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Adenoid ameloblastoma is a newly recognized epithelial odontogenic tumor. Herein, we present the case of a 24-year-old male patient who exhibited swelling in the anterior region and right hemi-mandible. Computed tomography demonstrated the presence of a hypodense osteolytic lesion associated with an impacted tooth. Based on the clinical hypotheses of the dentigerous cyst, odontogenic keratocyst, and ameloblastoma, an incisional biopsy was performed, and the diagnosis of ameloblastoma was rendered. A surgical resection of the tumor was performed. Histopathological examination of the specimen revealed typical areas of ameloblastoma associated with ductiform structures and cell proliferation in a solid storiform pattern, features resembling those found in adenomatoid odontogenic tumor. Based on these findings, the diagnosis of adenoid ameloblastoma was rendered. The accurate diagnosis of this locally infiltrative tumor is essential due to its similarity to other odontogenic neoplasms. [ABSTRACT FROM AUTHOR]

Hybrid odontogenic tumors are characterized by presenting histopathological features of two or more distinct odontogenic lesions. Here we report a hybrid odontogenic tumor case composed of an ameloblastoma (AM) recurrence associated with ameloblastic fibroma (AF). A 60-year-old male patient underwent a clinical follow-up of an AM surgically treated 10 years ago. The computed tomography scan identified an isodense osteolytic lesion partially obliterating the left maxillary sinus. Due to the medical history, the clinical hypothesis was AM recurrence. Microscopic examination revealed a benign odontogenic neoplasm showing areas of ameloblastomatous epithelium proliferation in a dense connective tissue stroma and areas of ameloblastic epithelium with a myxoid cell-rich connective tissue. The final diagnosis was AM associated with AF. Hybrid odontogenic lesions are widely discussed, and an accurate microscopic examination is essential to determine their clinical behavior. Due to its sporadic reports, long-term follow-ups are necessary to better understand their prognosis. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

We performed an epidemiological, clinical and histopathological analysis of oral lymphoid lesions (OLLs) during a 47-year period. Data regarding patient age, sex, duration, location, symptomatology, type of growth, implantation, staining, presence of ulceration and bleeding of all cases were compiled from the clinical data. For the histopathological analyses, all slides stained by H/E were reassessed. During the analyzed period, 14,565 patients with oral and maxillofacial lesions were diagnosed, with 45 cases diagnosed as OLLs. The most prevalent location was the tongue. Females were more affected, and the mean age was 40.8 years. OLLs presented a heterogeneous frequency, with the prevalence of reactive lesions (42.3%) followed by developmental lesions (35.6%). Among the reactive lesions, foreign body granulomas were the most common. Regarding diagnosed neoplasms, malignant represented 13.2% of the cases. The average time of evolution of OLLs in general was of 22.2 months. Regarding the histopathological characteristics, the presence of primary lymphoid follicles was observed in 37.8% of the cases, while inflammatory infiltrates were diffuse in 66.7% and epimyoepithelial islands were observed in 13.3%. Our study concludes that OLLs involves a broad spectrum of lesions that share the presence of the lymphoid component, which can range from indolent to more aggressive behavior. [ABSTRACT FROM AUTHOR]

To analyze the clinicopathologic features of oral neurofibromas (ONs) diagnosed in 2 Brazilian oral and maxillofacial pathology referral centers. A retrospective clinicopathologic study of ONs was performed (2000-2020). All cases were revised, and clinicopathologic data were collected. Among 18,121 diagnoses, 44 (0.2%) were ONs. There was a high frequency of females (62.6%) and a mean age of 43.4 years. Three patients had neurofibromatosis type 1 (6.8%), and 1 showed multiple ONs (2.3%). The palate was the most affected anatomic site (50%). Microscopically, most lesions were not well delimited (90.9%), and the stroma was predominantly fibrous (52.3%). Thirty cases exhibited mast cells (68.2%). Meissner bodies were present in 2 cases (4.5%). Forty-one cases were classified as diffuse ONs (93.2%). ONs may occur as single or multiple lesions, associated or not with neurofibromatosis type 1. ONs may be composed of the fibrous stroma, and mast cells and chronic inflammatory cells are commonly found. Diffuse ONs are more common. Knowledge of clinicopathologic features is essential for the correct diagnosis of ONs. [ABSTRACT FROM AUTHOR]

