There is a high prevalence of oral lesions in the elderly patients of Valparaiso. The use of drugs and /or denture increases significantly the likelihood that a person over 60 years presents lesions in the oral mucosa.
Odontogenic fibromas are a rare benign odontogenic neoplasia, characterized by the presence of odontogenic epithelium with an inactive appearance in a cellular fibrous stroma. Histopathologically there are two types of odontogenic fibromas: an epithelium-poor type (simple type) and an epithelium-rich type (WHO or complex type). Depending on its primary location, two variables can be distinguished, one central or intraosseous and one peripheral or extraosseous. Several cases were published in the literature, but always as unique lesions, and when seen in a multiple manner, they were described as hamartomas associated with enamel dysplasia and other dental malformations. The following report describes a case of bilateral WHO-type central odontogenic fibromas in the premolar area of the mandible in a 13-year-old boy, with 5-year radiographic follow-up. The patient showed no clinical evidence of the lesions, just inclusion of the premolars, so the lesions were a radiographic finding. The teeth were extracted together with the lesions and they were sent for biopsy with a presumptive diagnoses of dentigerous cysts. Both samples were examined using routine techniques (hematoxylin and eosin with light microscopy), and a diagnosis of an odontogenic fibroma was made. The samples were stained with picro-sirius red and were examined under polarized light, which confirmed the diagnosis. We present the complete case with 5-year complete radiographic follow-up with the corresponding histopathological and histochemical characteristics.
Alveolar soft-part sarcomas are clinically and morphologically distinct soft-tissue sarcomas, with an unknown histogenesis. When the tumors affect the region of the head and neck, they are often located in the orbit and tongue. We report a case of an alveolar soft-part sarcoma in the left masseter of a 28-year-old female. The patient had chronic pain and paresthesia of her left lower lip. Panoramic radiography and computed tomography showed a well-delimited radiolucent mass in the left ramus. An incisional biopsy was performed, and the sample submitted for histopathological study. The tumor showed positive periodic acid-Schiff diastase-resistant granules. Immunohistochemically, the tumor cells were diffusely positive for myoglobin, and focally positive for actin and desmin.
Neurofibroma is a benign neoplasm derived from peripheral nerves. Most of these are associated with Neurofibromatosis but may also occur as solitary lesions. When found on the head and neck they are generally located in the soft tissue. Intraosseous location is very rare. The following report describes a case of an intraosseous neurofibroma located in the left mandibular ramus of a 14-year-old child. The patient did not had clinical evidence of the lesion and it was found on a routine radiographic examination. Surgical excision of the lesion was scheduled and the sample was submitted to histopathological study. Representative sample cuts were studied using conventional techniques of hematoxylin-eosin and immunohistochemistry using primary antibodies anti S-100 protein, vimentin, and neuroespecific enolase. A review of clinical, radiographic, histologic and immunohistochemical features of other cases of intraosseuos neurofibromas located in the jaws together with the possible differential diagnosis of the lesion are discussed. Our case corresponds to a intraosseous neurofibroma of controveltial diagnosis because even though it presents typical neurofibroma histomorphological features it has immunophenotype different from usual.
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