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Myoepithelioma is a rare benign tumor of the salivary glands, in which the vast majority of neoplastic cells are myoepithelial. A rare microscopic finding in salivary gland tumors, including myoepitheliomas, is the presence of psammoma bodies (PBs), whose etiology and role in the tumors are uncertain. The objective of this study is to describe the unusual histopathologic findings, such as psammomas, of a large myopephelioma on the palate and the prosthetic restorative treatment performed after resection of the tumor. A 52-year-old woman was referred for evaluation of a tumor-like lesion, of smooth surface and normal mucosal color, measuring approximately 5 cm, on the left side hard palate, which had been identified 4 years earlier. The diagnostic hypothesis was a pleomorphic adenoma (PA), and an incisional biopsy was performed. After histopathologic analysis, a PA was suggested, and surgical resection of the tumor was performed. The histopathologic findings were compatible with myoepithelioma showing numerous calcified basophilic structures compatible with PB. Sixteen months after resection of the tumor, a removable maxillary obturator prosthesis was made because of the communication into oral and nasal cavity due from the surgical procedure. The treatment of choice for myoepithelioma is surgical excision with a nonlesional area margin. In the present report, the authors achieve good postoperative results without recurrences. After installation of the prosthesis, the patient had an excellent adaptation and acceptance, thus restoring her function and psychologic condition.

The aim of this study was to evaluate the effects of red light emitting diode (LED) photobiomodulation therapy protocol on inflammatory cells during the healing of third-degree skin burns. Fifty Wistar rats were randomly divided into control group (CTRL) (n = 25) and red group (RED) (n = 25), with subgroups (n = 5) for each time of euthanasia (7, 14, 21, 28, and 32 days). Treatment animals were daily irradiated (630 nm ± 10 nm, 300 mW, 9 J/cm

This study evaluated the lymphatic density and HIF-1α immunoexpression in lower lip squamous cell carcinoma (LLSCC) and their correlation with clinicopathological (nodal metastasis, clinical stage, histological grade, recurrence and disease outcome) and survival parameters in 20 metastatic and 20 non-metastatic LLSCCs. Lymphatic density was established by counting microvessels (D2-40+) at the tumor core (intratumoral lymphatic density, ILD) and at the invasive front (peritumoral lymphatic density, PLD) and percentages of immunopositive cells for HIF-1α were established. No statistically significant differences in lymphatic densities in relation to clinicopathological parameters were observed (P > 0.05). All cases exhibited nuclear and cytoplasmic HIF-1α immunoexpression, with relatively high percentages of positivity, but this expression was not statistically different in relation to clinicopathological variables (P > 0.05). Positive correlations were observed between ILD and PLD (P = 0.002), and between nuclear HIF-1α immunoexpression at the tumor core and ILD (P = 0.001). The results suggest ILD and PLD are not directly related to the development of lymph node metastasis in LLSCC. The striking expression of HIF-1α suggests the involvement of this protein in the etiopathogenesis of LLSCCs, possibly stimulating lymphangiogenesis at the tumor core. However, this protein does not seem to exert a determining influence on the biological aggressiveness of these tumors.

The aim of this study was to evaluate the effects of blue light-emitting diode (LED) on the healing process of third-degree skin burns in rats through clinical and histological parameters. Forty male Wistar rats were divided into two groups: control (CTR) (n = 20) and blue LED (BLUE) (n = 20), with subgroups (n = 5) for each time of euthanasia (7, 14, 21, and 28 days). LED (470 nm, 1 W, 12.5 J/cm2 per point, 28 s) was applied at four points of the wound (total, 50 J/cm2). Feed intake was measured every other day. It was observed that there were no statistically significant differences in the Wound Retention Index (WRI) of the BLUE group in relation to CTR group (p > 0.05) at the evaluation times. After 14, 21, and 28 days, it was observed that the animals in the BLUE group consumed more feed than animals in the CTR group (p

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.

