Fibronectin as an adjuvant in the diagnosis of oral inflammatorymyofibroblastic tumor

Inflammatory myofibroblastic tumor is a distinctive lesion composed of myofibroblastic spindle shaped cells accompaniedby inflammatory infiltrate that may arise in various organs. It is believed to be a noneoplastic inflammatorycondition, although this is still controversial. The recognition of inflammatory myofibroblastic tumor asan entity is important especially to avoid unnecessary surgery. A few cases have been reported in the oral cavity.This report primarily presents a case of inflammatory myofibroblastic tumor that arose in the floor of mouth ofa 23-year-old woman. The proliferating spindle cells were immunoreactive for vimentin, smooth muscle actin,and muscle specific actin and negative for desmin, AE1/AE3, S-100, CD68, MyoD1 and caldesmon. In an attemptto assess the potential neoplastic nature of this lesion, immunohistochemical expression of ALK protein wasperformed, although no immunoreactivity was detected. Also, the presence of well differentiated myofibroblastsidentified by fibronectin is discussed, as well as the importance in establishing an immunoprofile to better consolidatethe diagnosis. We conclude that the study of fibronectin in case series may aid the diagnosis as well as theprediction of the tumor course (AU)

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Central mucoepidermoid carcinoma: Report of a case with 11 years’ evolution and peculiar macroscopical and clinical characteristics

Central mucoepidermoid carcinomas (CMC) are uncommon tumours, comprising 2-3% of all mucoepidermoid carcinomas reported. They have been reported in patients of all ages, ranging from 1 to 78-years, with the overwhelming majority occurring in the 4th and 5th decades of life. They are histologically low-grade cancers, usually affecting the mandible as uniocular or multiocular radiographic lesions. The authors report a case of CMC of the mandible with a long evolution, and peculiar clinical and macroscopical features related with the long term evolution of the disease. A 53-year-old male patient had expansion of buccal and lingual cortices of the anterior region of the mandible, covered by ulcerated mucosa, with 11 years evolution. An incisional biopsy was performed, and the histopathological findings confirm low-grade mucoepidermoid carcinoma. The patient was treated with a mandibulectomy, followed by supraomohyoid neck dissection. There was no evidence of local recurrence, regional or distant metastasis revealed; and the patient was alive and without disease after a follow- up interval of 36 months (AU)