squamous cell carcinoma of the maxillary sinus: a challenging diagnosis

1
Boy, 6, was brought to UNINCOR with caries and poor dental hygiene. He had DEB-R, anemia, and low weight. He reported the use of NeutroferÒ, ProfolÒ, and mineral oil. Multiple ves- icobullous and ulcerated lesions in the skin and oral mucosa, ankyloglossia, caries, white spots, and crowding were observed. The proposed treatment protocol included continuing the previous care (extra-soft toothbrush BitufoÒ, panoramic radiography); the use of articial saliva, chlorhexidine, and BepantolÒ; and post- operative dexamethasone, Nystatin, Oral BalanceÒ gel, Nutren KidsÒ, and sodium uoride (NaF) applications. All procedures were performed in a single session, without anesthesia. Follow-up at 15 days showed satisfactory oral health and absence of oral lesions. Patients with DEB-R need multidisciplinary assistance with specic protocols (Support: CNPq/FAPEMIG). AO-60 - RENAL OSTEODYSTROPHY: ATYPICAL CASE IN THE MAXILLA. DIEGO DA CRUZ COELHO, LUIZ CARLOS FERREIRA DA SILVA, BERNARDO FERREIRA BRASILEIRO, MARIA DE FÁTIMA BATISTA DE MELO, MARTA RABELLO PIVA. UNIVERSIDADE FEDERAL DE SERGIPE. Renal osteodystrophy (ROD) is a multifactorial disorder of bone metabolism in chronic kidney disease (CKD). With the progression of CKD, abnormalities in vitamin D metabolism and parathyroid hormone (PTH) secretion result in distortion of the trabecular microarchitecture as well as thinning and increased porosity of the cortical bone. Man, 39, reported having CKD for 10 years that was being treated with hemodialysis. He complained of swelling in the jaw observed by his physician that had grown over the previous 3 months. On examination, there was swelling in the left anterior region of the maxilla that had hardened but was painless. The laboratory examinations performed included blood count, coagulation studies, and measurements of alkaline phosphatase, serum calcium, and serum parathyroid hormone (PTH) levels. The patient was imaged using cone-beam computed tomography and underwent incisional biopsy. Evaluation of the results yielded a diagnosis of ROD. AO-61 - SCLEROSING POLYCYSTIC ADENOSIS OF THE PAROTID GLAND: CASE REPORT. KATYA PULIDO DIAZ, ALICIA RUMAYOR PIÑA, LEANDRO AURELIO LIPORONI MARTINS, OSLEI PAES DE ALMEIDA, PABLO AGUSTIN VARGAS. FACULDADE DE ODONTOLOGIA DE PIRACICABA-FOP UNICAMP. Sclerosing polycystic adenosis (SPA) is an uncommon lesion of the major and minor salivary glands similar to adenosis of the breast, described for the rst time by Smith et al. in 1996. Woman, 44, had SPA of the right parotid gland that was misdiagnosed as a low-grade adenocarcinoma. Histopathological analysis showed multiple ducts involved with apocrine differentiation and focal areas of acinar structures in a highly collagenous stroma. Immu- nohistochemical study included SMA, S-100 protein, Calponin, GFAP, CEA, P63, CD44, CD68, Ki67, AE1/AE3, CK7, CK8, CK14 and CK18 and prompted the diagnosis of SPA. Oral pa- thologists should be able to recognize the histopathological fea- tures of SPA and distinguish them from pleomorphic adenoma, mucoepidermoid carcinoma, or low-grade adenocarcinoma. AO-62 - SEVERE CHRONIC OSTEOMYELITIS OF THE MANDIBLE ASSOCIATED WITH AUTOSOMAL DOMI- NANT OSTEOPETROSIS: CASE REPORT. DENISE HÉLEN IMACULADA PEREIRA DE OLIVEIRA, GIORDANO BRUNO PAIVA CAMPOS, ADRIANO ROCHA GERMANO, JOSÉ SANDRO PEREIRA DA SILVA, ÉRICKA JANINE DANTAS DA SILVEIRA, LÉLIA BATISTA DE SOUZA, LÉLIA MARIA GUEDES