Squamous odontogenic tumor-like proliferations (SOT-LPs) are an uncommon histopathological finding occurring in the fibrous capsule of odontogenic cysts, which share certain microscopic features with squamous odontogenic tumor (SOT). A 36-year-old woman presented with an 18-month history of a painless, slow-growing swelling in the maxilla. Her medical history was unremarkable. Computed tomography revealed a well-defined, unilocular hypodense lesion extending from nonvital tooth #21 to tooth #11, with expansion and rupture of vestibular cortical bone, measuring approximately 1.5 cm. Under the diagnostic hypothesis of radicular cyst, an excisional biopsy was performed. Histopathological analysis disclosed a cystic cavity lined by nonkeratinized stratified squamous epithelium exhibiting hyperplasia, exocytosis, and spongiosis. The fibrous capsule revealed conspicuous islands of well-differentiated squamous epithelium, some of them exhibiting foci of microcystic degeneration. The final diagnosis was radicular cyst with SOT-LPs. The patient remains under close follow-up.

The purpose of this study was to evaluate the immunoexpression of vascular endothelial growth factor C (VEGF-C) and VEGF receptor 3 (VEGFR-3) and their correlation with intratumoural lymphatic density (ILD) and peritumoural lymphatic density (PLD) in metastatic and non-metastatic lower lip squamous cell carcinoma (LLSCC). Twenty-five LLSCC with regional nodal metastasis and 25 LLSCC without metastasis were selected. The percentages of VEGF-C and VEGFR-3 staining in each tumour core and at the deep invasive front were assessed. PLD and ILD were determined using anti-podoplanin antibody. Immunohistochemical findings were correlated with nodal metastasis, clinical staging, local recurrence, clinical outcome, and histological grade. Cytoplasmic immunoexpression of VEGFR-3 in the tumour core was associated with metastasis (P=0.009), patient death (P=0.008), and histological grade (P0.005). PLD, ILD, and VEGF-C expression showed no significant associations with clinicopathological parameters (P0.05). PLD and ILD were not significantly correlated with the immunoexpression of VEGF-C or VEGFR-3 (P0.05). There was a significant positive correlation between PLD and ILD (P=0.004), and between cytoplasmic immunoreactivity of VEGF-C and VEGFR-3 (P=0.011). These results suggest an important role for VEGFR-3 in the progression of LLSCC, and highlight the possible influence of its expression on the prognosis of these tumours. ILD and PLD may not be associated with lymph node metastasis in LLSCC.

Objective: To analyze the frequency and clinical and demographic features of oral lymphoepithelial cyst (OLEC) from 5 Brazilian services of oral and maxillofacial pathology. Study Design: Ethical approval (80249117.0.0000.5149). A cross-sectional retrospective study was conducted in 5 oral pathology services. The biopsy records were reviewed from 1952-2018. Cases with a microscopic diagnosis of OLEC were retrieved. Hematoxylin-eosin slides were reviewed by a single pathologist to confirm the diagnosis. Lesions of major salivary glands were excluded. Frequency and clinical and demographic data were analyzed descriptively. Results: Seventy-seven OLECs were found, representing 0.05% of the lesions submitted to diagnosis in the centers (n = 146,150). OLEC was predominantly diagnosed in females (n = 54; 70.1%). The mean age was 46.51 years (range [SD], 13-84 [14.80]). Lesions arose mainly in the tongue, lateral border (n = 31; 40.3%). The lesions measured up to 1 cm in size (n = 47; 61.0%) and were asymptomatic (n = 50; 64.9%). Twenty-four cases (31.2%) were white in color. Conclusion: OLECs are very uncommon diagnoses in oral pathology services. Lesions usually affect women, are small and asymptomatic, and located in the lateral border of the tongue. Detailed microscopic and immunohistochemical features will be accessed in the next step of this study. Support: CAPES, FAPEMIG, CNPq.

Objective: To evaluate the immunoexpression of autophagy-related proteins (p62 and Atg7) in odontogenic keratocysts associated with Gorlin syndrome (SOKCs) and nonsyndromic odontogenic keratocysts (NSOKCs).Study design: The percentages of immunopositive cells (nuclear and cytoplasmic/membrane) for p62 and Atg7 in the epithelial component of 25 SOKCs and 25 NSOKCs were assessed. The results were analyzed statistically using the nonparametric Mann-Whitney U test and Spearman correlation test. Results: Expression of p62 and Atg7 was observed in all cases studied. Compared with NSOKCs, SOKCs exhibited higher nuclear expression of p62 (P

