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1.
Artigo em Inglês | MEDLINE | ID: mdl-37516618

RESUMO

OBJECTIVE: To describe the use of cell block (CB) preparation from fine-needle aspiration cytology for diagnosing oral and maxillofacial diseases. STUDY DESIGN: We performed a retrospective analysis of 568 samples collected by our laboratory for CB preparation from fine-needle aspiration cytology of the oral and maxillofacial region between January 2001 and October 2021. We performed cytologic diagnoses and compared them with the available histopathologic diagnoses to calculate the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CB preparation for identifying malignant lesions. RESULTS: The most frequent diagnosis was pleomorphic adenoma (n = 44, 7.7%), followed by metastatic squamous-cell carcinoma (n = 28, 4.9%) and odontogenic keratocyst (n = 26, 4.6%). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CB preparation, which revealed detailed morphologic and architectural patterns, were 70.0%, 100.0%, 100.0%, 62.5%, and 80.0%, respectively. CONCLUSIONS: Cell block preparation from fine-needle aspiration cytology of the oral and maxillofacial region may be a useful adjunctive diagnostic tool for diagnosing oral and maxillofacial diseases because it reveals morphologic and architectural patterns similar to those shown on histopathologic slides, leading to the better categorization of diseases.


Assuntos
Adenoma Pleomorfo , Humanos , Biópsia por Agulha Fina , Sensibilidade e Especificidade , Estudos Retrospectivos , Valor Preditivo dos Testes , Adenoma Pleomorfo/patologia
2.
J Oral Pathol Med ; 52(2): 119-126, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36565263

RESUMO

BACKGROUND: Fibroblast growth factor receptor 1 is a potential prognostic factor for tongue squamous cell carcinoma and is associated with oral epithelial dysplasia grade in oral leukoplakia. METHODS: Thirty cases of tongue squamous cell carcinoma and 30 cases of oral leukoplakia were analyzed. Fibroblast growth factor receptor 1 and phosphorylated Akt protein expression were analyzed by immunohistochemistry and quantified using a digital algorithm. Fibroblast growth factor receptor 1 gene amplification was analyzed by fluorescent in situ hybridization in the tongue squamous cell carcinoma cases. RESULTS: Clinical appearance and dysplasia grade were correlated with oral leukoplakia malignant transformation. Oral leukoplakia cases presenting high fibroblast growth factor receptor 1 expression showed a higher risk of malignant transformation (p = 0.016, HR: 7.3, 95% CI: 1.4-37.4). Phosphorylated Akt showed faint to no expression in oral leukoplakia, which did not correlate with dysplasia grade or malignant transformation. High expression of fibroblast growth factor receptor 1 and phosohorylated Akt were associated with poor overall survival and disease-free survival in tongue squamous cell carcinoma, although only fibroblast growth factor receptor 1 expression was significantly associated with poor overall survival (p = 0.024; HR: 4.9, 95% CI: 1.2-19.9). Cases presenting double fibroblast growth factor receptor 1/phosphorylated Akt overexpression (n = 8) showed markedly impaired overall survival (p = 0.020; HR: 6.4, 95% CI: 1.3-31.1) and disease-free survival (p = 0.001, HR: 13.0, 95% CI: 3.0-55.7). Fibroblast growth factor receptor 1 amplification was observed in 16.6% of tongue squamous cell carcinoma cases, being correlated with vascular and neural invasion (p = 0.001 and 0.017, respectively), but not with fibroblast growth factor receptor 1 protein expression, overall survival, or disease-free survival. CONCLUSION: Fibroblast growth factor receptor 1 protein expression is an important prognostic factor in oral leukoplakia and tongue squamous cell carcinoma.


Assuntos
Carcinoma de Células Escamosas , Neoplasias da Língua , Humanos , Carcinoma de Células Escamosas/patologia , Neoplasias da Língua/patologia , Prognóstico , Receptor Tipo 1 de Fator de Crescimento de Fibroblastos/genética , Hibridização in Situ Fluorescente , Proteínas Proto-Oncogênicas c-akt/genética , Leucoplasia Oral/patologia , Língua/patologia
3.
Med. oral patol. oral cir. bucal (Internet) ; 26(3): e284-e291, May. 2021. tab, graf, ilus
Artigo em Inglês | IBECS | ID: ibc-224505

