Vol. 114 No. 4 October 2012

SOBEP Oral Papers

HETEROTOPIC GASTROINTESTINAL MUCOSA IN Bladder cancer is one of the most common cancers world- ORAL CAVITY Martins F1, Milani B2, Jorge WA, Gallottini wide. Oral bladder cancer metastases are unusual and occurred M3, Sousa S - 1UNIVERSITY OF SAO PAULO - ORAL frequently in the jawbones. This study describes case of a 28 PATHOLOGY, 2UNIVERSITY OF SAO PAULO - ORAL years-old male patient presenting with a symptomatic mouth SURGERRY, 3UNIVERSITY OF SAO PAULO - ORAL PA- lesion which had developed over a period of 20 days. In medical THOLOGY history the patient reported a bladder cancer treatment in 2009. Heterotopic gastrointestinal mucosa (HGM) is a rare entity The clinical exam revealed an extensive nodular lesion in the occurring more frequently in male infants. Floor of the mouth and right lower alveolar ridge, extending to buccal mucosa with tongue are the most common affected sites in oral cavity. Histo- erythematous and ulcerative surface. Incisional biopsy was done logically, HGM can be cystic or solid type, resembling gastric, followed by histopathological analysis to establish the definitive intestinal or colonic mucosa. A 35-year old man was referred for diagnosis. The histopathological aspects revealed an undifferen- diagnosis of a red, painless mass in the tongue (2.0 cm), which tiated malignant lesion. An immunohistochemical panel (AE1/ the patient presented since childhood. After an incisional biopsy, AE3, CK7, CK20, CK9, CK10, p63, s-100, HMB-45, desmine, the specimen revealed gastric glandular type tissue lined by actin, Factor VIII, CD-34, vimentin and CD-31) were realized. pseudostratified columnar epithelium, showing crypts and fundic The diagnosis of infiltrative high grade bladder carcinoma was glands. Submucosa exhibited gland ducts and the glands at the established. The patient was referred to head and neck surgeon to base of the crypt had cystic appearance. The cystic glands ex- the oral lesion treatment. tended into the underlying smooth muscle. Immunohistochemis- try revealed immunoreactivity for cytokeratins 7, 8 and 18 and XERODEMA PIGMENTOSUM: CASE REPORT Ribeiro SMA. Final diagnosis of HGM was made and the lesion was CMB1, Ferreira SM2, Peixoto FB3, Mikami JR4, Oliveira CB, surgically removed without margins. The patient has been fol- Leandro JF, Lima ALO3 - 1CENTRO UNIVERSITÁRIO CES- lowed for one year with no recurrences. MAC - PATOLOGIA BUCAL, 2CENTRO UNIVERSITÁRIO CESMAC - ESTOMATOLOGIA, 3CENTRO UNIVERSI- OSSEOUS CHORISTOMAS IN THE MASSETER MUSCLE TÁRIO CESMAC, 4CENTRO UNIVERSITÁRIO CESMAC - Amorim RFB1, Rosa EA1, Barbosa IM2, Cortez ALV3, Lawall CIRURGIA BUCO-MAXILO-FACIAL MA, Macedo SB3 - 1UNIVERSIDADE DE BRASÍLIA - PRO- Xerodema pigmentosum (XP) is a genodermatosis charac- GRAMA DE PÓS-GRADUAÇÃO EM CIÊNCIAS MÉDICAS, terized by photosensitivity and development of squamous cancers 2HOSPITAL UNIVERSITÁRIO DA UNB - PROGRAMA DE in young patients. XP is a genetic condition due to absence of RESIDÊNCIA MULTIPROFISSIONAL EM SAÚDE, 3UNI- repair in DNA defects resulted from ultra-violet radiation (UVR). VERSIDADE DE BRASÍLIA - CENTRO DE CIRURGIA E People with XP are more sensitive to UVR and have a greater TRAUMATOLOGIA BUCO-MAXILO-FACIAL risk to develop head-and-neck-skin-cancers compared to normal Osseous choristoma is a rare condition of the oral cavity individuals. XP-patients are diagnosed before 20-years-old and occurring usually in the posterior third of tongue. It is a mass of commonly show pre-malignant or malignant skin lesions. Com- normal bony structure with mature cells in an abnormal position. monly, squamous lesions show fast growing, thus the early The aim of the present work is to report a case of a 32-years-old detection of XP is useful to reduce morbidity and mortality of woman admitted at Maxillofacial Surgery Department for eval- XP-patients. The study reports a case of XP affecting a female uation of painful hardened nodules present among the left mas- patient, 5-years-old, dark skin, referred to a Dentistry School seter muscle. Spheroids calcifications laterally located to the presenting a nodule in the lower lip during 3 months with mandibular ramus could be observed on computed tomography. ulcerated surface and multiples actinic keratosis. After incisional Under general anesthesia, seven hard structures were removed biopsy, microscopic analysis revealed an oral squamous cell through a submandibular access, the largest measuring 0.7 ϫ 0.4 carcinoma. Patient was referred to surgical treatment and she is cm. Histopathological examination revealed vital bone, osteo- under follow-up during one-year. cytes, incremental lines, and bone marrow, supporting the clinical diagnose. After 12 months of follow up there was no clinical or EOSINOPHILIC ULCER AFFECTING THE DORSUM OF radiographic sign of recurrence. This case is the second described 1 1 1 choristoma on masticatory muscles and also differs from osseous THE TONGUE Fonseca FP , Flores IL , Coletta RD , 1 1 1 choristomas in general by the presence of pain. Almeida OP , Santos-Silva AR - FACULDADE DE ODON- TOLOGIA DE PIRACICABA - UNIVERSIDADE ESTADUAL DE CAMPINAS - DEPARTAMENTO DE DIAGNOSTICO ORAL METHASTASIS OF BLADDER CANCER: REPORT ORAL 1 1 OF A RARE LESION Curra M , Medella Júnior F , Martins Eosinophilic ulcer of the oral mucosa is a self-limited con- 1 2 1 1 MD , Martins MAT , Carrard VC , Sant’Ana Filho M , Mu- dition first described in adults by Popoff in 1956. The pathogenic 2 1 nerato MC - UNIVERSIDADE FEDERAL DO RIO mechanisms implicated in its development remain poorly under- GRANDE DO SUL - PATOLOGIA BUCAL, 2HOSPITAL DE stood, but local trauma is the most reported etiologic factor. CLÍNICAS DE PORTO ALEGRE - SERVIÇO DE ESTOMA- Clinically, the eosinophilic ulcer usually manifests as a rapidly TOLOGIA developing solitary ulcer, with elevated borders, arising most

e31 ORAL MEDICINE OOOO e32 Abstracts October 2012 commonly in the lateral surface of the tongue. Microscopically, a remains in clinical and radiological follow-up for 22 months poorly formed granulation tissue with a dense polymorphous without any changes associated to the affected area. In conclu- inflammatory infiltrate containing abundant eosinophils and ex- sion, Stafne’s defect should be also considered in the differential tending to the deeper structures is usually observed. The ulcers diagnosis of anterior mandibular radiolucencies. commonly regress spontaneously in less than a month. The diagnosis of oral eosinophilic ulcer is usually difficult because UNUSUAL ORAL MANIFESTATIONS OF HISTOPLASMOSIS different processes may share similar clinical and histopatholog- Motta ACF1, Komesu MC1, Guerrini LB1, Shatetich C2, ical appearances. Therefore, the objective of this paper is to Roselino AMF3 - 1FACULDADE DE ODONTOLOGIA DE report a case of eosinophilic ulcer of the dorsum of the tongue RIBEIRÃO PRETO/USP - MORFOLOGIA, ESTOMATOLO- affecting a 64 year old male patient that following the incisional GIA E FISIOLOGIA, 2HOSPITAL DAS CLÍNICAS DE RI- biopsy revealed adequate remission. BEIRÃO PRETO - SERVIÇO DE PATOLOGIA, 3FAC- ULDADE DE MEDICINA DE RIBEIRÃO PRETO/USP - LINGUAL MANDIBULAR BONE DEPRESSION IN AN CLÍNICA MÉDICA/DIVISÃO DE DERMATOLOGIA 1 2 UNCOMMON LOCATION Pires FR , Espíndola CB ,Es- Histoplasmosis is a systemic fungal infection caused by the 2 3 4 1 píndola SHF , Miranda AMMA , Netto JNS - STATE UNI- Histoplasma capsulatum. Mucosal manifestations are uncom- VERSITY OF RIO DE JANEIRO - ORAL PATHOLOGY, mon, but, when present, they are usually associated with pulmo- 2 3 GENERAL DENTISTRY - PRIVATE PRACTICE, ESTÁCIO nary or chronic disseminated infection in immunocompromised DE SÁ UNIVERSITY - STOMATOLOGY AND ORAL AND patient. This case refers to a 29-year-old woman who presented MAXILLOFACIAL SURGERY, 4FEDERAL UNIVERSITY OF oral lesions, which had appeared 2 years before. She had reported RIO DE JANEIRO - ORAL PATHOLOGY contact with pigeon. On physical examination, a slightly painful Lingual mandibular bone depression (Stafne’s defect) mostly ulcerated lesion on the buccal gingiva and hard palate was affects the posterior mandible. Stafne’s defects on the anterior detected. Blood tests just revealed a mild anemia, whereas sero- region are rare, frequently posing difficulties on diagnosis. The logic tests for HIV, HBV, HCV, paracoccidioidomicosis, leish- aim of this study is to report a Stafne’s defect affecting the maniasis, tuberculosis, and syphilis were all negative. Counter- anterior mandible, discussing its main differential diagnostic immunoelectrophoresis test for histoplasmosis was positive (titer considerations. A 43-year-old male was referred for evaluation of 1:2). Chest X-ray was normal. Histopathological analysis indi- a well-defined radiolucent area on the anterior mandible in close cated a chronic inflammation with granulomas presenting yeast- association to the roots of the right canine and incisors, discov- like organisms. Isolation of H capsulatum provided the definitive ered during routine dental radiographic evaluation. Pulp tests diagnosis. Patient is on treatment with oral itraconazole (200mg/ revealed that all teeth in the area were vital and a cone-beam day) presenting remission of the lesions. This case represents an computed tomography scan showed a lingual depression in the interesting demonstration that histoplasmosis may cause unusual area. Final diagnosis was anterior Stafne’s defect and the patient oral presentation. OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e33

SOBEP Free Oral Papers

OXIDATIVE DNA DAMAGE IN ORAL KERATINOCYTES ER stress markers, and analyzing their correlations with the CAUSED BY CYTOKINES RELEASED FROM FIBRO- clinical outcome and prognosis. BLASTS BY ARECA NUT EXPOSURE Illeperuma RP1, 2 1 1 3 Illeperuma RP , Park YJ , Son HK , Jung DW , Tilakaratne EXPRESSION OF TNF-ALPHA AND ITS CORRELATION 4 1 1 WM , Kim J - ORAL CANCER RESEARCH INSTITUTE, WITH DIFFERENT GRADES OF ORAL SUBMUCOUS YONSEI UNIVERSITY COLLEGE OF DENTISTRY, SEOUL, FIBROSIS Swastika N1, Gawande M1, Chaudhary M1 - 2 KOREA - DEPARTMENT OF ORAL PATHOLOGY, IIM, 1SHARAD PAWAR DENTAL COLLEGE - ORAL PATHOL- UNIVERSITY OF COLOMBO, RAJAGIRIYA, SRI LANKA - OGY AND MICROBIOLOGY 3 MODERN UNIT, GWANGJU INSTITUTE OF SCIENCE Background: Oral submucous fibrosis is one of the most AND TECHNOLOGY, GWANGJU, KOREA - DEPART- common pre-cancerous conditions in the South Asian Subconti- 4 MENT OF LIFE SCIENCE, FACULTY OF DENTAL SCI- nents. Numerous cytokines have a role to play in this disease, ENCES, UNIVERSITY OF PERADENIYA, PERADENIYA, e.g., IL-1B, IL-6, IL-8, TNF-alpha. SRI LANKA - DEPARTMENT OF ORAL PATHOLOGY TNF-alpha, though an anticancer cytokine, when dysregu- Objective: Areca nut (AN) consumption is the main etiology lated and secreted in the circulation mediates a wide variety of of oral submucous fibrosis (OSF). Carcinogenic mechanism in diseases, including cancer. OSF is not clearly understood. We hypothesized that AN-ex- Objective: To assess TNF-alpha expression in OSMF and posed fibroblasts in OSF would secrete cytokines, by which correlate its expression with grades of OSMF. facilitate malignant transformation of epithelium via DNA dam- Study design: 30 clinically diagnosed cases of oral submu- age. cous fibrosis were categorized clinically in accordance with grad- Study design: This study aims to find out the cytokines ing system of Khanna & Andrade(1995). Incisional biopsy was released from AN-stimulated fibroblasts and to elucidate their taken. They were then treated with TNF-alpha (Santa Cruz- role in carcinogenesis in OSF. Cytokine secretion pattern was mouse monoclonal antibody antihuman, sc-52250) by IHC. studied. Oxidative DNA damage on oral keratinocytes (OK) was Result: Significantly higher expression of TNF-alpha are assessed. Tissue sections of OSF patients were also assessed to demonstrated in patients with GRADE IV OSMF as compared to elucidate cytokine expression and oxidative DNA damage. lower grades. Results: GRO-␣, IL-6, and IL-8 were secreted by the AN- Conclusion: This study reveals that presence of TNF-AL- exposed fibroblasts. These cytokines generated ROS and caused PHA could be a contributory piece in the transformation of oxidative DNA damage in OK. OSF tissues were in accord with OSMF into malignancy. in vitro findings. Conclusion: This study shows a contributory mechanism CLEAR CELL ODONTOGENIC CARCINOMA OR CLEAR responsible for malignant transformation of OSF by which cyto- CELL AMELOBLASTOMA: A CASE REPORT AND LITER- kines induced oxidative stress in DNA damage of OK. ATURE REVIEW AlSheddi MA, Al Weteid A2, Al Shahrani F3, Al Faleh W1 - 1KING SAUD UNIVERSITY - ORAL MEDICINE AND DIAGNOSTIC SCIENCES, 2KING SAUD ENDOPLASMIC RETICULUM STRESS AND RUSSELL 3 1 MEDICAL CITY, SALMAN BIN ABDULAZIZ UNIVERSITY - BODIES IN PERIODONTAL INFLAMMATION Seo BL , ORAL AND MAXILLOFACIAL SURGERY Coates D, Seymour GJ, Milne T, Leichter J, Rich AM - 1 Clear cell odontogenic carcinoma is an uncommon odonto- UNIVERSITY OF OTAGO, NEW ZEALAND - SIR JOHN genic neoplasm of epithelial origin. It is an aggressive tumor with WALSH RESEARCH INSTITUTE metastatic and recurrence potential. Clear cell ameloblastoma is Objective: A) To identify and quantify Russell body (RB) histologically composed of an ameloblastomatous component containing cells and B) to assess the unfolded protein response intermixed with clear cell component. Based on the relatively (UPR) gene expression profile in inflamed periodontal tissues small number of cases in the literature, it is difficult to separate with or without RB. the two lesions. We report a tumor with ameloblastic and clear Study design: Inflamed periodontal tissues, with and with- cell differentiation in the anterior mandible of a 24 year old Saudi out RB, were stained with haematoxylin and eosin (H&E), peri- female with history of one recurrence. The clinico-pathological 2 odic-acid Schiff and methyl green pyronin stains. qRT -PCR was and radiographic features are discussed. used for the gene expression analysis. Results: H&E staining was the most sensitive stain for the detection of RB. Genes in the IRE1 pathway were up-regulated in HPV-RELATED ORAL LESIONS IN HIV/AIDS PATIENTS: RBϩve tissues. Furthermore, molecular chaperones (DNAJC3, CLINIC-PATHOLOGICAL AND TYPING PROFILE 1 1 SIL1), ER quality control genes (GANC, UGCGL1) and ER- Flores-Moreno B , Gabriela Anaya-Saavedra , García-Car- 2,3 1 2,3 associated degradation gene (EDEM3), were up-regulated. rancá A , Irigoyen-Camacho E , Guido-Jiménez M ,Mi- 4 1 1 Conclusion: We have demonstrated the UPR genes involved chel Guerrero-Tenorio , Ramírez-Amador V - UNIVERSI- in RB presentation. These genes can be used as markers of ER DAD AUTÓNOMA METROPOLITANA - HEALTH CARE, stress in diseases containing RB. Future studies will be directed 2UNIVERSIDAD NACIONAL AUTÓNOMA DE MÉXICO - toward sub-classifying patients according to RB presentation and INSTITUTO DE INVESTIGACIONES BIOMÉDICAS, ORAL MEDICINE OOOO e34 Abstracts October 2012

