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OBJECTIVE: This study aimed to explore perceived barriers to early diagnosis and management of oral cancer, as well as potential pathways for improvement in Latin America and the Caribbean (LAC). METHODS: This cross-sectional study used a self-administered online questionnaire created via the Research Electronic Data Capture platform. The survey was distributed to health professionals trained in Oral Medicine, Oral Pathology, Oral and Maxillofacial Surgery, and Dentists with clinical and academic expertise in oral potentially malignant disorder (OPMD) and oral cancer. Data obtained were systematically organized and analyzed descriptively using Microsoft Excel. RESULTS: Twenty-three professionals from 21 LAC countries participated. Major barriers included the limited implementation of OPMD and oral cancer control plans (17.4%), low compulsory reporting for OPMD (8.7%) and oral cancer (34.8%), unclear referral pathways for OPMD (34.8%) and oral cancer (43.5%), and a shortage of trained professionals (8.7%). Participants endorsed the utility of online education (100%) and telemedicine (91.3%). CONCLUSION: The survey highlights major perceived barriers to early diagnosis and management of OPMD and oral cancer in LAC, as well as potential avenues for improvement.
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Detecção Precoce de Câncer , Neoplasias Bucais , Humanos , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/terapia , América Latina , Estudos Transversais , Região do Caribe , Inquéritos e Questionários , Telemedicina , Feminino , Acessibilidade aos Serviços de Saúde , Masculino , Encaminhamento e Consulta , Adulto , Atitude do Pessoal de SaúdeRESUMO
OBJECTIVE: To report the clinicopathologic features of acquired oral syphilis cases in South American countries. MATERIALS AND METHODS: Clinical data were retrospectively collected from the records of 18 oral diagnostic services in Argentina, Brazil, Chile, Colombia, Venezuela, Uruguay, and Peru. Serologies of nontreponemal and treponemal tests were used for diagnosis. RESULTS: The series comprised 339 cases of acquired oral syphilis. Secondary syphilis ranked as the most common stage (86.7%). Lesions were more frequent among males (58.0%) and young adults with a mean age of 33.3 years. Individuals aged 20-29 years were most affected (35.3%). The most commonly involved sites were the tongue (31.6%), lip/labial commissure (25.1%), and hard/soft palate (20.4%). Clinically, acquired oral syphilis usually presented as mucous patches (28.4%), papules (25.7%), and ulcers (18.1%). Skin manifestations occurred in 67.7% of individuals, while lymphadenopathy and fever were observed in 61.3% and 11.6% of all subjects, respectively. Most patients were treated with the benzathine penicillin G antibiotic. CONCLUSION: This report validates the spread of acquired oral syphilis infection among young adults in South America. Our directives include accessible diagnostic tools for proper disease screening, surveillance, and counselling of affected individuals, especially in low- and middle-income countries.
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Doenças da Boca , Sífilis , Adulto , Brasil/epidemiologia , Humanos , Masculino , Doenças da Boca/diagnóstico , Doenças da Boca/tratamento farmacológico , Doenças da Boca/epidemiologia , Palato Duro , Estudos Retrospectivos , Sífilis/diagnóstico , Sífilis/tratamento farmacológico , Sífilis/epidemiologia , Adulto JovemRESUMO
BACKGROUND: Hydroa vacciniforme-like lymphoproliferative disorder (HVLPD) is a chronic Epstein-Barr virus (EBV)-positive lymphoproliferative disease which may either present as an indolent condition or progress to a systemic T-cell lymphoma. METHODS: All HVLPD diagnosed over a 10-year period were retrieved, and clinical data regarding sex, age, oral and systemic manifestations, and clinical follow-up were obtained. Immunohistochemistry was done in order to characterize the lymphoid cells, and in situ hybridization was used to demonstrate the presence of EBV. RESULTS: Eleven cases were included, with a male predominance and a mean age of 25.1 years. Buccal mucosa and the lips were the most affected oral sites, appearing as painful ulcers. All patients exhibited facial oedema, usually affecting the lips, nose and periorbital region. The clinical course was gradual but progressive, with four patients having fever and 3 showing lymphadenopathies. All cases showed a moderate to severe lymphocytic infiltrate with angiotropism, angiocentricity and epidermotropism. Two cases affecting the lip skin exhibited a periappendageal lymphocytic infiltrate. Few large pleomorphic cells were found, surrounded by smaller and medium-sized lymphoid cells, as well as reactive plasma cells, macrophages, neutrophils and eosinophils. All lesions exhibited a cytotoxic T-cell (CD8+) phenotype with a variable proliferative index. All cases were associated with EBV, and all patients died due to complications of the disease. CONCLUSIONS: HVLPD is a rare disease that may show oral involvement with a cytotoxic T-cell phenotype, and is strongly associated with EBV. As shown in this series, HVLPD may show aggressive clinical behaviour.
