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Objective Analyze the epidemiological profile and the specific survival of patients diagnosed with tongue squamous cell carcinoma at the National Cancer Institute (INCA). Materials and methods Hospital Cancer Registry System Data and Mortality Information from 2007 to 2009 were retrieved in a retrospective cohort study of patients diagnosed with tongue squamous cell carcinoma. Specific survival was estimated using the Kaplan-Meier method. The association between independent variables and the risk of death was explored in a Cox proportional hazards regression model. Results A total of 346 patients were eligible, mostly male (77.5%), smokers (87.6%), with alcohol consumption (80.9%), with low education (65.6%), advanced staging at the time of diagnosis (71.1%) and presenting a high mortality rate (72.5%). In total, 44.5% of patients underwent a surgical approach alone or associated with another treatment modality, of which 85.1% of patients underwent neck dissection and 90.1% had free surgical margins. Specific survival was 40.6% in two years and 31.2% in five years. Conclusion The 5-year specific survival was considered worse in individuals over 60 years, and who did not undergo surgical treatment or had surgery associated with another treatment, compared to patients undergoing isolated surgery.

Thermal burns of the oral cavity usually arise from ingestion of hot foods or beverages. A 38-year-old female patient presented with two painful ulcerative erythematous patches of the palate. The patient was consulted on the same day lesions appeared. Medical history was unremarkable. Clinically significant self-inflicted injuries may result in wide ulcers in the mouth and usually do not take less than 2 weeks to heal, whereas our patient, treated with low-level laser therapy, had a complete response in day 4, after 2 days of treatment. The fact that multiple lesions were present signaled against the World Health Organization exclusion diagnosis of erythroplakia for red patches. A traumatic ulcer, regardless of its cause of origin, usually heals within 2 weeks, after the source of injury is resolved. A thermal burn in the oral cavity usually takes longer than that to heal, but whenever this time frame is not respected, the suspicion of a potentially malignant disorder should always arise, and a biopsy should be performed. The present case showed two painful thermal burns with great results in terms of speeding up the relieve of symptoms and healing time with soft laser as opposed to the traditional treatment with oral topical corticosteroid.

Objective The aim of this systematic review was to describe the epidemiology, diagnostic criteria, differential diagnosis, treatment, prognostic factors, and treatment outcomes of secretory carcinoma. Study Design A comprehensive search of Lilacs, PubMed, Science Direct, and Web of Science databases was conducted to identify all case reports, letter to the editor, and histopathologic reclassifications regarding salivary gland secretory carcinoma published in English, Spanish, French, and Portuguese. Results The final analysis included 119 studies, which totaled 642 secretory carcinoma diagnoses, with 239 case reports and 403 diagnostic reclassifications, mostly in the United States. The age range was 5 to 87 years, and cases were predominantly in males (58.7%) and mostly affecting the parotid glands (73.7%). The disease usually presents as a slow-growing, painless mass. The main differential diagnosis is acinic cell carcinoma, and the tumor is usually treated with surgery. The prognosis is considered favorable, although there have been reports of local recurrences, distant metastases, and deaths. Conclusions It is important that clinicians become aware of this salivary gland neoplasm and report clinical data, clinical course, management and long-term follow-up. There is an urgent need to conduct more clinical trials, especially on tropomyosin receptor kinase (TRK) inhibitors and other potential target therapy modalities.

Mucosal melanomas are primary malignant neoplasias originated from melanocytes within mucous membranes in any part of mucosal surface lining, more commonly, in the nasal cavity and accessory sinuses, oral cavity, lips, pharynx, vulvar, vaginal, cervix and anorectal mucosa. Epidemiology data regarding mucosal melanomas in Brazil is scarce, hence the motivation to conduct this research paper. The χ2 test was used to compare categorical variables. Forward stepwise logistic regression method was used in the multivariate analysis to identify independent predictors of early death. A total of 801 patients were included in the analysis. Surgical resection is frequently the first approach to primary tumours (65.3%), even though the utility of lymph node surgery and radiation therapy is not well established. Advanced stage was observed in more than two thirds of patients. Early death was observed in 28.3%. MM cases with regional or distant metastases as well as those located in unusual locations had almost 4 times more risk for early death. Besides that, MM located in lips, oral cavity and pharynx and those receiving chemotherapy had 2 times more risk of early death.

Objectives This study aim was to review cases of acinic cell carcinoma (the main differential diagnosis of secretory carcinoma) that were diagnosed and treated at the National Cancer Institute of Brazil (INCA) between 1996 and 2016. The primary objective was to identify underdiagnosed cases of secretory carcinoma via a clinical, immunopathological and molecular reassessment. Materials and methods This is a cross sectional study, with retrospective data collection from medical records and histological specimen review, with staining for periodic acid-Schiff (PAS) and PAS with diastase, immunohistochemistry for S-100, mammaglobin, and DOG-1, and droplet digital RT-PCR for ETV6-NTRK3. The Research Ethics Committee approved this study, and the patients allowed their participation through informed consent. Results Eighty-three cases of acinic cell carcinoma were diagnosed and treated in the specified period at INCA, of which, seven had their diagnosis changed to secretory carcinoma. Conclusion The present study adds seven cases of secretory carcinoma to the literature, contributing to a better understanding of the epidemiological, histological, immunohistochemical and molecular characteristics of this recently described tumor. Also, the use of a comprehensive diagnostic approach, including immunohistochemical and molecular methods, along with classical morphological studies, allowed the reclassification of acinic cell carcinoma to secretory carcinoma.

