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Acute myeloid leukemia is an aggressive malignant neoplasm occurring mainly in elderly, with the median age of 65 years. Oral manifestations, mainly spontaneous bleeding, are a common finding in acute myelocytic leukemia and may represent the initial evidence of the disease. This report describes a case of a 47-year-old man with a one-month history of spontaneous oral bleeding. The patient had already been consulted by two professionals but he remained undiagnosed. The physical examination revealed paleness, fever, epistaxis and ecchymoses in the oral mucosa. The complete blood count revealed anemia, severe thrombocytopenia and leukocytosis with blasts predominance, reinforcing the diagnosis hypothesis of an acute leukemia. The patient was immediately referred to the Hospital and despite having received a quick intervention, he died 3 days after the admission due to diffuse pulmonary alveolar hemorrhage. According to the peripheral blood immunophenotyping the diagnosis of hypogranular variant of acute promyelocytic leukemia was established. The delay in the diagnosis may have influenced the unfavorable outcome. Early diagnosis and management are indispensable for survival of leukemia patients. In this way, dentists may be responsible for an early detection of oral manifestations of leukemia and for a fast referral to an adequate professional.

Objective: the aim of this paper is to report a case of palatal Mucoepidermoid carcinoma (MEC) mimicking a mucocele, to highlight the main differential diagnoses, and to point out the need of a biopsy to establish the diagnosis even in a suspicion of benign reactive lesions. Case report: a female was referred to a stomatologist for evaluation of a palate swelling noticed about two months earlier. Physical exam revealed a painless translucent submucosal nodule, with an erythematous halo, in the right soft palate. Considering the clinical appearance, diagnostic hypothesis included mucocele and pleomorphic adenoma. An incisional biopsy was performed. Histological analysis of the specimen showed definitive diagnosis of low grade MEC. The case was managed through a complete surgical excision. Currently, she has been followed up without any signs of recurrence. Conclusion: early diagnosis of MEC may guide an adequate therapeutic management and, consequently, promote a favorable prognosis.

Salivary gland tumors are rare, generally benign and affect mainly the parotid gland. AIM: The purpose of this study was to retrospectively analyze all cases of parotid tumors treated at our institution from 1953 to 2003. METHODS: All patients with primary parotid tumors were selected; clinical and histopathological data were analyzed and described. RESULTS: 600 cases of parotid tumors were selected; 369 were benign and 231 were malignant. Pleomorphic adenoma was the most frequent benign tumor. The most common malignant tumor was the mucoepidermoid carcinoma. Therapy in most cases consisted of parotidectomy. Adjuvant therapy - mainly radiotherapy - was used in some cases with malignant tumors. The incidences of local, regional and distant recurrences of malignant tumors were 10%, 8% and 9%. CONCLUSION: Patients with parotid tumors treated at our institution were mainly adults, with marginally more female patients. Benign tumors were mostly the pleomorphic adenoma, which were more frequent than malignancies. Most of the patients were treated by partial or total parotidectomy. Adjuvant therapy, mainly radiotherapy, was used in selected malignant cases.Os tumores de glândula salivar são raros e acometem principalmente a parótida, sendo a maioria de natureza benigna. OBJETIVOS: Avaliar todos os casos de tumor de parótida atendidos na nossa instituição, durante o período de 1953 a 2003. Estudo Retrospectivo. CASUÍSTICA E MÉTODOS: Todos os pacientes com tumores primários de parótida foram selecionados e os dados clínicos e histopatológicos foram analisados e descritos. RESULTADOS: Foram selecionados 600 casos, sendo 369 benignos e 231 malignos. Dentre os tumores benignos, o adenoma pleomorfo foi o mais comum, e dentre os malignos, o carcinoma mucoepidermoide. A principal modalidade de tratamento foi a parotidectomia e em alguns casos malignos, terapias adjuvantes, principalmente a radioterapia, foram aplicadas. Os índices de recorrência local, regional e à distância dos tumores malignos foram de 10%, 8% e 9%, respectivamente. CONCLUSÕES: O perfil dos pacientes com tumor de parótida foi formado predominantemente por adultos e discreta predileção pelo gênero feminino. Os tumores benignos foram os mais frequentes. A maioria dos pacientes foram tratados por parotidectomia parcial ou total. O uso de terapias adjuvantes, principalmente a radioterapia, foi reservada para casos específicos de tumores malignos.