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Infecções por Vírus Epstein-Barr , Hidroa Vaciniforme , Transtornos Linfoproliferativos , Adulto , Infecções por Vírus Epstein-Barr/complicações , Feminino , Herpesvirus Humano 4 , Humanos , Masculino , PeruRESUMO
Primordial odontogenic tumor (POT) is a recently described benign odontogenic tumor, with only 16 cases reported in the literature. We present 2 new cases of POT affecting the mandible. Case 1 is that of 12-year-old girl with an asymptomatic, slow-growing mass, causing facial asymmetry. Radiography showed a well-defined unilocular radiolucency surrounding an impacted second premolar. Case 2 is that of a 13-year-old girl with a mass involving the crown of the unerupted third molar and showing similar radiographic features. Microscopically, both lesions were composed of variably cellular fibromyxoid tissue surrounded by thin ameloblastic epithelium, with stellate reticulum-like areas, but no mineralized tissue, yielding the diagnosis of POT. Immunohistochemical analysis showed diffuse expression of CK14 in epithelial cells, whereas CK19 was expressed mainly in the basal layer. Syndecan-1 (CD138) was expressed in the stellate-like regions and in the subepithelial zone. Both patients were treated surgically, with no signs of recurrence seen after 15 and 60 months, respectively.
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Recidiva Local de Neoplasia , Tumores Odontogênicos , Adolescente , Criança , Epitélio , Feminino , Humanos , Mandíbula , Dente Serotino , Tumores Odontogênicos/diagnóstico por imagem , Tumores Odontogênicos/cirurgiaAssuntos
Melanoma/genética , Mutação , Nevo Pigmentado/genética , Proteínas Proto-Oncogênicas B-raf/genética , Neoplasias Cutâneas/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Melanoma/metabolismo , Melanoma/patologia , Pessoa de Meia-Idade , Mucosa Bucal/patologia , Nevo Pigmentado/metabolismo , Proteínas Proto-Oncogênicas B-raf/metabolismo , Neoplasias Cutâneas/metabolismo , Neoplasias Cutâneas/patologia , Adulto JovemRESUMO
This study reports 2 odontogenic carcinosarcomas, including the clinicopathologic and immunoprofile characteristics of these rare tumors. The first case occurred in a 22-year-old male presenting a bilobular mass involving the gingiva and bone of the premolar region of the left mandible, with paresthesia of the lower lip. Microscopic examination revealed a tumor similar to ameloblastic fibrosarcoma, with atypical mesenchymal cells; however, the odontogenic epithelium also showed atypia. In the second case, a 16-year-old female had a painless, asymptomatic, large intraosseous mandibular lesion. The patient received radiotherapy to treat a rhabdomyosarcoma of the parotid 13 years before. The tumor was composed of atypical spindle cells, positive for vimentin and smooth muscle actin, intermingled with malignant odontogenic epithelium. Both epithelial and mesenchymal components of the tumors showed high index of p53- and Ki67-positive cells. The first case was diagnosed as odontogenic carcinosarcoma possibly originated from an ameloblastic fibrosarcoma, and the second as de novo odontogenic carcinosarcoma possibly caused by previous radiotherapy.
