Atypical Location of Oral Metastasis as the First Manifestation of Renal Carcinoma. Case Report / Localización Atípica de Metastasis Oral como Primera Manifestación de Carcinoma Renal. Reporte de Caso

Oral cavity metastatic tumors derived from primary tumors from other corporal regions are rare, representing barely 1 % of all malignant tumors. Differential diagnosis of these lesions is challenging due to the wide spectrum of lesions with similar clinical presentation and especially when the presence of a primary tumor goes undetected. We present the case of a 55-year-old male with a painless tumor in the anterior maxillary region, vestibular gingiva and palate, with a 2-month evolution. Anatomopathological diagnosis was malignant clear cell tumor, highly suggestive of clear cell renal carcinoma metastasis, and the oral lesion constituted the first sign of illness.

Los tumores metastásicos de cavidad oral derivados de tumores primarios de otras regiones corporales son raros, representando apenas el 1 % de todos los tumores malignos. El diagnóstico diferencial de estas lesiones es desafiante debido al amplio espectro de lesiones con presentación clínica similar y especialmente cuando la presencia de un tumor primario pasa desapercibida. Presentamos el caso de un varón de 55 años con una tumoración indolora en región maxilar anterior, encía vestibular y paladar, de 2 meses de evolución. El diagnóstico anatomopatológico fue de tumor maligno de células claras, altamente sugestivo de metástasis de carcinoma renal de células claras, y la lesión bucal constituyó el primer signo de enfermedad.

Presence of human papillomavirus in the buccal mucosa of blood donors / Presencia del virus del papiloma humano en la mucosa oral de donantes de sangre

Objective To determine the presence of human papillomavirus (HPV) in the oral mucosa of blood donors (BD) and risk factors associated with HPV and oral cancer. Materials and methods Prospective cross-sectional study, population matched to BD from the National Cancer Institute, Mexico for HPV identification in oral cytological samples using the CLART® Human Papillomavirus 2 Kit (35 genotypes) and risk factors. Results Of 352 BD with signed informed consent, 285 were selected by simple randomization. The prevalence of oral HPV was 17.5% (95% CI 13–21.9%), the genotype was identified in 13 cases, with a total of 16 genotypes (10 high-risk), the most common being 16 and 84. Five cases had multiple infections, three with at least one high-risk type. Associations were found for marital status (OR 3.3) and educational level (OR-1.9). Conclusions The percentage of HPV-positive cases in blood donors with no risk practices was similar to that found in Spanish-speaking population studies in which at least one risk practice was described. The presence of other genotypes with high oncogenic risk and multitype infection, described as a marker of persistence of HPV infection, is highlighted (AU)

Objetivo Identificar la presencia del virus del papiloma humano (VPH) en la mucosa oral de donantes de sangre (DS), así como los factores de riesgo relacionados con el VPH y el cáncer oral. Materiales y métodos Estudio transversal prospectivo. La población correspondió a los DS del Instituto Nacional de Cancerología, México, para la identificación de VPH en muestras citológicas orales con el kit CLART® Human Papillomavirus 2 (35 genotipos) y factores de riesgo. Resultados De 352 DS con firma de consentimiento informado, se seleccionaron 285 por aleatorización simple. La prevalencia de VPH oral fue del 17,5% (IC 95%: 13-21,9%); en 13 casos se identificó el genotipo, con un total de 16 genotipos (10 de alto riesgo), los más frecuentes el 16 y el 84. Cinco casos presentaron infección multitipo, 3 con al menos un tipo de alto riesgo. Las asociaciones encontradas fueron para el estado civil (OR 3,3) y el nivel de estudios (OR 1,9). Conclusiones El porcentaje de casos positivos para VPH en DS sin prácticas de riesgo fue similar a los hallazgos en estudios de población hispanohablante en los que se ha descrito al menos una práctica de riesgo. Se destaca la presencia de otros genotipos con alto riesgo oncogénico y la infección multitipo descrita como marcador de persistencia de la infección por VPH (AU)

Presence of human papillomavirus in the buccal mucosa of blood donors.

OBJECTIVE: To determine the presence of human papillomavirus (HPV) in the oral mucosa of blood donors (BD) and risk factors associated with HPV and oral cancer. MATERIALS AND METHODS: Prospective cross-sectional study, population matched to BD from the National Cancer Institute, Mexico for HPV identification in oral cytological samples using the CLART® Human Papillomavirus 2 Kit (35 genotypes) and risk factors. RESULTS: Of 352 BD with signed informed consent, 285 were selected by simple randomization. The prevalence of oral HPV was 17.5% (95% CI 13-21.9%), the genotype was identified in 13 cases, with a total of 16 genotypes (10 high-risk), the most common being 16 and 84. Five cases had multiple infections, three with at least one high-risk type. Associations were found for marital status (OR 3.3) and educational level (OR-1.9). CONCLUSIONS: The percentage of HPV-positive cases in blood donors with no risk practices was similar to that found in Spanish-speaking population studies in which at least one risk practice was described. The presence of other genotypes with high oncogenic risk and multitype infection, described as a marker of persistence of HPV infection, is highlighted.

