Tongue cancer in non-smoking and non-alcoholic mother and daughter.

Tongue cancer is more prevalent in male smokers and alcoholics. Although an increased incidence of tongue cancer has been noted in non-smoking and non-alcoholic women, reports of its occurrence in mother and daughter are extremely rare. Here, we report a case of a non-smoking and non-alcoholic mother and her daughter diagnosed and treated surgically for tongue squamous cell carcinoma (SCC). The daughter is still being monitored and the mother died from complications from COVID-19 after 6 years of treatment. This report shows that OSCC should be considered in the differential diagnosis of oral ulcerated lesions in non-smoking and non-alcoholic women, especially if there is a family history of first-degree oral cancer.

Bilateral intra-lymph node Warthin's tumor as a potential diagnostic pitfall mimicking metastatic carcinoma.

Warthin's tumor (WT) is a benign and frequent salivary gland tumor primarily affecting the parotid gland. In some cases, this tumor can involve the extra parotid region and affect cervical lymph nodes. Fine-needle aspiration can be the first step in the diagnostic approach to lymphadenopathy; however, specimens from intra-nodal WT can present a potential pitfall, leading to a misdiagnosis of metastasis. Here, we report an unusual case of a patient with bilateral WT in parotid lymph nodes misdiagnosed as metastases. In addition, we highlight the cytopathological aspects of WT to alert cytopathologists about this challenging diagnosis.

Clinicopathological and prognostic profile of non-smoking and non-drinking head and neck cancer patients: a population-based comparative study.

Tobacco and alcohol consumption are the main risk factors for head and neck cancer (HNC). However, some individuals do not have a history of addiction and even so they develop the disease. This study evaluated clinicopathological and prognostic features of non-smoking and non-drinking (NSND) HNC patients. A sample of smoking and/or drinking (SD) HNC patients was used to explore the differences with NSND patients. Data were obtained from 667 patients with squamous cell carcinoma in oral cavity, oropharynx or larynx. The group of NSND individuals represented 12.6% of the HNC patients and had higher prevalence of women and elderly compared to SD group. Among NSND patients, most of them displayed tumors in oral cavity, advanced clinical staging and absence of second primary tumor. NSND HNC patients had higher tumor recurrence and increased overall and specific survival rates at 5-years follow-up. The NSND group showed higher prevalence of tumors in lips and alveolar ridge, lower rate of tumors in floor of mouth and no tumor in soft palate. NSND patients show a distinct profile from that found in SD patients. Clinicopathological features from NSND patients should be considered for HNC management.

In situ melanoma of oral cavity: Diagnosis and treatment of a rare entity.

Oral melanoma is an extremely aggressive and rare tumor. Commonly, oral melanomas are diagnosed as invasive tumors, which considerably reduces the chances of cure. In situ oral melanomas being exceedingly rare, which makes its clinicopathological and prognostic characteristics poorly known. Herein, we report a case of 67-year-old non-white woman with a large black patch on the maxillary alveolar mucosa. A biopsy was made and microscopical analysis revealed moderate atypical junctional melanocytic. Tumor cells were positive for S100 (Polyclonal), Melan-A (Clone A103) and Melanosome (HMB-45). The diagnosis of in situ oral melanoma was made and the patient was treated surgically with partial maxillectomy and rehabilitated with obturator prosthesis. Although extremely rare in situ melanomas should be considered in the differential diagnosis of non-invasive pigmented lesions of the oral mucosa.

Multifocal papillary carcinoma of the thyroid with heterotopic ossification and extramedullary hematopoiesis associated with a lipomatous follicular nodule.

Heterotopic ossification has been described in papillary thyroid carcinoma in association with high incidence of extrathyroidal invasion, multifocality, lymph node metastasis, and older age. Nevertheless, it has not been described as a specific subtype of papillary thyroid carcinoma, because of its rarity. We described the case of an 80-year-old female patient, with familial history of papillary thyroid carcinoma. In the annual screening examination, she was diagnosed with thyroid nodules. The patient was submitted to a thyroidectomy because the fine needle aspiration cytology was positive for malignancy according to the Bethesda classification. The surgical specimen analyses showed a multifocal papillary carcinoma with one major lesion in the left lobe measuring 0.9 cm, and two small lesions (0.4 cm and 0.2 cm) in the right lobe. Only the biggest lesion in the right lobe had the osteoid matrix with rare osteoclasts and fat metaplasia with progenitor cells. There was perineural invasion, but vascular invasion was not identified. The margins were free and there was no extrathyroidal extension. In the left lobe there was an oncocytic nodule and a lipomatous follicular nodule. In recent years there has been a significant increase in the diagnosis of thyroid cancer, mainly because of the finding of microcarcinomas as a result of many requests for cervical image exams. Future studies may define (i) whether papillary thyroid carcinoma with heterotopic ossification is a true histological variant; (ii) the causes of that alteration; and (iii) eventual follow-up implications.

