Objective
To report the clinicopathologic features of acquired oral syphilis cases in South American countries.
Materials and Methods
Clinical data were retrospectively collected from the records of ...18 oral diagnostic services in Argentina, Brazil, Chile, Colombia, Venezuela, Uruguay, and Peru. Serologies of nontreponemal and treponemal tests were used for diagnosis.
Results
The series comprised 339 cases of acquired oral syphilis. Secondary syphilis ranked as the most common stage (86.7%). Lesions were more frequent among males (58.0%) and young adults with a mean age of 33.3 years. Individuals aged 20–29 years were most affected (35.3%). The most commonly involved sites were the tongue (31.6%), lip/labial commissure (25.1%), and hard/soft palate (20.4%). Clinically, acquired oral syphilis usually presented as mucous patches (28.4%), papules (25.7%), and ulcers (18.1%). Skin manifestations occurred in 67.7% of individuals, while lymphadenopathy and fever were observed in 61.3% and 11.6% of all subjects, respectively. Most patients were treated with the benzathine penicillin G antibiotic.
Conclusion
This report validates the spread of acquired oral syphilis infection among young adults in South America. Our directives include accessible diagnostic tools for proper disease screening, surveillance, and counselling of affected individuals, especially in low‐ and middle‐income countries.
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CMK, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Background
The diagnosis of oral and maxillofacial mature T/NK‐cell neoplasms is challenging because of their rarity, morphological heterogeneity and complex immunophenotype with scarce available ...data describing their clinical and microscopic aspects. Therefore, in this study, we investigated a series of mature T/NK‐cell neoplasms affecting this anatomical region and provided an updated literature review.
Methods
Cases diagnosed as mature T/NK‐cell lymphomas affecting the oral and maxillofacial region were retrospectively retrieved from six pathology files and their diagnoses were confirmed using haematoxylin and eosin‐stained slides, immunohistochemical reactions and in situ hybridization for Epstein‐Barr virus (EBV) detection. Patients’ clinical data were collected from their pathology forms.
Results
A total of 22 cases were included in this study. Eleven (50%) consisted of extranodal NK/T‐cell lymphomas, nasal type; eight (36.4%) were peripheral T‐cell lymphomas, NOS; two (9.1%) were adult T‐cell leukaemia/lymphomas, and one (4.5%) was an ALK‐positive anaplastic large cell lymphoma. Overall, males predominated, with a mean age of 55.7 years. The palate was the most affected site (50%), and tumours usually presented as destructive and painful ulcers. EBV was present in all cases of extranodal NK/T‐cell lymphoma nasal type but was absent in the other subtypes.
Conclusion
Among mature T/NK‐cell lymphomas of the oral and maxillofacial region, extranodal NK/T‐cell lymphoma, nasal type and peripheral T‐cell lymphoma, NOS predominated. Older men were the most affected patients, and this heterogeneous group of neoplasms has a very aggressive clinical behaviour.
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CMK, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Peripheral odontogenic keratocyst (POKC) is a rare soft tissue entity showing the same histological characteristics of odontogenic keratocyst. Herein, we report two cases of POKC affecting the ...gingiva/alveolar mucosa. Case 1. A 43-year-old female was referred for evaluation of a painless well-defined nodular, sessile, non-tender swelling in the right maxillary buccal gingiva. No radiological alterations were observed. The patient was submitted to excisional biopsy and histological diagnosis was POKC. There were no signs of local recurrence after a 4-year follow-up. Case 2. A 63-year-old female was referred for evaluation of a painless well-defined nodular, sessile, yellowish swelling in the anterior mandibular alveolar mucosa. No radiological alterations were observed. The patient was submitted to excisional biopsy and histological diagnosis was POKC. Patient recovery was uneventful but she did not return for follow-up. POKC should be considered in the differential diagnosis of gingival cystic swellings and can be managed through conservative surgery.
Key words:
Odontogenic keratocyst, peripheral, gingiva, alveolar mucosa.
