Immunoexpression of stem cell markers SOX-2, NANOG AND OCT4 in ameloblastoma.

Background: Ameloblastoma (AME) is characterized by a locally invasive growth pattern. In an attempt to justify the aggressiveness of neoplasms, the investigation of the role of stem cells has gained prominence. The SOX-2, NANOG and OCT4 proteins are important stem cell biomarkers. Methodology: To verify the expression of these proteins in tissue samples of AME, dentigerous cyst (DC) and dental follicle (DF), immunohistochemistry was performed and indirect immunofluorescence were performed on the human AME (AME-hTERT) cell line. Results: Revealed expression of SOX-2, NANOG and OCT4 in the tissue samples and AME-hTERT lineage. Greater immunostaining of the studied proteins was observed in AME compared to DC and DF (p < 0.001). Conclusions: The presence of biomarkers indicates a probable role of stem cells in the genesis and progression of AME.

Gene Expression and Immunochemistry Analysis of ADAMTS-1 and Versican in Ameloblastoma.

Background: Ameloblastoma is a benign but locally invasive odontogenic epithelial tumor, associated with a high recurrence rate after treatment. The action of enzymes of the metalloproteinase family is important to the degraded extracellular matrix, contributing to invasion. Thus, this study aimed to investigate the gene and protein expression of ADAMTS-1 and versican in ameloblastoma. Materials and Methods: Twenty cases of ameloblastoma (n = 20) and ten dental follicles (DF) (n = 10) were used as a source for immunochemistry and quantitative RT-PCR for determining the protein and mRNA expressions of the concerned genes, respectively. Moreover, western blot and indirect immunofluorescence analysis were performed in AME cells. Results: ADAMTS-1 and versican were overexpressed in DF than ameloblastoma by RT-PCR. However, in the immunolocalization analysis, ADAMTS-1 was expressed in ameloblastoma more than in DF and versican immunostaining obtained a similar pattern between ameloblastoma and DF. Indirect immunofluorescence detected the ADAMTS-1 and versican expression in cell lines derived from ameloblastoma. Western blot from cell lysate and conditioned medium detected ADAMTS-1 bands representing full-length and different processed forms. Monensin treatment confined ADAMTS-1 in the cell cytoplasm. Versican fragments also were detected in different compartments, intracellular and conditioned medium, allowing the versican process by ADAMTS-1. Conclusion: This study showed a distinct expression of ADAMTS-1 and versican in ameloblastoma and DF, with ADAMTS-1 protein higher expression observed in ameloblastoma and possibly cleaved versican. These findings suggested that ADAMTS-1 may participate in tumor invasion, especially for the degradation of substrates (versican) in the ECM.

Bilateral Sinonasal Inverted Papilloma: Report of an Uncommon Case Involving Sinuses of the Face and Orbital Cavity.

BACKGROUND Nasosinusal papilloma is a benign aggressive tumor. It usually occurs unilaterally in the nasal cavity and can extend to the sinuses. The diagnosis is made by the correlation of findings observed in tomographic and histopathological exams. The recommended treatment is surgical excision with clinical monitoring. Orbital involvement occurs in about 9% of cases of advanced SIP. However, there is no report of cases of a benign tumor that invaded the adjacent soft tissues. Therefore, our objective is to report an unusual case of SIP that bilaterally involved the nasal cavity and maxillary sinuses, and extended to involve the ethmoidal cells and sphenoid and frontal sinuses. CASE REPORT In this article, we report an unusual presentation of sinonasal inverted papilloma (SIP) in a 60-year-old man. The tumor bilaterally involved the nasal cavity and maxillary sinuses and extended to involve the ethmoidal cells and the sphenoid and frontal sinuses, as well as the orbital cavity on the right side. An open surgical procedure was performed for complete removal of the lesion and follow-up with imaging exams. CONCLUSIONS The involvement of these structures is uncommon in SIP. This highlights the importance of this case report. Diagnosis and surgical treatment must be carefully planned. In this work, we describe all the steps that helped guide the choice of the best surgical technique to be performed and offer the best clinical follow-up.

Basal Cell Nevus Syndrome with Unusual Associated Findings: A Case Report with 17 Years of Follow-Up.