Objective: To analyze the determinant clinical and histologic aspects in the establishment of the diagnosis of the glandular odontogenic cyst (GOC).Study Design: A cross-sectional study was performed in 2 oral pathology services. All slides of GOCs were reviewed and clinical data were obtained from the patient records. The determination of the diagnosis followed predetermined microscopic parameters according to the World Health Organization. Statistical analysis was performed in order to identify the predictive parameters for the diagnosis of GOC. Results: From the 9 patient cases of GOCs, 55.5% were male, with a mean age of 50.6 years, and 66.6% were located in the mandible. All cases presented with intraepithelial microcysts or duct-like spaces, clear or vacuolated cells, variable thickness of the cyst lining, and papillary projections into the lumen. Multiple compartments, surface eosinophilic cuboidal cells, and epithelial spheres or plaque-like thickenings were observed in 8 (88%) cases. Apocrine snouting of hobnail cells were present in 6 (66%), mucous goblet cells in 3 (33.3%), and cilia in only 1 (11%). Conclusion: The association between the predictive clinical and histopathological aspects for the diagnosis of this rare lesion is fundamental, since GOC has the potential to mimic other potentially more aggressive lesions.

Objective: To evaluate DNA base excision repair (BER) in APE-1 and XRCC1; and nucleotide excision repair (NER) in XPF proteins in benign epithelial odontogenic lesions with different biological behaviors. Study design: Thirty solid ameloblastomas (AMEs), 30 isolated odontogenic keratocysts (NSOKCs), 29 syndromic odontogenic keratocysts (SKOCs), 30 dentigerous cysts (DCs; n = 30), and 20 dental follicles (DFs) were evaluated quantitatively for APE-1, XRCC1 and XPF through immunohistochemistry. Results: All the odontogenic lesions studied revealed a statistically significant expression of APE-1 (nuclear), XRCC1 (nuclear), and XPF (nuclear and cytoplasmic) compared with DFs (P

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.

Oral squamous cell carcinoma (OSCC) is a more common malignant neoplasm in the oral cavity, being rare as simultaneous primary tumors. Based on this, we aimed to report a rare case of simultaneous OSCC. A 76-year-old female patient presented in intraoral examination 2 lesions, one localized in palate and the other localized in alveolar ridge, with history of evolution of 4 months. Both lesions had a tumoral aspect and corrugated and whitish surface. For lesion in palate was observed area of ulcerations. Incisional biopsy was performed for both lesions, and histopathologic analysis revealed a proliferation of atypical squamous cells in nests and sheets exhibiting atypical mitosis, moderate hyperchromatic nuclei, and nuclear pleomorphism. Final diagnosis was simultaneous differentiated moderate OSCC. Treatment indicated was surgery and radiotherapy, and after 12 months of follow-up, no sign of recurrence was observed.

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.

Central odontogenic fibroma (COF) is a rare, benign mesenchymal odontogenic neoplasm that has a wide patient age range and a relatively similar distribution in the maxilla and mandible. A 60-year-old woman was referred for evaluation of a painless, slow-growing swelling in the mandible, extending from the left ramus to the distal root of tooth #36, covered by normal mucosa. Computed tomography showed an expansive, unilocular hypodense lesion with hyperdense foci, associated with unerupted tooth #38, measuring approximately 4.5 cm in diameter. Under the diagnostic hypothesis of calcifying epithelial odontogenic tumor, an incisional biopsy was performed. Histopathological analysis disclosed a moderately cellular, fibroblastic connective tissue intermixed with inactive-looking odontogenic epithelial islands and strands. The definitive diagnosis was COF. The treatment consisted of enucleation, curettage, and extraction of the associated tooth. No signs of recurrence were observed after 14 months of surgical excision. The patient remains under clinical and radiographic follow-up.

The aim of the present study was to describe a case report on the treatment of recurrent herpes using photodynamic therapy as a therapy of choice. A 21-year-old white man presented for evaluation of vesicles arranged in a skin region just below the transition zone between mucosa and skin of lower lip. The clinical diagnosis was of recurrent herpes and, for treatment, photodynamic therapy was applied, with application of 0.1% methylene blue as photosensitizer and a pre-irradiation time of 5 minutes. The low power device used was Therapy XT, with wavelength of 660 nm, power of 100 mW, in a spot area of 0.028 cm2, using the total energy of 4.0 J. It was possible to observe total repair after 10 days of treatment and the patient remained in follow-up for 8 months without recurrences.

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.

