Alveolar soft-part sarcoma of the masseter and mandibular ramus: Report of a case and review of the literature.

Alveolar soft-part sarcomas are clinically and morphologically distinct soft-tissue sarcomas, with an unknown histogenesis. When the tumors affect the region of the head and neck, they are often located in the orbit and tongue. We report a case of an alveolar soft-part sarcoma in the left masseter of a 28-year-old female. The patient had chronic pain and paresthesia of her left lower lip. Panoramic radiography and computed tomography showed a well-delimited radiolucent mass in the left ramus. An incisional biopsy was performed, and the sample submitted for histopathological study. The tumor showed positive periodic acid-Schiff diastase-resistant granules. Immunohistochemically, the tumor cells were diffusely positive for myoglobin, and focally positive for actin and desmin.

Cáncer Bucomaxilofacial en Niños III: Tumores Malignos del Tejido Blando / Oral and Maxillofacial Cancer in Children III: Malignant Soft Tissue Tumors

RESUMEN: El grupo de neoplasias malignas de tejido blando de la región de cabeza y cuello en pacientes pediátricos está representado por carcinomas, sarcomas, melanomas y tumores de diferenciación incierta. La neoplasia más prevalente en la población pediátrica es el Rabdomiosarcoma, seguido por el carcinoma de células escamosas. Los rangos de presentación son muy amplios, siendo los grupos entre 2-6 años y 15-19 años los que presentan mayor incidencia. Se ha planteado que la etiología de estas neoplasias es incierta. El tratamiento de estas neoplasias es comúnmente de enfoque multimodal, combinando un procedimiento quirúrgico con quimioterapia y radioterapia. El pronóstico y sobrevida del paciente dependerán principalmente del momento en que se realice el diagnóstico de la lesión. Un diagnóstico y tratamiento temprano favorecen las posibilidades de sobrevida y el pronóstico del paciente. Este estudio corresponde a la 3ra parte de "Cáncer bucomaxilofacial en niños". Se hará referencia a los distintos tumores malignos del tejido blando en la población pediátrica en el territorio de cabeza y cuello, abarcando sus generalidades, etiología, epidemiología, tratamiento y pronóstico.

ABSTRACT: Head and neck malignant tumors in pediatric patients comprise carcinoma, sarcoma, melanoma and tumours of uncertain differentiation. Within the pediatric population, the most prevalent neoplasm is rhabdomyosarcoma, followed by squamous cell carcinoma. There is a wide range in the presentation, and it varies significantly with age groups of 2-6 and 15-19 year-olds who present the higher incidence rates. For this reason, it has been suggested that the etiology of head and neck neoplasms remains unclear. Treating these pathologies usually involves a multimodal approach that combines surgery, radiation and chemotherapy. Prognosis and survival rates depend mainly of the stage at the time of diagnosis. Early diagnosis and treatment can improve prognosis and survival rates. In this 3rd part of "Maxillofacial Cancer in Pediatric Patients", we studied a variety of malignant tumors in head and neck soft tissue from a paediatric sample. Specifically, we aim to analyze their etiology, epidemiology, treatment and prognosis.

Morphea "en coup de sabre": An unusual oral presentation.

Morphea, or localized scleroderma, is an inflammatory disease that leads to sclerosis of the skin and underlying tissues due to excessive collagen deposition. Oral involvement is unusual and it may produce white linear fibrotic areas with a scar-like appearance, atrophy of tongue papillae, gingival recession and alveolar bone resorption. We report a case of a 13-year-old girl who consulted for progressive recession on the attached gingiva of her upper left incisors. She also presented a hypopigmented line on the left side skin of her upper lip, which continued through the vermilion and the lip mucosa, including the gingiva of the affected teeth. Clinical examination, blood tests, computerized axial tomography, echo-Doppler ultrasound and histopathological evaluation confirmed the diagnosis of morphea. Treatment with methotrexate and systemic corticosteroids was conducted. After 24 months, no other lesions appeared. No adverse side effects have been reported so far. Key words:Localized scleroderma, oral morphea, linear scleroderma, oral involvement, intraoral lesions.

