Gingival exophytic lesions as first oral manifestation of primary lung adenocarcinomas: Systematic review.

Metastases from malignant tumors in the oral cavity are rare and comprise approximately 1% of all oral neoplasms, being more frequent in the jaws than in the soft tissues. The presentation of a gingival metastasis as the first manifestation of a primary tumor in the oral cavity is extremely rare. The objective of this review is to update the diagnosis and management of oral metastasis being the first clinical manifestation of the tumor and review all the cases published to date, providing a new original clinical case with very specific histopathological characteristics. We systematically reviewed the literature in order to find all the cases of primary lung tumors that appeared with a gingival metastasis as the first manifestation. The search process involved a total of 1916 articles. After reading the latter, 15 (one of them with two different cases) met the inclusion criteria. Of the 15 articles, 6 were rated as medium quality (40%) and 9 as high quality (60%). We present a lung adenocarcinoma that first manifested as a metastasis in the gum, simulating a benign lesion. The unusually high growth rate of this lesion should conduct to have other diagnostic possibilities, and histopathological confirmation is essential.

Tratamiento quirúrgico del carcinoma epidermoide de un 40 % del labio inferior. Reporte de caso / Surgical treatment of squamous cell carcinoma of 40 % of the lower lip. Case report

RESUMEN Fundamento: La técnica del tonel de Schuchardt, está indicada cuando el defecto en el labio compromete del 30-75 % del labio, de localización central y paramedial que afecta bermellón y piel; en este caso se usó el colgajo para reconstruir una lesión tumoral más lateral. La técnica aparece descrita para extraer el tonel de espesor parcial, sin embargo, teniendo en cuenta el margen oncológico recomendado en este caso la excéresis abarcó todo el espesor del labio. Objetivo: Presentar un caso de un paciente con un carcinoma epidermoide del 40 % en el labio inferior intervenido en el Hospital General Camilo Cienfuegos. Presentación del caso: Paciente masculino de 43 años de edad tratado durante un año por queilitis actínica, portador de una lesión exofítica, infiltrante que ocupaba el 40 % del labio inferior. Se estableció como impresión diagnóstica un carcinoma epidermoide y se decidió el tratamiento quirúrgico. Atendiendo a las características individuales del paciente y a las de la lesión, se eligió la técnica del tonel descrita por Schuchardt. Conclusiones: Las lesiones malignas de los labios pueden incidir enmascaradas por el cuadro clínico de lesiones premalignas como la queilitis actínica por lo que es importante mantener un seguimiento estrecho de estos casos. Al aplicar el método clínico puede decidirse la intervención quirúrgica con diagnóstico presuntivo de carcinoma epidermoide, deben respetarse entonces los márgenes oncológicos recomendados. La técnica del tonel inicialmente descrita para pérdidas de tejidos mediales y paramediales del labio, de espesor parcial puede emplearse en defectos de localización más lateral y de espesor total con resultados satisfactorios.

ABSTRACT Background: The barrel of Schuchardt technique, is indicated when the defect in the lip compromises 30-75 % of it, from central to paramedial location which affects both, vermilion and skin; in this case, the flap was used for rebuilding a more lateral tumor lesion. The technique is described to extract the partial thickness barrel; however, taking into account the oncological margin recommended in this case, the hysteresis covered the entire thickness of the lip. Objective: To present a case of a patient with 40 % squamous cell carcinoma in the lower lip intervened at Camilo Cienfuegos General Hospital. Case report: A 43-year-old male patient treated for a year having actinic cheilitis, with an infiltrated exophytic lesion, occupying 40 % of the lower lip. A squamous cell carcinoma was diagnosed, so surgical treatment. Based on the individual characteristics of the patient and those of the lesion, the barrel technique described by Schuchardt was chosen. Conclusions: Malignant lesions of the lips can affect masked by the clinical picture of premalignant lesions such as actinic cheilitis, so it is important to keep a close follow-up of these cases. When applying the clinical method, the surgical intervention with presumptive diagnosis of squamous cell carcinoma can be decided, then the recommended oncological margins must be respected. The barrel technique initially described for losses of medial and paramedial tissues of the lip, of partial thickness can be used in defects of more lateral location and of total thickness with satisfactory results.