QUEIROZ. UNI- VERSIDADE FEDERAL DO RIO GRANDE DO NORTE. Osteopetrosis (OP) represents a heterogeneous group of rare hereditary bone disorders with variable clinical features and increased bone density. Osteomyelitis (OM) is a common complication asso- ciated with OP caused by immunodeciency and reduced bone vascularization. Man, 42, with OP came for evaluation of advanced mandibular OM with multiple active, draining extraoral stulas. Microscopic examination showed lamellar bone replacement and predominantly medullary compact bone deposition, with necrotic cell debris and poorly vascularized tissue. This suggested a diagnosis of OP associated with OM. Surgery consisted of resection of the necrotic bone plus soft tissue debridement associated with a trache- ostomy, which was needed because the soft tissue of the mandibular segment collapsed. The patient developed obstruction of the trache- ostomy tube that evolved into cardiac arrest, leading to his death. AO-63 - SOLITARY FIBROUS TUMOR OF THE FLOOR OF THE MOUTH. ALINE CORREA ABRAHAO, JULIANA DE NORONHA SANTOS NETTO, MICHELLE AGOSTINI, VALDIR MEIRELLES JÚNIOR, NATHALIE HENRIQUES SILVA CANEDO, OSLEI PAES DE ALMEIDA, MÁRIO JOSÉ ROMAÑACH. FEDERAL UNIVERSITY OF RIO DE JANEIRO. Solitary brous tumor is a soft tissue neoplasm of uncertain origin that can affect the oral cavity. Woman, 67, presented with a painless, slow-growing, pedunculated nodule in the anterior re- gion of the oor of the mouth that measured 3 2 cm. The lesion had a smooth surface with supercial blood vessels. An exci- sional biopsy was done, with microscopic evaluation revealing a circumscribed tumor characterized by bundles of spindle to ovoid cells with scanty cytoplasm and bland nuclei organized in a storiform pattern, presenting a highly hemangiopericytoma-like vascular stroma. Tumor cells were positive for CD34, CD99, and Bcl-2. Solitary brous tumor was diagnosed. The patient has been followed up for 6 months with no signs of recurrence. Oral sol- itary brous tumor is uncommon, and clinicians should consider this entity when managing swellings on the oor of the mouth. AO-64 - SQUAMOUS CELL CARCINOMA OF THE MAXILLARY SINUS: A CHALLENGING DIAGNOSIS. ISADORA PERES KLEIN, ALESSANDRA DUTRA DA SILVA, GRASIELI RAMOS, MARCO ANTONIO TREVIZANI MARTINS, MANOELA DOMINGUES MARTINS, VINICIUS COELHO CARRARD. UNIVERSIDADE FEDERAL DO RIO GRANDE DO SUL. Squamous cell carcinomas (SCCs) of the paranasal sinuses are uncommon, accounting for about 3% of all head and neck malig- nancies. White man, 40, was referred to the oral pathology clinic of the FO/UFRGS with a chief complaint of pressure on the teeth and diffuse painful swelling in the right maxilla. The lesion had been present for about 1 year but had grown over the last 6 months. Palpation showed a smooth swelling on the right side of the face and palpable, enlarged cervical lymph nodes. Intraorally, an expansile swelling extended from the second premolar to the second molar. Panoramic radiographs revealed opacication in the right maxillary sinus. Microscopic evaluation of a biopsy specimen conrmed SCC. The tumor was treated by maxillectomy, radiotherapy, and chemotherapy. The pa- tient has been closely followed up and has shown no signs of recur- rence after 12 months. Oral rehabilitation is being planned. ORAL AND MAXILLOFACIAL PATHOLOGY OOOO e132 Abstracts February 2014

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Page 1: Squamous Cell Carcinoma of The Maxillary Sinus: A Challenging Diagnosis

