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To investigate the stimulated salivary flow (SSF) and unstimulated salivary flow (USF) in adults with acromegaly and to identify possible clinical factors associated with salivary flow. A case-control study was conducted with a group composed of adults diagnosed with acromegaly (n = 29, mean age = 50.2 years) and a control group (n = 29, mean age = 54.3 years). Variables for socio-demographic characterization, lifestyle habits, and diabetes diagnosis, body mass index (BMI), cervical circumference (CC) and abdominal circumference (AC) were collected. USF and SSF variables were analyzed as outcomes. Unpaired t-test, Pearson's correlation, and multivariate regression models were used for statistical analysis. Both groups were 44.8% male and 55.2% female. Diabetes was present in 55.2% of the acromegaly group and in 51.7% of the controls (P =.792). The acromegaly group had a higher USF than the control group (0.50 mL/min versus 0.22 mL/min). SSF showed a direct correlation with CC (r = 0.470, P =.010). Acromegaly was associated with higher USF (standardized coefficient = 0.780, P =.039), and age was inversely related to USF (standardized coefficient = −0.333, P =.013). The findings suggest that adults with acromegaly have an increased USF and that being older is associated with a decrease in USF. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate 2-dimensional (2D) and 3D morphometric parameters of C-shaped root canals on cone beam computed tomography (CBCT) and microcomputed tomography (microCT) images using nanocomputed tomography (nanoCT) as the reference standard. Sixty mandibular molars with C-shaped canals were individually scanned using nanoCT and microCT. Cone beam computed tomography acquisitions were then performed with 4 CBCT systems, using high and standard resolutions. The 2D parameters of roundness and major and minor diameters were obtained in the cross sections of the root canals at 1, 2, and 3 mm from the root apex. The 3D parameters of surface area, volume, and structure model index were measured considering the entire extension of the root canals. Absolute error (AE) in measurement was calculated against the nanoCT values. Data were statistically analyzed with the Shapiro-Wilk test and analysis of variance (α = 0.05). No significant differences in AE were discovered for the 2D parameters among microCT and the CBCT scans. The AE values for the 3D parameters of volume and surface area were significantly smaller in microCT compared to all CBCT units (P <.05). Significantly lower AE values for surface area were observed in high resolution compared to standard resolution for all CBCT units (P <.05). Structure model index did not differ significantly among microCT and all CBCT protocols. Cone beam computed tomography images showed accuracy for evaluating 2D parameters and over- and underestimation for 3D parameters. [ABSTRACT FROM AUTHOR]

To evaluate oral lymphomas' clinical manifestations and investigate whether clinical features are associated with lymphoma subtypes. Oral lymphomas with at least 1 representative clinical image were evaluated. They were classified according to their microscopic grade (high vs low), predominant cell size (small vs medium/large), and cellular lineage (B cell vs T cell). Clinical images were described according to tumor location, number, swelling, ulcer, necrosis, telangiectasia, predominant color, and lobulation. Lymphomas affecting the palate were compared with salivary gland tumors (SGTs) affecting this location. Data from 107 cases were included. High-grade subtypes (80.4%), with medium/large-sized cells (52.3%), and diagnosed as diffuse large B cell lymphomas (29%) predominated. High-grade lymphomas often presented as painful, ulcerative, and osteolytic diseases (P <.05). Tumors predominantly composed of medium/large-sized cells were associated with painful lesions, ulcerated, with necrosis and bone destruction (P <.05). When only palate tumors were considered, multiple and bilateral lesions, the presence of pain, ulceration, and necrosis were significantly more associated with a diagnosis of lymphoma than SGT (P <.001). High-grade oral lymphomas are more associated with destructive presentation than low-grade subtypes, and bilateral lesions in the palate are more associated with a lymphoma diagnosis than SGT. [ABSTRACT FROM AUTHOR]

to address the importance of the differential diagnosis between oral manifestations of Kawasaki Syndrome (KS) and Pediatric Multisystemic Inflammatory Syndrome - PMI-S), associated with COVID-19, in pediatric patients. a literature review was performed, searching the terms "differential diagnosis", "oral manifestations", "KS", "PMI-S" and "COVID-19" in Pubmed and Scholar Google databases, in the period between 2020-2023, according to inclusion criteria (pediatric patients, systematic reviews and cross-sectional studies) and exclusion criteria (case reports). 20 potentially relevant articles were selected for the analysis between 352 papers found in the literature, after removing duplicates and following the inclusion and exclusion criteria. KS and PMI-S were found to have clinical and laboratory similarities and some suspected cases of KS were subsequently confirmed as SIM-P. Oral manifestations of both diseases included erythematous mucosa, ulcers, dry, swollen, and cracked lips, and strawberry tongue. there are clinical and laboratory similarities between KS and PMI-S and both can be triggered by COVID-19. Since they manifest oral and oropharyngeal alterations, the dental surgeon has an important role in these diseases´ differential and early diagnosis. Thus, the health professional should be alert to the differences between these conditions, which determine different conduct. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the fractal dimension (FD) and lacunarity of the mandibular bone in patients who received radiation therapy for head and neck cancer, comparing those who developed osteoradionecrosis (ORN) to those who did not develop. Two groups of patients were selected: ORN+ (case group) and ORN- (control group). Exclusion criteria were radiation dose < 60 Gy, age < 40 and > 70 years, reirradiation, use of bisphosphonates or other bone-modifying drugs, and poor image quality of panoramic radiograph. Fractal analysis was performed in the radiographs acquired after the end of radiotherapy, using ImageJ software. Intralesional, perilesional, and contralateral side of the ORN region were evaluated. No significant difference was found in the mean values of FD and lacunarity between ORN+ and ORN- patients (p >0.05, paired T-test). The fractal dimension and lacunarity of the mandible did not differ between patients with and without osteoradionecrosis. Support: CNPq, PROEX-UFMG (PBEXT) [ABSTRACT FROM AUTHOR]