Tratamiento quirúrgico del carcinoma epidermoide de un 40 por ciento del labio inferior. Reporte de caso / Surgical treatment of squamous cell carcinoma of percen of the lower lip. Case report

RESUMEN Fundamento: La técnica del tonel de Schuchardt, está indicada cuando el defecto en el labio compromete del 30-75 % del labio, de localización central y paramedial que afecta bermellón y piel; en este caso se usó el colgajo para reconstruir una lesión tumoral más lateral. La técnica aparece descrita para extraer el tonel de espesor parcial, sin embargo, teniendo en cuenta el margen oncológico recomendado en este caso la excéresis abarcó todo el espesor del labio. Objetivo: Presentar un caso de un paciente con un carcinoma epidermoide del 40 % en el labio inferior intervenido en el Hospital General Camilo Cienfuegos. Presentación del caso: Paciente masculino de 43 años de edad tratado durante un año por queilitis actínica, portador de una lesión exofítica, infiltrante que ocupaba el 40 % del labio inferior. Se estableció como impresión diagnóstica un carcinoma epidermoide y se decidió el tratamiento quirúrgico. Atendiendo a las características individuales del paciente y a las de la lesión, se eligió la técnica del tonel descrita por Schuchardt. Conclusiones: Las lesiones malignas de los labios pueden incidir enmascaradas por el cuadro clínico de lesiones premalignas como la queilitis actínica por lo que es importante mantener un seguimiento estrecho de estos casos. Al aplicar el método clínico puede decidirse la intervención quirúrgica con diagnóstico presuntivo de carcinoma epidermoide, deben respetarse entonces los márgenes oncológicos recomendados. La técnica del tonel inicialmente descrita para pérdidas de tejidos mediales y paramediales del labio, de espesor parcial puede emplearse en defectos de localización más lateral y de espesor total con resultados satisfactorios.

ABSTRACT Background: The barrel of Schuchardt technique, is indicated when the defect in the lip compromises 30-75 % of it, from central to paramedial location which affects both, vermilion and skin; in this case, the flap was used for rebuilding a more lateral tumor lesion. The technique is described to extract the partial thickness barrel; however, taking into account the oncological margin recommended in this case, the hysteresis covered the entire thickness of the lip. Objective: To present a case of a patient with 40 % squamous cell carcinoma in the lower lip intervened at Camilo Cienfuegos General Hospital. Case report: A 43-year-old male patient treated for a year having actinic cheilitis, with an infiltrated exophytic lesion, occupying 40 % of the lower lip. A squamous cell carcinoma was diagnosed, so surgical treatment. Based on the individual characteristics of the patient and those of the lesion, the barrel technique described by Schuchardt was chosen. Conclusions: Malignant lesions of the lips can affect masked by the clinical picture of premalignant lesions such as actinic cheilitis, so it is important to keep a close follow-up of these cases. When applying the clinical method, the surgical intervention with presumptive diagnosis of squamous cell carcinoma can be decided, then the recommended oncological margins must be respected. The barrel technique initially described for losses of medial and paramedial tissues of the lip, of partial thickness can be used in defects of more lateral location and of total thickness with satisfactory results.

An exophytic and symptomatic lesion of the labial mucosa diagnosed as labial seborrheic keratosis.

Seborrheic keratosis is a common benign epidermal tumor that occurs mainly in the skin of the face and neck, trunk. The tumors are not, however, seen on the oral mucous membrane. Herein, we describe a case of labial seborrheic keratosis confirmed by histopathology. A healthy 63-year-old man was referred to our hospital for evaluation and treatment of a 2-month history of a labial mass with mild pain. Clinically, the initial impressions were malignant transformation of chronic discoid lupus erythematosus, syphilitic chancre, or keratoacanthoma. Surprisingly, our laboratory results and histopathologic evaluations established a novel diagnosis of a hyperkeratotic type of labial seborrheic keratosis (SK). This reminds us that atypical or varying features of seborrheic keratosis make it difficult to provide an accurate diagnosis. Clinical manifestations of some benign lesions may be misdiagnosed as malignancy. Consequently, dentists should consider this as a differential diagnosis in labial or other oral lesions.

Hiperplasia fibrosa inflamatória provocada por uma prótese parcial removível / Inflammatory fibrous hyperplasia caused by removable partial prosthesis ­ a case report

A hiperplasia fibrosa inflamatória (HFI) é um crescimento gengival que tem como principal causa etiológica o uso de próteses inadequadas ou mal adaptadas. A HFI é uma lesão exofítica benigna de tecido epitelial e conjuntivo fibroso. Seu tratamento de eleição é a exérese cirúrgica e a remoção do agente irritante. Este trabalho teve como objetivo relatar um caso clínico de hiperplasia gengival inflamatória diagnosticada em uma paciente, leucoderma e com 38 anos de idade, que procurou atendimento na Clínica de Periodontia do Sindicato dos Dentistas de Mato Grosso do Sul (Sioms). Após a remoção cirúrgica da lesão e análise histopatológica, o estudo concluiu que o tratamento aplicado neste caso é o mais efetivo para esta patologia, contudo, deve haver avaliações periódicas da prótese para evitar recidiva da lesão.