3INSTITUTO NACIONAL DE CANCEROLOGÍA - UNIDAD PEI, TAIWAN - DEPARTMENT OF DENTISTRY, 3MIN- DE VIRUS Y CÁNCER, 4UNIVERSIDAD AUTÓNOMA SHENG GENERAL HOSPITAL, TAOYUAN, TAIWAN - DE- METROPOLITANA - BIOLOGICAL SYSTEMS PARTMENT OF PATHOLOGY, 4NATIONAL TAIWAN Objective: To describe clinicopathological and genomic UNIVERSITY, TAIWAN - GRADUATE INSTITUTE OF PA- characteristics of human papillomavirus-associated oral lesions THOLOGY (HPV-OL) in HIV/AIDS patients. Lymphoid-enhancing factor 1 (LEF1) is a transcription fac- Study design: Cross-sectional, observational and descriptive tor mediating Wnt/b-catenin signaling. In the current study, we study. HIV/AIDS-patients showing HPV-OL (2004-2011) were analyze the clinicopathologic significance of LEF1 expression in included. A biopsy was taken for histopathological diagnosis and 135 oral squamous cell carcinomas (OSCCs) by immunohisto- DNA purification. PCR (PCO4/6H20, MY09/MY11 and GP5ϩ/ chemistry. LEF1 was only occasionally detected in basal and GP6ϩ) and direct sequentiation was done. Associations were parabasal cells of nontumorous squamous epithelium. Overex- analyzed by Chi2 or Fisher’s exact two-tailed tests. pression of LEF1 was observed in 33 of 135 OSCCs (24%). Results: Fifty-two of 779 patients (6.6%) showed HPV-OL, Overexpression of LEF1 was significantly associated with poor median age of 40 (Q1-Q3:30-44) years. Sites most affected were prognosis (Pϭ0.0176, Hazards ratioϭ1.96, 95% CIϭ 1.02-3.75). lower labial (31/59.6%) and buccal mucosa (10/19.2%). Squa- Multivariate analysis revealed LEF1 to be the only significant mous papilloma (20/38.5%) was the most common diagnosis, independent predictor for overall survival. Our study suggests followed by multifocal epithelial hyperplasia (15/28.8%). Thir- LEF1 expression in OSCC may play important roles in tumor teen of the 23 (56.5%) samples sequentiated showed HPV-13, 5 progression and can be served as a predictor of poor prognosis for (14.7%) samples had multiple HPV-types. High-risk HPV (16,18 patients with OSCC. and 31) were identified in 6 samples (26%). Conclusions: Considering the benign nature of these lesions, a relatively high frequency of high-risk HPV was found, probably MCM2 AND D2-40 EXPRESSION IN TONGUE SQUA- related with altered immune function and/or sexual behavior. MOUS CELL CARCINOMA AND THEIR RELATION WITH LYMPH NODE METASTASIS Motahhary P1,Es- maeili V, Rahro Taban S1 - 1TEHRAN UNIVERSITY OF ORAL SECONDARY SYPHILIS: FIRST OR MOST FLORID 1 MEDICAL SCIENCES - ORAL & MAXILLOFACIAL PA- CLINICAL SIGN IN SYPHILIS Ramírez-Amador V , Gabri- ela Anaya-Saavedra1, Crabtree-Ramírez B2, Esquivel-Pe- THOLOGY DEPARTMENT draza L3, Saeb-Lima M4, Sierra-Madero J2 - 1UNIVERSI- Objectives: The aim of this study was to evaluate the ex- DAD AUTÓNOMA METROPOLITANA - HEALTH CARE, pression of MCM2 and D2-40 in tongue squamous cell carci- noma (TSCC) and investigate their relation with lymph node 2INSTITUTO NACIONAL DE CIENCIAS MÉDICAS Y NU- metastasis and patient survival. TRICIÓN “SALVADOR ZUBIRÁN” - HIV CLINIC, INFEC- Study design: Paraffin block samples of 52 patients with TIOUS DISEASES DEPARTMENT, 3INSTITUTO NACIO- TSCC who underwent surgery and radical neck dissection were NAL DE CIENCIAS MÉDICAS Y NUTRICIÓN “SALVADOR 4 selected. Nodal status and other clinicopathologic factors were ZUBIRÁN” - DERMATOLOGY DEPARTMENT, INSTI- retrieved from their medical records. Immunohistochemical TUTO NACIONAL DE CIENCIAS MÉDICAS Y NUTRICIÓN staining for MCM2 and D2-40 was performed in all cases. “SALVADOR ZUBIRÁN” - PATHOLOGY DEPARTMENT Lymphatic vessel density (LVD) was determined by D2-40 eval- Objective: To describe the clinical spectrum of oral second- uation. MCM2 labeling index (LI) was also determined by count- ary syphilis in HIV-infected patients and its relevance in the ing of the positive cells. diagnosis of systemic syphilis. Results: LVD of the group with lymph node metastasis was Study design: Cross-sectional, observational and descriptive significantly higher than lymph node negative group (pϭ0.014) study. Consecutive HIV/AIDS adult subjects (2003-2011) had an and also showed a significant relation with patients survival. oral examination performed at three HIV/AIDS referral centers in There was not significant relation between MCM2 LI and lymph Mexico City. Diagnosis of oral syphilis was confirmed with a node metastasis. positive non-treponemal test (VDRL) and a fluorescent trepone- Conclusion: This study showed that D2-40 could be used as mal antibody test. Lesions were evaluated by histopathological a marker in predicting nodal metastasis in TSCC. (H-E and Warthin-Starry) and immunohistochemical methods. Results: Seventeen male patients (median age 30, range 21-59) years, were identified; in 13 (76.5%) oral lesions were the POLYMORPHISMS AT REGIONS 1P22.1 AND 8Q24 first or most florid clinical sign. Mucous patch was the most ARE RISK MARKERS FOR NONSYNDROMIC CLEFT LIP common (82.3%), followed by shallow ulcers (11.8%) and mac- AND/OR PALATE (NSCL/P) IN THE BRAZILIAN 1 2 3 ular syphilides (5.9%). Differential diagnoses included herpes POPULATION Bagordakis E , Paranaíba LMR , Brito LA , simplex infection, erythematous candidiasis and hairy leukopla- Martelli-Júnior H2, Swerts MSO4, Passos-Bueno MR3,Co- kia. letta RD1 - 1SCHOOL OF DENTISTRY, STATE UNIVER- Conclusions: Due to the recent rise in HIV-syphilis co- SITY OF CAMPINAS - DEPARTMENT OF ORAL DIAGNO- infection, syphilis should be considered in the differential diag- SIS, 2STATE UNIVERSITY OF MONTES CLAROS - nosis of oral lesions in HIV-patients. STOMATOLOGY CLINIC, 3UNIVERSITY OF SÃO PAULO, - HUMAN GENOME RESEARCH CENTER, INSTITUTE OF EXPRESSION OF LEF1 IS AN INDEPENDENT PROG- BIOSCIENCES, 4UNIVERSITY OF ALFENAS - CENTER NOSTIC FACTOR FOR PATIENTS WITH ORAL SQUA- FOR REHABILITATION OF CRANIOFACIAL ANOMALIES MOUS CELL CARCINOMA Lin CYC1,2,SuMC3, Jeng YM4 Backgorund/objective: We carried out a structured associ- - 1UFTM / UNIUBE, 2TAIPEI MEDICAL UNIVERSITY, TAI- ation study to determine the role of polymorphisms at regions OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e35

1p22.1, 1q32, 8q24, 9q21, 10q25.3, 18q22 and 20q12 in NSCL/P hypothesize that candida colonization along with the expression susceptibility in Brazilians. of p53 is indicative of deeper lesion process. Study design: A total of 223 NSCL/P patients and 235 healthy controls were genotyped for 9 polymorphic sites by THE MICROSCOPIC DIVERSITY OF ORAL KAPOSI TaqMan 5=-exonuclease allelic discrimination assay, and each SARCOMA Carvalho MV1, Bunn BK2, Vargas PA1, van sample was also independently typed for 40 biallelic short inser- Heerden W2 - 1PIRACICABA DENTAL SCHOOL, UNIVER- tion/deletion markers to characterize the genomic ancestry. SITY OF CAMPINAS - ORAL DIAGNOSIS, 2SCHOOL OF Results: After adjustment to ancestry contribution, DENTISTRY, FACULTY OF HEALTH SCIENCES, UNIVER- rs560426, rs1530300 and rs987525 polymorphisms were signif- SITY OF PRETORIA - ORAL PATHOLOGY AND ORAL icantly associated with an increase in the risk of cleft lip and/or BIOLOGY palate (CLϮP), but not with isolated cleft palate (CP). Haplotype Background: Kaposi sarcoma is the most common HIV- analysis revealed that the presence of the risk alleles (G-A) of associated neoplasm with frequent oral mucosal involvement. 8q24 polymorphisms (rs1530300 and rs987525) attributed a sig- Objective: This retrospective study aimed to assess the nificant susceptibility to NSCL/P. morphological spectrum of oral Kaposi sarcoma (OKS). Conclusion: The present study shows the association of Methods: One hundred and thirty-five cases diagnosed be- polymorphisms located at 1p22.1 and 8q24 with NSCL/P in the tween 1990 and 2011 were retrieved from the archives of the Oral ethnically admixed Brazilian population. and Dental Teaching Hospital of the University of Pretoria, South Africa. Results: Following histological review, each case was CANDIDAL CARRIAGE AND ITS SUBSPECIES IDENTI- placed into 1 of 8 categories based on the predominant pattern of FICATION IN ORAL LEUKOPLAKIA Swastika N1, growth. These histological divisions included lesions designated Gawande M1, Chaudhary M1 - 1SHARAD PAWAR DENTAL as solid, lymphangioma-like, telangiectatic, desmoplastic, lymp- COLLEGE - ORAL PATHOLOGY AND MICROBIOLOGY hangiectatic, pyogenic granuloma-like, ecchymotic and pleomor- Background: Leukoplakia is a common tobacco associated phic. Furthermore, the presence of co-existent pathology was premalignant lesion. The changes in the oral mucosa caused by identified in 25 cases, largely represented by superimposed can- tobacco makes the environment conducive for the growth of didiasis. Concomitant cytomegalovirus and non-necrotising gran- Candida which may lead to the malignant changes. ulomatous inflammation were also observed. Objectives: To evaluate prevalence of candida and its sub- Conclusions: Whilst the prognostic significance of these species identification in individuals with oral leukoplakia To variants is yet to be determined, the appreciation and recognition compare prevalence of oral candidal species on lesional side with of such morphologic diversity remains essential in distinguishing the unaffected side. these lesions from possible mimics. Study design: Scrape from the lesional site of 30 clinically diagnosed cases of oral leukoplakia was taken using a sterile swab and from the same side, gingival crevicular fluid was ANALYSIS OF MICRORNAS EXPRESSION PROFILE IN SALIVA OF PATIENTS WITH HEAD AND NECK SQUA- collected using absorbent paper strips. Each sample was inocu- 1 1 lated on SDA and CHROMagar media. Candida species identi- MOUS CELL CARCINOMA Pelarin MF , Horst MA ,de 2 1 1 fication was done using KB006 Candida identification kit. Carvalho AC , Vettore AL - UNIVERSIDADE FEDERAL Result and conclusion: The prevalence of oral candidal DE SÃO PAULO - UNIFESP - CIÊNCIAS BIOLÓGICAS, 2 carriage is higher in individuals with oral leukoplakia as com- UNIVERSIDADE FEDERAL DE SÃO PAULO - UNIFESP - pared to healthy individuals. BIOQUÍMICA Background: Squamous cell carcinoma of head and neck (HNSCC) is a disease with high incidence and mortality, and YEAST CARRIAGE AND P53 EXPRESSION IN ORAL constitutes the sixth most common cancer worldwide. Altered SUBMUCOUS FIBROSIS Agarwal R1, Chaudhary M1 - epigenetic profiles in cancer show that molecular mechanisms 1SHARAD PAWAR DENTAL COLLEGE - ORAL PATHOL- contribute significantly to the carcinogenesis. OGY AND MICROBIOLOGY Objective: To compare the miRNAs expression profiles in Objectives: To determine the co-existence of Candida and saliva samples from individuals without cancer and patients with its subspecies with p53 expression in oral submucous fibrosis. HNSCC in order to identify potential prognostic markers for this Study design: The study comprised of 20 clinically diag- cancer. nosed cases of oral submucous fibrosis. For candida colonization Study design: The microRNA expression profile is being buccal mucosa was sampled by sterile swab. Incisional biopsy determined in 100 salivary rinse samples collected from HNSCC was carried out for histopathologic diagnosis. IHC staining of the patients and health donors. same was carried out. Swab samples were cultivated on SDA and Results: The expression of 762 miRNAs was evaluated by CHROMagar. Candida species identification was done using qRT-PCR, allowing the selection of microRNAs differentially KB006 Candida kit. IHC staining was carried out using p53 expressed. Preliminary results identified two miRNAs downregu- (Dako - Monoclonal Mouse Anti-Human p53). lated with sensitivity of 34-80%, and specificity of 90%. Results: 4(20%) cases in study group yielded Candida. Conclusion: The identification of cancer-specific microRNA 16(80%) cases were positive for p53 expression. in salivary rinse is a non-invasive approach useful as marker for Conclusion: This study indicates that oral submucous fibro- early detection of HNSCC. sis favors the colonization of Candida. Mucosal alteration due to underlying disease process might lead to Candidal colonization, PROGNOSTIC SIGNIFICANCE OF EXPRESSION OF ES- in the absence of clinically evident mycotic manifestation. We TROGEN AND PROGESTRON RECEPTOR (ER/PR ) IN ORAL MEDICINE OOOO e36 Abstracts October 2012

