Emeline das Neves de Araújo Lima

ANALYSIS OF INFLAMMATORY INFILTRATE, PERINEURAL INVASION, AND RISK SCORE CAN INDICATE CONCURRENT METASTASIS IN SQUAMOUS CELL CARCINOMA OF THE TONGUE

PURPOSE In this retrospective study, the aim was to compare individual histopathologic parameters of malignancy between nonmetastatic and metastatic squamous cell carcinoma of the tongue. MATERIALS AND METHODS Sixty-two cases of squamous cell carcinoma of the tongue were selected and examined according to the system established by Brandwein-Gensler et al (Am J Surg Pathol 29:167, 2005) and included the pattern of invasion (most to least favorable), lymphocytic infiltration, perineural invasion, risk score, keratinization, eosinophilia, perivascular invasion, and tumor thickness. RESULTS The least favorable pattern had no association with nodal metastasis (P > .05). The scarcity or density of the lymphocytic infiltration, perineural invasion, and a risk score ≥ 3 were associated with nodal metastasis (P < .05). Keratinization, eosinophilia, perivascular invasion, and tumor thickness had no association with nodal metastasis (P > .05). A significant positive correlation was found between the pattern of invasion and perineural invasion and between the pattern of invasion and tumor thickness (P < .05). CONCLUSIONS The scarcity or density of the lymphocytic infiltration, perineural invasion, and histopathologic risk score may be helpful as parameters of histologic malignancy for the evaluation of metastatic and nonmetastatic squamous cell carcinoma of the tongue.

Intraoral molluscum contagiosum in a young immunocompetent patient

Molluscum contagiosum (MC) is a contagious disease caused by a virus of the poxvirus family. In children, the disease commonly manifests as a variable number of discrete umbilicated papules on the face and trunk. In healthy and immunosuppressed adults, the disease appears on or near the genital organs and is often sexually transmitted. MC involving the intraoral mucosa has been documented but is rare. We report a case of MC involving the oral mucosa exclusively and discuss the main clinical, histopathologic, and therapeutic characteristics, comparing the findings with cases of this rare oral presentation described in the literature.

Comparative Analysis of Psychological, Hormonal, and Genetic Factors Between Burning Mouth Syndrome and Secondary Oral Burning

OBJECTIVE The objective of this study was to evaluate the association between psychological, hormonal, and genetic factors with the development of burning mouth syndrome (BMS) and secondary oral burning (SOB) in order to provide a better characterization and classification of these conditions. DESIGN Cross sectional study. SETTING Patients with complaints of mouth burning registered at the Oral Diagnostic Service of the Federal University of Rio Grande do Norte between 2000 and 2013. SUBJECTS The sample consisted of 163 subjects divided into a group of patients with BMS (n = 64) and a group of subjects with SOB (n = 99). METHODS The following variables were analyzed: passive and stimulated saliva flow, stress levels and phase, depression, anxiety, serum cortisol and dehydroepiandrosterone (DHEA) levels, and the presence of polymorphisms in the interleukin 6 (IL-6) gene. RESULTS The results showed significant differences in the presence of xerostomia (p = 0.01), hyposalivation at rest (p < 0.001) and symptoms of depression (p = 0.033) between the two groups, which were more prevalent in the BMS group. DHEA levels were lower in the BMS group (p = 0.003) and were sensitive and specific for the diagnosis of this condition. Genetic analysis revealed no significant association between the polymorphisms analyzed and the development of BMS. CONCLUSION These results suggest a possible role of depression, as well as of reduced DHEA levels, as associated factors for development of BMS.

Factors associated with clinical characteristics and symptoms in a case series of oral lichen planus

Oral lichen planus (OLP) is a relatively common chronic inflammatory disease whose etiopathogenesis is not completely understood. Several factors have been proposed in an attempt to explain the variety of clinical manifestations and periods of exacerbation and remission of symptoms of these lesions. The objective of this study was to associate local factors, systemic diseases, and level of anxiety with clinical characteristics of OLP.