Multifocal papillary carcinoma of the thyroid with heterotopic ossification and extramedullary hematopoiesis associated with a lipomatous follicular nodule

Heterotopic ossification has been described in papillary thyroid carcinoma in association with high incidence of extrathyroidal invasion, multifocality, lymph node metastasis, and older age. Nevertheless, it has not been described as a specific subtype of papillary thyroid carcinoma, because of its rarity. We described the case of an 80-year-old female patient, with familial history of papillary thyroid carcinoma. In the annual screening examination, she was diagnosed with thyroid nodules. The patient was submitted to a thyroidectomy because the fine needle aspiration cytology was positive for malignancy according to the Bethesda classification. The surgical specimen analyses showed a multifocal papillary carcinoma with one major lesion in the left lobe measuring 0.9 cm, and two small lesions (0.4 cm and 0.2 cm) in the right lobe. Only the biggest lesion in the right lobe had the osteoid matrix with rare osteoclasts and fat metaplasia with progenitor cells. There was perineural invasion, but vascular invasion was not identified. The margins were free and there was no extrathyroidal extension. In the left lobe there was an oncocytic nodule and a lipomatous follicular nodule. In recent years there has been a significant increase in the diagnosis of thyroid cancer, mainly because of the finding of microcarcinomas as a result of many requests for cervical image exams. Future studies may define (i) whether papillary thyroid carcinoma with heterotopic ossification is a true histological variant; (ii) the causes of that alteration; and (iii) eventual follow-up implications.

Gingival metastasis from salivary duct carcinoma of the parotid gland.

BACKGROUND: This article reports a rare case of metastasis of salivary duct carcinoma of the parotid gland to the gingiva and reviews the occurrence of metastatic processes to the oral mucosa. METHODS: A 67-year-old white male presented with a chief complaint of a painless nodular tissue growth on the gingiva with reportedly 5 months of evolution. The intraoral examination revealed a reddish, superficially ulcerated nodular lesion ( approximately 2 cm in diameter) on the right mandibular buccal attached gingiva, and the clinical aspect was that of a benign reactive lesion. The patient had undergone a parotidectomy for removal of a salivary duct carcinoma of the parotid gland almost 1 year before. A biopsy of the gingival lesion was performed, and the biopsied tissue was forwarded for histopathologic examination. RESULTS: The analysis of the histopathologic sections of the gingival lesion revealed histomorphologic characteristics very similar to those of the primary parotid gland tumor. The definitive diagnosis was gingival metastasis from a salivary duct carcinoma of the parotid gland. The patient died of complications of a pulmonary metastasis 1 month after the diagnosis of the oral metastatic lesion. CONCLUSIONS: Gingival lesions that mimic reactive and hyperplastic lesions may be metastases from malignant neoplasias of diverse origins. An accurate and timely diagnosis is crucial to establish proper and immediate treatment of the metastatic tumor and possibly identify an occult primary malignant neoplasia.

Perfil de pacientes acometidos por câncer de laringe atendidos no Centro de Oncologia Bucal-UNESP / Patients' profile attack for laryngeal cancer attended in Oral Cancer Center-UNESP

Um estudo foi realizado no Centro de Oncologia Bucal da Universidade Estadual Paulista, Campus de Araçatuba. Entre 88 casos de câncer atendidos no Centro de tratamento oncológico entre 1991 e 2003, 80 casos de câncer de laringe foram identificados em homens. Sexo, idade, uso de tabaco e ßlcool, realização de cirurgia e tratamentos oferecidos após a cirurgia foram dados obtidos de pacientes com um questionßrio padrão. O maior número de casos de câncer de laringe ocorreu em região glótica e necessitou de intervenção cirúrgica (laringectomia parcial ou total). A freqüência de câncer de laringe foi mais alta em fumantes e foi mais comum em idade entre 50 e 69 anos. O tratamento fonoaudiológico e a utilização de prótese estética ainda estão restritos a menor porcentagem dos pacientes.

Reconstrução da pirâmide nasal com prótese / Reconstruction of nasal pyramid with prosthesis

Os autores descrevem uma técnica de confecção de prótese nasal, em que o modelo do nariz do paciente, antes da perda, serviu como base para a escultura e modelagem desse órgão. O método proposto facilita sessões clínicas e viabiliza uma reprodução mais próxima à fisionomia do paciente.

Coristoma osteocartilaginoso de língua: relato de caso / Osteocartilaginous choristoma of the tongue: report of a case

Os autores descrevem um caso de coristoma osteocartilaginoso localizado no dorso da língua. Foi revisada a literatura, as características clínicas e histopatológicas e sua patogênese