A novel interlamellar oral mucosa graft surgery technique using fibrin glue for the treatment of trichiasis / Nova técnica cirúrgica de enxerto interlamelar de mucosa oral usando cola de fibrina para o tratamento de triquíase

ABSTRACT Purpose: The purpose of this study was to evaluate the long-term outcomes of patients with trichiasis treated with a modified interlamellar oral mucosa graft surgery technique using fibrin glue. Methods: A prospective study was conducted at the Oculoplastic Department of Ouro Verde Hospital Complex. Patients with recurrent trichiasis without entropion who did not respond to conventional therapy, underwent intermarginal lamellar splitting of the eyelid and oral mucous graft insertion with fibrin glue replacing sutures. They were then evaluated at 1-day, 1-week, 1-month, 6-month, and 4-year follow-ups. Graft adherence, symptom resolution, esthetic satisfaction, overall patient satisfaction, and trichiasis recurrence were assessed at 6-month and 4-year follow-ups. Results: Fifteen patients (a total of 19 eyes) were included, of whom 10 (66.7%) were female and 5 (33.3%) were male. The mean age was 75.4 ± 10.5 years (range, 54-98 years). Acquired trichiasis was the main cause. Of the patients with acquired trichiasis, 12 (86.7%) had chronic blepharitis, 2 (13.3%) had an undetermined cause, and one (6.7%) had trachomatous trichiasis. Most cases involved only one eyelid segment (89.4%) and =5 lashes (84.2%; minor trichiasis). No adverse reactions from the fibrin glue were reported and no sutures were required after graft placement. At 6 months, no graft failures occurred, 17 eyes of 13 patients (89.4%) showed good graft adherence, 2 eyes of 2 patients (10.5%) showed partial graft adherence, and 2 eyes of 1 patient (10.5%) had trichiasis recurrence. At 4-year follow-up, no graft failure occurred, 3 patients (3 eyes) were lost to follow-up, and 2 eyes of 2 patients (14.2%) had trichiasis recurrence. The 4-year cumulative success rate was 78.9%. Conclusions: The modified interlamellar surgery with fibrin glue showed a good long-term success rate. This technique reduces surgical time, facilitates smaller graft insertion, and therefore, should be considered for recalcitrant minor trichiasis without entropion.>

RESUMO Objetivo: O objetivo deste estudo foi avaliar os resultados a longo prazo da técnica cirúrgica modificada de enxerto interlamelar de mucosa oral usando cola de fibrina para o tratamento de triquíase. Métodos: Um estudo prospectivo foi realizado no Departamento de Óculo-plástica do Complexo Hospital Ouro Verde. Pacientes com triquíase recorrente sem entrópio, que não responderam à terapia convencional, foram submetidos à cirurgia com separação intermarginal das lamelas das pálpebras e inserção de enxerto de mucosa oral usando cola de fibrina, substituindo a sutura. Pacientes foram avaliados 1 dia, 7 dias, 1 mês, 6 meses e 4 anos após a cirurgia. A aderência do enxerto, resolução dos sintomas, satisfação estética, satisfação geral do paciente e recorrência de triquíase foram avaliados aos 6 meses e aos 4 anos. Resultados: Quinze pacientes (total de 19 olhos) foram incluídos, dos quais 10 (66.7%) eram do sexo feminino e 5 (33.3%) do sexo masculino. A média de idade foi 75.4 ± 10.5 anos (intervalo 54-98 anos). Triquíase adquirida foi a principal causa, da qual 12 pacientes apresentaram blefarite crônica (86.7%), 2 pacientes com causa indeterminada (13.3%) e 1 paciente com triquíase tracomatosa (6.7%). A maioria dos casos envolveu apenas um segmento da pálpebra (89.4%) e com =5 cílios (84.2%; triquíase menor). Nenhuma reação adversa foi reportada com o uso da cola de fibrina e nenhum caso necessitou de sutura após inserção do enxerto. Aos 6 meses, não houve nenhuma falha de enxerto, 17 olhos de 13 pacientes (89.4%) apresentaram boa aderência de enxerto, 2 olhos de 2 pacientes (10.5%) mostraram aderência parcial do enxerto e 2 olhos de 1 paciente (10.5%) apresentaram recorrência da triquíase. Aos 4 anos, não houve nenhuma falha de enxerto, 3 olhos de 3 pacientes tiveram perda de seguimento e 2 olhos de 2 pacientes (14.2%) apresentaram recorrência da triquíase. A taxa de sucesso acumulativa após 4 anos foi de 78.9%. Conclusão: A cirurgia modificada de enxerto interlamelar de mucosa oral usando cola de fibrina mostrou uma boa taxa de sucesso a longo prazo. Esta técnica reduz o tempo cirúrgico, facilita a inserção de enxertos menores e, portanto, deve ser considerada em triquíase menor sem entrópio resistente ao tratamento convencional.

