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Silva Cunha JL, Leite AA, de Castro Abrantes T, Vervloet LP, de Lima Morais TM, de Oliveira Paiva Neto G, Kimura TNL, Ferreira SMS, de Albuquerque-Júnior RLC, Abrahão AC, Romañach MJ, Benevenuto de Andrade BA, de Almeida OP, Soares CD. Oral focal mucinosis: A multi-institutional study and literature review. J Cutan Pathol 2020; 48:24-33. [PMID: 33410541 DOI: 10.1111/cup.13813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 07/05/2020] [Accepted: 07/15/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Oral focal mucinosis (OFM) is a rare benign condition of unknown etiology, considered the oral counterpart of cutaneous focal mucinosis. We report the clinicopathologic features of 21 cases of OFM in conjunction with a review of the literature. METHODS Clinical data were collected from the records of five oral and maxillofacial pathology services. All cases were evaluated by hematoxylin and eosin staining, histochemistry, and immunohistochemistry (vimentin, S-100, α-SMA, CD34, and mast cell). RESULTS The series comprised 14 females (66.7%) and seven males (33.3%), with a mean age of 48.2 ± 20.7 years (range: 8-77 years) and a 2:1 female-to-male ratio. Most of the lesions affected the gingiva (n = 6, 28.6%) and presented clinically as asymptomatic sessile or pedunculated nodules with fibrous or hyperplasic appearance. All cases were negative for S-100 protein, CD34, and α-SMA and positive for Alcian blue staining. Conservative surgical excision was the treatment in all cases, and there was only one recurrence. CONCLUSION OFM is a rare benign disorder that is often clinically misdiagnosed as reactive lesions or benign proliferative processes. Dermatologists and pathologists should consider OFM in the differential diagnosis of soft tissue lesions in the oral cavity, mainly located in the gingiva.
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Affiliation(s)
- John Lennon Silva Cunha
- Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Amanda Almeida Leite
- Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Thamiris de Castro Abrantes
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Lorena Passoni Vervloet
- Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Thayná Melo de Lima Morais
- Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | | | | | | | | | - Aline Corrêa Abrahão
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Mario José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | - Oslei Paes de Almeida
- Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Ciro Dantas Soares
- Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
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2
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Tamiolakis P, Chrysomali E, Sklavounou-Andrikopoulou A, Nikitakis NG. Oral neural tumors: Clinicopathologic analysis of 157 cases and review of the literature. J Clin Exp Dent 2019; 11:e721-e731. [PMID: 31598201 PMCID: PMC6776406 DOI: 10.4317/jced.55944] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 07/04/2019] [Indexed: 12/12/2022] Open
Abstract
Background Oral neural tumors (ONTs) are rare lesions and represent reactive or neoplastic proliferations of nerve sheath cells. The purpose of the present study is to report the clinical, demographic and histopathologic features of 157 ONTs diagnosed in a single Oral Pathology Department and review the pertinent literature. Material and Methods 157 cases of ONTs diagnosed during a 44-year period were retrospectively collected and the diagnosis was reconfirmed by studying representative haematoxylin and eosin stained tissue sections. The patients’ gender and age, as well as the main clinical features of the lesions, were retrieved from the biopsy submission forms. Results The 157 ONTs represented approximately 0.4% of 35,590 biopsies accessioned during the study period. They affected 71 male and 86 female patients with a mean age of 38.4±18.8 years. They mainly appeared as asymptomatic nodules of normal or white colour on the tongue, lip mucosa and hard palate. The most common ONT was granular cell tumour (38.9%) followed by neurofibroma (19.7%), schwannoma (15.9%), traumatic neuroma (15.9%), palisaded encapsulated neuroma (8.3%) and nerve sheath myxoma (1.3%). Conclusions This study confirmed the rarity of ONTs. Their clinical characteristics mimic other oral lesions; thus, microscopic examination is the only mean to arrive at a definitive diagnosis. Key words:Oral neural tumors; oral neural neoplasms; neurofibroma; oral neurofibroma; schwannoma; oral schwannoma; neurilemmoma; oral neurilemmoma; granular cell tumor; oral granular cell tumor; traumatic neuroma; oral traumatic neuroma; palisaded encapsulated neuroma; oral palisaded encapsulated neuroma.
