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Increasing clinical evidence indicates that Th17 cells may promote or inhibit tumor progression, however the exact role of these cells in Oral Squamous Cell Carcinoma (OSCCs) pathogenesis and progression remains unclear. Tumor associated macrophages are highly plastic phenotype cells which can differentiate as M1 or M2. The mechanism and cellular phenotype of IL-17 expressing macrophages are unknown. 40 cases of lip and 28 of tongue SCCs were submitted to immunohistochemical analysis, and histologically graded. In tongue cases TNM was analyzed. The number of IL-17+ T cells was higher in lip SCC (p = 0.028). IL-17+ macrophages was greater in tongue SCC (p = 0.014). There were more IL-17+ macrophages in the high-grade malignancy oral tongue SCCs (p = 0.016), yet there was no significant difference in the numbers of RORγt+ lymphocytes by histopathological or TNM analysis. This study provides evidence concerning IL-17’s pleiotropic roles, being possibly dependent on its cellular sources in the tumor microenvironment.

Background Histopathologic grading has been routinely used as a complement for clinical staging in the prognostication of patients with oral tongue squamous cell carcinoma (OTSCC). However, this subject remains contentious because there is no universally accepted grading system. Objectives This study compared the prognostic significance of four histopathologic grading systems in 80 cases of oral tongue squamous cell carcinoma (OTSCC). Methods Clinical and follow-up information of the patients were obtained from medical records. Histopathologic malignancy grading of the tumor invasive front, Histologic risk assessment (HRA), World Health Organization (WHO) grading system, and Budding and Depth of invasion (BD) model were evaluated in the surgical specimens. Results The HRA, histopathologic malignancy grading and WHO systems did not predict survival. Patients with larger tumor size [Hazard ratio (HR): 2.38; 95% confidence interval (CI): 1.07-5.27; P = 0.026] and patients with BD model high-grade tumors (HR: 2.99; 95% CI: 1.03-8.68; P = 0.034) were significantly associated with a poor 5-year overall survival rate. In the multivariate analysis, tumor size was identified as the only significant independent prognostic factor (HR: 2.23; 95% CI: 1.00-4.99; P = 0.050). None of the grading systems studied was associated with 5-year disease-free survival rates. Conclusions BD model was the only histopathologic grading system associated with the outcome of patients with OTSCC, indicating its potential value as an effective tool for the prognostication of OTSCC.

Cripto-1 also known as teratoma-derived growth factor 1 (TDGF-1) belongs to the EGF-CFC family of growth factor-like molecules. Cripto-1 is involved with embryonic development and not expressed in adult tissue, but some tumours are accompanied by reactivation. The aim of this study was to evaluate the immunohistochemical expression of Cripto-1 in most common odontogenic cysts and tumours. Thirty ameloblastomas, 30 keratocysts, 30 dentigerous cysts and two ameloblastic carcinomas were evaluated using the polymeric immunoperoxidase technique. Immunohistochemical expressions were analysed by the IRS (immunoreactive score). Statistical analyses were performed by the Kruskal–Wallis and Mann–Whitney tests (p ≤ 0.05). Age ranged from 9 to 75 years old, with a prevalence of females (n = 49/53.3%). The mandible was the most affected anatomical site (n = 69/75.0%). Cripto-1 immunoexpression was observed in all ameloblastoma, keratocyst and ameloblastic carcinoma cases, although nine dentigerous cyst cases (30%) were negative. Expression scores were higher in ameloblastoma, keratocyst and ameloblastic carcinoma cases (median ranging from 8 to 11) when compared with dentigerous cyst cases (median of 2), with a statistically significant difference (p

A 16-days-old female patient exhibiting an exophytic nodular lesion located at anterior maxilla on the alveolar ridge since birth. The clinical hypothesis of congenital granular cell epulis (CGCE) was established, and the patient underwent excisional biopsy. Microscopically, a sheet-like proliferation of eosinophilic cells with granular cytoplasm was observed in a stroma of vascularized fibrous connective tissue. The immunohistochemical analysis for S100 evidenced the absence of immunostaining. The CGCE hypothesis was confirmed and, after six months, the patient showed no signs of recurrence of the lesion.

