. Material and Methods: Convenience sampling was employed to select the participants, who had their medical records of the period 200-2009 investigated. Sociodemographic and clinical-pathological data were collected and correlated with site of the lesion, TMN classification, of the tumor, and survival of the patients. Fisher’s and Chi-square tests, Kaplan-Meir curve associated with the Long Rank Mantel-Cox test, and Cox’s regression for survival analysis were performed to evaluate the results. Results: Sixty-year-old illiterate females presented higher prevalence of oral cancer with a more severe lymphonodular infiltration, worse tumor staging, and chemo and radiotherapy treatment. Meanwhile, sixty-year-old illiterate males presented higher prevalence of pharyngeal cancer, lower rates of lymphonodular infiltration, and chirurgical treatment. The survival of the patients with oral cancer was correlated with the lymphonodular infiltration level, while for patients with pharyngeal cancer the survival was correlated with chirurgical treatment. Thus, head and neck cancer are still diagnosed belatedly, mainly when it affects the pharynx.Conclusion: Therefore, preventive and educative strategies, as well as amplification of access to health care should be considered targets for achieving reduction in the mortality rates of populations with oropharyngeal cancer

Epidermoid Cyst Arising in the Buccal Mucosa: Case Report and Literature Review

Epidermoidne ciste benigne su supkutane lezije vrlo česte u dnu usne šupljine, a rijetke na bukalnoj mukozi. Do danas je objavljeno pet članaka o samo šest slučajeva epidermoidnih cista na tom mjestu. Svrha ovoga članka je opisati klinička, histopatološka i imunohistokemijska obilježja epidermoidne ciste na bukalnoj sluznici. Prema našim spoznajama, ovo je prvi slučaj oralne epidermoidne ciste koja izaziva upalnu reakciju gigantocelularnog tipa prema epitelnom keratinu. Iako se uobičajeni dijagnostički postupak u slučaju epidermoidne ciste temelji na histopatološkom nalazu, u ovom prikazu nalaze se nove informacije o imunohistokemijskim uzorcima u ovakvim lezijama.Epidermoid cysts are benign subcutaneous lesions, and the large majority of these cysts affect the floor of the mouth; however, the buccal mucosa is not a usual site of occurrence. To date, only 5 articles have been published with 6 cases of epidermoid cysts arising in the buccal mucosa. Therefore, the aim of this study was to describe the clinical, histopathological and immunohistochemical features of a case of epidermoid cyst located in the buccal mucosa. To our knowledge, this is the first report of an oral epidermoid cyst describing an intense foreign body gigantocellular inflammatory reaction against epithelial keratin component. Although the usual diagnosis for epidermoid cysts is based on histopathological findings, this case report addresses novel information regarding to the immunohistochemical pattern that may be found in these lesions