Multiple oral fibropapillomatosis as an initial manifestation of Cowden Syndrome. Case report.

Cowden syndrome is a rare hereditary disease included within hamartoma-type gastrointestinal polyposis. It is characterised by associated mucocutaneous anomalies and by the extraordinary tendency to develop malignant neoplasia, mainly in the breast and thyroid. Early diagnosis of the syndrome and adequate tumoral screening in patients with mucocutaneous papillomatosis make it possible to make an earlier diagnosis of associated pathologies which have great morbidity when detected late. We present the case of a patient diagnosed with Cowden syndrome after consultation for labial papillomatous lesions of long evolution who was subsequently treated for breast and kidney cancer in initial stages. The correct diagnosis of a banal pathology of oral mucosa made it possible for us to take early action against the neoplastic pathology associated with this disease.

Fibropapilomatosis oral múltiple como manifestación inicial de Síndrome de Cowden. Caso clínico / Multiple oral fibropapillomatosis as an initial manifestation of Cowden Syndrome. Case report

El síndrome de Cowden es una infrecuente enfermedad hereditaria englobada dentro de las poliposis gastrointestinales de tipo hamartomatoso. Se caracteriza por asociar anomalías cutaneomucosas y por la extraordinaria tendencia a desarrollar neoplasias malignas, principalmente de mama y tiroides. La importancia de un diagnóstico precoz del síndrome y de un adecuado screening tumoral en pacientes con lesiones papilomatosas cutaneomucosas, nos va a permitir adelantarnos en el diagnóstico de patologías con enorme morbimortalidad asociada en caso de una detección tardía. Presentamos el caso de una paciente diagnosticada de síndrome de Cowden tras consultar por lesiones papilomatosas labiales de largo tiempo de evolución y tratada posteriormente de cáncer de mama y riñón en estadios iniciales. El correcto diagnóstico de una patología banal de mucosa oral, nos ha permitido actuar de manera muy precoz frente a la patología neoplásica asociada a dicha enfermedad

Cowden syndrome is a rare hereditary disease included within hamartoma-type gastrointestinal polyposis. It is characterisedby associated mucocutaneous anomalies and by the extraordinary tendency to develop malignant neoplasia, mainly in the breast and thyroid. Early diagnosis of the syndrome and adequate tumoral screening in patients with mucocutaneous papillomatosis make it possible to make an earlier diagnosis of associated pathologies which have great morbidity when detected late. We present the case of a patient diagnosed with Cowden syndrome after consultation for labial papillomatous lesions of long evolution who was subsequently treated for breast and kidney cancer in initial stages.The correct diagnosis of a banal pathology of oral mucosa made it possible for us to take early action against the neoplasticpathology associated with this disease

Factores histopatológicos en el carcinoma lingual de células escamosas / Histopathologic factors in the squamous carcinoma of tongue

I. Introducción: Se realiza un estudio sobre los principalesparámetros histopatológicos en el carcinoma escamosode lengua, neoplasia que representa hoy día un auténtico problemade salud pública. II. Material y Métodos: 1. Diseño:Estudio retrospectivo de base hospitalaria integrado por 60pacientes desde enero de 1990 a julio de 1997 (seguimientomínimo de 8 años). 2. Variables: Filiación del paciente (edady sexo) y factores histopatológicos (diferenciación tumoral,índice mitótico, eosinofilia peritumoral, infiltración perivasculary perineural y patrón de crecimiento). 3. Estadística:Análisis descriptivo y estadística inferencial mediante test dechi-cuadrado y test exacto de Fischer (p<0,05). III. Resultados:Se obtuvieron un 26,66% de mujeres frente a un 73,34%de hombres, con una edad media de 58 años (Rango de 88-21). La invasión perineural y perivascular se asoció con unpatrón de crecimiento tumoral tipo II (8.4; p=0,01 y 9,74;p=0,03). Se obtuvo independencia estadística entre índicemitótico y diferenciación tumoral. IV. Conclusiones: Se hadeterminado una alta asociación entre la infiltración perivasculary perineural con el patrón de crecimiento tipo II. Estoshallazgos permiten elaborar un protocolo aplicable de formarutinaria en la evaluación del carcinoma epidermoide lingual

I. Introduction: A study is made of the main histopathologicalparameters in squamous cell carcinoma of thetongue. This neoplasm represents nowadays a outstandinghealth problem. II. Material and Methods: 1. Design: Ahospital population retrospective study over 60 patients sinceJanuary-1990 to July-1997 (minimal follow-up of 8years). 2. Variables: Patient data (age and sex) and histopathologicalfactors (tumoral grading, mitotic index, peritumoraleosinophilic, vascular and perineural infiltration,growth pattern). 3. Statistics: Descriptive analysis. Associationbetween variables was assessed with chi-square test andFischer exact test. (p<0.05). III. Results: There were26.66% females and 73.34% males, with a mean age of 58(range 88-21). The perineural and perivascular infiltrationwas associated with a tumoral pattern type II (8.4; p=0.01and 9.4; p=0.03). Mitotic Index and tumoral grading wereindependent parameters. IV. Conclusions: We determine ahigh association between perivascular and perineural infiltrationwith the tumoral pattern type II. This protocol maybe applied as routine for an accurate evaluation of the squamouscell carcinoma of the tongue