Introduction and objective Oral benign neoplasms (OBNs) exhibit some features that can guide the professionals to the correct diagnosis and best treatment. Through retrospective studies, medical records can be reviewed to better describe a given population and, furthermore, help clinicians in routine practice. In this context, the objective of this paper was to analyze the cases of OBNs of an oral pathology referral department, from 2003 to 2017, in order to better understand their epidemiological and clinicopathological characteristics. Methods A total of 8355 histopathological reports were analyzed. Lesions diagnosed as OBNs were selected and the following variables were recorded: gender, age, histological type of the lesion, anatomical location, rate and pattern of growth, type of base, color, symptomatology and diagnostic hypotheses on clinical examination. Results OBNs represented 9.4% of all lesions diagnosed. The most frequent histopathological types were fibroma (39.9%), papilloma (22%), fibroblastoma (13.1%), lipoma (10.2%) and hemangioma (6.1%). Overall, most cases affected females (n = 518; 65.6%) and in the fifth decade of life (n = 148; 18.7%). The oral mucosa was the most common site (n = 265; 33.5%). The most common features of each OBN were also highlighted. Conclusion The most common OBNs were fibroma, papilloma, fibroblastoma, lipoma and hemangioma. Overall, the OBN presented common clinical features; however, in particular cases, there are some characteristics that can lead the professionals to the correct diagnosis. Nevertheless, in general, histopathological analysis must be performed to confirm diagnosis. Intraosseous tumors and large lesions may require imaging tests to help diagnosis.

Peripheral odontoma is a very rare odontogenic hamartoma arising in soft tissues. Here, we report a case of peripheral odontoma in a pediatric patient and review the cases published in the literature. An 11-year-old male patient presented a nodular lesion in the anterior region of the palate for over 1 year. Under the clinical hypothesis of fibroma, an excisional biopsy was performed. Histopathological examination revealed the presence of tooth-like structures, formed by enamel, and dentin matrix, occasionally associated with the dental papilla and surrounding pulp tissue, thus, the histopathological diagnosis of peripheral odontoma was established. The patient has been undergoing follow-up for 6 months without any signs of lesion recurrence. Peripheral odontomas are uncommon lesions that usually affect young patients and display a preference for the maxilla and limited growth potential. The recognition of the clinical and histopathological features of the peripheral odontoma is indispensable for the establishment of its diagnosis.

Juvenile ossifying fibroma (JOF) is a rare fibro-osseous neoplasm that develops among the craniofacial bones at an early age. Their aggressiveness added to their high tendency to recur, provoke real diagnostic and therapeutic challenges. We present an agressive case of a nineteen-year-old girl showing facial asymmetry with a large facial mass. The lesion was surgically excised with a satisfactory esthetic result, besides maintenance of the physiological functions. After two years there is no evidence of recurrence of the lesion. Although JOF is a benign lesion, it typically presents aggressive behavior. The high recurrence rates justifies long-term clinical and radiological surveillance.

Laugier-Hunziker syndrome (LHS) is a rare mucocutaneous disorder, of unknown etiology, characterized by multiple hyperpigmented macules, dispersed mostly on the oral mucosa, occasionally associated with longitudinal ridging of the nails. The diagnosis requires exclusion of other conditions, such as Addison's disease and Peutz-Jeghers syndrome. We report a case of a 34-year-old male patient, presenting with hyperpigmented macules on the lips, buccal mucosa and palate, as well as mild dark striations on toenails. After careful clinical and laboratorial investigations, the diagnosis of LHS was established. Given the lack of aesthetic complaints and symptoms, no treatment was necessary.

O granuloma piogênico é uma lesão benigna relativamente comum que pode acometer pacientes de todas as idades, sendo mais prevalente em adultos jovens e com predileção pelo sexo feminino, principalmente, no período gestacional. Sua etiologia não é totalmente compreendida, mas parece ter natureza reacional. Normalmente, apresenta-se como um nódulo de crescimento exofítico, coloração, tipicamente, avermelhada, superfície ulcerada, facilmente sangrante. A lesão é tratada convencionalmente através de remoção cirúrgica, sendo essencial a eliminação dos fatores irritativos locais para redução da ocorrência de recidivas. O presente trabalho tem como objetivo relatar um caso de Granuloma piogênico diagnosticado em uma paciente do sexo feminino, 18 anos de idade, que apresentou lesão localizada em papila interdental, entre dentes 12 e 13, com evolução assintomática de, aproximadamente, 6 meses. A lesão foi tratada cirurgicamente e o material removido foi encaminhado ao laboratório de Anatomia patológica para confirmação do diagnóstico. Após 30 dias de acompanhamento pós-operatório, observou-se satisfatório reparo tecidual e a paciente encontra-se há 1 ano sem sinais de recidiva da lesão.

