Reacción liquenoide por enalapril: Reporte de un caso clínico / Enalapril-induced lichenoid reaction: Clinical case report

El enalapril es un medicamento muy utilizado por su efectividad para el tratamiento de la hipertensión arterial; sin embargo, en algunos casos genera como efecto adverso reacciones liquenoides. El cuadro clínico de esta alteración es variado, manifiesta lesiones similares al liquen plano en piel y/o en mucosa bucal, resultado de una reacción de hipersensibilidad de un organismo susceptible a este medicamento. Presentamos el caso de un paciente femenino de 49 años de edad, quien refiere sangrado gingival espontáneo y al cepillado dental, dolor y ardor con alimentos ácidos, calientes y picantes desde hace tres años, multitratada con antibióticos y antimicóticos sin mejorar la sintomatología. Se diagnostica interdisciplinariamente por el Servicio de Periodoncia, Patología Bucal y Dermatología. El tratamiento bucal consistió en la enseñanza de una correcta higiene bucal junto con terapia corticoidea tópica y cambio del medicamento que provocó las lesiones.

Enalapril is a drug widely used due to its effectiveness in the treatment of blood hypertension cases, nevertheless, it occasionally generates lichenoid reactions as negative effect. The clinical picture of this alteration can be varied, in the skin and/or oral mucosae, it can induce lesions similar to those of lichen planus. These lesions could be the result of hypersensitivity reactions of a body which is susceptible to this drug. The present article documents the case of a 49 year old female patient, who sought consultation due to spontaneous gingival bleeding, bleeding caused by dental brushing, pain, and burning sensation with acid, hot or spicy foods. The condition had been present for the last three years. The patient had been repeatedly treated with antibiotics and antifungal drugs; nevertheless, these treatments proved to be unsuccessful. Oral Pathology, Dermatology and Periodontics Departments emitted a multi-disciplinary diagnosis. Oral treatment consisted of teaching appropriate oral hygiene techniques along with topical corticoid therapy, and substitution of the drug which induced the lesions.

Sialolipoma of minor salivary glands: presentation of five cases and review of the literature with an epidemiological analyze.

UNLABELLED: Sialolipoma is rare benign neoplasm arise from salivary glands (majors and minors) characterized by neoplastic adipose tissue with scattered non-neoplastic salivary gland acinus. To date 60 cases (including 5 cases reported in the present paper) have been reported in scientific literature. This article presents 5 new cases of sialolipoma affecting minor salivary glands (MiSG) and additionally reviews and analyzes the previously published cases to assess possible demographical differences between sialolipoma from minor and from major salivary glands. CASE REPORTS: 5 cases (3 females; 2 males; age means 63.8 years), of sialolipoma from MiSG, are reported. 2 of them were located in buccal mucosa, 1 in upper lip mucosa, 1 in floor of the mouth and 1 in retromolar area. All tumors were composed by neoplastic adipocytes cells interlaced with normal salivary gland acinus cover it by a fibrous tissue capsule. Analyzes of literature showed that MiSG sialolipoma is most frequent in females over 60 years old, therefore and in conclusion this article assess different demographical profile of sialolipoma in respect to their topography.

Clear cell cystic variant of calcifying epithelial odontogenic tumor.

Calcifying epithelial odontogenic tumor (CEOT) is a solid, locally aggressive, benign odontogenic neoplasm characterized by sheets and nests of polyhedral epithelial cells exhibiting eosinophilic and less often clear cytoplasm, occasional nuclear pleomorphism without mitotic activity, calcifications, and deposits of amyloid. A cystic variant has been reported only twice. Herein, we present an additional example of cystic CEOT occurring in a 31-year-old male and featuring clear cell epithelial lining with deposits of amyloid and osteodentin.