CARCINOMA OF BUCCAL MUCOSA AND TONGUE MENTO DE ODONTOLOGIA, 5UNIVERSIDADE DE Patel M1 - 1SHARAD PAWAR DENTAL COLLEGE AND BRASÍLIA - PROGRAMA DE PÓS-GRADUAÇÃO EM RESEARCH INSTITUTE, WARDHA,MAHARASHTRA, IN- CIÊNCIAS MÉDICAS DIA - ORAL PATHOLOGY & MICROBIOLOGY Odontomas are the most common odontogenic tumors, gen- Background: Squamous cell carcinoma affects buccal mu- erally found in the second decade of life with a less aggressive cosa and tongue and may or may not be associated with tobacco. behavior. This report aims to present an aberrant form of this The tongue epithelium is derived from endoderm and that of tumor with a more aggressive behavior and extremely unusual buccal mucosa from ectoderm. Carcinomas derived from endo- presentation in a 21-one-year male and make a brief discussion. derm often express ER/PR which in oral malignancies may have Panoramic films and computed tomography suggested a large prognostic value. radiolucent lesion (45x35x20mm) involving entire mandibular Objective: The study aim to demonstrate expression of ramus associated with an impacted third molar. The lesion had estrogen and progestron receptor in carcinoma of buccal mucosa radiopaque margin and radiopaque focus inside. During the bi- and tongue. The expression is correlated with origin of epithe- opsy an empty cavity lined by numerous enamel projections was lium and the survival of epithelium. found. The lesion was entirely removed under general anesthesia Study design: 20 histopathological diagnosed cases of oral and histological analysis revealed dental tissues separated from squamous cell carcinoma of buccal mucosa and tongue each were the bone by a thin capsule consisted with odontoma. After seven subjected to immunohistochemical expression of ER/PR . months, bone regeneration was demonstrated by CT, with areas Result and conclusion: Quantitative difference in expres- of bone defects. As conclusion, this study reports a very uncom- sion of ER/PR in carcinoma of the buccal mucosa and tongue mon form of odontoma, and the definition as inverted odontoma were documented. is proposed by the authors.

MICRORNAS AS DIAGNOSTIC MARKERS FOR LYMPH HIGH INCIDENCES OF DNA PLOIDY ABNORMALITIES NODE METASTASIS IN OSCC de Carvalho AC1, Maia ASSOCIATED WITH MCM2 IMMUNOEXPRESSION DCC1, Carvalho AL2, Scapulatempo-Neto C3, Vettore AL1 - MAY CONTRIBUTE TO PREDICT AREAS PRONE TO 1FEDERAL UNIVERSITY OF SÃO PAULO - LABORATORY MALIGNIZATION IN ORAL PROLIFERATIVE VERRU- FOR MOLECULAR CANCER BIOLOGY, 2BARRETOS COUS LEUKOPLAKIA Gouvêa AF1, Santos-Silva AR2, Spei- CANCER HOSPITAL - DEPARTMENT OF HEAD AND tght PM3, Hunter K3, Carlos R4, Vargas PA2, Lopes MA2 - NECK SURGERY, 3BARRETOS CANCER HOSPITAL - DE- 1INSTITUTO DO CÂNCER DO ESTADO DE SÃO PAULO, PARTMENT OF PATHOLOGY 2DEPARTMENT OF ORAL DIAGNOSIS, PIRACICABA Background: The status of metastatic disease in cervical DENTAL SCHOOL, STATE UNIVERSITY OF CAMPINAS, lymph nodes of OSCC patients is the most important determinant SÃO PAULO, BRAZIL, 3ACADEMIC UNIT OF ORAL AND in therapy choice and prognosis. MicroRNAs play a role in many MAXILLOFACIAL PATHOLOGY, THE UNIVERSITY OF pathways involved in tumor metastasis. SHEFFIELD, SCHOOL OF CLINICAL DENTISTRY, Objectives: To identify microRNAs associated with cervical UNITED KINGDOM., 4HEAD AND NECK PATHOLOGY lymph node metastasis, enabling the development of a more SECTION. CENTRO CLÍNICO DE CABEZA Y CUELLO/ sensitive, specific and rapid diagnosis method, and the delinea- HOSPITAL HERRERA-LLERANDI, GUATEMALA tion of a more appropriate therapy, thus influencing the patient Objectives: To analyse the DNA ploidy, immunoexpression overall survival. of Mcm2, geminin and Ki-67 and clinicopathological data of 21 Study design: cT1-cT2-cT3 cN0 OSCC patients were se- oral proliferative verrucous leukoplakia cases. lected. All pNo lymph nodes underwent anti-cytokeratin immu- Study design: Clinicopathological data were collected, im- nohistochemical evaluation for micrometastasis. MicroRNA ex- munohistochemistry for Ki-67, Mcm2 and geminin and image pression was evaluated using qRT-PCR. cytometry for DNA quantification were performed. Results: 35 patients (15 non-metastatic lymph nodes, 15 Results: Female:male ratio was 6:1, average age was 65.5 macrometastasis and 5 micrometastasis) were included. Our pre- years, seventeen patients did not report tobacco and alcohol liminary results identified 4 microRNAs able to discriminate consumption. Nine patients developed carcinoma. Mcm2 expres- Ͻ positive lymph nodes (p 0.05) with sensitivity of 80-100%, sion showed a progressive increase according to the epithelial specificity of 100% and accuracy of 88.6-100%. changes (pϭ 0.03). Ninety patients demonstrated DNA aneu- Conclusion: Our results show a great potential of microR- ploidy (95%). The frequency and severity of aneuploidy NAs as diagnostic markers of cervical metastasis in OSCC pa- (pϽ0.0001), the mean values of the DNA heterogeneity index tients. (pϽ0.0001) and the 5n-exceeding fractions (pϭ0.0007) in- creased according to epithelial abnormalities. INVERTED ODONTOMA: AN ABERRANT FORM OF AN Conclusions: Mcm2 immunoexpression and DNA ploidy ODONTOGENIC TUMOR Rosa EA1, Tiussi M2, Vieira analysis could be used to predict areas prone to malignant EO3, Lawall MA, Leite AF4, Amorim RFB5 - 1UNB - PÓS changes. The association of clinicopathological findings with immunohistochemical and DNA ploidy results supports the dis- GRADUAÇÃO EM CIÊNCIAS MÉDICAS, 2HOSPITAL DE tinct and aggressive profile of this entity. BASE DO DISTRITO FEDERAL - PROGRAM DE RESIDÊNCIA EM CIRURGIA BUCOMAXILOFACIAL, 3HOSPITAL DE BASE DO DISTRITO FEDERAL - PRO- DOCUMENTATION OF HISTOLOGICAL CHANGES IN GRAME DE RESIDÊNCIA EM CIRURGIA BUCOMAXILO- MINOR SALIVARY GLAND OF PATIENTS WITH OSMF FACIAL, 4UNIVERSIDADE DE BRASILIA - DEPARTA- Patel M1 - 1SHARAD PAWAR DENTAL COLLEGE AND OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e37

RESEARCH INSTITUTE, WARDHA, MAHARASHTRA, The solid/multicystic ameloblastoma is a slowly growing, INDIA - ORAL PATHOLOGY & MICROBIOLOGY locally invasive, epithelial odontogenic tumour of the jaws with Background: Oral submucous fibrosis is a chronic progres- a high rate of recurrence if not removed adequately, but with sive disease affecting many people in our world. Submucous virtually no tendency to metastasize. It spreads slowly by infil- fibrosis affects all parts of the oral mucosa and occurs in both tration through the medullary spaces and may erode cortical sexes over a wide age range. The most common initial symptoms bone. Eventually, it will resorb the cortical plate and may extend of submucous fibrosis are burning sensation of the oral mucosa into adjacent tissues. aggravated by spicy food, followed by either hypersalivation or The case we present is about a female patient, 47 years, with dryness of the mouth. Hydration of the oral mucosa is a major a huge solid ameloblastoma of mandible, who underwent an function of minor salivary gland which are found scattered in the hemimandibulectomy elsewhere. Two years later she came to our lamina propria of the entire oral mucosa, with concentrations in service with a large swelling on the temporal region. A biopsy the lips and soft palate mucosa. was made and the result was solid ameloblastoma too. We Aim: The aim of this study is to demonstrate the histological believe that, in the first surgery, tumour was left in the soft tissue, changes in the structure of the minor salivary glands in the patient which lead to recidivation. Another resection was made and the with OSMF. patient is now under periodic revision, showing no clinical or Material and method: Salivary Gland from 15 diagnosed radiographic sign of recurrence. cases with oral submucous fibrosis were examined. These spec- imens were subjected to routine Hematoxylin & Eosin, Mucicar- mine, PAS, Alcian Blue, Van Gieson and mucicarmine stain. PLEOMORPHIC ADENOMA OF THE MAXILLA: CASE 1 Structural and functional changes in the salivary gland of patient REPORT AND LITERATURE REVIEW Kang SR , Kim 2,3 1,3 2,3 1 with OSMF were evaluated and these were compared with nor- HS , Kim HJ , Kim J - COLLEGE OF DENTISTRY, mal controls. YONSEI UNIVERSITY, SEOUL, SOUTH KOREA - DEPART- Result and conclusion: There are definite changes in struc- MENT OF ORAL AND MAXILLOFACIAL SURGERY, ture and functional capacity of minor salivary gland in patient 2COLLEGE OF DENTISTRY, YONSEI UNIVERSITY, with OSMF. SEOUL, SOUTH KOREA - DEPARTMENT OF ORAL PA- THOLOGY, 3COLLEGE OF DENTISTRY, YONSEI UNI- EXPRESSION OF P53 AND KAI1 IN ORAL SQUAMOUS VERSITY, SEOUL, SOUTH KOREA - ORAL CANCER RE- CELL CARCINOMA AND EPITHELIAL DYSPLASIA Agar- SEARCH INSTITUTE wal R1, Chaudhar M1 - 1SHARAD PAWAR DENTAL COL- Pleomorphic adenoma (PA) is one of the salivary gland LEGE - ORAL PATHOLOGY tumors that frequently affect the parotid gland, followed by the submandibular and the minor salivary glands. The most common Aim: 1. To evaluate the expression of p53 and KAI1 in intraoral site for minor salivary gland tumors is the palate, fol- OSCC and epithelial dysplasia. lowed by the upper lip and buccal mucosa. Usually, PA is a 2. To formulate a risk assessment index. painless, slowly growing and insidious tumor, which can reach Introduction: In the oral cavity the most common lesions great proportions if not treated surgically. This is mostly true for recognized as potentially malignant are leukoplakia but it is also PA of the major salivary glands. Lesions of the palate are usually apparent that as many as 50% of OSCC arise from apparently found on the posterior lateral aspect of the palate, as a solitary normal oral mucosa. firm mass lateral to the midline. However, PA intraosseous Materials And method: 1. 45 paraffin embedded blocks of extension to the rest of the maxilla or other sites in the head and each OSCC and epithelial dysplasia and 10 normal buccal mu- neck are very rare. A 75-year-old woman was referred for treat- cosa were selected from the archives of Department of Oral ment of a painless swelling of the maxilla which slowly disturbed Pathology and Microbiology, SPDC, Wardha. her facial appearance. CT scan revealed a multilocular low at- 2.The paraffin embedded tissue were cut and mounted on tenuated intraosseous soft tissue mass arising from the anterior silane coated slide. maxilla to the posterior palate and up to the nasal floor, nasal 3.They were stained through IHC for KAI1 and p53. septum and maxillary sinuses. Dental root resorption, thinning of 4.Labeling index for p53 and KAI1 were calculated both labial and palatal cortical layers and bilateral alar base 5. Risk assessment index was also calculated ϭ Labeling lengthening were observed as well, making more difficult to index of p53/Labeling index of KAI1. assess an accurate early diagnosis and prognosis. Incisional bi- Results: In epithelial dysplasia increased expression of p53 opsy revealed PA with questionable malignant degeneration and decreased expression of KAI1 is indicative of potentially probably associated to the 10-year history of untreated tumor. malignant nature of lesion and in Oral Squamous Cell Carci- The aim of this report is to present and discuss the management noma, the combination of both these molecular markers shows of an interesting case of an intraosseous PA of the maxilla to the increased proliferation of p53 and decrease in KAI1 indicative of light of the published literature and emphasize the need of his- its more aggressive nature. Risk assessment index for Oral Squa- topathological analysis, defined and guided treatment, and ade- mous cell carcinoma is in the range of 1.38-2.59 and for epithelial quate follow-up. dysplasia 0.19-0.79 respectively.

