RESUMO
O hemangioma é uma neoplasia benigna que se caracteriza pela proliferação anormal de vasos sanguíneos, comum na região de cabeça e pescoço, e é relativamente raro na cavidade oral; porém, quando essa região é acometida, comumente, atinge lábios, língua e mucosa jugal. O objetivo deste trabalho foi descrever um caso clínico de hemangioma em mucosa jugal direita, o qual foi tratado através de escleroterapia com Oleato de Etanolamina (Ethamolin®), e ultras sonografia para guiar as aplicações intralesionais. No momento, a paciente está com 2 anos de acompanhamento, o que possibilitou observar a fibrose da lesão. A escleroterapia com Ethamolin® guiada por ultrassom é um procedimento seguro que pode ser realizado em lesões mais profundas, minimizando a possibilidade de complicações e favorecendo a recuperação do paciente.
Hemangioma is a benign neoplasm characterized by an abnormal proliferation of blood vessels, common in the head and neck region. It is relatively rare in the oral cavity, but if this region is affected, it occurs more commonly in the lips, tongue, and oral mucosa. The aim of this study was to describe a clinical case of hemangioma in the right jugal mucosa, which was treated through sclerotherapy with Ethanolamine Oleate (Ethamolin®), and the use of ultrasonography to guide the intralesional applications. Now, the patient has a 2-year follow-up, which allowed the observation of the involution of the lesion. The ultrasound-guided sclerotherapy with Ethamolin® is a safe procedure that can be performed in deeper lesions, minimizing the possibility of complications, and favoring the patient's recovery.
Assuntos
Hemangioma , Vasos Sanguíneos , EscleroterapiaRESUMO
A central giant cell lesion (CGCL) is a reactive lesion that causes destruction of bone and soft tissues and has a high recurrence rate. Only 16 percent of CGCLs are observed in children. Treatment is determined by the aggressiveness and size of the lesion and it usually involves curettage or resection. Alternative treatments, such as nasal calcitonin and intralesional corticosteroid injections, are also used. The purposes of this paper are: (1) to report the case of a nine-year-old patient who presented with a CGCL; (2) to describe its pharmacological management; and (3) to review the literature about the clinical, radiographic, and histological features of CGCL.
Assuntos
Granuloma de Células Gigantes , Doenças Mandibulares , Criança , Tratamento Farmacológico , Células Gigantes , Humanos , Injeções IntralesionaisRESUMO
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.
Assuntos
Neoplasias Maxilares/patologia , Tumor Neuroectodérmico Melanótico/patologia , Biópsia , Detecção Precoce de Câncer , Feminino , Humanos , Imuno-Histoquímica , Lactente , Neoplasias Maxilares/diagnóstico , Tumor Neuroectodérmico Melanótico/diagnóstico , Tomografia Computadorizada por Raios XRESUMO
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.
RESUMO O tumor neuroectodérmico melanocítico da infância é uma neoplasia rara e de crescimento rápido. Neste estudo, relata-se o caso de uma paciente do sexo feminino de 6 meses de idade, que apresentou tumefação na região anterior de maxila. A reconstrução tomográfica revelou área unilocular hipodensa e expansiva associada ao incisivo central superior direito decíduo. Realizou-se biópsia incisional, considerando as hipóteses diagnósticas de cisto dentígero, tumor odontogênico adenomatoide, tumor neuroectodérmico melanocítico da infância e rabdomiossarcoma. Microscopicamente, a lesão revelou população celular bifásica, consistindo de células pequenas, ovoides, de aparência neuroblástica, e de células epitelioides, contendo melanina. A análise imuno-histoquímica demonstrou que o componente celular contendo melanina era positivo de forma intensa e difusa para HMB-45 e Melan-A, mas levemente positivo para S100. Com base nestes achados, foi estabelecido o diagnóstico definitivo de tumor neuroectodérmico melanocítico da infância. Em seguida, foi realizada a enucleação da lesão com curetagem cuidadosa. Após 2 anos de acompanhamento, não foram verificadas evidências clínicas ou radiográficas de recorrência. O presente caso destaca a importância do diagnóstico precoce e da intervenção terapêutica no momento apropriado, a fim de alcançar um desfecho favorável para o paciente.