Squamous cell carcinoma (SCC) with a rhabdoid phenotype (SCCRP) is an extremely rare entity in the maxillofacial region. To date, only 2 oral SCCRP cases have been reported. The presence of this phenotype is associated with a worse prognosis than conventional SCC. A 44-year-old man was referred presenting painful facial asymmetry evidenced by increase of volume in the left maxilla with several months of evolution. Computerized tomography examination showed extensive osteolytic lesion on the left maxilla and maxillary sinus. The histopathologic analysis showed typical morphologic features of SCCRP constituted by polygonal and discohesive cells with large hyaline cytoplasmic inclusions and eccentric nuclei with single prominent nucleoli. Immunohistochemistry revealed positivity for CK AE1/AE3, epithelial membrane antigen (EMA), vimentin, CD138, INI-1, focally for α–smooth muscle actin, and CD68. Ki-67 was > 40%. Although rare, SCCRP should be considered in the differential diagnosis when assessing malignant neoplasms affecting the maxilla. FAPESP (2016/11419-0 and 2017/02502-4).

Objective To evaluate the immunoexpression of human leukocyte antigen-DR (HLA-DR) in actinic cheilitis (AC) and lower-lip squamous cell carcinomas (LLSCCs), and to correlate the findings with clinicopathologic parameters (tumor size and extent, regional lymph node metastasis, clinical stage, risk of malignant transformation for AC and histopathologic grade of malignancy for LLSCCs). Study Design The percentage of HLA-DR–positive cells in the epithelial component of 24 cases of AC and 48 LLSCCs (24 with regional nodal metastasis and 24 without metastasis) were assessed. The results were analyzed statistically using the nonparametric Mann-Whitney test. Results Only 5 (20.8%) cases of AC (2 low risk and 3 high risk) exhibited expression of HLA-DR, with a very low mean percentage of immunopositivity. Most LLSCCs (97.7%) presented with expression of HLA-DR, with a relatively high mean of immunopositivity. The percentage of HLA-DR–positive cells tended to be higher in tumors with regional metastasis, and tumors in advanced clinical stages (P > .05). There was a tendency for higher expression of HLA-DR in low-grade LLSCCs, and in highly or moderately keratinized tumors (P > .05). Conclusions The results suggest a potential role for HLA-DR in lip carcinogenesis, particularly in the progression of LLSCCs. The expression of this protein can be related to the degree of cell differentiation in these tumors.

The aim of this study was to evaluate the photobiomodulation of red and green lights in the repair process of third-degree skin burns in rats through clinicopathological and immunohistochemical parameters. Sixty male Wistar rats were divided into three groups: control (CTRL) (n = 20), red LED (RED) (n = 20), and green LED (GREEN) (n = 20), with subgroups (n = 5) for each time of euthanasia (7, 14, 21, and 28 days). Daily applications in RED (λ630 ± 10 nm, 300 mW) and GREEN groups (λ520 ± 30 nm, 180 mW) were performed at four points of the wound (total 36 J/cm2 in RED and 240 J/cm2 in GREEN). After euthanasia, the wound retraction index (WRI) was evaluated. In histological sections, the re-epithelialization degree, the angiogenic index (AI), and the amount of myofibroblasts in wounds were analyzed. At 14 and 21 days, the RED group induced higher re-epithelialization and WRI compared to CTRL (p > 0.05) and GREEN groups (p