Adenoid cystic carcinoma (ACC) prognosis is mainly estimated based on general clinical and pathologic features and still lacks a validated biomarker to predict patient survival or response to therapy. The objective of this study was to assess the prognostic significance of NOTCH1 in patients diagnosed with ACC through a systematic review of published studies and meta-analysis. This study followed the PRISMA 2020 checklist and was registered in PROSPERO register. A comprehensive search was conducted across multiple databases without publication date restrictions in October 2023. Inclusion criteria comprised studies examining NOTCH1-related features at ACC diagnosis and their relationship with critical outcomes such as recurrence-free or disease-specific survival. Meta-analysis was performed on studies reporting hazard ratios (HRs) and sharing similar inclusion criteria and outcome measures. Initial exploration yielded 532 articles, of which 9 studies met the eligibility criteria after rigorous screening. These studies, spanning from 2017 to 2022, were predominantly conducted in the United States and China. Notably, NOTCH1 mutational status, Notch1 immunoexpression, and NICD1 immunoexpression exhibited significant associations with survival outcomes across all included studies. Methodological disparities hindered integration of results. Meta-analyses of HRs were conducted with 2 studies for each index factor, revealing a 2.31-fold increased risk of death for primary ACC cases with NOTCH1 mutations and a 2.6-fold increased risk for those exhibiting positive NICD1 expression. Furthermore, high N1 expression was linked to a 1.91-fold heightened risk of disease recurrence. This comprehensive review underscores the prognostic relevance of NOTCH1 in ACC, indicating its potential as a valuable risk stratification tool. [ABSTRACT FROM AUTHOR]

to identify if there is any relationship between vaccination against COVID-19 and the reactivation of the Varicella-Zoster Virus (VZV) in trigeminal nerve (TN), resulting in oral manifestations. a database search using Pubmed was conducted, between 2021-2023, using the terms "herpes zoster", "covid- 19" and "vaccine", and 28 articles were eligible for review. Inclusion criteria: VZV affecting the TN with or without oral manifestations. Exclusion criteria: patients with immunological commitment. No filters regarding the type of articles were applied. Case reports were filtered according to the pertinence. most of the clinical VHZ manifestations related to the TN presented as ocular or meningeal lesions. Only eight cases of VZV reactivation in TN resulted in oral lesions: six cases in the palate, one in the mandible, and one in the perioral region. All oral reactions occurred after the use of the BNT162b2 vaccines (Pfizer-BioNTech®). However, recent reviews show that only myocarditis is consistently associated with BNT162b2 vaccines. due to the scarcity of cases, oral VZV reactivation in the oral cavity after BNT162b2 vaccination is inconclusive. The immunosenescence of the reported patients, together with the immunomodulation caused by vaccines, could explain the awakening of VZV latency in reported cases. [ABSTRACT FROM AUTHOR]

To analyze the clinical and histopathological features, treatment, and outcome of sialoblastoma. Case reports and case series of sialoblastoma with histopathological confirmation were searched in PubMed, Embase, Scopus, Web of Science and in the gray literature. A total of 52 studies (62 patients) were identified. There was no gender predilection, the patients were mainly affected at birth (N=38; 61.3%), and the parotid was the most common site (N=28; 45.2%). In the log-rank test, there was a significant increase in disease-associated survival in patients younger than 1 year of age (82.8%; [CI: 317-493.7]; p=0.003), individuals with tumors in major salivary glands (79.4%; [CI: 280.1-467.3]; p=.005), patients without metastases (77.8%; [CI: 95.9 - 151.2]; p=.011), encapsulated lesions (85.7%; [CI: 285.3 - 541.6]; p=0.0001), congenital tumors (83.3%; [CI: 283.0 - 488.8]; p= 0.0001) and lesions without perineural invasion (89.5%; [CI: 117.2 - 161.1]; p= 0.035). Kaplan-Meier curves estimated overall survival and disease-free survival at 5 years of 95.5% and 68.1%, respectively. In the multivariate Cox regression model, only the presence of metastasis was identified as an independent prognostic factor (hazard ratio [HR]=9.81; p=0.010). Although sialoblastoma presents a good prognosis, the tumor has a high recurrence rate. [ABSTRACT FROM AUTHOR]

To analyze the immunohistochemical expression of the ING3 protein in 45 cases of actinic cheilitis (AC) and 48 cases of lower lip squamous cell carcinoma (LLSCC). Additionally, it was investigated associations with clinical and pathological parameters of the studied lesions. The protein expression was analyzed and compared between the two groups. Exact Fisher's, Kruskal-Wallis', and Mann-Whitney's tests, as well as Spearman's correlation test, were performed. AC cases showed significant differences in ING3 expression (nuclear-cytoplasmic and cytoplasmic-only) when graded according to the binary system proposed by Kujan et al. (2006) (p = 0.028; p = 0.016, respectively). In LLSCCs, no significant differences were observed between ING3 cellular expressions and clinical and pathological parameters (p > 0.05). Nuclear-cytoplasmic expression was significantly less observed in LLSCCs when compared to AC cases (p = 0.001), and cytoplasmic-only expression was significantly higher in LLSCCs (p = 0.001). These results suggest a notable decrease in the nuclear expression of ING3 in malignant transformation, indicating the defective tumor suppression role of this protein in ACs and LLSCCs. Nevertheless, it is believed that, in lip carcinogenesis, ING3 is better characterized as a predictor biomarker of malignant transformation than a biological tumor behavior one. [ABSTRACT FROM AUTHOR]

To evaluate the prognosis of patients diagnosed with oral cancer by specialists in oral medicine before referral to a high-complex oncology center (HCOC). A retrospective cohort study was performed with 282 participants diagnosed with oral cancer between 1998 and 2016 at an HCOC. Group I consisted of participants referred by oral medicine specialists (n = 129), while Group II consisted of participants referred by non-oral medicine specialists (n = 153). Sociodemographic, clinical, and treatment-related variables were tested as predictors of survival. Data analysis was performed using the Chi-square test, Mann-Whitney test, multiple logistic regression, Kaplan-Meier curves, and Cox regression. Stage T was lower in group I, as well as the occurrence of locoregional and distant metastases. Exclusive surgical treatment was more indicated in group I, while in group II it was surgery followed by adjuvant treatment. Indication of surgical treatment was associated with lower TNM. Higher TNM stages were associated with worse overall survival. Specialized care did not influence the chances of surgery or overall survival. Patients referred by specialists in oral medicine had lower clinical staging and higher chances of surgical treatment, although no differences in survival were observed between groups. [ABSTRACT FROM AUTHOR]

To associate clinicopathological findings with ultrasonographic (US) features of major salivary glands in patients with primary Sjogren´s syndrome (pSS) and sicca non-Sjogren (snS). A pilot study was conducted on eight patients with pSS and ten with snS. US evaluation was performed using the OMERACT gray-scale and vascularity scoring system. Clinicopathological data were compared between the two groups. Gray-scale US findings showed significant differences between pSS and snS patients (p<0.05), with higher grades scoring in the pSS group. Doppler mode revealed differences in vascularity between the groups (p<0.05). Moderate and severe US abnormalities were associated with a positive focus score and anti-SSA/Ro (p<0.05). Only the right parotid gland did not show differences between both groups (p>0.05). The other clinicopathological parameters evaluated (sex, hyposalivation, and anti-SSB/Lo) did not show an association with US findings (p>0.05). Higher grades of abnormalities and vascularization were found in pSS patients and positively associated with focus score and anti-SSA/Ro. Despite being preliminary, the data could favor US as a complementary diagnostic test for pSS diagnosis. Funding: CAPES; FAPEMIG [ABSTRACT FROM AUTHOR]

