Gingival metastasis of angiosarcoma of the breast as a first manifestation of spreading disease: Case report and review of the literature.

BACKGROUND: Angiosarcoma is an aggressive malignant neoplasm of vascular origin. Oral metastases of angiosarcoma are rare and have a non-specific clinical presentation, thus the diagnosis may be challenging. CASE REPORT: Herein we report a case of a 34-year-old female patient after treatment of a high-grade angiosarcoma of the breast, who presented an asymptomatic bleeding purplish nodule in the maxillary interdental papilla between the first and second premolar. A biopsy was performed, and the histological examination revealed infiltration by malignant neoplasm of epithelioid and fusocellular pattern. Immunohistochemical analysis demonstrated that neoplastic cells were positive for ERG and CD31, and negative for cytokeratins AE1/AE3, confirming the diagnosis of metastatic angiosarcoma. After investigation, multiple metastases were discovered. The patient is under management with chemotherapy and palliative radiotherapy for the bone lesions. CONCLUSION: Metastases should be considered in the differential diagnosis of oral lesions in patients with a previous history of cancer. Due to the morphology of angiosarcomas, the metastatic lesions may resemble benign vascular lesions, therefore, biopsy is mandatory to exclude malignancy.

Síndrome de Hamman em gestante: relato de caso / Hamman syndrome in pregnant women: case report

A síndrome de Hamman foi descrita pela primeira vez por Louis Hamman, em 1939, como "enfisema mediastinal espontâneo" e corresponde à presença de ar livre no mediastino, sem relação com trauma e/ou procedimentos invasivos na região torácica. A condição apresenta sintomas inespecíficos como dor torácica, dispneia, tosse, disfonia, disfagia e dor cervical. Devido aos sinais e sintomas inespecíficos, essa condição pode ser subdiagnosticada, contribuindo para a sua baixa incidência. O diagnóstico é estabelecido com exames de imagem como radiografia e tomografia computadorizada de tórax. No relato de caso descrito, temos uma paciente de 31 anos, gestante, G2P1A0, que desenvolve a síndrome concomitantemente a episódios de hiperêmese gravídica com cinco semanas e cinco dias de idade gestacional. O objetivo deste relato concentra-se em destacar essa hipótese diagnóstica para assistência adequada à paciente, uma vez que tal condição não faz parte do escopo cotidiano dentro da obstetrícia.(AU)

Hamman's syndrome was first described by Louis Hamman in 1939 as "spontaneous mediastinal emphysema" and is characterized by the presence of air in the mediastinum, unrelated to trauma, and/or invasive procedures in the thoracic region. The condition presents nonspecific symptoms such as thoracic pain, cervical pain, dyspnea, cough, and dysphonia. Due to the nonspecific signs and symptoms, this condition can be misdiagnosed, contributing to its low incidence. A diagnosis is established through imaging examinations such as chest radiography and computerized tomography. Here, we report the case of a 31-year-old female who developed Hamman's syndrome concomitantly with episodes of severe hyperemesis when she was five weeks and five days pregnant. Hamman's syndrome is a rare presentation in the field of obstetrics. This report seeks to highlight how Hamman's syndrome was diagnosed, discuss the care given to the patient, and explain the correlation between hyperemesis gravidarum and Hamman's syndrome.(AU)