To analyze the clinicopathologic features of nasopalatine duct cysts (NDCs) diagnosed in 2 Brazilian oral and maxillofacial pathology referral centers. A retrospective clinicopathologic study of NDCs diagnosed between 2000 and 2020 was performed. All cases were revised, and clinicopathologic data were collected. Among 18,121 diagnoses in the oral pathology services, 45 were NDCs (0.2%), with a slightly high prevalence of males (53.3%) and mean age of 43.2 years old. Most lesions were asymptomatic (60%), with a mean size of 2.1 cm. Microscopically, nonkeratinized stratified squamous epithelium was the most common (66.7%). However, epithelial lining varied in 88.9% of cases. There was no significant association between the type of epithelium and cyst size (P =.389). In the histopathological exam, nerves, blood vessels, hemorrhage and chronic inflammatory infiltrate were commonly observed. There was low frequency of mucous glands, sebaceous glands, cholesterol clefts, and multinucleated giant cells. Our clinical, radiographic, and microscopic findings are similar to those reported in the literature. Due to the morphological diversity of NDC, it is necessary to correlate its histopathologic features with clinical and radiographic findings to establish a correct diagnosis. [ABSTRACT FROM AUTHOR]

Angina Bullosa Hemorrhagica (ABH) is a recurrent disorder characterized by the appearance of oral mucosal blisters filled with blood, mainly in the soft palate and tongue of middle-aged or older adults. We report a case of a 68-year-old White female patient with no relevant medical history complaining of a blood blister on the lateral surface of the tongue lasting 2 days. No possible triggering factors were identified. Based on clinical features and exclusion of hematologic disorders, the diagnosis was ABH. The treatment was an incision of the blister and prescription of analgesic drugs. At 15 days of follow-up, the oral mucosa was normal. ABH can easily be confused with autoimmune or hematologic disorders. Therefore, recognition of the lesion is essential to dentists to avoid misdiagnosis. The clinical management of ABH is often focused only on the relief of symptoms. [ABSTRACT FROM AUTHOR]

This research aimed to evaluate the immunoexpression of IL-17 and IL-23 proteins in papillary thyroid carcinomas (PTCs), follicular adenomas (FAs), colloid goiters (CGs), and Hashimoto's thyroiditis (HTs; isolated and associated with PTCs or GCs) in order to better understand the role of these cytokines in these entities. The sample consisted of 30 cases of PTCs, 10 FAs, 15 CGs and 15 HTs. The analysis of protein immunoexpression in follicular/tumor cells with cytoplasmic marking, under 400 × magnification, was semiquantitatively performed in all lesions, which were classified using 3 scores: 1 (≤33%), 2 (>33%-66%) and 3 (>66%). In the evaluation of IL-23, a higher immunostaining of follicular/tumor cells in HTs was detected in relation to PTCs (P =.002). In addition, a statistically significant correlation between the immunoexpression of IL-17 and IL-23 in both follicular/tumor cells (r = 0.539; P =.038) of the HTs was observed. It is suggested that IL-17 and IL-23 influence the pathogenesis of these thyroid lesions and that in some of them they may represent an action of the TH17 immune response. [ABSTRACT FROM AUTHOR]