Assuntos
Carcinossarcoma/diagnóstico , Mandíbula/patologia , Neoplasias Mandibulares/diagnóstico , Tumores Odontogênicos/diagnóstico , Biópsia , Carcinossarcoma/patologia , Diagnóstico Diferencial , Feminino , Fibrossarcoma/diagnóstico , Gengiva/diagnóstico por imagem , Gengiva/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Mandíbula/diagnóstico por imagem , Neoplasias Mandibulares/patologia , Mucosa Bucal/diagnóstico por imagem , Mucosa Bucal/patologia , Tumores Odontogênicos/patologia , Radiografia Panorâmica , Rabdomiossarcoma/diagnóstico , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
Objective. To present 4 new cases of oral leiomyomatous hamartomas (OLH), describing its clinical, microscopical, and immunohistochemical features, and a literature review. Methods. The OLH cases were retrieved from the files of 2 Brazilian and 1 Peruvian oral pathology services. Clinical data were obtained from the pathology reports. Microscopical features were reviewed, and immunohistochemical reactions were performed. A review of the English-language literature about OLH was done. Results. The sample was composed of 3 females (4-, 10-, and 15-year-old) and 1 male (3-year-old). Three cases affected the dorsum of the tongue and one the incisive papilla, and all presented sessile or pedunculated smooth nodules. Microscopically, the lesions were composed of varying-size fascicles of smooth muscle fibers in a fibrous connective tissue background. Immunohistochemistry revealed positivity of the smooth muscle bundles for myogenic markers. The English-language literature review revealed 38 OLH cases reported, most were congenital or diagnosed up to 5 years old. The main locations were tongue and anterior maxilla. Conclusions. Although OLH is a rare lesion, it must be considered in the differential diagnosis of midline tongue or maxillary masses in newborns, infants, and youngsters.
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Gengiva/patologia , Doenças da Gengiva/diagnóstico , Hamartoma/diagnóstico , Doenças da Língua/diagnóstico , Língua/patologia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Gengiva/cirurgia , Doenças da Gengiva/congênito , Doenças da Gengiva/cirurgia , Hamartoma/congênito , Hamartoma/cirurgia , Humanos , Imuno-Histoquímica , Masculino , Maxila , Língua/cirurgia , Doenças da Língua/congênito , Doenças da Língua/cirurgiaRESUMO
BACKGROUND: Coronectomy involves the section of the tooth crown leaving the roots in the socket. Possibility of inferior alveolar nerve injury and mandibular fracture are the main indications for this approach. Herein, we describe a case series of coronectomy to highlight its indication in normal and oncological patients. MATERIAL AND METHODS: A total of 9 patients were submitted to coronectomy, 6 of them were oncological. Three patients were evaluated before head and neck radiotherapy (HNRT), 2 after HNRT and 1 before bone marrow transplantation. RESULTS: Mean age of the patients was 49 years, most of them male (n=7). Lower third molars were the main teeth that received this procedure, and all cases presented intimate anatomic relationship between the roots and the mandibular canal. Moreover, three cases also presented evident mandibular fracture risk in removing the tooth. During the follow-up period, none complications were observed related to coronectomy and oncological treatment. CONCLUSIONS: Coronectomy is a safe approach including for cancer patients and it should be considered in high-risk impacted teeth extractions. Key words:Coronectomy, impacted teeth, oncological patients, postoperative complications.
RESUMO
BACKGROUND: Cyclooxygenase-2 (COX-2) catalyses the conversion of arachidonic acid to prostaglandin, and its overexpression has been demonstrated in different malignant tumors, including cutaneous melanoma. However, no data about the expression of this protein in oral melanocytic lesions are available to date. The aim of this study was to evaluate the immunohistochemical expression of COX-2 in oral nevi and melanomas, comparing the results with correspondent cutaneous lesions. METHODS: COX-2 was evaluated by immunohistochemistry in 49 oral melanocytic lesions, including 36 intramucosal nevi and 13 primary oral melanomas, and in four cutaneous nevi and eight melanomas. RESULTS: All cases of oral and cutaneous melanomas were positive for COX-2. On the other hand, all oral and cutaneous melanocytic nevi were negative. CONCLUSION: COX-2 is highly positive in oral melanomas and negative in oral nevi and might represent a useful marker to distinguish melanocytic lesions of the oral cavity.