ORAL AND MAXILLOFACIAL PATHOLOGY OOOO

e132 Abstracts February 2014

Boy, 6, was brought to UNINCOR with caries and poor dentalhygiene. He had DEB-R, anemia, and low weight. He reportedthe use of Neutrofer�, Profol�, and mineral oil. Multiple ves-icobullous and ulcerated lesions in the skin and oral mucosa,ankyloglossia, caries, white spots, and crowding were observed.The proposed treatment protocol included continuing the previouscare (extra-soft toothbrush Bitufo�, panoramic radiography); theuse of artificial saliva, chlorhexidine, and Bepantol�; and post-operative dexamethasone, Nystatin, Oral Balance� gel, NutrenKids�, and sodium fluoride (NaF) applications. All procedureswere performed in a single session, without anesthesia. Follow-upat 15 days showed satisfactory oral health and absence of orallesions. Patients with DEB-R need multidisciplinary assistancewith specific protocols (Support: CNPq/FAPEMIG).

AO-60 - RENAL OSTEODYSTROPHY: ATYPICAL CASEIN THE MAXILLA. DIEGO DA CRUZ COELHO, LUIZCARLOS FERREIRA DA SILVA, BERNARDO FERREIRABRASILEIRO, MARIA DE FÁTIMA BATISTA DE MELO,MARTA RABELLO PIVA. UNIVERSIDADE FEDERAL DESERGIPE.

Renal osteodystrophy (ROD) is a multifactorial disorder of bonemetabolism in chronic kidney disease (CKD). With the progressionof CKD, abnormalities in vitamin D metabolism and parathyroidhormone (PTH) secretion result in distortion of the trabecularmicroarchitecture as well as thinning and increased porosity of thecortical bone. Man, 39, reported having CKD for 10 years that wasbeing treated with hemodialysis. He complained of swelling in thejaw observed by his physician that had grown over the previous 3months. On examination, there was swelling in the left anterior regionof the maxilla that had hardened but was painless. The laboratoryexaminations performed included blood count, coagulation studies,and measurements of alkaline phosphatase, serum calcium, andserum parathyroid hormone (PTH) levels. The patient was imagedusing cone-beam computed tomography and underwent incisionalbiopsy. Evaluation of the results yielded a diagnosis of ROD.

AO-61 - SCLEROSING POLYCYSTIC ADENOSIS OF THEPAROTID GLAND: CASE REPORT. KATYA PULIDODIAZ, ALICIA RUMAYOR PIÑA, LEANDRO AURELIOLIPORONI MARTINS, OSLEI PAES DE ALMEIDA, PABLOAGUSTIN VARGAS. FACULDADE DE ODONTOLOGIADE PIRACICABA-FOP UNICAMP.

Sclerosing polycystic adenosis (SPA) is an uncommon lesionof the major and minor salivary glands similar to adenosis of thebreast, described for the first time by Smith et al. in 1996. Woman,44, had SPA of the right parotid gland that was misdiagnosed as alow-grade adenocarcinoma. Histopathological analysis showedmultiple ducts involved with apocrine differentiation and focalareas of acinar structures in a highly collagenous stroma. Immu-nohistochemical study included SMA, S-100 protein, Calponin,GFAP, CEA, P63, CD44, CD68, Ki67, AE1/AE3, CK7, CK8,CK14 and CK18 and prompted the diagnosis of SPA. Oral pa-thologists should be able to recognize the histopathological fea-tures of SPA and distinguish them from pleomorphic adenoma,mucoepidermoid carcinoma, or low-grade adenocarcinoma.

