RESUMO
OBJECTIVES: The aim of this study was to investigate the prevalence of oral sarcomas from geographic regions of Brazil. MATERIALS AND METHODS: A cross-sectional study was conducted on biopsies obtained from January 2007 to December 2016 at twelve Brazilian oral and maxillofacial pathology centres. Gender, age, evolution time, clinical aspects, tumour location, tumour size at diagnosis, radiographic aspects and histopathological diagnosis were evaluated. Data were analysed using descriptive statistical methods. RESULTS: From 176,537, a total of 200 (0.11%) oral sarcomas were reported, and the most prevalent were osteosarcomas (74 cases; 37%) and Kaposi's sarcomas (52 cases; 26%). Males were more affected than females at a mean age of 32.2 years old (range of 3-87 years). The most common symptoms were swelling¸ localised pain and bleeding at a mean evolution time of 5.14 months (range <1-156 months). The lesions were mostly observed in the mandible (90 cases; 45%), with a mean tumour size of 3.4 cm (range of 0.3-15 cm). Radiographically, the lesions presented a radiolucent aspect showing cortical bone destruction and ill-defined limits. CONCLUSIONS: Oral sarcomas are rare lesions with more than 50 described subtypes. Osteosarcomas and Kaposi's sarcomas were the main sarcomas of the oral cavity in Brazil.
Assuntos
Neoplasias Bucais/epidemiologia , Sarcoma/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteossarcoma/epidemiologia , Estudos Retrospectivos , Sarcoma de Kaposi/epidemiologia , Adulto JovemRESUMO
Metastases to the oral cavity are extremely rare events, representing less than 1% of all malignant oral tumors. Renal cell carcinoma constitutes about 3% of solid tumors in adults, and it is the most frequent kidney neoplasm, representing about 90% of kidney malignancies. Due to the silent growth of this neoplasm, most patients have no symptoms and the diagnosis is belated, usually after metastases. The present study reports an additional patient of metastatic renal cell carcinoma to the oral cavity regarding the clinical and pathologic features.
Assuntos
Carcinoma de Células Renais/secundário , Neoplasias Renais/patologia , Neoplasias Bucais/secundário , Boca/patologia , Adulto , Antineoplásicos/uso terapêutico , Biópsia , Carcinoma de Células Renais/diagnóstico , Carcinoma de Células Renais/terapia , Feminino , Humanos , Neoplasias Renais/terapia , Osteotomia Mandibular/métodos , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/terapia , Radiografia PanorâmicaRESUMO
Melanoma is a highly aggressive neoplasm in which the neoplastic cells display melanocytic differentiation. Less than 1 % of all melanomas arise in the mucosal surfaces of the oral cavity, with purely in situ lesions being exceedingly rare tumors, but with a favorable prognosis compared with invasive lesions. We describe the clinical, histopathological and immunohistochemical findings in an uncommon case of in situ mucosal melanoma of the oral cavity with intense tumor-associated pigment deposition and inflammation complicating the morphological assessment of infiltrative areas.
Assuntos
Neoplasias Gengivais/patologia , Melanoma/patologia , Biomarcadores Tumorais/análise , Feminino , Humanos , Imuno-Histoquímica , Inflamação/patologia , Pessoa de Meia-IdadeRESUMO
The phosphatidylinositol 3-kinase (PI3K)/Akt pathway has an anti-apoptotic effect through several downstream targets, which includes activation of the transformed mouse 3T3 cell double-minute 2 (Mdm2) protein, its translocation to the nucleus and degradation of the tumor suppressor p53. We show that Mif, the Macrophage Migration Inhibitory Factor, an important cytokine at the maternal fetal interface in several species, triggers phosphorylation of Mdm2 protein in a PI3K/Akt-dependent manner, thereby preventing apoptosis in cultured mouse decidual cells. Inhibition of Akt and PI3K suppresses the pathway. Mif treatment also changes the nuclear translocation of p53 and interferes with the apoptotic fate of these cells when challenged with reactive oxygen species. In conclusion, an important mechanism has been found underlying decidual cell survival through Akt signaling pathway activated by Mif, suggesting a role for this cytokine in decidual homeostasis and in the integrity of the maternal-fetal barrier that is essential for successful gestation.