Enfrentamiento de lesiones de cavidad oral: clasificación y diagnóstico diferencial / Assessment of oral cavity lesions: classification and differential diagnosis

Las lesiones de la cavidad oral corresponden a un hallazgo frecuente y muchas veces difíciles de diagnosticar. Su correcto reconocimiento podría ser clave en detectar patologías que podrían cambiar el pronóstico del paciente. El objetivo de esta revisión es describir una clasificación de las lesiones de la cavidad oral que permita ayudar al diagnóstico en la práctica clínica. Para esto, se detallan y se describen las lesiones, orientando al diagnóstico y a la necesidad de biopsiar. Para simplificar la orientación diagnóstica, las lesiones se clasifican en 2 grandes grupos: tumorales y no tumorales. Las lesiones no tumorales se subdividen en lesiones de la mucosa oral y lesiones de la lengua.

Lesions of the oral cavity are frequent and often difficult to diagnose. However, correct recognition could change the patient's prognosis. This review aims to describe a classification of oral mucosa lesions, to help the diagnosis in clinical practice. The lesions are described for this, guiding the diagnosis and the need for biopsy. To simplify the diagnostic orientation, the lesions are classified into two groups: tumor and non-tumor lesions. Non-tumor lesions are subdivided into lesions of the oral mucosa and lesions of the tongue.

Lesiones en Mucosa Oral Pesquisadas en un Servicio de Urgencia Hospitalario

RESUMEN: En mucosa oral se pueden expresar múltiples lesiones y condiciones que se alejan de la normalidad las cuales deben ser sujeto de estudio y manejo con el fin de mejorar el pronóstico de los pacientes y su calidad de vida, siendo algunas veces motivo de consulta en servicios de urgencia. Un estudio observacional retrospectivo fue realizado con los datos de atención de urgencia del Hospital Barros Luco Trudeau, incorporando las consultas producto de hallazgos en mucosa oral. Se evaluaron los datos de 121 pacientes, 54 hombres y 67 mujeres entre 12 y 84 años, promedio de 45 años. La sospecha de Tumores malignos agrupó un 24,8 % de la muestra, siendo las lesiones en tejidos contiguos a paladar duro las más frecuentes dentro de este subgrupo, seguidos de cuadros de Estomatitis y Gingivitis (21,5 %), Granulomas (20,7 %) y Hiperplasias y Fibrosis (14,9 %). Los tejidos más afectados fueron el gingival con 47 casos (38,9 %) y el palatino con 39 casos (32,2 %). Nuestros resultados se condicen con lo expresado en la literatura donde en población adulta se tienden a identificar hallazgos asociados a daño crónico sobre los tejidos, con estímulos mecánico s de baja intensidad constantes y asociación con patologías base, mientras que en pacientes de primera y segunda década las lesiones traumáticas y asociadas a virus son más frecuentes. Es crítico que los profesionales conozcan las lesiones más frecuentes de identificar en la población, conociendo su etiología y manejo adecuado, junto con disponer de una red de trabajo continuo, realizando seguimiento del caso a lo largo del proceso diagnóstico.

ABSTRACT: Multiple lesions and conditions that are far from normal can be expressed in the oral mucosa, which should be the subject of study and management in order to improve the prognosis of patients and their quality of life, sometimes being a reason for consultation in emergency services. A retrospective observational study was carried out with the emergency care data from the Barros Luco Trudeau Hospital, incorporating the consultations resulting from findings in the oral mucosa. Data from 121 patients, 54 men and 67 women between 12 and 84 years old, average 45 years old, were evaluated. Suspicion of malignant tumors grouped 24,8 % of the sample, being the lesions in tissues adjacent to the hard palate the most frequent within this subgroup, followed by pictures of Stomatitis and Gingivitis (21.5 %), Granulomas (20.7 %) and Hyperplasias and Fibrosis (14.9 %). The most affected tissues were the gingival with 47 cases (38.9 %) and the palatal with 39 cases (32.2 %). Our results are consistent with what is expressed in the literature where, in the adult population, findings associated with chronic tissue damage tend to be identified, with constant low intensity mechanical stimuli and association with base pathologies, while in first and second patients In the decade, traumatic and virus-associated injuries are more frequent. It is critical that professionals know the most frequent injuries to identify in the population, knowing their etiology and proper management, along with having a continuous work network, monitoring the case throughout the diagnostic process.

Oral Mucosal Melanoma: A Case Report and Literature Review

ABSTRACT: Oral mucosal melanoma is an unusual and aggressive malignant tumor that mainly affects the palate of men aged between 50 and 60 years. We present a literature review focusing on the etiopathogenesis and the clinicopathologic features of this entity. In addition, we reported a rare case of an oral mucosal melanoma arising in the left cheek of a 60-yea r- old man. Computed tomography scan revealed infiltration of the tumor to other anatomic structures including the maxillary sinus, the zygomatic bone and the pterygoid processes. Based on its extension, the lesion was considered inoperable and treatment with three-dimensional conformal radiation therapy was proposed but the patient only attended to the first session and died from cancer progression 6 months after the diagnosis. This paper reinforces the importance of inclusion of this malignant tumor in the differential diagnosis of pigmented lesions of the oral mucosa.

