Clinicopathological analysis of odontogenic tumors over 22 years period: Experience of a single center in northeastern Brazil.

BACKGROUND: Odontogenic tumors (OTs) are uncommon neoplastic lesions of the maxilla and mandible, which present difficult diagnosis and therapeutics. This paper aims to determine the frequency and distribution of OTs, over a period of 22 years, at a public university in Northeastern Brazil. MATERIAL AND METHODS: We reviewed all cases of OTs from oral pathology laboratory of Federal University of Rio Grande do Norte (UFRN), from 1996 to 2017. The tumors were classified according to the latest (2017) World Health Organization Classification of Tumors. Data on age, gender, anatomic site, symptomatology, radiographic findings and tumor size were analyzed. RESULTS: In the analyzed period, 247 cases of OTs were diagnosed. Epithelial tumors were more common with 127 cases (51.8%). The most common tumors were ameloblastoma (n = 112 / 45.4%), odontoma (n = 89 / 36.1%) and odontogenic myxoma (n = 17 / 6.9%). Malignant odontogenic tumors were extremely rare in the studied population with only 2 cases (0.8%) of diagnosed carcinomas. These tumors were diagnosed in a wide age range, from 5 to 81 years, being more common in the second and third decades of life. In general, the mandible was the most affected anatomic site (n = 162/66%) and the mandible:maxilla ratio was of 2:1. Ameloblastoma was the tumor with the highest number of symptomatic cases (n = 26) and with the highest mean size (cm) with 4.5cm. CONCLUSIONS: Odontogenic tumors were rare in the sample studied (2.2%), with ameloblastoma and odontoma being the most common tumors. Continuous studies that show the characteristics of these lesions are fundamental, especially after modifications in the international classification.

Clinicopathological evaluation and survival of patients with squamous cell carcinoma of the tongue.

BACKGROUND: Early detection of oral cancer is the most effective means of reducing morbidity, complexity, and extent of treatment. This study evaluated the clinicopathological profile of epidermoid carcinoma of the tongue, including treatment and survival. MATERIAL AND METHODS: This observational, retrospective cross-sectional study evaluated patients with squamous cell carcinoma of the tongue treated at the Dr. Luiz Antônio Hospital, Natal, Brazil, from January 2001 to December 2011. Survival variables were calculated using the Kaplan-Meier method and compared by log rank tests. RESULTS: Of the 412 patients diagnosed in this period, 298 (72.3%) were men; their mean age was 60.5 years, and 69.2% were diagnosed with stage III/IV tumours. Improved survival was associated with early stage diagnosis, absence of affected lymph nodes at diagnosis, and treatment with surgery alone. CONCLUSIONS: Late stage diagnosis of oral cancer negatively affects patient survival. In addition, the general public should be made aware of the prognostic factors for oral SCC of the tongue and of the importance of periodic examinations of the oral cavity.

Epidemiologic study of odontogenic and non-odontogenic cysts in children and adolescents of a Brazilian population.

BACKGROUND: the objective of this study was to describe the frequency of cystic lesions in a Brazilian population of patients histopathologically diagnosed in the first and second decade of life. MATERIAL AND METHODS: Retrospective descriptive cross-sectional study was performed. Biopsy records were obtained from the archives of a Brazilian referral center between 1980 and 2016. RESULTS: A total of 2.114 biopsy records of pediatric patients were analyzed with oral and maxillofacial lesions. Data such as gender, age, anatomical location, and histopathological diagnosis were collected and categorized. Among all oral and maxillofacial lesions (n=2.114), were diagnosed 294 cases of odontogenic cysts (13.9%) and 16 cases of non-odontogenic cysts (0.8%). The most frequent lesions in each group were, respectively: radicular cyst (n=145) and epidermoid cyst (n=4). These lesions were most common in female (n=158), with a mean age of 14 years. For intraosseous lesions, the mandible (n=148) was the most affected anatomic site; moreover, the floor of the mouth (n=6) was most affected by cysts in soft tissues. CONCLUSIONS: Odontogenic cysts were relatively common in population studied, but non-odontogenic cysts were rare in these patients.

Virulence factors of Candida spp. obtained from blood cultures of patients with candidemia attended at tertiary hospitals in Northeast Brazil.

BACKGROUND: Yeasts of the Candida genus are one of the most common causes of bloodstream infections associated with high rates of morbidity and mortality, mainly affecting immunocompromised patients. We aimed to identify yeasts obtained from blood cultures of patients interned at tertiary hospitals in Brazil. METHODS: We evaluated some of the major virulence factors of Candida spp., including the ability to adhere to human buccal epithelial cells, biofilm formation, hemolytic and phospholipase activity. RESULTS: We analyzed 70 isolates of Candida spp. obtained from March 2011 and March 2015. Candida spp. showed different peculiarities in terms of expression of virulence factors evaluated in vitro. C. albicans strains were more adherent to HBEC than all the other Candida species. C. tropicalis strains were considered strong biofilm producers. Strains belonging to the C. parapsilosis species complex were able to produce hemolysins, while C. glabrata was also able to lyse erythrocytes and to produce phospholipase. CONCLUSION: These results suggest that Non-Candida albicans Candida species are also able to express virulence factors which play an important role in bloodstream infectious caused by these yeasts.

Immunoexpression of VEGFR-3, but not the immunoexpression of VEGF-C or lymphatic density, is correlated with metastasis in lower lip squamous cell carcinoma.

