RESUMEN
Central ossifying fibroma is a benign, slow-growing tumor of mesenchymal origin with a predilection for the mandibular premolar and molar areas. The immunophenotype of T cells involved in the antitumor response against this benign tumor is unknown. In this case report, we described a case of a 48-year-old woman presenting with a very large recurrent ossifying fibroma in the mandible, which was successfully treated with hemimaxillectomy. In addition, we evaluated the expression of programmed cell death 1 receptor (PD-1), lymphocyte activation gene-3 (LAG-3), T cell immunoglobulin and mucin-domain containing-3 (TIM-3), cytotoxic T lymphocyte-associated antigen-4 (CTLA-4), CD69 (activation inducer molecule), and CD25 (α chain of the high-affinity IL-2 receptor) in T cell populations from the tumor and peripheral blood of this uncommon lesion. The patient presented recurrent ossifying fibroma, and the tumor-infiltrating and peripheral blood T cells showed expression of PD-1, LAG-3, and TIM-3, suggesting an exhausted T cell response.
RESUMEN
Dermoid cysts usually occur later in the second decade of life; we present the approach of an unusual case of an infant who presented a cyst within the oral cavity, which is important because it can be confused with other pathologies.
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El cáncer oral representa un grave problema de salud a nivel mundial debido a su importante morbilidad y mortalidad. Ocupa la sexta causa de muerte por cáncer y tienen una supervivencia mundial a cinco años cercana a 50%, en gran parte debido a la falta de su reconocimiento en estadios iniciales por parte de los pacientes y de los mismos profesionales de la salud, lo que ocasiona un grave retraso en su diagnóstico y tratamiento. Se presenta el caso de una mujer de 64 años de edad con úlceras de larga evolución en la cavidad oral y quien acude a múltiples profesionales de salud sin ser diagnosticada en las fases iniciales de la enfermedad; acude a la Universidad Autónoma de Tlaxcala en donde se diagnostica carcinoma oral de células escamosas en el maxilar. En el presente artículo se hace énfasis en el reconocimiento de signos clínicos y factores precipitantes que puedan generar sospecha de un crecimiento maligno y así concientizar a los profesionales de la salud para promover la prevención (AU)
Oral cancer represents a serious health problem worldwide due to its significant morbidity and mortality, it is the sixth leading cause of cancer death and has a global 5-year survival rate of 50%, largely due to the lack of recognition in early stages by patients and health professionals themselves, which causes a serious delay in diagnosis and treatment. We present the case of a 64-year-old woman with long-standing ulcers in the oral cavity who went to multiple health professionals without being diagnosed in the initial stages of the disease. She went to the Autonomous University of Tlaxcala where oral squamous cell carcinoma (OSCC) in the maxilla was diagnosed. This article emphasizes the recognition of clinical signs and precipitating factors that may generate suspicion of malignant growth and thus raise awareness among health professionals to promote prevention (AU)
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Neoplasias Palatinas , Facultades de Odontología , Signos y Síntomas , Causalidad , Úlceras Bucales , MéxicoRESUMEN
Cockayne s syndrome is a genetic disorder with a recessive autosomal inheritance, described first by Cockayne in 1936. Patients with this syndrome present failure to thrive, short stature, premature aging, neurological alterations, photosensitivity, delayed eruption of the primary teeth, congenitally absent of some permanent teeth, partial macrodontia, atrophy of the alveolar process and caries. It could be caused by two gene mutations, CNK1 (ERCC8) and ERCC6, located on the 5 and 10 chromosomes respectively, causing two variations of Cockayne s syndrome, CS-A, secondary to a ERCC8 mutation and CS-B with ERCC6 mutation, the last one causes hypersensitivity to the ultraviolet light secondary to a DNA repair defect. The syndrome is also associated with mutations of the XPB, XPD and XPG genes. In this report we present a 9 year and 4 month old patient. He had a height of 94 cm, weight of 8.6 Kg, head circumference of 42 cm. and blood pressure of 120/80. Cachectic habitus, kyphosis, microcephaly, oval face, sunken eyes, a thin and beaklike nose, lack of subcutaneous facial fat (especially in the middle of the face), and large ears give the patient a birdlike appearance. It is notorious the photosensitivity in all the sun-exposed skin. The patient also displays delayed psychomotor skills and mental retardation. In the oral cavity we found deficient hygiene, gingivitis, cervical caries, enamel hipoplasia, abnormal position of the upper and inferior lateral incisors, macrodontia of the upper central teeth, the left one presented a caries. In the x-ray we observed congenital absence of 14, 23 and 24 teeth and mandibular hipoplasia. The aim of this review is to show the dentistry community the characteristics of the Cockayne s syndrome by means of a clinical case.