RESUMEN: El melanoma de la mucosa oral es un tumor maligno inusual y agresivo que afecta principalmente al paladar de hombres de entre 50 y 60 años. Presentamos una revisión bibliográfica centrada en la etiopatogenia y las características clínico-patológicas de esta entidad. Además, reportamos un caso raro de melanoma de la mucosa oral que surgió en la mejilla izquierda de un hombre de 60 años. La tomografía computarizada reveló la infiltración del tumor a otras estructuras anatómicas, incluido el seno maxilar, el hueso cigomático y los procesos pterigoideos. En base a su extensión, la lesión se consideró inoperable y se propuso tratamiento con radioterapia conformada tridimensional pero el paciente solo asistió a la primera sesión y falleció por progresión del cáncer 6 meses después del diagnóstico. Este trabajo refuerza la importancia de la inclusión de este tumor maligno en el diagnóstico diferencial de las lesiones pigmentadas de la mucosa oral.

Prevalence of oral mucosal lesions and oral health related quality of life among adolescents in a rural Nigerian population

Background: Oral mucosal lesions affect people of all age groups, and vary in presentation; from asymptomatic to severely debilitating. Studies reporting the prevalence and effects of these lesions in adolescents are generally few compared to those describing the demography of dental caries and other oral diseases. Objective: To determine the prevalence of oral mucosal lesions, factors that contribute to the prevalence, and the association with the oral-health related quality of life (OHRQoL) of adolescents in the population. Methods: A cross-sectional survey was done on 240 secondary school students aged 10-19 from three secondary schools selected using multi-stage cluster random sampling. A pre-designed questionnaire was used to collect demographic information, presence of systemic illness, and oral habits. Oral-health related quality of life was assessed using the oral-health impact profile (OHIP-14), and intraoral examination was performed within the school premises by a single trained investigator. Results: A total of 33 participants (13.7%) had oral mucosal lesions. Overall, commissural lip pits (5.0%) were the most prevalent, while geographic tongue and irritation fibroma (0.4% each) were the least prevalent lesions. The mean OHIP-14 score of the participants in this study was 7.17+8.64. Participants with systemic diseases and cheek biting habits had statistically significant worse scores than those without either. Conclusion: The most prevalent oral mucosal lesions in the adolescent age group are those of developmental origin. Quality of life was negatively impacted by the presence of systemic diseases as well as cheek biting habit.

Manifestações orais do Covid-19: uma breve revisão da literatura / Oral manifestations of Covid-19: a brief review of the literature

A pandemia gerada pelo SARS-CoV-2 gerou uma série de estudos sobre essa nova doença. Este cenário proporcionou mudanças na odontologia, modificando a forma de atendimento e a rotina do consultório. O conhecimento sobre as implicações desse vírus no sistema estomatognático pode fornecer informações valiosas no conhecimento sobre o mecanismo dessa doença na cavidade oral. Dessa forma, foi realizada uma revisão de literatura, a fim de discutir os efeitos do COVID-19 na cavidade oral. No entanto, há poucas evidências na literatura sobre a correlação da COVID-19 e manifestações orais. Pode-se concluir que o vírus possui reflexo na cavidade oral, apresentando diferentes alterações, tais como: úlceras, periodontite, alterações do paladar, infecções oportunistas, dentre outras. Ainda se faz necessária a realização de mais estudos, para compreensão dos mecanismos fisiopatológicos da doença. Além disso, o trabalho ressalta a importância do cirurgião-dentista no ambiente hospitalar, para diagnóstico e conduta no tratamento dessas manifestações na cavidade oral(AU)

The SARS-CoV-2 pandemic has spawned several studies on this new disease. This scenario provided changes in Dentistry by modifying the form of care and the routine of the office. The knowledge about the implications of this virus in the stomatognathic system can provide valuable information in the knowledge about the mechanism of this disease in the oral cavity. Thus, a literature review was carried out to discuss the effects of COVID-19 on the oral cavity. However, there is little evidence in the literature about the correlation between COVID-19 and oral manifestations. It can be concluded that the virus is reflected in the oral cavity, such as ulcers, periodontitis, changes in taste, opportunistic infections, among others. Further studies are still needed to understand the pathophysiological mechanisms of the disease. Besides, the work highlights the importance of the Dental Surgeon in the hospital environment for diagnosis and management in the treatment of these manifestations in the oral cavity(AU)

Correlación del diagnóstico clínico e histopatológico de lesiones de la mucosa oral entre 2008-2015 en la Universidad de Costa Rica / Correlation of Clinical and Histopathological Diagnosis of Oral Mucosa Lesions at the University of Costa Rica Between 2008 and 2015