Clinical fluorescence (VelScope) has been utilized as an adjuvant tool in some clinical conditions, mainly to select a proper area for biopsy. Our purpose in this pilot study was to assess the usefulness of this device in predicting epithelial dysplasia levels in potentially malignant conditions, mainly leukoplakia and actinic cheilitis (AC). The patients enrolled in the study were selected from our institution's outpatient clinic. All patients with a clinical suspicion of leukoplakia or AC underwent VelScope examination, followed by a biopsy. Histological results were compared with fluorescence features. Eleven patients were diagnosed with leukoplakia, comprising seven women and four men with a mean age of 59.6 years, and 15 with AC, comprising four women and 11 men with a mean age of 61.4 years. Epithelial dysplasia grades and the loss of fluorescence levels were concordant in 54.5% of leukoplakia cases and 60% of AC cases; high discrepancies were noted in 18.1% of leukoplakia and 6.6% of AC cases. The fluorescence evaluation method helps predict the level of epithelial dysplasia in cases of potentially malignant disorders, showing a significant level of conformity between the clinical assessment and microscopic study of such cases. [ABSTRACT FROM AUTHOR]

analyze the sensitivity of X-rays, computed tomography (CT SCAN), and ultrasound exam (US) in the diagnosis of severe odontogenic infection, especially with deep cervical involvement. a prospective cohort study of twenty consecutive patients (13M, 7F) with the diagnosis of deep-neck propagation of odontogenic infection from July 2020 to November 2020. Patients were included if they had symptoms and signs of odontogenic infection with deep-neck propagation, confirmed by clinical and immunological examination. All the patients enrolled in this study received both X-rays, CT SCAN, and the US for the assessment of the infection. the X-ray was the least sensitive exam for the diagnosis of collections, being enough to confirm the condition in only 20% of the patients. The CT SCAN promoted an increase in the sensitivity of the diagnosis for 95%, in addition to that, the US was considered sufficient in 100% of the patients. the US is a reliable option with sensitivity comparable to the Gold-Standard CT SCAN. [ABSTRACT FROM AUTHOR]

A 57-year-old woman was referred to our service for the assessment of a nodular lesion in the oral mucosa that exhibited spontaneous bleeding. According to the patient, the lesion had been present for five years. Over the past year, she had experienced multiple episodes of significant bleeding and struggled to control the hemorrhage. Her medical history included episodes of nosebleeds (epistaxis) and spontaneous skin hematomas. During the extraoral examination, petechiae were observed on her face. Upon intraoral examination, a purplish submucosal nodule measuring approximately 1.5 x 1.0 cm was identified in the upper lip mucosa. Following the clinical assessment, hematological tests were ordered. While the red and white blood cell counts were within the normal range, the results revealed a severe thrombocytopenia characterized by a low platelet count. Additionally, reduced prothrombin activity was detected. The patient was subsequently referred to a hematologist, who diagnosed idiopathic thrombocytopenic purpura. After the diagnosis, the patient initiated hematological treatment and is currently under clinical follow-up with our interdisciplinary team. [ABSTRACT FROM AUTHOR]

A hamartoma typically occurs as an overgrowth of mature tissue and is commonly found in this specific anatomical location. While the tongue does contain scattered adipocytes, hamartomatous lesions display disorganized adipose tissue that surrounds other normal structures. In the case of a 2-year-old boy, he presented with bilateral pinkish nodules on the lateral surface of the tongue. During the clinical examination, features such as polydactyly, hypotonia, low visual acuity, and developmental motor delay were noted. To confirm the diagnosis, excisional biopsies were performed on both sides of the tongue. Microscopic examination revealed mature adipocytes predominantly arranged in lobules and surrounding the salivary gland tissue. The histopathological diagnosis for both sides was lipomatous hamartoma. Further investigation through whole exome sequencing uncovered two heterozygous variants in the CPLANE1 gene, which are associated with Joubert syndrome 17 and orofaciodigital syndrome type 6, both of which are autosomal recessive disorders. The patient is currently receiving medical and dental follow-up care.. [ABSTRACT FROM AUTHOR]

The ectomesenchymal chondromyxoid tumor (ECT) is a rare and benign mesenchymal neoplasm primarily found in the tongue. Here is a revision of your text without changing the word count: A 15-year-old boy presented with a painless nodule measuring 15mm on the lingual side of the left mandible, situated between teeth 33 and 35. The lesion, which appeared approximately 6 months ago, displayed a normal color and a smooth surface, with no history of local trauma. Computed tomography (CT) imaging revealed a well-defined, circular isodense area. Initially, the differential diagnoses considered were peripheral ameloblastoma and peripheral ossifying fibroma. Surgical excision of the lesion was performed, and microscopic examination revealed a well-demarcated lesion organized in lobules. It consisted of round and spindle-shaped tumor cells embedded in a myxoid and chondroid matrix. Immunohistochemistry demonstrated diffuse positivity for GLUT1, S-100, CD56, and AE1/AE3. Molecular analysis further confirmed the diagnosis of ECT by identifying a RREB1-MKL2 fusion gene. Two years post-surgery, the patient remains free of recurrence. [ABSTRACT FROM AUTHOR]

Diffuse large B-cell lymphoma (DLBCL), the most prevalent non-Hodgkin´s lymphoma, can manifest in the oral cavity. A 23-year-old male, presenting with pain linked to gingival swelling and weight loss over 45 days, sought consultation at the Stomatology clinic. Extra-oral examination revealed facial asymmetry and increased volume in the right cervical lymph node chain. Intraoral examination showed generalized gingival enlargement. Diagnostic measures, including panoramic imaging, chest x-rays, chest and abdomen computed tomography, magnetic resonance imaging, and fine-needle aspiration biopsy (FNAB) of the cervical lesion, indicated large cell lymphoma. Confirmation came through histopathological and immunohistochemical analysis. The patient was directed for antineoplastic treatment but succumbed to the condition merely two months post-diagnosis. [ABSTRACT FROM AUTHOR]