Teratomas are tumors composed by tissues derived from the three germ cell layers, and they are relatively uncommon in head and neck. The term epignathus has been applied to teratomas from the oropharynx. This paper reports the case of a giant epignathus teratoma discovered at birth, which was successfully managed and followed up for 7 years. A newborn boy presented a polypoid tumor mass exteriorizing through the mouth over a length of 9 cm, with some surface areas resembling skin and others exhibiting hair. Computed tomography showed that the mass arose deep from the left hemiface. Alpha-fetoprotein (AFP) levels were high (316,000 ng/mL). Surgery was performed and microscopic analysis confirmed the diagnosis of mature teratoma. Because of residual tumor and high AFP levels, the patient was submitted to chemotherapy, resulting in complete regression of the lesion and normalization of AFP levels. Surgical repair of a cleft palate was performed at 5 years of age. At 7 years of age, the patient was in good general health and showed no clinical signs of recurrence. Although epignathus is a rare condition, it should be diagnosed in the fetus as early as possible. Prenatal care provides unquestionable benefits, providing the early diagnosis of anomalies that can jeopardize the life of the fetus and contributing to the indication of cases that require treatment before birth. Resumo Teratomas são tumores constituídos por tecidos derivados das três camadas de células germinativas e são relativamente incomuns em cabeça e pescoço. O termo epignathus tem sido utilizado para designar teratomas que se originam na orofaringe. Este artigo relata o caso de um teratoma epignathus gigante descoberto ao nascimento, o qual foi tratado com sucesso e proservado por 7 anos. Um menino recém-nascido apresentou uma massa tumoral polipoide que se exteriorizava através da boca por uma extensão de 9 cm, com regiões da superfície semelhantes à pele e outras exibindo pelos. Exame de tomografia computadorizada revelou que a massa se originava profundamente na hemiface esquerda. Os níveis de alfa-fetoproteína (AFP) se apresentavam elevados (316.000 ng/mL). Foi realizada cirurgia e a análise microscópica confirmou o diagnóstico de teratoma maduro. Por apresentar lesão residual e altos níveis de AFP, o paciente foi submetido à quimioterapia, resultando em regressão completa da lesão e normalização dos níveis de AFP. Correção cirúrgica de uma fenda palatina foi realizada aos 5 anos de idade. Aos 7 anos de idade, o paciente apresentava um bom estado de saúde geral, sem sinais clínicos de recorrência da lesão. Embora o epignathus seja uma condição rara, seu diagnóstico no feto deve ser realizado o mais precocemente possível. O cuidado pré-natal proporciona benefícios inquestionáveis, permitindo o diagnóstico precoce de anomalias que podem comprometer a vida do feto e contribuindo para a indicação de casos que requerem tratamento antes do nascimento.

Objective Actinic cheilitis (AC), a potentially malignant disorder, exhibits unpredictable progression to lip squamous cell carcinoma. Therefore, this study describes clinical and pathologic findings of cases of AC. Study Design Observational and cross-sectional study. Sample was composed of 60 cases of AC diagnosed in the period from 2011 to 2017 in an oral diagnosis referral center. Clinical data of patients (age, sex, and race) and lesions (anatomic site, size, symptomatology, and type of biopsy) were obtained from records. Morphologic analysis was graded according to the World Health Organization (WHO) (2017). Results Mean age of patients was 57.9 ± 12.9 years old; male were most affected (n = 45; 75%), with ratio of 3:1. White individuals were most affected (n = 30; 50.0%). Lower lip was the anatomic site more affected (n = 58; 96.7%). In relation to clinical aspect, AC showed predominance of white lesions (n = 30; 50.0%), aspect of plaque (n = 25; 41.7%), size ≤ 1 cm (n = 29; 48.3%) and asymptomatic (n = 37; 61.7%). Incisional biopsy was the most performed (n = 29; 48.3%). Histopathologically, most AC cases were classified as mild epithelial dysplasia (n = 26; 43.3%). Conclusions The results showed that clinical aspects of AC can reflect morphologic findings, so it is important to make a more accurate diagnosis.

A 53-year-old male patient presented with an approximately 8-year history of an asymptomatic "blood blister" on the lower lip. Extraoral examination revealed a soft, purplish, lobulated swelling on the left side of the lower lip skin. Intraoral examination showed a well-defined, purplish stain and papules on the left lower lip and alveolar mucosa, measuring approximately 1.5 × 1.0 cm. The diagnostic hypothesis was vascular lesion, which was later confirmed by a positive diascopy result. Under local anesthesia, the patient was submitted to 2 clinical sessions of photocoagulation with high-intensity diode laser (Thera Lase Surgery; 808∼830 nm ± 20 nm, 2.5 W, defocused 2 mm beam in continuous mode). The postoperative course was uneventful. After 6 months of follow-up, the patient reported only mild sensitivity in the region. Clinical examination revealed fibrosis compatible with the tissue repair process without aesthetic or functional impairment.

Objective Biological behavior of oral squamous cell carcinoma (OSCC) in young patients is controversial. Therefore, this study compared prognostic factors of OSCC between young and older patients, through a systemic review. Study Design Electronic search in the databases Pubmed/Scopus/Ovid/Proquest/Cochrane Library/Web of Science/Lilacs was performed until April 2018, without filters by language or year of publication. Only cohort studies were included and evaluated by Newcastle-Ottawa scale for risk of bias. Analysis of titles and abstracts was made by 2 calibrated researchers (kappa = 0.94). Results A total of 5370 articles were reviewed, and 10 of the most relevant articles that are suitable to the criteria were selected. All included studies had a low risk of bias. Independent of age group, male was more affected, and tongue was anatomic site more frequent. Main risk factors were smoking and alcoholism in both age groups. Most patients in both age groups were diagnosed in early clinical stages (I/II). Regarding to histologic grading, majority of OSCC was classified as moderately differentiated in both age groups. Lower survival was observed in older patients. Conclusions Among all prognostic factors evaluated, survival showed difference in age groups, suggesting, then, that OSCC in older patients could exhibit more aggressive biologic behavior.

