Oral Spindle Cell Lipoma in a Rare Location: A Differential Diagnosis.

BACKGROUND: Spindle cell lipoma (SCL) is an uncommon and histologically distinct variant of lipoma. It usually occurs as a solitary, subcutaneous, and well-circumscribed lesion in the posterior neck, shoulders, and back of older men. SCL of the oral cavity is rare. We present the clinical-pathologic features of the third case of SCL located on the hard palate and discuss the histological differential diagnosis with other fusiform neoplasms. CASE REPORT: A 56-year-old man was evaluated for an asymptomatic swelling on the right side of the hard palate. The intraoral examination showed a 25×20 mm sessile and circumscribed tumor, underlying an apparently healthy mucosa of normal color. The lesion revealed a floating consistency during palpation. Excisional biopsy was carried out based on a clinical diagnosis of lipoma or a benign minor salivary gland tumor. The histopathology demonstrated a well-circumscribed but unencapsulated proliferation of bland spindle cells admixed with mature adipocytes in a collagenous/myxoid stroma. The spindle cells were uniform, exhibiting elongated nuclei and narrow cytoplasmic processes without atypia. They were positive to CD34 and negative to factor VIII, alpha-smooth muscle actin, S100, cytokeratin, and actin. Mitotic activity was low, as confirmed by Ki-67 immunostaining. No lipoblastic activity was found. The diagnosis of SCL was therefore established. CONCLUSIONS: Oral spindle cell lipoma is a rare benign lipomatous tumor. The histologic picture shows a range of variations and the observation of morphological features is important to distinguish this lesion from other fusiform tumors. Immunohistochemistry should be helpful in this differentiation.

Síndrome da ardência bucal: uma revisão sobre aspectos clínicos, etiopatogenia e manejamento / Síndrome de ardor bucal: aspectos clínicos, etiopatogenia y tratamiento / Burning mouth syndrome: clinical characteristics, etiological factors and treatment

El síndrome de boca ardiente (SBA) es una enfermedad crónica que se caracteriza por una sensación de quemazón de la mucosa bucal, que impresiona clínicamente normal. Es una entidad nosológica frecuente, sin embargo, los mecanismos implicados en su desarrollo en la actualidad son poco conocidos. El objetivo de este trabajo fue llevar a cabo una revisión de la literatura sobre dicho síndrome y se hizo énfasis en sus principales factores etiológicos y en el tratamiento de esta enfermedad. El SBA es una afección multifactorial compleja, debido a la diversidad de sus síntomas, dificultad en el tratamiento y las características psicológicas particulares de los pacientes. El diagnóstico correcto es el elemento principal para establecer el tratamiento. Es necesario realizar nuevas investigaciones para aclarar con precisión las causas del SAB, especialmente en la forma primaria(AU)

Burning mouth syndrome (BMS) is a chronic condition characterized by burning sensation on a clinic normal oral mucosa. BMS is not a rare condition, however, mechanisms involved in their development remains poorly understood. The aim of this paper was to carry out a review of literature about this syndrome, highlighting the main etiological factors as an approach to the management of this condition(AU)

Immunohistochemical localization of the NM23 protein in salivary gland neoplasms with distinct biological behavior.

The NM23 protein was shown to be associated with metastasis suppression in human malignancies with various tissue origins. However, its association with the metastatic phenotype of salivary gland neoplasms (SGN) remains unknown. To evaluate the role of NM23 in SGN, the expression patterns of NM23 in the following were compared: benign (pleomorphic adenoma) vs malignant (adenoid cystic carcinoma and mucoepidermoid carcinoma) SGN, and primary malignancies with/without evidence of metastasis vs their metastatic implants (MI). The lesions were studied immunohistochemically. NM23 protein was found in the cytoplasm of 75% of benign SGN, 73.3% of primary SGN malignancies with no evidence of metastasis, 86.6% of primary SGN malignancies with evidence of metastasis, and 60% of MI. There was no statistically significant difference in the frequency of NM23-positive cells between benign and primary malignant tumors (p = 0.79), nor between primary malignancies with/without evidence of metastasis and MI (p = 0.51). However, nuclear NM23 protein was restricted to primary SGN malignancies with evidence of metastasis and MI. The presence of nuclear NM23 protein may be a good marker for predicting the metastatic potential of SGN malignancies.

Immunohistochemical evaluation of metallothionein in palatal mucosal cells of mice treated with 4NQO.

OBJECTIVE: Metallothionein (MT) may play a preventive role in various carcinogenic process. 4NQO is an alkaline compound and potent mutagen that causes the formation of DNA adducts. The purpose of this study was to evaluate the immunoexpression of MT in palatal cells of mice submitted to the carcinogen 4NQO. STUDY DESIGN: C57BL/6 mice received applications of 4NQO to palate for periods of 8, 16, 20 and 24 weeks (experimental group). A control group received only applications of propylene glycol for the same periods. Subsequently animals of experimental and control groups were sacrificed and the palate was histologically analysed and MT immunohistochemistry performed. RESULTS: Although morphological atypical features were scant, the expression of MT was higher in the experimental group in comparison to controls. There was an amplified induction of MT expression in oral epithelium of mice treated by 4NQO. CONCLUSION: These results suggest that MT may act as an endogenous defensive factor against 4NQO in early phases of oral carcinogenesis.

Immunohistochemical evaluation of metallothionein in palatal mucosal cells of mice treated with 4NQO

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Objective: Metallothionein (MT) may play a preventive role in various carcinogenic process. 4NQO is an alkaline compound and potent mutagen that causes the formation of DNA adducts. The purpose of this study was to evaluate the immunoexpression of MT in palatal cells of mice submitted to the carcinogen 4NQO. Study design: C57BL/6 mice received applications of 4NQO to palate for periods of 8, 16, 20 and 24 weeks (experimental group). A control group received only applications of propylene glycol for the same periods. Subsequently animals of experimental and control groups were sacrificed and the palate was histologically analysed and MT immunohistochemistry performed. Results: Although morphological atypical features were scant, the expression of MT was higher in the experimental group in comparison to controls. There was an amplified induction of MT expression in oral epithelium of mice treated by 4NQO. Conclusion: These results suggest that MT may act as an endogenous defensive factor against 4NQO in early phases of oral carcinogenesis