RESUMO
A case of acinic cell adenocarcinoma of the left facial area of 10-years' duration in a 29-year-old man is presented. The patient reported surgical resection of a nodular lesion in the left buccal mucosa 8 years earlier in another hospital. Since then, the lesion recurred 3 times within 2 years. The first lesion and 2 recurrent ones were surgically removed. With the third recurrent lesion, the patient did not return promptly for treatment and was directed to our clinic after 6 years. The clinical, tomographic, immunohistochemical, and therapeutic aspects are analyzed.
Assuntos
Carcinoma de Células Acinares/patologia , Recidiva Local de Neoplasia , Neoplasias das Glândulas Salivares/patologia , Adulto , Carcinoma de Células Acinares/química , Carcinoma de Células Acinares/cirurgia , Diagnóstico Diferencial , Humanos , Técnicas Imunoenzimáticas , Queratina-7/análise , Queratina-8/análise , Antígeno Ki-67/análise , Masculino , Mucosa Bucal/patologia , Neoplasias das Glândulas Salivares/química , Neoplasias das Glândulas Salivares/cirurgia , Vimentina/análiseRESUMO
OBJECTIVES: To assess the accuracy of cone beam computed tomography (CBCT) using two fields of view (FOVs) in the diagnosis of peri-implant defects. STUDY DESIGN: Eighty implants were placed in bovine ribs, in which peri-implant bone defects of two sizes (T1 and T2) were simulated using 70% perchloric acid. CBCT images were acquired with the use of two FOV size settings of the i-CAT NG unit: 6 × 16 cm and 8 × 8 cm. One oral and maxillofacial surgeon (OMS) and two oral and maxillofacial radiologists (OMRs) evaluated the presence of defects, and their findings were compared with direct visual evaluation. The kappa (κ)-statistic, area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the examinations were calculated. AUC values were compared with the Student t test. RESULTS: The obtained κ-values indicated good intra- and interobserver agreement. A significant difference was found between T1 and T2 (P = .01) with regard to AUC values, and no significant difference was found between the different FOVs in both test groups (T1, P = .06; T2, P = .33). The sensitivity, specificity, PPV, and NPV of the examinations were higher for the OMRs than for the OMS involved in the study. CONCLUSIONS: The ability of CBCT to detect chemically created peri-implant bone defects was good, especially for larger defects (Group T2) but only for the observations of the OMRs. The observations of the OMS were less accurate. The two FOVs tested were appropriate to detect peri-implant bone defects.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Implantes Dentários , Costelas/diagnóstico por imagem , Costelas/cirurgia , Animais , Bovinos , Técnicas In Vitro , Percloratos , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
The SAPHO syndrome is characterized by specific clinical manifestations of synovitis, acne pustulosis, hyperostosis, and osteitis. It is a rare disease with a combination of osseous and articular manifestations associated with skin lesions. We describe a patient with SAPHO syndrome of the mandible and involvement of the temporomandibular joint (TMJ ankylosis). The findings from orthopantomography, computed tomography (CT), and clinical and histopathological examinations are compared and analyzed to improve the final diagnosis. Our patient was submitted to a bilateral high condylectomy and coronoidectomy to correct the open mouth limitation. No previous report of SAPHO syndrome associated with secondary TMJ ankylosis was found in the literature.