Maria Aparecida de Albuquerque Cavalcante

Surgical approach and clinical outcome of a deforming brown tumor at the maxilla in a patient with secondary hyperparathyroidism due to chronic renal failure

Brown tumors are relatively uncommon but they are serious complications of renal osteodystrophy. We describe a 31-year-old woman with end-stage renal disease who had undergone hemodialysis for nine years and developed severe secondary hyperparathyroidism and a maxilla brown tumor despite increasing doses of oral calcitriol and calcium carbonate. The fast increase of the right maxillary bone tumor led to indication of parathyroidectomy (PTx). Despite normalization of serum PTH there was a slow regression of the mass and the patient still complained about her appearance after two-years of follow-up. Excision of the maxillary mass followed by recontouring of the maxilla was then performed, with adequate masticator rehabilitation.

Uncommon Diagnosis of Oral Kaposi's Sarcoma in an Elderly Human Immunodeficiency Virus–Seronegative Adult

To the Editor: Kaposi’s sarcoma (KS) has been characterized as a multifocal malignant neoplasm, originating in vascular endothelial cells. The oral lesions appear as purplish nodules and maculae that may ulcerate, resulting in pain, bleeding, dysphagia, and difficulties in mastication. KS formation is usually attributed to infection by human herpesvirus 8 (HHV-8). Several studies have demonstrated the association between this viral strain and all forms of KS and also with other clinical manifestations such as multicentric Castleman’s disease and primary effusion lymphoma or body cavity lymphoma. In immunocompetent individuals HHV-8 has been identified in multiple myeloma, pemphigus vulgaris, nonneoplastic tumors of salivary glands, acute apical abscess, and periodontal diseases, in which its role is unclear. This study reports a case of KS in an elderly adults not infected with the human immunodeficiency virus (HIV), as well as the challenges for KS diagnosis.

Congenital dilatation of the submandibular duct

Congenital dilatation of the submandibular duct also known as imperforate submandibular duct is a rare condition of unknown etiology, clinically characterized as a well-defined, fluctuant swelling in the floor of the mouth, and microscopically defined as a cystic cavity covered with pseudostratified columnar epithelium consistent with a dilated salivary duct. A 1-month-old female presented with a translucent, smooth cystic swelling in the floor of the mouth causing breastfeeding difficulty. The lesion was surgically excised and microscopically, a cystic cavity lined with pseudostratified columnar epithelium was observed. The final diagnosis was congenital dilatation of the submandibular duct. Dentists and otolaryngologists should consider congenital dilatation of the submandibular duct when evaluating fluctuant swelling in the floor of the month of infants.

Treatment of cavitary myiasis in the face: a case report

OBJECTIVE: The word “myiasis” is derived from the Greek myio (fly) and ase (disease), and describes the infestation of humans and vertebrate animals by the larvae of flies, which feed on healthy or dead tissues of the host. The diagnosis is clinical, based on the presence of worms, and its treatment consists of the total removal of these larvae. The authors report a case of surgical debridement as a safe alternative for the treatment of cavitary myiasis in the face. CASE DESCRIPTION: The patient, a 58-year-old male, was admitted with a cavitary lesion on the face of the right side containing fly larvae. Surgical debridement was performed in two phases, with no use of drugs or less invasive maneuvers. Total remission of the condition was achieved, but the patient died due to a squamous cell carcinoma in the posterior region of the tongue and oropharynx, a month and a half after beginning oncologic treatment. CONCLUSION: The use of antiparasitic medication is controversial in the literature, as in specific situations this may put the patient’s life at risk. Prevention is still the best way to combat an infestation by myiasis. The authors report a case of myiasis cavitation in the face using only surgical debridement as treatment.

Keratocystic odontogenic tumor

OBJECTIVE to evaluate the frequency of keratocystic odontogenic tumor (KOT) in the Oral Surgery Service (OSS) of the University Hospital Clementino Fraga Filho of the Federal University of Rio de Janeiro (HUCFF / UFRJ), with respect to recurrence rate, gender, age of recurrence and location of the injury Methods: clinical records were reviewed and histopathological reports of KOT patients of the HUCFF/UFRJ between 2002 and 2012. Patients diagnosed with KOT were divided into two groups for the occurrence of relapse: positive (n=6) and negative (n=19) Results: regarding the location, there was a predilection for the mandible. In the average age of patients in the positive group was 40.5 and the negative group, 35.53. In the distribution by gender, positive group showed equal distribution, different from that observed in the negative group, which showed a predilection for males Conclusion: KOT was the second most frequent injury in our patients, recurrence was lower among males and had the jaw as most affected location.

Study of the causes of facial fractures in a reference center in Rio de Janeiro, Brazil from 2003-2012

OBJECTIVE This study describes the facial fractures of patients at a reference center in oral and maxillofacial surgery of a Public University Hospital in the city of Rio de Janeiro, from January 2003 to December 2012. METHODS The data were collected from medical records and included the fractured bones, etiology, gender, and age of the patients. A total of 202 cases were identified, and 159 were included in the study (129 men and 30 women). RESULTS The mandible was the most commonly injured bone (90 cases, 73 men and 17 women) with a mean age of 33.7 years old (±15.2), and traffic accidents (75 cases) were shown to be the major cause. CONCLUSION In the city of Rio de Janeiro, young men in their fourth decade of life are prone to trauma to their facial bones, especially the mandible, and they are most commonly caused by traffic accidents.