Oral and maxillofacial cancer in pediatric patients: 30 years experience from a Brazilian reference center.

OBJECTIVE: The aim of this study is to determine the relative frequency, demographic distribution and clinicopathological features of pediatric oral and maxillofacial cancer (POMC). METHODS: Medical records were retrospectively reviewed for all cancer cases diagnosed from 1986 to 2016 affecting patients aged 19 years and younger. Demographic variables, anatomical site, and histopathological diagnoses were collected and analyzed by descriptive statistics. RESULTS: Fifty-five (0.77%) POMCs were found among 7181 pediatric malignancies. Mean age at diagnosis was 8 years and patients aged 5-9 years presented the higher prevalence of malignant tumors (40%). White male patients were more frequently affected (78.18% and 65.45%, respectively). The most common cancer type was lymphomas (52.73%) followed by sarcomas (27.27%) and carcinomas (20%). Burkitt lymphoma (32.73%), rhabdomyosarcoma (14.55%), diffuse large B-cell lymphoma (9.09%), and mucoepidermoid carcinoma (9.09%) were the most common histopathological diagnoses. The main affected anatomical site was the oropharynx (38.18%), followed by salivary glands (30.91%), maxillofacial bone (20%), and oral cavity (10.91%). CONCLUSION: POMC has a low incidence; however, highly aggressive tumors, such as lymphomas and sarcomas, are common in this scenario. A better knowledge about the clinicopathological distribution of POMC may contribute to early diagnosis and improve survival rates.

[Tumoral degeneration occurring over a non-healing meningocele. Report of two cases]. / Degeneración tumoral en meningocele no intervenido. Descripción de dos casos.

A giant meningocelic sac has not been usually described in adult patients, due to the fact that it shows a low incidence and few newborn have survived to date though the malformation is benign. We report two cases of patients born with the described malformation and who were not operated at that time, so they reached adulthood with bigger sacs. They needed surgery to remove the sacs, for a different reason. The older one had a fistulous abcess but the LCR did not come out, and it did not improved by the application of topic and antibiotic treatment. The other patient showed a progressive growth of the malformation during the last year, skin hardening and pain. The histological study of the dried sacs proved the existence of a carcinomatous degeneration. In the patients we have treated, it seems that a chronic irritation of the LCR and the appearance of multipotent cells in the meningocele may favour the malignancy of the tissues surrounding the sac. This possible malignancy, already described in the bibliography, suggests a prompt elective surgical treatment of the patients with these congenital lesions as soon as possible.

Efficacy of Wnt-1 monoclonal antibody in sarcoma cells.

BACKGROUND: Sarcomas are one of the most refractory diseases among malignant tumors. More effective therapies based on an increased understanding of the molecular biology of sarcomas are needed as current forms of therapy remain inadequate. Recently, it has been reported that Wnt-1/beta-catenin signaling inhibits apoptosis in several cancers. In this study, we investigated the efficacy of a monoclonal anti-Wnt-1 antibody in sarcoma cells. METHODS: We treated cell lines A-204, SJSA-1, and fresh primary cultures of lung metastasis of sarcoma with a monoclonal anti-Wnt-1 antibody. Wnt-1 siRNA treatment was carried out in A-204. We assessed cell death using Crystal Violet staining. Apoptosis induction was estimated by flow cytometry analysis (Annexin V and PI staining). Cell signaling changes were determined by western blotting analysis. RESULTS: We detected Wnt-1 expression in all tissue samples and cell lines. Significant apoptosis induction was found in monoclonal anti-Wnt-1 antibody treated cells compared to control monoclonal antibody treated cells (p < 0.02). Similarly, we observed increased apoptosis in Wnt-1 siRNA treated cells. Blockade of Wnt-1 signaling in both experiments was confirmed by analyzing intracellular levels of Dishevelled-3 and of cytosolic beta-catenin. Furthermore, the monoclonal anti-Wnt-1 antibody also induced cell death in fresh primary cultures of metastatic sarcoma in which Wnt-1 signaling was active. CONCLUSION: Our results indicate that Wnt-1 blockade by either monoclonal antibody or siRNA induces cell death in sarcoma cells. These data suggest that Wnt-1 may be a novel therapeutic target for the treatment of a subset of sarcoma cells in which Wnt-1/beta-catenin signaling is active.

Reticulopatías (reticulosis) versus mesenquimopatías sistémicas extraembrionarias: revisión histórica de conceptos. Cánceres mesenquimales (sarcomas) versus tumores sistémicos extraembrionarios / Extraembrionary sistemic mesenchymopathies vs reticulopathies

