ABSTRACT
Background: We present an unusual case of a graphite foreign body granuloma causing palatal perforation. Case description: A 62-year-old female presented with a macule on the hard palate clinically consistent with a blue nevus. On biopsy a black nodular mass was excised, establishing oroantral communication that was verified by a computed tomography scan. A diagnosis of malignant melanoma was strongly suspected, but microscopic examination showed a graphite foreign body granuloma. It was suggested that the graphite was implanted in a thin area of the palatal bone causing perforation. Conclusions: Graphite tattoos should be excised, both for diagnostics purposes and the possibility of causing tissue destruction by generating a foreign body granuloma reaction. Key words:Pencil core granuloma, graphite, foreign body, palate, case report.
ABSTRACT
BACKGROUND: To investigate the relative frequency of localized mucosal swellings of the upper and lower labial mucosa, the clinical-pathological diagnosis agreement and whether patient's age and gender and tumor's site and size may raise the suspicion of neoplasm. MATERIAL AND METHODS: Retrospective analysis was performed on upper or lower labial mucosal tumors, histopathologically diagnosed between 2009-2018. The diagnostic categories developmental/reactive tumors, benign and malignant neoplasms were associated with patient's age and gender and tumor's site and size; clinical-pathological diagnosis agreement was, also, evaluated. RESULTS: Overall, 1000 (95.7%) developmental/reactive tumors, 35 (3.3%) benign and 10 (1%) malignant neoplasms were found. Upper/lower lip tumor ratio was 0.14:1. The diagnostic category was significantly associated with age (p < 0.0001), site (p < 0.0001) and diameter (p < 0.0001). Age ≥60 years, tumor's location on the upper lip and diameter >1cm were independent predictors for neoplasms. Patients presenting 2 or 3 of these variables were 20.2 times (p < 0.0001) or 33.6 times (p < 0.0001), respectively, more likely to have a neoplasm. Complete/partial agreement between clinical and pathological diagnosis was seen in 96.3% of the cases. CONCLUSIONS: Most lip tumors involve the lower lip and are reactive, but upper lip tumors measuring > 1 cm in patients ≥ 60 years have significantly higher probability to be neoplasms
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