Inflammatory fibrous hyperplasia (HFI) is a gingival overgrowth that has as its main etiological cause the use of inappropriate or poorly fitting dentures. The HFI is a benign exophytic lesion of epithelial and connective fibrous tissues. The treatment of choice of choice is surgical excision and removal of the irritant. This study aimed to report a clinical case of inflammatory gingival hyperplasia diagnosed in a 38 years-old female patient who sought care in Union Periodontics Clinic of Mato Grosso do Sul Dentists (Sioms). After surgical removal of the lesion and histopathologic analysis the treatment applied in this case is the most effective for this condition, however, periodic reviews must be made to avoid recurrent fibrotic lesions.

Primary oral leishmaniasis mimicking oral cancer: a case report.

Primary mucosal leishmaniasis is a rare infectious disease, particularly in immunocompetent patients. We present a 50-year-old patient with a 6-week history of a painful lesion of the left buccal mucosa that mimicked cancer. The exophytic lesion looked invasive, and we took an incisional biopsy specimen to exclude cancer. The diagnosis of leishmaniasis was unexpected, and the patient was successfully treated with amphotericin B for five weeks. After five months the patient had a visceral recurrence. Chronic exophytic and ulcerated mucosal lesions that do not heal within 3-4 weeks should be regarded as the first signs of oral cancer, but primary oral leishmaniasis can easily mimic it.

[Radiological diagnosis of enchondroma protuberans of the humerus]. / Diagnóstico radiológico del encondroma protuberans humeral.

Enchondroma protuberans (EP) is an uncommon exophytic cartilaginous tumor described as an intramedullary osseous lesion that protrudes through a cortical defect in one of the sides of the affected bone and expands to the adjacent soft tissues. Due to its peculiar features on imaging studies, the main differential diagnosis is with osteochondroma, chondrosarcoma, and periosteal chondral tumors. In this article, we describe the imaging findings in two patients with EP in the humerus. We review the literature and discuss the imaging features that can enable a definitive diagnosis. The identification of the connection between the two components of the lesion through a cortical defect is a key finding for the diagnosis. Available imaging techniques, especially MRI, make it possible to establish the diagnosis in this type of lesions and thus to choose the appropriate treatment, reducing the chance of local recurrence and malignant transformation.

Primary glioblastoma multiforme of medulla oblongata: Case report and review of literature.

Glioblastoma multiforme (GBM) is the most common glial tumor of the adult brain. However, the primary GBM of medulla oblongata is a rarity. To the best of our knowledge, only four cases of GBM of medulla oblongata have been reported so far in the literature, and this is the second report of conventional GBM of the medulla oblongata in adults. We describe a case of 51-year-old female, who presented with a heterogeneous mass with exophytic feature located in the caudal brain stem that was approached and a near total tumor removal was achieved by median suboccipital route. A literature review with emphasis on anatomical location, radiological and histopathological findings, extent of tumor resectibility, and outcome is included.

Consistency rates of clinical and histopathologic diagnoses of oral soft tissue exophytic lesions.

BACKGROUND AND AIMS: Histpathologic diagnosis of exophytic lesions is occasionally influenced by clinical and radiograph-ic diagnosis and even the surgeon's observation during biopsy. The aim of this study was to evaluate the cases with failure in clinical diagnosis. MATERIALS AND METHODS: A total of 73 patients with peripheral exophytic lesions were evaluated in Zahedan Faculty of Den-tistry in 2006. Specialists gave their differential diagnoses based on the criteria of oral medicine texts. Then a biopsy was taken and the histopathologic diagnosis was determined. Finally, consistency rates of clinical and histopathologic diagnoses were de-termined. Statistical analysis was carried out with SPSS software using Chi-Square and Fisher's exact tests. RESULTS: In the present study 73 subjects with oral soft tissue (peripheral) exophytic lesions were orally examined and biopsies were taken. Forty-four subjects (60.35%) were females and 29 (39.7%) were males. A total of 81.7% (62 subjects) of clinical diagnoses were consistent with histopathologic reports. In 18.3% (11 subjects) of the cases clinical diagnoses were not con-firmed by histopathologic reports. CONCLUSION: In order to reach a diagnostic agreement, conformity of clinical and histopathologic diagnoses is necessary.