Paracoccidioidomycosis (PCM) is a systemic mycosis caused by a dimorphic fungus and it represents a significant infection in tropical countries. Brazil is considered an endemic country, with a higher prevalence in the south, southeast, and midwest regions. The aim of this study was to evaluate the clinicopathologic features of a case series of oral PCM in a southwestern and north region of Brazil. A retrospective study was carried out and included 15 patients with oral biopsies diagnosed as PCM, between the years 2022 and 2023 at the Dental Service of the Barretos Cancer Hospital, Brazil. In all, both hematoxylin-eosin and Grocott staining reached the final diagnosis. 15 cases were retrieved in a single Institution in 3 states from Brazil. In all, 86,7% were male, with a mean age of 58 years (ranging from 30 to 66 years), 73.3% were in white people. Multiple lesions in a single patient were observed in 9 cases (60%) and a single lesion was observed in 6 cases (40%). The most common fundamental lesion found was ulceration (n=12; 80.0%), followed by nodule (n=3; 20%). The most affected sites were attached gingiva (33.3%) followed by floor of the mouth (20%), buccal mucosa (20%), lip mucosa (20%) and soft palate (20%). The mean time of diagnosis was 3 months. Histopathological features consisted of hyperplastic epithelium, intraepithelial microabscesses, and formation of granulomatous chronic inflammatory reaction in a fibrous connective tissue with severe chronic inflammatory reaction. Yeasts were observed inside of multinucleated giant cells or extracellularly. Also, Grocott's methenamine silver stain showing multiple, narrow-based budding yeast cells with steering wheels. PCM is rare, it should be included in diagnosis mainly multiple, ulcerated, erythematous, or granular lesions affecting preferentially the buccal mucosa, soft and hard palate, and gingiva. [ABSTRACT FROM AUTHOR]

To conduct a systematic review of the available data on pycnodysostosis (PYCD), determining clinical and imaging craniofacial characteristics. Systematic review in specific search engines with the research question: "What are the craniofacial oral and imaging alterations in patients with pycnodysostosis?". A total of 84 published articles were included, totaling 179 cases. PYCD showed a slight preference for females (55.3%), with a mean age of 14.7 years at the time of diagnosis. Clinically, there was a predominance of short stature (86.1%), brachydactyly (66%), presence of frontal cranial bossing (82.1%), exophthalmos (49.2%), and prominent nose (57.5%). Regarding the craniofacial imaging characteristics, acroosteolysis (58.1%), open cranial sutures (53.6%), open fontanelles (67.1%), increased bone density (56.4%), and obtuse mandibular angle (84.3%) predominated. Concerning oral alterations, malocclusion (59.2%), micrognathia (62.6%), dental crowding (54.2%), narrow and grooved palate (54.2%), and dental anomalies such as impacted teeth, agenesis, delayed eruption, and enamel hypoplasia predominated. PYCD is a rare osteosclerotic dysplasia, which, despite genetic tests for diagnosis, reinforces the knowledge of the most common clinical and imaging characteristics to thus raise suspicion of PYCD. [ABSTRACT FROM AUTHOR]

To explore studies on the uses and effectiveness of antimicrobial peptides in viral oral lesions. A bibliographic review was conducted in Pubmed, Web of Science and Scielo databases, using as descriptors "antimicrobial peptides", "virus", "treatment" and "oral". From a total of 64 publications, 3 studies published between 2000 and 2023 were selected. The use of peptides represents an important therapy, which acts in a targeted way to kill viral agents. Therefore, these active molecules can prevent the virus from binding to host cell receptors, inhibiting the viral cycle. It has proven been demonstrated that the use of defensins against enveloped viruses that lead to oral infections acts on glycoproteins, which are necessary for the membrane fusion process. Furthermore, it was seen that the HIV-1 virus promotes the expression of β-defensins in cells of oral epithelium, molecules that act to block viral replication through a direct interaction with virions and modulating the CXCR4 co-receptor. The application of antimicrobial peptides is a promising alternative for therapies against viruses, due to the difficulty in developing resistance to viral agents, and thus contributes to better results in oral infections. [ABSTRACT FROM AUTHOR]

To analyze cases of epithelial dysplasias (EDs) present in actinic cheilitis (AC) and lower lip squamous cell carcinomas (LLSCC) based on four morphological grading systems, as well as to investigate the prognostic impact of two of those systems in LLSCC. Thirty-nine EDs and 45 LLSCCs were included in this study. AC cases were analyzed based on morphological criteria determined by the 4th classification of the World Health Organization (WHO) and the binary system proposed by Kujan et al. (2006). LLSCC cases were graded according to WHO (2017) criteria and the BD model proposed by Almangush et al (2015). Analysis of ACs based on the binary system showed a slight predominance of high-risk grading (51.3%). Based on WHO criteria, most cases were exhibited moderate dysplasia (29.2%), and of these, most were graded as high risk (64.2%) in the binary system. For LLSCC cases, a predominance of moderately differentiated carcinomas was observed (53.3%) according to WHO criteria. Regarding the BD model, most cases exhibited intermediate risk (44.4%) and death was a significantly frequent outcome in those with histopathological high-risk score (p = 0.048). The BD model was the only histopathological gradation system associated with outcomes in LLSCC patients. [ABSTRACT FROM AUTHOR]

This study aimed to describe the clinicopathological features of a calcifying odontogenic cyst (COC) series from 3 Brazilian oral pathology services. All cases of COC were retrieved from clinical records of 3 Brazilian oral pathology laboratories and selected for the study. A total of 60 cases were reviewed. Most patients were male (n = 39; 65%). The mean age was 28.2 years (ranging from 6 to 81 years). The maxilla was more involved (n = 32; 53.3%) than the mandible (n = 25; 41.7%). Most cases were intraosseous (n = 57; 95%), and 3 were peripheral COCs (5%), 2 affecting the upper gingiva and 1 the lower gingiva. The mean time of evolution was 13.8 months, and 24 (40%) lesions were asymptomatic. The mean size of the lesions was 3.0 cm, and the type of biopsy performed was mainly excisional (n = 33; 55%). Clinical and histological diagnosis disagreed in most cases (n = 39; 65%). COC is an uncommon odontogenic cyst. In the present series, COC was more prevalent in young male adults, mainly as slow-growing, asymptomatic, and maxillary lesions. [ABSTRACT FROM AUTHOR]