Asunto(s)
Síndrome de Cockayne/diagnóstico , Anomalías de la Boca/diagnóstico , Niño , Síndrome de Cockayne/genética , Humanos , Masculino , Anomalías de la Boca/genética , FenotipoRESUMEN
UNLABELLED: Incontinentia pigmenti is a genodermatosis described by Garrod and in 1920 by Bloch, Sulzberger, Siemens y Bardach. It is an ectodermic disorder that affects skin, teeth, eyes and may also have neurological problems. The IP2 name describes the histological characteristics, the incontinence of melanin into the melanocytes cells in the epidermal basal layer and its presence in superficial dermis. IP2 is an x-linked dominant condition but genetic heterogeneity may exist. CASE REPORT: The patient was 4 yrs 5 months old when she came for the first time. In a physical exploration she presented sparse and thin hair, eyelashes and eyebrows, beaked nose, labial protrusion, the four central teeth have a conic crown and there was also a delayed eruption of other teeth, right eye strabismus, hipoacusia, language defects and a trunk, legs, feet, and face dermatosis characterized by grouped vesicles, hyperkeratotic and warty lesions and brownish-gray lesions in a lineal pattern. The patient s father had hypopigmented lesions in the posterior regions of both legs. The oral clinical and radiographic exams showed diverse anomalies. Both the patient's and the father's chromosomal studies were normal. DISCUSSION: In the present case we can see that the father has IP2 without supernumeraries X, with the antecedent that his mother had something similar. It is possible that the inheritance was autosomic dominant or it is a different mutation of NEMO (NF-kappa-B essential modulator) gene to a classical one, which was found in some affected men. It is necessary to carry out a molecular study of these patients.
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Incontinencia Pigmentaria/genética , Incontinencia Pigmentaria/patología , Anomalías Dentarias/etiología , Preescolar , Cromosomas Humanos X , Salud de la Familia , Femenino , Enfermedades Genéticas Ligadas al Cromosoma X/patología , Humanos , Incontinencia Pigmentaria/complicaciones , Masculino , LinajeRESUMEN
Las heridas por mordida en la región maxilofacial son relativamentecomunes y se consideran de tratamiento complejo; son contaminadas con una flora oral bacteriana única y, en ocasiones, tienen resultados estéticos devastadores. Las heridas pueden ser ocasionadas por animales domésticos, salvajes y humanos. El clínico debe tener una comprensión multidisciplinaria del manejo de las mismas, incluyendo el abordaje médico, quirúrgico, viral, bacteriológico y la secuencia propia del tratamiento. Se presenta una revisión de la literatura, así como casos clínicos para el tratamiento integral de este tipo de trauma.
Bite wounds in the maxillofacial region are relatively common and are regarded as diffi cult to treat given the associated contamination with what is a unique polymicrobial inoculum. The aesthetic consequences can occasionally prove devastating. The wounds can be caused by both domestic and wild animals, as well as by humans. Clinicians need to have a multidisciplinary understanding of how to manage such wounds, including surgical, medical, virological, and bacteriological aspects, and the proper sequence of treatment. We present a review of the literature and a number of clinical cases for the comprehensive management of this type of trauma.
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Humanos , Masculino , Adolescente , Animales , Femenino , Niño , Adulto Joven , Animales Domésticos , Mordeduras y Picaduras/cirugía , Mordeduras y Picaduras/complicaciones , Mordeduras y Picaduras/tratamiento farmacológico , Antibacterianos/administración & dosificación , Cicatrización de Heridas/fisiología , Combinación Amoxicilina-Clavulanato de Potasio/uso terapéutico , Infección de Heridas/prevención & control , Mordeduras y Picaduras/clasificación , Mordeduras y Picaduras/diagnóstico , Mordeduras y Picaduras/epidemiología , Procedimientos Quirúrgicos Orales/métodosRESUMEN
El adenoma pleomorfo es el tumor benigno más frecuente de lasglándulas salivales. Su localización principalmente es en la glándula parótida, pero cuando aparece en una glándula salival menor, el paladar es su localización más común. Presenta un crecimiento lento y continuo; clínicamente se presenta como un nódulo o tumor asintomático, firme y bien delimitado. El diagnóstico se realiza mediante biopsia por aspiración con aguja fi na o biopsia escisional de la lesión, siendo de gran importancia debido a que a pesar de ser una tumoración benigna, en ocasiones puede presentar transformación maligna. El tratamiento consiste en la exéresis completa de la lesión con márgenes sanos. Se presenta el caso de un paciente masculino de 40 años, con una masa en el paladar duro y blando de seis años de evolución. Tras la exéresiscompleta de la lesión, el estudio histopatológico confirmó el diagnósticode adenoma pleomorfo
Pleomorphic adenomas are the most common benign tumor of the minor salivary glands. They are primarily found in the parotid gland, except when they appear in a minor salivary gland, in which case the palate is the most common site. They display a slow, steady growth. Clinically the adenoma appears as a fi rm, well-defi ned, asymptomatic nodule or tumor. Diagnosis is confi rmed by means of fi ne-needle aspiration biopsy or excisional biopsy of the lesion. It is extremely important that they are tested given that, despite their being a benign tumor, they can sometimes become malignant. Treatment consists of the complete excision of the lesion with clean surgical margins. We report the case of a 40-year-old male patient with a mass in the hard and soft palate that had evolved over a period of six years. Following the complete excision of the le-sion, histopathology confi rmed the diagnosis of pleomorphic adenoma.