RESUMO

Background: Pigmented lesions are uncommon in the oral mucosa, and studies investigating the incidence andtypes of these lesions are desired to improve the diagnostic knowledge of clinicians. The aim of this study was toanalyze the distribution of oral pigmented lesions in a Brazilian population.Material and Methods: A retrospective descriptive cross-sectional study was performed. Oral pigmented lesionswere retrieved from the files of two oral and maxillofacial pathology services from Brazil over a 45-year period(1974-2019). The clinical data and the diagnoses of each case were retrieved and included in a Microsoft Excel®database.Results: From 77.074 lesions diagnosed in this period, 761 (0.99%) represented pigmented lesions of the oralmucosa, including 351 (46.1%) melanocytic and 410 (53.9%) non-melanocytic lesions, with a higher incidence infemales (73.2%) between the fourth and seventh decades of life. Amalgam tattoo (53.6%) represented the most common lesion, followed by melanotic macule (18.3%) and racial pigmentation (10.8%). Other pigmented lesionsincluded nevus (9.9%), post-inflammatory pigmentation (3%), melanoma (2.1%), melanoacanthoma (1.4%), smoker'smelanosis (0.4%), drug-induced pigmentation (0.3%), and melanotic neuroectodermal tumor of infancy (0.1%). Thebuccal mucosa was the most commonly affected site (25.2%), followed by the alveolar ridge (14.5%), and gingiva(11.8%).Conclusions: The current findings were similar to previous studies with minor differences due methodology andcharacteristics of the services from where lesions were retrieved. The knowledge of these data may contribute to abetter understanding of oral pigmented lesions and assist clinicians to better recognize and manage them.(AU)


Assuntos
Humanos , Masculino , Feminino , Mucosa Bucal/lesões , Doenças da Boca/diagnóstico , Doenças da Boca/epidemiologia , Diagnóstico Bucal , Boca/lesões , Saúde Bucal , Patologia Bucal , Medicina Bucal , Cirurgia Bucal , Brasil , Estudos Retrospectivos , Epidemiologia Descritiva , Estudos Transversais
4.
Med. oral patol. oral cir. bucal (Internet) ; 26(1): e8-e13, ene. 2021. graf
Artigo em Inglês | IBECS | ID: ibc-200532

RESUMO

BACKGROUND: Whole Slide Imaging (WSI) is an alternative method to light microscopy (LM). However, few studies have compared the diagnostic agreement between WSI and LM, especially to grade oral epithelial dysplasia (OED). The purpose of this study was to evaluate the variability in grading OED by the World Health Organization grading system, using WSI and conventional LM, and to investigate whether the access to clinical information, and psychologic or physical states of the pathologists could interfere with the diagnosis. MATERIAL AND METHODS: eleven experienced pathologists from seven Brazilian universities independently evaluated twenty-five OED cases. The analyses were performed in duplicate for each method, with an interval of at least 30 days, and the time consumed in each analysis was measured. Physical and psychologic states were evaluated by blood pressure levels, heart rate and two questionnaires: State-Trait Anxiety Inventory and Perceived Stress Scale. Clinical information was provided after the second evaluation using WSI and the pathologist could change their diagnostic decision or not. RESULTS: LM showed a higher inter-examiner agreement (k=0.53) than WSI (k=0.45) and a smaller time consumed by the pathologists (mean of 65.53 seconds compared to 91.02 seconds in WSI). In the first analysis using conventional microscopy, there was a positive correlation between kappa values and anxiety (r=0.47, p = 0.02), and stress (r=0.64, p < 0.01), and an inverse correlation with heart rate (r=-0.48, p = 0.02). In the digital analysis, there was also a positive correlation between kappa values and anxiety (r=0.75, p < 0.001). After clinical information was given, there was a slight change in 11.3% of the cases, and a great discrepancy in 1.1% of the cases, mainly increasing the OED grade. CONCLUSIONS: both microscopy systems had similar results, although LM had slightly higher kappa values, and WSI was more time consuming


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Doenças da Boca/patologia , Mucosa Bucal/patologia , Lesões Pré-Cancerosas/patologia , Processamento de Imagem Assistida por Computador/métodos , Microscopia/métodos , Doenças da Boca/diagnóstico , Lesões Pré-Cancerosas/diagnóstico , Fatores de Tempo , Variações Dependentes do Observador , Valores de Referência
5.
Int J Surg Pathol ; 29(3): 263-272, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-32734791

