Study of the causes of facial fractures in a reference center in Rio de Janeiro, Brazil from 2003-2012.

OBJECTIVE: This study describes the facial fractures of patients at a reference center in oral and maxillofacial surgery of a Public University Hospital in the city of Rio de Janeiro, from January 2003 to December 2012. METHODS: The data were collected from medical records and included the fractured bones, etiology, gender, and age of the patients. A total of 202 cases were identified, and 159 were included in the study (129 men and 30 women). RESULTS: The mandible was the most commonly injured bone (90 cases, 73 men and 17 women) with a mean age of 33.7 years old (±15.2), and traffic accidents (75 cases) were shown to be the major cause. CONCLUSION: In the city of Rio de Janeiro, young men in their fourth decade of life are prone to trauma to their facial bones, especially the mandible, and they are most commonly caused by traffic accidents.

Myeloid sarcoma of the oral cavity: A case report and review of 89 cases from the literature.

Myeloid sarcoma is a tumor mass of immature myeloid or granulocytic cells that affects extramedullary anatomic sites, including uncommonly the oral cavity. A 24-year-old female was referred for evaluation of a fast growing painful gingival swelling lasting 2 weeks, associated with fever, fatigue, and cervical lymphadenopathy. Intraoral examination showed a bluish swelling on the right posterior lower gingiva exhibiting necrotic surface. Incisional biopsy of the gingival lesion displayed diffuse infiltration of undifferentiated tumor cells with granulocytic appearance, strongly immunopositive for CD99, myeloperoxidase and Ki-67 (60%), and negative for CD20, CD3, CD34 and TdT. Blood tests presented a severe pancytopenia, and genetic analysis confirmed the diagnosis of acute promyelocytic leukemia. The final diagnosis was of oral myeloid sarcoma associated with acute promyelocytic leukemia with t(15;17). The patient was submitted to chemotherapy but died of the disease one month later. The clinicopathologic and immunohistochemical features of the present case are compared with the 89 cases of oral myeloid sarcoma previously reported in the English-language literature. Key words:Myeloid sarcoma, chloroma, granulocytic sarcoma, gingiva, oral, acute promyelocytic leukemia, acute myeloid leukemia.

Sarcoma mieloide em cavidade oral: relato de caso e revisão de 84 casos da literatura / Myeloid sarcoma in oral cavity: case report and review of 84 cases of literature

Sarcoma mielóide é uma massa tumoral de céluas mielóides imaturas ou células granulocíticas que afeta locais anatómicos extramedulares, incluindo a cavidade oral com pouca frequência. Uma mulher de 24 anos de idade, foi encaminhada para avaliação de um núdulo gengival doloroso de rápido crescimento com duração de 2 semanas, associada a febre, fadiga e linfadenopatia cervical. O exame intra-oral mostrou um nódulo azulado em região posterior inferior da gengiva à direita exibindo superfície necrótica. A biópsia da lesão gengival mostrou infiltração difusa de células tumorais indiferenciadas com aparência granulocítica, fortemente imuno positivo para CD99, mieloperoxidase e Ki-67 (60%), e negativo para CD20, CD3, CD34 e TdT. Os exames de sangue apresentaram uma pancitopenia grave, e análise genética confirmou o diagnóstico de leucemia promielocítica aguda. O diagnóstico final foi de sarcoma mielóide oral associado a leucemia promielocítica aguda com t (15; 17). A paciente foi submetida à quimioterapia, mas morreu da doença um mês depois. As características clinicopatológicas e imuno-histoquímico do presente caso são comparadas com os 84 casos de sarcoma mielóide oral, previamente relatados na literatura de língua Inglês. (AU)

Myeloid sarcoma is a tumor mass of immature myeloid or granulocytic cells that affects extramedullary anatomic sites, including uncommonly the oral cavity. A 24-year-old female was referred for evaluation of a fast growing painful gingival swelling lasting 2 weeks, associated with fever, fatigue, and cervical lymphadenopathy. Intraoral examination showed a bluish swelling on the right posterior lower gingiva exhibiting necrotic surface. Incisional biopsy of the gingival lesion displayed diffuse infiltration of undifferentiated tumor cells with granulocytic appearance, strongly immunopositive for CD99, myeloperoxidase and Ki-67 (60%), and negative for CD20, CD3, CD34 and TdT. Blood tests presented a severe pancytopenia, and genetic analysis confirmed the diagnosis of acute promyelocytic leukemia. The final diagnosis was of oral myeloid sarcoma associated with acute promyelocytic leukemia with t(15;17). The patient was submitted to chemotherapy but died of the disease one month later. The clinicopathologic and immunohistochemical features of the present case are compared with the 84 cases of oral myeloid sarcoma previously reported in the English-language literature. (AU)