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Non-neoplastic proliferative processes (NNPPs) are reactive lesions frequently found in the oral cavity. Despite their benign nature, some aggressive malignant lesions may mimic those lesions. We report a case of a 64-year-old female with a chief complaint of a painful rapidly growing nodule with bleeding on palpation in the vestibular and palatal gingiva of teeth 11 and 21. Histologic examination showed nests of atypical neoplastic squamous cells infiltrating the connective tissue. Immunohistochemical analysis revealed positivity for AE1/AE3, CK5, 34 βE12, p63, p53, and Ki-67 (over 75%) but negativity for CK19. The diagnosis was gingival squamous cell carcinoma (GSCC). The patient was referred to a head and neck surgical service for proper management of the tumor. GSCC is a well-recognized malignant neoplasm of the oral cavity that may clinically mimic an NNPP. It is essential for the clinician to be aware of such a presentation to allow for proper diagnosis and treatment.

Ameloblastic fibroma (AF) is an uncommon benign odontogenic tumor in which both the epithelial and ectomesenchymal components are neoplastic. We report a case of a 6-year-old male patient presenting a painless swelling in the left posterior mandibular region with 1-month evolution. Computed tomography scans showed a large osteolytic lesion (6.0 × 4.5 cm). An incisional biopsy was performed, and the histopathologic analysis revealed cords and islands of proliferating odontogenic epithelium laid in a loose cell-rich connective tissue. The diagnosis was AF. A surgical conservative excision followed by curettage was performed, but the lesion recurred after 6 years, which was histologically confirmed. A new surgical excision and curettage was performed, including the removal of the tooth involved. The patient is under follow-up for 3 months with no recurrence sign. Despite the benign nature, a judicious pathologic analysis in cases of recurrent tumors is essential to rule out any malignant changes.

Objective: To analyze the clinical profile of a series of salivary gland tumors diagnosed in the state of Sergipe. Study Design: This is an epidemiologic, analytical, and retrospective study of the clinical characteristics of salivary gland tumors, carried out in medical/oral pathology reference services in the state of Sergipe. The cases were collected in the laboratories database. All cases of major and minor salivary gland tumors that met the diagnostic criteria established by the World Health Organization (WHO) and diagnosed between 2006 and 2016 were selected. Cases were diagnosed by fine needle aspiration; inconclusive reports and secondary tumors were excluded. Results: A total of 588 cases were found. The majority of tumors occurred in women (55.7%), ranging from 41 to 50 years of age (19.06%). Benign tumors were more common (79.5%), and major salivary glands were more affected (61.73%), particularly the parotid gland (51.7%). Pleomorphic adenoma (88.96%) and Warthin tumor (6.8%) were the most common benign tumors, whereas mucoepidermoid carcinoma (24.58%), not otherwise specified adenocarcinoma (20.34%), and adenoid cystic carcinoma (17.8%) were the most frequent malignant tumors. Conclusions: Pleomorphic adenoma and mucoepidermoid carcinoma were the most common benign and malignant salivary gland tumors, respectively, and the parotid gland was the most affected anatomic site.

Ameloblastoma is an aggressive benign odontogenic neoplasm that occurs more frequently in the mandible, and only 5% to 20% of cases affect the maxilla. We reported a case of a 28-year-old white female who was referred to a dentistry radiology service for routine examinations for orthodontic purposes. CT scans revealed the presence of an ill-defined hypodense lesion in the left posterior maxillary region causing rupture and invasion of the maxillary sinus floor. An incisional biopsy was performed, and histopathologic examination revealed islands, trabeculae, and nests of basaloid epithelial cells, sometimes presenting peripheral ameloblastic differentiation. The diagnosis was basal cell ameloblastoma. The tumor was treated with decompression for 10 months, with approximately 60% of regression of the lesion, and then a surgical enucleation followed by curettage was performed. Despite rarely occurring in the maxilla, ameloblastoma is an aggressive tumor that must be considered in the differential diagnosis of multilocular lesions in this anatomic site.

Pemphigus vulgaris (PV) is an autoimmune disease, characterized by the formation of autoantibodies against desmosomes of keratinocytes, resulting in intraepithelial blisters. We report a case of a 70-year-old female patient presenting with widespread, painful, eroded, or ulcerated mucosal lesions with 3 weeks’ evolution. Nikolsky’s sign was negative. Incisional biopsy of a jugal mucosa lesion was performed, and histopathologic analysis revealed squamous epithelium showing acantholysis, with suprabasal clefts containing so-called acantholytic Tzanck cells. The diagnosis was PV, confirmed by direct immunofluorescence. Prednisolone (60 mg/once/daily) was prescribed for 15 days, with improvement of the condition, and further gradual dose reduction was carried out. The patient is undergoing follow-up for 20 months, with no oral or cutaneous manifestation of the disease. Although PV is a systemic disorder, oral manifestations often precede cutaneous manifestations and are the first signs of disease. Thus, dentists have a fundamental role in the early diagnosis and treatment of these conditions.

Glandular odontogenic cyst (GOC) is a rare developmental cyst, comprising less than 1.0% of the jaws cysts. We report a case of a 45-year-old Caucasian male, presenting with a slight painless swelling in the posterior region of the mandible. Cone beam computed tomography revealed a well-defined hypodense lesion, approximately 3.2 × 2.2 cm, involving the tooth 48. An incisional biopsy was performed, and microscopic examinations revealed multiple pathologic cavities lined by odontogenic epithelium of variable thickness, presenting small duct-like structures and occasional goblet cells, surrounded by a fibrous capsule. The diagnosis was GOC. Cystic marsupialization was carried out, and clear regression of the lesion is observed after 9 months’ follow-up. Because of the aggressive biologic behavior, a correct diagnosis of GOC is essential to ensure the proper management of the lesion. As the diagnosis of GOC may be challenging, we provide a discussion of the histopathologic criteria of differential diagnosis.