RESUMO

Mucosal melanomas are aggressive tumors, rarely observed in the oral cavity. The diagnosis is based on the clinical and microscopical features. Often these tumors had variable amounts of melanin pigmentation. However, when melanin is absent, the tumors are denominated amelanotic, presenting a tendency to misdiagnosis and delayed treatment. The aim of this study was to describe the clinicopathologic features of a series of oral amelanotic melanomas (OAM). Records of all cases of OAM were retrospectively retrieved from oral pathology services from January 2002 to January 2019. Data regarding the clinical features, morphological aspects, immunohistochemical reactions, treatment, and follow-up status were collected. Eight cases of OAM were included, 6 in men and 2 in women (ratio of 3:1) ranging in age from 33 to 77 years (mean 53.6 years). Clinically, the tumors presented as masses or ulcerated swellings. The most common intraoral locations of the tumors were gingiva and palate. Cervical lymph node metastasis was detected in 3 patients at the first examination. All but one patient died from complications of the tumors after a mean follow-up period of 8.5 months. In conclusion, OAM is a very aggressive malignant tumor, and when melanin is absent, an immunohistochemical panel comprising S100, melan A, HMB45, and SOX10 should be performed.


Assuntos
Metástase Linfática/diagnóstico , Melanoma Amelanótico/diagnóstico , Mucosa Bucal/patologia , Neoplasias Bucais/diagnóstico , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Quimioterapia Adjuvante , Diagnóstico Diferencial , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Linfonodos/patologia , Metástase Linfática/patologia , Masculino , Melaninas/análise , Melanoma Amelanótico/mortalidade , Melanoma Amelanótico/patologia , Melanoma Amelanótico/terapia , Pessoa de Meia-Idade , Neoplasias Bucais/mortalidade , Neoplasias Bucais/patologia , Neoplasias Bucais/terapia , Pescoço , Procedimentos Cirúrgicos Bucais , Estudos Retrospectivos
6.
Med. oral patol. oral cir. bucal (Internet) ; 25(6): e728-e731, nov. 2020. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-197179

RESUMO

BACKGROUND: Oral melanomas have some histopathological resemblance with its cutaneous counterpart; howev-er, an aggressive behavior is more common in tumors that occur in the oral cavity. Several markers have been suggested as indicative of tumoral progression and aggressiveness, such as cyclooxygenase 2 (COX-2) and Ki67. MATERIAL AND METHODS: In this study, we have compared the expression of COX-2 and Ki67 in a series of amelanotic (n = 7) and melanotic oral melanomas (n = 22). The cases were selected from 4 pathology laboratories and sub-mitted to the immunohistochemical (IHC) reactions. We analyzed the IHC staining based on a qualitative - using visual scores; and a computer-assisted method (quantitative) using scanned slides and software for digital analysis. RESULTS: COX-2 was expressed in all oral melanomas; however, its intensity was significantly higher in the amelanotic ones (P < 0.001). Similarly, a high Ki67-positivity index was observed in the amelanotic than melanotic ones (P < 0.001). CONCLUSIONS: Based on these results, we suggest that amelanotic oral melanomas have marked pro-inflammatory and high-proliferative phenotype, justifying their more aggressive behavior compared with the melanotic ones


No disponible


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Melanoma/patologia , Neoplasias Bucais/patologia , Ciclo-Oxigenase 2/análise , Antígeno Ki-67/análise , Imuno-Histoquímica , Inclusão em Parafina , Carga Tumoral , Melanoma Amelanótico/patologia
7.
J Oral Pathol Med ; 48(5): 373-381, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30916813

RESUMO

BACKGROUND: Head and neck mucosal melanomas (MMs) are rare tumors with adverse outcomes and poorer prognoses than their more common cutaneous counterparts (cutaneous melanomas-CMs). Few studies have compared the expression of mitochondrial dynamic markers in these tumors. This study aimed to assess the correlations of mitochondrial markers with melanoma progression and their potential as predictors of lymph node involvement and distant metastasis. METHODS: Immunohistochemistry against anti-mitochondrial (AMT), dynamin-related protein 1 (DRP1), mitochondrial fission protein 1 (FIS1), mitofusin-1 (MFN1), and mitofusin-2 (MFN2) antibodies was performed in 112 cases of head and neck CM and MM. A Cox regression multivariate model was used to assess the correlation of AMT, FIS1, and MFN2 expressions considering the risk for nodal and distant metastasis. RESULTS: All markers studied presented higher staining in tumor cells than normal adjacent tissues. Higher mitochondrial content was observed in MM than in CM, and it was significantly associated with nodal metastasis in oral melanomas. Both FIS1 and DRP1 expressions were related to advanced Clark's levels in CM, and they were overexpressed in oral melanomas. Moreover, increased immunoexpression of MFN2 was significantly associated with a higher risk of metastasis in CM, and it was also overexpressed in sinonasal melanomas. CONCLUSIONS: Our results suggest that mitochondrial fission and fusion processes can play an important role during multiple stages of tumorigenesis and the development of nodal and distant metastasis in cutaneous and mucosal melanomas.