RESUMEN: El objetivo de este estudio es determinar la concordancia existente entre el diagnóstico clínico e histopatológico de las lesiones en la mucosa oral en la Facultad de Odontología de la Universidad de Costa Rica (UCR). Es un estudio retrospectivo de 261 informes de lesiones orales recuperados del archivo de biopsias de la Facultad de Odontología de la UCR de 2008 a 2015, fueron analizados 165 reportes que cumplian con los criterios de inclusión. La concordancia entre el diagnóstico clínico e histopatológico fue verificada mediante el test Kappa. Del total de los informes, 96 (36.8%) no contaban con alguna hipótesis diagnóstica. La concordancia con la primera hipótesis diagnóstica se presentó en 114 (69.1%) casos, el valor de kappa fue de 0.663 (concordancia sustancial). Las lesiones premalignas presentaron una concordancia excelente (kappa=0.902). La concordancia del grupo de lesiones proliferativas no neoplásicas fue moderada (kappa=0.504) y las condiciones dermatológicas y autoinmunes con una concordancia insignificante (0.157). La concordancia se produjo en la mayoría de los pacientes investigados con un valor correspondiente a un acuerdo sustancial, sin embargo, se debe mejorar el porcentaje de informes que no contaban con hipótesis clínica.

ABSTRACT: The objective of this study is to determine the existing concordance between the clinical and histopathological diagnosis of lesions in the oral mucosa at the Faculty of Dentistry of the University of Costa Rica (UCR). A retrospective study of 261 reports of oral lesions recovered from the biopsy archive of the UCR Faculty of Dentistry from 2008 to 2015. Of the total reports 165 were included in the analysis, 96 (36.8%) did not have any diagnostic hypotheses. The concordance between the clinical and histopathological diagnosis was verified by the Kappa test. Concordance with the first diagnostic hypothesis was presented in 114 (69.1%) cases, the value of kappa was 0.663 (substantial agreement) and 36.8% without clinical diagnosis only a description of the lesion. The premalignant lesions presented an excellent concordance (kappa=0.902). The concordance of the group of non-neoplastic proliferative lesions was moderate (kappa=0.504) and the dermatological and autoimmune conditions with negligible concordance (0.157). Concordance occurred in the majority of the patients investigated with a value corresponding to a substantial agreement, however, the percentage of reports that did not have a clinical hypothesis should be improved.

Oral manifestations present in patients with COVID-19 Scoping Review / Manifestaciones orales presentes en pacientes con COVID-19. Revisión sistemática exploratoria

The new COVID-19 is caused by the SARS-CoV2 virus, which has a high affinity for the human ACE-2 receptor, those that are in high presence in the oral cavity. There have been various oral manifestations associated with COVID-19, however, the prevalence and etiology of these lesions is still unknown. The objective of the study is to determine in an updated way, the oral manifestations in patients with the disease, identifying type of basic lesion, associated pathology, location and prevalence. In this study the databases used were Scopus, MedLine and Web of Science. 28 articles were included in this review, which included a total of 591 patients with COVID-19 and oral manifestations. Finally, we determined that there are three types of general oral alterations: neurological, oral mucosa and glandular manifestations. The neurological are the most prevalent, followed by those of the oral mucosa and finally the glandular ones. About location, the sites where it is most common to find basic lesions are the tongue and lips.

El nuevo COVID-19 es originado por el virus SARS-CoV2, el cual posee alta afinidad por el receptor humano ACE-2, los que se encuentran en alta presencia en la cavidad oral. Se han presentado diversas manifestaciones orales asociadas a COVID-19, no obstante, aún se desconoce la prevalencia y la etiología de estas lesiones. El objetivo del estudio es determinar de manera actualizada, las manifestaciones orales en pacientes que se encuentran cursando la enfermedad, identificando el tipo de lesión básica, patología asociada, ubicación y prevalencia. En este estudio las bases de datos utilizados fueron Scopus, MedLine y Web of Science. Se incluyeron 28 artículos en esta revisión, los que engloban un total de 591 pacientes con COVID-19 y manifestaciones orales. Finalmente, determinamos que existen tres tipos de alteraciones orales generales: manifestaciones neurológicas, de mucosa oral y glandulares. Las neurológicas son las más prevalentes, seguidas por las de mucosa oral y finalmente las glandulares. Con respecto a la ubicación, los sitios en donde es más frecuente encontrar lesiones básicas vienen siendo lengua y labios.

Uretroplastia bulbar con injerto: Una actualización sobre las diferentes técnicas quirúrgicas / Graft Urethroplasty for Bulbar Strictures: An Update on the Different Surgical Techniques

En pacientes con estrechez uretral bulbar de una longitud mayor a 2 cm, que no sean candidatos a otras técnicas, se realiza uretroplastia con injerto. Actualmente se emplean diversas técnicas, cada una con ventajas y desventajas propias. Describir las ventajas y desventajas de las técnicas quirúrgicas empleadas actualmente en la uretroplastia con injerto, así como sus tasas de éxito. Se hizo una búsqueda en PubMed, ClinicalKey y en ScienceDirect, utilizando las palabras claves: "urethral stricture," "urethroplasty," "oral graft" y "flap." Se utilizaron los estudios más relevantes, tanto originales como revisiones sistemáticas y metaanálisis, en inglés y en español. Las diferentes técnicas quirúrgicas ofrecen ventajas y desventajas teóricas frente a las otras, aunque las tasas de éxito en todas es cercana al 90%, sin ser una francamente superior frente a las demás. La elección de la técnica quirúrgica a realizar depende de las preferencias y experiencia del cirujano, dado que la tasa de éxito para todas las técnicas es similar.