Cáncer oromaxilofacial en niños: Parte II tumores odontogénicos y de glándulas salivales malignos / Maxillofacial cancer in children: Part II malignant odontogenic and salivary gland tumors

A nivel mundial, la información acerca de tumores malignos del territorio maxilofacial que afectan a niños es limitada. La mayoría de los resportes consiste principalmente en datos de la población adulta. Las neoplasias malignas originadas del aparato odontogénicos y glándulas salivales son lesiones que con cierta frecuencia pueden afectar a la población infantil. Los tumores odontogénicos malignos son entidades sumamente raras que, correspondiendo a menos del 5 % del total de tumores odontogénicos. Los sarcomas odontogénicos, si bien son poco frecuentes, corresponden a los tumores odontogénicos malignos más comunes en la infancia. Las neoplasias malignas de glándulas salivales corresponden al 35­60 % de los tumores de gándulas salivales en la infancia, siendo el más común de ellos el carcinoma mucoepidermoide. En general, el pronóstico de estas entidades es positivo sobre todo si es acompañado de un diagnóstico oportuno. A pesar de la baja frecuencia que presenta este grupo de patologías, no es menos cierto que es necesario saber con precisión cuales son los tejidos orales desde los cuales se pueden originar neoplasias malignas en los niños y tener una breve referencia diferencial entre ellos.

Globally, information about the maxillofacial malignant tumors affecting children is limited. Most reported data consists mainly of studies in the adult population. Malignant neoplasms arising from odontogenic apparatus and salivary glands are lesions that frequently can affect children. Malignant odontogenic tumors are extremely rare entities, corresponding to less than 5 % of all odontogenic tumors. Odontogenic sarcomas, although they are rare, correspond to the most common malignant odontogenic tumors in childhood. Malignant salivary gland neoplasms correspond to 35­60 % of tumors of salivary glands during childhood and the most common of these is mucoepidermoid carcinoma. In general, the prognosis of these entities is positive especially when there is a timely diagnosis. Despite the low frequency presented by this group of diseases, the fact remains that it is necessary to know precisely what the originating oral tissues are which can cause malignancies in children and have a brief reference differential between them.

Incidence and prevalence of salivary gland tumours in Valparaiso, Chile

BACKGROUND: To determine the incidence and prevalence of salivary gland tumours in the province of Valparaíso, Chile. MATERIAL AND METHODS: Retrospective review of salivary gland tumours diagnosed between the years 2000 and 2011 from four local pathology services. Information on demographics and histopathology were retrieved from the medical records. RESULTS: The study sample consisted of 279 salivary gland tumours. Prevalence and incidence rates per 100.000 persons were 15.4 and 2.51, respectively. Most of the neoplasms corresponded to benign tumours (70.3%). The most affected gland was the parotid gland. Pleomorphic adenoma was the most common benign tumour (53.8%) and mucoepidermoid carcinoma was the most common malignant tumour (7.2%). CONCLUSIONS: Salivary gland tumours are uncommon neoplasms that usually arise in the parotid gland. Pleomor- : Salivary gland tumours are uncommon neoplasms that usually arise in the parotid gland. Pleomorphic adenoma and mucoepidermoid carcinoma were the most common benign and malignant tumours reported in this series

Cáncer oromaxilofacial en niños: Parte I tumores malignos de tejido duro / Oromaxillofacial cancer in children: Part I hard tissue malignant tumors