Assuntos
Neoplasias de Cabeça e Pescoço/patologia , Melanoma/patologia , Dinâmica Mitocondrial , Neoplasias Cutâneas/patologia , Biomarcadores Tumorais/metabolismo , Progressão da Doença , Dinaminas/metabolismo , GTP Fosfo-Hidrolases/metabolismo , Humanos , Imuno-Histoquímica , Proteínas de Membrana/metabolismo , Proteínas Mitocondriais/metabolismo , Mucosa Bucal/patologia
8.
Saf Health Work ; 10(4): 445-451, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31890327

RESUMO

OBJECTIVE: The objective of this study was to evaluate the prevalence and incidence of accidents with biological material, the level of knowledge, and compliance to standard precautions (SPs) among dentists, physicians, nurses, and dental and medical students. METHODS: A closed cohort study with a prospective and retrospective component was conducted between August 2014 and September 2015. The participants were contacted in two moments during the follow-up period, during which a structured questionnaire divided into six sections was used; the interviews were conducted during the follow-up period (Month 6) and at the end of the observation period (Month 12). RESULTS: The global prevalence of accidents in the previous 12 months was 10.2%, with a difference between professionals and students (13.0% vs. 5.1%, respectively; p < 0.003). The incidence rate was 6.49 per 100 person/year, with difference between the groups (6.09 per 100 person/year in professionals and 7.26 per 100 person/year in students), type of specialization (hazard ratio, 3.27), and hours worked per week (hazard ratio, 2.27). The mean of compliance to SP was 31.99 (±3.85) points, with a median of 33 (30, 35) points against the expected 27.75 points. Adherence to SP was associated with the accident report (p < 0.020). CONCLUSION: We conclude that the proportion/incidence rate of accidents with biological material was high in relation to that in the literature, being higher in professionals and especially among physicians. The levels of knowledge and adherence to SP were good, with the best found in dentists and dental students.

9.
Hum Pathol ; 85: 279-289, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30468799

RESUMO

Mitochondrial dysfunction is caused by an imbalance in the fission and fusion processes, and it has been implicated in the pathogenesis of several human cancers. However, the role of mitochondrial markers in melanomas still remains poorly understood. In this study, the authors assessed the expression of 3 mitochondrial markers (antimitochondrial, fission protein 1 [FIS1], and mitofusin 2 [MFN2]) in a series of head and neck mucosal and cutaneous melanomas. Patients with cutaneous (n = 56) and mucosal (oral, n = 30, sinonasal, n = 26) melanomas of the head and neck region were enrolled in this study. Clinical and follow-up data were retrieved from medical records. The expression of 3 mitochondrial markers was assessed by the immunohistochemistry, and then digitally quantified and correlated with clinicopathological data and outcome information. In the multivariate model, high mitochondrial content was identified as an independent prognostic value for disease-free survival (DFS) in cutaneous melanomas and overall survival in oral melanomas. FIS1 expression was significantly associated with lower overall survival rates in patients with oral melanomas and strictly correlated with vascular invasion in mucosal melanomas. MFN2 was associated with high risk of distant metastasis in patients with cutaneous melanomas. In summary, the authors demonstrated that mitochondrial content, along with FIS1 and MFN2 expressions, is correlated with important clinicopathological characteristics in patients with cutaneous and mucosal head and neck melanomas.


