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Ameloblastic fibroma (AF) is a rare mixed odontogenic tumor that may present with aggressive behavior and may have potential for malignant transformation. Despite its very well-established histopathologic patterns, AF may have different types of tissues that might affect the final diagnosis, treatment choices, and outcome. An 11-year-old female patient presented with a well-defined multilocular lesion related to the impacted left inferior second molar, which was submitted to incisional biopsy. At the microscopic analysis, mesenchymal (resembling dental papilla) and epithelial (resembling odontogenic epithelium and disposed in small nests and cords) proliferating components were observed, characterizing as AF. Moreover, cystic degenerations, clear cells, ameloblastoma-like nests, and an epithelial fragment with ghost cells resembling the calcifying odontogenic cyst lining were found. The patient underwent another incisional biopsy, but no additional unusual features were found. Thus, treatment was decided as the total removal of the lesion and long-term follow-up.

Oral lymphoepithelial cyst (OLC) is a rare developmental cyst of soft tissue. Clinically, OLC exhibits as a small and asymptomatic mass, with color ranging from rose to yellowish. OLC develops manly in floor of mouth and lateral and ventral surfaces of tongue. Based on this, we aimed to report a case of OLC in a young patient. A 17-year-old male patient presented a painless nodular aspect located in floor of mouth with a history of evolution of 2 months. Clinical hypothesis was ranula. Excisional biopsy was performed, and histopathologic analysis revealed a cystic cavity lined by keratinized stratified epithelium; cystic lumen showed desquamated epithelial cells. Cystic capsule was composed of connective tissue exhibiting numerous lymphocytes, sometimes arranged in germinal centers. Superficially, epithelium of oral mucosa was observed. Based on pathologic findings, final diagnosis was OLC. After 12 months of follow-up, no sign of recurrence was observed.

Pyogenic granuloma (PG) is a non-neoplastic vascular tissue growth, which occurs in response to several stimuli. A 15-year-old nonwhite male patient presented with a nonsymptomatic lesion in the lower lip, which was noted for the first time 4 months before. Clinical examination revealed a rigid, brownish, well-delimited, and pediculated nodule, features that led to the clinical diagnosis of cutaneous horn. In an attempt to promote a better wound healing, total removal of the lesional area using the high-power diode laser (808 nm; 1.5 W; continuous mode) was decided. Microscopic examination revealed intense endothelial cells proliferation and new blood vessel formation, besides extensive ulceration areas. Based on these morphologic features, the final diagnosis of PG was established. The patient had very good healing of the incised area on the postsurgical examination and underwent long-term follow-up.

Calcifying odontogenic cyst (COC) is a rare, developmental odontogenic cyst that usually arises in the anterior region of the jaws. An 18-year-old, dark-skinned man was referred for evaluation of a painless, slow-growing swelling in the maxilla, extending from tooth #21 to tooth #25. Extraoral examination revealed slight elevation of the left nasal ala, producing discrete facial asymmetry. Computed tomography showed an expansive, unilocular hypodense lesion with small hyperdense foci, measuring approximately 3.0 cm in diameter. Under the diagnostic hypothesis of COC, an incisional biopsy was performed. Histopathological analysis disclosed a cystic cavity lined by ameloblastoma-like epithelium, with focal accumulation of ghost cells. Calcifications within the ghost cells could also be observed. The definitive diagnosis was COC. The patient was referred for surgical treatment and remains under close follow-up.

Lipomas are mesenchymal neoplasms consisting of mature adipocytes, which account for only 1% to 5% of all oral benign tumors. These lesions are occasionally altered by an admixture of other mesenchymal elements that comprise an intrinsic part of the tumor. A 76-year-old white woman was referred for evaluation of a painless, slow-growing swelling on the tongue that had been identified 3 years earlier. Her medical history was unremarkable. Intraoral examination revealed a yellowish, soft, sessile nodule on the right lateral border and ventral surface of the tongue, measuring approximately 2 cm. Under the diagnostic hypothesis of lipoma, an excisional biopsy was performed. Histopathologic analysis revealed a well-delimited proliferation of mature adipocytes arranged in lobules and separated by thin septa of fibrovascular connective tissue. The final diagnosis was lipoma. Eight months after surgical excision, clinical signs of recurrence were not detected. The patient remains under clinical follow-up.

