Quiste sinovial de articulación temporomandibular: presentación de un caso / Synovial cyst of the temporomandibular joint: presentation of a case

El quiste sinovial localizado en la articulación temporomandibular es una entidad rara, con pocos casos reportados en la literatura médica. Gaisford et al. fueron los primeros autores que informaron de un caso de quiste sinovial, patología que afecta más frecuentemente a articulaciones como la muñeca o la rodilla. Estos quistes están delimitados por células sinoviales, y pueden estar comunicados o ser independientes de la cavidad articular. Se han propuesto varias teorías para explicar la etiología de esta patología, un incremento de la presión en la cavidad articular causado por una inflamación o traumatismo puede ser clave para producir una herniación de la membrana sinovial dando lugar a la entidad. Entre los diagnósticos que hay que considerar ante una tumoración preauricular se encuentran los tumores de parótida, los quistes sebáceos, los gangliones y los quistes sinoviales, entre otros. El tratamiento quirúrgico es el tratamiento frecuentemente propuesto por la literatura, logrando una escasa tasa de recurrencia (AU)

A synovial cyst located in the temporomandibular joint is rare, with few cases reported in the medical literature. Gaisford et al. were the first authors to report a case of a synovial cyst. This a condition that more frequently affects joints such as the wrist or knee. These cysts are delimited by synovial cells, and may be connected to, or be independent of, the joint cavity. Several theories have been proposed to explain the etiology of this disease: an increase in pressure in the joint cavity caused by inflammation or trauma may be the reason that a herniation of the synovial membrane could be produced. Among the diagnoses to be considered when faced with a tumor are pre-auricular parotid tumors, sebaceous cysts, ganglia and synovial cysts, among others. Surgery is the treatment most frequently proposed in the literature, achieving a low rate of recurrence (AU)

Úlcera eosinofílica lingual: un reto diagnóstico de patogénesis controvertida / Eosinophilic ulcer tongue: a diagnostic challenge controversial pathogenesis

La úlcera eosinofílica, también conocida como granuloma ulcerativo traumático con eosinofilia estromal, es una infrecuente y benigna lesión ulcerativa de la mucosa oral que presenta una evolución persistente, planteando a menudo diferentes diagnósticos clínicos diferenciales. Su diagnóstico se establece solo a partir del estudio histopatológico, si bien su morfología presenta a menudo características que pueden sugerir al patólogo la existencia de un proceso linfoproliferativo, traduciendo una patogénesis lesional controvertida todavía no bien aclarada. Comunicamos una observación clínico-patológica de úlcera eosinofílica afectando a una mujer de 76 años de edad. La lesión, de 2,5 cm de diámetro, afectaba al borde lateral lingual, siendo biopsiada en dos ocasiones, presentando tras un seguimiento clínico de 5 meses una evolución cicatricial, programándose actualmente un seguimiento clínico prologando de 24 meses. Se presentan las características morfológicas e inmunohistoquímicas del estudio biópsico, discutiendo las hipótesis patogéneticas que esta infrecuente lesión ulcerativa plantea(AU)

Eosinophilic ulcer, also know as traumatic ulcerative granuloma with stromal eosinophilia, is a rare and benign ulcerative lesion of oral mucosa that has a persistent progression, often requiring a differential clinical diagnosis. The diagnosis is only established from histopathological studies, which frequently show morphological features that may be suggestive of a lymphoproliferative process, resulting in a controversial pathogenesis that is still not clarified today. We report the clinical and pathological observations of an eosinophilic ulcer affecting a woman 76 year-old woman. A biopsy was performed twice on a 2.5 cm diameter ulcer affecting the lingual edge. After a clinical follow-up of 5 months, a self-limiting course with the production of a scar was verified. She has currently been scheduled for an extended 24-month clinical follow-up. The morphological and immunohistochemical features found in the biopsy study are presented, and the pathogenesis hypothesis of this uncommon ulcerative lesion is discussed(AU)

Management of fibro-osseous lesions of the craniofacial area. Presentation of 19 cases and review of the literature

Introduction: Fibro-osseous lesions constitute a rare benign type of pathology with a non-odontogenic lineage that affect the craniofacial area. According to Waldrom’s classification, these lesions are divided into: fibrous dysplasia (FD), cemento-ossifying fibroma (COF) and desmoplastic fibroma (DF).Material and Methods: A retrospective study was performed on patients diagnosed with fibro-osseous lesions of the craniofacial area at the Hospital Universitario La Fe, Valencia, during 1987-2009. A total of 19 cases were collected:15 cases compatible with an FD diagnosis, 3 cases with a COF diagnosis and 1 case with a DF diagnosis. Results: In the differential diagnosis, entities having similar clinical manifestations in the maxillofacial area with possible involvement of teeth or manifestations present as an asymptomatic radiolucent image should be ruled out. We hereby present the management and development of patients treated in our hospital for fibro-osseous lesions. Conclusions: Fibro-osseous lesions share many clinical and radiological characteristics in common, with histological features confirming the nature of the lesion. Management of patients should be individualized and casespecific, assessing the clinical evolution of each case and taking into account the benign nature and growth behavior of this type of tumors (AU)

Management of fibro-osseous lesions of the craniofacial area. Presentation of 19 cases and review of the literature.

INTRODUCTION: Fibro-osseous lesions constitute a rare benign type of pathology with a non-odontogenic lineage that affect the craniofacial area. According to Waldrom's classification, these lesions are divided into: fibrous dysplasia (FD), cemento-ossifying fibroma (COF) and desmoplastic fibroma (DF). MATERIAL AND METHODS: A retrospective study was performed on patients diagnosed with fibro-osseous lesions of the craniofacial area at the Hospital Universitario La Fe, Valencia, during 1987-2009. A total of 19 cases were collected: 15 cases compatible with an FD diagnosis, 3 cases with a COF diagnosis and 1 case with a DF diagnosis. RESULTS: In the differential diagnosis, entities having similar clinical manifestations in the maxillofacial area with possible involvement of teeth or manifestations present as an asymptomatic radiolucent image should be ruled out. We hereby present the management and development of patients treated in our hospital for fibro-osseous lesions. CONCLUSIONS: Fibro-osseous lesions share many clinical and radiological characteristics in common, with histological features confirming the nature of the lesion. Management of patients should be individualized and case-specific, assessing the clinical evolution of each case and taking into account the benign nature and growth behavior of this type of tumors.