Assuntos
GTP Fosfo-Hidrolases/metabolismo , Neoplasias de Cabeça e Pescoço/metabolismo , Melanoma/metabolismo , Proteínas de Membrana/metabolismo , Mitocôndrias/metabolismo , Proteínas Mitocondriais/metabolismo , Neoplasias Cutâneas/metabolismo , Adulto , Idoso , Biomarcadores Tumorais/metabolismo , Intervalo Livre de Doença , Feminino , Neoplasias de Cabeça e Pescoço/mortalidade , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Imuno-Histoquímica , Masculino , Melanoma/mortalidade , Melanoma/patologia , Pessoa de Meia-Idade , Prognóstico , Neoplasias Cutâneas/mortalidade , Neoplasias Cutâneas/patologia , Taxa de Sobrevida
10.
J Oral Pathol Med ; 47(9): 816-822, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30080932

RESUMO

Fibroblast growth factor 2 (FGF-2) is a multifunctional cytokine expressed in several tissues and involved in a wide variety of biologic activities, with one low molecular weight (LMW) protein present in the cytosol, which is secreted, acting via its receptors (FGFRs), and four high molecular weight (HMW) proteins located in the nucleus. Fibroblast growth factor receptor (FGFR) family has four (FGFR1-4) transmembrane tyrosine kinase receptors expressed on several cell types, and FGFR-1 has been indicated as a potential molecular target in several types of cancer, including oral squamous cell carcinoma (OSCC). The FGF-2/FGFR-1 expression has been studied in the oral cavity, and it was associated with the wound repair process, the development of benign and malignant salivary gland tumors, besides being related to oral potentially malignant disorders (OPMDs) and OSCC. Hence, we critically review the currently available data on FGF-2/FGFR-1 expression in the normal mucosa and lesions of the oral cavity.


Assuntos
Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/metabolismo , Fator 2 de Crescimento de Fibroblastos/genética , Fator 2 de Crescimento de Fibroblastos/metabolismo , Expressão Gênica , Mucosa Bucal/metabolismo , Neoplasias Bucais/genética , Neoplasias Bucais/metabolismo , Boca , Lesões Pré-Cancerosas/genética , Lesões Pré-Cancerosas/metabolismo , Receptor Tipo 1 de Fator de Crescimento de Fibroblastos/genética , Receptor Tipo 1 de Fator de Crescimento de Fibroblastos/metabolismo , Glândulas Salivares/metabolismo , Humanos , Mucosa Bucal/fisiologia , Cicatrização/genética
11.
Histopathology ; 73(4): 585-592, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29856905

RESUMO

AIMS: Sebaceous carcinomas are uncommon malignant cutaneous tumours originating from the pilosebaceous unit. Although its occurrence is mostly common in peri-ocular glands, other anatomical regions of the head and neck may be affected, including major and minor salivary glands. METHODS AND RESULTS: We describe a series of sebaceous adenocarcinomas of the parotid and submandibular glands. The mean age was 62.1 (range = 31-90) years. Two patients (20%) presented regional or distant metastasis to mandible and lungs. All cases were positive for cytokeratins (AE1AE3 and CK-5), epithelial membrane antigen and adipophilin and negative for androgen receptor, Factor XIIIa, S-100, vimentin and perforin. MLH1 and MSH2 were expressed in the nuclei of most tumour cells, and one case showed loss of MSH2 expression. Proliferative index (assessed by Ki-67 expression) and microvessel density (CD34-positive vessels) were higher in metastasis-associated cases. P63 expression was noted in the periphery of the tumour nests, in the basaloid cells, with a mean of 69.2% nuclear positivity. CONCLUSIONS: The sebaceous adenocarcinoma of salivary glands is rare and may show an unfavourable outcome; therefore, its correct diagnosis may be challenging. For this reason, immunohistochemical studies, including adipophilin in particular, constitute an important diagnostic tool.


Assuntos
Adenocarcinoma Sebáceo/patologia , Neoplasias Parotídeas/patologia , Neoplasias das Glândulas Sebáceas/patologia , Neoplasias da Glândula Submandibular/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/análise , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
12.
Medicine (Baltimore) ; 97(13): e9934, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29595701

