Inflammatory myofibroblastic tumor, also known as inflammatory pseudotumor and plasma cell granuloma, is a tumor that occurs most often in the lungs, abdomen, skin, soft tissue, genital system, and mediastinal. Before surgery, the diagnosis is difficult to establish because of its diverse manifestations. In the head and neck, manifestation is rare and may occur in the upper respiratory tract, soft tissues, orbits, and skull base. This article aims to report a rare manifestation of the disease in the face, highlighting the importance of a correct diagnosis to determine the most appropriate form of treatment, in male patient, leucoderma, 22 years old, with complain of a painless unilateral growth in the left cheek, beginning 2 months before and with progressive growth.
Introduction: Ameloblastoma is the most common benign tumor of odontogenic origin, and represents about 11% of all odontogenic tumors. It is characterized by being locally aggressive and having high recurrence rates. Objective: To evaluate the occurrence of ameloblastoma in the Erasto Gaertner Hospital in patients from 1972 to 2012. In addition, to assess the main treatments, the most prevalent histological variants, the recurrence rate, the anatomical location of the lesion and patient profile. Material and methods: A retrospective study of patients diagnosed with ameloblastoma at the Erasto Gaertner Hospital between the years 1972-2012 was performed. Epidemiological data were collected such as gender, age, race, lesion location, type of surgical procedure, follow-up and recurrence rate; and analyzed using descriptive statistics. Results: A total of 40 patients were selected for the study. The most affected age group was between the third and fifth decade of life, with 19 cases (47.5%), followed by the second and fourth decade, with 14 cases (35%); the sixth decade, with 5 cases (12.5%) and seventh decade with 1 case (2.5%). The patients' ages ranged from 13 to 66 years, with an average age 34.9 years. The mandible was the most affected site, with 38 cases (95%) of cases, and maxilla had only 2 cases (5%). Thirty-eight patients were treated with radical surgery and 5 patients presented recurrence after 1 year of follow-up. Both cases that occurred in maxilla presented recurrence. Conclusion: Recurrence of ameloblastoma decreases significantly when surgery is performed properly, with wide excision and margin. Combination of full tumor resection and reconstruction was the best approach observed in this study. In addition, we recommend a long period of clinical and radiographic follow-up.
O diagnóstico tardio de lesões císticas odontogênicas é comum devido o seu crescimento assintomático. Dentre os tratamentos propostos na literatura, atualmente a descompressão ou a marsupialização é indicada para diminuir o tamanho do cisto, para posterior enucleação completa da lesão. A utilização do intensificador de imagem durante o transoperatório, é comumente realizado para orientação e localização de corpos estranhos, projéteis de arma de fogo ou agulhas fraturadas, sendo dificilmente relatado em estudos para auxílio no tratamento de cistos odontogênicos. O presente artigo tem como objetivo relatar um caso clínico de uma paciente jovem, diagnosticada com ceratorcisto odontogênico, a qual foi submetida ao tratamento de marsupialização e posterior enucleação cística. Durante o transoperatório, houve dificuldade localização do dente incluso associado a lesão, devido ao grande deslocamento para a base da mandíbula. Sendo assim utilizado o intensificador de imagem para a localização e remoção do dente. Complicações transoperatórias são comuns de ocorrer, principalmente tratando-se de lesões císticas extensas, devido o grau de dificuldade. A utilização de técnicas e equipamentos que favoreçam benefícios de facilitar e agilizar o procedimento cirúrgico acarretam a diminuição de morbidades ao paciente. A utilização do intensificador de imagem, apresenta-se viável em situações incomuns, tanto para localização de corpos estranhos, quanto dentes inclusos em localizações atípicas.
Ameloblastoma is the most common benign tumor of odontogenic origin, and represents about 11% of all odontogenic tumors. It is characterized by being locally aggressive and having high recurrence rates. Objective: To evaluate the occurrence of ameloblastoma in the Erasto Gaertner Hospital in patients from 1972 to 2012. In addition, to assess the main treatments, the most prevalent histological variants, the recurrence rate, the anatomical location of the lesion and patient profile. Material and methods: A retrospective study of patients diagnosed with ameloblastoma at the Erasto Gaertner Hospital between the years 1972-2012 was performed. Epidemiological data were collected such as gender, age, race, lesion location, type of surgical procedure, follow-up and recurrence rate; and analyzed using descriptive statistics. Results:A total of 40 patients were selected for the study. The most affected age group was between the third and fifth decade of life, with 19 cases (47.5%), followed by the second and fourth decade, with 14 cases (35%); the sixth decade, with 5 cases (12.5%) and seventh decade with 1 case (2.5%). The patients’ ages ranged from 13 to 66 years, with an average age 34.9 years. The mandible was the most affected site, with 38 cases (95%) of cases, and maxilla had only 2 cases (5%). Thirty-eight patients were treated with radical surgery and 5 patients presented recurrence after 1 year of follow-up. Both cases that occurred in maxilla presented recurrence. Conclusion: Recurrence of ameloblastoma decreases significantly when surgery is performed properly, with wide excision and margin. Combination of full tumor resection and reconstruction was the best approach observed in this study. In addition, we recommend a long period of clinical and radiographic follow-up.
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