SOLID AMELOBLASTOMA: A RARE CASE OF IN VIVO BEHAVIOR OF NANOSTRUCTURED BIOCER- RECIDIVATION Netto R1, Cortezzi W, Merly F, Fróes R1, AMICS IN A GUIDED BONE REGENERATION MODEL Capistrano P1, Seabra R1, Marcello V1 - 1HOSPITAL DOS IN RABBITS Levandowski-Jr N1,2, Weinfeld I3,2, Camargo SERVIDORES DO ESTADO - SERVIÇO DE CIRURGIA NHA1 - 1UNIVERSIDADE DO ESTADO DE SANTA CA- ORAL E MAXILOFACIAL TARINA (UDESC) - PGCEM, 2UNIVERSIDADE DE SANTO ORAL MEDICINE OOOO e38 Abstracts October 2012

AMARO (UNISA), 3UNIVERSIDADE DE SÃO PAULO Case presentation: A 74 years old woman witha1cm, (USP) growth in the right alveolar ridge of the first low molar, with the Objective: The purpose of the present research was to ana- same color as the normal oral mucosa, asymptomatic, evolution lyze the in vivo behavior of conventional versus nanostructured of one year, radiographic findings saucerization. Gross examina- biphasic calcium phosphate bioceramics. tion: smooth, firm, brown nodule, 1.5 x1.5x1.0 cm, Microscopic Study design: The evaluated biomaterials possessed the examination: with H&E stain shows, spindle myofibroblastic same composition: 60% hydroxyapatite (HAp) and 40% b-trical- proliferation, with pushing margins and compression of the sur- cium phosphate (b-TCP). An exoskeletal model for guided bone rounding tissue, with mitotic activity, with this outcome was regeneration (GBR) was used. Eight New Zealand rabbits re- necessary to use immunohistochemistry and the result was: Actin ceived four hollow titanium cylinders that were fixed to the skull (focal ϩ), Ki 67 10%, H-Caldesmon (Ϫ), S-100(Ϫ), this result and filled with microstructured particles (MP), nanostructured give the diagnosis of low grade myofibroblastic sarcoma. granules (NG), nanostructured biocement (NB) and blood clot Conclusion: This LGMS is a rare tumor in this localization, (BC). and to do a good diagnosis it is important to have the immuno- Results: Specimens were obtained after 12 weeks and ana- histochemistry markers, and do the ultrastructural (EM) study to lyzed by clinical and histological findings, histomorphometry and support the myofibroblastic differentiation and we are doing this. scanning electron microscopy. The amount of bone tissue forma- Differential diagnosis was made with leiomyosarcoma and tion was significantly higher to nanostructured granules (NG), fibrosarcoma. followed by NB, BC and MP. The cytogenic and molecular genetic studies indicate that Conclusion: Nanostructured biomaterials proved to be bio- sarcomas can be divided in two genetic groups. The focal inflam- compatible, did not promote inflammation process, neither for- matory infiltration can help to do the differential diagnosis. The eign body reaction. LGMS contain more poorly developed myofibroblast and tends to be more uniform in appearance with a higher cellularity. ORAL CYTOPATHOLOGY ASSOCIATED DIRECT IM- MUNOFLUORESCENCE IN THE DIAGNOSIS OF PEM- ODONTOGENIC AND ORAL SOFT TISSUE MYXOMAS: PHIGUS VULGARIS: AN EFFECTIVE OPTION Cunha CLINICOPATHOLOGIC ANALYSIS OF 16 CASES FROM 1 2 1 3 KSG , Picciani BLS , Silva-Junior A , Silva-Junior GO , ILE-IFE, NIGERIA Adebiyi KE1, Ndukwe KC1, Aregbesola 4 5 1 Cantisano MH , Oliveira AV - UNIVERSIDADE FED- SB1 - 1OBAFEMI AWOLOWO UNIVERSITY - ORAL/MAX- 2 ERAL FLUMINENSE - PATOLOGIA, UNIVERSIDADE ILLOFACIAL SURGERY & ORAL PATHOLOGY 3 FEDERAL FLUMINENSE, UNIVERSIDADE FEDERAL Background/objective: Odontogenic myxomas (OMs) are 4 FLUMINENSE - CIÊNCIAS BÁSICAS, UNIVERSIDADE considered slow-growing tumours with potential for extensive DO ESTADO DO RIO DE JANEIRO - ESTOMATOLOGIA, bone destruction. We analyzed the cases histologically diagnosed 5UNIVERSIDADE DO ESTADO DO RIO DE JANEIRO - as OM in our centre and compared these to the data found in the PATOLOGIA current literature. Pemphigus vulgaris (PV) is an autoimmune disease that Study design: A record-based study of OMs histologically often begins in the oral mucosa. Hence, a timely diagnosis is diagnosed at the Obafemi Awolowo University Teaching Hospi- necessary in order to give appropriate therapy. The cytopathology tal Complex, Ile-Ife, Nigeria between 1990 and 2009 was con- is sensitive and rapid exam to diagnose PV, mainly, when asso- ducted. Data was analyzed using SPSS version 11. ciated with direct immunofluorescence (DIF). The purpose of this Results: A total of 16 cases were histologically diagnosed, study was to evaluate the role of cytopathology associated with 11(68.8%) in females and 5 (31.2%) in males. Maxilla (7 cases, DIF in the diagnosis of PV. A 73-year-old man with histopatho- 43.8%) was the most common site and the mean age at the time logical diagnosis of PV, presented oral lesions of PV was sub- of diagnosis was 31.1Ϯ18.0 years. Myxomas, exhibiting com- jected to collect material for making smears to cytopathological plete myxomatous tissue (8 cases, 50%) with no appreciable analysis and DIF using anti-IgG. The Pap-stained smears showed fibrous component were the most common histological type. findings consistent with PV, as presence of typical acantholytic Conclusion: OMs exhibited extensive bone destruction and cells, showing an abundant basophilic cytoplasm, round hyper- cortical expansion. The recommended treatment of choice is trophic nucleus with prominent nucleoli. The smears positive by radical surgery or conservative excision depending on tumour DIF showed deposition of anti-IgG between acantholytic cells. size. The use of the cytopathology associated with DIF is an alterna- tive more specific, economical, user-friendly to the diagnostic of MALIGNANT CEOT, A CASE REPORT IN MEXICO Acosta oral PV. FO1, JVS2, Espinoza AV3, Legorreta B4, Barrios BCA4 - 1UABC - ORAL PATHOLOGY, 2UABC - ORAL SURGERY, A LOW GRADE MYOFIBROBLASTIC SARCOMA OF 3HOSPITAL GENERAL TIJUANA BC - PATHOLOGY, THE ALVEOLAR RIDGE Barrios BCA1, Legorreta B1, Lopez 4UNAM - ORAL PATHOLOGY R1 - 1UNAM - ORAL PATHOLOGY The malignant variant of the epithelial odontogenic tumor The low grade myofibroblastic sarcoma is an heterogeneous (CEOT) is a rare variant of malignant odontogenic with, only 20 neoplasm, with a biological spectrum from a benign to malignant cases reported in the literature, the first benign variant was neoplasma. Misdiagnosed as benign lesions can be made. Iden- described by Jens Jorgen Pindborg in 1955. Represent less than tifying neoplastic myofibroblasts is important for diagnosis as a 1% of all odontogenic tumors. myofibroblastic neoplasm. The currently accepted markers for Case report: In 2010, a 37 year old female went to the identifying myofibroblasts are muscle-specific actin MSA, diagnostic clinic of the School of Dentistry for presenting a smooth muscle actin SMA, desmin, and calponin. painful swelling on the right body of the mandible with a cortical OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e39 expansion, no evidence of positive cervical nodes, the swelling as poorly or moderately demarcated radiolucencies without cor- have 6-7 months of evolution, and eventually became painful. tical expansion; 53% were painful. Microscopically, bone was The patient denied other illness and, besides of the evidence of always viable (43% showed new bone) and all cases showed the tumor, she appeared to be in good health. A panoramic X-ray moderately dense to dense fibrous replacement of marrow with study showed a well-defined mixed radiolucency with central small to moderate numbers of chronic inflammatory cells (no radiopacity making the premolars roots of that side to diverge and neutrophils), occasional mast cells and dilated marrow capillar- involving the mandibular nerve. An incisional biopsy was per- ies. There was minimal marrow necrosis (7%) but 38% showed formed and clearly the tumor eroded the mandibular cortex and chronic ischemic marrow disease in addition to inflammatory surrounded the mandibular nerve sheath. Microscopically, a solid changes. Comparison was made between CFO and chronic scle- and strand like epithelial pattern was revealed intermixed with rosing osteomyelitis, chronic granulomatous osteomyelitis, Gar- fibrous stroma and concentric mineralization (Liesegang rings). ré’s osteomyelitis and intramedullary fibrous scar. The epithelial component was polygonal in shape, had evidence Conclusion: CFO has distinct microscopic features and of atypia -increase in mitotic activity and cellularity, abnormal should be differentiated from other ischemic and inflammatory mitosis, cellular and nuclear pleomorphic- and presenting necro- bone disorders. CFO seems to be frequently misdiagnosed today. sis (comedo-type), in the solid epithelial pattern. Also, a duct-like structures was showing in some areas of the tumor. The all panel A CLINICOPATHOLOGICAL AND IMMUNOHISTO- immunohistochemical help us to diagnosis a malignant Calcify- CHEMICAL STUDY OF ORAL CARCINOMA CUNICU- ing Epithelial Odontogenic Tumor, the patient was send to a LATUM (CC) Sun Y1, Kuyama K1, Burkhardt A2, Takanashi cancer center for further studies and proper therapy. After 2 years H1, Yamamoto H1 - 1NIHON UNIVERSITY SCHOOL OF of the diagnosis the patient is still on radiotherapy sessions to DENTISTRY AT MASTUDO - DEPARTMENT OF ORAL avoid recurrence. The treatment was a resection of the entire PATHOLOGY, 2KREISKLINIKEN REUTLINGEN - DE- mass with tumor free surgical margins and a long-term follow-up PARTMENT OF PATHOLOGY is necessary. This is the first malignant CEOT report in the Background/objective: Carcinoma cuniculatum (CC) is a Mexican literature. distinct variant of oral squamous cell carcinoma (SCC) and remains a histopathological challenge to pathologists. The pur- PSEUDOEPITHELIOMATOUS HYPERPLASIA IN BRONJ pose of this study was to illustrate the clinicopathological and MAY MIMIC SQUAMOUS CELL CARCINOMA Bouquot immunohistochemical factors of CC. 1 2 1 JE , Doug Gnepp - UNIVERSIDADE FEDERAL DO Study design: 15 CC were identified and clinicopathological MARANHÃO - ODONTOLOGIA, 2BROWN UNIVERSITY, characters were analysed. Immunohistochemical staining of cy- PROVIDENCE, RHODE ISLAND - PATHOLOGY, SCHOOL tokeratins, gene-related protein and cell-cell adhesion molecules OF MEDICINE was performed, compared to conventional SCC and verrucous Objective: To present the first cases of pseudoepithelioma- carcinoma. tous hyperplasia (PEH) of marginal soft tissue from bisphospho- Results: The tongue and the mandible were the most fre- nate related osteonecrosis of the jaws (BRONJ), some initially quently affected sites. Histopathologically, the unique, cunicula- misdiagnosed as carcinoma. tum architecture and branching crypts were defining features Study design: Cases were identified from 89 BRONJ biop- leading to a diagnosis. Cytokeratins 10, 13 showed greater pos- sies in a surgical pathology service. itive expression and gene-related p53, Ki-67 and p63 revealed Results: Of 13 subjects: 9 were using IV & 5 were using oral low immunopositive rates in CC. Laminin 5␥2, E-cadherin, and bisphosphonates; 8 were females. Average age at diagnosis: 63 integrin ␣6 were revealed strongly in the basal layer of CC. years (range: 54-79). Biopsies from nonerythematous mucosal Conclusion: CC was a well-differentiated lesion with low- margins of exposed bone showed: extreme hyperplasia of the proliferative activity, and cell-cell adhesion molecules might alveolar epithelium with no dysplasia, mitotic figures, bizarre participate in construction of unique architecture of CC. nuclei or necrosis. Epithelium partially or completely surrounded bone fragments (n ϭ 6) or was found within or immediately MUTATIONAL STATUS OF FGFR3 IN ORAL SQUA- adjacent to bony sequestrae (n ϭ 7). Acute & chronic inflamma- MOUS CELL CARCINOMA Motahhary P1, Amini Shakib tory cells were routinely seen and nonviable bone routinely P2, Baghaie F1, Mamishi S3 - 1TEHRAN UNIVERSITY OF showed resorption lacunae. MEDICAL SCIENCES - ORAL AND MAXILLOFACIAL PA- Conclusion: BRONJ-associated PEH must be ruled out be- THOLOGY DEPARTMENT, 2BABOL UNIVERSITY OF fore a carcinoma diagnosis can be applied to a BRONJ lesion. MEDICAL SCIENCES - ORAL AND MAXILLOFACIAL PA- THOLOGY DEPARTMENT, 3TEHRAN UNIVERSITY OF CHRONIC FIBROSING OSTEOMYELITIS (CFO) – NEW MEDICAL SCIENCES - PEDIATRIC INFECTIOUS DIS- OR LONG FORGOTTEN JAWBONE DISEASE? Bouquot EASES RESEARCH CENTER 1 2 3 1 2 JE , Qari H , McMahon R - UFTM / UNIUBE, UNVER- Objective: Mutations in the fibroblast growth factor receptor SITY OF TEXAS, HOUSTON - DIAGNOSTIC & BIOMEDI- 3 (FGFR3) genes have been identified in some human cancers but CAL SCIENCES, 3THE ORAL SURGERY GROUP, VAL- its role in oral squamous cell carcinoma (OSCC) has not been PARAISO, INDIANA, USA clarified completely yet. The aim of this study was to evaluate the Objective: To characterize the “forgotten” disease, chronic FGFR3 mutations in exons 7 and 15 in OSCC. fibrosing osteomyelitis (CFO). Study design: DNA was extracted and purified from snap Study design: 459 cases were identified from 12,856 can- frozen tissue biopsy sections of 20 OSCCs. Exons 7 and 15 were cellous bone samples from 2 biopsy services. Results: Average amplified by PCR and sequenced in both directions. subject age was 44 years; 68% were females. All cases presented Results: In three cases silent mutations were identified in ORAL MEDICINE OOOO e40 Abstracts October 2012 exon 7 (882 T to C) which may be introduced as Single Nucle- IMMUNOREGULATORY CELLS IN ORAL LICHEN otide Polymorphism and no mutation was identified in exon 15. PLANUS Firth FA1, Friedlander LT1, Parachuru P1, Kardos Conclusion: It seems that FGFR3 gene mutation in exon 7 TB1, Rich AM1, Seymour GJ1 - 1FACULTY OF DENTISTRY, and 15 has no significant role in the development and progression UNIVERSITY OF OTAGO of OSCC. Analyzing other exons or considering other advanced Objective: The aim of this study was to investigate the role gene mutation assessment techniques may clarify the role of this of two regulatory T-cell subsets: T regulatory cells (Tregs, receptor mutation in OSCC pathogenesis. FoxP3ϩ) and Th17 cells (IL-17ϩ), in the regulation of oral lichen planus (OLP). Study design: 12 archival cases of non-specific oral mucosal HISTOPATHOLOGICAL FEATURES OF TUMOR-NEGA- inflammation and 17 OLP cases were processed for immunohis- TIVE LYMPH NODES FROM PATIENTS WITH ORAL tochemistry and double-labeled immunofluorescence with anti- CANCER ARE PREDCITORS OF CLINICAL OUTCOMES bodies to FoxP3, IL-17 and CD3. Every second high power field in the superficial connective tissue was photographed and the Vered M, Schiby G, Salo T, Bello I, Schnaiderman-Shapiro A, number of positively stained cells per defined area determined. Buchner A, Dayan D ϩ Results: OLP displayed significantly more FoxP3 cells Background/objective: to investigate tumor-negative (TN) Ϫ (OLP 79.3; control 20.6 ϩve cells/area, pϭ6.45x10 17) and lymph nodes (LNs) from patients with oral cancer in order to fewer IL-17ϩ (OLP 1.05; control 3.30 ϩve cells/area, identify potential tumor-related histopathological changes and pϭ2.95x10Ϫ4) cells than the controls. Double-labeled IF showed their association with clinical outcomes. that FoxP3ϩ cells co-localised with T cells, while IL-17ϩ cells Study design: H&E-stained slides of 766 selected TN-LNs did not. were assessed for the histopathological parameters of capsule Conclusion: The profile of Tregs and Th17 cells differs in thickness, degree of dilatation of the subcapsular and medullary OLP compared with non-specific inflammation, supporting the sinuses, and percent of reactive follicles for their potential to concept of their involvement in the regulation of OLP. predict metastasis, recurrence and survival using a three-step procedure to combine the information of each parameter in one numeric variable and the logistic regression and Cox proportional HEAVY METAL TOXICANTS IN ARECA NUT-CONTAIN- 1 1 1 hazard model. ING PRODUCTS Cox SC , Dyer J, Lau S , Minard L , 1 1 Results: the capsule thickness was a predictor of metastases Arora M - UNIVERSITY OF SYDNEY (Pϭ0.0028) and survival (Pϭ0.0094), capsular sinus and med- Objectives: This study sought to determine the concentra- ullary sinus were predictors of metastases (Pϭ0.0246, Pϭ0.0062, tion of heavy metal toxins in areca nut products used in regions respectively) and of survival (Pϭ0.0130, Pϭ0.0105, respec- with a high incidence of oral cancer. Areca nut products are tively). The percent of reactive follicles was a predictor for associated with oral mucosal disorders including leukoplakia, survival (Pϭ0.0041). oral submucous fibrosis and oral squamous cell carcinoma. Al- Conclusion: Routine histopathological parameters of TN- though the alkaloids within the nut are known to be responsible LNs are valuable predictors for survival in patients with oral for many of these effects, heavy metals including arsenic, cad- cancer. mium and chromium, have been shown to be carcinogenic. Study design: Fifteen areca nut products were sourced in Sydney, Australia. The concentration of metals was determined UNSUSPICIOUS AREAS IN ACTINIC CHEILITIS Marques using inductively coupled plasma-mass spectrometry. YMFS1, Andrade CR1, Viera EH2, Gabrielli MFR2, Navarro Results: Arsenic, cadmium and mercury levels were4–82 CM2, Massucato EMS2 - 1UNIVERSIDADE ESTADUAL times above the maximum standards set by Food Standards PAULISTA - UNESP (FOAR) - FISIOLOGIA E PATOLO- Australia and New Zealand with copper, lead and zinc levels at 2 GIA, UNIVERSIDADE ESTADUAL PAULISTA - UNESP the maximum set by these same standards. (FOAR) - DIAGNÓSTICO E CIRURGIA Conclusion: Significant concentration and possibly harmful The actinic cheilitis (AC) comprises a pre-malignant condi- levels of the heavy metals present in areca nut products. tion that may progress to squamous cell carcinoma (SCC), for this reason careful attention should be given to AC analysis and treatment. Two cases of ACs were analysed and histopathological COMPARISON OF PROTEOMIC PROFILES IN VX2 findings of surgical specimens of vermilionectomies were com- INDUCED RABBITS AND DMBA INDUCED HAMSTER 1,2,3,4,5,6,7,8 1 pared with initial biopsy and clinical aspects. In both cases, the OSCC LM Lin - KAOHSIUNG MEDICAL UNI- 2 histopathological findings of incisional biopsy demonstrated VERSITY HOSPITAL - SCHOOL OF DENTISTRY, LI-MIN moderate dysplasias; however the vermilionectomies specimens, LIN - DEPARTMENTS OF ORAL PATHOLOGY ORAL AND 3 sectioned every 3 mm, exhibited areas with different grades of MAXILLOFACIAL IMAGING CENTER, YAN-HSIUNG severity, including microinvasive SCC, severe and mild dysplasia WANG - SCHOOL OF DENTISTRY, 4YU-WEN CHEN - DE- even far from the biopsied area. These findings showed that cases PARTMENT OF NUCLEAR MEDICINE, 5SHIH-HSIEN CHEN of ACs may bear severe histopathological changes even in un- - DEPARTMENT OF RADIOLOGY, 6CHING-YI CHEN - DE- suspicious areas of clinical changes; in addition, the result of PARTMENT OF ORAL PATHOLOGY, 7WEN-CHEN WANG - incisional biopsy could not represent the most important site of DEPARTMENT OF ORAL PATHOLOGY, 8YUK-KWAN CHEN malignant changes. Do the histopathological changes always - DEPARTMENT OF ORAL PATHOLOGY produce clinical expression? Should vermilionectomies be per- Background/objective: The purpose of study is to use pro- formed in moderate and severe dysplasia? Financial support: teomic analysis in VX2 induced rabbit and DMBA induced Univ Estadual Paulista, Fundunesp (00472/12-DFP). hamster OSCC to observe the difference between early and late OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e41 stage of tumors, ultimately to identify novel-invasive serum ONCOGENIC PATHWAYS AND ORAL CARCINO- biomarkers of OSCC. GENESIS Mendes RA1 - 1THE CATHOLIC UNIVERSITY OF Study design: Ten adult white New Zealand male rabbits PORTUGAL - ORAL ONCOLOGY AND CLINICAL PA- received Vx2 inoculation whilst twelve adult Syrian golden male THOLOGY hamsters were painted with DMBA. Venous blood was drawn The progression towards malignancy includes sequential from each animal. All serum samples were collected and stored pathological alterations ranging from hyperplasia through dys- for Ϫ80°C before 2D gel electrophoresis analysis. Protein spots plasia to invasive carcinoma and is determined by the accumu- were visualized by silver staining and identified by liquid chro- lation of a series of genetic and epigenetic events. matography/ tandem mass spectrometry. Thus, oral carcinogenesis must be seen as a molecular and Results and conclusion: Nineteen protein-spots of sera sam- histological multistage process featuring genetic interaction and ples showed significant change during the development of VX2- phenotypic markers for each stage, which involves enhanced induced rabbit OSCC. Transthyretin, paraoxonase 1, paraoxonase 1B, alpha-2-glycoprotein 1 and alpha 1B-glycoprotein-like, were function of several oncogenes and/or the deactivation of tumour identified. Transthyretin and paraoxonase 1 strongly decreased suppressor genes, resulting in the loss of cell cycle checkpoints. after tumor inoculation. Hence, there are several signal transduction pathways fre- Fifteen protein spots were visualized in DMBA induced quently altered in cancer, which generate changes in cell survival, OSCC. C-reactive protein, complement factor B, complement cell proliferation, morphology, angiogenesis, longevity and other C3, immunoglobulin kappa-chain, liver carboxylesterase, and properties known to characterize cancer cells. haptoglobin were identified. The protein level of C-reactive pro- The underlying pathways governing the progression of tein and haptoglobin decreased at 4 weeks and increased at 9 and oral premalignant lesions and of the molecular changes which 13 weeks. Other proteins decreased with time. antedate the occurrence of invasive malignancy are reviewed The relationship between these biomarkers and OSCC de- and so is the potential use of biomarkers for risk assessment velopment requires further testing in cancer patients. purposes. ORAL MEDICINE OOOO e42 Abstracts October 2012