BACKGROUND Nevoid basal cell carcinoma syndrome (NBCCS), also known as Gorlin-Goltz syndrome (GGS), is an inherited autosomal dominant disorder caused by mutations in the patched (PTCH) tumor-suppressor gene, which has high penetrance and variable phenotypic expressivity. In 1960, Gorlin and Goltz defined the condition by 3 main characteristics: multiple basal cell carcinomas, odontogenic keratocyst (OKC), and skeletal anomalies. Nowadays, many neurologic, ophthalmic, endocrine, and genital manifestations are known to be associated with this syndrome. Considering the complexity of the clinical manifestations, a multidisciplinary approach is necessary for the diagnosis and follow-up of patients with NBCCS. CASE REPORT We report the case of a 27-year-old woman who presented with multiple maxillary and mandibular OKCs, as well as mandibular dentigerous cysts, all detected by X-ray. The medical records of the patient reported other findings such as falx cerebri calcification, osteolysis in femoral bones, and focal bone alteration suggestive of simple bone cysts. Based on the presented manifestations, it was concluded that the patient had characteristics of NBCCS. A multidisciplinary approach was necessary, and odontological intervention was used in managing treatment of the jaw cysts. CONCLUSIONS In view of this combination of findings, it is of primary importance for dental surgeons and physicians to be able to recognize the signs and symptoms of NBCCS in order to achieve an early diagnosis and avoid the progression of oral cysts, the metastasis of skin lesions, and progression of other less frequent manifestations.

Methylmercury-Induced Toxicopathologic Findings in Salivary Glands of Offspring Rats After Gestational and Lactational Exposure.

Methylmercury (MeHg) is one of the main global pollutants. The vulnerability of fetus and newborn to MeHg-induced changes is extensively reported, making relevant investigation possible for alternative sample matrix for human biological monitoring for at this stage of life. This study aimed to characterize tissue change effects of environmental-experimental MeHg on salivary glands of offspring rats after pre- and postnatal exposure. For this, pregnant Wistar rats were orally exposed to MeHg (40 µg/kg BW/day) or only vehicle (control group), from the gestational period to the end of the lactation period. Salivary glands (SG) were collected from the offspring to analyze possible Hg levels and main findings by histopathological evaluations and CK19 and α-SMA immunostaining. The results indicated that Hg levels in SG of intoxicated offspring were associated with histologic abnormalities, such as acinar atrophy and an increase in the intercellular matrix among the acini, as well as damages in the architecture of epithelium and myoepithelial cells, evidenced by a decrease in immunostaining area. Thus, this is the first study to show in the literature the toxicopathologic findings on SG of offspring after pre- and postnatal exposure to MeHg. Moreover, it presents the SG as an attractive target to futures studies, mainly in children exposed to environmentally relevant doses.

Marsupialization before enucleation as a treatment strategy for a large calcifying odontogenic cyst: Case report.

INTRODUCTION: Odontogenic pathological lesions can generally be divided into cysts and tumors. Calcifying odontogenic cyst (COC) is a non-aggressive odontogenic cyst, however, in a few occasions, COC can show excessive growth and destruction. This study describes an uncommon aggressive presentation of a large COC and discusses the treatment strategies used to achieve a favorable result. PRESENTATION OF CASE: A 11-year-old child sought treatment for a painless growth on his mandible that caused facial asymmetry. On clinical and imaging examination, a large radiolucent lesion was observed in a panoramic x-ray involving the right side of the mandible. Radiopaque areas were observed within the lesion. Treatment comprised of an initial marsupialization followed by surgical removal of the lesion. Follow up extended for more than 10 years and no signs of recurrence were observed. DISCUSSION: Initial marsupialization was successfully employed in order to decrease the lesion, inducing bone formation, and reducing the risk of mandibular fracture and inferior alveolar nerve damage. Four months after marsupialization, the lesion substantially reduced its volume and enucleation with peripheral ostectomy was carried out. This approach allowed a safer surgical removal of the lesion and achieve an excellent result. CONCLUSION: Although some authors consider marsupialization as an unnecessary step that delays final treatment, when well indicated, it facilitates surgical treatment, promotes and preserves normal tissues, reduces the necessity of surgical reconstruction and costs, yet showing excellent results.

An Alternative Approach for Treating Severe Injured Temporomandibular Joints by Gunshot Wounds.