In patients with urethral stricture longer than 2 cm who are not candidates for other techniques, graft urethroplasty is the most performed surgery. Currently, several techniques are used, each with their own advantages and disadvantages. Describe the advantages and disadvantages of the surgical techniques currently used in graft urethroplasty, as well as their success rates. A search was made in PubMed, ClinicalKey and ScienceDirect, using the keywords: "urethral stenosis," "urethroplasty," "oral graft" and "flap." The most relevant original studies, systematic reviews and meta-analyzes were used, both in English and Spanish. The different surgical techniques offer theoretical advantages compared with the others, although the success rates in all are close to 90%, without being frankly superior compared with the others. The choice of the surgical technique to be performed depends on the preferences and experience of the surgeon, given that the success rate for all techniques is similar.

Detección de papilomavirus humano en mucosa oral en hombres con verrugas anogenitales / Detection of human papillomavirus in oral mucosa in men with anogenital warts

El virus del papiloma humano (HPV) es el agente etiológico de infecciones de transmisión sexual relacionadas con procesos oncogénicos genitales y orales. La biología molecular, mediante la identificación de los tipos virales involucrados, proporciona precisión diagnóstica con un enfoque epidemiológico. El objetivo de este estudio fue determinar la presencia de HPV en la mucosa oral de hombres con verrugas anogenitales y correlacionar los genotipos detectados en ambas muestras. Se estudiaron 26 pacientes varones con verrugas anogenitales que acudieron al Instituto de Dermatología de la ciudad de Resistencia (Argentina). La presencia de HPV en muestras orales y anogenitales se estudió mediante reacción en cadena de la polimerasa (PCR) y la genotipificación se realizó mediante PCR-RFLP. La prevalencia de HPV oral en pacientes con HPV anogenital fue del 46,2% (12/26). Se encontraron dieciocho genotipos con alto riesgo oncogénico en muestras orales de pacientes con infecciones únicas o múltiples y el tipo 16 fue el más frecuente (6 pacientes). Catorce genotipos en muestras orales fueron de bajo riesgo oncogénico, el más frecuente fue el tipo 6 (10 pacientes). En muestras anogenitales el genotipo 6 fue el más frecuente (13 pacientes), solo o en coinfección. Se encontró una alta prevalencia de HPV oral de malignidad de alto grado en nuestra población y coinfección con tipos oncogénicos. Las prácticas de sexo oral fueron la principal conducta de riesgo para la infección, lo que quedó demostrado por el hallazgo simultáneo del mismo tipo de HPV en muestras orales y anogenitales

The human papillomavirus (HPV) is the etiologic agent of sexually transmitted infections related to genital and oral oncogenic processes. Molecular biology provides accurate diagnosis with an epidemiological approach, by identifying the viral types involved. The objective of this study was to determine the presence of HPV in oral mucosa from men with anogenital warts and to correlate the genotypes detected in both samples. Twenty-six male patients suffering anogenital warts who attended to the Institute of Dermatology in Resistencia (Argentina) were studied. The presence of HPV in oral and anogenital samples was studied by PCR and genotyping was performed by PCR-RFLP. The prevalence of oral HPV in patients with anogenital HPV was 46.2% (12/26). Eighteen genotypes with high oncogenic risk were found in oral samples of patients with single or multiple infections and type 16 was the most frequent (6 patients). Fourteen genotypes in oral samples were of low oncogenic risk and the most frequent was type 6 (10 patients). In anogenital samples the genotype 6 was the most frequent (13 patients), alone or in co-infection. A high prevalence of high-grade malignancy oral HPV in our population and co-infection with oncogenic types were found. Oral sex practices were the main risk factor for infection, which was demonstrated by the simultaneous finding of the same HPV type in oral and anogenital samples

Estudio retrospectivo a 5 años sobre la prevalencia de lesiones de la mucosa oral en una clínica universitaria / 5-year retrospective study on the prevalence of oral mucosa lesions in a university clinic