Fenômenos de extravasamento de muco (mucocele) são lesões benignas encontradas frequentemente na cavidade oral. Originam-se a partir do rompimento do ducto excretor das glândulas salivares com consequente extravasamento de mucina para os tecidos adjacentes. Geralmente, ocorrem em crianças e adultos jovens sem haver predileção em relação ao sexo e etnia dos pacientes. Apresentam-se como lesões bolhosas com tamanho variável, sendo o lábio inferior o sítio mais acometido. Sua coloração pode variar da cor normal da mucosa, no caso de lesões profundas, até o azulado, em lesões superficiais. Esse trabalho tem o objetivo de relatar o caso de uma paciente do sexo feminino, 12 anos, apresentando lesão bolhosa localizada no lado esquerdo do lábio inferior que surgiu após trauma na área e que diminuía e aumentava de tamanho há aproximadamente 4 meses. A lesão foi submetida à biópsia excisional e os espécimes obtidos foram encaminhados para análise microscópica, sendo confirmado o diagnóstico de fenômeno de extravasamento de muco. A paciente evoluiu satisfatoriamente no pós-operatório e encontra-se há 2 anos sem sinais de recidiva da lesão. Destaca-se a necessidade do conhecimento dos achados clínicos e realização de anamnese criteriosa pelo Cirurgião-Dentista, o que proporciona a correta conduta terapêutica da referida lesão por esses profissionais.

O carcinoma epidermoide oral (CEO) é o sexto tipo de câncer mais comum em todo o mundo, acometendo, principalmente, pacientes do sexo masculino, acima dos 45 anos, tabagistas e etilistas crônicos. Entretanto, sua prevalência entre indivíduos mais jovens e em mulheres tem aumentado gradativamente ao longo dos últimos anos. Esta neoplasia apresenta comportamento biológico agressivo, com altas taxas de recidiva e potencial metastático, principalmente, quando diagnosticado tardiamente. O esquema terapêutico é escolhido baseado no estadiamento clínico de cada caso. Este trabalho tem o objetivo de relatar um caso de CEO diagnosticado pela Equipe de Saúde Bucal de uma Unidade de Saúde da Família (USF) em um paciente jovem, não exposto aos fatores de risco mais fortemente associados à doença.

Myoepithelioma is a benign salivary gland neoplasm, locally invasive and uncommon in children. The aim of this study is to present and discuss the clinical, morphological and immunohistochemical findings of this tumor in a pediatric patient. This is a case report of a 12-year-old female patient showed a nodular lesion in the palate with osseous resorption with one year of evolution. After incisional biopsy, the histopathological examination revealed encapsulated lesion with proliferation of myoepithelial cells, including plasmacytoid, fusiform and clear cells, arranged in sheets, nests and cords. Immunohistochemical analysis revealed immunostaining for AE1/AE3, p63, cytokeratin-7, calponin, SMA and S-100. Based on these findings, diagnosis of myoepithelioma was confirmed. The lesion was completely removed through enucleation, in follow-up 2 years; there was no recurrence of the tumor. Myoepithelioma of salivary glands although rare in children may be invasive, however it is less aggressive than other tumors, a conservative treatment avoiding facial mutilation in pediatric patients is sufficient in these cases.

O objetivo do presente estudo foi relatar um caso de lipoma diagnosticado em um paciente do sexo masculino, 56 anos de idade, melanoderma e que apresentou lesão nodular. Este processo patológico apresentava-se assintomático, bem delimitado, de consistência amolecida, recoberto por mucosa de superfície íntegra, com coloração amarelada e média, aproximadamente, 2,5 cm. Sua evolução era de aproximadamente 4 anos e estava localizado em fundo de vestíbulo inferior entre os dentes 32 e 34. Diante dos aspectos clínicos, levantou-se a hipótese diagnóstica de lipoma. Assim, foi realizada a biópsia excisional e, em junção ao exame histopatológico do espécime removido, pôde-se confirmar o diagnóstico clínico da lesão. O paciente encontra-se há 7 meses sem sinais de recidiva da mesma. Vale destacar a necessidade da realização de anamnese criteriosa, além do conhecimento acerca dos achados clínicos pelo Cirurgião-Dentista, o que capacita e, também, proporciona uma correta conduta terapêutica da referida lesão por estes profissionais.