Las enfermedades malignas de cabeza y cuello en la población pediátrica son poco frecuentes. Considerando todos los tumores de cabeza y cuello, tanto benignos como malignos, éstos están representados por una frecuencia entre un 2% a 5% de todos los tumores pediátricos. A nivel de los maxilares, los tumores malignos en niños está representado por un rango que varía entre un 7% a 51%. En Chile, se estiman menos de 500 casos nuevos por año y en el rango entre los 5 y 15 años constituyen la segunda causa de muerte, precedida por los accidentes, traumatismos y violencias. Es importante considerar, al estudiar este grupo de enfermedades, que existen diferencias con los tumores de adultos, tanto en su incidencia, biología, comportamiento, histología y manejo. Es por esta razón que nos parece necesario realizar una revisión de la literatura científica para obtener un perfil del cáncer bucomaxilofacial infantil, que aporte en el entendimiento y aplicación de programas adecuados en el contexto de la salud bucomaxilofacial. Adicionalmente, buscamos actualizar el conocimiento de estas patologías, caracterizándolas en relación a su epidemiología, etiopatogenia y tratamiento, de manera que contribuya a los cirujanos dentistas para realizar diagnósticos y la pronta derivación a un centro especializado de patología oral. Para un estudio preciso, esta revisión constará de tres partes: la primera es sobre "tumores malignos de tejido óseo", mencionando, entre ellos, al osteosarcoma, sarcoma de Ewing, linfomas tanto Hodgkin como No Hodgkin, fibrosarcoma e histiocitosis de células de Langerhans.

Malignant head and neck disease in the pediatric population are rare. Considering all head and neck tumors, both benign and malignant, they represent between 2% to 5% of all pediatric tumors. At the level of the jaws, malignant tumors in children present in a range that varies from 7% to 51%. In Chile, fewer than 500 new cases are reported each year and in the 5 to 15 year-range are estimated to constitute the second cause of death, preceded by accidents, injuries and violence. When studying this group of diseases it is important to consider the differences with adult tumors, both in incidence, biology, behavior, histology and management. Therefore we believe it necessary to conduct a review of scientific literature to obtain a profile of child oral maxillofacial cancer, contributing to the understanding and implementation of appropriate programs in the context of maxillofacial health. In addition, we seek to update knowledge of these pathologies, characterizing their epidemiology, pathogenesis and treatment, so as to contribute to dental surgeons for diagnosis and early referrals to specialized centers for oral pathology. For a detailed study, this review will consist of three parts: the first is on "malignant bone tumors", included among these are: osteosarcoma, Ewing's sarcoma, Hodgkin's lymphoma, non-Hodgkin's lymphoma, Langerhans cell histiocytosis and fibrosarcoma.

Incidence and prevalence of salivary gland tumours in Valparaiso, Chile.

BACKGROUND: To determine the incidence and prevalence of salivary gland tumours in the province of Valparaíso, Chile. MATERIAL AND METHODS: Retrospective review of salivary gland tumours diagnosed between the years 2000 and 2011 from four local pathology services. Information on demographics and histopathology were retrieved from the medical records. RESULTS: The study sample consisted of 279 salivary gland tumours. Prevalence and incidence rates per 100.000 persons were 15.4 and 2.51, respectively. Most of the neoplasms corresponded to benign tumours (70.3%). The most affected gland was the parotid gland. Pleomorphic adenoma was the most common benign tumour (53.8%) and mucoepidermoid carcinoma was the most common malignant tumour (7.2%). CONCLUSIONS: Salivary gland tumours are uncommon neoplasms that usually arise in the parotid gland. Pleomorphic adenoma and mucoepidermoid carcinoma were the most common benign and malignant tumours reported in this series.

Epidemiological characterization of oral cancer: literature review / Caracterización epidemiológica del cáncer oral: revisión de la literatura

Oral cancer is a disease of high impact globally. It ranks as the sixth more frequent one among all types of cancer. In spite of being a widely known pathology and easy access to the diagnosis, the lack of epidemiological data reported in the last 10 years in Chile called attention to. At the global level, the World Health Organization (WHO) has developed a project called “GLOBOCAN” in order to collect epidemiological data of the global cancer, between its data, highlights the high incidence and high rate of mortality in the male sex, parameter that shows tendency to replicate in both America and Chile. In consequence to these data, a narrative review of the literature concerning the epidemiological profile of the different forms of oral cancer in the past 15 years was done. The diagnosis of oral cancer crosses transversely the Dental Science, forcing us to establish triads of work between oral and maxillofacial surgeons, pathologists and dentists of the various specialties, so as to allow a timely research, appropriate biopsies and histopathological studies finishes with the purpose of, on the one hand, obtain timely and accurate diagnostics, in addition, maintaining the epidemiological indicators...