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Affiliation(s)
- Paris Tamiolakis
- DDS, MSc, Department of Oral Medicine and Pathology, Department of Dentistry, School of Health Sciences, National and Kapodistrian University of Athens, Greece
| | - Evanthia Chrysomali
- DDS, PhD, Associate Professor, Department of Oral Medicine and Pathology, Department of Dentistry, School of Health Sciences, National and Kapodistrian University of Athens, Greece
| | - Alexandra Sklavounou-Andrikopoulou
- DDS, MSc, PhD, Professor, Department of Oral Medicine and Pathology, Department of Dentistry, School of Health Sciences, National and Kapodistrian University of Athens, Greece
| | - Nikolaos G Nikitakis
- MD, DDS, PhD, Professor, Head of Department of Oral Medicine and Pathology, Department of Dentistry, School of Health Sciences, National and Kapodistrian University of Athens, Greece
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3
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Miranda-Rius J, Brunet-Llobet L, Lahor-Soler E. The Periodontium as a Potential Cause of Orofacial Pain: A Comprehensive Review. Open Dent J 2018; 12:520-528. [PMID: 30197691 PMCID: PMC6110068 DOI: 10.2174/1874210601812010520] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/25/2018] [Accepted: 07/16/2018] [Indexed: 12/18/2022] Open
Abstract
Introduction: Orofacial pain of periodontal origin has a wide range of causes, and its high prevalence and negative effect on patients' quality of life make intervention mandatory. This review provides a periodontological overview of the field of orofacial pain, focusing on the entities which involve the periodontal tissues and may be the cause of this pain or discomfort. Methods: The study comprised a literature search of these pathologies conducted in the MEDLINE/PubMed Database. Acute infectious entities such as gingival and periodontal abscesses are emergencies that require a rapid response. Periodontitis associated with endodontic processes, necrotizing periodontal disorders, desquamative gingivitis, gingival recession, and mucogingival herpetic lesions, cause mild to severe pain due to tissue destruction and loss. Other lesions that lead to periodontal discomfort include gingival enlargement and periodontal ligament strains associated with occlusal trauma, parafunctional habit and the impaction of food or foreign bodies. Conclusion: A range of therapeutic, pharmacological and surgical alternatives are available for the management of these injuries. However, the wide variety of causes of orofacial pain or periodontal discomfort may confuse the clinician during diagnosis and may lead to the wrong choice of treatment.
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Affiliation(s)
- Jaume Miranda-Rius
- Department of Odontostomatology, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,Hospital Dentistry & Periodontal Medicine Research Group, Institut de Recerca Sant Joan de Déu (IRSJD), Fundació Sant Joan de Déu, Barcelona, Spain
| | - Lluís Brunet-Llobet
- Division of Orthodontics and Pediatric Dentistry, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain.,Hospital Dentistry & Periodontal Medicine Research Group, Institut de Recerca Sant Joan de Déu (IRSJD), Fundació Sant Joan de Déu, Barcelona, Spain
| | - Eduard Lahor-Soler
- Department of Odontostomatology, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.,Hospital Dentistry & Periodontal Medicine Research Group, Institut de Recerca Sant Joan de Déu (IRSJD), Fundació Sant Joan de Déu, Barcelona, Spain
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4
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Hernández-Ríos P, Espinoza I, Salinas M, Rodríguez-Castro F, Baeza M, Hernández M. Distribution of biopsied non plaque-induced gingival lesions in a Chilean population according to the classification of periodontal diseases. BMC Oral Health 2018; 18:112. [PMID: 29921254 PMCID: PMC6009048 DOI: 10.1186/s12903-018-0567-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 05/30/2018] [Indexed: 02/05/2023] Open
Abstract
Background Many gingival lesions are not induced by plaque. The aim of this study was to analyze the frequency of biopsied non-plaque-induced gingival lesions (NPIGL) in a Chilean population. Methods One thousand twelve cases of biopsied gingival lesions with confirmed anatomopathologic diagnosis were included, from the records of the Oral Pathology Referral Institute (OPRI), Faculty of Dentistry, University of Chile, between years 1990 and 2009. Results The most frequent non plaque-induced gingival lesions categories from biopsied cases included hyperplastic lesions, malignancies and benign neoplasms. The most frequent diagnoses in each category were fibrous hyperplasia (35.47%), squamous cell carcinoma (3.85%) and giant cell fibroma (2.08%), respectively. From all lesions, only 8.3% fitted in the specified categories of the current classification of periodontal diseases. Conclusions The most frequent biopsied NPIGL were hyperplastic lesions and neoplasms. These categories represent relevant lesions to be included in a future periodontal classification system to improve the care needs of the patients, as well as early diagnosis and treatment.