Assuntos
Decídua/citologia , Fatores Inibidores da Migração de Macrófagos/farmacologia , Fosfatidilinositol 3-Quinase/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Proteínas Proto-Oncogênicas c-mdm2/metabolismo , Células 3T3 , Animais , Apoptose , Sobrevivência Celular , Feminino , Humanos , Troca Materno-Fetal/fisiologia , Camundongos , Fosforilação/efeitos dos fármacos , Gravidez , Transdução de Sinais/fisiologiaRESUMO
The present study aimed to evaluate the Fine Needle Aspiration Biopsy in different staining techniques in nodular lesions of the oral cavity and head and neck region, as their sensitivity, specificity and accuracy, staining with Panoptic, Papanicolaou and Hematoxylin-Eosin (H&E) stains. 46 patients who sought the Clinic of the Discipline of Clinical Stomatology at FOUSP were selected consecutively, with nodular lesions in the oral cavity and head and neck region. The material obtained by FNAB was sent on 6 different slides, stained by the method of Panoptic, Papanicolaou and H&E, to the same pathologist only with the clinical diagnosis. After the final report of FNAB, the biopsy report was issued, serving as gold standard. After the calculations, the results of sensitivity, specificity and accuracy for Panoptic staining were 28.6%, 76% and 15.4%, respectively. The result of sensitivity, specificity and accuracy for Papanicolaou staining were 71.4%, 76.7% and 23.3%, respectively. The result of sensitivity, specificity and accuracy for H&E staining were 82.1%, 23.3%, 28.6%, respectively. We can conclude, according to the methodology of this study that, H&E and Papanicolaou stains showed the same sensitivity of diagnosing malignant neoplasms. H&E stain showed a better specificity for diagnosing benign neoplasms, compared with Papanicolaou and Panoptic stains. H&E stain showed better accuracy, to give definitive diagnosis, followed by Papanicolaou and Panoptic stains.
Assuntos
Biópsia por Agulha Fina/métodos , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias Bucais/patologia , Boca/patologia , Pescoço/patologia , Coloração e Rotulagem/métodos , Adenoma Pleomorfo/patologia , Corantes , Amarelo de Eosina-(YS) , Reações Falso-Negativas , Reações Falso-Positivas , Feminino , Hematoxilina , Humanos , Masculino , Teste de Papanicolaou/métodos , Reprodutibilidade dos Testes , Neoplasias das Glândulas Salivares/patologia , Sensibilidade e EspecificidadeRESUMO
BACKGROUND: The aim of this study was to identify the expression of MCM3, Ki-67 and p27 in normal mucosa, leucoplakia and oral squamous cell carcinoma (OSCC) and determine whether altered expression could serve as a prognostic marker of a malignant progression of dysplastic lesions. METHODS: The samples were collected from 37 patients with oral leucoplakia (13 with mild dysplasia - MLD, 12 with moderate dysplasia - MD and 12 with severe dysplasia - SD). Eleven samples of mouth floor mucocele (M) and 50 floor mouth and tongue samples OSCC of untreated patients were included in this study. Immunohistochemical expression of MCM3, Ki-67 and p27 of all the groups was analysed. Kruskal-Wallis and Dunn's test were used to determine differences among groups, and a Pearson's correlation test was used to evaluate the correlation between the proteins. RESULTS: Ki-67 expression was higher in OSCC than M (P < 0.001) and MLD (P < 0.01) groups, and there was a lower expression in M compared with MD and SD (P < 0.05). Regarding p27, its expression was lower in OSCC compared with M, MD and SD. MCM3 expression was lower in M compared with SD and OSCC (P < 0.001), and MLD showed a lower expression when compared SD (P < 0.01) and OSCC (P < 0.001). Moreover, a better correlation was observed between the proteins MCM3 and p27 than between Ki-67 and p27 proteins when all lesions were examined together. CONCLUSIONS: This study showed that MCM3 could be a better marker than Ki-67 for evaluation of dysplastic oral lesions.