Temporomandibular joint (TMJ) reconstruction is a challenging clinical problem that has been revolutionized due to the development of total alloplastic TMJ replacement (TMJ-TJR); however, the costs are still very high. We used an alternative approach to treat comminuted mandibular condyle fracture with an unviable condyle head caused by gunshot wounds. Our surgical technique consisted of an extended preauricular incision; removal of the fractured condyle, bone fragments, and foreign bodies; reshape/flattening of the fracture edge; fixation of the articular disc (if viable); lining of the TMJ with temporalis muscle/fascia; application of Erich arch bars; and early elastic therapy. We successfully used this approach in five sequential cases that resulted in a good mouth opening (>35 mm) and satisfactory occlusion with teeth in maximum intercuspation. We believe that this technique is an excellent option for treating severe injured TMJs in places where TMJ-TJR is not available.

Mechanisms of human cytomegalovirus infection with a focus on epidermal growth factor receptor interactions.

Human cytomegalovirus (HCMV) is a widespread opportunistic herpesvirus that causes severe diseases in immunocompromised individuals. It has a high prevalence worldwide that is linked with socioeconomic factors. Similar to other herpesviruses, HCMV has the ability to establish lifelong persistence and latent infection following primary exposure. HCMV infects a broad range of cell types. This broad tropism suggests that it may use multiple receptors for host cell entry. The identification of receptors used by HCMV is essential for understanding viral pathogenesis, because these receptors mediate the early events necessary for infection. Many cell surface components have been identified as virus receptors, such as epidermal growth factor receptor (EGFR), which is characterized by tyrosine kinase activity and plays a crucial role in the control of key cellular transduction pathways. EGFR is essential for HCMV binding, signaling, and host cell entry. This review focuses on HCMV infection via EGFR on different cell types and its implications for the cellular environment, viral persistence, and infection.

Primary leiomyosarcoma of the mandible. A case report

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The aim of this article is to describe a case of leiomyosarcoma of the mandible with immunohistochemical analysis that was useful in making the final diagnosis. A 40-year-old woman was referred to the Stomatology Clinic of São Paulo Tatuapé Hospital, , for evaluation of a lesion on the left side of the mandible. This lesion presented a fast growth in the last 6 months. Intraoral examination showed a firm, fixed, red colored mass measuring, approximately 60-mm in diameter. No lymph nodes involvement was found. The radiographic examination showed a lytic lesion showed ill-demarcated radiolucent with facial and lingual cortical bone destruction. Microscopic examination of the mandibular lesion showed a neoplasm composed by interlacing fascicles of spindle-shaped cells. Most of the cells presented a blut-ended elongated shape. A marked cellular pleomorphism was observed, represented by cells with irregular shape and abundant eosinophilic cytoplasm. Nuclei were large, hyperchromatic, either vacuoled or cigar-shape. The cytoplasm of the cells stained red with Masson’s trichrome stain. Neoplastic cells expressed vimentin, smooth-muscle actin, HHF-35 and desmin. These findings were consistent with the diagnosis of leiomyosarcoma

Progressive hemifacial atrophy – Case report

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Progressive Hemifacial Atrophy, also known as Parry-Romberg Syndrome, is an uncommon degenerative and poorly understood condition. It is characterized by a slow and progressive atrophy affecting one side of the face. The incidence and the cause of this alteration is unknown. A cerebral disturbance of fat metabolism has been proposed as a primary cause. This can be the result of a trophic malformation of Cervical Sympathetic Nervous System. Possible factors that are involved in the pathogenesis include trauma, viral infections, heredity, endocrine disturbances and auto-immunity, among others. The most common complications that appear in association to this health disorder are: trigeminal neuritis, facial paresthesia, severe headache and epilepsy, being this last one the most frequent complication of the Central Nervous System. Characteristically, the atrophy progresses slowly for several years and, soon after, it become stable. Now, plastic surgery with graft of autogenous fat can be performed, after stabilization of the disease, to correct the deformity. Orthodontic treatment can help in the correction of any associated malformation. The objective of this work is, through the presentation of a clinical case, to accomplish a literature review concerning general characteristics, etiology, physiopathology, differential diagnosis and treatment of progressive hemifacial atrophy