Melanoma is an aggressive malignant tumor, rarely observed in the oral cavity. The aim of this study was to describe the clinicopathologic features of a series of oral melanomas.
A retrospective ...descriptive study was performed. A total of 15,482 biopsy records from two oral and maxillofacial pathology services in Brazil were analyzed. All cases of oral melanomas were reviewed, and clinical, demographic, histopathological data, treatment, and follow-up status were collected. In addition, immunohistochemistry stains (pan-cytokeratin AE1/AE3, vimentin, α-SMA, CD45, S-100 protein, HMB-45, Melan A, and Ki-67) were performed.
The series comprised of 5 males (71.4%) and 2 females (28.6%), with a mean age of 58.0 ± 9.2 years (range: 45-69 years) and a 2.5:1 male-to-female ratio. The gingiva (n = 3, 42.8%) and hard palate (n = 2, 28.6%) were the most common affected sites, presenting clinically as ulcerated swellings with a brown to black color. Cervical lymph node metastasis was detected in three patients during the first examination. Microscopically, 6 cases (85.7%) were melanotic, and one (14.3%) was amelanotic. Most cases (n = 4, 57.1%) presented a predominance of epithelioid cells. S-100 and HMB-45 were positive in all cases (n = 7, 100.0%). In contrast, only 4 cases (57.1%) were positive for Melan-A. The proliferative index with Ki-67 was high, with labeling index ranging from 70.0% to more than 90% of positive cells. Five patients died from complications of the tumors after a mean follow-up period of 7.8 months.
Melanoma is an aggressive malignant tumor that rarely occurs in the oral cavity. It occurs mainly in adult and elderly patients and often is diagnosed in advanced stages. The current findings were similar to previous studies and reflected the characteristics of the services from where lesions were retrieved.
LARGE DERMOID CYST OF THE FLOOR OF THE MOUTH RODRIGUES, Bruno Teixeira Gonçalves; GALM, Nathália da Fonseca; ISRAEL, Mônica Simões ...
Oral surgery, oral medicine, oral pathology and oral radiology,
June 2024, Volume:
137, Issue:
6
Journal Article
Peer reviewed
Dermoid cysts (DC) of the head and neck are relatively rare, presenting as a slow-growing and painless mass, usually located in the floor of the mouth at the midline. However, when they reach large ...proportions, they can cause dysphagia, dysphonia, and dyspnea. Herein, we report a case of a 23-year-old male presenting with a painless swelling in the floor of the mouth. Magnetic resonance imaging revealed the location of the lesion above the mylohyoid muscle, between the geniohyoid muscles. The patient was submitted to an excisional biopsy under general anesthesia, and histopathology revealed a cyst lined by a keratinizing squamous epithelium, containing adnexal structures in the wall, confirming the diagnosis of DC. There were no signs of local recurrence on the follow-up. DC should be considered in the differential diagnosis of the floor of the mouth swellings.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Oral paracoccidioidomycosis (PM) is chronic granulomatous disease caused by the dimorphic fungus Paracoccidioidis brasiliensis that often presents clinically as a painful and bleeding ulcer - ...resembling a malignant lesion. Therefore, we report a case of a 56-year-old male that was referred for evaluation of an oral ulcer. Extraoral physical exam showed no alterations. Intraorally, an extense bleeding and painful ulcer was observed extended from the lower lip to the left buccal mucosa, crossing the mouth floor. The patient had no systemic disease and was a regular smoker. An incisional biopsy was performed under local anesthesia and histological diagnosis was PM. The patient was referred to the infectologist for treatment. PM should be considered in the differential diagnosis of oral ulcers.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Calcifying odontogenic cyst (COC) is an uncommon intraosseous lesion with almost equal frequency in the maxilla and mandible. Therefore, we report a case of a 17-year-old male presenting with a ...painless swelling on the left hemiface. A computed tomography exam revealed a well-defined unilocular radiolucency with focal areas of radiopacity associated with an impacted upper left lateral incisor, extending from the apical region of tooth 62 posteriorly to the left maxillary sinus. An incisional biopsy was performed, and the histopathologic analysis was characterized by a cystic lesion lined by ameloblastoma-like epithelium with the presence of ghost cells and calcifying material consistent with the diagnosis of COC. The patient was referred for surgical treatment and removal of the impacted tooth, under general anesthesia. Patient recovery was uneventful, and no signs of recurrence were observed in the follow-up. COC is a benign odontogenic lesion with a good prognosis when surgically excised.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
8.