Lower lip squamous cell carcinoma (LLSCC) represents frequent lip malignant neoplasms, and the majority is preceded by actinic cheilitis (AC), a potentially malignant disorder. In this context, we report 3 cases of AC and 1 of LLSCC, emphasizing the importance of thermography as an auxiliary tool in diagnosis. In AC and LLSCC, thermography showed, respectively, whitish areas with higher heat emission and reddish circular area of irregular thermal distribution. After acquisition of thermography images, incisional biopsies were performed to evaluate microscopic alterations according to the criteria described by the World Health Organization (2017). Of the AC cases, 1 was diagnosed as mild epithelial dysplasia and 2 were moderate epithelial dysplasia. LLSCC was confirmed on anatomopathologic examination. As a result, we observed that thermography is not able to distinguish the different degrees of epithelial dysplasia found in AC, but it is a new imaging method useful in distinguishing AC from LLSCC.

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.

Objective: To determine the distribution of odontogenic cysts diagnosed histologically over a period of 38 years in a Brazilian population according to age, gender and site affected and to compare these data with previously reported studies from other countries. Study design: A total of 1019 cases of odontogenic cysts diagnosed between 1970 and 2007 were studied. Clinical features obtained from the patient records and microscope slides were reviewed according to the 1992 World Health Organization classification. Results: The mean age was 31.0 years, and there was a predominance of females. The most frequent odontogenic cysts were radicular cysts (61.4%), followed by dentigerous cysts (20.1%) and odontogenic keratocysts (6.4%). Radicular cysts were more frequent in females (62.0%), and the maxillary teeth were the site most commonly involved (63.05%). The peak incidence of dentigerous cysts occurred in the second decade of life, with the posterior region of the mandible being the site most affected (46.3%), followed by the anterior region of the maxilla (27.8%). Odontogenic keratocysts showed a peak incidence between the third and fourth decades of life and predominance among females. The posterior region of the mandible was the site most frequently affected (65.6%). Conclusion: The present results showed a similar frequency of odontogenic cysts in this Brazilian population and other populations around the world, with inflammatory cysts being identified as the most frequent odontogenic cyst. Radicular cysts, dentigerous cysts, and odontogenic keratocysts are the most common cystic lesions, accounting for 87.9% of all odontogenic cysts.

Desmoplastic melanoma is a rare variant of malignant melanoma and one of the main causes of clinical and histological misdiagnosis in the realm of melanocytic neoplasms. Its relatively innocuous clinical appearance and the absence of pigmentation usually lead to a clinical misdiagnosis. The authors report a case of desmoplastic melanoma located in the lower lip of a 42-year-old man and review the literature regarding pathogenesis, clinicopathological features, differential diagnosis, and therapeutic management of desmoplastic melanomas.

Objective. The objective of this study was to analyze the expression of matrix metalloproteinases (MMPs) 1, 7, and 26 in odontogenic keratocysts (OKCs) associated with Gorlin syndrome (SOKCs) and nonsyndrome OKCs (NSOKCs). Study design. Twenty-one SOKCs and 20 NSOKCs were evaluated for epithelial expression of MMP-1, MMP-7, and MMP-26 and for mesenchymal expression of MMP-1 by immunohistochemistry. Results. Strong epithelial positivity to MMP-1 was observed in 76% of SOKCs and in 15% of NSOKCs (P .05). Strong mesenchymal immunoreactivity to MMP-1 was observed in 38% of SOKCs and in 20% of NSOKCs (P .05). Epithelial immunoreactivity to MMP-7 was strongly positive in 67% of SOKCs and in 40% of NSOKCs (P .05). For MMP-26, strong positivity was found in 62% of SOKCs, in contrast to 35% of NSOKCs (P .05). Conclusion. MMPs-1, 7 and 26 may play important roles in the biology of OKCs. Furthermore, the presence of these proteases at higher levels in SOKCs may help to explain increased OKC aggressiveness associated with nevoid basal cell carcinoma syndrome.