El cáncer oral es una patología de alto impacto a nivel mundial, ocupando el sexto lugar más frecuente entre todos los tipos de cáncer. A pesar de unapatología ampliamente conocida y de fácil acceso al diagnóstico, llama la atención la falta de datos epidemiológicos reportados en los últimos 10 años en Chile. A nivelmundial, la Organización Mundial de Salud (OMS) ha desarrollado un proyecto denominado “GLOBOCAN”con el fin de recolectar datos epidemiológicos mundiales del cáncer, entre sus datos, destaca la gran incidencia y elevada tasa de mortalidad en el sexo masculino, parámetro que muestra tendencia a replicarse en tanto América como en Chile. En consecuencia a estos datos, se realizóuna revisión narrativa de la literatura, referente al perfil epidemiológico de las diferentes formas de cáncer oral enlos últimos 15 años. El diagnóstico del cáncer oral cruza de manera transversal a la Odontología, obligándonos a establecer triadas de trabajo entre cirujanos orales y maxilofaciales,patólogos y odontólogos de las diversas especialidades, para permitir así una oportuna pesquisa, biopsias adecuadas y estudios histopatológicos acabados con la finalidad de, por una parte, obtener diagnósticos oportunos y certeros, además, mantener actualizados los indicadores epidemiológicos...

Prevalence and risk factors for HPV infection in normal oral mucosa of chilean dentistry students / Prevalencia y factores de riesgo de infección por virus papiloma humano en mucosa oral normal de estudiantes de odontología chilenos

Abstract: aim: to determine the prevalence and risk factors for HPV infection in normal oral mucosa of Chilean dentistry students. Materials and methods: A cross-sectional study was performed. The study group was comprised of 103 individuals between 18 and 33 years old. A self-administered survey of cancer family history, sexual habits, smoking and alcohol drinking was applied. Oral mucosal samples were taken using a sterile swab. Subsequently, all samples were analyzed by polymerase chain reaction technique (PCR). Results: Results were negative for HPV detection in all analyses. Of the study population, 58 percent had a family history of cancer, 40.9 percent had had more than 3 sexual partners, 76.3 percent had sexual intercourse before the age of 19, 66.3 percent had engaged in oral sex, 69.9 percent drank alcohol and 20.6 percent were smokers. Conclusions: The group studied is exposed to various risk factors for HPV infection, so it is necessary to educate about the relationship between them and the spread of the virus. Despite the presence of risk factors, the detected prevalence of HPV was 0 percent.

Resumen: se realizó un estudio de corte transversal. El grupo de estudio fue constituido por 103 individuos entre 18 y 33 años. Se aplicó una encuesta autoadministrada sobre antecedentes familiares de cáncer, hábitos sexuales y consumo de tabaco y alcohol. Se tomaron muestras de la mucosa oral utilizando un hisopo estéril. Posteriormente, todas las muestras fueron analizadas mediante técnica de reacción en cadena de la polimerasa (PCR). Resultados: Los resultados fueron negativos para la detección de VPH en todos los análisis. De la población estudiada el 58 por ciento presentó antecedentes familiares de cáncer, el 40,9 por ciento ha tenido más de 3 parejas sexuales, el 76,3 por ciento se inició sexualmente antes de los 19 años, el 66,3 por ciento ha practicado sexo oral, un 69,9 por ciento es bebedor de alcohol y el 20,6 por ciento es fumador. Conclusiones: El grupo analizado está expuesto a diversos factores de riesgo de infección VPH, por lo que es necesario educar acerca de la relación entre estos y el contagio con el virus. A pesar de la presencia de factores de riesgo en los encuestados, la prevalencia detectada de VPH fue de 0 por ciento.

Human papilloma virus and oral cancer: narrative review of the literature / Virus papiloma humano y cáncer oral: revisión narrativa de la literatura

The Human Papilloma Virus (HPV) infection is now more common sexually transmitted diseases, with an incidence of 5.5 million worldwide, with 85 percent of the carrier of this virus adult population. Their oncogenic potential and increased oral lesions associated with oral HPV infection have led us to make a narrative of the literature on the role of HPV in oral cancer, especially types 16 and 18. Here we refer to the possible routes of infection, oncogenic mechanisms, both benign and potentially malignant oral lesions associated with the infection, different methods used for detection, prediction and prevention of infection. We stress the importance of the role of the dentist to identify individuals considered high risk and ease of performing detection in the oral cavity, through a quick and easy method as exfoliative cytology.

