Clinicoradiological spectrum of primary aneurysmal bone cysts of the maxillofacial region : a series of 31 cases

OBJECTIVES : The aim of the current study was to analyse the demographic, clinical and radiological features of primary aneurysmal bone cysts (ABCs) involving the maxillofacial region. METHODS : Histologically confirmed cases affecting the maxillofacial region were retrospectively reviewed over a 21-year period (2000–2021). Cases were collected from the archives of five Oral Pathology laboratories from three countries: South Africa, Guatemala and Brazil. The information was analysed, with emphasis on the clinical and radiological spectrum. RESULTS : Following the inclusion criteria, a total of 31 cases of primary ABCs were included in the study. A nearly equal male-to- female distribution was seen, with ABCs occurring in males at an earlier age compared to females. Localised swelling was the main clinical presentation. ABCs had a mandibular predominance, particularly in the posterior regions. All ABCs presented as blow-out expansile well-demarcated radiolucent lesions with the majority having a multilocular appearance. Cortical expansion was seen in 91% of cases with loss of cortical integrity being common (78%). CONCLUSION : Primary ABCs involving the maxillofacial region are extremely rare with the majority of current published literature consisting of isolated case reports. The current study is the first large series detailing the radiological features.http://birpublications.org/dmfram2023Oral Pathology and Oral Biolog

The need for communication between clinicians and pathologists in the context of oral and maxillofacial diseases

Good communication between clinicians and pathologists is a vital element in the diagnostic process, and poor communication can adversely affect patient care. There is a lack of research about communication in diagnostic oral and maxillofacial pathology. This narrative review explores different aspects of the quality of communication between clinicians and oral pathologists, with a focus on the diagnosis of oral and maxillofacial diseases. An electronic search was carried out in MEDLINE through the PubMed, Scopus, and Embase databases up to April 2021. No studies reporting communication, its adequacy or the required skills between clinicians and pathologists in oral diagnosis were found. According to studies published in medicine, strategies for improving communication skills include clinicianpathologist collaboration; a well-formatted, clear and thorough report; training in communication skills; and patient-centered care. Further studies evaluating the current practices and quality in oral and maxillofacial pathology are required to identify barriers and encourage optimal communication to facilitate diagnosis, as well as patient safety.The Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES), the Brazilian National Council for Scientific and Technological Development, CNPq and a PhD scholarship from the São Paulo State Research Foundation.https://www.scielo.br/j/bordm2022Oral Pathology and Oral Biolog

Malignant peripheral nerve sheath tumor of the lower labial mucosa: case report and literature review

Malignant peripheral nerve sheath tumor (MPNST) is an uncommon soft tissue sarcoma with a predilection for the extremities and trunk of adults, rarely occurring in the oral cavity. To date, 10 cases of MPNSTs affecting the lower labial mucosa have been reported in the English language literature. We describe an additional case of MPNST in the lower labial mucosa of a 67-year-old male patient, who exhibited a painful swelling with a history of 4 months of evolution. Microscopic examination showed dense plexiform fascicles of spindle cells with wavy atypical nuclei. Mitotic figures and nuclear pleomorphism were evident. Immunohistochemical analysis of tumor cells revealed positivity for S-100 protein, CD56, CD34, and neuron-specific enolase but was negative for neurofilament protein, glut-1, claudin-1, desmin, and smooth muscle actin. Ki-67 labeling was 20%. The final diagnosis was MPNST. The lesion was surgically removed with wide margins, with no signs of recurrence after 4 years of follow-up1222E64E68sem informaçã

Clinical and radiologic spectrum of glandular odontogenic cysts : a multicenter study of 92 cases

OBJECTIVE : The purpose of this multicenter retrospective study was to report the clinical and radiologic features of 92 glandular odontogenic cysts (GOCs) diagnosed over a 20-year period. STUDY DESIGN : Histologically confirmed cases of GOC were retrospectively reviewed from 4 oral pathology laboratories in South Africa and Brazil to categorize the clinical and radiologic spectrum of GOCs. RESULTS : The mean age of patients was 46 years (range 17-87) with a male-to-female ratio of 1.2:1. GOCs had a mandibular predilection (68%), with 42% of all cases located anteriorly. Additionally, 42% of cases crossed the midline. Radiologically, most lesions were unilocular (53%) and uniformly radiolucent (97%), with well-demarcated borders (93%). Cortical expansion (62%), loss of cortical integrity (71%), and maxillary sinus (67%) and nasal cavity encroachment (72%) were common findings. Significant differences in lesions between the 2 countries were discovered in sex predilection, clinical signs and symptoms, and lesion locations within the mandible and maxilla. CONCLUSION : GOCs present with a wide spectrum of clinical and radiologic features, ranging from cysts with typical GOC-like presentations to more aggressive lesions. The need for advanced imaging in the surgical planning of GOCs exhibiting radiologic signs of aggression is justified based on the high recurrence rate.http://www.journals.elsevier.com/oral-surgery-oral-medicine-oral-pathology-and-oral-radiology2022-11-27hj2022Financial ManagementOral Pathology and Oral Biolog