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Humanos , Masculino , Adulto , Adenoma Pleomórfico/cirugía , Adenoma Pleomórfico/diagnóstico , Neoplasias Palatinas/cirugía , Neoplasias Palatinas/diagnóstico , Distribución por Edad y Sexo , Adenoma Pleomórfico/epidemiología , Biopsia con Aguja/métodos , Técnicas Histológicas , Cuidados Posoperatorios , Procedimientos Quirúrgicos Orales/métodosRESUMEN
El Síndrome de Cockayne (CS) es un desorden genético con un patrón de herencia autosómico recesivo que fue descrito por primera vez en 1936 por Cockayne. Los pacientes con este síndrome presentan detención del crecimiento, talla baja, envejecimiento prematuro, anormalidades neurológicas, fotosensibilidad, retraso en la erupción de los dientes primarios, ausencia congénita de dientes permanentes, macrodoncia parcial, atrofia de los procesos alveolares y caries dental. Puede ser causado por mutación en dos genes, el CKN1 (ERCC8) y el ERCC6, localizados en los cromosomas 5 y 10 respectivamente; originando dos tipos: CS-A que tienen mutación en ERCC8 y CS-B con mutación en ERCC6, este último provoca sensibilidad a la luz ultravioleta, secundaria a una deficiencia en la reparación de DNA. También se ha asociado el síndrome a mutaciones de los genes XPB, XPD y XPG. En el presente reporte se informa de un paciente de 9 años con cuatro meses de edad. En la exploración física se registró talla de 94 cm, peso de 8.6 kg y perímetro cefálico de 42 cm. TA 120/80. Hábito caquéctico, problemas posturales con encorvamiento, así como microcefalia, cara ovalada, ojos hundidos, nariz delgada y afilada, falta de grasa en la cara, más notorio en el tercio medio y orejas grandes que le confieren una apariencia de pajarito. Se observa marcada fotosensibilidad en toda la piel expuesta al sol. Presenta retraso psicomotor y mental. Intrabucalmente se aprecia higiene deficiente, gingivitis, caries cervical, hipoplasia del esmalte, mala posición dentaria de los incisivos laterales superiores e inferiores, y macrodoncia de los dientes centrales superiores, el izquierdo presenta una lesión por caries. Radiográficamente se observa ausencia congénita de los dientes 14, 23, 24 e hipoplasia mandibular. El objetivo de este trabajo es dar a conocer a la comunidad odontológica las características del síndrome de Cockayne a través de un caso clínico
Cockaynes syndrome is a genetic disorder with a recessive autosomal inheritance, described first by Cockayne in 1936. Patients with this syndrome present failure to thrive, short stature, premature aging, neurological alterations, photosensitivity, delayed eruption of the primary teeth, congenitally absent of some permanent teeth, partial macrodontia, atrophy of the alveolar process and caries. It could be caused by two gene mutations, CNK1 (ERCC8) and ERCC6, located on the 5 and 10 chromosomes respectively, causing two variations of Cockaynes syndrome, CS-A, secondary to a ERCC8 mutation and CS-B with ERCC6 mutation, the last one causes hypersensitivity to the ultraviolet light secondary to a DNA repair defect. The syndrome is also associated with mutations of the XPB, XPD and XPG genes. In this report we present a 9 year and 4 month old patient. He had a height of 94 cm, weight of 8.6 Kg, head circumference of 42 cm. and blood pressure of 120/80. Cachectic habitus, kyphosis, microcephaly, oval face, sunken eyes, a thin and beaklike nose, lack of subcutaneous facial fat (especially in the middle of the face), and large ears give the patient a birdlike appearance. It is notorious the photosensitivity in all the sun-exposed skin. The patient also displays delayed psychomotor skills and mental retardation. In the oral cavity we found deficient hygiene, gingivitis, cervical caries, enamel hipoplasia, abnormal position of the upper and inferior lateral incisors, macrodontia of the upper central teeth, the left one presented a caries. In the x-ray we observed congenital absence of 14, 23 and 24 teeth and mandibular hipoplasia. The aim of this review is to show the dentistry community the characteristics of the Cockaynes syndrome by means of a clinical case