RESUMO

RATIONALE: Oral metastases occur more commonly in bone, but can also manifest in soft tissues and eventually resemble a reactive lesion. Few cases of oral metastases mimicking reactive lesions in soft tissues have been reported to date. PATIENT CONCERNS: We report a metastasis of gastric carcinoma (GC) to the oral mucosa without bone involvement in a 43 yom clinically and microscopically mimicking a reactive lesion. The patient related that the lesion had 1 month of evolution, and the ulcerated area suggested the lesion was related to trauma. DIAGNOSES: The histopathological examination of the lesion revealed an exuberant granulation tissue with few neoplastic cells, and the initial diagnosis of pyogenic granuloma was considered. In a second analysis, clusters of clear cells morphologically similar to degenerating mucous cells or macrophages, positive for Cytokeratin (CK)-20, and CDX2 were found. At the moment, it was confirmed the presence of a primary GC in the patient. INTERVENTIONS: A palliative radiotherapy/chemotherapy was started. OUTCOMES: However, the patient died 3 months after the diagnosis of oral metastasis. LESSONS: This report highlights the importance of careful clinical and microscopic examinations in cases of oral metastasis that may mimic a reactive lesion.


Assuntos
Adenocarcinoma/patologia , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/secundário , Neoplasias Gástricas/patologia , Adulto , Diagnóstico Diferencial , Granuloma Piogênico/diagnóstico , Humanos , Masculino
13.
Artigo em Inglês | MEDLINE | ID: mdl-29104033

RESUMO

OBJECTIVE: To describe the oral and maxillofacial manifestations of patients diagnosed with chronic kidney disease-mineral and bone disorders. STUDY DESIGN: Over a 13-year period, clinicopathologic data of patients diagnosed with CKD-MBD who had oral and maxillofacial alterations were retrieved from the files of 4 Brazilian institutions. Data included clinical, radiographic, microscopic, and biochemical findings; treatment employed; and follow-up status. RESULTS: Twenty-one cases were identified, with 13 patients diagnosed as brown tumor of hyperparathyroidism (BTH) and 8 as osteitis fibrosa/renal osteodystrophy (OF/RO) (4 of them clinically consistent with Sagliker syndrome). The mean age was 32.7 years, and the mandible was the most affected site (42.8%). OF/RO had an ill-defined "ground glass" radiographic appearance, and BTH produced well-defined radiolucent images. Biochemically the following mean values were obtained: parathormone 1511.07 pg/mL, calcium 9.25 mg/dL, phosphorus 5.19 mg/dL, alkaline phosphatase 941.55 U/L, urea 125.42 mg/dL, and creatinine 7.14 mg/dL. Treatment comprised vitamin D and calcium intake, parathyroidectomy, hemodialysis, renal transplantation, and local surgery. During follow-up, 5 patients with BTH were free of lesions, whereas 2 affected by OF/RO/Sagliker syndrome died. CONCLUSIONS: Oral and maxillofacial manifestations of BTH and OF/RO are uncommon, but they can be associated with an important life-threatening scenario.


Assuntos
Distúrbio Mineral e Ósseo na Doença Renal Crônica/complicações , Doenças da Boca/etiologia , Adolescente , Adulto , Idoso , Brasil , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
14.
Oncotarget ; 9(99): 37291-37304, 2018 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-30647870

RESUMO

Melanomas are highly aggressive tumours derived from melanocytes, which occur most commonly in the skin. Occasionally, these tumours may appear in oral and sinonasal mucous membranes. In this study, we performed a comparative analysis of the Phosphorylated Akt1 (p-Akt1) expression in 144 patients affected by cutaneous (CM), 34 oral cavity (OM), and 31 sinonasal melanomas (SNM). Similar to the metastatic cutaneous melanomas, p-Akt1 was overexpressed in 17/34 of the oral cavity and 20/31 of the sinonasal melanomas. In addition, the p-Akt1-nuclear expression was associated with poorer cancer-specific survival in cutaneous (P < .0001), oral (P < .0001), and sinonasal (P = .001) melanomas. Multivariate analysis showed p-Akt1 to be an independent prognostic marker in oral (P = .041) and sinonasal (P < .0001) melanomas patients. In conclusion, p-Akt1 overexpression is an independent prognostic marker in mucosal melanomas and is significantly up-regulated in sinonasal melanomas. As both mucosal and metastatic cutaneous melanomas showed high frequency of p-Akt1 expression, these findings suggest that mucosal melanomas have a biological behaviour, similar to the aggressive cutaneous melanomas.