Assuntos
Ciclo-Oxigenase 2/biossíntese , Melanoma/enzimologia , Neoplasias Bucais/enzimologia , Nevo/enzimologia , Neoplasias Cutâneas/enzimologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/biossíntese , Feminino , Humanos , Imuno-Histoquímica , Melanócitos/enzimologia , Melanócitos/patologia , Melanoma/diagnóstico por imagem , Melanoma/patologia , Pessoa de Meia-Idade , Mucosa Bucal/diagnóstico por imagem , Mucosa Bucal/enzimologia , Mucosa Bucal/patologia , Neoplasias Bucais/diagnóstico por imagem , Neoplasias Bucais/patologia , Nevo/diagnóstico por imagem , Nevo/patologia , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/patologia , Adulto Jovem , Melanoma Maligno CutâneoRESUMO
De acuerdo con la Organización Mundial de la Salud (OMS), el ameloblastoma es un tumor odontogénico benigno, siendo una de sus variantes intraóseas más frecuentes el ameloblastoma sólido o multiquístico, el cual tiene un comportamiento local agresivo por su capacidad de alcanzar grandes dimensiones y desplazar estructuras anatómicas vecinas. Se reporta el caso de un paciente masculino que presentaba un ameloblastoma sólido en la mandíbula, de 7 años de evolución, que producía marcada asimetría facial y limitación de la función de la zona anatómica afectada. Debido a las dimensiones de la lesión, se utilizaron diversas técnicas imaginológicas con la finalidad de contribuir en el diagnóstico, determinar la extensión de la lesión y planificar el tratamiento. Se presenta una revisión de la literatura sobre tomografía computarizada (TC) e imagen por resonancia magnética (IRM) del ameloblastoma, cuyo objetivo es contribuir a definir sus características imaginológicas. Se enfatiza la importancia de estas técnicas de imagen modernas en el proceso de diagnóstico, planificación del tratamiento quirúrgico y el seguimiento a largo plazo de esta patología...
According to the World Health Organization (WHO) ameloblastoma is a benign odontogenic tumor. The most frequent intraosseous variety is the solid or multicystic ameloblastoma, which exhibits a locally aggressive behavior due to its potential to reach large dimensions and displace adjacent anatomic structures. We report a case of mandibular solid ameloblastoma in a 33 year old male, with an evolution time of 7 years. The lesion produced marked facial asymmetry as well as functional limitations of the involved anatomical areas. Given the dimensions of the tumor, proper imaging techniques were used to assist the diagnosis, determine the extent of the lesion and guide treatment planning. A review of the literature regarding the characteristics of the solid ameloblastoma in computed tomography and magnetic resonance imaging is presented in order to better understand its imaging features. The value of these modern imaging techniques in diagnosis, surgical treatment planning and the long term follow up of this lesion is emphasized...
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Humanos , Ameloblastoma , Ameloblastoma/diagnósticoRESUMO
OBJECTIVE: The aim of this study was to analyze the immunohistochemical expression of Skp2 protein in 38 oral nevi and 11 primary oral melanomas. STUDY DESIGN: Expression of this ubiquitin protein was evaluated by immunohistochemistry in 49 oral melanocytic lesions, including 38 intramucosal nevi and 11 primary oral melanomas. The labeling index (LI) was assessed considering the percentage of cells expressing nuclear positivity out of the total number of cells, counting 1000 cells per slide. RESULTS: Skp2 protein was rarely expressed in intramucosal nevi, in contrast to oral melanomas, which showed high levels of this protein. CONCLUSION: These results indicate that Skp2 protein may play a role in the development and progression of oral melanomas, and it also could be useful as an immunohistochemical marker for differential diagnosis of oral benign and malignant melanocytic lesions.
