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Purpose: This study aims to report clinicopathologic and imaging features of odontogenic myxomas (OM), highlighting uncommon findings., Methods: Clinicopathologic and imaging data of OMs diagnosed in the five Brazilian diagnostic pathology centers were collected and analyzed., Results: The series comprised 42 females (68.9%) and 19 males (31.1%), with a 2.2:1 female-to-male ratio and a mean age of 34.5±15.4 years (range: 4-80). Clinically, most OMs presented as painless intraoral swelling (n = 36; 70.6%) in the mandible (n=37; 59.7%). Multilocular lesions (n=30; 83.3%) were more common than unilocular lesions (n=6; 16.7%). There was no statistically significant difference between the average size of unilocular and multilocular OMs (p=0.2431). The borders of OMs were mainly well-defined (n=24; 66.7%) with different degrees of cortication. Only seven tumors caused tooth resorption (15.9%), while 24 (54.5%) caused tooth displacement. Cortical bone perforation was observed in 12 (38.7%) cases. Morphologically, OMs were characterized mainly by stellate or spindle-shaped cells in a myxoid background (n=53; 85.5%). Surgical resection was the most common treatment modality (n=15; 65.2%), followed by conservative surgery (n=8; 34.8%). Outcomes were available in 20 cases (32.3%). Seven of these patients had local recurrence (35%). Enucleation was the treatment with the highest recurrence rate (4/7; 57.1%)., Conclusions: OM has a predilection for the posterior region of the jaws of female adults. Despite their bland morphological appearance, they displayed diverse imaging features. Clinicians must include the OM in the differential diagnosis of osteolytic lesions of the jaws. A long follow-up is needed to monitor possible recurrences., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Some odontogenic cysts (OCs) and odontogenic tumors (OTs) are infiltrative and often recur, causing bone destruction and tooth loss. In the elderly, in particular, these injuries cause significant morbidity, making rehabilitation difficult and compromising the quality of life of these individuals. Objective: To determine the prevalence and demographic characteristics of OCs, non-odontogenic cysts (NOCs), and OTs diagnosed in an elderly Brazilian population (≥60 years)., Material and Methods: A retrospective descriptive cross-sectional study was carried out in three Brazilian pathology referral centers (1999-2019). Data regarding age, sex, ethnicity, anatomical location, symptomatology, and histopathological diagnosis were obtained from histopathological records and analyzed. Pearson's Chi-squared and Fisher's exact tests were used to evaluate the association between the different groups of oral lesions and demographic findings, adopting a P-value of ≤ 0.05 and a 95% confidence interval., Results: A total of 7,476 histopathological records were evaluated, of which 389 (5.2%) cases were classified as OCs, 86 (1.15%) as NOCs, and 83 (1.11%) as OTs. The most common lesions in each group were periapical cysts (n=166; 68.9%), ameloblastomas (n=65; 77.4%), and salivary duct cysts (n=45; 52.3%). Overall, males were slightly more affected (n=279, 50.2%). Most individuals were between 60 and 69 years (n=358; 64.2%). OCs and OTs preferentially affected the mandible (n=280; 62.2%). NOCs occurred more frequently in the lips (n=19; 22.1%), followed by buccal mucosa (n=18; 20.9%). The overall concordance between clinical and histopathologic diagnoses was 47.2% (213 of 451 cases)., Conclusions: OCs were relatively common, whereas NOCs and OTs were rarer among the elderly. The low concordance between clinical and histopathological diagnosis highlights the importance of histopathological analysis to ensure an accurate diagnosis. Dentists and geriatricians must be familiar with these lesions to ensure an early diagnosis, reduce morbidity and improve the quality of life of these individuals. Key words: Odontogenic cysts, Non-odontogenic cysts, Odontogenic tumors, Oral diseases, Older people, Oral lesions., Competing Interests: No conflicts of interest were declared concerning the publication of this article., (Copyright: © 2024 Medicina Oral S.L.)

