Despite its effectiveness, radiochemotherapy treatment in the head and neck region is accompanied by acute oral complications such as oral mucositis, dysphagia, xerostomia, and dysgeusia. The aim of this study was to analyze and prospectively assess the frequency and evolution of acute oral complications during radiochemotherapy in patients diagnosed with squamous cell carcinoma in the head and neck region. We have analyzed oral complications of 20 patients during 6 weeks of radiochemotherapy treatment for squamous cell carcinoma. Oral mucositis was evaluated according to the World Health Organization criteria, dysphagia, and dysgeusia according to the National Cancer Institute Common Toxicity Criteria, and xerostomia according to parameters set by the Seminars in Radiation Oncology. Mucositis was first observed in the second week and all patients presented some degree of mucositis in the fourth week of radiotherapy. Xerostomia and dysphagia were initially reported already in the first week of radiotherapy. All patients presented xerostomia in the fourth week; however, dysphagia was observed in all patients, only in the sixth week. Dysgeusia was first observed in the second week, becoming more severe in the third week. Acute oral complications can be observed throughout the treatment, but the third week of radiotherapy seems to represent a critical week, regardless of the grade of the complication. The sixth week presents the worst grades of these complications. Knowledge about the natural course of oral complications during radiotherapy is important to develop better strategies for treatment and improve the patients’ quality of life.

The present study proposed to systematically review case reports of metastasis to the oral cavity and compile epidemiological, clinical, radiological, and histopathological features, intending to identify common aspects that may favor early diagnosis of such condition. Articles were found by searching the following databases: PubMed; EMBASE; LIVIVO; Web of Science; LILACS; Scopus and SciELO. The search was carried out in March 2021 by two independent researchers, with no restrictions of publication date or language. A total of 2379 studies were retrieved and 60 articles completely matched inclusion criteria, totalizing 65 cases from 19 countries. Metastasis to oral cavity cases were slightly frequent in males (1.7:1) in the sixth decade of life, manifesting in oral soft tissues (58%, 37/65), mostly originated from the lungs (20%, 13/65) as primary site. Adenocarcinoma was the most reported type of malignacy. In 51% of cases the oral metastatic lesion was the first sign of cancer and 60% of the patients already presented metastasis to other locations. In 23% of the reports, only benign lesions were considered as diagnostic hypothesis, due to a remarkable clinical resemblance to hyperplastic, reactive lesions and odontogenic infections. The survival probability at 6 months after oral metastasis diagnosis was 49%. Metastatic lesions to the oral cavity are often misdiagnosed as benign lesions; due to its severity and quick progression, they must be considered in the differential diagnosis process, conducted by a multidisplinary healthcare team comprising an oral surgeon, especially for patients with history of cancer.

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Chin liposuction is a procedure for removing fat from the submental region that can generate significant aesthetic and functional complications. Subcutaneous hematoma is one of these unusual physical changes and is characterized by the accumulation of blood in an ectopic space. A 25-year-old Caucasian male patient came to the emergency room 3 days after double chin liposuction, complaining of decreased cervical mobility, shortness of breath, pain, and aesthetic damage. Physical, imaging, and laboratory tests showed extensive subcutaneous hematoma associated with significant leukocytosis.The patient was hospitalized and submitted to surgical drainage of the submandibular, submental, and cervical fascial spaces in addition to intravenous anti-inflammatory and analgesic medication. After hospital discharge, he was followed up as an outpatient.There was complete remission of signs and symptoms and functional recovery. The correct diagnosis and management of subcutaneous hematoma offers a volumetric reduction of the affected area, allows favorable positioning of tissue planes, ensures airway maintenance, and improves local aesthetics. Thus, adequate control of this complication contributes positively to the patient's quality of life. (Rev Port Estomatol Med Dent Cir Maxilofac. 2022;63(3):xxx-xxx)