Malignant Transformation of Actinic Cheilitis: A Decade-long Retrospective Study in Southern Brazil.

Background: Actinic cheilitis (AC), an oral potentially malignant oral disorder (OPMD), predominantly affects fair-skinned individuals, particularly males, with a higher prevalence in their sixth and seventh decades. In the Southeast region of Brazil, oral cancer ranks as the fourth most common tumor among males, with squamous cell carcinoma (SCC) constituting 90% to 95% of lip tumor cases, primarily impacting the lower lip. This retrospective study aims to evaluate the malignant transformation rate in previously diagnosed AC patients between 2008 and 2018, utilizing biopsy records. Material and Methods: We retrospectively reviewed medical records of lip lesion patients at the Department of Oral and Maxillofacial Surgery (DOMS) during the stated period, collecting demographic and medical data for analysis. Results: Among the 224 analyzed AC cases, 67.8% were male, with an average age of 65 years. Approximately 87.6% of patients reported occupational exposure to AC-associated risk factors. Malignant transformations occurred in 27 patients (12.05%). Conclusions: Our study underscores the possible effect of early intervention and preventive measures in stabilizing AC lesions and averting their progression to malignancy. These findings underscore the significance of prompt AC diagnosis and management to mitigate the risk of malignant transformation. Key words:Actinic cheilitis, oral squamous cell carcinoma, malignant transformation.

Comparison of Immunohistochemistry and DNA Sequencing for BRAF V600E Mutation Detection in Mandibular Ameloblastomas.

This study aimed to investigate the presence of BRAF V600E mutation in mandibular ameloblastoma by comparing the results of molecular detection and immunohistochemical analysis. A 128 cases of mandibular ameloblastoma and 30 cases of dentigerous cyst (control group) were selected for analysis. Detection of BRAF V600E mutation was performed with immunohistochemistry (IHC) and polymerase chain reaction techniques. Clinico-pathologic data were collected in order to investigate possible associations with the mutation. Of the 128 cases submitted to IHC, 81.2% (108 cases) showed positivity for anti-BRAF V600E antibody, whereas 24 were negative (18.8%). Molecular analysis of the BRAF V600E mutation by polymerase chain reaction was possible in 116 cases due to DNA quality. Of these cases, 96 were positive (82.8%) and 20 negative (17.2%). All cases of dentigerous cyst were negative for BRAF V600E mutation in both techniques. Considering the sequencing as a gold standard method, the receiver operating characteristics curve analysis showed sensitivity of 0.99 and specificity of 1 (area under the curve=0.995, standard error=0.006; P<0.001; 95% confidence interval=0.983 to 1). We also tested the agreement between the techniques by using the Cohen's κ coefficient, with κ being 0.97 (P<0.001). IHC is a reliable test for identifying the BRAF V600E mutation in ameloblastomas, presenting advantages such as being more frequently used in surgical pathology laboratories and requiring fewer critical steps for paraffin-embedded tissue compared with molecular biology techniques.

Accuracy, Sensitivity and Specificity of Fine Needle Aspiration Biopsy for Salivary Gland Tumors: A Retrospective Study from 2006 to 2011

Objective: This article concerns evaluation of the sensitivity, specificity and accuracy of FNAB for pre-surgical diagnosis of benign and malignant lesions of major and minor salivary glands of patients treated in the Department of Head and Neck Surgery of Erasto Gartner Hospital. Methods: This retrospective study analyzed medical records from January 2006 to December 2011 from patients with salivary gland lesions who underwent preoperative FNAB and, after surgical excision of the lesion, histopathological examination. Results: The study had a cohort of 130 cases, but 34 cases (26.2%) were considered unsatisfactory regarding cytology analyses. Based on the data, sensitivity was 66.7% (6/9), specificity was 81.6% (71/87), accuracy was 80.2% (77/96), the positive predictive value was 66,7% (6/9) and the negative predictive value was 81.6% (71/87). Conclusion: Despite the high rate of inadequate samples obtained in the FNAB in this study the technique offers high specificity, accuracy and acceptable sensitivity.

Unusual presentation of oral amyloidosis.

