Dermoid and epidermoid cysts of the oral cavity : a 48-year retrospective study with focus on clinical and morphological features and review of main topics

Dermoid and epidermoid cysts are slow-growing, benign developmental cysts that arise from ectodermal tissue and can occur anywhere in the body. Less than 7% of these cysts involve the head and neck region, with only 1.6% of cases presenting in the oral cavity. To evaluate the clinical and histopathological features of dermoid (DCs) and epidermoid (ECs) cysts stored in the archives of a referred Oral Pathology Service over a 48-year-period, and to review current concepts about these cysts. All DCs and ECs were reviewed, and clinical data were obtained from the patient records. Fourteen cases of DCs and thirteen cases of ECs were re-evaluated microscopically by 2 oral pathologists. Among 15.387 cases, 14 (0.09%) had a histopathological diagnosis of DCs and 13 (0.08%) of ECs. For DCs, ten (71.4%) patients were women, with the mean age of 37.2 years. All DCs were lined by a stratified squamous epithelium (100%), with gut and respiratory epithelium observed in 1 (7.1%) and 2 (14.3%) cases, respectively. Chronic inflammatory cells, melanin, multinucleated giant cell reaction, and Pacini bodies were also observed. For ECs, eight (61.5%) cases were in women, and the mean age was 38.2 years. All ECs were lined by a stratified squamous epithelium (100%). Chronic inflammatory cells, melanin pigmentation, and adipose tissue were observed in the fibrous capsule. Our results suggest that stratified squamous epithelium is the predominant epithelial lining of these cystic lesions. Also, we may find some unusual findings in DCs, such as Pacini bodies

Clinical findings and risk factors to oral squamous cell carcinoma in young patients: a 12-year retrospective analysis

Background: In recent years have been observed an increased incidence of OSCC in young individuals. Based on this, the aim this study was to describe the clinical characteristics of all cases of OSCC in younger patients, diagnosed in two oncology referral hospitals, at the northeast region of Brazil within a 12-year period. Material and Methods: Data regarding general characteristics of patients (age, gender and tobacco and/or alcohol habits) and information about the lesions (tumor location, size, regional lymph node metastasis, distant metastasis and clinical stage) were submitted to descriptive and inferential analysis. Statistical analysis included Chi-square and Fisher’s exact tests (P<0.05). Results: Out of 2311 registered cases of OSCC, 76 (3.3%) corresponded to OSCC in patients under 45 years old. Most of them were male (n=62, 81.6%) and tobacco and/or alcohol users (n=40, 52.8%). The most frequent site was the tongue (n=31, 40.8%), with predominance of cases classified at advanced clinical stage (III and IV, n = 46, 60.5%). The advanced stage of OSCC (III and IV) was statistically associated with male gender (P=0.035), lower education level (P=0.007), intraoral sites (P<0.001), presence of pain symptomatology (P=0.006), and consumption of tobacco and/or alcohol (P=0.001). Conclusions: The profile of OSCC in young patients resembles to the commonly characteristics reported for overall population. The late diagnosis in young patients usually results in poor prognosis, associated with gender, harmful habits and tumor location. Although prevalence is low, stimulus to prevention and to early diagnosis should be addressed to young individuals exposed to risk factor

Clinicopathological significance of SNPs in RAD51 and XRCC3 in oral and oropharyngeal carcinomas

This study investigated the influence of single nucleotide polymorphisms (SNP) in RAD51 and XRCC3 on susceptibility to oral and oropharyngeal squamous cell carcinomas (SCC) and determined their clinicopathological significance. Subjects and Methods SNPs rs1801320 and rs1801321 in RAD51 and rs861539 in XRCC3 were genotyped in 81 patients presenting oral SCC, 45 presenting oropharyngeal SCC, and 130 healthy controls, using TaqMan allelic discrimination assays. Multiple logistic regression models were used to explore the association between SNPs and cancer development, as well as gene-gene (GxG) interaction and gene-environmental factor (GxE) interaction. Clinicopathological associations were verified through the chi-square test, and univariate and multivariate methods were applied for survival analyses. Results Although allelic and genotypic models and the GxG interaction analysis were nonsignificant, the GxE analysis revealed synergistic effects of the risk alleles of rs1801320, rs1801321, and rs861539 with smoking and alcohol consumption on susceptibility to oral and oropharyngeal SCC. Furthermore, oropharyngeal SCC patients carrying the XRCC3 rs861539 GT/TT genotype (T risk allele) presented a shorter overall survival than GG genotype carriers. Conclusion Combined effects of RAD51 (rs1801320 and rs1801321) and XRCC3 (rs861539) SNPs with environmental carcinogens (tobacco and alcohol) are associated with oral and oropharyngeal SCC development2515463COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPE

Calcifying Odontogenic Cyst with Extensive Areas of Dentinoid: Uncommon Case Report and Update of Main Findings

The calcifying odontogenic cyst (COC) is a benign odontogenic cyst that occurs in the gnathic bones. This cyst is part of a spectrum of lesions characterized by odontogenic epithelium containing “ghost cells,” which may undergo calcification. Areas of an eosinophilic matrix material compatible dentinoid also may present adjacent to the epithelial component. However, these areas of dentinoid commonly do not appear so abundant in COCs. In this study, we report a case of intraosseous COC with extensive areas of dentinoid and perform an update regarding the clinical, radiographical, histopathological, and differential diagnosis, treatment, and prognosis of this cystic lesion

Macrófagos e sua relação com o carcinoma de células escamosas oral

 Os macrófagos constituem uma população heterogênea de células mieloides inatas que exibem considerável plasticidade. Estas células, que desempenham papéis importantes no combate às infecções e na resolução dos processos inflamatórios, representam um componente significativo do infiltrado inflamatório de vários tumores. Em virtude da sua capacidade de liberação de fatores angiogênicos, proteases e citocinas, os macrófagos associados a tumores (MATs) têm sido implicados na progressão de diversas neoplasias, incluindo o carcinoma de células escamosas (CCE) oral. Objetivo:Realizar uma revisão da literatura sobre a origem dos macrófagos, seus principais aspectos fisiológicos e discutir sua relação com o CCE oral. Metodologia: Foi realizada uma busca eletrônica na base de dados PubMed, selecionando os principais artigos da literatura em língua inglesa relacionados ao tema, publicados entre Janeiro de 2000 e Janeiro de 2015. Conclusão: Osmacrófagos constituem um componente importante do microambiente do CCE oral. A maior quantidade de MATs, em especial o fenótipo M2, pode estar associada com um comportamento biológico mais agressivo do CCE oral e, consequentemente, com a diminuição da sobrevida dos pacientes. Em decorrência do número relativamente pequeno de estudos sobre o assunto, pesquisas ainda são necessárias para esclarecer os mecanismos moleculares pelos quais os macrófagos são capazes de influenciar o comportamento biológico do CCE oral

Cisto periodontal lateral em maxila mimetizando cisto residual: Relato de caso incomum

Introdução: O cisto periodontal lateral (CPL) é um cisto odontogênico de desenvolvimento incomum. Esta lesão acomete predominantemente a mandíbula e é comumente observada lateralmente à raiz de um dente vital. Em raros casos, esta lesão pode permanecer mesmo após a exodontia do dente associado e se assemelhar, radiograficamente, a um cisto residual. Objetivo:Relatar um caso incomum de CPL em maxila que mimetizava, radiograficamente, um cisto residual. Além disso, serão abordadas suas características clínico-patológicas, diagnóstico diferencial e terapêutica para esta lesão. Relato do caso: Paciente de 76 anos, apresentava uma lesão nodular na região palatina de rebordo alveolar, na área correspondente aos dentes 13 e 14. O exame radiográfico da região afetada demonstrou uma imagem radiolúcida unilocular e bem delimitada. Sob a hipótese diagnóstica de cisto residual, procedeu-se a enucleação da lesão. Após análise histopatológica, os achados microscópicos foram compatíveis com CPL. Quatorze meses após a remoção cirúrgica da lesão, sinais clínicos ou radiográficos de recidiva não foram constatados. Conclusão: Em virtude da possibilidade do CPL permanecer mesmo após a exodontia do dente associado e se assemelhar, radiograficamente, a um cisto residual, o diagnóstico desta lesão deve ser baseado nos achados histopatológicos e menor importância deve ser dada à sua localização adjacente ou lateral à raiz de um dente vital