To investigate the incidence and demographic profile of hamartomatous, choristomatous, and teratoid lesions in a population over a 49-year period. A retrospective cross-sectional study was performed, and data regarding demographic and clinical information and histopathologic diagnosis were collected. Medical records were obtained from a referral center for a 49-year period. The collected data were submitted to descriptive analysis and 'Pearson's chi-square, Fisher's exact, and Kruskal-Wallis tests (P ≤.05). From a total of 16,412 medical records analyzed, 1.83% were hamartomatous, 0.01% choristomatous, and 0.01% teratoid lesions. Hamartomas were most diagnosed in females and adults. Odontoma and vascular malformations were the most frequent hamartomatous lesions. The anatomical site most affected by hamartoma was the gingiva/alveolar ridge. Choristomas were observed on the mandible and tongue, and teratoid lesions were seen on the floor of the mouth. The results showed a low occurence of choristomatous and teratoid lesions when compared to hamartomatous lesions. The analyzed variables showed a heterogeneous occurrence profile. [ABSTRACT FROM AUTHOR]

To evaluate oxidative DNA damage (8-hydroxy-2′-deoxyguanosine [8-OHdG]) and its repair by the base excision repair pathway (Redox factor-1 [Ref-1]; X-ray Repair Cross Complementing-1 [XRCC-1]) in oral leukoplakia (OL) with different degrees of epithelial dysplasia (ED). Forty-four cases of OL and 10 normal oral mucosa (NOM) were evaluated quantitatively for 8-OHdG, Ref-1, and XRCC-1 by immunohistochemistry. Cytoplasmic 8-OHdG expression was significantly associated with multiple synchronous lesions (P =.048). A significantly gradual cytoplasmic 8-OHdG increase was observed between NOM and ED (P <.05). Nuclear Ref-1 expression was significantly lower (P =.004) in nondysplasia/mild ED, whereas its cytoplasmic expression was higher in nondysplasia/mild ED and moderate/severe ED compared to NOM (P =.03, P <.0001, respectively). Significantly higher cytoplasmic XRCC-1 expression in OL (P <.0001) was observed. 8-OHdG plays a role in the onset of multiple synchronous OL and the severity of ED. The subcellular level of Ref-1 implies different roles according to the ED degree. Cytoplasmic XRCC-1 expression indicates a DNA repair mechanism failure during oral carcinogenesis. [ABSTRACT FROM AUTHOR]

To analyze the clinicopathologic features of oral melanocytic nevi (OMN) diagnosed in an oral and maxillofacial pathology service. A retrospective clinicopathologic study of OMNs diagnosed between 2000 and 2020 was performed. All cases were revised, and clinicopathologic data were collected. Among 17,030 diagnoses, 29 were OMNs (0.17%), with a high prevalence among females (n = 22; 75.9%) and a mean age of 37.6 years old. Most lesions exhibited a nodular aspect (31%) and affected the lips (31%) and oral mucosa (24.1%). Clinically, 62.1% of OMNs were pigmented. Blackish and brownish coloration was observed in 37.9% and 24.1% of cases, respectively. A mean size of 0.5 cm was found and 75.9% of cases were asymptomatic. Microscopically, intramucosal nevus was the most common (n = 26; 89.7%), followed by compound nevus (n = 2; 6.9%). The clinical features observed in this study are similar to those reported in the literature. Intramucosal nevus is the most common type of OMN. Because OMNs can exhibit a broad of clinical features, it is necessary to correlate the clinical and histopathologic features to establish a correct diagnosis. [ABSTRACT FROM AUTHOR]

To report the clinicopathologic features of a large series of oral mucoceles from Brazil. A retrospective descriptive cross-sectional study was performed. A total of 43,754 biopsy records of oral and maxillofacial lesions from 4 pathology services in Brazil were analyzed. All cases of oral mucoceles were reviewed, and clinical and demographic data were collected. The study comprised 1002 females (56.2%) and 782 males (43.8%) with a mean age of 19.8 ± 16.4 years (range, 01-87 years). The lower lip (n = 1,160, 67.4%) and floor of mouth (n = 172, 10.0%) were the most common affected sites, presenting clinically as nodules (n = 978, 79.4%) with a smooth surface (n = 428, 77.5%) and normal color (n = 768, 46.7%). Excisional biopsy was the treatment in most cases (n = 1392, 78.0%). Recurrent oral mucoceles represented 6.2% of all diagnosed cases (n = 117). Our results confirm the findings of previous studies regarding the major clinical features of oral mucoceles. Mucoceles are lesions commonly seen in oral pathology and oral medicine services, mainly affecting the lower lip of children and young adults. [ABSTRACT FROM AUTHOR]