Background: Granular Cell Tumor (GCT) is an uncommon benign lesion in the oral cavity whose pathogenesis remains poorly understood. Due to their infrequent occurrence and similarity to other oral lesions, they are often forgotten during the initial clinical diagnosis. Therefore, understanding its prevalence, clinical and pathological characteristics is crucial for an accurate diagnosis and adequate management., Methods: All cases diagnosed as GCTs in six Brazilian and Argentinian oral diagnostic centers were re-evaluated by HE staining, and clinical, demographic, and histopathological data were collected and evaluated., Results: The series comprised 45 female (73.8%) and 16 male (26.2%), with a 2.8:1 female-to-male ratio and a mean age of 35.3 ± 16.9 years (range: 7-77 years). Most cases occurred on the tongue (n = 49; 81.6%) and presented clinically as asymptomatic papules or nodules (n = 50; 89.3%) with a normochromic (n = 25; 45.5%) or yellowish (n = 11; 20.0%) coloration and sizes ranging from 0.2 to 3.0 cm (mean ± SD: 1.40 ± 0.75 cm). Morphologically, most tumors were characterized by a poorly delimited proliferation (n = 52; 88.1%) of cells typically rounded to polygonal containing abundant, eosinophilic, finely granular cytoplasm. Pustulo-ovoid bodies of Milian were identified in all lesions (n = 61; 100%). Entrapment of skeletal striated muscle (n = 44; 72.1%) and nerve fibers (n = 42; 68.9%) were common findings. Pseudoepitheliomatous hyperplasia (PEH) was observed in 23 cases (39.0%). In only 27.7% of cases (n = 13) there was agreement between the clinical and histopathological diagnosis. Outcome information was available from 16 patients (26.2%), with clinical follow-up ranging from 4 to 36 months (mean 13.3 months), and none developed local recurrence., Conclusions: The clinical and histopathological features of GCTs were consistent with those described in previous studies. In general, these lesions have a predilection for the lateral region of the tongue in adult women. It is essential to consider GCTs in the differential diagnosis of yellow or normochromic papules and nodules in the oral cavity. Histopathological evaluation is essential for the definitive diagnosis and the prognosis is excellent., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The primordial odontogenic tumor (POT) is a rare mixed odontogenic tumor composed of mesenchymal cells, columnar odontogenic epithelium, and fibromyxoid stroma affecting the posterior mandible of children and adolescents. Herein, we report 3 patients with POT and the clinicopathological features of POT previously reported in the literature. A 12-year-old, 19-year-old, and 4-year-old patient presented an asymptomatic swelling in the posterior maxilla and posterior mandible. Imaging exams revealed radiolucent lesions associated with unerupted teeth. The lesions were surgically removed, and the histopathological examination revealed spindle-to-ovoid mesenchymal cells in a fibromyxoid stroma surfaced by columnar odontogenic epithelial cells with reverse nuclear polarization. Deposition of mineralized tissue was observed. The final diagnosis was POT, and patients did not exhibit signs of recurrence. POT should be included in the differential diagnoses of intraosseous lesions in the posterior mandible in pediatric patients., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: To report the clinicopathologic features of 19 oral solitary fibrous tumors (SFTs)., Methods: Clinical data were collected from the records of seven pathology services. All cases were re-evaluated by HE staining and confirmed by immunohistochemistry., Results: The series comprised 11 females (57.9%) and 8 males (42.1%), with a mean age of 47.3 ± 14.7 years (range: 22-71 years) and a 1.3:1 female-to-male ratio. Most tumors affected the buccal mucosa (n = 7; 36.8%) and presented clinically as an asymptomatic solitary submucosal well-circumscribed nodule with coloration similar to the oral mucosa. Morphologically, most SFTs (n = 10; 52.6%) exhibited a classic hybrid pattern characterized by a well-circumscribed proliferation of densely cellular areas alternating with hypocellular areas in a variably collagenous vascular stroma. Remnants of accessory salivary glands were observed in two cases (n = 2; 10.5%). All tumors were positive for STAT6 and CD34 (n = 19; 100%). Outcome information was available from 6 patients (31.6%), with clinical follow-up ranging from 6 to 24 months (mean ± SD, 9.5 ± 6.8 months), and none developed local recurrence., Conclusions: Oral SFTs are rare and often clinically misdiagnosed. Pathologists should consider SFT in the differential diagnosis of oral spindle cell tumors. Accurate diagnosis requires careful morphological evaluation supported by immunohistochemical analysis., (© 2023 Wiley Periodicals LLC.)