Amyloidosis is a rare disease of difficult diagnosis that occurs due accumulation of amyloid substance localized or systemic. The oral cavity is an unusual site and can be related to both localized and systemic forms and for that reason a full investigation is necessary to determine the extent of the disease. This study reports a case of a 58-year-old melanoderm male patient referred to the Department of Oral and Maxillofacial Surgery with white plaques on the tongue and multiple nodules in the region of the buccal mucosa and labial commissure, with 6 months of evolution and painful symptoms. An incisional biopsy was performed on both sites and histological examination indicated the presence of eosinophilic amorphous material within the connective tissue, positive for crystal violet staining, consistent with amyloidosis. At the present time, there is no consensus on the management of local amyloidosis. Surgical treatment of localized forms is indicated in some cases to reduce the functional prejudice. Moreover, follow-up is mandatory, both to manage recurrences and to monitor the possible evolution of the disease to the systemic form.

Retrospective study of 25 cases of keratocystic odontogenic tumor: epidemiology and treatment.

AIM: Keratocystic odontogenic tumor (KOT) is a benign odontogenic neoplasm with locally aggressive behavior and high recurrence rates. It is associated with nevoid basal cell carcinoma syndrome which usually has a more rapid growth. The aim of the study is to report the experience of our service on diagnosis and treatment of KOT. MATERIALS AND METHODS: Twenty-five cases of KOT were diagnosed between the years of 1989 and 2006. Demographic data was collected as well as diagnose and treatment. RESULTS: Fifty-six percent were female with a mean age of 33 years old. Seventy percent occurred in mandibula and all received surgical treatment, associate or not with adjuvant therapy, such as cryotherapy and Carnoy's solution. Recidive was observed in 48% of cases with a mean period of time of 18 months. CONCLUSION: Our data analysis showed the importance of previous diagnosis before enucleation procedure and long-term follow-up for recurrence early detection. Recurrence incidence is more frequent on first year after diagnosis. CLINICAL SIGNIFICANCE: KOT is a benign tumor with local aggressive behavior and therefore its treatment must consider the high index of recidive. Reports of protocol treatment should raise new discussion to decrease recurrence rates.

Linfoma De Burkitt / Burkitt's Lymphoma

Introdução: o linfoma pertence ao grupo dos linfomas não-Hodgkin, apresentando condições malignas heterogêneas que surgem de células muito diversificadas do sistema imunológico, tendo origem no linfócito B. Acomete principalmente crianças. Relato de Caso: paciente masculino, com cinco anos de indade, caucasiano, apresentou-se com aumento de volume em hemiface esquerda com trinta dias de evolução, indolor de crescimento rápido. Não foram notadas alterações dentárias. Observou-se abaulamento em hemiface esquerda. A tomografia computadorizada mostrou uma lesão destrutiva de aspecto sólido, acometendo a porção alveolar da mandíbula bilateralmente e as paredes de ambos os seios maxilares, invadindo os antros. A análise cromossômica mostrou o linfoma de Burkitt. O tratamento foi quimioterápico, observando-se redução da lesão após a vigésima sessão. O paciente permanece sem sinal de doença, decorridos cinco anos do início do tratamento. Discussão: esse tipo de linfoma é de crescimento rápido, etiologia incerta, mas com provável envolvimento do vírus Epstein-Barr e origem genética. A lesão tem uma predominância em crianças, com ocorrência maior em meninos. Apresenta duas subclasses, a forma endêmica ou africana e a forma não endêmica ou amaericana; alguns autores citam uma terceira subclasse que seria associada com imunodeficiência adquirida. No entanto, todos esses subtipos são idênticos histologicamente, diferenciando-se apenas nas características epidemiológicas e biológicas.

Introduction: burkitt's lymphoma belongs to the group of the Non-Hodgkin's lymphomas. It presents heterogenic malignant conditions that usually stem from highly diversified cells of the immune system, having their origin in B lymphocytes. Case report: a male Caucasian 5-year-old patient presented a painless growth on his left hemiface for 30 days. No dental disorders were found. The extraoral exam showed a lump in his left hemiface. The computed tomography showed a solid-looking destructive lesion in the alveolar region of the mandible (bilaterally), left mandibular ramus, maxilla (bilaterally), and the walls of both maxillary sinuses, reaching the antra. The Burktt's lymphoma diagnosis was confirmed through the chromosome analysis. The treatment consisted of 20 sessions of chemotherapy, with tumor reduction. The patient remains disease-free after 5 years from the begining of the treatment. Discussion: this kind of lymphoma is a fast-growing tumor whose etiology is uncertain, but which may have association with the Epstein-Barr virus, and/or with genetic conditions. It is a childhood tumor afflicting mainly the boys. It has 2 subclasses, the endemic (or African) form, and the non-endemic (or American) one. Some authors claim that there is a third subclass which would be associated to acquired immunodeficiency. Despite that, all subtypes present identical histology with different epidemiologic and biologic features.