Poster 1

USEFULNESS OF TELEDIAGNOSIS IN STOMATOLOGY SERVIÇO DE PATOLOGIA ORAL DO HOSPITAL UNIVER- Nunes AC1, Tango EK2, Mesquita ATM3, Vasconcellos AFG4, SITÁRIO JOÃO DE BARROS BARRETO Cruz AD5, Takahama Júnior A1 - 1UNIVERSIDADE FED- Background/objective: Few reports show the expression of ERAL FLUMINENSE - FACULDADE DE ODONTOLOGIA Msx2 and Ctip2/Bcl11b in odontogenic tumors. The aim of this - PÓLO UNIVERSITÁRIO DE NOVA FRIBURGO, 2UNI- study was to identify the expression of Ctip2 and Msx2 in VERSIDADE ESTADUAL PAULISTA - FACULDADE DE ameloblastoma variants. ODONTOLOGIA DE SÃO JOSÉ DOS CAMPOS, 3UNIVER- Study design: Immunohistochemical analysis of Msx2 and SIDADE FEDERAL DE DIAMANTINA - FACULDADE DE Ctip2 were performed in 36 ameloblastomas (both multicystic ODONTOLOGIA, 4INSTITUTO DO CÂNCER DO ESTADO and unicystic), with confirmed histological diagnoses, selected DE SÃO PAULO - ODONTOLOGIA ONCOLÓGICA, 5UNI- from the Oral Pathology clinic of the João de Barros Barreto VERSIDADE FEDERAL FLUMINENSE - FACULDADE DE University Hospital. Fisher’s exact test was used to compare the Յ ODONTOLOGIA expression of Ctip2 and Msx2 in ameloblastomas. P 0.05 was considered to be statistically significant. Background: The use of online communication and infor- Results: The results showed that all the specimens of amelo- mation technology for sharing data, images and videos among blastoma had strong positivity for Msx2 protein in the peripheral professionals who are in distant locations, in order to aid in the collunar cells of the tumoral islands, while absent staining was diagnosis, treatment plan and prognosis, has been called ”teledi- observed in all the specimens for Ctip2 protein. agnosis. Conclusions: The staining pattern found in the ameloblas- Objectives: The objective of this study was to evaluate the toma specimens for the proteins tested suggests that Msx2 takes feasibility of this method in the diagnosis of oral lesions. part of the pathogenesis of this lesion. Study design: Forty clinical cases containing digital photos and medical information, were sent by email to 3 professional’s experts in stomatology. These evaluators had to provide diagnos- ODONTOGENIC GLANDULAR CYST DIAGNOSED IN tic hypotheses and actions to be performed for each case. A HEAD AND NECK CANCER PATIENT: THE IMPOR- Results: At the end we found an average of 90% of correct TANCE OF PRE-RADIOTHERAPY DENTAL SCREENING hypothesis and 100% of correct actions. Gouvêa AF1, Ribeiro ACP1, Rosa GB1, Jaguar GC1, Santos- Conclusion: The “telediagnosis” is an effective tool in help- Silva AR2, de Almeida OP2, Brandão TB1 - 11. DENTAL ing establish the diagnosis of oral lesions. Online communication ONCOLOGY SERVICE, SAO PAULO CANCER INSTITUTE, could be used in public health system as a method to reduce costs ICESP, SÃO PAULO, BRAZIL., 2 and improve the care of the population. 2. DEPARTMENT OF ORAL DIAGNOSIS, PIRACICABA DENTAL SCHOOL, STATE UNIVERSITY OF CAMPINAS, SÃO PAULO, BRAZIL CALCIFYING EPITHELIAL ODONTOGENIC TUMOR IN The authors report the case of a 40 years-old heavy smoker MAXILA: CASE REPORT Gomes TG, Silva RV1, Resende and drinker male diagnosed with an oropharynx squamous cell RFB1, Spyrides KS1, Oliveira SP2, Medeiros N1, Alves carcinoma (SCC), referred for pre-radiotherapy dental evalua- ATNN - 1UNIVERSIDADE GAMA FILHO - ODONTOLO- tion. A radiolucent lesion involving left ramus and body of the GIA, 2OCEX - ESTOMATOLOGIA mandible was observed on panoramic radiography, but it was Calcifying epithelial odontogenic tumor (CEOT) is a rare, be- unnoticed in the medical oncologic examination of the computed nign odontogenic tumor. It constitutes 0.4-3% of all odontogenic tomography, which showed a hypodense expansive lesion nar- tumors. Although these lesions are benign, they can be locally rowing the mandibular cortical bone and shifting the mandibular aggressive. Considering its locally aggressive nature, appropriate canal inferiorly. The lesion was biopsied and diagnosed as a management and long-term follow-up is recommended. The rate of glandular odontogenic cyst, which may present a local aggres- recurrence after surgical excision ranging 10-15%. Microscopically, siveness and destructive course. Combined chemoradiotherapy these are composed of large sheets of epithelial cells, amorphous was started for the treatment of the oropharynx SCC, but patient amyloid-like material and calcification. We describe a rare case of evolved with progressive disease and died eleven months later CEOT in maxilla occurring in a 26-year-old black male that who due to septic shock without treatment of the mandible lesion. attended the oral surgery clinic dental school of Universidade Gama Proper dental management in such cases must be done, since Filho for removal of third molar. At physical examination, we there is a risk of later irradiation-related oral complications, identified swelling in the left maxilla. The panoramic radiograph especially osteoradionecrosis. revealed an image of the jaws inaccurate in the region corresponding to the ipsilateral upper molars; resorption of the roots of the teeth and fourth molar were identified. Incisional biopsy was performed with EVALUATION OF STUDENT’S PERCEPTION ABOUT histopathologic diagnosis of CEOT. HIV, HTLV AND HBV SEROPOSITIVES PATIENTS Gomes TM, Pedreira AA, Santos MCC, Santos MS, Reis SRA, Me- drado ARAP MSX2 AND CTIP2/BCL11B EXPRESSION IN AMELO- Background/objective: HIV, HTLV and HBV viruses have BLASTOMAS Jesus AS1, Abreu MC1, Silva BTC1, Borsero caused a huge tension among health professionals. This study AD1, Carvalho PL1, Pontes HAR1, Pontes FSC1 - 1UFPA - aims to describe the perception of the students of a Dentistry OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e43

