Ameloblastoma is an uncommon odontogenic neoplasm that accounts for approximately 10% of all tumors originating from gnathic bones. Although its growth is localized, the tumor can also be infiltrative and persistent; however, its behavior is usually benign. The mandible is the most commonly affected site, and ameloblastoma is most frequently diagnosed between the fourth and fifth decades of life. In addition to a brief review of the literature, the present study discusses the clinical, imaging, histopathological and prognostic characteristics of these tumors by presenting two case reports. In these cases, the patients were aged 40 and 66 years, of different sexes and ethnicities and presented with the same complaint regarding localized and asymptomatic swelling. Both cases occurred in the posterior region (but on opposite sides) of the mandible. The patients were initially subjected to clinical examination and imaging of the face, followed by incisional biopsy to confirm (in both cases) the diagnosis of multicystic intraosseous ameloblastoma with a plexiform pattern. Both patients were treated by wide resection of the lesion (with safety margins), and only one patient experienced tumor recurrence. After 42 and 68 months of follow-up, the patients are still alive and show no signs of recurrence. Clinical and imaging findings aid in the differential diagnosis of ameloblastomas; however, histopathological evaluation is essential for its definitive diagnosis. Early diagnosis and precise detection of the borders to provide adequate safety margins during the surgical resection of the tumor are necessary to achieve successful treatment and recurrence-free survival for solid ameloblastomas.
Central ossifying fibroma is a benign slow-growing tumor of mesenchymal origin and it tends to occur in the second and third decades of life, with predilection for women and for the mandibular premolar and molar areas. Clinically, it is a large asymptomatic tumor of aggressive appearance, with possible tooth displacement. Occasionally treated by curettage enucleation, this conservative surgical excision is showing a recurrence rate extremely low. The objective of this study was to report a case of a 44-year-old woman, presenting a very large ossifying fibroma in the mandible, which was successfully treated with curettage, and to conduct a brief literature review of this lesion, focusing on the histology, clinical behavior, and management of these uncommon lesions.
A schwannoma, also called neurilemmoma, is a benign, encapsulated, slow growing tumor, arising from the neural sheath's Schwann cells of the peripheral, cranial or autonomic nerves. The etiology is unknown, there is no gender preference and the tumors occur most commonly between the ages of 20 and 50 years. Approximately 25–48 % of these tumors occur in the head and neck region, with only 1% occurring in the mouth. The current case reports a schwannoma of the tongue, found in a 12 year-old boy. The lesion was present for 6 months. The clinical examination revealed a 1.5x1.0 cm, sessile, rubbery, non-tender, non-ulcerated mass on the right posterior lateral border of the tongue. An excisional biopsy was performed under local anesthesia. The histological sections showed a circumscribed submucosal nodule composed of spindle cells with thin wavy nuclei arranged as typical Antoni A (with Verocay bodies) and Antoni B areas. Nuclear palisading distribution (typical of a schwannoma) was readily identifiable. The patient was recurrence free after one year.
The aim of this study is to identify the epidemiology profile of oral squamous cell carcinoma in a population of patients treated at the Bom Pastor FHOMUV Hospital of Varginha, in the state of Minas Gerais, Brazil. To this end, the medical records of patients admitted between 2004 and 2014 were collected and analyzed. The variables analyzed were: age, gender, habits, tumor location, histological grade, tumor size, presence of lymph nodes and metastasis, staging, treatment and relapse. The population studied consisted of 310 patients. Men represent the majority of cases – 79.68% - with ages varying around 60 years. The most common tumor locations were tongue (40.32%), oropharynx (21.29%) and floor of mouth (12.90%). Regarding staging, 54.25% of patients were in stage IV, of which 41.92 % reached 5-year survival. Radiation combined with chemotherapy was the most prescribed treatment (32.90%). Statistically significant correlations were found between gender and age, gender and tumor location, and tumor location and age. Results suggest a need for the implementation of public policies to prevent and control oral cancer in the state of Minas Gerais, aiming at reducing the number of new cases, promoting early diagnostics and improving prognosis and treatment of such neoplasias.
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