RESUMEN
Oral focal mucinosis (OFM) is a rare lesion first described in 1974, but the aetiology remains unknown. Clinically, OFM presents as an asymptomatic nodular lesion and the similarity of clinical features to other soft tissue injuries makes the diagnosis difficult. The aim of this study was to integrate the demographic, clinical, and histopathological characteristics from previously published cases of OFM into a systematic review. Electronic searches without publication date restriction were performed in the following databases: Embase, PubMed, Medline, Web of Science, and Scopus. Case reports or case series of OFM published in English and presenting enough clinical and histopathological information were included. This systematic review identified 42 studies from 12 countries, comprising 113 cases of OFM. This lesion affected more females than males, usually in the fourth decade of life. The gingiva was the most common anatomical location, followed by the palate. Clinical presentation was most often an asymptomatic nodule. Imaging exams revealed that most cases did not have bone involvement. Surgical removal was the treatment of choice for most cases and only one recurrent case was reported. In conclusion, OFM is an uncommon pathology, and its diagnosis depends on histopathological analysis. The lesion could be included as a differential diagnosis of benign soft tissue lesions of the oral cavity, especially those affecting the gingiva.
RESUMEN
INTRODUCTION: The aim of this study was to perform an audit of oral and maxillofacial specimens submitted for cytological diagnosis to verify the importance of this complementary examination. METHODS: A retrospective analysis of our institutional cytopathology database was performed over an 18-year period. Clinical information and cytological data were collected. Associations between independent variables and outcomes were assessed using the Pearson χ2 test or Fisher's test, with a 5% significance level. When available, the histological diagnosis was compared with cytological diagnosis to identify the percentage of agreement and the specificity, sensitivity and accuracy of cytology in identifying malignant neoplasms. RESULTS: A total of 1082 cases were identified, which included 65 different cytological diagnoses. Exfoliative cytology (EC) was performed in 312 cases (29.1%) and fine needle aspiration cytology (FNAC) in 770 cases (70.9%). EC was mainly employed to diagnose oral infectious diseases (P < 0.001) and FNAC to diagnose neoplasms, cystic, reactive and miscellaneous lesions (P < 0.001). Cell-block was performed in 555 FNAC cases (51.3%). Panoptic, Papanicolaou and haematoxylin-eosin staining were performed in FNAC and periodic acid-Schiff in EC (P < 0.001). In 211 cases (19.5%), the histological diagnosis was available and the percentage agreement with the cytological diagnosis was 41.2%. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy to identify malignant neoplasms were 84.6%, 100%, 100%, 77.8% and 90.0%, respectively. CONCLUSIONS: EC was mainly performed for diagnosis of infectious diseases and FNAC for diagnosis of salivary gland tumours, odontogenic lesions, reactive lesions and cervical metastasis.