Assuntos
Biomarcadores Tumorais/análise , Antígeno Ki-67/análise , Componente 3 do Complexo de Manutenção de Minicromossomo/análise , Neoplasias Bucais/patologia , Lesões Pré-Cancerosas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/química , Carcinoma de Células Escamosas/patologia , Transformação Celular Neoplásica/patologia , Inibidor de Quinase Dependente de Ciclina p27/análise , Progressão da Doença , Epitélio/química , Epitélio/patologia , Feminino , Humanos , Imuno-Histoquímica , Leucoplasia Oral/química , Leucoplasia Oral/patologia , Masculino , Pessoa de Meia-Idade , Soalho Bucal/química , Mucosa Bucal/química , Neoplasias Bucais/química , Mucocele/metabolismo , Mucocele/patologia , Lesões Pré-Cancerosas/química , Prognóstico , Inibidores de Proteínas Quinases/análise , Fumar/metabolismo , Fumar/patologia , Neoplasias da Língua/química , Neoplasias da Língua/patologiaRESUMO
The calcifying odontogenic cystic tumor (CCOT) is a benign lesion of odontogenic origin characterized by an ameloblastoma-like epithelium with ghost cells that may calcify. Despite broadly considered as a cyst, some investigators prefer to classify it as a neoplasm. Clinically, it occurs predominantly during the third decade of life. No difference in gender prevalence has been observed nor predilection of the lesion between maxilla and mandible. The most affected region extends from the incisor tooth to bicuspids. The classic treatment of the lesion is full excision, although a different approach may be determined by the possible association with another odontogenic tumor. Depending on the tumor size and the vicinity with important structures, decompression may be undertaken before its complete removal. The present report describes a case of CCOT with large proportions, located at the right maxilla and extending to the maxillary sinus, nasal cavity, and orbital floor. The treatment option was surgical decompression as the initial procedure, with satisfactory outcome. After partial remission, the lesion was fully removed, and the post-operative follow-up was uneventful.
RESUMO
Canalicular adenoma (CA) is an uncommon benign salivary gland tumor that mostly occurs in the upper lip. Despite its benign nature, some patients may present multiple nodules and also microscopic growth that can be multifocal with foci of tumor within the adjacent gland. Microscopically, CA can be mistaken for a polymorphous low-grade adenocarcinoma (PLGA) or basal cell adenoma (BCA), and immunohistochemistry can be helpful in differentiating them. Two cases of canalicular adenoma showing tumor foci within the adjacent gland are described. Both cases occurred in the upper lip of white females aged 72 and 79 years. In addition to the histological multifocal aspect, one of the patients presented bi-lateral nodules. Histological examination of both lesions revealed interconnecting and branching canal-like structures composed by uniform columnar and sometimes cuboidal cells, partially encapsulated. Immunohistochemical analysis showed intense expression of cytokeratins (CK) 7, a weak reaction to CK14 and a negative reaction to vimentin. Upon the diagnosis of CA the lesions were excised. In conclusion, it is important to properly diagnose CA and differentiate its multifocal aspect from a malignant behavior.
Assuntos
Adenoma/patologia , Neoplasias Labiais/patologia , Adenoma/cirurgia , Idoso , Feminino , Humanos , Neoplasias Labiais/cirurgiaRESUMO
Oral leukoplakias (OL) are potentially malignant lesions that are typically white in color. Smoking is considered a risk factor for developing OL, and dysplastic lesions are more prone to malignant transformation. The aim of this study was to describe the clinical features observed in dysplastic and non-dysplastic OL in both smokers and non-smokers. A total of 315 cases of OL were retrieved and separated into either dysplastic or non-dysplastic lesions, and these cases were further categorized as originating in either smokers or non-smokers. Frequencies of the type of OL lesion, with respect to whether the patients smoked, were established. The results demonstrated that 131 cases of OL were dysplastic (74 smokers and 57 non-smokers), and 184 were non-dysplastic (96 smokers and 88 non-smokers). For OL cases in smokers for which information about alcohol consumption was also available (84 cases), the results revealed no significant difference in the amount of dysplastic and non-dysplastic lesions. Dysplastic lesions were more frequent in male smokers and in non-smoking females. The median age of smokers with cases of OL was significantly lower than in non-smokers; the lowest median ages were observed for female smokers with dysplastic OL. The most frequent anatomical sites of dysplastic lesions were the floor of the mouth in smokers and the tongue in non-smokers. Dysplastic lesions in smokers were significantly smaller than non-dysplastic lesions in non-smokers. Being a male smoker, being female, being younger, and having smaller lesions were associated with dysplastic features in OL. These clinical data may be important for predicting OL malignant transformation.
Assuntos
Leucoplasia Oral/patologia , Fumar/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Distribuição de Qui-Quadrado , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Fumar/efeitos adversos , Estatísticas não Paramétricas , Língua/patologiaRESUMO
The central granular cell odontogenic tumor (CGCOT) is a rare benign odontogenic neoplasm composed of varying amounts of large eosinophilic granular cells and apparently inactive odontogenic epithelium. It tends to occur as a small asymptomatic swelling in the posterior region of the mandible with nonaggressive appearance. We report an unusual case of CGCOT in the maxillary region with clinical features of malignancy. The patient underwent surgical treatment, and the 2-year follow-up revealed no signs of recurrence. Central granular cell odontogenic tumor is a very rare condition with few cases reported, especially in the maxillary region. This case highlights the possibility of aggressive behavior by these lesions.