Objetivo: Identificar as intercorrências vasculares mais prevalentes pela injeção de ácido hialurônico em harmonização orofacial e descrever as estratégias de intervenção para tratamento dessas complicações. Revisão bibliográfica: A embolização e compressão vascular são as formas mais graves de intercorrência na harmonização orofacial ocasionadas por grandes quantidades de material injetado, desenvolvendo-se quadros de isquemia, necrose e até mesmo cegueira. A aplicação hialuronidase ainda continua off label para degradar ácido hialurônico nos casos de oclusão/compressão vascular, no entanto, esta enzima é até o momento a única opção eficiente para reverter essas complicações, onde seu efeito é incontestável nas melhores evidências disponíveis. Apesar dos preenchedores de ácido hialurônico ser bem tolerados, a compreensão adequada dos critérios clínicos e protocolos de tratamento, domínio e competência técnica para correção das intercorrências são elementos fundamentais para segurança do ácido hialurônico nas harmonizações orofaciais. Considerações finais: O conhecimento da anatomia, o planejamento adequado do tratamento, bem como o diagnóstico precoce e tratamento correto das complicações vasculares (compressão e embolização arterial, necrose, cegueira) faz com que procedimentos em harmonização facial tenham resultados previsíveis e eficientes.

Oral pyogenic granuloma (PG) is a frequent reactive lesion. Angiogenesis and inflammation are involved in its development, however, its etiopathogenesis is still not fully understood. Objective: The immunoexpression of CD34 and COX2, markers used in the study of angiogenesis and inflammation, respectively, was evaluated. Study Design: Forty-nine PG cases were selected and divided into 25 cases of lobular capillary hemangioma (LCH) and 24 cases of non-LCH. For the analysis of CD34, 5 hot spot areas were chosen, from which 2 fields were selected, in which the positive cells were counted and a mean was taken from these values. The evaluation of COX immunoexpression was by means of a semi-quantitative analysis in 5 selected fields. For all evaluations, significant values were considered with P

Objective: To evaluate the immunohistochemical expression of CRIPTO-1 in odontogenic cysts and tumors. Study Design: Thirty ameloblastomas, 30 keratocysts, 30 dentigerous cysts, and 2 ameloblastic carcinomas were evaluated using the biotin-free immunoperoxidase technique. The immunohistochemical expression was analyzed from the immunoreactive score (IRS). Kruskal Wallis and Mann-Whitney U tests were performed for statistical analysis (P ≤ .05). Results: Ages ranged from 9 to 75 years, with female gender being the most prevalent (n = 49; 53.3%). The mandible was the most affected anatomic site (n = 69; 75.0%). Immunoexpression of CRIPTO-1 was observed in all cases of ameloblastoma, keratocyst, and ameloblastic carcinoma; however, 9 cases (30%) of dentigerous cysts were negative. Expression scores were higher in cases of ameloblastomas, keratocysts, and ameloblastic carcinomas (median, 8-11) compared with cases of dentigerous cysts (median, 2) being statistically significant (P

Cripto-1 is a member of the epidermal growth factor—Cripto-1/FRL-1/Cryptic family. Besides being critical for early embryonic development, Cripto-1 is also associated with the development and behavior of several cancers. Objective: We analyzed the immunoexpression of Cripto-1 in normal salivary glands (NSGs), pleomorphic adenomas (PAs), and carcinoma ex pleomorphic adenomas (CaExPAs) of salivary glands. A total of 12 NSGs, 16 PAs and 12 CaExPAs underwent immunohistochemical study by the polymeric biotin-free technique. Immunopositive cells were evaluated semiquantitatively (scores 0–3). For statistical analysis, Mann–Whitney and Kruskal–Wallis tests were performed and a significance level of p ≤ 0.05 was established. Most CaExPAs (n = 10) were strong positive (score 3) for Cripto-1, and only three cases of PAs and two specimens of NSGs exhibited some expression (score 1), being statistically significant these findings (p