BROADCASTING SCIENTIFIC KNOWLEDGE ON SOCIAL MEDIA—ORAL DISEASES Valvano, Beatriz Menegon; Da Silva, Júlia Braga; Da Silva Coelho, Andressa ...
Oral surgery, oral medicine, oral pathology and oral radiology,
September 2022, 2022-09-00, Volume:
134, Issue:
3
Journal Article
Peer reviewed
The aim of this study was to facilitate access to information for the general population about the specialty of oral medicine and the main diseases that affect the mouth.
In December 2020, an account ...was created on the social media Instagram, and posts about the main oral diseases were published weekly. Along with these posts, podcasts were recorded on the same subject, which were carried out by the project team and by invited specialists.
Currently, 1990 followers, 3202 likes, and 179 shares have been made on Instagram, resulting in the reach of 1951 accounts and 14,326 impressions in the last 30 days. Regarding podcasts, 31 episodes were released, 15 in Portuguese, 8 in English, and 8 in Spanish. A total of 526 plays were obtained, 432 for episodes in Portuguese, 67 for English, and 27 for Spanish. The age range of the listeners ranges from 17 to 60 years old.
The association between social media and scientific knowledge has positive points for the dissemination of relevant information to the population, allowing access to scientific information in an easily understood way.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
9.
DIAGNOSIS OF ADULT T-CELL LYMPHOMA/LEUKEMIA FROM ORAL INJURY Barreto, Maria Eduarda Zeraik; De Almeida Freire, Nathália; Romañach, Mário José ...
Oral surgery, oral medicine, oral pathology and oral radiology,
September 2022, 2022-09-00, Volume:
134, Issue:
3
Journal Article
Peer reviewed
Adult T-cell lymphoma/leukemia (ATL) is a rare and aggressive peripheral variant, specific to T-cell non-Hodgkin's lymphoma. One of the criteria for the diagnosis of ATL is positive serology for ...human type 1 lymphotropic virus (HTLV). This study reports a rare presentation of ATL in a 36-year-old female patient. The diagnosis was obtained by means of histopathologic and immunohistochemical aspects (positivity for CD3 and negativity for ALK and EMA, with Ki-67 of 80%) and positivity in the anti-HTLV exam. The patient underwent 3 chemotherapy sessions. After an emergency hospitalization, the patient died. In view of its aggressiveness and its potentially fatal behavior, it is important to know the signs and symptoms of lymphoma so the diagnosis can be made early.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Sialolithiasis is defined as the development of stones within the parenchyma or ducts of the salivary glands, and it frequently affects the submandibular gland duct of male adults. We report a case ...of sialolithiasis occurring in the submandibular gland parenchyma and its surgical treatment. A 44-year-old male patient was referred for evaluation of a painful swelling in the submandibular region with 1-week evolution. The extraoral examination revealed a volume growth in the right submandibular region. Intraorally, there were no alterations. The panoramic radiography revealed a well-defined radiopaque lesion measuring approximately 2.5 cm. The clinical and radiographic findings established the sialolithiasis diagnosis. The treatment consisted of the excision of both sialolith and the right submandibular gland due to its location in the parenchyma, under general anesthesia, using an extraoral submandibular approach. The specimen was subsequently sent to the laboratory for histologic confirmation. The patient's recovery was uneventful.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP