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1.
Cir. plást. ibero-latinoam ; 45(3): 323-326, jul.-sept. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-184409

RESUMO

El fibroma osificante es una neoplasia osteogénica benigna que representa el 3.1% de los tumores orales y el 9.6% de las lesiones gingivales. Su tratamiento de elección es la enucleación por curetaje completado hasta márgenes de hueso sano, con una recurrencia de aproximadamente el 7-20% probablemente por remoción incompleta, irritación continua o daño repetido. Presentamos un caso clínico en el que complementamos el tratamiento quirúrgico con métodos adyuvantes para disminuir la recurrencia y acelerar la regeneración ósea mediante uso de nitrógeno líquido y hueso liofilizado cadavérico combinados con plasma rico en plaquetas. En el control postoperatorio a los 6 meses no evidenciamos recurrencia clínica o radiológica y comprobamos regeneración ósea acelerada. Sugerimos el uso en este tipo de lesiones de nitrógeno líquido como adyuvante para la prevención de recurrencia, hueso liofilizado para favorecer la regeneración ósea guiada y plasma rico en plaquetas para acelerar el proceso de curación ósea


Ossifying fibroma is a benign osteogenic neoplasm, representing 3.1% of oral tumors and 9.6% of gingival lesions. Enucleation by curettage is the treatment of choice, completed to healthy bone margins, with a recurrence of approximately 7-20%, probably due to incomplete removal, continued irritation or repeated damage. We describe a clinical case ttreated in combination with adjuvant methods to decrease recurrence and accelerate bone regeneration, with the placement of liquid nitrogen and cadaveric lyophilized bone, combined with platelet-rich plasma. Post-operative control at 6 months showed no clinical or radiological evidence of recurrence and the presence of accelerated bone regeneration. We suggest liquid nitrogen as an adjuvant for the prevention of recurrence and bone regeneration guided with lyophilized bone in conjunction with platelet-rich plasma as a feasible option to accelerate the bone healing process


Assuntos
Humanos , Feminino , Adulto , Fibroma Ossificante/diagnóstico por imagem , Fibroma Ossificante/cirurgia , Terapia Combinada , Neoplasias Gengivais/diagnóstico por imagem , Neoplasias Gengivais/terapia , Retalhos Cirúrgicos , Neoplasias Bucais/diagnóstico por imagem , Neoplasias Bucais/terapia , Biópsia/métodos , Soalho Bucal/patologia , Regeneração Óssea
2.
Braz. j. otorhinolaryngol. (Impr.) ; 85(4): 399-407, July-Aug. 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1019582

RESUMO

Abstract Introduction Reactive hyperplastic lesions develop in response to a chronic injury simulating an exuberant tissue repair response. They represent some of the most common oral lesions including inflammatory fibrous hyperplasia, oral pyogenic granuloma, giant cell fibroma, peripheral ossifying fibroma, and peripheral giant cell lesions. Objective The incidence of those lesions was investigated in an oral pathology service, and the clinical characteristics, associated etiological factors, concordance between the clinical and histopathological diagnostic was determined. Methods A total of 2400 patient records were screened from 2006 to 2016. Clinical features were recorded from biopsy reports and patients' files. Results A total of 534 cases of reactive hyperplastic lesions were retrieved and retrospectively studied, representing 22.25% of all diagnoses. The most frequent lesion was inflammatory fibrous hyperplasia (72.09%), followed by oral pyogenic granuloma (11.79%), giant cell fibroma (7.30%), peripheral ossifying fibroma (5.24%), and peripheral giant cell lesions (3.55%). Females were predominantly affected (74.19%), the gingiva and alveolar ridge were the predominant anatomical site (32.89%), and chronic traumatism was presented as the main etiological factor. The age widely ranges from the 1st decade of life to the 7th. Clinically, the reactive hyperplastic lesions consisted of small lesions (0.5-2 cm) and shared a strong likeness in color to the oral mucosa. The concordance between the clinical and histopathological diagnostic was high (82.5%). Conclusion Reactive hyperplastic lesions had a high incidence among oral pathologies. The understanding of their clinical features helps to achieve a clearer clinical and etiological diagnosis, and the knowledge of factors related to their development. This may contribute to adequate treatment and positive prognosis.


Resumo Introdução As lesões hiperplásicas reativas se desenvolvem em resposta a uma lesão crônica que estimula uma resposta acentuada de reparo tecidual. Elas representam uma das lesões orais mais comuns, inclusive hiperplasia fibrosa inflamatória, granuloma piogênico oral, fibroma de células gigantes, fibroma periférico ossificante e lesão periférica de células gigantes. Objetivo A incidência dessas lesões foi investigada em um serviço de patologia bucal e as características clínicas, os fatores etiológicos associados e a concordância entre os diagnósticos clínico e histopatológico foram determinados. Método Foram selecionados 2.400 registros de pacientes entre 2006 e 2016. As características clínicas foram registradas a partir de laudos de biópsia e dos prontuários dos pacientes. Resultados Um total de 534 casos de lesões hiperplásicas reativas foram recuperados e retrospectivamente estudados, representando 22,25% de todos os diagnósticos. A lesão mais frequente foi hiperplasia fibrosa inflamatória (72,09%), seguida por granuloma piogênico oral (11,79%), fibroma de células gigantes, (7,30%), fibroma periférico ossificante (5,24%) e lesão periférica de células gigantes (3,55%). O sexo feminino foi predominante (74,19%), a gengiva e a crista alveolar foram o local anatômico predominante (32,89%) e o traumatismo crônico foi demonstrado como o principal fator etiológico. A idade variou desde a 1ª década de vida até a 7ª. Clinicamente, as LHR consistiram em pequenas lesões (0,5 a 2 cm) que apresentaram uma forte semelhança de cor com a mucosa oral. A concordância entre o diagnóstico clínico e histopatológico foi alta (82,5%). Conclusão As lesões hiperplásicas reativas apresentaram alta incidência entre as patologias bucais. A compreensão das características clínicas ajuda na realização de um diagnóstico clínico e etiológico mais claro, bem como determinar os fatores relacionados ao seu desenvolvimento. Dessa forma contribui para um tratamento adequado e um prognóstico positivo.

3.
Afr Health Sci ; 19(1): 1687-1694, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31148999

RESUMO

Background: Reactive localized hyperplastic lesions of the oral cavity (RHLs) are relatively common peripheral lesions which present as a range of clinically similar lesions at dental centers. Diagnosis can be challenging if dentists are unfamiliar with their clinicopathological across various populations. Objective: This study reviews the pattern of distribution of RHLs of the oral mucosa in a hospital- the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife. Materials and methods: We reviewed 10 years data from the archives of the Department of Oral Maxillofacial Surgery and Oral Pathology, Obafemi Awolowo University, Nigeria. Information on RHLs were extracted and recorded on standardized data forms and analyzed using STATA. Results: The most common lesions were pyogenic granuloma (43.7%) and focal fibrous hyperplasia (39.7%), respectively. RHLs were found to be more frequent in women (66.7%) than men (33.3%). The most common locations of involvement was the gingivae (84.6%), and lesions were more common in the 9-29 year age group and the mean age was 37.7 (±21.1) years. The relationship between age group and reactive lesions was however not statistically significant. Conclusion: The major benefit of this study is an improved knowledge of the frequency and distribution of oral reactive lesions in sub-Saharan Africa which may be highly beneficial when establishing a diagnosis and treatment plan in clinical practice.


Assuntos
Hiperplasia/epidemiologia , Mucosa Bucal/patologia , Boca/patologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Estudos Transversais , Feminino , Fibroma/epidemiologia , Fibroma/patologia , Fibroma Ossificante/epidemiologia , Fibroma Ossificante/patologia , Granuloma de Células Gigantes/epidemiologia , Granuloma de Células Gigantes/patologia , Granuloma Piogênico/epidemiologia , Granuloma Piogênico/patologia , Humanos , Hiperplasia/classificação , Hiperplasia/patologia , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Estudos Retrospectivos , Distribuição por Sexo , Adulto Jovem
4.
Dermatol Online J ; 25(5)2019 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-31220904

RESUMO

Cowden syndrome (CS) is an infrequent genodermatosis caused by mutations in the phosphatase and tensin homolog (PTEN) gene in the majority of cases. As such, it belongs to the PTEN hamartoma tumor syndrome spectrum. This disease has a variable clinical expression characterized by the development of multiple hamartomatous tumors in different organs, usually during the second and third decades of life, and a high cumulative risk of several malignancies. We present a case of Cowden syndrome with late diagnosis presenting with a florid dermatological expression and multiple benign tumors, but no malignancies. A novel PTEN mutation was identified.


Assuntos
Fibroma/genética , Síndrome do Hamartoma Múltiplo/genética , Neoplasias Bucais/genética , PTEN Fosfo-Hidrolase/genética , Neoplasias Cutâneas/genética , Feminino , Fibroma/diagnóstico , Fibroma/etiologia , Fibroma/patologia , Folículo Piloso , Síndrome do Hamartoma Múltiplo/complicações , Síndrome do Hamartoma Múltiplo/diagnóstico , Síndrome do Hamartoma Múltiplo/patologia , Humanos , Pessoa de Meia-Idade , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/etiologia , Neoplasias Bucais/patologia , Mutação , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/patologia
5.
Acta otorrinolaringol. esp ; 70(3): 158-164, mayo-jun. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-185387

RESUMO

Introduction and objective: Oral benign neoplasms (OBNs) exhibit some features that can guide the professionals to the correct diagnosis and best treatment. Through retrospective studies, medical records can be reviewed to better describe a given population and, furthermore, help clinicians in routine practice. In this context, the objective of this paper was to analyze the cases of OBNs of an oral pathology referral department, from 2003 to 2017, in order to better understand their epidemiological and clinicopathological characteristics. Methods: A total of 8355 histopathological reports were analyzed. Lesions diagnosed as OBNs were selected and the following variables were recorded: gender, age, histological type of the lesion, anatomical location, rate and pattern of growth, type of base, color, symptomatology and diagnostic hypotheses on clinical examination. Results: OBNs represented 9.4% of all lesions diagnosed. The most frequent histopathological types were fibroma (39.9%), papilloma (22%), fibroblastoma (13.1%), lipoma (10.2%) and hemangioma (6.1%). Overall, most cases affected females (n = 518; 65.6%) and in the fifth decade of life (n = 148; 18.7%). The oral mucosa was the most common site (n = 265; 33.5%). The most common features of each OBN were also highlighted. Conclusion: The most common OBNs were fibroma, papilloma, fibroblastoma, lipoma and hemangioma. Overall, the OBN presented common clinical features; however, in particular cases, there are some characteristics that can lead the professionals to the correct diagnosis. Nevertheless, in general, histopathological analysis must be performed to confirm diagnosis. Intraosseous tumors and large lesions may require imaging tests to help diagnosis


Introducción y objetivos: Las neoplasias benignas orales (NBO) presentan características clínico-patológicas específicas que pueden guiar al profesional al diagnóstico correcto y a un mejor tratamiento. Los estudios retrospectivos son uno de los principales recursos utilizados para conocer la situación actual de una población determinada y estimar sus necesidades para la implementación y el mantenimiento de los servicios de salud. En este contexto, el objetivo de este trabajo fue analizar los casos de NBO de un servicio de referencia en patología oral, de 2003 a 2017, para comprender mejor sus características epidemiológicas y clínico-patológicas. Métodos: se analizaron un total de 8355 informes histopatológicos. Se seleccionaron las lesiones diagnosticadas como NBO y se registraron las siguientes variables: sexo, edad, tipo histológico de la lesión, ubicación anatómica, índice y patrón de crecimiento, tipo de base, color, sintomatología e hipótesis diagnósticas en el examen clínico. Resultados: Las NBO representaron el 9,4% de todas las lesiones diagnosticadas. Los tipos histopatológicos más frecuentes fueron fibroma (39,9%), papiloma (22%), fibroblastoma (13,1%), lipoma (10,2%) y hemangioma (6,1%). También fueron verificados el perfil de los pacientes y las presentaciones clínicas de estas lesiones. Conclusiones: Las NBO más comunes fueron fibroma, papiloma, fibroblastoma, lipoma y hemangioma. En general, las NBO presentaron características clínicas comunes; sin embargo, en casos particulares, existen algunas características que pueden llevar al profesional al diagnóstico correcto. Sin embargo, de forma general, el análisis histopatológico debe hacerse para confirmar el diagnóstico. Los tumores intraóseos y las lesiones de gran tamaño pueden requerir exámenes de imagen para ayudar al diagnóstico


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias Bucais/patologia , Distribuição por Idade , Brasil/epidemiologia , Fibroma/epidemiologia , Fibroma/patologia , Fibrossarcoma/epidemiologia , Fibrossarcoma/patologia , Hemangioma/epidemiologia , Hemangioma/patologia , Lipoma/epidemiologia , Lipoma/patologia , Mucosa Bucal/patologia , Neoplasias Bucais/epidemiologia , Papiloma/epidemiologia , Papiloma/patologia , Estudos Retrospectivos , Distribuição por Sexo , Fatores de Tempo
6.
Rev. Odontol. Araçatuba (Impr.) ; 40(2): 43-47, maio/ago. 2019. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1006564

RESUMO

O objetivo deste estudo é descrever o diagnóstico e conduta clínica no tratamento do Fibroma Traumático (FT). O FT é uma lesão proliferativa de natureza benigna que surge na cavidade bucal devido à traumas de repetição, que desencadeiam reações inflamatórias em tecido conjuntivo, causando uma hiperplasia tecidual, geralmente assintomática, podendo interferir na mastigação e na fala causando desconforto ao paciente. Sua prevalência é alta, geralmente em mucosa jugal, linha oclusal, mucosa labial, língua e gengiva. O tratamento consiste na excisão cirúrgica e a confirmação do diagnóstico é dado através de envio para exame histopatológico. Paciente do gênero masculino, 46 anos de idade, procurou atendimento por apresentar nódulo único, exofítico, unilateral de aproximadamente 3 cm em seu diâmetro, localizado na mucosa jugal do lado direito, com bordas regulares e indolor a palpação, apresentando há cerca de 12 meses. Foi submetido a remoção cirúrgica total da lesão e encaminhamento ao laboratório para análise histopatológica para confirmação diagnóstica, além de proservação do caso em 7, 30 e 60 dias. Desta forma, foi possível concluir que a excisão cirúrgica da lesão promove maior conforto, melhora na fala e mastigação, além de um bom reparo tecidual, devolvendo assim, condições de saúde a mucosa bucal e mínimas chances de recidiva(AU)


The objective of this study is to describe the diagnosis and clinical management in the treatment of Traumatic Fibroma (FT). FT is a proliferative lesion of benign nature that arises in the buccal cavity due to repetitive traumas, which trigger inflammatory reactions in connective tissue, causing a tissue hyperplasia, usually asymptomatic, that can interfere in chewing and speech causing discomfort to the patient. Its prevalence is high, usually in jugal mucosa, occlusal line, labial mucosa, tongue and gingiva. The treatment consists of surgical excision and confirmation of the diagnosis is given by sending for histopathological examination. A 46-year-old male patient sought care for having a single, exophytic, unilateral nodule of approximately 3 cm in diameter, located on the right side of the jugal mucosa, with regular borders and painless palpation, presenting about 12 months. He was submitted to total surgical removal of the lesion and sent to the laboratory for histopathological analysis for diagnostic confirmation, in addition to case proservation at 7, 30 and 60 days. In this way, it was possible to conclude that the surgical excision of the lesion promotes greater comfort, improvement in speech and chewing, besides a good tissue repair, thus returning health conditions to the oral mucosa and minimal chances of relapse(AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Fibroma/cirurgia , Cirurgia Bucal , Fibroma , Fibroma/diagnóstico , Fibroma/terapia , Hiperplasia , Mucosa Bucal/patologia
7.
Swiss Dent J ; 129(3): 214-215, 2019 Mar 11.
Artigo em Alemão | MEDLINE | ID: mdl-30932397

RESUMO

The CO2 laser has found great acceptance in the stomatologic field of dentistry. This article gives an overview of the most important bene fits. The absorption of the laser light produces photothermal effects such as coagulation, vaporization and photoablation. The main indications in stomatology are pain alleviation and prevention of recurences in aphthae and cold sores (minor aphthae, herpes simplex), ablation of benign and irritant tissue excess (stimulus fibroma), lip and tongue band correction and soft tissue hemostasis. One great advantage is the minimal bleeding in the surgical field, which allows for optimal visibility. In addition, the CO2 laser offers high patient comfort since no primary wound closure with sutures are required. However, in suspect of malignancy a sharp excision with a scalpel is still preferred due to possible compromisation of the histopathologic evaluation.


Assuntos
Terapia a Laser , Lasers de Gás , Medicina Bucal , Humanos , Língua
8.
Rev. Odontol. Araçatuba (Impr.) ; 40(1): 52-55, jan.-abr. 2019. tab, graf
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-995188

RESUMO

A grande quantidade de patologias com características clínicas semelhantes possibilita a coexistência de vários diagnósticos diferenciais frente a uma única lesão na mucosa bucal. Muitas vezes a realização de exames complementares, como a biópsia, torna-se mandatória para confirmação do diagnóstico sugestivo. Realizar levantamento dos laudos histopatológicos provenientes de biópsias executadas em uma clínica-escola odontológica no período entre 2011 e 2018. A partir dos prontuários odontológicos, as informações foram coletadas e tabuladas. Foram determinadas a frequência de cada lesão em relação ao total e ao seu próprio grupo de doenças e as características dos indivíduos. Um total de 106 diagnósticos de 105 pacientes (idade média 47,5 anos), sendo a maioria do sexo feminino (68 indivíduos - 64,8%) e leucoderma (67 indivíduos - 63,8%), foram avaliados. Em relação aos grupos de doenças, o mais representativo foi o das neoplasias benignas epiteliais ou mesenquimais (35 casos - 33%), seguido pelo dos processos proliferativos não neoplásicos (30 casos - 28,3%). Quanto aos diagnósticos, foram observados 25 diferentes, nos quais se destacaram o fibroma (30 casos - 28,3%) e a hiperplasia fibrosa inflamatória (22 casos - 20,8%). Não foi constatada nenhuma patologia maligna. Traçar o perfil epidemiológico de certo grupo de indivíduos pode muitas vezes facilitar os diagnósticos, além de auxiliar na implementação de medidas de prevenção e na orientação dos assuntos a serem abordados nos cursos das instituições de ensino superior(AU)


A large number of pathologies with similar clinical features may allow coexistence of several differential diagnoses in a single lesion on the buccal mucosa. According to the clinical picture, complementary exams such as biopsy are often mandatory to confirm the suggestive diagnosis. To carry out a survey of histopathological diagnoses from biopsies performed in a dental school clinic in the period from 2011 to 2018. Information from dental records was gathered and tabulated. The frequency of each lesion was determined in relation to the total and its own group of diseases as well as the epidemiological characteristics of the individuals. A total of 106 diagnoses from 105 patients (mean age 47.5 years) were evaluated, being the majority of them female (68 individuals - 64.8%) and white (67 individuals - 63.8%). In relation to the groups of diseases, epithelial or mesenchymal benign neoplasms (35 cases - 33%) were the most representative, followed by nonneoplastic proliferative processes (30 cases - 28.3%). Regarding the diagnoses, 25 different ones were observed, in which fibroma (30 cases - 28.3%) and inflammatory fibrous hyperplasia (22 cases - 20.8%) were more prevalent. No malignant pathology was found. To describe the epidemiological profile of a population can often facilitate diagnoses, besides assisting in the implementation of preventive measures and in the definition of graduate and post-graduate courses' scope(AU)


Assuntos
Doenças Estomatognáticas/patologia , Mucosa Bucal/lesões , Mucosa Bucal/patologia , Biópsia , Doenças Estomatognáticas/epidemiologia
9.
Methods Mol Biol ; 1929: 763-771, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30710310

RESUMO

Oncologic relevant members of S100 proteins are described as promising biomarkers in molecular pathology for risk estimation in oral neoplasia exhibiting different stages of malignancy: gingiva as healthy tissue, irritation fibroma as benign, leukoplakia as precancerous, and oral squamous cell carcinoma as malignant entity. Gene expression levels of S100A4 (metastasin), S100A7 (psoriasin), S100A8 (calgranulin A), and S100A9 (calgranulin B) were analyzed using quantitative RT-PCR. In addition, immunohistochemistry-based microscopy was used to examine cellular localization and distribution of these biomarkers in tissue sections. The results indicate that S100 proteins represent promising biomarkers for early-stage diagnosis in oral lesions. The inclusion of expression profiles and ratios for each entity even improves their diagnostic validity.


Assuntos
Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Transformação Celular Neoplásica/metabolismo , Neoplasias Bucais/diagnóstico , Proteínas S100/genética , Proteínas S100/metabolismo , Calgranulina A/genética , Calgranulina A/metabolismo , Calgranulina B/genética , Calgranulina B/metabolismo , Transformação Celular Neoplásica/genética , Perfilação da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Humanos , Imuno-Histoquímica , Neoplasias Bucais/genética , Neoplasias Bucais/metabolismo , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Proteína A7 Ligante de Cálcio S100/genética , Proteína A7 Ligante de Cálcio S100/metabolismo , Proteína A4 de Ligação a Cálcio da Família S100/genética , Proteína A4 de Ligação a Cálcio da Família S100/metabolismo , Distribuição Tecidual
10.
Head Neck Pathol ; 13(1): 80-90, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30693456

RESUMO

Human papillomaviruses (HPVs) are causative of a group of clinically papillary lesions. The HPV-related lesions of the oral cavity include squamous papilloma, condyloma acuminatum, verruca vulgaris, and multifocal epithelial hyperplasia. Benign entities, such as verruciform xanthoma or giant cell fibroma, as well as malignancies, such as papillary squamous cell carcinoma and verrucous carcinoma, may be considered in the clinical and/or histologic differential diagnoses of these lesions. Mechanisms of infection, epidemiology, clinical presentations, histologic features, and differential diagnoses of the HPV-related oral pathologies are discussed. Current concepts of viral transmission, especially as pertaining to lesions in pediatric patients, and the impacts of HPV vaccination are reviewed.


Assuntos
Doenças da Boca/patologia , Doenças da Boca/virologia , Mucosa Bucal/patologia , Mucosa Bucal/virologia , Infecções por Papillomavirus/patologia , Humanos
11.
Head Neck Pathol ; 13(1): 71-79, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30693457

RESUMO

Excluding human papillomavirus (HPV)-driven conditions, oral papillary lesions consist of a variety of reactive and neoplastic conditions and, on occasion, can herald internal malignancy or be part of a syndrome. The objectives of this paper are to review the clinical and histopathological features of the most commonly encountered non-HPV papillary conditions of the oral mucosa. These include normal anatomic structures (retrocuspid papillae, lingual tonsils), reactive lesions (hairy tongue, inflammatory papillary hyperplasia), neoplastic lesions (giant cell fibroma), lesions of unknown pathogenesis (verruciform xanthoma, spongiotic gingival hyperplasia) and others associated with syndromes (for instance Cowden syndrome) or representing paraneoplastic conditions (malignant acanthosis nigricans). Common questions regarding differential diagnosis, management, and diagnostic pitfalls are addressed, stressing the importance of clinico-pathologic correlation and collaboration.


Assuntos
Doenças da Boca/patologia , Mucosa Bucal/patologia , Neoplasias Bucais/patologia , Acantose Nigricans/patologia , Fibroma/patologia , Síndrome do Hamartoma Múltiplo/patologia , Humanos , Língua Pilosa/patologia , Xantomatose/patologia
12.
Braz J Otorhinolaryngol ; 85(4): 399-407, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29705120

RESUMO

INTRODUCTION: Reactive hyperplastic lesions develop in response to a chronic injury simulating an exuberant tissue repair response. They represent some of the most common oral lesions including inflammatory fibrous hyperplasia, oral pyogenic granuloma, giant cell fibroma, peripheral ossifying fibroma, and peripheral giant cell lesions. OBJECTIVE: The incidence of those lesions was investigated in an oral pathology service, and the clinical characteristics, associated etiological factors, concordance between the clinical and histopathological diagnostic was determined. METHODS: A total of 2400 patient records were screened from 2006 to 2016. Clinical features were recorded from biopsy reports and patients' files. RESULTS: A total of 534 cases of reactive hyperplastic lesions were retrieved and retrospectively studied, representing 22.25% of all diagnoses. The most frequent lesion was inflammatory fibrous hyperplasia (72.09%), followed by oral pyogenic granuloma (11.79%), giant cell fibroma (7.30%), peripheral ossifying fibroma (5.24%), and peripheral giant cell lesions (3.55%). Females were predominantly affected (74.19%), the gingiva and alveolar ridge were the predominant anatomical site (32.89%), and chronic traumatism was presented as the main etiological factor. The age widely ranges from the 1st decade of life to the 7th. Clinically, the reactive hyperplastic lesions consisted of small lesions (0.5-2cm) and shared a strong likeness in color to the oral mucosa. The concordance between the clinical and histopathological diagnostic was high (82.5%). CONCLUSION: Reactive hyperplastic lesions had a high incidence among oral pathologies. The understanding of their clinical features helps to achieve a clearer clinical and etiological diagnosis, and the knowledge of factors related to their development. This may contribute to adequate treatment and positive prognosis.


Assuntos
Hiperplasia/patologia , Doenças da Boca/patologia , Boca/patologia , Adolescente , Adulto , Idoso , Brasil , Criança , Pré-Escolar , Feminino , Fibroma/etiologia , Fibroma/patologia , Fibroma Ossificante/etiologia , Fibroma Ossificante/patologia , Células Gigantes/patologia , Granuloma Piogênico/congênito , Granuloma Piogênico/patologia , Humanos , Hiperplasia/classificação , Hiperplasia/etiologia , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Doenças da Boca/classificação , Doenças da Boca/diagnóstico , Doenças da Boca/etiologia , Mucosa Bucal/patologia , Estudos Retrospectivos , Adulto Jovem
13.
J Am Acad Dermatol ; 81(1): 43-56, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30447312

RESUMO

A diverse spectrum of benign oral mucosal lesions exists, presenting as either isolated oral findings or in association with dermatologic conditions. Oral lesions can closely resemble one another; therefore, it is important for clinicians to be able to recognize their distinctive features, to be able to recognize benign versus malignant disease, and to recognize when obtaining a biopsy specimen is warranted. The first article in this continuing medical education series reviews oral anatomy, the clinical attributes of several benign lesions of the oral cavity, and appropriate management and therapeutic modalities.


Assuntos
Mucosa Bucal/patologia , Neoplasias Bucais/patologia , Boca/patologia , Biópsia por Agulha , Diagnóstico Diferencial , Educação Médica Continuada , Feminino , Humanos , Imuno-Histoquímica , Masculino , Doenças da Boca/patologia , Neoplasias Bucais/cirurgia , Medição de Risco
14.
Dis Mon ; 65(6): 155-163, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30502099

RESUMO

Human papillomavirus is a well-established risk factor for oropharyngeal cancer, although its role in oral cancer is still debated. Inconclusive evidence of its role in oral cancer is due to conflicting data arising from methodological differences, mostly due to the use of diagnostic tests with varying sensitivity and specificity. In addition, there is a lack of experimental data linking HPV to oral cancer. Recent epidemiological studies provide data on HPV prevalence in oral squamous cell carcinoma and other potentially malignant oral disorders. Further, molecular data from in vivo and in vitro models have led to new insights into the role of human papillomavirus in oral cancer. The clinical significance of identifying HPV as an etiology for oral squamous cell carcinoma is that if proven, vaccination could be an effective prevention tool. Further, like oropharyngeal squamous cell carcinoma, prognostic differences may exist between human papillomavirus positive and negative oral squamous cell carcinoma. This manuscript reviews data from the published literature using Bradford Hill criteria of causation to assess the role of human papillomavirus in oral cancer. Due to the advancement in molecular biology, the requirements of each of the Bradford Hill criteria of causation are modified to include integrated data from both epidemiological studies and experimental studies exploring molecular carcinogenesis.


Assuntos
Carcinoma de Células Escamosas/virologia , Neoplasias Bucais/virologia , Neoplasias Orofaríngeas/virologia , Infecções por Papillomavirus/complicações , Infecções Tumorais por Vírus/complicações , Carcinoma de Células Escamosas/etiologia , Medicina Baseada em Evidências , Humanos , Neoplasias Bucais/etiologia , Neoplasias Orofaríngeas/etiologia , Papillomaviridae/isolamento & purificação , Prognóstico , Fatores de Risco
15.
Acta Otorrinolaringol Esp ; 70(3): 158-164, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30497661

RESUMO

INTRODUCTION AND OBJECTIVE: Oral benign neoplasms (OBNs) exhibit some features that can guide the professionals to the correct diagnosis and best treatment. Through retrospective studies, medical records can be reviewed to better describe a given population and, furthermore, help clinicians in routine practice. In this context, the objective of this paper was to analyze the cases of OBNs of an oral pathology referral department, from 2003 to 2017, in order to better understand their epidemiological and clinicopathological characteristics. METHODS: A total of 8355 histopathological reports were analyzed. Lesions diagnosed as OBNs were selected and the following variables were recorded: gender, age, histological type of the lesion, anatomical location, rate and pattern of growth, type of base, color, symptomatology and diagnostic hypotheses on clinical examination. RESULTS: OBNs represented 9.4% of all lesions diagnosed. The most frequent histopathological types were fibroma (39.9%), papilloma (22%), fibroblastoma (13.1%), lipoma (10.2%) and hemangioma (6.1%). Overall, most cases affected females (n=518; 65.6%) and in the fifth decade of life (n=148; 18.7%). The oral mucosa was the most common site (n=265; 33.5%). The most common features of each OBN were also highlighted. CONCLUSION: The most common OBNs were fibroma, papilloma, fibroblastoma, lipoma and hemangioma. Overall, the OBN presented common clinical features; however, in particular cases, there are some characteristics that can lead the professionals to the correct diagnosis. Nevertheless, in general, histopathological analysis must be performed to confirm diagnosis. Intraosseous tumors and large lesions may require imaging tests to help diagnosis.


Assuntos
Neoplasias Bucais/patologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Fibroma/epidemiologia , Fibroma/patologia , Fibrossarcoma/epidemiologia , Fibrossarcoma/patologia , Hemangioma/epidemiologia , Hemangioma/patologia , Humanos , Lactente , Recém-Nascido , Lipoma/epidemiologia , Lipoma/patologia , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/patologia , Neoplasias Bucais/epidemiologia , Papiloma/epidemiologia , Papiloma/patologia , Estudos Retrospectivos , Distribuição por Sexo , Fatores de Tempo , Adulto Jovem
16.
Oral Dis ; 25(1): 174-181, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30168888

RESUMO

OBJECTIVE: To immunohistochemically characterize a group of oral myofibroblastic lesions (MLs) and to evaluate the ultrastructural features of myofibroblasts. MATERIAL AND METHODS: Using a tissue microarray technique (TMA), cases of myofibroma (MF), of nodular fasciitis (NF), of desmoplastic fibroma (DF), and of myofibroblastic sarcoma (MS) from the Universidad Autónoma Metropolitana Xochimilco, and a Private Oral Pathology Service in Mexico City were stained with antibodies against alpha-smooth muscle actin (α-SMA), H-caldesmon, vimentin, desmin, ß-catenin, CD34, anaplastic lymphoma protein kinase (ALK-1), and Ki-67. RESULTS: Nineteen of the 22 MF cases, 2/5 of the NF cases, 1/10 of the DF cases, and 1/2 of the MS cases were positive for α-SMA. 1/2 of the MS cases were positive for desmin; 6/10 of the DF cases were positive for ß-catenin, and 2 of the MF cases were positive for ALK-1. All of the MLs were positive for vimentin and negative for H-caldesmon and CD-34. The Ki-67 labeling index in all of the 8/22 MF, 3/5 NF, and 2/2 MS cases was ≥10%. For all of the MLs evaluated, ultrastructural analysis revealed spindle-shaped cells containing endoplasmic reticulum and peripheral actin filament bundles. CONCLUSION: In certain myofibroblastic lesions, the use of auxiliary techniques (such as immunohistochemistry) can be critical for differential diagnosis.