Dermoid cysts (DCs) and epidermoid cysts (ECs) are uncommon developmental cysts affecting the oral cavity. This study aims to evaluate patients with oral DCs and ECs and their demographic and clinicopathologic features. A retrospective descriptive cross-sectional study was performed. A total of 105,077 biopsy records of oral and maxillofacial lesions from seven Brazilian oral pathology centers were analyzed. All cases diagnosed as oral DCs and ECs were reviewed, and clinical, demographic, and histopathological data were collected. The series comprised 32 DCs (31.4%) and 70 ECs (68.6%). Most of the DCs occurred on the floor of the mouth (n = 14; 45.2%) of women (n = 17; 53.1%) with a mean age of 34.6 ± 21.6 years. All DCs were lined partially or entirely by stratified squamous epithelium (100%). Chronic inflammatory cells, melanin pigmentation, multinucleated giant cell reaction, and cholesterol clefts were observed in the fibrous capsule . Most of the ECs affected the labial mucosa (n = 20; 31.7%) of men (n = 39; 56.5%) with a mean age of 48.0±19.8 years. Microscopically, most ECs (n = 68; 97.1%) were lined entirely by stratified squamous epithelium. Two cysts (2.9%) showed areas of respiratory metaplasia. Chronic inflammatory cells, melanin pigmentation, multinucleated giant cell reaction, and cholesterol clefts were also observed in the fibrous capsule. Conservative surgical excision was the treatment of choice in all cases. Oral DCs and ECs are uncommon and often clinically misdiagnosed lesions. Clinicians should consider DCs and ECs in the differential diagnosis of soft tissue lesions in the oral cavity, mainly located on the floor of the mouth and labial mucosa.

Few studies on the distribution of oral diseases in older people are available in the literature. This study aimed to investigate the prevalence and demographic characteristics of oral and maxillofacial lesions in geriatric patients (age ≥ 60 years). A retrospective descriptive cross-sectional study was performed. Biopsy records were obtained from archives of three Brazilian oral pathology centers over a 20-year period. Data on sex, age, anatomical site, skin color, and histopathological diagnosis were collected and analyzed. Pearson's chi-square test was used to evaluate differences in the frequency of the different oral and maxillofacial lesion groups. A total of 7,476 biopsy records of older patients were analyzed. Most cases were diagnosed in patients aged 60 to 69 years (n = 4,487; 60.0%). Females were more affected (n = 4,403; 58.9%) with a female-to-male ratio of 1:0.7 (p < 0.001). The tongue (n = 1,196; 16.4%), lower lip (n = 1,005; 13.8%), and buccal mucosa (n = 997; 13.7%) were the most common anatomical sites. Reactive and inflammatory lesions (n = 3,840; 51.3%) were the most prevalent non-neoplastic pathologies (p < 0.001), followed by cysts (n = 475; 6.4%). Malignant neoplasms were more frequent (n = 1,353; 18.1%) than benign neoplasms (n = 512; 6.8%). Fibrous/fibroepithelial hyperplasia (n = 2,042; 53.2%) (p < 0.001) and squamous cell carcinoma (n = 1,191; 88.03%) (p < 0.001) were the most common oral lesions in older adults. Biopsy data allow the accurate characterization of the prevalence of oral and maxillofacial lesions, supporting the development of public health policies that can enable the prevention, early diagnosis, and appropriate treatment of these lesions. Also, they bring valuable information that helps dentists and geriatricians diagnose these diseases.

Background: This study analyzed the immunoexpression of calcitonin receptor (CTR) and glucocorticoid receptor (GR) in central giant cell lesions (CGCLs) and verified potential associations with patient's response to clinical treatment with intralesional injection of triamcinolone., Materials and Methods: Fifty-four cases of CGCLs, including 22 non-aggressive, and 32 aggressive, were investigated by immunohistochemistry., Results: Surgery was the therapeutic choice for 53.1% of the aggressive CGCLs, and 46.9% were submitted to the conservative treatment with intralesional triamcinolone injections. Among patients submitted to conservative treatment, 60% (n = 9) showed favorable response. CTR expression was observed in 68.51%, and GR in 94.44% of the total sample. There were no differences in the expression of CTR, neither GR in mononucleated stromal cells (MSCs) or multinucleated giant cells (MGCs), in relation to aggressiveness, treatment performed for and the response to conservative treatment. Both markers showed a positive correlation between their expression in MSCs and MGCs in the total sample (P < 0.0001). CTR expression on MSCs showed a positive correlation with MGCs in the aggressive and non-aggressive groups (P < 0.0001)., Conclusions: Calcitonin receptor and GR expression were diffuse and similar in non-aggressive and aggressive cases, and it did not influence the response to clinical treatment with triamcinolone in the sample studied., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)