To report the clinical features of angina bullosa hemorrhagica (ABH) cases, emphasizing the clinical and therapeutic characteristics. A retrospective descriptive cross‐sectional study was performed in 3 oral and maxillofacial pathology services and 1 private practice in Brazil. Clinical data were collected from the clinical records and evaluated. The series comprised 12 males (52.2%) and 11 females (47.8%), with a mean age of 56.8 ± 14.6 years. Most of the lesions affected the soft palate (n = 15, 65.2%) and tongue (n = 6, 26.1%). Clinically, the lesions presented mainly as an asymptomatic (n = 17, 73.9%) blood-filled blister that ruptured after a few minutes or hours, leaving an erosion. When specified, the masticatory trauma was the most frequent triggering event. No individual had coagulation disorders. Treatment was symptomatic with a favorable outcome. ABH is still poorly documented in the literature, and its etiology remains uncertain. ABH mainly affects the soft palate of elderly adults and has a favorable evolution in a few days. However, it can share some clinical features with more serious diseases. Therefore, a careful clinical examination is essential to rule out possible autoimmune or hematologic disorders. [ABSTRACT FROM AUTHOR]

A 26-year-old male sought an oral medicine service, presenting with multiple lesions in the oral cavity and skin. The patient had recently been diagnosed with human immunodeficiency virus infection. Laboratory tests showed an evident CD4 cell deficiency and an elevated viral load (337,000 copies/mL). Intraoral examination revealed multiple bluish-purple nodules and red plaques on the hard palate lasting 8 months. Purple spots and papules on the nose and trunk were also observed. The diagnostic hypothesis was Kaposi's sarcoma (KS) associated with acquired immunodeficiency syndrome. An incisional biopsy of the oral lesions was performed. Microscopic examination revealed a proliferation of spindle cells and numerous vascular channels with irregular, dilated thin walls, hemorrhage, and hemosiderin deposition. Immunohistochemistry showed tumor cells positive for human herpesvirus 8. The diagnosis was KS. The patient is currently undergoing chemotherapy with doxorubicin and shows evident signs of lesion remission. [ABSTRACT FROM AUTHOR]

Benign osteolytic lesions are common in children and include true neoplasms and tumor-like lesions. A 7-year-old female patient presented with swelling in the left hemiface with 3 months of evolution. Facial asymmetry and mouth opening limitation were observed on extraoral examination. Intraorally, the lesion had a normal color and firm consistency. Computed tomography revealed an osteolytic isodense lesion in the left posterior mandible and zygomatic arch. The patient's medical history was not contributory. The diagnosis of incisional biopsy was suggestive of ossifying fibroma with osteosarcoma-like areas. The patient underwent resection of the lesion and rehabilitation. Microscopically, the surgical specimen showed proliferation of multinucleated giant cells and ovoid to spindle-shaped mononuclear mesenchymal cells as well as immature bone trabeculae exhibiting osteocytes and osteoblastic pavimentation, both atypical, in connective tissue with variables density. The final diagnosis was central giant cell granuloma. The patient has been followed up, showing no signs of local complications. [ABSTRACT FROM AUTHOR]

Ameloblastoma is an aggressive odontogenic tumor with a relatively high recurrence rate. A 60-year-old male patient presented, in a follow-up computed tomography, an osteolytic isodense lesion obliterating the left maxillary sinus and involving the orbit floor, zygomatic bone, and infratemporal fossa. The lesion was asymptomatic, and no facial asymmetry was observed. His past medical history revealed ameloblastoma in the left ramus of the mandible, coronoid process, which was surgically treated 10 years prior. The clinical diagnosis was recurrent ameloblastoma. Excisional biopsy revealed areas of benign epithelial odontogenic neoplasm characterized by a cystic cavity lined by ameloblastomatous epithelium and stroma of fibrous connective tissue, and areas of benign mixed odontogenic tumor composed of ameloblastic cells in a myxoid and cell-rich mesenchyma. The final diagnosis was ameloblastoma associated with ameloblastic fibroma. The patient underwent rehabilitation and has been followed up, showing no signs of local complications. [ABSTRACT FROM AUTHOR]