Assuntos
Fibroma/diagnóstico , Fibroma/patologia , Boca/patologia , Miofibroblastos/patologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Imuno-Histoquímica , Lactente , Masculino , México , Pessoa de Meia-Idade , Miofibroblastos/ultraestrutura , Análise Serial de Tecidos , Adulto Jovem
17.
Rev. cuba. estomatol ; 55(4): 1-10, oct.-dic. 2018. ilus
Artigo em Português | CUMED | ID: cum-73792

RESUMO

Introdução: O fibroma de células gigantes é uma neoplasia fibrosa benigna, considerada rara, com fatores etiológicos incertos e características clinico-patológicas peculiares. Objetivo: Descrever a exérese do fibroma de células gigantes, em mucosa jugal direita, utilizando laser cirúrgico. Relato de caso: Paciente do sexo feminino, 33 anos, parda, atendida na clínica de Estomatologia da Universidade Estadual da Paraíba, motivada por uma lesão neoplásica, de crescimento lento em região de mucosa jugal direita. Clinicamente, observou-se massa tumoral única, assintomática, com aproximadamente dois centímetros, de base séssil, normocorada, de consistência firme e superfície lisa. Após exame clínico, foi realizada uma biópsia excisional com fins diagnósticos, utilizando o laser cirúrgico. O diagnóstico, após o resultado do exame histopatológico, revelou um fibroma de células gigantes. A abordagem da biópsia excisional, além de ter fins de diagnóstico bucal, foi responsável pelo tratamento da lesão, visto que proporcionou a remoção completa da patologia. Optou-se por cicatrização por segunda intenção, e para acelerar esse processo, foi realizada aplicação local com laser de baixa potência de espectro de luz vermelha. No acompanhamento de sete dias, observou-se cicatrização adequada, com mínima alteração tecidual. Após oito meses, notou-se regeneração tecidual adequada sem recidiva da lesão. Conclusão: A remoção de um fibroma de células gigantes, utilizando laser de diodo de alta potência, se mostrou como uma abordagem terapêutica viável para o tratamento dessa patologia(AU)


Introducción: El fibroma de células gigantes es una neoplasia fibrosa benigna, considerada rara, con factores causales inciertos y características clínico-patológicas peculiares.Objetivo: Describir la exéresis del fibroma de células gigantes, en mucosa yugal derecha, utilizando láser quirúrgico. Presentación del caso: Paciente del sexo femenino, 33 años, mulata, atendida en la Clínica de Estomatología de la Universidad Estatal de Paraíba, por una lesión neoplásica, de crecimiento lento en región de mucosa yugal derecha. Clínicamente, se observó una masa tumoral única, asintomática, de aproximadamente 2 cm, de base sésil, normocoloreada, de consistencia firme y superficie lisa. Después del examen clínico, se realizó una biopsia excisional con fines diagnósticos, utilizando el láser quirúrgico. El diagnóstico, después del resultado del examen histopatológico, reveló un fibroma de células gigantes. El abordaje de la biopsia excisional, además de tener fines de diagnóstico bucal, fue responsable del tratamiento de la lesión, ya que proporcionó la remoción completa de esta. Se optó por cicatrización por segunda intención, y para acelerar ese proceso, se realizó aplicación local con láser de baja potencia de espectro de luz roja. En el seguimiento de siete días, se observó una cicatrización adecuada, con mínima alteración hística. Después de ocho meses, se notó regeneración hística adecuada sin recidiva de la lesión.Conclusiones: La remoción de un fibroma de células gigantes, utilizando láser de diodo de alta potencia, se mostró como un abordaje terapéutico viable para el tratamiento de esa afección(AU)


Introduction: Giant-cell fibroma is a rare benign fibrous neoplasm of uncertain etiological factors and peculiar clinical-pathological characteristics. Objective: To describe the excision of giant-cell fibroma in the right jugal mucosa using surgical laser. Case report: A 33-year-old female patient, treated at the dental clinic of State University of Paraíba, due to neoplastic lesion, with slow growth in the region of the right jugal mucosa. Clinically, a single, asymptomatic tumor mass of approximately two centimeters, sessile, normocorated, with a firm consistency and a smooth surface was observed. After clinical examination, an excisional biopsy was performed for diagnostic purposes, using the surgical laser. The diagnosis, after the histopathological examination, revealed a giant-cell fibroma. The management of the excisional biopsy, in addition to having the purpose of oral diagnosis, was responsible for the treatment of the lesion, since it provided its complete removal. Second healing intention was chosen and, in order to accelerate this process, a local application with low-power red-light spectrum laser was carried out. At 7-day follow-up, adequate healing was observed, with minimal tissue change. After eight months, adequate tissue regeneration was observed without relapsed lesion.Conclusions: Removal of a giant-cell fibroma using high-power diode laser was shown to be a viable therapeutic approach for the treatment of this pathology(AU)


Assuntos
Humanos , Feminino , Adulto , Células Gigantes/patologia , Diagnóstico Bucal/métodos , Fibroma , Terapia a Laser/métodos
18.
Rev. cuba. estomatol ; 55(4): 1-10, oct.-dic. 2018. ilus
Artigo em Português | LILACS | ID: biblio-991081