The purpose of this study was to evaluate the immunoexpression of vascular endothelial growth factor C (VEGF-C) and VEGF receptor 3 (VEGFR-3) and their correlation with intratumoural lymphatic density (ILD) and peritumoural lymphatic density (PLD) in metastatic and non-metastatic lower lip squamous cell carcinoma (LLSCC). Twenty-five LLSCC with regional nodal metastasis and 25 LLSCC without metastasis were selected. The percentages of VEGF-C and VEGFR-3 staining in each tumour core and at the deep invasive front were assessed. PLD and ILD were determined using anti-podoplanin antibody. Immunohistochemical findings were correlated with nodal metastasis, clinical staging, local recurrence, clinical outcome, and histological grade. Cytoplasmic immunoexpression of VEGFR-3 in the tumour core was associated with metastasis (P=0.009), patient death (P=0.008), and histological grade (P<0.005). PLD, ILD, and VEGF-C expression showed no significant associations with clinicopathological parameters (P>0.05). PLD and ILD were not significantly correlated with the immunoexpression of VEGF-C or VEGFR-3 (P>0.05). There was a significant positive correlation between PLD and ILD (P=0.004), and between cytoplasmic immunoreactivity of VEGF-C and VEGFR-3 (P=0.011). These results suggest an important role for VEGFR-3 in the progression of LLSCC, and highlight the possible influence of its expression on the prognosis of these tumours. ILD and PLD may not be associated with lymph node metastasis in LLSCC.

Stereological study of acinar growth in the rat parotid gland induced by isoproterenol.

The growth of the rat parotid gland induced by daily treatment with isoproterenol (IPR) for 2 weeks was investigated by stereological methods applied to light microscopy. After 7 days of treatment, the glandular mass presented a 286% growth, with the first 3 days being the period of greatest growth. Total acinar volume exhibited a 363% increase during the period from 0 to 7 days, while acinar-cell volume presented a 468% growth from 0 to 5 days of treatment. On the other hand, total acinar-cell number did not increase during the study period. Thus, under the conditions used, IPR-stimulated gland growth was essentially hypertrophic. However, a significant increase in the number of bipolar and multipolar mitoses was also observed, especially on the third and fifth days of treatment. As no increase in acinar-cell number occurred during growth, the presence of these mitoses suggests that cell death occurred during gland growth. On this basis, bipolar mitoses may occur to replace cells that probably degenerated during treatment, whereas multipolar mitoses may lead to the occurrence of polyploidy.

[Miliary tuberculosis - report of a case]. / Tuberculose miliar--relato de caso.

This is a case report of generalized miliary tuberculous infection in a 80-year old white male without the acquired immunodeficiency syndrome, whose death was caused by progressive hematogenous seeding similar to those cases of preantibiotic era. The importance of autopsy studies to uncover silent or protean infections specially in cases of cryptic or chronic hematogenous miliary tuberculosis, is emphasized.

Odontogenic tumors: analysis of 127 cases.

One hundred and twenty-seven cases of histologically confirmed odontogenic tumors were retrieved from a total of 5,289 oral and maxillary lesions diagnosed at the Division of Oral Pathology, Federal University of Rio Grande do Norte, during a period of 30 years (1970-1999). The most common histological diagnosis was odontoma (50.40%), followed by ameloblastoma (30.70%). The prevalence of odontogenic tumors was greater in females and the peak incidence occurred in the second and third decades of life. The main anatomical location was the mandible, and no malignant tumors were found.

Genotoxic evaluation, secondary metabolites and antioxidant capacity of leaves and roots of Urera baccifera Gaudich (Urticaceae).

In addition to phenolics, flavonoids, flavonols, alkaloids and condensed tannins, our tests identified the antioxidant and genotoxic properties in the crude extract (CE) and fractions of Urera baccifera (Urticaceae) roots and leaves. Oxalic acid (OA) content was determined by HPLC-DAD, which presented high values in the roots (1.82 ± 0.21, 1.79 ± 0.22 and 1.38 ± 0.15 mg/g in butanolic, CE and ethyl acetate fraction, respectively). OA caused a 30.7% reduction in the leucocyte proliferation, followed by butanolic fractions of roots (24.15%) and leaves (23.28%). The mitotic index was lower in butanolic fractions of leaves (8.7%) and roots (8.3%), similar to the OA index, which was 6.0%. The DNA damage index in cultured leukocytes was observed for OA (19.33) and butanol fraction treatments (22.67 and 16, respectively, for leaves and roots). Antioxidant capacity (DPPH and TBARS) was moderated, which was confirmed by the low phenolic, flavonol and flavonoid contents in both parts of the plant.

Oral foreign body granuloma: unusual presentation of a rare adverse reaction to permanent injectable cosmetic filler.

A variety of injectable permanent fillers have been used in orofacial tissues for cosmetic purposes. Most of these substances seem to be well tolerated but adverse reactions have been reported. Foreign body granulomas are a rare adverse reaction to injectable permanent fillers. The authors report the unusual case of a 56-year-old woman with a foreign body granuloma located exclusively in the oral cavity that was due to injection of a permanent filler.

[Multiple neurofibromatosis--report of a case]. / Neurofibromatose múltipla--relato de um caso.

A case of multiple neurofibromatosis with oral manifestation in a 37-year-old woman is reported. The general examination revealed the presence of "café-au-lait" spots and cutaneous nodular lesions scattered in different sites of the body. A brief review of the literature concerning the polymorphus characteristics of the disease is presented.

[Histopathological and immunohistochemical study of myoepithelioma of the salivary gland]. / Estudo histopatológico e imunohistoquímico do mioepitelioma de glândula salivar.

The histopathologic and immunohistochemical features of the myoepithelioma are presented. Antibodies used were: keratin, vimentin, and S-100 protein. Vimentin proved to be the ideal marker for myoepithelial cells being present in the different morphological types exhibited by the cell.