Central mucoepidermoid carcinoma (CMC) of the jaw bones is a rare malignant salivary gland tumor of unknown pathogenesis, comprising about 4% of all mucoepidermoid carcinomas (MECs). Most cases are histologically classified as a low-grade tumor and radiographically appear as a well-defined unilocular or multilocular radiolucent lesion. Block resection or wide local excisions are the treatment of choice and patients usually show a good overall prognosis although a long-term follow-up is necessary. This report describes a case of a 28-year-old male with MEC in the posterior region of the mandible and discusses its clinical, radiographic and histopathological findings. Although rare, CMC may be considered a differential diagnosis in cases of proliferative and osteolytic lesions in the oral cavity even when its clinical and/or radiographic findings do not suggest malignancy.

Peripheral odontoma is an odontogenic hamartoma considered extremely uncommon whose development results from the rests of odontogenic epithelium that resides in the soft tissues of the maxillomandibular complex. We report here a case of an 11-year-old female patient showing an asymptomatic nodular exophytic lesion on the anterior region of the palate with normochromic coloration, hardened consistency, and 1 year of duration. From the observed clinical features and under the hypothesis of fibroma, an excisional biopsy was performed. Anatomopathologic analysis revealed the presence of teeth-like structures formed by enamel and dentin matrix sometimes associated with the dental papilla or surrounding pulp tissue; thus, the diagnosis of compound odontoma was established. The patient has been under follow-up for 6 months without signs of recurrence.

Congenital epulis, also called congenital granular cell lesion, is an uncommon benign soft tissue lesion of unknown etiology that affects the gums of fetuses and neonates. This report describes the case of a 16-day-old female neonate whose lesion was detected at birth. During the intraoral examination, a pink to red staining nodular exophytic lesion was observed with smooth surface and firm consistency located in the anterior region of the maxillary alveolar ridge. The lesion was submitted to excisional biopsy, and the histopathologic examination revealed the presence of large, rounded cells with abundant granular eosinophilic cytoplasm and basophilic nuclei presenting shapes ranging from round to oval in a richly vascularized fibrous connective tissue stroma. Follow-up was performed after 6 months, and the patient's mucosa had an aspect of normality.

Nasopalatine duct cyst (NDC) is a nonodontogenic developmental cyst originating from the epithelial rests of the nasopalatine duct. We report the case of a 61-years-old male patient showing a swelling of softened consistency sensitive to palpation with texture and normal coloration in the anterior region of the maxilla close to the midline. The sensibility test revealed vitality of the adjacent teeth. Radiographically, we observed a well-circumscribed unilocular radiolucent defect. An excisional biopsy was performed, and the surgical specimen was sent for histopathologic analysis, which revealed the presence of a cystic lesion lined by pseudostratified columnar epithelium with few cell layers associated with a cyst wall of dense fibrous connective tissue. Thus, the diagnosis of nasopalatine duct cyst was established. After 2 years, the postoperative control did not reveal recurrence of the lesion.

Introdução: O carcinoma de células acinares é uma neoplasia epitelial maligna rara de glândulas salivares que afeta predominantemente a glândula parótida na população feminina. Ocorrências menos comuns desta neoplasia são relatadas no palato, seio maxilar, lábios e mucosa jugal. A recorrência desses tumores após cirurgia é de aproximadamente 35% e está relacionada a tumores diagnosticados tardiamente e com presença de metástase no momento do diagnóstico. Objetivo: Relatar um caso raro de um tumor em glândula salivar menor e comparar os achados clínicos com outros casos relatados na literatura. Relato de Caso: Paciente do sexo feminino, 35 anos, apresentou um nódulo doloroso de aproximadamente 2cm em mucosa jugal que foi diagnosticado inicialmente como um schwanoma devido aos seus achados clínicos e radiológicos. Após biópsia incisional, o exame histopatológico e imunoistoquímico revelou um carcinoma de células acinares. Uma Tomografia por emissão de pósitrons não revelou presença metástases. Conclusão: Nódulos submucosos orais podem representar neoplasias malignas e mesmo diante de uma hipótese diagnóstica de tumor benigno, recomenda-se uma biopsia incisional imediata para obtenção de um diagnóstico precoce e conduta terapêutica adequada nesses casos.