Tongue hamartomas in pediatric patients: an international case series and literature review

This study reports 9 additional tongue hamartomas in children paired with a literature review. A retrospective analysis was performed from 3 Oral Pathology laboratories. Additionally, a literature review was conducted through 5 electronic databases and gray literature. A total of 9 cases were identified in the retrospective analysis. Females outnumbered males with a ratio of 1.25:1. The age of presentation ranged from 2 weeks to 7 years. The posterior dorsum tongue was the most affected subsite (n = 4). One case was seen in a patient with oro-facial-digital syndrome, 2 cases in patients with cleft palates, and one case with an encephalocele. The most common predominant component was salivary gland tissue (n = 4). A literature search included 79 pediatric patients presenting with 95 tongue hamartomas. A slight female (n = 47) predilection was observed, with ages varying from 15 hours to 19 years. The posterior tongue dorsum (n = 31) was the most affected site. Seven cases were seen in association with syndromes. The most common predominant component was smooth muscle (n = 35). Although hamartomas are rare in the oral cavity, they should be considered in the differential diagnosis of masses involving the posterior tongue dorsum in children.The São Paulo State Research Foundation and National Council for Scientific Development (CNPq).http://www.journals.elsevier.com/oral-surgery-oral-medicine-oral-pathology-and-oral-radiology2023-12-03hj2023Oral Pathology and Oral Biolog

Clinical predictors of malignancy in palatal salivary gland tumors

To establish a predictive clinical index of malignancy risk in palatal salivary gland tumors (PSGT). Materials and methods One hundred cases of PSGT were evaluated. Clinical data were retrieved from the patient's files. Representative clinical photographs of each tumor were evaluated to identify clinical features suggestive of a malignant tumor. Features significantly associated with malignancy were included in a binary logistic regression model. Results Malignant tumors were more common in the hard palate, in women and in older patients. Features associated with a malignant diagnosis included pain (p = .017), irregular surface (p = .004), bluish/purple coloration (p < .001), ulceration (p = .005), and telangiectasia (p = .015). After multivariate logistic regression, pain (OR: 4.017; 95% CI: 1.198-13.471; p = .024) and color alteration (OR: 7.243; 95% CI: 2.068-25.363; p = .002) were independently associated with malignancy. Including these factors in a predictive index, the proportion of malignant tumors in patients presenting none, one and two factors were 25% (95% CI: 0.13-0.40), 67% (95% CI: 0.48-0.83), and 85% (95% CI: 0.42-0.99), respectively. Conclusion Pain and color alteration might be independent predictors of malignancy in PSGT, which could support the decision to perform an incisional or excisional biopsy25819191924CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPE

Central odontogenic fibroma : an international multicentric study of 62 cases

OBJECTIVE : The aim of this study was to report the clinicopathologic features of 62 cases of central odontogenic fibroma (COdF). STUDY DESIGN : Clinical and radiographic data were collected from the records of 13 oral pathology laboratories. All cases were microscopically reviewed, considering the current World Health Organization classification of tumors and were classified according to histopathologic features. RESULTS : There were 43 females and 19 males (average age 33.9 years; range 8–63 years). Clinically, COdF lesions appeared as asymptomatic swellings, occurring similarly in the maxilla (n = 33) and the mandible (n = 29); 9 cases exhibited palatal depression. Imaging revealed well-defined, interradicular unilocular (n = 27), and multilocular (n = 12) radiolucencies, with displacement of contiguous teeth (55%) and root resorption (46.4%). Microscopically, classic features of epithelial-rich (n = 33), amyloid (n = 10), associated giant cell lesion (n = 7), ossifying (n = 6), epithelial-poor (n = 3), and granular cell (n = 3) variants were seen. Langerhans cells were highlighted by CD1a staining in 17 cases. Most patients underwent conservative surgical treatments, with 1 patient experiencing recurrence. CONCLUSIONS : To the best of our knowledge, this study represents the largest clinicopathologic study of COdF. Most cases appeared as locally aggressive lesions located in tooth-bearing areas in middle-aged women. Inactive-appearing odontogenic epithelium is usually observed within a fibrous/fibromyxoid stroma, occasionally exhibiting amyloid deposits, multinucleated giant cells, or granular cells.http://www.journals.elsevier.com/oral-surgery-oral-medicine-oral-pathology-and-oral-radiology2021-08-27hj2021Oral Pathology and Oral Biolog