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Melanoma/metabolismo , Neoplasias Bucais/metabolismo , Nevo/metabolismo , Proteínas Quinases Associadas a Fase S/biossíntese , Adolescente , Adulto , Idoso , Feminino , Humanos , Imuno-Histoquímica , Masculino , Melanoma/química , Pessoa de Meia-Idade , Neoplasias Bucais/química , Nevo/química , Proteínas Quinases Associadas a Fase S/análise , Adulto JovemRESUMO
Evaluation of cell cycle using antibodies against nuclear proteins involved in regulating DNA replication has gained special interest in the effort to predict biologic behavior of benign and malignant tumors. The aim of this study was to analyze the expression of minichromosome maintenance 2, Ki-67, and geminin in oral nevi and melanomas. Expression of these cell proliferation markers was evaluated by immunohistochemistry in 49 oral melanocytic lesions, including 38 intramucosal nevi and 11 primary oral melanomas. The labeling index of each proliferation marker was assessed considering the percentage of cells expressing nuclear positivity out of the total number of cells, counting 1000 cells per slide. Minichromosome maintenance 2, Ki-67, and geminin were rarely expressed in intramucosal nevi, in contrast to oral melanomas, which showed high levels of these cell proliferation markers, particularly minichromosome maintenance 2, indicating it is a more sensitive marker in primary oral melanomas than Ki-67 and geminin. These results indicate that these markers may be involved in the pathogenesis of oral melanomas and could be eventually useful as an additional diagnostic tool for differential diagnosis of oral benign and malignant melanocytic lesions.
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Proteínas de Ciclo Celular/metabolismo , Antígeno Ki-67/metabolismo , Melanoma/metabolismo , Neoplasias Bucais/metabolismo , Nevo Pigmentado/metabolismo , Proteínas Nucleares/metabolismo , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/metabolismo , Proliferação de Células , Diagnóstico Diferencial , Feminino , Geminina , Regulação Neoplásica da Expressão Gênica , Humanos , Masculino , Melanoma/diagnóstico , Melanoma/patologia , Pessoa de Meia-Idade , Componente 2 do Complexo de Manutenção de Minicromossomo , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/patologia , Nevo Pigmentado/diagnóstico , Nevo Pigmentado/patologia , Estudos Retrospectivos , Adulto JovemRESUMO
Entre los tumores mandibulares, destacamos el ameloblastoma como una patología frecuente en el área maxilofacial, descrito como un crecimiento local persistente, agresivo e invasivo con potencial de recidiva considerable, por lo que la integración clínica, imaginológica e histopatológica histopatológica nos dirige a establecer diagnósticos para definir el tratamiento quirúrgico. Con el conocimiento de técnicas quirúrgicas maxilofaciales, indicadas para la ablación de tumores en el Maxilar inferior empleamos la mandibulectomía parcial o segmentaria con reconstrucción inmediata y posterior rehabilitación con implantes, demostrando efectividad en el tratamiento. La combinación de injertos autólogos ofrece: contención y estabilidad que da la cortical externa de calota craneana hacia el particulado de cresta ilíaca, y el volumen óseo obtenido es brindado por el injerto particulado para facilitar la instalación de implantes.
Among the tumors mandibular ameloblastoma highlighted as a common pathology in the maxillofacial area, described as a persistent local l growth, aggressive and invasive with significant potential for recurrence, so that clinical integration, imagiologic and histopathologic diagnoses directs us to define surgical treatment. With knowledge of maxillofacial surgical techniques, indicated for ablation of tumors in the lower jaw used the partial or segmental mandibulectomy with immediate reconstruction with implants and subsequent rehabilitation, demonstrating effectiveness in treatment. The combination of autologous grafts provides: containment and stability which gives the particulate calvaria into the iliac crest bone volume obtaining suitable for the installation of the implant provided by particulate graft.
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Humanos , Masculino , Adolescente , Ameloblastoma , Bioprótese , Implantes Dentários , Reconstrução Mandibular , Transplante AutólogoRESUMO
La transformación maligna de un tumor odontogénico es poco común y puede desarrollarse a partir de un tumor odontogénico benigno. Se presenta el caso de una paciente de sexo femenino de 19 años de edad, con el seguimiento secuencial de las radiografías y tomografía computarizada de una lesión inicialmente diagnosticada como Ameloblastoma, que posterior al tratamiento quirúrgico se establece como Fibroma ameloblastico y al cabo de seis años sufre una transformación maligna determinado con un diagnostico histológico a Fibrosarcoma ameloblastico. El objetivo del presente reporte es exponer un caso que llego al Servicio de Medicina, Cirugía y Patología Oral de la Universidad Peruana Cayetano Heredia donde se recopilo los datos de la historia médica con los estudios de imágenes.