15.
Melanoma Res ; 27(5): 448-456, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28604419

RESUMO

Cyclooxygenase 2 (COX-2) and phosphorylated Akt1 (p-Akt1) are associated with tumor spreading, cell proliferation, high metabolism, and angiogenesis in solid tumors. This study aimed to investigate COX-2 and p-Akt1 expression in primary and metastatic melanomas by correlating with the cellular proliferation index (as revealed by minichromosome maintenance 2 expression) and the outcome of patients with malignant melanomas. Seventy-seven biopsies of malignant melanomas, including 42 primary nonmetastatic melanomas (PNMMs), 12 primary metastatic melanomas (PMMs), and 23 metastatic melanomas (MMs), were retrospectively selected. Tissue microarrays were developed and submitted for immunohistochemical staining for COX-2, p-Akt1, and minichromosome maintenance 2. Increased COX-2 cytoplasmic staining patterns were observed in PMM and MM when compared with PNMM (P=0.0011). Higher nuclear and cytoplasmic expression of p-Akt1 was more closely associated with PMM than with MM and PNMM (P<0.00001). Coexpression of these biomarkers was closely correlated with lower overall survival rates in melanomas. Furthermore, we observed a statistically significant positive correlation between the mitosis index and increased COX-2 expression (P=0.0135) and between p-Akt1 (P=0.0038) and the cellular proliferation index (P=0.0060). Taken together, our findings demonstrate that COX-2 and p-Akt1 play an important combined role during melanoma progression and are associated with highly metastatic tumors and survival rates in patients with MM. In addition, these biomarkers can be used to predict melanoma prognosis independently of metastatic status. However, further studies are required to elucidate the biological role of these biomarkers during the progression of MM events.


Assuntos
Ciclo-Oxigenase 2/metabolismo , Melanoma/enzimologia , Proteínas Proto-Oncogênicas c-akt/metabolismo , Neoplasias Cutâneas/enzimologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ciclo-Oxigenase 2/biossíntese , Ciclo-Oxigenase 2/genética , Feminino , Humanos , Melanoma/genética , Melanoma/mortalidade , Melanoma/patologia , Pessoa de Meia-Idade , Fosforilação , Prognóstico , Proteínas Proto-Oncogênicas c-akt/biossíntese , Proteínas Proto-Oncogênicas c-akt/genética , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/mortalidade , Neoplasias Cutâneas/patologia , Análise de Sobrevida
16.
Rev. Assoc. Paul. Cir. Dent ; 70(1): 88-94, jan.-mar. 2016. tab, ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: lil-797059

RESUMO

Cementoblastoma é um tumor odontogênico benigno incomum de origem mesenquimalque usualmente afeta ossos gnáticos de indivíduos jovens, produzindo dor ou desconforto. Pode ser erroneamente diagnosticado como outras lesões, devido sua variada apresentação clínica era diográfica. Frequentemente o tratamento sugerido é a ressecção tumoral em conjunto como dente associado. Entretanto, abordagem mais conservadora pode ser uma opção em alguns casos assintomáticos e estáveis, como observado neste estudo. Apresentamos oito novos casos e uma breve revisão da literatura a fim de melhor caracterizar o comportamento biológico desta relativamente rara lesão.


Cementoblastoma is an uncommon benign odontogenic tumour of mesenchymal originthat affects the jaws of generally young persons, producing pain or discomfort. It may be mistakenfor several other lesions, due to its varied clinical and radiographic features. The suggestedtreatment is often tumour resection in conjunction with the associated tooth. However, a moreconservative approach could be an option in asymptomatic and stable lesions as seen in thepresent study. Eight new cases and a brief review of the literature are presented here to bettercharacterize the biological behavior of this relatively rare lesion.


Assuntos
Humanos , Masculino , Feminino , Condutas Terapêuticas/classificação , Condutas Terapêuticas/normas , Condutas Terapêuticas/organização & administração , Protocolos Clínicos/normas , Tumores Odontogênicos/complicações , Tumores Odontogênicos/diagnóstico , Tumores Odontogênicos/metabolismo
17.
Am J Orthod Dentofacial Orthop ; 145(1): 103-7, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24373660

RESUMO

Oral squamous cell carcinoma traditionally affects older men who smoke and drink. A change in this profile has been reported because of an increased incidence in young nonsmoking and nondrinking patients. The purpose of this article was to describe a series of young nonsmoking and nondrinking patients diagnosed with tongue squamous cell carcinoma who had recently received orthodontic treatment or evaluation. Details regarding diagnosis, treatment, follow-up, and disease evolution are presented, with a review of the pertinent literature. Orthodontists often treat young adults, who have frequent dental appointments and long-term follow-ups. Thus, practitioners should pay special attention to young patients during dental consultations, since the incidence of malignant oral lesions in this segment of the population seems to be increasing.


