Ademar Takahama Junior

Clinicopathological and immunohistochemical analysis of twenty-five head and neck osteosarcomas

The aim of this study was to analyze the clinicopathological features and immunohistochemical expression of p53, MDM2, CDK4, PCNA and Ki67 proteins in 25 head and neck osteosarcomas registered in a single institution. The mean age of the patients was 29 years and the most common site was the mandible (60%). The predominant histological type was the chondroblastic (72%) and 52% of the cases were classified as intermediate-grade of malignancy. The immunohistochemical analysis displayed positivity in 52% of the cases for p53, 24% for MDM2, 84% for CDK4, 92% for PCNA and 88% for Ki-67. The majority of cases were treated with surgery alone or associated with chemotherapy. Five patients developed local recurrences, four had distant metastasis and six had persistent disease after initial treatment. The overall 5-year and 10-year survival rates were 59% and 49%, respectively, and the most important prognostic factors were prior history of radiation exposure and osteoblastic histological type.

Parotid neoplasms: analysis of 600 patients attended at a single institution

UNLABELLED Salivary gland tumors are rare, generally benign and affect mainly the parotid gland. AIM The purpose of this study was to retrospectively analyze all cases of parotid tumors treated at our institution from 1953 to 2003. METHODS All patients with primary parotid tumors were selected; clinical and histopathological data were analyzed and described. RESULTS 600 cases of parotid tumors were selected; 369 were benign and 231 were malignant. Pleomorphic adenoma was the most frequent benign tumor. The most common malignant tumor was the mucoepidermoid carcinoma. Therapy in most cases consisted of parotidectomy. Adjuvant therapy -- mainly radiotherapy -- was used in some cases with malignant tumors. The incidences of local, regional and distant recurrences of malignant tumors were 10%, 8% and 9%. CONCLUSION Patients with parotid tumors treated at our institution were mainly adults, with marginally more female patients. Benign tumors were mostly the pleomorphic adenoma, which were more frequent than malignancies. Most of the patients were treated by partial or total parotidectomy. Adjuvant therapy, mainly radiotherapy, was used in selected malignant cases.

Rhabdomyosarcoma of the head and neck: a clinicopathological and immunohistochemical analysis of 29 cases

Rhabdomyosarcoma is a malignant tumor occurring more frequently in the childhood. The purpose of this study was to analyze the clinicopathological and immunohistochemical features of rhabdomyosarcomas of the head and neck (RHNs). Twenty nine patients treated in a single institution were selected. The histological slides were reviewed and the tumors were classified. The immunohistochemical reactions were performed using antibodies against vimentin, desmin, myogenin, MyoD1, AE1/AE3, p53, PCNA, Ki67, C-erbB2, FAS and CDK4. The mean age was 14.3 years. The nonparameningeal site was affected in 16 cases (55.2%). Eleven cases (37.9%) affected parameningeal sites and 2 cases the orbit. The p53 was positive in 4 cases (13.8%), CDK4 in 10 cases (34.5%), C-erbB2 in 19 cases (70.4%), FAS in 9 cases (31%), PCNA in 28 cases (96.5%) and Ki67 in 16 cases (55.2%). The overall survival was 28.7% in 5 and 10 years, and p53 expression may be related with poor prognosis.

Neoplasias de parótida: análise de 600 pacientes atendidos em uma única instituição

Os tumores de glândula salivar sao raros e acometem principalmente a parotida, sendo a maioria de natureza benigna. OBJETIVOS: Avaliar todos os casos de tumor de parotida atendidos na nossa instituicao, durante o periodo de 1953 a 2003. Estudo Retrospectivo. CASUISTICA E METODOS: Todos os pacientes com tumores primarios de parotida foram selecionados e os dados clinicos e histopatologicos foram analisados e descritos. RESULTADOS: Foram selecionados 600 casos, sendo 369 benignos e 231 malignos. Dentre os tumores benignos, o adenoma pleomorfo foi o mais comum, e dentre os malignos, o carcinoma mucoepidermoide. A principal modalidade de tratamento foi a parotidectomia e em alguns casos malignos, terapias adjuvantes, principalmente a radioterapia, foram aplicadas. Os indices de recorrencia local, regional e a distância dos tumores malignos foram de 10%, 8% e 9%, respectivamente. CONCLUSOES: O perfil dos pacientes com tumor de parotida foi formado predominantemente por adultos e discreta predilecao pelo genero feminino. Os tumores benignos foram os mais frequentes. A maioria dos pacientes foram tratados por parotidectomia parcial ou total. O uso de terapias adjuvantes, principalmente a radioterapia, foi reservada para casos especificos de tumores malignos.

EBV-Associated Polymorphic Posttransplant Lymphoproliferative Disorder Presenting as Gingival Ulcers

Posttransplant lymphoproliferative disorders (PTLDs) present a wide clinicopathological spectrum, varying from the usual Epstein-Barr virus (EBV)-driven infectious mononucleosis-type polyclonal proliferations to EBV-positive or EBV-negative proliferations indistinguishable from overt lymphomas that occur in immunocompetent individuals. PTLDs characteristically have a predilection for extranodal sites and association with EBV.These disorders are usually B-cell type, although T-cell and rare cases involving both T- and B-cell types have also been described. The initial treatment consists in decreasing the immnosupressive therapy, usually with favorable results. The authors report on a rare case of a 19-year-old girl, with post—renal transplantation EBV-associated polymorphic lymphoproliferative gingival ulcerated lesions. To the best of their knowledge, this is the first case described in the English-language literature of polymorphic PTLD involving both B-cell and T-cell lineages, with an unusual immunoprofile affecting the mouth. The authors warn that this condition could be easily misdiagnosed as malignant lymphoma if not properly recognized.