Malignant transformation of an odontogenic tumor is rare and can develop from a benign odontogenic tumor. We report the case of a female patient of 19 years old, with tracking sequential radiographs and CT scan of a lesion initially diagnosed as ameloblastoma, after surgical treatment that is established as ameloblastic fibroma, six years after malignant transformation occurs with a histologic diagnosis given to ameloblastic fibrosarcoma. The objective of this report is to present this case to be referred to the Department of Medicine, Surgery and Oral Pathology, Peruvian University Cayetano Heredia where collected data on medical history with imaging studies.
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Humanos , Feminino , Adulto Jovem , Fibroma , Odontoma , Tumores OdontogênicosRESUMO
The acquisition of abnormalities at G1/S is considered a crucial step in the genesis and progression of melanoma. The expression of cell cycle regulators has also been used in various neoplasms as an adjunct to diagnosis. The aim of this study was to compare the expression of p16, p21, p27 and cyclin D1 in oral nevi and melanomas. Expression of these cell cycle regulatory proteins was evaluated by immunohistochemistry in 51 oral melanocytic lesions, including 38 intramucosal nevi and 13 primary oral melanomas. p16 and p27 were highly expressed in intramucosal nevi, whereas p21 and cyclin D1 expression was higher in oral melanomas. The results indicate that p21 and cyclin D1 may be involved in the development of oral melanomas, and eventually they may be useful in the differential diagnoses of oral benign and malignant melanocytic lesions.
Assuntos
Biomarcadores Tumorais/análise , Melanoma/metabolismo , Neoplasias Bucais/metabolismo , Nevo/metabolismo , Adolescente , Adulto , Idoso , Ciclina D1/análise , Ciclina D1/biossíntese , Inibidor p16 de Quinase Dependente de Ciclina , Inibidor de Quinase Dependente de Ciclina p21/análise , Inibidor de Quinase Dependente de Ciclina p21/biossíntese , Inibidor de Quinase Dependente de Ciclina p27/análise , Inibidor de Quinase Dependente de Ciclina p27/biossíntese , Feminino , Humanos , Imuno-Histoquímica , Masculino , Melanoma/diagnóstico , Pessoa de Meia-Idade , Neoplasias Bucais/diagnóstico , Proteínas de Neoplasias/análise , Proteínas de Neoplasias/biossíntese , Nevo/diagnóstico , Adulto JovemRESUMO
OBJECTIVE: The aim of this study was to analyze the histopathological and immunohistochemical characteristics of 22 cases of primary oral melanomas (OM). STUDY DESIGN: Twenty two cases of primary oral melanoma were analyzed by description of their histopathological features and immunohistochemical study using the antibodies S-100, HMB-45, Melan-A and Ki-67. RESULTS: The mean age was 58 years and 14 cases were female. The main affected sites were the hard palate, followed by the upper gingiva. Microscopically, 15 cases presented level III of invasion, 2 cases were amelanotic and 13 showed a mixed epithelioid and plasmacytoid or spindle cells composition. Some cases showed necrosis, perivascular and perineural invasion. S-100 and HMB-45 were positive in all cases, but 3 cases were negative for Melan-A. The proliferative index with Ki-67 was high, with labeling index ranging from 15.51% to 63% of positive cells. CONCLUSION: S-100 and HMB-45 are more frequently expressed than Melan-A in primary oral melanomas and these markers are helpful to confirm the diagnosis.
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Melanoma/patologia , Neoplasias Bucais/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Imuno-Histoquímica , Antígeno Ki-67/análise , América Latina , Antígeno MART-1/análise , Masculino , Melanoma/química , Antígenos Específicos de Melanoma/análise , Pessoa de Meia-Idade , Neoplasias Bucais/química , Proteínas S100/análise , Adulto Jovem , Antígeno gp100 de MelanomaRESUMO
Se presenta un caso de fibromixoma odontogénico de la mandíbula en un paciente adolescente de 14 años de edad, cuyos cambios radiográficos sugerían osteosarcoma. El análisis y la integración de los datos clínicos con las imágenes de la tomografía axial computarizada fueron claves para establecer el diagnostico diferencial entre ambas entidades.