Estudo epidemiológico das doenças dermatológicas imunologicamente mediadas na cavidade oral

BACKGROUND: Immune-mediated skin diseases encompass a variety of pathologies that present in different forms in the body. OBJECTIVE: The objective of this study was to establish the prevalence of the principal immune-mediated skin diseases affecting the oral cavity. METHODS: A total of 10,292 histopathology reports stored in the archives of the Anatomical Pathology Laboratory, Department of Oral Pathology, Federal University of Rio Grande do Norte, covering the period from 1988 to 2009, were evaluated. For the cases diagnosed with some type of disease relevant to the study, clinical data such as the gender, age and ethnicity of the patient, the anatomical site of the disease and its symptomatology were collected. RESULTS: Of all the cases registered at the above-mentioned service, 82 (0.8%) corresponded to immune-media ted skin diseases with symptoms affecting the oral cavity. The diseases found in this study were: oral lichen planus, pemphigus vulgaris and benign mucous membrane pemphigoid. Oral lichen planus was the most common lesion, comprising 68.05% of the cases analyzed. Of these cases, 64.3% were women and the cheek mucosa was the anatomical site most commonly affected (46.8%). CONCLUSION: Immune-mediated skin diseases affecting the oral cavity continue to be rare, the prevalence found in this study being similar to that reported for the majority of regions worldwide. Nevertheless, early diagnosis is indispensable in the treatment of these diseases, bearing in mind that systemic involvement is possible in these patients.

Florid cemento-osseous dysplasia and osteomyelitis: A case report of a simultaneous presentation

PURPOSE: To report a case of florid cemento-osseous dysplasia (FCOD) and chronic diffuse sclerosing osteomyelitis (CDSO) in a simultaneous presentation, emphasizing the significance of differential diagnosis and appropriate management of these conditions. CASE DESCRIPTION: A female, 69 years old, black patient had a complaint of itching and pain in posterior left mandibular region. The patient had a yellowish hard mass throughout all quadrants of the jaws. A panoramic radiograph showed a lobular, diffuse and irregular radiopaque lesion. Based on clinical and histopathological findings, the diagnosis was FCOD associated with secondary osteomyelitis. CONCLUSION: This report reinforces the need of accurate assessment of clinical, radiographic and histopathological aspects for the diagnosis and correct selection of treatment in cases of combined lesions.

Bone marrow transplantation: graft versus host disease and oral changes

PURPOSE: This study aimed to evaluate the prevalence of oral changes and their association with graft versus host disease (GVHD) in patients undergoing bone marrow transplantation (BMT). METHODS: The sample consisted of 51 BMT patients. A questionnaire was used to collect data on age, gender, disease, type and time of transplant, cell origin, and GVHD occurrence. The extraoral and intraoral clinical examinations were performed by specialized professionals. RESULTS: Systemic GVHD was observed in 32.5% of the allogeneic transplant patients, and all of the patients with GVHD had oral manifestations. There was a statistically significant association between systemic GVHD and oral manifestations (P<0.001). CONCLUSION: Given the relatively high prevalence of oral changes associated with GVHD in patients undergoing BMT, this study confirms the need to consider dental aspects in the examination, diagnosis, treatment and prognosis of possible complications after BMT.

MANAGEMENT AND FOLLOW-UP OF EXTENSIVE TERATOID CYST IN MOUTH FLOOR

. The majority of cases is reported in the midline of the body and especially in testes and ovaries. The most common site in the head and neck region is the lateral eyebrow, the so-called angular dermoid, and approximately 6.5% of the cases occur in the oral cavity. The teratoid cyst of the floor of the mouth is distinctly uncommon, with only a few cases reported, usually in the anterior portion

Oral Langerhans cell histiocytosis: case report with follow-up of ten years

Langerhans cell histiocytosis (LCH) is characterized by clonal proliferation of Langerhans cells exhibiting Birbeck granules and positive immunohistochemistry for S100 and CD1A. A malignant transformation or a functional proliferation of Langerhans cells responding to external stimuli are possible sources. In the oral cavity, they can occasionally present as hyperplasia of the gingiva or ulcers of the cheek, palate, or tongue mucosa. The diagnosis is made after careful examination, and the exclusion of other similar diagnostic possibilities. Several therapeutic modalities have been suggested for LCH, such as intralesional corticosteroid injection, antibiotics, steroids, radiation therapy, and chemotherapy. Surgical options ranging from extensive resections to more conservative approaches are available and, in many cases, healing has resulted from a single biopsy. The present report regards LCH in the oral cavity and emphasizes the rarity of this lesion, as well as the importance of differential diagnosis, treatment, and appropriate follow-up for these patients.