Resumen: El objetivo de este estudio fue determinar la prevalencia y distribución de las lesiones de la mucosa oral en los pacientes que acudieron a la Policlínica Universitaria de la Universidad Europea de Madrid entre 2014 y 2018, así como establecer si existe una relación entre el sexo y la edad con la presencia de lesiones de la mucosa oral. Material y métodos: Al ser un estudio retrospectivo a 5 años, se requería la revisión de 2000 historias clínicas para obtener un nivel de precisión y de confianza aceptable. La recogida de las variables de investigación se llevó a cabo mediante una base de datos diseñada en Access. El análisis de los datos se realizó con el paquete estadístico Stata IC versión 14 (StataCorp LLC., Texas USA). Resultados: En un análisis preliminar de 1536 historias clínicas se determinó que la prevalencia global de lesiones orales era del 29,27%, existiendo una diferencia estadísticamente significativa en cuanto al sexo, y no encontrándose diferencias estadísticamente significativas entre los diferentes grupos de edad. Siendo las lesiones de la mucosa oral más frecuentes la línea alba (9,78%) y el morsicatio buccarum (9,38%). Conclusiones: Este estudio tiene unaprevalencia global similar a otros publicados previamente, destacamos la importancia de la exploración oral para la identificación y prevalencia de lesiones orales. (AU)

Abstract: The objective of this study was to determine the prevalence and distribution of oral mucosa lesions in patients who attended the University Clinic of the European University of Madrid, between the years 2014 and 2018. Secundary objectives were to assess if there is a relationship between sex and age and the presence of lesions in the oral mucosa. Material and methods: Being a 5-year retrospective study, the review of 2000 medical records was required to obtain an acceptable level of precision and confidence level. The collection of all the variables was carried out using a database designed in Access. Data analysis was performed with the Stata IC version 14 statistical package (StataCorp LLC., Texas USA). Results: In a preliminary analysis of 1536 medical records we determined that the global prevalence of oral lesions was 29.27%, with a significant difference regarding sex. No significant differences were found between the different age groups. The most frequent lesions of the oral mucosa were linea alba (9.78%) and morsicatio buccarum (9.38%). Conclusions: Our study has a global prevalence similar to other previously published studies; we highlight the importance of oral examination for the identification and prevalence of oral lesions. (AU)

Tumor de células granulares. Estudio clínico de 81 pacientes / Granular Cell Tumor: A Clinical Study of 81 Patients

Introducción: El tumor de células granulares (TCG) suele desarrollarse en la piel o en la mucosa oral, pero se ha descrito en muchos otros órganos. Suele ser único, pero puede ser múltiple y asociarse a otras enfermedades. Objetivos: Analizar las características clínicas de nuestros pacientes con TCG en la piel y la mucosa oral y su posible asociación con otras afecciones. Material y métodos: Estudio retrospectivo de los pacientes con TCG diagnosticados entre 1995-2019. Se revisaron las historias clínicas para obtener los siguientes datos: edad, sexo, localización, número de lesiones, diámetro, tiempo de evolución, diagnóstico clínico de sospecha, estado de los márgenes de resección, desarrollo de recidiva, tiempo de seguimiento y enfermedades asociadas. Resultados: Ochenta y un pacientes presentaron 89 TCG en la piel y la mucosa oral (43 mujeres/38 varones, edad media 40,21años). El diámetro medio fue de 1,34cm. Contabilizando los tumores extracutáneos 5 de los 81 pacientes presentaban TCG múltiple (6,2%). La edad media de los pacientes con TCG múltiple fue significativamente inferior a la de los pacientes con un único tumor (p=0,004). Solamente un paciente presentó recidiva local y ninguno desarrolló metástasis a distancia. No hemos detectado ningún caso asociado a otras enfermedades. Conclusiones: La mayoría de TCG son benignos, y a pesar de tener los márgenes afectados no suelen presentar recidivas locales. Sin embargo, hay que tener en cuenta la posibilidad de presentar TCG múltiples, tanto en la piel y en la mucosa oral como en órganos internos, especialmente en pacientes jóvenes (AU)

Introduction: Although a granular cell tumor (GCT) usually develops on the skin or oral mucosa, it has been described in many other organs. GCT typically presents as a solitary tumor, but multiple lesions can occur. It has also been described in association with other diseases. Objective: To describe the clinical characteristics of cutaneous and oral mucosal GCTs and explore potential associations with other diseases. Material and methods: Retrospective study of patients diagnosed with GCT at our hospital between 1995 and 2019. The following information was collected from the patients’ medical records: age, sex, number of GCTs, location, diameter, time to diagnosis, tentative clinical diagnosis, surgical margin status, recurrence, follow-up time, and associated diseases. Results: We detected 89 cutaneous or oral mucosal GCTs in 81 patients (43 women, 38 men) with a mean age of 40.21 years. The mean tumor diameter was 1.34cm. Five of the 81 patients (6.2%) had multiple GCTs, including noncutaneous tumors. Patients with multiple GCTs were on average younger than those with a single tumor (P=.004). There was only a single case of local recurrence and no cases of distant metastasis. None of the patients had associated diseases. Conclusions: Most GCTs are benign and local recurrence is uncommon, even in patients with positive margins. Nevertheless, the possibility of multiple tumors affecting the skin, oral mucosa, or internal organs should be borne in mind, especially in young patients (AU)

Clase metodológica instructiva de la asignatura Sistema Masticatorio, orientada a la relación básico-clínica / Instructive methodological class of the Masticatory System subject, oriented towards the basic-clinical relationship