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Affiliation(s)
- Patricia Hernández-Ríos
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Avenida Sergio Livingstone 943, Comuna de Independencia, Santiago, Chile
| | - Iris Espinoza
- Department of Pathology, Faculty of Dentistry, University of Chile, Sergio Livingstone 943, Independencia, Santiago, Chile
| | - Macarena Salinas
- Faculty of Dentistry, University of Chile, Sergio Livingstone 943, Independencia, Santiago, Chile
| | - Fernando Rodríguez-Castro
- Dentistry Unit, Faculty of Health Sciences, Universidad Autónoma de Chile, Pedro de Valdivia, 425, Santiago, Chile
| | - Mauricio Baeza
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Avenida Sergio Livingstone 943, Comuna de Independencia, Santiago, Chile.
| | - Marcela Hernández
- Department of Pathology, Faculty of Dentistry, University of Chile, Sergio Livingstone 943, Independencia, Santiago, Chile.,Dentistry Unit, Faculty of Health Sciences, Universidad Autónoma de Chile, Pedro de Valdivia, 425, Santiago, Chile
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5
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Frydrych AM, Firth NA. Oral nerve sheath myxoma: a rare and unusual intraoral neoplasm. Clin Case Rep 2018; 6:302-305. [PMID: 29445466 PMCID: PMC5799657 DOI: 10.1002/ccr3.1341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 11/29/2017] [Accepted: 12/01/2017] [Indexed: 12/18/2022] Open
Abstract
We present a rare case of intraoral nerve sheath myxoma. Clinically, the neoplasm mimics many other oral mucosal pathosis, underscoring the importance of histopathology in ensuring accurate diagnosis of oral mucosal lesions. Reports of intraoral nerve sheath myxomas are essential to enhance our understanding of this rare intraoral entity.
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Affiliation(s)
- Agnieszka M Frydrych
- Oral Medicine UWA Dental School The University of Western Australia M512, 17 Monash Avenue Nedlands Western Australia 6009 Australia.,Oral Medicine WA Suite 3, 42-44 Parliament Place West Perth Western Australia 6005 Australia
| | - Norman A Firth
- Oral Medicine and Oral Pathology UWA Dental School The University of Western Australia M512, 17 Monash Avenue Nedlands Western Australia 6009 Australia
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Bartake A, Palaskar SJ, Narang B, Kathuriya P. Nerve sheath myxoma of the oral cavity: a distinct entity. Br J Neurosurg 2017; 33:213-214. [DOI: 10.1080/02688697.2017.1301379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Anirudha Bartake
- Department of Oral Pathology & Microbiology, Sinhgad Dental College & Hospital, Pune, India
| | - Sangeeta J Palaskar
- Department of Oral Pathology & Microbiology, Sinhgad Dental College & Hospital, Pune, India
| | - Bindiya Narang
- Department of Oral Pathology & Microbiology, Sinhgad Dental College & Hospital, Pune, India
| | - Pargatsingh Kathuriya
- Department of Oral Pathology & Microbiology, Sinhgad Dental College & Hospital, Pune, India
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Tenorio F, Campos P, Paramo JI, Fuente JDL, Pérez N. Chondroid Metaplasia in a Fibroepithelial Polyp of Gingiva. J Clin Diagn Res 2016; 10:ZD09-ZD10. [PMID: 27790592 DOI: 10.7860/jcdr/2016/20007.8481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 06/23/2016] [Indexed: 11/24/2022]
Abstract
Gingival masses are commonly encountered in clinical practice and can be a result of many conditions one of them could be metaplasia. Metaplasia is defined as the replacement of the lining of an organ with the type of lining normally found at another site. We are reporting a case of a 17-year-old Mexican male who presented with a pedunculated nodule associated to maxillary anterior gingiva. The histopatological examination revealed a chondroid material covered by stratified squamous epithelium and was diagnosed as chondroid metaplasia.