Condyloma acuminatum is induced disease by human papillomavirus that commonly affects the genital region and is rarely observed on oral mucosa. Pathogenesis is associated with sexual contact or trauma, and when it develops in children it can indicate sexual abuse. Based on this, we aimed to report a case of condyloma acuminatum in a child. A 9-year-old male patient clinically presented verrucous nodule, asymptomatic, with history of evolution of 18 months, measuring 1 cm, and localized in left side of lower lip. No signs of other lesions in the skin were present. Clinical hypothesis was squamous papilloma or condyloma acuminatum. Excisional biopsy was performed, and histopathologic analysis revealed hyperplasia of parakeratinized squamous epithelium, with exophytic projections exhibiting acanthosis and exocytosis. Clear cytoplasm cells, suggestive of koilocytosis, were also observed. Subjacent fibrovascular connective tissue was also seen. Based on histopathologic findings, final diagnosis was condyloma acuminatum. After 12 months of follow-up, no sign of recurrence was observed.

Objective To perform an oral vascular anomalies (OVAs) retrospective analysis in a Brazilian population, in order to investigate its frequency distribution, demographic peculiarities and clinical-pathology characteristics. Study Design Data about the sex, age, race, clinical characteristics, location, and histopathologic diagnosis were extracted from cases recorded as OVAs in a reference center in the period between 1970 and 2016. Then, a database was created for analysis in the SPSS 20.0 system, in which they were submitted to a descriptive analysis. Results A total of 14,560 records were analyzed, of which 597 cases were histologically confirmed as OVA, indicating a 4.1% incidence. The lesions were grouped as the following: pyogenic granuloma (n = 454), hemangioma of childhood (n = 57), vascular malformation (n = 37), lymphangioma (n = 20), hemangiolymphangioma (n = 10), vascular thrombus (n = 7), hemangioendothelioma (n = 5), Kaposi sarcoma (n = 5), angiofibroma (n = 1), and hemangioendotheliosarcoma (n = 1). The patients’ sociodemographic profile was predominantly women (64.2%) and white people (48.2%), with a greater occurrence between the second and fourth decades of life. The majority was located in the gingiva or alveolar ridge (42.9%), presenting a red color (50.9%), sessile implantation (42%), soft consistency (44.5%), nodular appearance (38.3%), nonhemorrhagic (42.9%), and asymptomatic (32.8%). Conclusions These lesions particularities knowledge is important for a correct diagnosis and adequate treatment decision.

An 11-year-old female patient complained of "a blister in the mouth." Intraoral examination evidenced a bullous lesion in the left mouth floor measuring approximately 4 cm with exophytic growing, bluish coloration, defined limits, soft consistency, smooth surface, and 5 days of evolution. Clinical diagnosis was ranula. Micromarsupialization was performed after infiltrative anesthesia, and surgical knots were made far from the mucosa by the interposition of a hemostatic clamp, forming fistulas originating from the epithelization around the thread, allowing salivary flow. In the transoperative period, there was immediate drainage of part of the content retained within the lesion, reducing its initial volume. Surgical knots were removed after 7 days, and the patient was followed up for 3 months. The lesion regressed entirely without signals of recurrence, ruling out the need of excision. Therefore, micromarsupialization stands as a conservative therapy for the treatment of ranulas and mucoceles of significant size.

Ameloblastoma is a benign epithelial odontogenic neoplasm characterized by locally aggressive behavior. This lesion is often asymptomatic, and some cases are detected during routine radiographic examination. A 33-year-old female patient undergoing orthodontic treatment presented with a 1-month history of a painful swelling in the posterior mandible. Her medical history was noncontributory. Panoramic radiograph showed a well-defined, multilocular radiolucency on the left side of the mandible extending from tooth #37 to the mandibular ramus. A panoramic radiograph obtained for orthodontic documentation 7 years earlier revealed a well-defined, unilocular radiolucency associated with the crown of unerupted tooth #38. Under the diagnostic hypothesis of odontogenic keratocyst, an incisional biopsy was performed. Histopathologic findings confirmed the diagnosis of ameloblastoma. The patient was referred for surgical treatment and remains under close follow-up. This case emphasizes the importance of a detailed analysis of patient images, irrespective of the diagnostic goal, before any dental treatment planning.