Tumors of the salivary gland in Mexicans. A retrospective study of 360 cases

Objective: To establish distribution frequency and demographic characteristics of salivary gland tumours (SGT)in order to identify possible risk profiles. Design of study: The present report constitutes an eight year retrospective study (January 2000-August 2007). The archives of the Clinical and Experimental Pathology Laboratory (Graduate and Research Division, Dental School, National Autonomous University of Mexico) as well as archives of the Surgical Pathology Service (General Hospital, Mexico City) were subject to revision in order to select all cases where SGT tumour diagnoses were emitted. Age and gender of patients as well as SGT topography were obtained from medical records. Selected cases were classified according to location of the lesion, histological lineage and biological behaviour. Results: 360 cases of SGT were included, 227 (67%) cases were benign tumours, while 83 cases (23%) were malignant tumours. SGT were most frequent in women with ages ranging from their 3rd to 5th decades of life.275 tumours were located in major salivary glands, 78.9% of them were identified in the parotid gland. The most frequent location of tumours arising from minor salivary glands (33 cases, 38%) was found in the palatine glands. Tumours of epithelial lineage were the predominant histological type. The most frequent benign tumours were pleomorphic adenomas (86.1%) and papillary cyst adenoma lymphomatosum (7.3%). The most frequent malignant tumours were adenoid cystic carcinomas (25%) and mucoepidermoid carcinomas (23.6%) (AU)

Trends in frequency and prevalence of oral cancer and oral squamouscell carcinoma in Mexicans. A 20 years retrospective study

Objective. To establish the time trends of the frequency and prevalence of oral cavity cancer in regard to age andgender in a 20-years (time period 1989 – 2008) cohort of Mexicans. Design and Setting. 13,235 head and neckbiopsies from the archive of the Oral Pathology Laboratory, Dental School, National Autonomous University ofMexico were revised. The cases with diagnoses of oral cancer were selected. Gender and age at diagnosis was obtained from medical records. The frequency and prevalence of oral cavity cancer and oral squamous cell carcinoma were assessed biannually in regard to the total number of population served by the oral pathology laboratory. The statistical significance of trends was established using the linear logistic regression (curve estimation)test (s 0.05). Results. 298 cases (138 males; 160 females) of oral cancer were included; 167 (92 females; 75 males; female: male ratio: 1.1:1) corresponded to oral squamous cell carcinoma. From 1989 to 2008 the prevalence of oralcancer and oral squamous cell carcinoma increased 200% (s 0.05) and 100% (s 0.000) respectively. The increase off requency and prevalence was observed in both genders however only in females was significant (s 0.000). We do not identify changes in the age at diagnosis. Conclusions. Oral cancer, specifically oral squamous cell carcinoma, has increase in Mexicans females in the last 20 years (AU)

Trends in frequency and prevalence of oral cancer and oral squamous cell carcinoma in Mexicans. A 20 years retrospective study.

OBJECTIVE: To establish the time trends of the frequency and prevalence of oral cavity cancer in regard to age and gender in a 20-years (time period 1989 - 2008) cohort of Mexicans. DESIGN AND SETTING: 13,235 head and neck biopsies from the archive of the Oral Pathology Laboratory, Dental School, National Autonomous University of Mexico were revised. The cases with diagnoses of oral cancer were selected. Gender and age at diagnosis was obtained from medical records. The frequency and prevalence of oral cavity cancer and oral squamous cell carcinoma were assessed biannually in regard to the total number of population served by the oral pathology laboratory. The statistical significance of trends was established using the linear logistic regression (curve estimation) test (s 0.05). RESULTS: 298 cases (138 males; 160 females) of oral cancer were included; 167 (92 females; 75 males; female:male ratio: 1.1:1) corresponded to oral squamous cell carcinoma. From 1989 to 2008 the prevalence of oral cancer and oral squamous cell carcinoma increased 200% (s 0.05) and 100% (s 0.000) respectively. The increase of frequency and prevalence was observed in both genders however only in females was significant (s 0.000). We do not identify changes in the age at diagnosis. CONCLUSIONS: Oral cancer, specifically oral squamous cell carcinoma, has increase in Mexicans females in the last 20 years.

Vascular leiomyoma of the oral cavity. Clinical, histopathological and immunohistochemical characteristics. Presentation of five cases and review of the literature.