Se realiza una revisión histórica de la concepción del "Sistema retículo-endotelial" o "sistema retículo-histiocitario" y su aplicación a la patología que generó las llamadas "reticulopatías" y en especial las "reticulosis" (reticulopatías de causa no determinada). Se analiza la naturaleza histológica ultraestructural y embriológica del SRE y se concluye que dicha concepción está basada en erróneas interpretaciones histofisiológicas y embriológicas. El "tejido reticular, que forma el armazón de sostén de los órganos hemocitopoyéticos (bazo, ganglios linfáticoas, médula ósea parda) representa simplemente una variedad de tejido conectivo especializado asociado a un armazón extracelular de fibrillas de reticulina constituidas como las fibras colágenas por proteínas colágenas. Los estudios ultraestructurales de las "células reticulares" no han logrado mostrar evidencias de actividad macrofágica y han permitido observar formas transicionales al fibroblasto. También se ha podido demostrar la imposibilidad de que la "célula reticular" se pueda transformar en "histiocito" o "macrófago". Por otro lado, los "sinusoides" del bazo y del hígado están constituídos por verdaderos endotelios fenestrados, sin vinculación con las células reticulares. Las células de Kupffer del hígado son macrófagos originados en hemocitoblastos (células troncales hemáticas del mesénquima extraembrionario), que viven en los intersticios de los endotelios fenestrados, sin tener vinculaciones citogenéticas con los endotelios sinusoidales. Estos hallazgos han determinado que no se puede seguir admitiendo una función de "mesénquima persistente" para las células reticulares y menos que dichas células puedan generar linfocitos, histiocitos y otras células vinculadas con las que constituyen las reticulosis. La revisión embriológica permite demostrar la existencia de dos mesénquimas, uno más primitivo desarrollado en la pared del saco vitelino, el "mesénquima extraembrionario" y otro posterior, generado en la lámina intermedia del disco embrionario, el "mesénquima embrionario". El "mesénquima extraembrionario" constituirá el real origen de las células que constituyen las llamadas reticulosis. Por dicho motivo se propone reemplazar la denominación "reticulosis" por la más correcta de "mesenquimopatías extraembrionarias sistémicas". Por otra parte, el "mesénquima del disco embrionario" o "mesénquima embrionario" generarías los "sarcomas", es decir tumores mesenquimales circunscriptos que se diseminan

Reticulopatías (reticulosis) versus mesenquimopatías sistémicas extraembrionarias: revisión histórica de conceptos. Cánceres mesenquimales (sarcomas) versus tumores sistémicos extraembrionarios / Extraembrionary sistemic mesenchymopathies vs reticulopathies

Se realiza una revisión histórica de la concepción del "Sistema retículo-endotelial" o "sistema retículo-histiocitario" y su aplicación a la patología que generó las llamadas "reticulopatías" y en especial las "reticulosis" (reticulopatías de causa no determinada). Se analiza la naturaleza histológica ultraestructural y embriológica del SRE y se concluye que dicha concepción está basada en erróneas interpretaciones histofisiológicas y embriológicas. El "tejido reticular, que forma el armazón de sostén de los órganos hemocitopoyéticos (bazo, ganglios linfáticoas, médula ósea parda) representa simplemente una variedad de tejido conectivo especializado asociado a un armazón extracelular de fibrillas de reticulina constituidas como las fibras colágenas por proteínas colágenas. Los estudios ultraestructurales de las "células reticulares" no han logrado mostrar evidencias de actividad macrofágica y han permitido observar formas transicionales al fibroblasto. También se ha podido demostrar la imposibilidad de que la "célula reticular" se pueda transformar en "histiocito" o "macrófago". Por otro lado, los "sinusoides" del bazo y del hígado están constituídos por verdaderos endotelios fenestrados, sin vinculación con las células reticulares. Las células de Kupffer del hígado son macrófagos originados en hemocitoblastos (células troncales hemáticas del mesénquima extraembrionario), que viven en los intersticios de los endotelios fenestrados, sin tener vinculaciones citogenéticas con los endotelios sinusoidales. Estos hallazgos han determinado que no se puede seguir admitiendo una función de "mesénquima persistente" para las células reticulares y menos que dichas células puedan generar linfocitos, histiocitos y otras células vinculadas con las que constituyen las reticulosis. La revisión embriológica permite demostrar la existencia de dos mesénquimas, uno más primitivo desarrollado en la pared del saco vitelino, el "mesénquima extraembrionario" y otro posterior, generado en la lámina intermedia del disco embrionario, el "mesénquima embrionario". El "mesénquima extraembrionario" constituirá el real origen de las células que constituyen las llamadas reticulosis. Por dicho motivo se propone reemplazar la denominación "reticulosis" por la más correcta de "mesenquimopatías extraembrionarias sistémicas". Por otra parte, el "mesénquima del disco embrionario" o "mesénquima embrionario" generarías los "sarcomas", es decir tumores mesenquimales circunscriptos que se diseminan

Synovial nature of pathologic periarticular structures, including subcutaneous nodules. descent from embryonic arthrogenic fibroblasts: a hypothesis.

In the embryo the periarticular fibroblasts were the producers of the greater part of the joint they surround in later life, as well as of the tendon sheaths and bursae. It is postulated that adult fibroblasts have retained atavistic arthrogenic properties, and may react to traumatizing, inflammatory and oncogenic stimuli by forming periarticular joint-like structures: "arthromas" such as ganglia, meniscal cysts, synovial cysts, synovial sarcoma and subcutaneous nodules. The arthroid nature of these growths manifests itself by the presence of a central cavity, which can be identified as a synovial cavity by histologic, histochemical and electron-microscopic methods. In case of affection of the joint all of these adnexa may be involved. A resemblance of these structures to embryonic joint tissues has been noted for years. The nature of the subcutaneous nodule is discussed at some length. It may contain one or more synovial clefts; synovial elements may be found in its centre by histochemistry and electron-microscopy. Recent and personal findings shed a new light on palisading cells, which may be fibroblasts, having taken up again their embryonic task as synovioblasts. From periarticular fibroblasts thus three kinds of tumors may arise; benign (ganglia, cysts, subcutaneous nodules), malignant (synovial sarcoma) and "semi-malignant" (pannus in rheumatoid arthritis).

Clear cell sarcoma with melanogenesis.

An example of clear cell sarcoma, from the great toe of a young woman having an otherwise classic history and appearance is described, and a malignant giant cell component is reported for the first time. Histochemical and electron microscopic studies clearly demonstrate melanogenesis. The controversy over tissue of origin of this uncommon neoplasm is discussed and evidence in support of neurectodermal derivation is presented.