El Virus Papiloma Humano (VPH) en la actualidad constituye la infección por transmisión sexual más frecuente, presentando una incidencia de 5,5 millones en el mundo, siendo un 85 por ciento de la población adulta portadora de este virus. Su potencial oncogénico y el aumento de lesiones orales asociadas a infección oral por VPH nos han llevado a realizar una narración de la literatura referente al rol del VPH en el cáncer oral, especialmente de los subtipos 16 y 18. Nos referiremos a sus posibles vías de contagio, mecanismos oncogénicos, lesiones orales tanto benignas como potencialmente malignas asociadas a su infección, diferentes métodos utilizados para su detección, pronóstico y prevención de contagio. Destacamos la importancia del rol del odontólogo para identificar individuos considerados de alto riesgo y la facilidad de realizar su detección en la cavidad oral, a través de un método rápido y sencillo como es la citología exfoliativa.

Prevalence of oral mucosal lesions in an elderly population in the city of Valparaiso, Chile.

OBJECTIVE: Chilean population is ageing, which means an increase in the prevalence of multiple pathologies, including those located in the oral cavity. AIM: To measure the prevalence and distribution of oral mucosal lesions and to identify associated risk factors in elderly patients in the city of Valparaiso. MATERIAL AND METHODS: This study includes 126 patients over 60 years. The sample was calculated with a sampling error of 3.7% from a population size of 6000 file cards. Frequency and contingency tables were made together with odds ratios, with a confidence interval of 95%. Finally, we built a predictive model based on a binary logistic regression. RESULTS: From the whole sample, 85 patients (67.5%) had some oral mucosal lesion. The most frequent lesions were denture-induced stomatitis (37.1%). It was noted that there is a statistically significant association between the use of denture and the presence of oral candidiasis. The consumption of drugs and the use of denture increase the likelihood of having oral mucosal lesions. CONCLUSION: There is a high prevalence of oral lesions in the elderly patients of Valparaiso. The use of drugs and /or denture increases significantly the likelihood that a person over 60 years presents lesions in the oral mucosa.

Solitary intraosseous neurofibroma of the mandible. Apropos of a case

Neurofibroma is a benign neoplasm derived from peripheral nerves. Most of these are associated with Neurofibromatosisbut may also occur as solitary lesions. When found on the head and neck they are generally located inthe soft tissue. Intraosseous location is very rare.The following report describes a case of an intraosseous neurofibroma located in the left mandibular ramus of a14-year-old child. The patient did not had clinical evidence of the lesion and it was found on a routine radiographicexamination. Surgical excision of the lesion was scheduled and the sample was submitted to histopathologicalstudy. Representative sample cuts were studied using conventional techniques of hematoxylin-eosin and immunohistochemistryusing primary antibodies anti S-100 protein, vimentin, and neuroespecific enolase.A review of clinical, radiographic, histologic and immunohistochemical features of other cases of intraosseuosneurofibromas located in the jaws together with the possible differential diagnosis of the lesion are discussed.Our case corresponds to a intraosseous neurofibroma of controveltial diagnosis because even though it presentstypical neurofibroma histomorphological features it has immunophenotype different from usual (AU)

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Solitary intraosseous neurofibroma of the mandible. Apropos of a case.

Neurofibroma is a benign neoplasm derived from peripheral nerves. Most of these are associated with Neurofibromatosis but may also occur as solitary lesions. When found on the head and neck they are generally located in the soft tissue. Intraosseous location is very rare. The following report describes a case of an intraosseous neurofibroma located in the left mandibular ramus of a 14-year-old child. The patient did not had clinical evidence of the lesion and it was found on a routine radiographic examination. Surgical excision of the lesion was scheduled and the sample was submitted to histopathological study. Representative sample cuts were studied using conventional techniques of hematoxylin-eosin and immunohistochemistry using primary antibodies anti S-100 protein, vimentin, and neuroespecific enolase. A review of clinical, radiographic, histologic and immunohistochemical features of other cases of intraosseuos neurofibromas located in the jaws together with the possible differential diagnosis of the lesion are discussed. Our case corresponds to a intraosseous neurofibroma of controveltial diagnosis because even though it presents typical neurofibroma histomorphological features it has immunophenotype different from usual.