School regarding the feelings and apprehensions through the Background/objective: Congenital hypothyroidism (CH) is everyday dealings with seropositive patients. a disease caused by a change in the thyroid gland, with irrevers- Study design: An exploratory, descriptive study was real- ible consequences if the disease is not early diagnosed and ized using the Oral Theme History to collect and analyze the data. properly treated. The diagnosis is established by newborn exams, The sample comprised 60 students of the first, sixth and tenth which is part of the neonatal screening of all newborns. This semesters. study reports a case of CH late diagnosed and the consequences Results: It was observed that 72.5% of the students reported in dental development. never attended patients seropositive for such viruses. Although Case report: Female patient with 18 years old, light weight HIV was more feared, 39.55% didn’t know about HTLV infec- and short stature. Delayed in motor and language development, tion. 82.58% of the interviewed students considered important to school learning disability and attention deficit were reported. Oral know about HIV, HTLV and HBV seropositive patients before examination revealed retention of deciduous teeth, oligodontia, treatment and 47.5% reported knowing the procedures to be periodontal disease and caries. Restorative, periodontal and sur- performed in case of an accidental exposure. gical treatments were performed. After this, the patient was Conclusion: It’s necessary to expand the knowledge about referred for orthodontic treatment. these infections and to make the assistance and care to such Discussion: Early diagnosis as well as treatment and control patients more human. of the patient’s hormone levels are important to avoid complica- tions in several organ and systems. HEAD AND NECK PERIPHERAL NERVE SHEATH TU- Conclusion: Late diagnosed CH is associated with changes MORS IN A BRAZILIAN POPULATION Alves AM1, in dental development. Gomes APN1, Etges A1, Furuse C1, Vasconcelos ACU1, Tar- quinio SBC1 - 1UNIVERSIDADE FEDERAL DE PELOTAS - SUPPURATIVE OSTEOMYELITIS AS A COMPLICATION SEMIOLOGIA E CLÍNICA OF TOOTH EXTRACTION Parisotto ACN1, Menezes 1 2 1 1 2 Objective: the aim of this study was to determine the prev- MSC , Câmara J , Jesus GP - UFAM - FAO, UFAM - alence of head and neck peripheral nerve sheath tumors (HN- DEPARTAMENTO DE PATOLOGIA E MEDICINA LEGAL PNST) and their clinical and epidemiological characteristics. The aim of the present study is to describe a case addressing Study design: biopsies files from Center of Diagnosis of clinical and pathologic features of a patient with osteomyelitis Oral Diseases (CDOD) were evaluated in the period between due to extraction of maxillary molar. A 26-year-old, man, was 1959 and 2012. Data about sex, age, site and lesion were col- evaluated in the Maxillofacial Surgery Department of the FAO- lected and submitted to descriptive analysis. UFAM. Reported extraction about one year, no area of tissue Results: from a total of 20,022 biopsies analyzed, 51 (0.3%) repair and is associated with pain and drainage of secretions, were originated from peripheral nerve sheath, being female progressing with the mobility of neighboring teeth. A minor 58.8% of the patients. The average age was 32.5 years (varying facial deformity was verified, extensive communication oro-an- from 2 to 86 years-old). The most prevalent lesion was neurofi- tral-nasal, foul smelling and necrotic bone with. Radiographic broma (64.7%), with three cases being associated with neurofi- findings showed poorly defined radiolucent appearance with cen- bromatosis, following by neurilemmoma (23.5%). The most tral radiopacity in the right maxilla, suggestive of degenerative prevalent sites were gingiva and tongue. Only one case of ma- bone lesion. He underwent an incisional biopsy procedure, bone lignant tumor was found. fragments were removed. Histopathological analysis concluded Conclusion: head and neck peripheral nerve sheath tumor as suppurative osteomyelitis. The treatment was surgical debride- are rare lesions, and neurofibroma was most prevalent condition. ment followed by closure of the oro-antral-nasal communication References: with pedicle flap buccal mucosa and buccal fat. The patient lies [1] Chrysomali E, Papanicolaou SI, Dekker NP, Regezi JA. with one year of preservation, with satisfactory healing of the Benign neural tumors of the oral cavity: a comparative immuno- area. histochemical study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997 Oct;84(4):381-90. UNCOMMON FUNGAL INFECTION OF THE MIDFACE: [2] Jones AV, Franklin CD. An analysis of oral and maxil- CASE REPORT Rumayor A1, Carlos R2, Martínez M1,Ro- lofacial pathology found in adults over a 30-year period. J Oral mañach MJ3, Almeida OP1 - 1PIRACICABA DENTAL Pathol Med 2006 Aug;35(7):392-401. SCHOOL, UNICAMP - ORAL PATHOLOGY SECTION, [3] Salla JT, Johann AC, Garcia BG, Aguiar MC, Mesquita 2CENTRO CLÍNICO DE CABEZA Y CUELLO/HOSPITAL RA. Retrospective analysis of oral peripheral nerve sheath tumors HERRERA LLERANDI, GUATEMALA, 3FEDERAL UNI- in Brazilians. Braz Oral Res 2009 Jan-Mar;23(1):43-8. VERSITY OF RIO DE JANEIRO (UFRJ), BRAZIL [4] Janardhanan M, Rakesh S, Vinod Kumar R. Intraoral Fungal infections are a group of diseases that can result in presentation of multiple malignant peripheral nerve sheath tu- significant morbidity and mortality. In the head and neck area, the mors associated with neurofibromatosis-1. J Oral Maxillofac most common sinonasal fungal infection is caused by Aspergillus Pathol 2011 Jan;15(1):46-51. sp., even though other kinds of fungi might be involved. Our aim is to present a case of a 21-year-old female patient exhibiting a CLINICAL FEATURES AND DENTAL MANAGEMENT OF destructive lesion involving the midfacial structures. Extra-oral PATIENT WITH CONGENITAL HYPOTHYROIDISM: A examination revealed reddish ulcerated lesions over the zygo- 1 1 1 CASE REPORT Weber A , Rodrigues RB , Pinto JV , Dor- matic area and nasal bridge. Intra-oral examination revealed an neles EM1, Mezomo MB1, Ferrazzo KL1, Payeras MR1 - oral-nasal communication and a diffuse erythematous area in the 1FRANCISCAN UNIVERSITY CENTER - UNIFRA - CURSO midline of the hard palate. Computerized tomography exhibited a DE ODONTOLOGIA destructive process involving the nasal cavity, maxillary sinus ORAL MEDICINE OOOO e44 Abstracts October 2012 and palate. The patient underwent an incisional biopsy and the DO CÂNCER DO ESTADO DE SÃO PAULO - ICESP, microscopic features showed granulomatous inflammation with 4FACULDADE DE ODONTOLOGIA DA USP - DEPARTA- multinucleated giant cells containing fungal structures with an MENTO DE CIRURGIA, PRÓTESE E TRAUMATOLOGIA uncommon appearance. Periodic acid-Schiff and Groccott stains MAXILOFACIAIS highlighted numerous large hyphae. A broad list of clinic and This presentation reports the case of a 38-year-old female microscopic differential diagnosis was considered. patient who was referred to our Clinic for evaluation of “dental abscess”. Her recent medical history included radical mastectomy CENTRAL GIANT CELL GRANULOMA IN A CHILD - due to an invasive metaplastic carcinoma of the left breast. CASE REPORT Farias AC1, Beder C1, Paiva K1, Melo Jr. Moderate asymmetry was observed in the right zygomatic area. EJM1, Ferreira SMS1, Franco AVM1 - 1CENTRO DE ESTU- Intraoral examination revealed periodontal disease, caries and DOS SUPERIORES DE MACEIÓ - ODONTOLOGIA residual roots. Diagnostic hypothesis included dental abscess and metastatic carcinoma. Head and neck computed tomography re- The Central giant cell granuloma (CGCG) has been classi- vealed wide zygomatic bone erosion and infiltration of the mas- fied as a rarely aggressive idiopathic benign intraosseous lesion. seter muscle. Incisional biopsy demonstrated islands of atypical It occurs most frequently in young women (aged Ͻ30 y) and squamous cell. Further immunohistochemical analysis showed mandible. In young and child differential diagnosis has to be positivity for AE1/AE3, p63, EGFR and negativity for Cerb-b2, made with other osteolytic neoformations of the jaws. This case estrogen and progesterone, this immune profile was similar to the reports a CGCG in a female child, 7-years- old, presented to the oral primary breast tumor. Thus, a diagnosis of metastatic breast medicine clinic for evaluation of a tumor in her mouth. The lesion carcinoma was rendered. Metastatic tumours to the maxillofacial had been present for six months, painless, on the left inferior region are rare and usually represent poor prognosis. The patient alveolar area, with a gradual increase in size. The clinical exam- is being treated with combined chemoradiotherapy with partial ination showed a pigmented nodule, painless, hard, not bleeding control of the zygomatic lesion. on the left lower gingival. A CT scan showed multilocular hypodense lesion on the mandibular symphysis, with cortical expansion, well-defined limits, from right canine to left canine SIALADENOMA PAPILIFERUM: CASE REPORT Omena 1 1 1 2 tooth. The clinical, laboratory, histopathologic and diagnostic ALCS , Carvalho KCS , Ferreira SMS , Silva AA , Vargas 2 1 1 imaging exams determined the diagnosis. PA , Ribeiro CMB - CENTRO UNIVERSITÁRIO CESMAC, 2UNICAMP - FACULDADE DE ODONTOLOGIA DE PI- RACICABA IMPACT OF ORAL HEALTH ON THE QUALITY OF LIFE Sialadenoma papiliferum (SP) is a rare benign neoplasia of AMONG WOMEN LIVING WITH HIV/AIDS- A CROSS- salivary glands. Commonly it affects males older than 50 years, SECTIONAL STUDY IN MACEIO, NORTHEASTERN 1 1 1 occurring in hard palate and oral mucosa. Clinically it is observed BRAZIL Lima ALO , Albuquerque VWT , Silva JIBW , Fer- an exophytic papilar surface and asymptomatic lesion. This study 1 2 1 reira SMS , Peixoto FB, Meeks VI - CENTRO UNIVERSI- reports a case of SP occurred in a female patient MJSS, 81 2 TÁRIO CESMAC, UNIVERSITY OF MARYLAND years-old, ex-smoker, complete denture prosthesis user. Who was Objective: To analyze the self-reported oral health and oral referred to dentistry and presenting a nodule located in the hard health-quality of life (OHRQOL) among women living with palate during 60 years, reddish, 2x1x1cm, verrucous surface, HIV/AIDS. irregular format, sessile, bleeding and painful due to prosthesis Methods: A cross-sectional study was conducted on a ran- trauma. Clinical diagnostic hypothesis was pyogenic Granuloma. dom sample using a questionnaire regarding socio-demographics Excisional biopsy was conducted and microscopic analysis re- and perception of oral health impact profile (OHIP-14). All data vealed benign neoplasia of salivary glands with solid cystic areas, was analyzed using SPSS for Windows, version 17. spaces similar to ducts with a layer of oncocyte cells and other Results: 108 women were interviewed; median age, 36 layer of basal cells and a stroma with lymphoid tissue. Histo- years; the majority living in urban centers (84.3%) with low pathological diagnostic was SP and no recurrence of the lesion income (70.4%), and without defined employment (93.5%). was observed in 6 months follow-up. 38.9% of the women self-reported their oral health as fair. The OHRQOL was perceived moderately (OHIP-14 total Mean GINGIVAL OVERGROWTH INDUCED BY DRUGS AND Ϯ 13.19 10.56). The greater perceived impact was psychological IDIOPATHIC GINGIVAL FIBROMATOSIS: SIMILARI- Ϯ distress (2.79 2.52). Subjects reporting oral health problems TIES ASSOCIATED WITH PCNA AND 〈-SMA Ͻ had a greater impact on their quality of life (p 0.05). IMMUNOEXPRESSIONS Andrade ALDL1, Leão LV2, Conclusion: This study reinforces the need to include mea- Galvão HC1, Rosa MRD3, Bonan PRF4 - 1UNIVERSIDADE sures of the quality of life’s impact on oral health when planning FEDERAL DO RIO GRANDE DO NORTE - PROGRAMA programs in dentistry for people living with HIV. DE PÓS-GRADUAÇÃO EM PATOLOGIA ORAL, 2UNIVER- SIDADE FEDERAL DOS VALES DO JEQUITINHONHA E METASTATIC BREAST CARCINOMA AFFECTING THE MUCURI, 3UNIVERSIDADE FEDERAL DA PARAÍBA - DE- ZYGOMATIC BONE IN A YOUNG PATIENT Ribeiro PARTAMENTO DE CLÍNICA E ODONTOLOGIA SOCIAL, ACP, Rosa GAB, Gouvêa AF1, Santos-Silva AR2, Medeiros 4UNIVERSIDADE FEDERAL DA PARAÍBA - DEPARTA- RSS3, Dias RB4, Brandão TB1 - 1INSTITUTO DO CÂNCER MENTO DE ODONTOLOGIA CLÍNICA E SOCIAL DO ESTADO DE SÃO PAULO - ICESP - SERVIÇO DE Background/objectives: This study aimed to compare the ODONTOLOGIA ONCOLÓGICA, 2FACULDADE DE OD- Gingival Overgrowth Induced by Drugs (GOID) and Idiopathic ONTOLOGIA DE PIRACICABA - FOP/UNICAMP - DE- Gengival Fibromatosis (IGF) according with PCNA and ␣-SMA PARTAMENTO DE DIAGNÓSTICO ORAL, 3INSTITUTO immunoexpressions and with epithelial thickness. OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e45