Assuntos
Carcinoma de Células Escamosas/diagnóstico , Ortodontia Corretiva , Neoplasias da Língua/diagnóstico , Adulto , Biópsia , Carcinoma de Células Escamosas/secundário , Diagnóstico Diferencial , Eritroplasia/diagnóstico , Feminino , Seguimentos , Glossectomia , Humanos , Leucoplasia Oral/diagnóstico , Masculino , Esvaziamento Cervical , Estadiamento de Neoplasias , Úlceras Orais/diagnóstico , Adulto Jovem
18.
Artigo em Inglês | MEDLINE | ID: mdl-24035112

RESUMO

Carcinoma cuniculatum is a rare variant of squamous cell carcinoma originally described on the sole of the foot and for a long time believed to be restricted to the skin. However, since its first description in 1954, several cases have been reported at other sites. Carcinoma cuniculatum characteristically invades the underlying subcutaneous, submucosal, or bone tissues, forming so-called "rabbit burrows," with crypts filled with keratin that are of utmost importance for distinguishing this neoplasm from other variants of squamous cell carcinoma. Oral carcinoma cuniculatum is an even rarer entity that is frequently misdiagnosed initially, a phenomenon described in about one-third of previously reported cases. The aim of this report is: (1) to describe the clinicopathologic features of 2 new cases of oral carcinoma cuniculatum, initially misdiagnosed as infected orthokeratinized cyst and abscess, respectively; and (2) to review the related English language literature.


Assuntos
Carcinoma de Células Escamosas/patologia , Carcinoma Verrucoso/patologia , Neoplasias Bucais/patologia , Carcinoma de Células Escamosas/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Bucais/diagnóstico por imagem , Radiografia
19.
J Cutan Pathol ; 40(9): 833-8, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23782298

RESUMO

Antimalarials are commonly prescribed in medical practice for conditions such as rheumatoid arthritis, lupus erythematosus, as well as malaria. They are generally well-tolerated, but side effects, although infrequent, are well known. The antimalarial chloroquine diphosphate may be associated with a bluish-gray to black hyperpigmentation of the oral mucosa, mainly on the hard palate. In this report we described five additional cases of palate hyperpigmentation related to the chronic use of chloroquine diphosphate. Professionals must be aware of the adverse effects of antimalarials as chloroquine diphosphate in order to make the correct diagnosis and appropriate management of the patient. Early diagnosis of oral pigmentation by antimalarials may be of great relevance, because it might be an early sign of ocular involvement, and therefore it may be helpful to prevent further complications of antimalarial therapy for the patient.


Assuntos
Antimaláricos/efeitos adversos , Cloroquina/efeitos adversos , Hiperpigmentação , Palato Duro/patologia , Idoso de 80 Anos ou mais , Antimaláricos/administração & dosagem , Cloroquina/administração & dosagem , Feminino , Humanos , Hiperpigmentação/induzido quimicamente , Hiperpigmentação/patologia , Masculino , Pessoa de Meia-Idade
20.
Spec Care Dentist ; 33(3): 150-3, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23600987

RESUMO

Hereditary hemorrhagic telangiectasia (HHT) is an inherited mucocutaneous disease characterized by recurrent epistaxis, lesions on skin and oral mucosa, and arteriovenous malformations of the soft tissues. This article describes the treatment of a 64-year-old woman with a bleeding nodule, which was diagnosed as an arteriovenous malformation of the gingival mucosa. She was treated using sclerotherapy. Patients with HHT can be treated in the dental office and vascular malformations of these patients can be successfully managed with sclerotherapy, which eliminates the need for invasive surgical procedures and the possibility of postsurgical complications.


Assuntos
Malformações Arteriovenosas/complicações , Malformações Arteriovenosas/tratamento farmacológico , Anormalidades da Boca/complicações , Telangiectasia Hemorrágica Hereditária/complicações , Malformações Arteriovenosas/diagnóstico , Diagnóstico Diferencial , Feminino , Gengiva/irrigação sanguínea , Humanos , Pessoa de Meia-Idade , Anormalidades da Boca/tratamento farmacológico , Mucosa Bucal/irrigação sanguínea , Ácidos Oleicos/uso terapêutico , Soluções Esclerosantes/uso terapêutico
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