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Primary oral malignant melanoma (OMM) is a rare disease, representing 0.2% to 8% of all melanomas. Eighty percent of the cases are located on the palate and maxillary gingiva, with the remainder found on the mandibular gingiva, buccal mucosa, tongue, and floor of the mouth. OMM are highly aggressive with the tendency to metastasize and invade the surrounding tissues more readily than other oral malignancies. Prognosis is poor and the five-year survival rate ranges from 5% to 20%. The usual therapeutic approach for OMM is surgical excision of the primary tumor, supplemented by radiotherapy, with chemotherapy and immunotherapy serving as adjuvant. The authors report a well-documented case of OMM in a 40-year-old male who was referred to the Oral Medicine Service of the Cancer Hospital, Cuiabá, Mato Grosso, Brazil exhibiting a firm mass at the right side of the face. Palpation revealed a painless soft tissue arising in maxillary gingiva, extending to the palate and vestibular mucosa. Pigmented areas were found in the mass. The patient underestimated his symptoms and look for treatment after a substantial growth of the lesion. This is an example of how a delayed detection affects the prognosis of OMM. The patient was treated by radiotherapy since surgical intervention was not possible, but died seven months later.

Chondrosarcoma is a rare flat bone neoplasm. Herein, we present the clinicopathological and immunohistochemical findings of a case affecting the periodontum. A 16-year-old girl presented a painless reddish mass in the lower anterior gingiva. Radiographs showed bone affected by vertical and horizontal loss and enlargement of periodontal space. The histopathological features showed atypical cartilage arranged in lobules compatible with chondrosarcoma. Immunohistochemistry showed that tumor cells were immunoreactive for the anti-vimentin and S-100 antibodies. Moreover, no tumor cells had been immunostained by anti-p53. Treatment consisted of chemotherapy, followed by radical surgery and postsurgery treatment with an association of radio and chemotherapy. After one year, no signs of recurrence have been observed.

Pleomorphic lipoma (PL) is a rare benign tumor mainly located in the upper back, upper shoulders, and back of the neck in elderly men. More rarely it is located in the head and neck region and in the oral cavity. The differential diagnosis should be made with sclerosing liposarcoma and well-differentiated liposarcoma. A 59-year-old male patient was referred for the presence of a lesion involving the marginal and adherent gingiva of teeth # 5; this lesion extended into the vestibular mucosa. The lesion had a 2 cm diameter, showed no tenderness, had a hard-parenchymatous consistency, was mobile on the underlying tissues and was covered by normal appearing mucosa. Under local anesthesia, the lesion was completely removed. A free gingival graft from the palate was used to cover the defect. Microscopically, it was possible to observe mature adipocytes, spindle cells and rare ''floret-like'' cells. Lipoblasts and mitoses were absent. The definitive pathologic diagnosis was pleomorphic lipoma. No recurrences were present after a 5 years follow-up. Local excision is adequate for PL and the tumor does not recur.

Bacillary angiomatosis is a rather frequent infectious pathology appearing mainly in the skin but can also affect the liver, spleen, heart, bones, lungs, muscles, central nervous system and other organs. The localization of the lesion in the oral cavity is rather rare, as it is evident in the literature. Bacillary angiomatosis can be clinically similar to the Kaposi's sarcoma and histologically confused with angiosarcoma, epitheloid hemangioma and pyogenic granuloma. A case of bacillary angiomatosis of the oral cavity in an immuno-competent patient is described. The high tendency to relapse, the capability in migration and to involve several localizations at the same time have induced the authors to deepen the research to exclude the possibility that it could be a Kaposi's sarcoma or a pyogenic granuloma and to get to an accurate diagnosis in order to resolve the disease.

A case of primary and exclusive gingival localization of a non-Hodgkin lymphoma (NHL) personally observed at the Surgical Out-patients Unit of the Department of Dentistry at the Umberto I Hospital in Rome, is described. A 71 year-old caucasian male was referred by his private dentist because of a severe pain at the soft tissue of the mandible even after dental, neurologic and parodontal treatments. At clinical examination, a severe gingival swelling in the symphysis region with hard bleeding, palpable lymph nodes and no important evidence in radiographic and CT examinations were found. After incisional biopsy and its examination, a diagnosis of NHL was made. Further examinations did not show metastasis dissemination. The patient was referred to the Hematology Department and after 4 chemotherapy cycles over 12 months, he completely recovered. After an introduction on NHL, the clinical case is described as well as how to make a correct diagnosis; moreover, the importance of the dentist in identifying diseases even not strictly related to oral cavity but whose signs and manifestations appear over there, is stressed.

Background: A computerised morphometric analysis of some vascularisation aspects of epulides is presented. The aim of this study is to evaluate the correlation between morphometric aspects and histological classification of epulides and to investigate its usefulness for the histopathologic diagnosis., Methods: The study was carried out on epulides from 72 patients (30 males, 42 females, age-range 16-60). Epulides were fixed in alcohol, paraffin embedded, and stained with haematoxyilin eosin, thereafter epulides were histopathologically classified as granulomatous epulides, fibrous epulides and giant cell epulides. Images of histological samples were then digitised, and by an image analysis system some morphometric vessels characteristics were evaluated: percent image area occupied by vessels, vessels number, mean vessels area and standard deviation of vessels area. Finally, the correlation between morphometric data and the histological classification of epulides was evaluated., Results: The statistic evaluation of morphometric data allowed to classify epulides in six groups characterised by a various degree of vascularisation, these groups showed a good correlation with histopathological classification., Conclusions: The morphometric analysis of vessels is a powerful aid for the histopathologic diagnosis and for a better knowledge of the etiopathogenetic factors of epulides.

Following a short critical review of the most recent literature, the present study reports a case of angiosarcoma of the gingiva, localized at the level of the vestibular surface of the lower incisor region. The intense positive reaction of neoplastic elements to factor VIII-correlated antigen, negative for cytokeratin and positive for vimentin, allowed the vascular nature of the neoplasia to be confirmed.

Spindle cell carcinoma is a relatively rare tumor which occurs often in the upper respiratory tract, the oral cavity, and in the esophagus and skin. In this paper a patient who presented a tumor mass of the lover gingiva which was subsequently diagnosed as a spindle cell carcinoma is reported. The clinicopathologic aspects and diagnostic problems of this unusual tumor of the oral mucosa are discussed.