Oral lichen sclerosus: a rare case and update

Lichen sclerosus (LS) is a chronic inflammatory mucocutaneous disease that often affects the anogenital area; oral mucosal lesions are extremely rare. A 52-year-old woman presented for evaluation of an 8-year history of a persistent whitish plaque in the buccal mucosa. Intraoral examination revealed multiple elevated whitish plaques diffusely distributed in the buccal mucosa associated with an area of tissue atrophy. Although both leukoplakia and lichen planus were considered, incisional biopsy and later, full excision confirmed the histopathological diagnosis of oral LS. After 6 months of follow-up, there are no clinical signs of relapse. This case highlights the importance of clinical and histopathological findings for the correct diagnosis and treatment of oral LS

Oral lichen sclerosus: a rare case and update

Lichen sclerosus (LS) is a chronic inflammatory mucocutaneous disease that often affects the anogenital area; oral mucosal lesions are extremely rare. A 52-year-old woman presented for evaluation of an 8-year history of a persistent whitish plaque in the buccal mucosa. Intraoral examination revealed multiple elevated whitish plaques diffusely distributed in the buccal mucosa associated with an area of tissue atrophy. Although both leukoplakia and lichen planus were considered, incisional biopsy and later, full excision confirmed the histopathological diagnosis of oral LS. After 6 months of follow-up, there are no clinical signs of relapse. This case highlights the importance of clinical and histopathological findings for the correct diagnosis and treatment of oral LS

Self-Medication for Toothache and its Associated Factors in Children and Adolescents

Objective:To evaluate self-medication for toothache and its associated factors in children and adolescents. Material and Methods:A cross-sectional study was carried out with 252 children/adolescents aged 6-16 years. A questionnaire was applied with questions related to demographic and socioeconomic characteristics; experience of, and self-medication for, toothache; as well as aspects related to the condition. Descriptive and inferential statistical analyses (Pearson’s Chi-square test and Fisher’s exact test) were performed, with a 5% significance level. Results:The prevalence of toothache was 41.7%. In 96 cases analyzed, there was prevalence of 69.8% of self-medication for toothache. There were no statistically significant associations between self-medication for toothache and variables related to the children/adolescents (gender and age), their parents or guardians (age and schooling), socioeconomic characteristics (family income and number of people in the household) and aspects related to toothache (fever, crying and school absenteeism) (p>0.05). The most commonly used drug was paracetamol (60.7%), whose choice was based to its previous use by the study population for conditions not related to toothache (47.8%). Conclusion:There was a high prevalence of self-medication for toothache in the study population. No independent variable was associated with self-medication practice

Clinical and immunohistochemical study of melanotic neuroectodermal tumor of infancy in the maxilla

<div><p>ABSTRACT Melanotic neuroectodermal tumor of infancy is a rare and fast-growing neoplasm. In this study, we describe the case of a 6-month-old female patient, who presented swelling in the anterior maxilla. Tomographic reconstruction showed an unilocular hypodense and expansive area associated with the upper right central primary incisor. The presumptive diagnoses were dentigerous cyst, adenomatoid odontogenic tumor, melanotic neuroectodermal tumor of infancy and rhabdomyosarcoma, and an incisional biopsy was performed. Microscopically, the lesion revealed a biphasic cell population, consisting of small, ovoid, neuroblastic-like cells and epithelioid cells containing melanin. Immunohistochemically, the melanocyte-like component was strongly and diffusely positive for HMB-45 and Melan-A, but weakly positive for S100. Based on these findings, definitive diagnosis of melanotic neuroectodermal tumor of infancy was established. Then, enucleation of the lesion was performed by careful curettage. After 2 year follow-up, no clinical or radiographical evidence of recurrence was verified. The present case highlights the importance of early diagnosis and therapeutic intervention at the appropriate time to achieve a favorable outcome for the patient.</p></div