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Affiliation(s)
- Fernando Tenorio
- Professor, Department of Oral and Maxillofacial Pathology, National Autonomous University of Mexico, National School of Superior Studies , Unit Leon Mexico
| | - Paola Campos
- Clinical Professor, Basic Integral Clinic, Endodontics Department, National Autonomous University of Mexico, National School of Superior Studies , Unit Leon Mexico
| | - Juan Ignacio Paramo
- Clinical Professor, Basic Integral Clinic, Periodontics Department, National Autonomous University of Mexico, National School of Superior Studies , Unit Leon Mexico
| | - Javier De La Fuente
- Professor, Department of Public Health, National Autonomous University of Mexico, National School of Superior Studies , Unit Leon Mexico
| | - Nancy Pérez
- Senior Resident, Department of Oral and Maxillofacial Pathology, National Autonomous University of Mexico, National School of Superior Studies , Unit Leon Mexico
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Ding YI, Zou F, Peng W, Dai M, Gu H, Zhang B, Nie T. A giant neurothekeoma of the left shoulder blade: A case report. Oncol Lett 2015; 11:1130-1134. [PMID: 26893705 DOI: 10.3892/ol.2015.4028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 09/17/2015] [Indexed: 01/29/2023] Open
Abstract
Neurothekeoma is a rare myxoma of the peripheral nerve sheath. The current report presents a case of a giant neurothekeoma with a partially-formed capsule, scapula erosion and unclear biological behavior, which originated in the intermuscular space between the left trapezius muscle and scapula. The patient was initially misdiagnosed with a fibromatosis using computed tomography and magnetic resonance image scanning. Diagnosis of the neoplasm was confirmed by pathological and immunohistochemical examination, revealing a neurothekeoma with unclear biological behavior. The patient underwent a wide and complete local resection. Using a comprehensive postoperative follow-up strategy, it was determined that the patient recovered well. The tumor was ~17×16×10 cm in size and was in contact with the scapula. The purpose of the present study was to describe a rare giant neurothekeoma and review the diagnostic techniques utilized to reach a definitive diagnosis. Histopathological and immunohistochemical analyses were recommended for the diagnosis of neurothekeoma. There have been no previous reports regarding neurothekeomas exhibiting malignant transformation. Early and complete surgical resection is considered to be an effective method of treating this type of neurothekeoma.
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Affiliation(s)
- Y I Ding
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Fan Zou
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Weixia Peng
- Department of Administration, The Fourth Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330003, P.R. China
| | - Min Dai
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Houyun Gu
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Bin Zhang
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Tao Nie
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
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9
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Unusual presentation of localized gingival enlargement associated with a slow-growing odontogenic myxoma. Int J Oral Sci 2013; 5:172-5. [PMID: 23722914 PMCID: PMC3967326 DOI: 10.1038/ijos.2013.27] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 04/22/2013] [Indexed: 11/24/2022] Open
Abstract
Unusual presentation of localized gingival enlargement associated with a subjacent tumoural pathology is reported. The patient was a 55-year-old black male, whose chief complaint was a progressive gingival overgrowth for more than ten years, in the buccal area of the anterior left mandible. According to the clinical features and the radiological diagnosis of odontogenic keratocyst, a conservative surgery with enucleation and curettage was performed. Tissue submitted for histopathological analysis rendered the diagnosis of odontogenic myxoma. After 12-month of follow-up, no evidence of recurrence was found. Clinicians should be cautious when facing any gingival enlargement to avoid diagnostic pitfalls and to indicate the appropriate treatment.
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10
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Rozza-de-Menezes RE, Andrade RM, Israel MS, Gonçalves Cunha KS. Intraoral nerve sheath myxoma: case report and systematic review of the literature. Head Neck 2013; 35:E397-404. [PMID: 23616426 DOI: 10.1002/hed.23361] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 04/10/2013] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Oral nerve sheath myxoma (NSM) is an uncommon benign neoplasm with Schwann-cell origin, which is frequently mistaken for neurothekeoma. We report a case of NSM on the buccal mucosa in a 42-year-old woman. This case is compared with previously reported cases and a systematic review is performed. METHODS AND RESULTS We conducted a case report and systematic review of oral cases considered true NSMs. A literature search was performed using PubMed, Lilacs, Scielo, Cochrane, SciVerse Scopus, Web of Science, and Embase electronic database. Twenty-five cases of oral NSM were included in the systematic review. CONCLUSION Oral NSM is rare and may represent a diagnostic challenge for pathologists. To confirm the diagnosis of NSM, the evaluation of S-100 protein expression or other neural marker is essential. The use of the terms NSM and neurothekeoma as synonymous or as variants of the same tumor should be avoided, because they are clearly distinct lesions.
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