Leiomyoma, a benign neoplasia arising from smooth muscle is an uncommon neoplasia of the oral cavity. The most common histological subtype in the oral cavity is the vascular one. To supplement information on vascular leiomyoma of the oral cavity (VLOC), we present cases of VLOC describing their clinical, histological, and immunohistochemical characteristics. Case reports. Five cases of VLOC (3 females; 2 males) from the Clinical and Experimental Pathology Laboratory, Dental School, National Autonomous University of México, are included. The most frequent clinical characteristic of VLOC was a single, asymptomatic, slow growing nodule. The age average of the cases was 40.6, however 3 out of our 5 cases were < or = 40 years old at the moment of their diagnosis. The lesions were composed of fusiform cells arranged in bundles or fascicles. The neoplastic cells were characterized by eosinophilic cytoplasm and tapered nuclei. The presence of vascular spaces was prominent in all cases. The immunocharacteristics of VLOC neoplastic cells were: alpha smooth muscle (+); vimentin (+), desmin (+), CD34 (-) and S-100 protein (-). The endothelial cells of vascular spaces were CD34 (+). Differential diagnosis of VLOC with fusocellular neoplasm is discussed.

Vascular leiomyoma of the oral cavity. Clinical, histopathological and immunohistochemical characteristics. Presentation of five cases and review of the literature

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Leiomyoma, a benign neoplasia arising from smooth muscle is an uncommon neoplasia of the oral cavity. The mostcommon histological subtype in the oral cavity is the vascular one. To supplement information on vascular leiomyoma of the oral cavity (VLOC), we present cases of VLOC describing their clinical, histological, and immunohistochemical characteristics. Case reports. Five cases of VLOC (3 females; 2 males) from the Clinical and Experimental Pathology Laboratory, Dental School, National Autonomous University of M¨¦xico, are included. The most frequent clinical characteristic of VLOC was a single, asymptomatic, slow growing nodule. The age average of the cases was 40.6, however 3 out of our 5 cases were ¡Ü 40 years old at the moment of their diagnosis. The lesions were composed of fusiformcells arranged in bundles or fascicles. The neoplastic cells were characterized by eosinophilic cytoplasm and tapered nuclei. The presence of vascular spaces was prominent in all cases. The immunocharacteristics of VLOC neoplastic cells were: alpha smooth muscle (+); vimentin (+), desmin (+), CD34 (-) and S-100 protein (-). The endothelial cells of vascular spaces were CD34 (+). Differential diagnosis of VLOC with fusocellular neoplasm is discussed

Plasmacytoid myoepithelioma of the palate. Report of one case and review of the literature.

INTRODUCTION: Myoepithelioma is a benign neoplasm of salivary glands, represents 1.5 % of all salivary glands neoplasm. The plasmacytoid myoepithelioma from palate salivary glands is considered as a rare entity, at date it has been reported 14 cases. It is present one case of plasmacytoid myoepithelioma of palate. CASE REPORT: A Hispanic female of 28 years old presented a not-ulcerate, painless ovoid swelling at left side of hard palate with a one year and a half of evolution. An excisional biopsy was done. The sample was fixed at 10% buffer formalin, embedded in paraffin, cuts at 5 micron and stained with H-E. Microscopically, the lesion was composed by myoepithelial neoplastic cells characterized by a round ovoid silhouette, an eccentric nuclei of dense chromatin and eosinophilic cytoplasm. In some myoepithelial neoplastic cells were identifies intranuclear cytoplasmatic inclusions. The lesion was analysed with immunohistochemical technique using the follow antibodies: vimentin, citokeratin AE1/AE3, S100 protein and actin muscle specific. We observe positive immunoreactivity against vimentin, citokeratin, S100 protein and actin muscle specific. A diagnosis of plasmacytoid myoephitelioma of palate salivary glands was done. Our findings supports the suggestion about plasmacytoid myoepithelioma is an independent entity. The histological diagnostic parameters of plasmacytoid myoepithelioma versus pleomorphic adenoma are discussed.

