ABSTRACT
OBJECTIVE: To investigate the clinicopathological, immunohistochemical and molecular features of histiocytic sarcomas affecting the oral cavity. METHODS: Pathology files of two institutions were searched for cases of histiocytic sarcoma, and new H&E-stained slides and immunohistochemistry reactions evaluated for diagnosis confirmation. Molecular screening for KRAS and PIK3CA mutations was performed through polymerase chain reaction (PCR) followed by Sanger sequencing. BRAFp.V600E mutation was assessed by pyrosequencing. Clinical data regarding sex, age, tumor location, systemic manifestations, clinical presentation, follow-up time, treatment applied and status at last follow-up were collected from patients' pathology and medical files. RESULTS: Three cases were retrieved during the period investigated (2000-2023). Two females and one male were affected, with a wide age range, involving the tongue, palate and gingiva. Histopathologically, the neoplasms presented as highly pleomorphic atypical cells distributed diffusely with infiltration of normal structures. All cases demonstrated histiocytic differentiation expressing CD68 and CD163, and a high Ki67 expression. Genetic mutations were evaluated in two cases. One case harboured BRAF-V600E mutation, but not in KRAS and PIK3CA, while the second case did not show mutation in BRAF-V600E, KRAS and PI3KCA. One patient was lost, and two patients died after eight and four months of follow-up. CONCLUSION: Histiocytic sarcomas involving the oral cavity are extremely rare, and may represent dissemination of a systemic condition. It has an aggressive biological behaviour with a poor overall prognosis.
Subject(s)
Class I Phosphatidylinositol 3-Kinases , Histiocytic Sarcoma , Immunohistochemistry , Mouth Neoplasms , Mutation , Proto-Oncogene Proteins B-raf , Proto-Oncogene Proteins p21(ras) , Humans , Male , Histiocytic Sarcoma/genetics , Histiocytic Sarcoma/pathology , Female , Middle Aged , Class I Phosphatidylinositol 3-Kinases/genetics , Proto-Oncogene Proteins p21(ras)/genetics , Proto-Oncogene Proteins B-raf/genetics , Mouth Neoplasms/genetics , Mouth Neoplasms/pathology , Adult , Biomarkers, Tumor/genetics , Aged , Polymerase Chain ReactionABSTRACT
OBJECTIVE: This study described the prevalence of periodontal conditions and assessed its association with social, economical and behavioral variables in adults aged 35 to 44 years old, residents in the city of Guarulhos, State of Sao Paulo, 2006. METHODS: This study was a population based survey with cluster sampling. Data collecting and exams were done at houses drew at random. The Community Periodontal Index was used to assess the periodontal condition. Data analysis used EPIINFO 6 and STATA 10 softwares. The assessment of association used the prevalence ratio (PR), as calculated by Poisson regression models with complex sampling and weighted sample adjustments. RESULTS: The total number of people was 263 in 237 domiciles. In the multivariate model, the prevalence of gingival bleeding and dental calculus was significantly associated to being male (PR=1.12, p=0.04), smoking (PR=1.11, p=0.01), school level of less than eight years of study (PR=1.14, p=0.01), and who have not received dental care for more than two years (PR=1.19, p<0.01). As for the presence of periodontal pocket, associated factors were smoking (PR=1.71, p=0.02) and who have not received dental care for more than 2 years (PR=1.97, p=0.03). CONCLUSION: We observed a higher prevalence (62.7%) of individuals with gingival bleeding and dental calculus in relation to the presence of shallow or deep periodontal pockets (26,6%). As shallow pockets are reversible, their treatment may be resolute in programs of primary dental care.