Paracoccidioidomycosis is the most prevalent systemic mycosis in Latin America. It is a fungal infection caused by the dimorphic fungus Paracoccidioides brasiliensis. This microorganism can penetrate the human body through direct contact and can cause intense lymphadenopathy, ulcerated lesions in the oral cavity and in the skin among other alterations. In this study, we report a case of paracoccidioidomycosis with unusual clinical presentation, as it manifested in the female sex and although it did not present any relevant complaints of respiratory focus, it presented a single ulcerated lesion in the buccal mucosa. A biopsy of the lesion and a mycological examination revealed Paracoccidioidesbrasiliensis infection.

Background The purpose of this current research was to clarify for the scientific community the trends of tongue cancer epidemiology in Brazil. Methods The data came from Population Based Cancer Registries, Hospital Cancer Registries, and Mortality Information System from 2000 to 2014. Results The age-adjusted incidence rate are increasing in both men and women for base of tongue cancer and for other and unspecified parts of the tongue in women, and decreasing in men for other and unspecified parts of the tongue. The majority of cases were diagnosed at clinical stages III and IV. The mortality rate remained relatively stable in both men and women in the period studied. Conclusion The increase in age-adjusted incidence rate for tongue cancers (except for other and unspecified parts of the tongue in men), with most patients over 50 years of age, with low education levels, and advanced disease reinforces the need for interventions that address access to health promotion resources and medical care in Brazil.

Oral leukoplakia is the most common lesion with malignant potential that may occur in the oral cavity. A white 60-year-old woman who never smoked or ingested alcoholic beverage presented with the diagnosis of a right infiltrating lobular carcinoma of the breast on May 18, 2009, and suspicion of an oral leukoplakia with 10 years of evolution. After an incisional biopsy, a well-differentiated superficially invasive squamous cell carcinoma was revealed approximately 1 week later. Subsequently, on August 17, 2010, a partial glossectomy was performed, and 6 months later a second incisional biopsy with a negative malignancy report was carried out. The patient is under control with no sequelae and no evidence of active disease. Early diagnosis of oral cancer through stomatologic screening of precursor epithelial lesions such as leukoplakia minimizes sequelae resulting from late diagnosis, improving not only quality of life but also patient survival rate.

Secretory carcinoma, described as mammary analog secretory carcinoma, is a recently described tumor of salivary glands that is defined by its histologic, immunophenotypic, and genetic similarities to the secretory breast carcinoma and is characterized by ETV6 translocation. The first description of mammary analog secretory carcinoma was reported by Skalova et al. in 2010. Retrospective studies showed that some tumors of salivary glands such as acinic cell carcinoma, low-grade salivary duct carcinoma, adenocarcinoma/cystadenocarcinoma not otherwise specified (NOS), and low-grade mucoepidermoid carcinoma were misdiagnosed. The purpose of this study is to review the literature showing the differential characteristics among these tumors and secretory carcinoma, highlighting how to perform the correct diagnosis, giving the patients the right treatment and improving their prognosis. Potential target therapy is also approached.

Background: Basosquamous carcinoma (BSC) is a rare non-melanoma skin cancer, considered to be a subtype of basal cell carcinoma (BCC). BSC often produces distant metastases with a higher risk of recurrence than that of BCC which is not commonly found in the lip. Case Report: A 57-year-old white female patient presented an ulcer on her lower lip that had an ongoing development for over six months. Physical examination, photo documentation, videoroscopy, scraped cytology, toluidine blue test, and biopsy of the ulcer were carried out. Results: Upon physical examination we observed an actinic cheilitis associated with the ulcer. Videoroscopy revealed the presence of fissures and erosion that had not been seen by oroscopy. Toluidine blue test was only positive for the region of the ulcer. Cytological analysis revealed rare nests compatible with carcinoma. Histopathology of the biopsy revealed a carcinoma with nests lined by basal cells associated with areas of squamous differentiation. The patient was then referred to surgery for the removal of the BCC. Analysis of the specimen showed free surgical margins and the immunohistochemical panel did not confirm the initial diagnosis of BCC, indicating a subtype of BSC. After surgery, the patient has been followed by periodic consultations. She is well and without further complications. Coments: BSC is considered to be an aggressive and rare tumor affecting mainly upper face and primarily affects men over 60 years of age. Since our patient is a woman presenting the lesion in the lower lip, this highlights the unusual and interesting presentation of this case report.

In order to understand how dentists should act whenapproaching patients that can present with cancer or precancerof the oral cavity, it is adamant that the professionalsfamiliarize themselves with the current trends of oral cancerand potentially malignant disorders. A study conducted onlythree years ago pinpointed that squamous cell carcinomaof the head and neck has a five-year survival rate of only 40to 60% in fifty years, despite advances in surgical techniques,radiotherapy, chemotherapy and combined therapies.1 Inorder to avoid these terrible statistics, a great effort must bemade by medical professionals, especially those thatconstantly examine the oral cavity, also known as: dentists. In order to understand how dentists should act when approaching patients that can present with cancer or precancer of the oral cavity, it is adamant that the professionals familiarize themselves with the current trends of oral cancer and potentially malignant disorders. A study conducted only three years ago pinpointed that squamous cell carcinoma of the head and neck has a five-year survival rate of only 40 to 60% in fifty years, despite advances in surgical techniques, radiotherapy, chemotherapy and combined therapies.1 In order to avoid these terrible statistics, a great effort must be made by medical professionals, especially those that constantly examine the oral cavity, also known as: dentists.

Background: Geographic stomatitis is an uncommon oral lesion that presents similar clinical, histopathological and genetic features as those of psoriasis. These findings suggest that this lesion may actually represent an oral manifestation of psoriasis. We report one case of geographic stomatitis and discuss a possible connection between this condition and psoriasis.