Study design: Gingival samples were obtained from 11 Results: No difference of FASN expression in MC and users of nifedipine and phenytoin, 6 of IGF and 4 of normal MGC between lesions. PGCL showed greater MVD-CD34 patients. The specimens were submitted to immunohistochemical (pϭ0.002); no difference in MVD-CD105 and D2-40. MVA in and morphological analysis. PGCL was greater than CGCL in CD34, CD105 and D2-40 (p Ͻ Results: It was observed that PCNA epithelial positive cells 0.05). There was positive correlation between (MC/FASNϩ with were slightly more common among IGF patients, but there MDV-CD105) in PGCL. Furthermore, in CGCL was observed weren’t statistically significant differences among the groups. positive correlation between (MC/FASNϩ with MVD-CD105), Comparing the vessels counts with ␣-SMA positive cells, there (MC/FASNϩ with MVA-CD105 and CD34), (MGC/FASNϩ weren’t statistical differences, although the control group pre- with MVA-CD105). sented a discrete higher count. The epithelial thickness analysis Conclusion: Similar levels of FASN expression and angio- revealed that the GOID group presented the higher mean, evi- genesis indicate constitutive processes of tissue maintenance in dencing statistically significant differences. both lesions. However, differences in vascularization between Conclusion: We observed similarities between GOID and lesions appear to be influenced by MC/FASNϩ. IGF according to PCNA and ␣-SMA immunoexpressions. How- ever, the epithelial thickness was higher in GOID group maybe ACTINIC CHEILITIS: VIDEOROSCOPY VALUE IN THE due to reduced apoptotic influence. 1 SELECTION OF THE BIOPSY AREA Miranda AMO , Fer- rari TM2, Picciani B1, Santos BM1, Fontes KBFC1, Silva Jr 1 1 1 2 ORAL COMPLICATIONS IN PATIENTS UNDERGOING A , Dias EP - UFF - PATOLOGIA, UFF HEMATOPOIETIC STEM CELL TRANSPLANTATION: A Background: Actinic cheilitis is a potentially malignant LONGITUDINAL STUDY Luiz AC1, Coracin FL2,3, Gallot- disorder caused by long exposure to sunlight. tini MHC1 - 1SCHOOL OF DENTISTRY, UNIVERSITY OF Objective: To demonstrate the value of videoroscopy in the SAO PAULO - ORAL PATHOLOGY, DEPARTAMENT OF selection of the biopsy area. STOMATOLOGY, 2NOVE DE JULHO UNIVERSITY - ORAL Study design: A total of 60 patients were submitted to PATHOLOGY AND STOMATOLOGY, DEPARTAMENT OF anamnesis, physical exam, videoroscopy, toluidine blue test and HEALTH, 3CLINICAS HOSPITAL, SCHOOL OF MEDI- biopsy. Results: Physical exam identified 284 and videoroscopy 681 CINE, UNIVERSITY OF SAO PAULO - BONE MARROW lesions. Of the 50 biopsies, 31 (63.26%) cases were selected by TRANSPLANTATION UNIT videoroscopy which also showed other cheilitis types associated To identify oral complications in 27 patients treated with or not with actinic cheilitis. HSCT in five consecutive moments, the temporal relationship Conclusions: Biopsy is important for an early diagnosis of between HSCT and these complications and the correlation be- actinic cheilitis a lesion at risk for the development of squamous tween oral mucositis (OM) and oral health indexes. The evalua- cell carcinoma. Considering that the changes in actinic cheilitis tion of these indexes was applied at the first moment and 10, 20, are diffuse and not always easy to identify, the videoroscopy 60 and 100 days after HSCT patients were evaluated for oral contributes more than physical exam by choosing the site of the manifestations. Mouth pain and dysphagia were the most fre- biopsy. The results of the videoroscopy are better reconciling quent complaint. OM incidence was 82,6%. Ten (37%) patients with the toluidine blue test and the histopathology results than the had GVHD (2 acute and 8 chronic) and 8 of them (80%) had physical exam. mouth involvement. Increased incidence of oral complications occurred between Dϩ10 and Dϩ20. No correlation between oral health indexes and the incidence of OM was found in this study. HYPERPLASIA OF THE MANDIBULAR CONDYLE - A 1 2 2 Between Dϩ10 and Dϩ20 patients would be benefited by regular CASE REPORT Vasconcelos ACU , Gomes APN , Furuse C , visits of the dentist that could treat the symptoms of xerostomia Etges A2, Alves AM2, Carlini JL, Tarquinio SBC2 - 1UNI- and oral pain with techniques already established in clinical VERSIDADE FEDERAL DE PELOTAS, 2UNIVERSIDADE practice. FEDERAL DE PELOTAS - SEMIOLOGIA E CLÍNICAS Condylar hyperplasia is a rare disorder characterized by progressive growth of the condyle that results in facial asymme- FASN IMMUNOEXPRESSION AND ANGIOGENESIS IN try, malocclusion and, occasionally, temporomandibular dys- CENTRAL AND PERIPHERAL GIANT CELL LESIONS Mes- 1 1 2 1 function, which etiology has not yet been fully clarified. The quita AT , Falci SGM , de Andrade BA , Miranda JL , León present case shows a 14-year-old female patient complaining 2 2 1 1 JE , Almeida OP , Santos CRR - UNIVERSIDADE FED- about a progressive facial asymmetry on the left side, asymptom- ERAL DOS VALES DO JEQUITINHONHA E MUCURI - atic, lasting around two years. There was no history of trauma. UFVJM, DIMANTINA, MINAS GERAIS, BRAZIL - DEN- Intra-oral examination revealed deviation of midline and maloc- 2 TISTRY, PIRACICABA DENTAL SCHOOL, UNIVERSITY clusion. Panoramic radiography showed elongation of the left OF CAMPINAS - UNICAMP, PIRACICABA, SÃO PAULO, axial head of mandibular condyle. Scintigraphy showed hyper BRAZIL. - ORAL DIAGNOSIS uptake at the region of the hyperplastic condyle. The patient Objectives: Evaluate FASN expression and angiogenesis underwent high condylectomy, on October/2011. Histological between central and peripheral giant cell lesions (CGCL, PGCL). evaluation showed as main aspect mandibular condyle presenting Study design: Immunohistochemical for FASN, CD34, thick layer of hyaline cartilage that projects into the underlying CD105 and D2-40 were evaluated in CGCL (nϭ13) and PGCL cancellous bone trabecular. The association of histologic, radio- (nϭ14). FASN expression was assessed in mononuclear (MC) graphic and scintigraphic findings led to the diagnosis of hyper- and multinucleated (MGC) cells, followed by measurement of plasia of the mandibular condyle. Currently, the patient shows microvessel density (MVD) and microvessel area (MVA). satisfactory facial aesthetics. ORAL MEDICINE OOOO e46 Abstracts October 2012