Our objective was to tackle the current lack of effective drugs capable of managing ACC progression, by identifying new drugs, through a high-throughput screening of epigenetic drugs, that prevent epithelial-mesenchyme transition (EMT) and disrupt cancer stem-cells (CSCs). UM-ACC-2A cell line was seeded using a robotic liquid handler system (Opentrons) and cultured in two 96-well plates. Changes in cell viability and morphology were analyzed 24 hrs after adding drugs using a high-content imaging system (ImageXpress). Aiming at changes associated with EMT, we used snail antibody while using H3K9 as indicative of epigenetic modifications. Those drugs identified as of clinical interest were validated by assays that determined the cellular toxicity index, flow of snails, the ability to reduce cell migration, and the capacity to interrupt tumor spheres. Seven compounds showing favorable levels of toxicity and capable of reducing cell viability, inhibiting snail expression, inducing histone acetylation, and interrupting CSCs were identified. The validation assays showed that the drugs Scriptaid and LMK235 presented the most promising results to open new ways for the treatment of salivary gland ACC. We have identified novel drugs that hold the promise for new therapeutic strategies to manage ACC tumors from the salivary glands. [ABSTRACT FROM AUTHOR]

analyze the respiratory compromise in patients who had infections of odontogenic origin in deep fascial spaces by measuring the airway column with the aid of an ultrasound exam (US). 20 patients were analyzed. The position of the airway column and the midline were marked. The anteroposterior and laterolateral diameters of the airway column were measured, and in addition, a twenty-millimeter lower and upper portion of the airway column were examined. The midline of the upper airway was determined by the difference between the central raphe of the mylohyoid muscle and the midline of the airway column in the central cervical area. The volume of the airway column was obtained using a formula for determining the volume of a cone with a height of twenty millimeters. The anteroposterior and anterolateral diameters were 13.13 mm and 19.12 mm, respectively. The mean volume of the airway column was 595.39mm3. All patients had dysphagia, 60% had dyslalia, 40% had dyspnea, 50% had some kind of voice alteration and 85% had neck swelling. the US proved to be efficient as an instrument for measuring the regions of interest. [ABSTRACT FROM AUTHOR]

To analyze the immunohistochemical expression of YAP protein and correlate it with markers involved in cell proliferation and apoptosis in benign epithelial odontogenic lesions. The sample consisted of 95 cases of odontogenic lesions - 25 dentigerous cysts (DCs), 30 odontogenic keratocysts (OKCs), 30 conventional AMB (C-AMBs), and 10 unicystic AMB (U-AMBs). Ten dental follicle (DF) specimens were selected as the control group. The immunohistochemical technique was performed on the tissue sections by using YAP, cyclin D1, Ki-67, and Bcl-2 antibodies, and their immunoexpression analysis was performed qualitatively and quantitatively. Collected data were submitted for descriptive and statistical analysis (p ≤ 0.05). YAP immunoexpression was significantly higher in OKCs, especially in the basal and parabasal layers, followed by U-AMBs and C-AMBs, which showed moderate immunoreactivity, predominantly in peripheral cells. In addition, there were significant differences in YAP immunoexpression between the analyzed groups, with statistically significant correlations between YAP and cyclin D1 in DCs and U-AMBs, and between YAP and Ki-67 in U-AMBs (p < 0.05). However, between YAP and Bcl-2 immunoexpression, there was no statistically significant correlation among the groups. YAP may influence the cell proliferation of odontogenic cysts and tumor epithelium, thus helping with their progression [ABSTRACT FROM AUTHOR]

To report the experience of creating and providing an online, self-instructional course on oral cancer, entitled "Abre a boca, meu povo - O que você precisa saber sobre o câncer de boca!" on a Telehealth platform, for Community Health Workers, and to analyze the clinical-demographic profile of the participants. The initial phase consisted of developing the course according to the ADDIE model, with simple language and contextualizing reality. The course was provided with a student guide, initial survey, initial knowledge check, four modules, formative assessments at the end of each module, a final knowledge test, a student satisfaction assessment, and certification. In the second phase, the course was conducted in a virtual learning environment, with subsequent evaluation. A descriptive analysis of the results with frequencies was performed. Kolmogorov-Smirnov test was applied with a 95% confidence level. The sample consisted of 205 graduates. The predominant profile consisted of professionals aged 40–49 years old, female, with >10 years of work experience and complete secondary education, located in Pernambuco, Brazil. Cellphones were the most commonly used device to carry out the course. The results of the first edition showed a satisfactory number of professionals, thus, achieving the objectives. [ABSTRACT FROM AUTHOR]

The accessory parotid gland (APG) is a salivary tissue, with an approximate reported incidence of 21% among human cadavers. Tumors arising from this structure are exceedingly rare, comprising 7% of all parotid gland tumors. A 20-year-old female was referred to a stomatology service due to an 18-month history of increased volume. Clinical examination revealed a mobile, palpable intraoral and extraoral nodule in the buccal mucosa, characterized by firm consistency, asymptomatic nature, well-defined contours, and the absence of associated lymphadenopathy. Ultrasonography identified a rounded hypoechoic image in the angle region of the left mandible, with no associated vascularization. An excisional biopsy was performed, revealing an encapsulated nodular lesion during the intraoperative assessment, indicating its origin from the APG. Histopathological analysis confirmed the diagnosis as Pleomorphic Adenoma. Following complete excision while preserving the capsule, the patient is undergoing stomatological follow-up, showing no clinical signs of lesion recurrence and presenting a highly satisfactory scarring appearance. [ABSTRACT FROM AUTHOR]

A 48-year-old woman was referred to our service due to severe xerostomia (dry mouth) and xerophthalmia (dry eyes). The patient reported neuropathic symptoms that had begun 8 months earlier, including involuntary reflexes in the upper lip, a burning sensation in the oral mucosa, and numbness in the lower lip, tongue, and hard palate. Upon intraoral examination, no apparent alterations were observed. Based on the reported symptoms, the primary suspicion was neuropathy associated with Sjögren's Syndrome. Further diagnostic tests were conducted, which yielded negative results for Anti-Ro (SSA), Anti-La (SSB), and the Schirmer test. An unstimulated salivary flow test was performed, indicating severe hyposalivation. To confirm the diagnosis, the patient underwent a biopsy of minor salivary glands. Histopathological analysis revealed focal lymphocytic sialadenitis. The patient was subsequently referred to a rheumatologist, who confirmed the diagnosis of Sjögren's syndrome. Treatment was initiated under rheumatological care, and the patient remains under clinical follow-up with our interdisciplinary team. [ABSTRACT FROM AUTHOR]

A 20-year-old man was admitted to the hospital after developing ulcerated and erosive lesions on the conjunctival and genital mucosa, as well as disseminated lesions throughout the oral cavity. He had been experiencing intense pain and difficulty eating for the past two weeks. The patient reported the use of Flexalgin for approximately two months. Based on clinical presentation, the diagnosis was consistent with Stevens-Johnson syndrome. Systemic treatment was initiated, which included intravenous administration of dexamethasone (4mg/mL) and 0.9% sodium chloride. Additionally, local treatment involved the application of dexpanthenol on the lips. Photodynamic therapy (PDT) was administered in areas with ulcerations, and red photobiomodulatory therapy (TFBM) was performed on areas with erosion and erythema. The TFBM was applied with a power of 2J for 20 seconds per stitch. Following the treatment, there was a significant reduction in pain, allowing the patient to transition from a liquid to a pasty diet. The oral and mucosal lesions began to regress, and after seven days of treatment, the patient no longer had dietary restrictions. He was subsequently discharged from the hospital and advised to continue treatment on an outpatient basis. [ABSTRACT FROM AUTHOR]