A case of odontogenic fibromixoma of the mandible in a 14-years-old patient which radiographic changes suggested osteosarcoma is reported. The analysis of clinical data together with the bone changes found in TC images was the clue to establish the differential diagnosis between both lesions.
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Humanos , Masculino , Adolescente , Osteossarcoma , Fibroma , Tomografia Computadorizada EspiralRESUMO
Se reporta el caso de una paciente mujer de 14 años de edad que presentaba una lesión asintomática de apariencia tumoral ubicada en la zona de la articulación témporo mandibular derecha. Durante la apertura bucal había desviación de la mandíbula hacia el mismo lado. El estudio imaginológico mediante radiografía panorámica, tomografía espiral multicorte y angiografía, fue determinante para plantear el diagnóstico de Quiste Óseo Aneurismático. Este es un tipo de pseudoquiste de los maxilares. Se discuten los aspectos clínicos, imaginológicos, anátomo-patológicos y el tratamiento de esta entidad. De la revisión de la literatura se concluye que es una lesión muy rara a nivel del cóndilo, no tiene una apariencia radiográfica patognomónica y puede confundirse con varias otras entidades que ocurren en esta zona anatómica. El estudio imaginológico cuidadoso y la punción aspiración fueron elementos importantes para el diagnóstico y por lo tanto para el correcto tratamiento.
A case of a 14-years-old girl with an asymptomatic tumour like mass located in the area of the right TMJ that produced deviation of the mandible to the same side is presented. The imaging study using panoramic radiograph, axial tomography and angiography were necessary to propose the diagnosis of aneurysmal bone cyst which is considered a type of pseudocyst of the jaw. The clinical aspects, imaging, histopathological studies and treatment regarding this lesion is discussed. By the review of the literature, it is concluded that this lesion very rarely involves the mandibular condyle, does not have pathognomonic radiographic appearance and can be confused with other several lesions affecting this anatomic zone. Careful imaging studies and aspiration puncture were important procedures for the diagnosis and therefore for the correct treatment.
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Humanos , Adolescente , Feminino , Côndilo Mandibular , Doenças Mandibulares , Cistos Ósseos Aneurismáticos , Tomografia Computadorizada por Raios XRESUMO
El fibrosarcoma ameloblástico es un tumor odontogénico raro, compuesto por epitelio benigno y tejido mesenquimal maligno que semeja a un fibrosarcoma. Se considera que es la contraparte maligna del fibrosarcoma ameloblástico. Aun cuando los cambios histológicos son claramente malignos, este tumor rara vez produce metástasis, pero su crecimiento progresivo es infiltrantey destruye los tejidos adyacentes pudiendo llegar hasta la base del cráneo. En este trabajo sepresenta un caso de fibrosarcoma ameloblástico desarrollado en la mandíbula derecha de una mujer joven de 19 años de edad. Las características clínicas, radiográficas y sintomatología de la lesión, correspondían a un tumor odontogénico benigno e igualmente en el estudio histológico se podía identificar una capsula fibrosa bien definida. Sin embargo, el tejido dentro de la cápsulamostraba cambios mesenquimales francamente malignos. El tratamiento consistió en la extirpación de la hemimandíbula complementado con radiaciones. El seguimiento después de 5,3 años mostró que la paciente se encontraba libre de enfermedad.
Ameloblastic fibrosarcoma is a rare odontogenic tumor composed by a benign epithelium and a malignant mesenchyme tissue resembling a fibrosarcoma. It is regarded as the malignant counterpart of the ameloblastic fibroma. Dispite the clearly malignant histologic features thistumor rarely produce distant metastasis. This work reports a case of ameloblastic fibrosarcoma developed in the right mandible of a 19-year-old girl. The clinical, radiographic and symptomsresembled a benign odontogenic tumor, also in the histology a well defined capsule was identified. However, the tissue inside the capsule showed defined malignant mesenchymal changes. Treatment was surgical removal of the hemimandible following by radiation of the remaining tissues. The follow up after 5.3 year demonstrated a patient free of disease.