Symptomatic subgemmal neurogenous plaque in patients with COVID-19: Is there an association?

BACKGROUND: Subgemmal neurogenous plaques (SNP) are composed of neural structures found in the posterolateral portion of the tongue, rarely biopsied as most of them are asymptomatic or eventually only clinically managed. We aimed to investigate a case series of possible correlation of symptomatic subgemmal neurogenous plaque (SNP) with coronavirus disease 2019 (COVID-19). METHODS: Eleven formalin-fixed paraffin-embedded cases from patients with previous confirmed COVID-19 (by RT-PCR) were retrieved from two pathology files. Histological sections were morphologically studied, and then submitted to immunohistochemical reactions against S-100 and neurofilament proteins, neuron-specific enolase, Glial fibrillary acidic protein (GFAP), synaptophysin, CD56, Ki67, cytokeratins (7, 8-18, 19, 20), nucleocapsid and spike proteins (SARS-CoV-1; and -2) and epithelial membrane antigen (EMA) antibodies. Clinical data were retrieved from the patients' medical files, including the symptoms and the complete history of the progression of the disease. RESULTS: The patients who had COVID-19 included in this study experienced painful lesions in the tongue that corresponded to prominent or altered SNP. Microscopically, neural structures were positive for S-100, GFAP and neurofilament protein. And the cellular proliferative index (by Ki-67) was very low. CONCLUSION: Thus, based on the current results, we hypothesize that symptomatic SNP may be a late manifestation of COVID-19 infection.

Clinical, morphogical and immunohistochemical aspects of oral inflammatory myofibroblastic tumor: a rare case report in a pediatric patient / Aspectos clínicos, morfológicos e imuno-histoquímicos do tumor miofibroblástico inflamatório oral: relato de caso raro em paciente pediátrico / Aspectos clínicos, morfológicos e inmuno-histoquímicos del tumor miofibroblástico inflamatorio oral: reporte de caso raro en paciente pediátrico

Inflammatory myofibroblastic tumor (IMT) is a rare benign neoplasm composed by myofibroblasts and fibroblasts admixed with inflammatory cells. Here, we report a case of IMT in the oral cavity of left mandible of a 12-year-old boy. Histopathological investigation revealed a proliferation of fibroblasts and myofibroblasts (positive for alpha-smooth muscle actin and vimentin) associated with inflammatory cells. The patient is still under follow-up and without evidence of recurrence. Oral IMT is a challenge for the clinician in diagnosis due to the nonspecific clinical presentation. Thus, histology and immunohistochemistry are required to reach an accurate diagnosis of this lesion(AU)

O tumor miofibroblástico inflamatório (TMI) é uma neoplasia benigna rara composta por miofibroblastos e fibroblastos associados com células inflamatórias. Aqui, relatamos um caso de TMI na cavidade oral da mandíbula esquerda de um menino de 12 anos. A análise histopatológica revelou uma proliferação de fibroblastos e miofibroblastos (positivos para alfa-actina de músculo liso e vimentina) associados à células inflamatórias. O paciente ainda está sob acompanhamento e sem evidências de recorrência. O TMI oral é um desafio diagnóstico para o clínico devido à apresentação clínica não específica. Assim, análises histopatológicas e imuno-histoquímicas são necessárias para alcançar um diagnóstico preciso dessa lesão(AU)

El tumor miofibroblástico inflamatorio (TMI) es una neoplasia benigna rara compuesta de miofibroblastos y fibroblastos asociados con células inflamatorias. Aquí, relatamos un caso de TMI en la cavidad oral de la mandíbula izquierda de un niño de 12 años. El análisis histopatológico reveló una proliferación de fibroblastos y miofibroblastos (positivos para alfa-actina de músculo liso y vimentina) asociados a las células inflamatorias. El paciente todavía está bajo seguimiento y sin evidencias de recurrencia. El TMI oral es un desafío diagnóstico para el clínico debido a la presentación clínica no específica. Así, los análisis histopatológicos e inmuno-histoquímicos son necesarios para alcanzar un diagnóstico preciso de esa lesión(AU)

Extensive Epidermoid Cyst and Breathing Difficulty.

Epidermoid cysts are common cystic lesions in the skin, ovaries, and testicles, but their occurrence in the oral cavity is uncommon. They consist of cysts delimited by a fibrous capsule without cutaneous annexes and are lined by stratified squamous epithelium. The differential diagnosis includes ranula, dermoid cysts, and lingual thyroid. Despite their benign presentation, these cysts can cause functional limitations, requiring special clinical attention for extensive lesions located in regions that preserve vital structures. This paper aims to report a case of epidermoid cyst in patient with swallowing and breathing difficulty, highlighting the clinical and surgical planning.