Association between psychological disorders and the presence of Oral lichen planus, Burning mouth syndrome and Recurrent aphthous stomatitis.

OBJECTIVE: The aim of this study was to determine the existing relation between the Oral Lichen Planus (OLP), Recurrent Aphthous Stomatitis (RAS), Burning Mouth Syndrome (BMS) and psychological alterations of the patient, such as stress, anxiety and depression. DESIGN OF THE STUDY: 18 patients with RAS, 9 patients with OLP and 7 patients with BMS, that presented the condition at the moment of the examination, were studied, as well as a control group of 20 healthy patients. Both groups were extracted of hospitals and university centers, where the clinical diagnosis was made by a team of oral pathologists. Two measuring instruments were applied to them about their psychological condition: the Test of Recent Experience, to measure the stress level and scale H.A.D., to determine the level of anxiety and depression; the score given by them were statistically analyzed through T-test and the ANOVA Tukey test. RESULTS: Our results suggested a statistically significant association between these psychological disorders and the diseases of the oral mucosa in study. It was observed that the stress level is greater in patients with RAS and OLP, depression is particularly high in patients with BMS, and levels of anxiety are raised in the three groups, in comparison with the group control. CONCLUSIONS: A positive relationship can be established between psychological alterations and RAS, OLP and BMS. The RAS and the OLP stress and anxiety levels were considered as high, whereas the BMS was more related to important levels of anxiety and depression. According to these findings it is possible to assume that psychological factors should be taking into account when oral health wants to be maintain as normal.

Asociación entre alteraciones psicológicas y la presencia de Liquen plano oral, Síndrome boca urente y Estomatitis aftosa recividante / Association between psychological disorders and the presence of Oral lichen planus, Burning mouth syndrome and Recurrent aphthous Stomatitis

OBJETIVO: El propósito de este estudio fue determinar la relación existente entre el Liquen Plano Oral (LPO), Estomatitis Aftosa Recividante (EAR), Síndrome de Boca Utente (SBU) y las alteraciones psicológicas del paciente, tales como el estrés, la ansiedad y la depresión. DISEÑO DEL ESTUDIO. Fueron estudiados 1 g pacientes con EAR, 9 pacientes con LPO y 7 pacientes con SBU, que presentaron la lesión en el momento del examen, más un grupo control de 20 pacientes sanos. Ambos grupos fueron extraídos de centros hospitalarios y docentes, donde el diagnóstico clínico fue realizado por un equipo de patólogos orales. A los pacientes se les aplicó dos instrumentos de medición del estado psicológico del individuo: el Test de Experiencia Reciente, para medir el grado de estrés y la escala HAD, para determinar el nivel de ansiedad y depresión; los puntajes entregados por ellos fueron analizados estadísticamente a través del test T de Student no pareado y el Anova Tukey. RESULTADOS : Nuestros resultados sugirieron que hay una asociación estadísticamente significativa entre estos desórdenes psicológicos y las patologías de la mucosa oral en estudio. Se estableció que el nivel de estrés -es mayor en los pacientes con EAR y LPO. Por otro lado la ansiedad es mayor en los tres grupos de pacientes con patología oral y la depresión es particularmente alta en los pacientes con SBU, todos estos datos respecto al grupo control. CONCLUSIONES : Existe una relación positiva entre alteraciones psicológicas y la EAR, LPO y SBU La EAR y el LPO se asociaron a altos niveles de estrés y ansiedad, mientras que el SBU se relacionó con importantes grados de ansiedad y depresión. De acuerdo a lo observado por nosotros, en el mantenimiento del estado de salud de los tejidos orales, los factores psicológicos desempeñan un papel importante (AU)