RESUMEN La preparación del personal docente en las universidades exige un alto nivel científico y de maestría pedagógica. Todo esto requiere un esmerado trabajo metodológico que garantice una planificación organización, regulación y control del proceso docente educativo. Para esto se diseñó una clase metodológica instructiva sobre mucosa oral, de la asignatura Sistema Masticatorio, en la disciplina Histología, con el objetivo de instruir al profesor en la utilización de la vinculación básico-clínica. Se indicó a los profesores cómo relacionar el contenido de la clase con la clínica, desde el punto de vista de las lesiones precancerosas y sus factores de riesgo. Se logró la instrucción de los docentes en la utilización del contenido de las asignaturas y disciplinas de las Ciencias Básicas con la relación básico-clínica, y así se contribuyó a ampliar el espectro científico metodológico de los docentes en la Universidad de Ciencias Médicas de Matanzas (AU).

ABSTRACT Training the teaching staff in the universities demands a high scientific level and pedagogical expertise. All of these requires a careful methodological work guaranteeing the teaching-learning process planning, organization, regulation and control. For that the authors designed an instructive methodological lesson aimed to train the teaching staff in the use of the basic-clinical link during a lesson of the subject Masticatory System about Oral Mucosa, in the subject Histology. They indicate to professors how to relate the lesson content to clinic from the point of view of pre-cancer lesions and its risk factors. Training the teaching staff in the use of subjects and disciplines of the Basic Sciences with the basic-clinical relation, the authors contribute to widening the scientific methodological spectrum of the teaching staff of the Matanzas University of Medical Sciences (AU).

El diagnóstico diferencial es fundamental: a propósito de un caso de síndrome de Laugier-Hunziker / The differential diagnosis is crucial: a case of Laugier-Hunziker syndrome

El síndrome de Laugier-Hunziker (SLH) es una enfermedad poco frecuente, benigna, no asociada a patología sistémica, cuya forma de presentación en adultos consiste en hiperpigmentación macular mucocutánea que afecta mayoritariamente a labios y mucosa oral, ocasionalmente puede afectar mucosa genital y con menos frecuencia al área palmo plantar. Se encuentra asociada en la mitad de los casos con melanoniquia longitudinal. La importancia de este síndrome es evidente una vez que es diagnóstico de exclusión de enfermedades con significativo riesgo de malignidad. Ante la sospecha de SLH, es obligatorio el despistaje de otras patologías asociadas a hiperpigmentación, lentiginosis y melanoniquia. Los autores presentan el caso de una mujer de63 años con hiperpigmentación de mucosa oral y de dedos de manos y pies, con el diagnóstico final de SLH. Realizan un resumen del estudio realizado que condujo al diagnóstico. Concluyen subrayando la importancia del diagnóstico diferencial con otras patologías. (AU)

Tatuaje de amalgama: Pigmentación exógena más común de la cavidad oral / Amalgam tattoo: Most common exogenous pigmentation of the oral cavity

Resumen El propósito de este estudio es analizar las características clínicas de la pigmentación de amalgama en la cavidad oral, comúnmente, denominada también tatuaje de amalgama, el objetivo es aumentar el conocimiento de esta entidad patológica y diferenciarla de otras lesiones de mayor importancia clínica.

Abstract The purpose of this study is to analyze the clinical characteristics of amalgam pigmentation in the oral cavity, commonly known as amalgam tattoo, in order to increase the knowledge of this pathological entity and to differentiate it from other important lesions.

Granular Cell Tumor: A Clinical Study of 81 Patients. / Tumor de células granulares. Estudio clínico de 81 pacientes.

INTRODUCTION: Although a granular cell tumor (GCT) usually develops on the skin or oral mucosa, it has been described in many other organs. GCT typically presents as a solitary tumor, but multiple lesions can occur. It has also been described in association with other diseases. OBJECTIVES: To describe the clinical characteristics of cutaneous and oral mucosal GCTs and explore potential associations with other diseases. MATERIAL AND METHODS: Retrospective study of patients diagnosed with GCT at our hospital between 1995 and 2019. The following information was collected from the patients' medical records: age, sex, number of GCTs, location, diameter, time to diagnosis, tentative clinical diagnosis, surgical margin status, recurrence, follow-up time, and associated diseases. RESULTS: We detected 89 cutaneous or oral mucosal GCTs in 81 patients (43 women, 38 men) with a mean age of 40.21 years. The mean tumor diameter was 1.34cm. Five of the 81 patients (6.2%) had multiple GCTs, including noncutaneous tumors. Patients with multiple GCTs were on average younger than those with a single tumor (P=.004). There was only a single case of local recurrence and no cases of distant metastasis. None of the patients had associated diseases. CONCLUSIONS: Most GCTs are benign and local recurrence is uncommon, even in patients with positive margins. Nevertheless, the possibility of multiple tumors affecting the skin, oral mucosa, or internal organs should be borne in mind, especially in young patients.