AO-62 - SEVERE CHRONIC OSTEOMYELITIS OF THEMANDIBLE ASSOCIATED WITH AUTOSOMAL DOMI-NANT OSTEOPETROSIS: CASE REPORT. DENISEHÉLEN IMACULADA PEREIRA DE OLIVEIRA,GIORDANO BRUNO PAIVA CAMPOS, ADRIANO ROCHA

GERMANO, JOSÉ SANDRO PEREIRA DA SILVA, ÉRICKAJANINE DANTAS DA SILVEIRA, LÉLIA BATISTA DESOUZA, LÉLIA MARIA GUEDES QUEIROZ. UNI-VERSIDADE FEDERAL DO RIO GRANDE DO NORTE.

Osteopetrosis (OP) represents a heterogeneous group of rarehereditary bone disorderswith variable clinical features and increasedbone density. Osteomyelitis (OM) is a common complication asso-ciated with OP caused by immunodeficiency and reduced bonevascularization. Man, 42, with OP came for evaluation of advancedmandibular OM with multiple active, draining extraoral fistulas.Microscopic examination showed lamellar bone replacement andpredominantly medullary compact bone deposition, with necroticcell debris and poorly vascularized tissue. This suggested a diagnosisof OP associated with OM. Surgery consisted of resection of thenecrotic bone plus soft tissue debridement associated with a trache-ostomy, which was needed because the soft tissue of the mandibularsegment collapsed. The patient developed obstruction of the trache-ostomy tube that evolved into cardiac arrest, leading to his death.

AO-63 - SOLITARY FIBROUS TUMOR OF THE FLOOROF THE MOUTH. ALINE CORREA ABRAHAO, JULIANADE NORONHA SANTOS NETTO, MICHELLE AGOSTINI,VALDIR MEIRELLES JÚNIOR, NATHALIE HENRIQUESSILVA CANEDO, OSLEI PAES DE ALMEIDA, MÁRIOJOSÉ ROMAÑACH. FEDERAL UNIVERSITY OF RIO DEJANEIRO.

Solitary fibrous tumor is a soft tissue neoplasm of uncertainorigin that can affect the oral cavity. Woman, 67, presented with apainless, slow-growing, pedunculated nodule in the anterior re-gion of the floor of the mouth that measured 3 � 2 cm. The lesionhad a smooth surface with superficial blood vessels. An exci-sional biopsy was done, with microscopic evaluation revealing acircumscribed tumor characterized by bundles of spindle to ovoidcells with scanty cytoplasm and bland nuclei organized in astoriform pattern, presenting a highly hemangiopericytoma-likevascular stroma. Tumor cells were positive for CD34, CD99, andBcl-2. Solitary fibrous tumor was diagnosed. The patient has beenfollowed up for 6 months with no signs of recurrence. Oral sol-itary fibrous tumor is uncommon, and clinicians should considerthis entity when managing swellings on the floor of the mouth.

AO-64 - SQUAMOUS CELL CARCINOMA OF THEMAXILLARY SINUS: A CHALLENGING DIAGNOSIS.ISADORA PERES KLEIN, ALESSANDRA DUTRA DA SILVA,GRASIELI RAMOS, MARCO ANTONIO TREVIZANIMARTINS, MANOELA DOMINGUES MARTINS, VINICIUSCOELHO CARRARD. UNIVERSIDADE FEDERAL DO RIOGRANDE DO SUL.

Squamous cell carcinomas (SCCs) of the paranasal sinuses areuncommon, accounting for about 3% of all head and neck malig-nancies.Whiteman, 40,was referred to the oral pathology clinic of theFO/UFRGSwith a chief complaint of pressure on the teeth and diffusepainful swelling in the right maxilla. The lesion had been present forabout 1 year but had grownover the last 6months. Palpation showed asmooth swelling on the right side of the face and palpable, enlargedcervical lymph nodes. Intraorally, an expansile swelling extendedfrom the second premolar to the secondmolar. Panoramic radiographsrevealed opacification in the right maxillary sinus. Microscopicevaluation of a biopsy specimen confirmed SCC. The tumor wastreated by maxillectomy, radiotherapy, and chemotherapy. The pa-tient has been closely followed up and has shown no signs of recur-rence after 12 months. Oral rehabilitation is being planned.