A 36-year-old woman with a painful lesion on the hard palate for three weeks is reported. Her medical history included Systemic Lupus Erythematosus (SLE), fibromyalgia, and hypothyroidism. Eight months earlier, she had a vaginal ulcer, which subsequently regressed. Intra-oral examination revealed multiple mucous patches with an erythematous halo on the hard palate, upper and lower labial mucosa. VDRL (Venereal Disease Research Laboratory) testing and incisional biopsy of the palate lesion with direct immunofluorescence analysis (DIF) were performed due to the diagnostic suspicion of secondary syphilis and an oral manifestation of SLE. Histopathological examination revealed focal fibrin-coated epithelial ulceration with polymorphs, along with moderate and diffuse intercellular edema, showing non-specific DIF. VDRL and fluorescent treponemal tests were positive, leading to a final diagnosis of secondary syphilis. Treatment involved a total dose of 7.2 MU benzathine benzylpenicillin administered intramuscularly. Improvement of oral lesions was reported two weeks after completing this treatment. [ABSTRACT FROM AUTHOR]

Plasmacytoma is a rare neoplastic proliferation of plasma cells, which can manifest in soft tissue (extramedullary) or within the bone. It may be associated with multiple myeloma (MM) or appear as a solitary lesion. Sometimes, it serves as an initial sign of MM or signals its recurrence. A 42-year-old female patient, developed a painless fibroelastic nodule measuring 5 cm with telangiectasias in the left maxilla. The nodule's color closely resembled the adjacent mucosa. Imaging examinations revealed a unilocular radiolucent lesion located between teeth 27 and 28. An incisional biopsy demonstrated diffuse infiltration of plasma cells, with positive staining for CD138 and the lambda light chain, while testing negative for CD56 and the kappa light chain. Additional laboratory examinations confirmed the presence of MM. The patient was initiated on chemotherapy treatment following the bortezomib, thalidomide, and dexamethasone protocol, which resulted in partial regression of the oral lesion. At this point, the patient continues to be closely monitored and is scheduled for autologous hematopoietic stem cell transplantation. [ABSTRACT FROM AUTHOR]

An 89-year-old female patient was admitted to our center for the evaluation of a painful ulcer in the palatine mucosa. She reported that the ulcer had been present for 20 days, and during this time, she had inadvertently traumatized the region with a hairpin in an attempt to relieve the pain caused by the ulcer. Upon intraoral examination, we observed a painful ulcer in the palatine mucosa, adjacent to teeth 25, 26, and 27. The ulcer measured approximately 2.0x1.0 cm, featured well-defined boundaries, and slightly raised edges. Considering diagnostic possibilities of an inflammatory ulcer, granulomatous infection, or malignant neoplasm, a biopsy was performed. Histopathological examination revealed an ulcerated lesion with a fibroleukocyte crust, the presence of a moderate inflammatory infiltrate, both superficial and deep, with an abundance of eosinophils, and proliferative vessels throughout. The final diagnosis confirmed the condition as an eosinophilic ulcer of the oral mucosa. Notably, a partial healing process was observed three weeks after the surgical procedure. This case underscores the importance of considering eosinophilic ulcers in the differential diagnosis of extensive oral lesions. [ABSTRACT FROM AUTHOR]

Lichen planus and lichenoid lesions affecting the oral mucosa often present very similar, if not identical, clinical features. The objective of this discussion is to present a clinical case that can assist clinicians in the process of differential diagnosis and management. In this study, a 69-year-old female patient exhibited symptomatic white plaques and erosive lesions primarily on the lateral mucous membranes of the tongue and cheeks. A biopsy of the lesion on the lateral tongue was performed. The results confirmed the diagnosis of lichen planus. Furthermore, the pathologist noted a prior skin examination that had yielded a diagnosis of lichen planus. The patient was educated about the condition and referred for a medical evaluation. In conclusion, this case study underscores the importance of conducting a thorough review of a patient's medical history and highlights the significance of anatomopathological examination for both skin and oral mucosal alterations in the diagnostic process. [ABSTRACT FROM AUTHOR]

Osteoporotic focal bone marrow defect, found in the maxillary bones, is characterized by a radiolucent, asymptomatic area, typically observed in the posterior mandible of middle-aged adult women. The objective of this discussion is to present a clinical case of focal osteoporotic bone marrow defect associated with a fixed prosthesis that led to the expansion of the lingual bone plate of the mandible. In this study, a 56-year-old female patient sought dental evaluation for an asymptomatic growth in the mandibular bone. An incisional biopsy was performed, and the tissue was sent for histopathological analysis. The microscopic sections revealed bone marrow with the presence of erythrocytes, leukocytes, and megakaryocytes infiltrating adipose tissue, along with thin, irregular bone trabeculae. The confirmed diagnosis was a focal osteoporotic bone marrow defect. This clinical case highlights the rarity of osteoporotic bone marrow defects causing bone expansion and underscores the importance of histopathological examination for a definitive diagnosis. [ABSTRACT FROM AUTHOR]

Odontogenic fibromyxoma (OF) is a benign mesenchymal tumor considered a variant of odontogenic myxomas. Typically, OF predominantly affects the mandible, manifesting as painless swelling. This tumor is more commonly found in adolescents and young adults, with rare occurrences in children. A 17-month-old boy was referred for an evaluation due to a swelling in the middle third of the right side of his face, which had been progressing for three weeks. A computed tomography scan revealed a circular hypodense image measuring approximately 3 x 2 cm. Based on the imaging and clinical findings, a benign maxillary odontogenic tumor was suspected, leading to the decision to surgically remove the lesion. Microscopic analysis of the removed tissue revealed spindle-shaped cells within a myxoid background, with alcian blue staining confirming the diagnosis of odontogenic fibromyxoma. This case report highlights the importance of considering odontogenic fibromyxoma in the differential diagnosis of rapidly growing tumors in young children. [ABSTRACT FROM AUTHOR]

Oral ulcers induced by medications are a well-recognized but often underappreciated adverse reaction to drug use. Clinically, they often present as "aphthous-like" lesions accompanied by painful symptoms. While numerous medications are known to trigger oral lesions, there have been relatively few reported cases of antidepressant-induced oral lesions. A 63-year-old female was referred for an investigation into painful ulcers that had appeared on the lateral border of her tongue and the floor of her mouth two months prior. She was taking nine different medications for various health conditions, including two antidepressants (Amitriptyline and Fluoxetine), without proper medical supervision. An incisional biopsy was performed, and histopathological analysis revealed moderate mononuclear inflammatory infiltrates beneath the epithelium. The clinical diagnosis indicated drug-induced oral ulcers, and the antidepressants were substituted with appropriate psychiatric support. After three months, the ulcers had completely healed. This case underscores the importance of considering adverse reactions to antidepressants as a potential cause of inflammatory oral ulcers in the differential diagnosis. [ABSTRACT FROM AUTHOR]