Osteosarcoma (OS) is a rare and aggressive malignant bone tumor, which occurs more frequently in long bones of young people. About 10% of the cases affect the head and neck region presenting peculiar features. The main sites of this tumor in head and neck are the mandible followed by the maxilla, and it seems to have a similar distribution between the genders. The most common clinical feature is the local swelling. Pain and paresthesia may be present in some cases. The early signs of this tumor in the jaw bones can be a dental mobility or widening of the periodontal ligament space. The diagnosis of OS is established with histological examination, which shows malignant mesenchymal cells producing osteoid or bone. The main modality treatment for head and neck OS is surgical resection with wide margins. The benefits of adjuvant therapies like chemotherapy and radiotherapy are still not clear. The major complication is local recurrence, with metastasis occurring as a solitary or a late stage event.

ABSTRACT Lipomas are benign neoplasms of adipose tissue presenting several histologic variants, which can be rarely found in the oral cavity. We present a case of a 62-year-old woman with a submucous nodule located in the tongue. Histopathological examination revealed an encapsulated tumor composed of myxoid tissue, spindle cells and mature adipocytes in transition to cartilaginous tissue. The final diagnosis was spindle-cell lipoma with myxoid change and chondroid differentiation. No sign of recurrence was found after five years. The diagnosis of intraoral mesenchymal lesions with chondroid differentiation requires careful histologic examination, mainly to differentiate between benign and malignant lesions.

Actinic cheilitis (AC) is a potentially malignant disorder of the lips. Because of its heterogeneous clinical aspect, it is difficult to indicate representative biopsy area. The purpose of this study was to evaluate the usefulness of tissue autofluorescence in AC diagnosis. The system was composed of a 405-nm light-emitting diode, sent to the sample by a dichroic, that allows the fluorescence signal to reach a camera directly plugged in the system. Fifty-seven patients with clinical diagnosis of AC and 45 normal volunteers were selected. According to clinical and fluorescence features, one or more areas were selected for biopsies in the AC group and epithelial dysplasia (ED) grades were established. The autofluorescence images were processed by a clustering algorithm for AC automated diagnosis. The tissue autofluorescence image revealed a heterogeneous pattern of loss and increase of fluorescence in patients with AC. ED was found in 93%of the cases, and most of the areas graded as moderate or severe ED were chosen with the aid of autofluorescence. The processed autofluorescence images from AC patients showed a higher number of spots in an irregular pattern. Tissue autofluorescence image system is a useful technique in association with clinical examination for AC diagnosis. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyze the clinicopathological features and immunohistochemical expression of p53, MDM2, CDK4, PCNA and Ki67 proteins in 25 head and neck osteosarcomas registered in a single institution. The mean age of the patients was 29 years and the most common site was the mandible (60%). The predominant histological type was the chondroblastic (72%) and 52% of the cases were classified as intermediate-grade of malignancy. The immunohistochemical analysis displayed positivity in 52% of the cases for p53, 24% for MDM2, 84% for CDK4, 92% for PCNA and 88% for Ki-67. The majority of cases were treated with surgery alone or associated with chemotherapy. Five patients developed local recurrences, four had distant metastasis and six had persistent disease after initial treatment. The overall 5-year and 10-year survival rates were 59% and 49%, respectively, and the most important prognostic factors were prior history of radiation exposure and osteoblastic histological type. [ABSTRACT FROM AUTHOR]

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Acute myeloid leukemia is an aggressive malignant neoplasm occurring mainly in elderly, with the median age of 65 years. Oral manifestations, mainly spontaneous bleeding, are a common finding in acute myelocytic leukemia and may represent the initial evidence of the disease. This report describes a case of a 47-year-old man with a one-month history of spontaneous oral bleeding. The patient had already been consulted by two professionals but he remained undiagnosed. The physical examination revealed paleness, fever, epistaxis and ecchymoses in the oral mucosa. The complete blood count revealed anemia, severe thrombocytopenia and leukocytosis with blasts predominance, reinforcing the diagnosis hypothesis of an acute leukemia. The patient was immediately referred to the Hospital and despite having received a quick intervention, he died 3 days after the admission due to diffuse pulmonary alveolar hemorrhage. According to the peripheral blood immunophenotyping the diagnosis of hypogranular variant of acute promyelocytic leukemia was established. The delay in the diagnosis may have influenced the unfavorable outcome. Early diagnosis and management are indispensable for survival of leukemia patients. In this way, dentists may be responsible for an early detection of oral manifestations of leukemia and for a fast referral to an adequate professional.