Plasmacytoid myoepithelioma of the palate. Report of one case and review of the literature

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Introduction: Myoepithelioma is a benign neoplasm of salivary glands, represents 1.5 % of all salivary glands neoplasm.The plasmacytoid myoepithelioma from palate salivary glands is considered as a rare entity, at date it has been reported 14 cases. It is present one case of plasmacytoid myoepithelioma of palate. Case report: A Hispanic female of 28 years old presented a not-ulcerate, painless ovoid swelling at left side of hard palate with a one year and a half of evolution.An excisional biopsy was done. The sample was fixed at 10% buffer formalin, embedded in paraffin, cuts at 5 ì and stained with H-E. Microscopically, the lesion was composed by myoepithelial neoplastic cells characterized by a round ovoid silhouette, an eccentric nuclei of dense chromatin and eosinophilic cytoplasm. In some myoepithelial neoplastic cells were identifies intranuclear cytoplasmatic inclusions. The lesion was analysed with immunohistochemical technique using the follow antibodies: vimentin, citokeratin AE1/AE3, S100 protein and actin muscle specific. We observepositive immunoreactivity against vimentin, citokeratin, S100 protein and actin muscle specific. A diagnosis of plasmacytoid myoephitelioma of palate salivary glands was done. Our findings supports the suggestion about plasmacytoid myoepithelioma is an independent entity. The histological diagnostic parameters of plasmacytoid myoepithelioma versus pleomorphic adenoma are discussed (AU)

Osseous choristoma of the oral soft tissue. Case report.

Oral osseous choristoma is a rare developmental alteration, their principal localization is nearly to base of the tongue (foramen caecum). The oral mucosa localization of osseous choristoma is extremely rare. At date only 10 cases of oral mucosa osseous choristoma had been reported. In the present paper we reported a new case of oral mucosa osseous choristoma in a Klippel-Feil syndrome patient. A review of available literature was made. We presented a 28 years old female patient who showed into the right oral mucosa, a hard, mobile, and asymptomatic mass, with minimum 4 years of evolution. The histological image showed a lesion constituted by lamellar bone, osteocytes and haematopoyetic tissue. The diagnosis of osseous choristoma was made. It is discusses their possible association with Klippel-Feil syndrome. The osseous choristoma of buccal mucosa is most frequently in fifth decade of the life although is reported between 12-to-64 years old, with a female predisposition.

Coristoma oseo de los tejidos blandos bucales. Presentación de un caso / Osseous choristoma of the oral soft tissue. Case report

El coristoma óseo de los tejidos blandos de cavidad oral es una alteración del desarrollo poco común, localizándose principalmente en la base de la lengua, siendo la mucosa bucal un sitio de localización sumamente raro habiéndose reportado a la fecha únicamente 9 casos de coristoma óseo de la mucosa bucal. Se describe un nuevo caso de coristoma óseo de la mucosa bucal, en un paciente con Síndrome de Klippel- Fiel y se hace una revisión de la literatura. Se presenta el caso de un paciente femenino de 28 años de edad con una masa circunscrita, móvil, asintomático, firme, de mas de 4 años de evolución localizado en la mucosa bucal derecha. La imagen histológica mostró una lesión consistente de hueso lamelar, con osteocitos vitales y tejido hematopoyético, diagnosticándose como coristoma óseo de la mucosa bucal. Se discute su posible asociación con el Síndrome de Klippel-Feil. De acuerdo a la revisión de la literatura el coristoma óseo se presenta entre los 12 y los 64 años de edad, siendo más frecuente en la quinta década de la vida, con ligera predisposición por el sexo femenino (AU)

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Calcifying odontogenic cyst: clinicopathological features and immunohistochemical profile of 10 cases.

BACKGROUND: Calcifying odontogenic cyst (COC) is an uncommon odontogenic lesion with few studies describing its immunohistochemical profile and proliferative activity reported in the literature. METHODS: Clinical and histological features and immunohistochemical expression of cytokeratins, Mel-CAM (CD146), bcl-2, PCNA and ki-67, in 10 cases of COC were studied. RESULTS: All 10 cases affected the maxilla, eight intraosseous and two peripheral. Five central cases were cystic and three were cystic associated with odontoma, and the two extraosseous showed solid histological pattern; immunohistochemistry was positive for cytokeratins 8, 14, 19, AE1/AE3 and 34betaE12 and bcl-2 in all cases, and Mel-CAM in six cases. Proliferative activity was greater in the epithelium of central cystic COC in relation to COC associated with odontoma and peripheral lesions. CONCLUSION: Calcifying odontogenic cysts showed odontogenic cytokeratin profile and bcl-2 and Mel-CAM expression indicate that these proteins may be involved in the development of COC. There were no recurrences after surgery, irrespective of their proliferative activity.