RESUMO

Introdução: O fibroma de células gigantes é uma neoplasia fibrosa benigna, considerada rara, com fatores etiológicos incertos e características clinico-patológicas peculiares. Objetivo: Descrever a exérese do fibroma de células gigantes, em mucosa jugal direita, utilizando laser cirúrgico. Relato de caso: Paciente do sexo feminino, 33 anos, parda, atendida na clínica de Estomatologia da Universidade Estadual da Paraíba, motivada por uma lesão neoplásica, de crescimento lento em região de mucosa jugal direita. Clinicamente, observou-se massa tumoral única, assintomática, com aproximadamente dois centímetros, de base séssil, normocorada, de consistência firme e superfície lisa. Após exame clínico, foi realizada uma biópsia excisional com fins diagnósticos, utilizando o laser cirúrgico. O diagnóstico, após o resultado do exame histopatológico, revelou um fibroma de células gigantes. A abordagem da biópsia excisional, além de ter fins de diagnóstico bucal, foi responsável pelo tratamento da lesão, visto que proporcionou a remoção completa da patologia. Optou-se por cicatrização por segunda intenção, e para acelerar esse processo, foi realizada aplicação local com laser de baixa potência de espectro de luz vermelha. No acompanhamento de sete dias, observou-se cicatrização adequada, com mínima alteração tecidual. Após oito meses, notou-se regeneração tecidual adequada sem recidiva da lesão. Conclusão: A remoção de um fibroma de células gigantes, utilizando laser de diodo de alta potência, se mostrou como uma abordagem terapêutica viável para o tratamento dessa patologia(AU)


Assuntos
Humanos , Feminino , Adulto , Células Gigantes/patologia , Diagnóstico Bucal/métodos , Fibroma/diagnóstico por imagem , Terapia a Laser/métodos
19.
Radiol Oncol ; 52(3): 263-266, 2018 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-30210036

RESUMO

Background Among the diseases of oral mucosa, malignant tumors are the most dangerous, but not the most common lesions that might appear in the oral cavity. Since most of the studies are focused on the detection of cancer in the oral cavity, we were interested in detecting the frequency of benign changes of the oral mucosa in Slovene population. Oral mucosal lesions are important pointer of oral health and quality of life, especially in elderly. The prevalence of oral mucosal lesions, together with information on the risk habits associated with oral health, such as tobacco and alcohol use, can help in planning future oral health studies and screening programs. Patients and methods Survey upon oral mucosal lesions was conducted during the national project for oral cancer screening in spring 2017 in the Slovenia in which more than 50% of dentists participated and 2395 patients (904 men and 1491 women) were included. Results Clinical examination, which was conducted according to the WHO standards revealed that 645 patients (27%) had oral mucosal lesions. The ten most common oral lesions detected were fibroma, gingivitis, Fordyce spots, white coated tongue, cheek biting, linea alba, denture stomatitis, geographic tongue, recurrent aphthous ulcerations and lichen planus. Conclusions Overall, these epidemiological data suggest need for specific health policies for prevention, diagnosis and treatment of oral mucosal lesions.


Assuntos
Doenças da Boca/epidemiologia , Mucosa Bucal , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Eslovênia/epidemiologia
20.
Orv Hetil ; 159(37): 1516-1524, 2018 Sep.
Artigo em Húngaro | MEDLINE | ID: mdl-30196718

RESUMO

INTRODUCTION: In a clinicopathological retrospective epidemiological study we investigated benign tumors and tumor-like lesions located in the orofacial region, diagnosed at the Universiy of Szeged, Department of Oral Medicine. METHOD: During a 54-year period (1960-2014), 14 661 biopsies were taken. The included subjects were 7491 patients diagnosed with benign tumors and tumor-like lesions. RESULTS: The average age of patients was 55.3 years, 2823 (37.7%) patients were male and 4668 (62.3%) female. The male : female ratio was 1 : 1.65. Most of the patients included in the study were aged 51-60 (1280, 17.1%). The number of children was 1014 (13.6%) and the number of adults was 6477 (86.3%). The number of non-neoplasms was 6420 (85.7%), being significantly higher than the number of neoplasms (1071, 14.3%). Most of the lesions were of mesenchymal origin (5574, 77.4%); the number of lesions of non-mesenchymal origin was 982 (13.1%). The most prevalent type of lesions was traumatic fibroma (fibrosis): 1806 (32.4%). The most common lesion type in the group of lesions of infectious/inflammational origin was pyogenic granuloma, the number of which was 465 (8.3%). The most common cystic lesion was mucocele (805, 10.7%). Hemangioma was the most frequent lesion type among developmental anomalies with the number of 815 (14.6%). The most common location of the lesions was the lip in 2081 cases (27.8%), followed by the gingiva in 2024 cases (27.0%), bucca in 1069 cases (14.3%), tongue in 981 cases (13.1%), and the facial skin in 695 cases (9.3%). After taking biopsy, the majority of benign lesions were treated with cryo-, laser-, or combined (cryo and laser) surgery. CONCLUSION: The present computer-aided study showed that irritational fibroma was the most common orofacial benign tumor, and the lip was the most frequent location. The diagnostic classification and the methodology are considerably different in the majority of the studies, which may hinder the exact comparison with other surveys from different regions of the world. Orv Hetil. 2018; 159(37): 1516-1524.


Assuntos
Doenças Maxilomandibulares/epidemiologia , Doenças da Boca/epidemiologia , Medicina Bucal , Adulto , Idoso , Biópsia/estatística & dados numéricos , Feminino , Fibroma/epidemiologia , Humanos , Hungria , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/epidemiologia , Doenças Periapicais/epidemiologia , Prevalência , Estudos Retrospectivos , Doenças das Glândulas Salivares/epidemiologia , Fatores Sexuais
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