Sialolipoma is a histologic variant of lipoma characterized by proliferation of mature adipocytes with secondary entrapment of normal salivary gland tissue. These tumors occur mainly in the parotid gland and palate of female adults. Herein, we report a rare case of a sialolipoma in a 42-year-old male patient, presenting as a painless yellowish nodular lesion of soft consistency on the border of the tongue. A provisional diagnosis of lipoma was established, and an excisional biopsy was performed. Histopathologic analysis revealed a proliferation of mature adipocytes in a lobular arrangement with secondary entrapment of normal salivary gland tissue. The diagnosis was sialolipoma. The patient remains with no evidence of recurrence at 5-month follow-up. Pathologists must recognize sialolipomas to avoid misdiagnoses with other lipomatous tumors that can affect salivary glands. [ABSTRACT FROM AUTHOR]

The relationship between infection by human immunodeficiency virus (HIV) and oral lymphoepithelial cyst (OLC) is uncertain. Herein, we presented a rare case of OLC on the tongue in a male patient with HIV. Intraoral examination revealed a yellow nodular lesion with a smooth surface on the tongue's right lateral border measuring 0.8 cm. Medical history revealed that the patient had been diagnosed with HIV 1 month earlier and was being treated with antiretroviral therapy. An excisional biopsy was performed. Histopathologic examination showed a cystic lesion covered by squamous epithelium surrounded by a fibrous capsule containing dense lymphoid infiltrate with prominent germinal centers. The diagnosis was OLC. No evidence of recurrence was observed after 1 year of follow-up. Although rare, OLC can arise in the context of HIV infection. The treatment of choice is conservative surgical removal, and recurrence is uncommon. [ABSTRACT FROM AUTHOR]

To evaluate the clinical and histopathologic aspects of the dermoid cysts (DCs) of the oral cavity. All DCs kept in the archives of an oral pathology service for 48 years were reviewed. Data were collected from patient charts and a total of 14 microscopy slides were reviewed by 2 previously trained examiners. DCs were slightly more common in women (71.4%) and the mean age was 37.2 ± 28.6 years. The lesions measured 3.3 ± 3.3 cm on average. Histologically, stratified squamous epithelium was noted in 14 (100%) cases followed by respiratory epithelium (14.3%). Hair follicle was present in 85.7% of the cases. Sweat (28.6%), sebaceous (85.7%), and salivary (14.3%) glands were observed in the cystic wall, and 10 (71.4%) cases showed chronic inflammatory cells. Adipose and neural tissues were observed in 7 (50%) cases and Pacini bodies was noted in 1 case (7.1%). This study reinforces the importance of knowledge of the clinical and histopathologic aspects of DCs for the correct diagnosis of these lesions. The clinical and histopathologic data of the DCs in our series are similar to studies in other populations. [ABSTRACT FROM AUTHOR]

Kaposi sarcoma (KS) is an uncommon angioproliferative endothelial neoplasm. The pathogenesis of KS is likely multifactorial, but the infection of the cells with the human herpesvirus 8 (HHV-8) and HIV infection represents a consistent etiologic factor. We report a case of KS associated with HIV infection. A 34-year-old male patient showed an asymptomatic nodular lesion on the anterior vestibular gingiva of the maxilla with purple color and slow evolution. The diagnostic hypothesis was of pyogenic granuloma. Excisional biopsy was performed, and results revealed the presence of fascicles of spindle cells and slit-like vascular spaces, which frequently contained erythrocytes. The immunohistochemical analysis showed positivity for the viral antigens of HHV-8. Thus, the histopathologic diagnosis of KS was established. After the final diagnosis, laboratory tests were performed, which revealed HIV infection. The patient died after 3 months of severe immunosuppression and pneumonia. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]