Assuntos
Humanos , Feminino , Lactente , Neoplasias Maxilares/patologia , Tumor Neuroectodérmico Melanótico/patologia , Biópsia , Imuno-Histoquímica , Neoplasias Maxilares/diagnóstico , Tomografia Computadorizada por Raios X , Tumor Neuroectodérmico Melanótico/diagnóstico , Detecção Precoce de CâncerRESUMO
ABSTRACT This case study aims to describe the effects of orthognathic surgery on the quality of life of a patient with class III dentofacial deformity. The protocols Oral Health Impact Profile, short version, and Orthognathic Quality of life Questionnaire were applied before and after orthognathic surgery to measure the quality of life of a subject. The data were collected from a clinical case report. We observed that, by the Oral Health Impact Profile, the quality of life was not affected by dentofacial deformity (score = 1), and that there was a 30-day postoperative score increase (score = 9), indicating a worsening of quality of life and an improvement after 90 days (score = 4). On the other hand, by the Orthognathic Quality of life Questionnaire, it was noticed that dentofacial deformity negatively affected the patient's quality of life (score = 34), and that there was a progressive improvement in scores after surgery, i.e., from score 15 to 2, showing a positive impact on quality of life. The orthognathic surgery positively influenced the patient's quality of life, requiring the application of specific protocols that accurately measure the impacts of the procedure on the individual's life.
RESUMO Este estudo de caso tem como objetivodescrever a influência da cirurgia ortognática na qualidade de vida de um paciente com deformidade dentofacial classe III. Foram aplicados os protocolos Oral Health Impact Profil, versão abreviada e Orthognathic Quality of life Questionaire antes e após a cirurgia ortognática, com o intuito de mensurar a qualidade de vida de um sujeito. O levantamento dos dados foi feito através de um relato de caso clínico. Foi observado através do Oral Health Impact Profil que a qualidade de vida não foi afetada pela deformidade dentofacial (escore=1) e que houve um aumento de escore no pós-operatório de 30 dias (escore=9) indicando piora na qualidade de vida, e, melhora após 90 dias (escore=4). Já no Orthognathic Quality of life Questionaire, foi possível ver que a deformidade dentofacial afetou negativamente a qualidade de vida do paciente (escore=34) e houve melhora progressiva nos escores após a cirurgia, passando de 15 para 2 pontos, indicando impacto positivo na qualidade de vida do paciente. a cirurgia ortognática exerceu influência positiva na qualidade de vida do paciente estudado, sendo necessária a aplicação de protocolos específicos, que mensure com precisão o impacto do procedimento, na vida do indivíduo.
RESUMO
ABSTRACT The adenomatoid odontogenic tumor is a benign, non-invasive tumor and has a slow growth. Its preferred location is the anterior maxillary area, most often causing root displacement, more rarely resorption and mostly affects young women. Being asymptomatic, this injury is discovered upon routine radiographic examination, in which, in most cases, a unilocular, radiolucent image is observed and it may have some degree of calcification within the lesion. This work aims to report the case of a 14-year-old patient who attended the Lauro Wanderley University Hospital (UFPB), complaining of increased volume over a period of 8 months, in the region of non-vital tooth 21. The CT scan showed well-delimited unilocular, radiolucent lesion, with buccal cortex resorption. The proposed treatment plan involved enucleation, followed by peripheral ostectomy and bone graft with alloplastic materials. Because of its benign character, encapsulated and slow growing, the treatment of choice for adenomatoid odontogenic tumor is conservative, the surgical enucleation of the injury being advocated. The excised piece was sent for histopathological analysis, where the AOT diagnosis was confirmed. After 7 months, new bone formation was observed without signs of recurrence.
RESUMO O Tumor Odontogênico Adenomatóide é um tumor benigno, não invasivo e de crescimento lento. Acomete principalmente mulheres jovens, na região anterior da maxila, causando na maioria das vezes deslocamento radicular e raramente reabsorção. Por ser assintomática, essa lesão é geralmente descoberta em exames radiográficos de rotina, no qual se observa na maioria dos casos uma imagem radiolúcida unilocular, podendo apresentar algum grau de calcificação no interior da lesão. Este trabalho tem como objetivo relatar o caso clínico de um paciente de 14 anos, gênero feminino, que compareceu ao Hospital Universitário Lauro Wanderley - Universidade Federal da Paraíba, com queixa de aumento de volume de 8 meses de evolução, em região de elemento 21 não vital. Ao exame tomográfico observou-se lesão radiolúcida, unilocular, bem delimitada, com reabsorção da cortical vestibular. O plano de tratamento proposto foi a enucleação seguida de ostectomia periférica e enxerto ósseo com material aloplásico. A análise histopatológica confirmou o diagnóstico de Tumor Odontogênico Adenomatóide. Após sete meses observa-se nova formação óssea e sem sinais de recidiva.
RESUMO
Dentigerous cyst (DC) is the second most common odontogenic cyst with greater incidence in young patients. It presents as a unilocular, asymptomatic radiolucency involving the crown of an impacted tooth, commonly noticed in X-rays to investigate absence, wrong tooth position, or delay in the chronology of eruption. Decompression/marsupialization (D/M) is the most implemented treatment, especially when preserving the tooth involved is advised. The aim of this study is to discuss the DC characteristics that contribute to spontaneous eruption of premolars, by reporting the case of a conservative treatment of DC. This eruption depends on factors such as age, angulation of inclusion, rate of root formation, depth of inclusion, and eruption space. This paper reports the case of a 10-year-old patient with a radiolucent lesion diagnosed as DC involving element 35, which erupted as a result of treatment. The patient was observed during 1 year and 6 months.
RESUMO
Resumo:O tema proposto é Intervenção Fonoaudiológica pré e pós Cirurgia Ortognática. Foi realizada avaliação (por meio do Protocolo de Avaliação Miofuncional Orofacial MBGR com escores) e intervenção fonoaudiológica em período pré-operatório (por três meses) e pós-operatório iniciado no 20º dia (por três meses), após a liberação do cirurgião. Além disso, investigou-se o impacto da deformidade dentofacial na qualidade de vida do paciente, por meio do Oral Health Impact Profile - versão reduzida. Na avaliação pré-operatória, foram encontradas mastigação bilateral simultânea, presença de ruídos na Articulação Temporomandibular e fechamento labial assistemático durante a realização da função. Durante a deglutição houve contração da musculatura perioral e presença de resíduos após essa função. Encontrou-se na fala distorção no fonema /r/. Houve dor à palpação nos músculos mastigatórios e diminuição da tonicidade na musculatura perioral e mastigatória. Encontrou-se alto impacto na qualidade de vida, totalizando em 32 pontos. Na avaliação após a intervenção fonoaudiológica, observou-se melhora nas funções de mastigação (pré: 4 pontos, pós: 1 ponto), deglutição (pré:14, pós :5), respiração (pré: 3, pós: 1) e fala (pré: 7, pós: 1), na mobilidade muscular (pré: 8, pós 1), na tonicidade da musculatura (pré 5, pós: 0) e na dor à palpação (pré: 10, pós: 2). Houve melhora na postura dos lábios e melhora significante na qualidade de vida, passando de 32 para 8 pontos. Constatou-se melhora na fisiologia das funções estomatognáticas, diminuição da dor à palpação, equilíbrio no tônus, na mobilidade muscular e melhora na qualidade de vida.
Abstract:The proposed theme is Speech Therapy Intervention before and after orthognathic surgery. Evaluation (through MBGR Protocol of Orofacial Myofunctional Evaluation with scores) and speech therapy intervention were performed in the preoperative (three months) and postoperative periods, started on the 20th day (for three months) after the surgeon's liberation. In addition, it was investigated the impact of dentofacial deformity in the patient's life quality through the Oral Health Impact Profile - reduced version. In the preoperative evaluation, Simultaneous bilateral chewing, presence of noise in the temporomandibular joint and unsystematic lip closure were found while performing the function. During swallowing, there was contraction of the perioral muscles and presence of residues after this function. It was found, in speech, distortion in the /r/ sound. There was pain on palpation in the masticatory muscles and decreased tone in the perioral and masticatory muscles. It was found high impact on quality of life, totaling 32 points. In the evaluation after speech therapy intervention, improvement was observed in the chewing functions (pre: 4 points, post: 1 point), swallowing (pre: 14, post: 5), breathing (pre: 3, post: 1) and speech (pre: 7, post: 1), muscle mobility (pre: 8, post: 1), tonicity of the muscles (pre: 5, post: 0) and pain on palpation (pre: 10, post: 2). There was improvement in the posture of the lips and significant improvement in quality of life, from 32 to 8 points. It was found an improvement in the physiology of the stomatognathic functions, decreased pain on palpation, balance in tone, muscle mobility and improved quality of life.