ABSTRACT
OBJECTIVE: This study aimed to explore perceived barriers to early diagnosis and management of oral cancer, as well as potential pathways for improvement in Latin America and the Caribbean (LAC). METHODS: This cross-sectional study used a self-administered online questionnaire created via the Research Electronic Data Capture platform. The survey was distributed to health professionals trained in Oral Medicine, Oral Pathology, Oral and Maxillofacial Surgery, and Dentists with clinical and academic expertise in oral potentially malignant disorder (OPMD) and oral cancer. Data obtained were systematically organized and analyzed descriptively using Microsoft Excel. RESULTS: Twenty-three professionals from 21 LAC countries participated. Major barriers included the limited implementation of OPMD and oral cancer control plans (17.4%), low compulsory reporting for OPMD (8.7%) and oral cancer (34.8%), unclear referral pathways for OPMD (34.8%) and oral cancer (43.5%), and a shortage of trained professionals (8.7%). Participants endorsed the utility of online education (100%) and telemedicine (91.3%). CONCLUSION: The survey highlights major perceived barriers to early diagnosis and management of OPMD and oral cancer in LAC, as well as potential avenues for improvement.
ABSTRACT
OBJECTIVE: To determine the frequency of oral squamous cell carcinoma (OSCC) associated or not with oral potentially malignant disorders (OPMD), and the epidemiological profile and traditional risk factors in Latin America. METHODS: A retrospective observational study was conducted in 17 Latin American centres. There were included cases of OSCC, analysing age, gender, OSCC and their association with previous OPMD. Clinicopathological variables were retrieved. The condition of sequential-OSCC versus OSCC-de novo (OSCC-dn) was analysed concerning the aforementioned variables. Quantitative variables were analysed using Student's t-test, and qualitative variables with chi-square. RESULTS: In total, 2705 OSCC were included with a mean age of 62.8 years old. 55.8% were men. 53.75% of the patients were smokers and 38% were common drinkers. The lateral tongue border was the most affected site (24.65%). There were regional variations in OPMD, being leukoplakia the most frequent. Of the overall 2705 OSCC cases, 81.4% corresponded to OSCC-dn, while s-OSCC were 18.6%. Regarding lip vermillion SCC, 35.7% corresponded to de novo lip SCC and 64.3% were associated with previous OPMD. CONCLUSIONS: In Latin America, OSCC-dn seems to be more frequent with regional variations of some clinical and histopathological features. Further prospective studies are needed to analyse this phenomenon.
ABSTRACT
Focal palmoplantar and gingival keratosis syndrome is a rare dominant inherited disease with an early onset in life. Clinically, the condition is characterized by pressure related thickening of the epidermis of the palms and soles, usually accompanied by pain and different levels of skin involvement and thickness between patients. Recently, we observed a 38-year-old woman with multiple non-removable, painless white plaques of variable size and thickness on the attached gingiva and a white plaque widespread across the hard palate. By further questioning, the patient comments that she has thick yellowish focal plaques in both soles of her feet. Histopathological analysis revealed a hyperplastic and hyperorthokeratinized stratified squamous epithelium with basal hyperplasia. The spinous, granular and stratum corneum showed dispersed basophilic keratohyalin granules. At higher magnification, the keratinocytes contained paranuclear bodies, seen as round eosinophilic condensation that indented the nuclei. Based on these findings the final diagnosis was rendered as focal palmoplantar and gingival keratosis. Key words:Genodermatoses, white plaque, dyskeratosis, gingiva.
ABSTRACT
Infectious mononucleosis (IM) is a very common disease, and although in most instances, the patient develops an asymptomatic infection, other patients progress into an array of signs and symptoms that tend to be characteristic of the pathological process, guiding the clinician into choosing the right laboratory examinations under the suspicion of this illness. The most common symptoms are pharyngitis, lymphadenopathies and pyrexia, and the probabilities to develop this mononucleosis triad become greater with age. In other instances, IM can be a challenging disease to diagnose, mainly because the patient debuts with unusual symptoms such as nausea, skin eruptions, diarrhea and epigastric discomfort. The aim of the present article is to report the case of a 21-year-old female with a reactivation of IM, developing only multiple, asymptomatic lymph node enlargements in the head and neck region, showing no other sign or symptom.
ABSTRACT
El adenocarcinoma no especificado o adenocarcinoma NOS de glándula salival, como comúnmente se le llama por sus siglas en inglés "Not Otherwise Specified", es un tipo de neoplasia que no cumple con los requisitos histológicos establecidos para lograr categorizarla dentro de los tumores que afectan las glándulas salivales. A causa de que son muy poco frecuentes, se ha dificultado su estudio, y el conocimiento que se tiene sobre esta entidad es escaso. El objetivo del presente artículo es el de reportar el caso de un paciente masculino de 68 años de edad, quien desarrolla un adenocarcinoma NOS a partir de una glándula salival menor a escala del paladar. Se detalla el alcance que tiene este tipo de patología en cuanto a la invasión, destrucción y alteración que puede generar localmente en el paciente, así como su comportamiento bajo la radio y quimioterapia.
Adenocarcinoma NOS of a minor salivary gland is a type of tumor that does not meet the histological requirements that it needs to be categorized within other salivary gland tumors. Because of their infrequency, there is little known about these tumors. The aim of this paper is to report the case of a 68 years old male patient, who developed an adenocarcinoma NOS arising from a minor salivary gland in the palate. The local invasion and destruction, as well as its behavior under radio and chemotherapy is discussed.