Oral Proliferative leukoplakia (OPL) is a rare and aggressive variant of oral leukoplakia that poses challenges in diagnosis and management due to its high malignant transformation rate. A 42-year-old female patient, who was a former smoker, sought oral diagnostic services due to the presence of a white patch in her mouth that had been evolving for two years. During the intraoral examination, it was noted that the white patch exhibited an irregular and rough surface, measuring approximately 2.5 cm in diameter, with extension into the lower vestibule, alveolar ridge, and left buccal mucosa. The initial histopathological diagnosis indicated hyperkeratosis. Over the subsequent 7-year follow-up period, clinical and histopathological features emerged that led to the confirmation of OPL. Two years later, during a follow-up biopsy, a diagnosis of verrucous carcinoma was made. The treatment plan involved surgical removal combined with radiotherapy and chemotherapy. [ABSTRACT FROM AUTHOR]

A 56-year-old woman presented with a four-month history of right-sided facial pain. Upon intraoral clinical examination, a swelling was observed in the right side of the mouth floor. This swelling had a hardened consistency, normal mucosa color, well-defined boundaries, and was sessile in nature. An occlusal radiograph of the mandible did not reveal any radiographic images associated with the lesion. An aspiration puncture yielded negative results. Initially, the diagnosis was considered to be Pleomorphic Adenoma, which is a benign salivary gland tumor. However, due to suspicion of malignancy, an incisional biopsy was performed. The histopathological examination revealed cuboid epithelial cells with basophilic nuclei and clear cytoplasm, organized in islets and cords that appeared to have a tubular or ductal aspect. Additionally, in some of these ducts, basophilic material suggestive of mucus was present, and tumor cells were found in close proximity to nerve fillets and blood vessels. These findings were consistent with Adenoid Cystic Carcinoma. The proposed treatment plan by the head and neck surgeon involves surgical excision combined with chemoradiotherapy. The significance of this case lies in its uncommon presentation and diagnostic challenges. [ABSTRACT FROM AUTHOR]

The nasolabial cyst is a rare non-odontogenic developmental cyst. In this case, a 77-year-old male patient presented with a soft, fluctuating swelling in the infra-orbital region, causing elevation of the nasal dorsum, facial asymmetry, and painful symptoms. Cone-beam computed tomography revealed a well-defined area with soft tissue density, leading to diagnostic hypotheses of a nasolabial cyst and epidermoid cyst. The surgical procedure involved a right paranasal and infraorbital incision in an inverted "L" shape. After divulsion, the lesion was visualized with the infraorbital plexus positioned over the capsule and was removed by enucleation. The histopathological examination confirmed the diagnosis of a nasolabial cyst. The upper location of the cyst in the infraorbital region suggests an origin from epithelial remnants of the nasolacrimal duct. Suture removal was performed after 9 days, with satisfactory wound healing. [ABSTRACT FROM AUTHOR]

Three female patients were submitted to biopsy of nodules of the lip mucosa. Case #1 presented large perfectly round apparently empty spaces, surrounded by giant cells, and some of these cells containing asteroid bodies, with a nodular pattern and moderate lymphocytic infiltrate admixed with some macrophages and scarce neutrophils. Case #2 showed large basophilic amorphous "pools" with a diffuse pattern, many lymphocytes and macrophages. Giant cells were not seen and there was positivity for CD68 and alcian blue. Case #3 evidenced different sizes of cholesterol cleft-like material within giant cells and surrounded by chronic inflammation composed of lymphocytes and some macrophages. Scarse eosinophils were seen. The material was refractile in polarized light. The final diagnosis was inflammatory reaction to the cosmetic fillers polymethylmethacrylate (case #1), hyaluronic acid (case #2), and poly-L-latic acid (case #3). Support: CAPES, CNPq. [ABSTRACT FROM AUTHOR]

Angiolipomas are uncommon benign mesenchymal tumors primarily composed of adipocytes with a significant vascular component. They typically manifest as well-defined masses enclosed by a thin fibrous capsule, often exhibiting slow growth and are usually asymptomatic. These tumors tend to affect females more frequently. In this case, a 7-year-old girl presented with facial asymmetry in the left jugal region. Clinical evaluation revealed the asymmetry, and a non-contrast enhanced facial CT scan had already been performed. To further assess the soft tissue abnormalities, a facial ultrasonography (US) was recommended due to its excellent ability to detect such disturbances. The US examination revealed the presence of a hyperplastic buccal fat pad with significant vascularity, which was confirmed using Doppler imaging. Surgical removal of the lesion was performed through a 5mm intraoral incision, with concurrent utilization of US to guide the procedure and assess the lesion's morphology. Subsequent pathological examination confirmed the diagnosis of an angiolipoma. The patient has been under follow-up for three years post-operatively without any concerning developments. [ABSTRACT FROM AUTHOR]

Four cases of subgemmal neurogenous plaque (SNP) are reported here, detailing their clinical presentation, histopathological features, and treatment outcomes. These cases exhibited a predilection for females, with an average age of 49.5 years. Clinically, the lesions presented as nodules or papules of varying colors, spanning from normochromic to erythematous or yellowish, and measuring between 0.5 to 2 cm. Patients reported painful symptoms, with some describing burning or tingling sensations, and no identifiable etiological factors were noted. Following excisional biopsy, the histopathological diagnosis was confirmed by the presence of fusiform cells, which were at times wavy or virguliform, organized in plexuses or dispersed within the connective tissue. In some cases, taste buds, inflammatory cells, and lymphoid tissue were observed. During follow-up, patients reported improvement in pain symptoms and no recurrence. SNP is a structure typically found on the tongue, with a higher prevalence in women over 40 years of age, and it is associated with painful symptoms. Therefore, it is crucial for clinicians and pathologists to be aware of SNP to avoid misdiagnosis. [ABSTRACT FROM AUTHOR]

Odontogenic myxoma (OM) is a benign tumor originating from the odontogenic ectomesenchyme. This report details two cases of OM with atypical characteristics. Case 1: A 21-year-old female presented with a complaint of swelling that had been present for 5 months. Panoramic radiography revealed a multilocular, mixed lesion involving the left mandibular body and ramus. Additionally, signs of root resorption and a sunburst appearance were evident. Case 2: A 24-year-old male had a large, painless swelling in the right jaw that had been progressing for 4 years. Imaging examinations showed a radiolucent area extending from the posterior maxilla to the floor of the orbit. An incisional biopsy was performed under local anesthesia. Microscopically, a loose myxoid tissue with few spindle cells and no atypia was observed, leading to the diagnosis of OM. Both patients underwent surgical resection, and no recurrences were observed. While rare, OM should be considered in the differential diagnosis of lesions displaying aggressive features. [ABSTRACT FROM AUTHOR]

Paracoccidioidomycosis is a systemic fungal infection first described in Brazil by Adolf Lutz in 1908. In this report, we present a case involving a 50-year-old male patient who had ulcerated oral cavity lesions persisting for five years. Additionally, he exhibited crusty lesions in the perioral and glabella regions, local lymphadenopathy, trismus, dry cough, and a recent weight loss of 13kg. An incisional biopsy revealed a chronic granulomatous inflammatory process with multinucleated giant cells and numerous fungal yeast. The patient was subsequently referred to a hospital, where he was diagnosed with multifocal paracoccidioidomycosis affecting the oral mucosa, skin, lungs, and adrenal glands. Treatment consisted of liposomal amphotericin B and hydrocortisone for 20 days. Following his hospital discharge, he continued treatment with hydrocortisone and Bactrim, resulting in a regression of the lesions and a weight gain of more than 14kg over the past ten months. He is currently under ongoing monitoring. This case underscores the essential role of dentists in diagnosing systemic diseases, which can aid in avoiding delays in receiving timely treatment. [ABSTRACT FROM AUTHOR]

Body Dysmorphic Disorder (BDD) is a psychiatric condition characterized by dissatisfaction with one's body image, leading individuals to undergo numerous aesthetic surgical procedures. This case involves a 41-year-old woman who had undergone over thirty plastic surgeries, including multiple grafts with polymethylmethacrylate (PMMA) and industrial silicone. The procedures, performed at least 10 years ago, involved various facial regions. PMMA, a biomaterial used in surgical rehabilitation, can pose toxicity risks due to residual monomers. The patient presented with intraoral granulomas, fistulas in the right pre-auricular region, and facial paralysis (House-Brackmann 3) with severe muscle impairment. The surgical removal of the biomaterial, guided by ultrasound, was performed under anesthesia, and the extracted material was sent for histopathological analysis. The patient was followed up postoperatively for six months. [ABSTRACT FROM AUTHOR]

Syphilis, a sexually transmitted disease caused by Treponema pallidum, manifests in distinct stages, each characterized by different oral lesions. A 38-year-old male presented with ulcerated lesions on the lateral border of the tongue and anterior vestibule fornix, evolving over 40 days. The patient reported additional symptoms such as weight loss, fever, and fatigue. An incisional biopsy of the anterior vestibule lesion revealed non-specific chronic ulceration. Following referral to the infectious and contagious diseases center, the patient received diagnoses of syphilis and HIV/AIDS, leading to a 6-month hospitalization. Treatment was administered, resulting in the patient's current well-being with an undetectable viral count. Timely and accurate diagnosis, along with proper referral, is crucial for determining an appropriate treatment strategy. [ABSTRACT FROM AUTHOR]

Pleomorphic adenoma stands as the most prevalent benign mixed tumor affecting the salivary glands, typically presenting as a painless, firm, and gradual swelling, commonly in the parotid gland. A 44-year-old male sought medical attention due to facial asymmetry attributed to a firm and painless swelling in the right submandibular region, exhibiting a growth period of eight months. Ultrasound examination unveiled a heterogeneous hypoechoic mass within the right submandibular gland parenchyma. The mass featured well-defined festooned contours and posterior acoustic enhancement, with sparse internal vascularity evident in the Doppler mode. The imaging findings substantiated the diagnosis of a benign mixed glandular tumor. Subsequent surgical excision of the approximately 3.5-centimeter mass confirmed the histological diagnosis of pleomorphic adenoma. Proper diagnosis and management are crucial to mitigate the risk of enlargement and potential malignancy. [ABSTRACT FROM AUTHOR]

Oral verruciform xanthoma (OVX) is an uncommon benign lesion of unknown etiology that resembles other papillary lesions. A 26-year-old male with a history of hematopoietic cell transplantation for the treatment of acute myeloid leukemia reported the appearance of an asymptomatic lesion with 5 months of evolution. Clinically, a sessile verrucous lesion with a slightly yellowish appearance and 1 cm in diameter was observed, located in the alveolar ridge. The differential diagnosis included squamous papilloma and verrucous carcinoma, for which an incisional biopsy was performed. Microscopically, it exhibited papillary epithelial hyperplasia forming uniformly elongated bulbous ridges, under which numerous xanthomized cells confined to the conjunctival papillae can be observed. The CD68+ immunohistochemical reaction showed xanthomized macrophages, allowing the histopathological diagnosis of OVX. Subsequently, an excisional biopsy was performed, and the patient is currently free of the lesion. The histopathology and clinical history are highlighted as auxiliary methods in the diagnosis of OVX. [ABSTRACT FROM AUTHOR]

Oral verruciform xanthoma (OVX) is an uncommon lesion of uncertain origin, allegedly related to trauma, inflammation, or altered immune response. Two cases of OVX are reported. The first patient, a 31-year-old man, with a history of graft-versus-host disease (GVHD) after allogeneic transplantation for acute myelocytic leukemia, presented painful nodular lesions on the lingual dorsum and hard palate, and diffuse lichenoid lesions. The provisional clinical diagnosis was verruciform xanthoma and lichenoid lesions in a patient with GVHD. The patient is currently taking Apixaban for six months due to a pulmonary thromboembolism, what postponed the biopsy. The second patient, also a 31-year-old man, smoker, presented an asymptomatic wart on the lower lip and a plaque on the right buccal mucosa with 1 year of evolution. Clinical appearance suggested verrucous leukoplakia or hyperkeratosis, however, histopathological and immunohistochemical examinations were compatible with OVX. Eight months after excisional biopsy, the patient remains well without recurrence. [ABSTRACT FROM AUTHOR]

A 56-year-old man presented with an 8-month history of a painless, crusted skin lesion on the right supercilium. In addition, during an oral clinical examination, he exhibited multiple ulcerated lesions with a granular appearance and hemorrhagic points on the lower lip, soft palate, and gingiva, which had been developing for three months. These oral lesions were accompanied by significant weight loss due to dysphagia. His medical history revealed prior visits to a dermatologist and otolaryngologist, with no specific diagnosis provided. An incisional oral biopsy was performed, and histopathological analysis revealed a granulomatous reaction along with multiple round structures consistent with P. brasiliensis in Grocott (methenamine silver) staining, leading to the diagnosis of paracoccidioidomycosis. The patient was subsequently referred to an infectologist and reported complete remission of oral and skin lesions after fourteen days of itraconazole treatment. The patient continues treatment and has been monitored for five months with no clinical evidence of the disease. [ABSTRACT FROM AUTHOR]