VEGF RECEPTOR IS ASSOCIATED WITH EPITHELIAL DENTAL SCHOOL, UNIVERSITY OF CAMPINAS (UNI- DYSPLASIA GRADING Fraga CAC1, Oliveira MVM1,Go- CAMP) - ORAL DIAGNOSIS mez RS2, De Paula AM1, Guimaraes ALS1 - 1DEPARTMENT Objective: The purpose of this study was to investigate the OF DENTISTRY, - UNIVERSIDADE ESTADUAL DE MON- effects of activin A, a member of TGF␤ superfamily that has TES CLAROS, MONTES CLAROS, BRAZIL, 2DEPART- been shown to be overexpressed in various cancers, in the mod- MENT OF CLINICAL, SURGERY AND ORAL PATHOL- ulation of the key events associated with oral tumorigenesis, OGY, - SCHOOL OF DENTISTRY, UNIVERSIDADE including proliferation, apoptosis and epithelial-mesenchymal FEDERAL DE MINAS GERAIS, BELO HORIZONTE, BRA- transition (EMT). ZIL Study design: To assess the effects of activin A, the normal Objectives: The present study aimed to identify whether epithelial cell line HaCAT was cultured in medium containing there are alterations in the levels of VEGFR2 and MMP-9 in 0-100 ng/ml of recombinant activin A. epithelial dysplasia grading. Results: Our results demonstrated that activin A promotes a Study design: This retrospective study was performed on dose-dependent decreased of apoptosis and death cell, with a archived tissue blocks 48 patients with ED and 20 patients with significant inhibition on cell proliferation only at 100 ng/ml as OSCC and 6 mucoceles biopsies were used as a control group. revealed by cell cycle analysis and BrdU-labeling index. Addi- Immunohistochemistry of VEGFR2 and MMP9 were performed tionally, activin A treatment stimulated significantly the expres- and compared among groups. sion of vimentin and N-cadherin, while reduced E-cadherin and ␤ Results: VEGFR2 and MMP9 immunoexpression appeared -catenin expression. to correlate with the degree of dysplasia and was observed to Conclusion: These findings demonstrate that activin A mod- increase in lesions with more severe dysplasia as compared to ulates apoptosis and acquisition of EMT phenotypes, contributing those with lower degrees of dysplasia. Immunoreactivity of to oral tumorigenesis. MMP-9 was lower in the ED samples compared to the OSCC samples (p ϭ 0.004). We observed no difference in VEGFR2 ONCOCYTIC METAPLASIA IN ORAL MYOEPITHELIO- protein levels between ED and OSCC samples. MA: REPORT OF A CASE Correia AL1, Gueiros Lam1, Leão Conclusion: Our data indicate that an increase in the levels JC1, Castro JFL1, León JE2, Almeida OP3, Perez DEC1 - of both VEGFR2 and MMP-9 is associated with worse ED 1UNIVERSIDADE FEDERAL DE PERNAMBUCO - PRO- grading. GRAMA DE PÓS GRADUAÇÃO EM ODONTOLOGIA, 2UNIVERSIDADE DE SÃO PAULO - FACULDADE DE 3 SQUAMOUS CELL CARCINOMA OF THE LIP: CLINICAL ODONTOLOGIA DE RIBEIRÃO PRETO, UNICAMP - PROFILE OF PATIENTS AND HISTOLOGICAL GRAD- FACULDADE DE ODONTOLOGIA DE PIRACICABA ING OF LESIONS IN A REFERENCE CENTER OF The occurrence of oncocytic metaplasia in salivary gland 1 1 1 tumors is a relatively common finding. However, depending on AMAZONAS Castro AS , Pereira FRS , Lopes MSP , the extension, these areas may lead to misdiagnosis. The aim of Almeida NS2, Camara J2, Santos PJB3, Libório TN2 - 1FED- this report is to describe a case of myoepithelioma with oncocytic ERAL UNIVERSITY OF AMAZONAS - SCHOOL OF DEN- metaplasia. A 40-year-old female presented a painless swelling in TISTRY, 2FEDERAL UNIVERSITY OF AMAZONAS - PA- 3 the hard palate with 4 years of evolution. Intraoral examination THOLOGY AND LEGAL MEDICINE, ONCOLOGY revealed a nodular lesion, with firm consistency and covered by CENTER CONTROL FOUNDATION OF THE AMAZONAS normal color oral mucosa. A salivary gland tumor was the main (FCECON) hypothesis of diagnosis. Microscopically, the lesion was com- Objective: This study aimed to evaluate the clinical profile posed by epithelioid cells, which were arranged in nests and and histological grading of SCC of the lip (LSCC). blocks. Several cells presented a granular, eosinophilic and en- Study design: It was a retrospective study of patients over 40 largement cytoplasm, similar to oncocytic cells. The tumor cells years old treated in a Reference Center of Oncology in Amazonas were positive for AE1/AE3, cytokeratin 8 and p63. The diagnosis from 2002 to 2011. Clinical data were collected from medical of myoepithelioma with oncocytic metaplasia was established. records and a review of histological sections was performed. The patient was submitted to surgical excision of the lesion. Results: Nineteen patients with LSCC were found, 52.6% of Currently, the patient is under periodical follow up. them were female, 68.4% had over 60 years old, 63,1% was represented by a mixed race called “pardo”, 84,2% didn’t report LIPOSARCOMA OF THE TONGUE: CASE REPORT Tor- alcohol consumption and just 12.5% reported tobacco use. Well rezani A1, Lima AN2, Esteves CMD3, Martins FM3, Nunes differentiated LSCC was the most common histological grading FD3, Milani B. de A2, Jorge WA2 - 1UNIVERSITY OF SÃO (52,63%), especially in lower lip (57,8%). Status of Linfonodal PAULO - STOMATOLOGY, 2MUNICIPAL HOSPITAL OF involvement and metastasis were not informed in most cases CAMPO LIMPO - MAXILLOFACIAL SURGERY, 3 - (84,2%). UNIVER Conclusion: In the North of Brazil, data of LSCC are scarce, SITY OF SÃO PAULO - ORAL PATHOLOGY probably due to the lack of studies and also due to the sub Liposarcoma is a rare mesenchymal malignancy and affects notification. more men, between the 4th and 6th decade of life. A 21-years-old male with a 4 year duration, asymptomatic swelling, on the dorsum of the tongue present himself for diagnosis. The clinical ACTIVIN A INHIBITS APOPTOSIS AND INDUCES AC- examination showed an approximately 4 cm nodule in diameter QUISITION OF EMT PHENOTYPES IN NORMAL with ulcerated surface, erythroplasia, telangiectasia and a firm KERATINOCYTES Bufalino A1, Rodrigues PC1, Bastos DC1, consistence. An incisional biopsy was made and the histopatho- Sammartino F1, Graner E1, Coletta RD1 - 1PIRACICABA logical findings revealed a proliferation of round cells with hy- OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e47 perchromatic nuclei and some lipoblasts. These cells were mostly MITF AND TFE3 EXPRESSION IN SELECTED GIANT organized in sheets and nests permeated by a myxoid back- CELL LESIONS OF THE JAWS Bunn BK1, Mahomed F1, ground. Imunohistochemistry showed positivity to MDM2/ Altini M1, Meer S1 - 1UNIVERSITY OF THE WITWA- CDK4/CPM/S100/HHF35 and negativity to AE1AE3/CD34/ TERSRAND, JOHANNESBURG, SOUTH AFRICA - DIVI- CD99/SMA/DESMIN. The diagnosis of low grade liposarcoma SION OF ORAL PATHOLOGY, SCHOOL OF ORAL was made and the patient was referred to a head and neck HEALTH SCIENCES surgeon. A partial glossectomy was performed, with radiotherapy Background: Microphthalmia-associated transcription fac- initiated 30 days after surgery. After three month follow-up, tor (Mitf) and Transcription factor E3 (Tfe3) function synergis- patient presents normal swallowing and speaking. tically in the terminal differentiation of osteoclasts whilst being crucial for osteoclastic bone resorption. STAGES OF DELAY IN ORAL CANCER CARE EVALU- Objectives: The aim of this study was to assess Mitf and ATED AT A TERTIARY HEALTH CENTRE Kolude BM1, Tfe3 expression within stromal and multinucleated giant cells Adisa AO1, Adeyemi BF1, Lawal AO1 - 1UNIVERSITY OF (MNGCs) in central giant cell granuloma (CGCG), peripheral IBADAN - ORAL PATHOLOGY giant cell granuloma (PGCG), cherubism and aneurysmal bone Background/objective: To examine the stages of delay in cyst (ABC) to enhance our understanding of the biological nature presentation and management of oral cancer patients at UCH of these cells. Ibadan. Study design: Mitf and Tfe3 immunoreactivity was quanti- Study design: A 20 year retrospective analysis of the delay tatively assessed by means of cell counting in archival tissue stages among oral cancer patients that utilized patient’s biodata sections diagnosed as CGCG (nϭ10), PGCG (nϭ10), cherubism and clinical data. (nϭ5) and ABC (nϭ5), followed by statistical analysis of the Results: 169 oral cancer cases consisting of 127 carcinomas, results. 25 sarcomas and 17 lymphomas were analyzed. There were Results: Immunostaining for both factors was consistently significant differences in mean evolution time according to his- greater in the MNGCs of all lesions with fewer adjacent positive tological type (oral carcinoma ϭ 282.8Ϯ414, oral sarcomas ϭ stromal cells. Mitf was expressed at higher levels compared to 219.2Ϯ247.3 & oral lymphomas 105.5Ϯ115 days; p ϭ 0.001) Tfe3 in CGCG, PGCG and cherubism with similar levels of and stage (mean ϭ 137.2Ϯ99 & 266.4Ϯ355; p ϭ 0.010). expression noted in ABC. Patients delay accounted for larger part of the total delay Conclusions: Mitf and Tfe3 co-expression verifies the oste- (65.9%, 59.1% & 60.1% for carcinomas, sarcomas and lympho- oclastic nature of the MNGCs. Focal positivity in adjacent round mas respectively). According to gender, treatment time was sig- mononuclear stromal cells, supports MNGC formation through nificantly different among the oral carcinoma & oral sarcoma stromal cell fusion. Preferential expression of Mitf in CGCG, groups. PGCG and cherubism confirms its principal role in the terminal Conclusion: Patients delay as against professional delay differentiation of osteoclasts in these lesions. The degree of Mitf formed the bulk of management delay in our centre. and Tfe3 expression does not correlate with osteolytic potential in PGCG. ORAL FOCAL MUCINOSIS CAUSING TOOTH DIS- PLACEMENT: A CASE REPORT Monteiro BVB1, Silva KR2, VEGF EXPRESSION IN ORAL CANCER BY NEU- Aragão TS, Oka SCR3, Godoy GP3, Miguel MCC1 - 1UNI- ROTRANSMITTER-INDUCED ACTIVATION OF BETA 1 VERSIDADE FEDERAL DO RIO GRANDE DO NORTE - ADRENERGIC RECEPTORS Vilardi BMR , Bravo-Calderón 1 2 3 1 PROGRAMA DE PÓS-GRADUAÇÃO EM PATOLOGIA DM , de Oliveira SHP , Bernabé DG , Oliveira DT - 1 ORAL, 2FACULDADE DE ODONTOLOGIA DE PIRACI- BAURU SCHOOL OF DENTISTRY - UNIVERSITY OF SÃO CABA - UNICAMP - PROGRAMA DE PÓS-GRADUAÇÃO PAULO, BRAZIL - DEPARTMENT OF STOMATOLOGY - 2 EM RADIOLOGIA ODONTOLÓGICA, 3UNIVERSIDADE AREA OF PATHOLOGY, ARAÇATUBA SCHOOL OF ESTADUAL DA PARAÍBA - PROGRAMA DE PÓS-GRADU- DENTISTRY - PAULISTA STATE UNIVERSITY, BRAZIL - AÇÃO EM ODONTOLOGIA DEPARTMENT OF BASIC SCIENCES - LABORATORY OF 3 Oral focal mucinosis is an unusual lesion of unknown etiol- PHARMACOLOGY, ARAÇATUBA SCHOOL OF DEN- ogy, which may result of hyaluronic acid overproduction. A TISTRY - PAULISTA STATE UNIVERSITY, BRAZIL - DE- 23-year-old female patient searched for dental service for exam- PARTAMENT OF PATHOLOGY AND CLINICAL PROPE- ination of an asymptomatic slow growing lump in the mandibular DEUTICS - ORAL ONCOLOGY CENTER gingiva causing displacement of the right first molar. The lesion Objective: The aim of this study was to investigate the gene was sessile, firm and the overlying mucosa was non-ulcerated and expression of vascular endothelial growth factors in oral squa- without colour alterations. The diagnostic hypothesis was peripheral mous carcinoma cell lines through norepinephrine induced acti- giant cell lesion. Excisional biopsy and histopathological analysis vation of beta adrenergic receptors. were performed. In the subepithelial area, circumscribed masses of Study design: Oral human squamous carcinoma cell lines loose myxomatous tissue were observed surrounded by dense fi- (SCC-9 and SCC-25) containing beta adrenergic receptors were brous connective tissue, separating them from the epithelial lining. stimulated with different concentrations of norepinephrine (0.1, 1 Within the myxomatosis area an evident proliferation of ovoid, and 10 ␮M) and 1 ␮M of propranolol, and analyzed after 1, 6 and stellate and spindle cells was observed. Alcian Blue-PAS staining 24 hours. Gene expression of VEGF-A and VEGF-C were eval- was strongly and diffusely positive, which confirmed the abundant uated by real time PCR. mucinous material dispersed throughout the connective tissue com- Results: The stimulation of beta adrenergic receptors did not patible with hyaluronic acid. The diagnosis was oral focal mucino- markedly alter vascular endothelial growth factors production by sis. The patient is under follow-up without any recurrences. SCC-9 and SCC-25. The gene expression of VEGF-A or ORAL MEDICINE OOOO e48 Abstracts October 2012

VEGF-C after stimulation with norepinephrine or blocking with second day. Variation of cortisol was higher between anxious/ propranolol was statistically similar (pϾ0.005) to control (non PTE patients than non-anxious, which had similar values on the stimulated cells). three moments (KW, pϭ0.30). Conclusion: These results suggest that stimulation of beta Conclusion: Salivary cortisol assessment seems promising adrenergic receptors through of norepinephrine seem not modu- for estimate dental anxiety. late the vascular endothelial growth factors expression in oral squamous carcinomas cell lines. CLINICAL-PATHOLOGICAL CHARACTERIZATION AND STUDY OF POLYMORPHISMS OF T-HELPER-1 AND 2 IMMUNOHISTOCHEMICAL EXPRESION OF FASN (TH1 / 2) RESPONSES IN IMMUNE-MEDIATED DIS- AND PROTEINS ASSOCIATED WITH PROLIFERATION EASES WITH ORAL MANIFESTATIONS: ORAL LICHEN AND CELL CYCLE CONTROL IN ORAL NEVI AND PLANUS AND AMALGAM-ASSOCIATE ORAL LICHEN- MELANOMA Andrade BAB1, León JE, Carlos R2, Delgado- OID REACTION Ribeiro CMB1, Jorge J2, Leão JC3, Lima Azañero W3, Mosqueda-Taylor A4, Almeida OP1 - 1ORAL ALO4 - 1CESMAC - PATOLOGIA BUCAL, 2FACULDADE PATHOLOGY SECTION, DEPARTMENT OF ORAL DIAG- DE ODONTOLOGIA DE PIRACICABA - UNICAMP - ES- NOSIS, PIRACICABA DENTAL SCHOOL, UNIVERSITY OF TOMATOPATOLOGIA, 3UNIVERSIDADE FEDERAL DE CAMPINAS (UNICAMP), PIRACICABA, SÃO PAULO, PERNAMBUCO - ESTOMATOLOGIA, 4CENTRO UNIVER- BRAZIL., 2PATHOLOGY SECTION, CENTRO CLÍNICO DE SITÁRIO CESMAC CABEZA Y CUELLO/HOSPITAL HERRERA LLERANDI, Background: Oral lichenoid lesions (OLL), such as oral GUATEMALA CITY, GUATEMALA, 3ORAL PATHOLOGY lichen planus (OLP) and amalgam-associate-oral-lichenoid-reac- AND MEDICINE DEPARTMENT. UNIVERSIDAD PE- tion (AAOLR) are inflammatory-immunologically-mediated dis- RUANA CAYETANO HEREDIA, PERU., 4DEPARTMENT eases. Objectives: The study aimed to determine hyposalivation, OF HEALTH CARE, UNIVERSIDAD AUTÓNOMA METRO- analyze histological features of OLL slides and OLL Th1/2- POLITANA, XOCHIMILCO, MÉXICO responses. Background/objective: Oral melanoma is a rare lesion and Study design: This study was conducted with 39 OLL- little is known about its etiological factors and molecular mech- volunteers, 39 healthy-volunteers and 100 DNA-samples ob- anisms involved. Evaluation of cell cycle regulators and prolif- tained from healthy-patients. Slides of OLL were analysed and eration markers has gained special interest in the effort to predict quantification of inflammatory cells was conducted. Saliva sam- biological behavior and to differentiate among benign and ma- ples were collected to determine hyposalivation. DNA samples lignant tumors. The objective of this study was to determine by were used to estimate frequency of single-nucleotide-polymor- immunohistochemistry the expression of FASN, p16, p21, p27, phism (SNP) in Th1/Th2-genes by means of PCR-RFLP. cyclin D1, Mcm-2, Ki-67 and geminin in oral nevi and mela- Results: Hyposalivation was common in patients with OLL. noma. Deep perivascular inflammatory infiltrate and lymphoid follicles Study design: Expression of these proteins was evaluated in were common in AAOLR. B-Lymphocytes count was higher in 38 intramucosal nevi and 13 primary oral melanomas. AAOLR. SNP of IL4-590T/TNF-␣-308A/IL10-592C were fre- Results: FASN, p21, cyclin D1, Mcm-2, Ki-67 and geminin quent in patients with OLL. were negative or rarely expressed in intramucosal nevi, in con- Conclusions: Patients with OLL have hyposalivation. OLL trast to oral melanomas, which showed high levels of these are associated with high rates of chronic inflammatory cell and proteins. high gene expression of cytokines related to Th1/2 response. Conclusion: The results indicate that these proteins may be involved in the development of oral melanoma, and eventually NON-INVASIVE TREATMENT IN INFANTILE HEMAN- may be useful to differentiate among benign and malignant oral GIOMA OF LARGE PROPORTION Gomes CBF1, Andrade melanocytic lesions. RE1, Mansur M1, Correa MB2, Farias KM3, Lopes MA1 - 1PIRACICABA DENTAL SCHOOL, UNIVERSITY OF EVALUATION OF STRESS AND DENTAL ANXIETY RE- CAMPINAS - ORAL DIAGNOSIS, 2PIRACICABA ONCOL- LATED TO THIRD MOLAR SURGERY Marcos BDN1, OGY CENTER - DEPARTMENT OF HEAD AND NECK Kanegane K1, Tornelli HR1, Tornelli MJ1, Penha SS1 - SURGERY, 3BAURU DENTAL SCHOOL, UNIVERSITY OF 1FOUSP - CLÍNICA INTEGRADA SÃO PAULO - ORAL DIAGNOSIS Objective: Dental procedures stimulate anxiety and stress. Infantile Hemangiomas (IH) are the most common benign Dental anxiety can be assessed by Modified Dental Anxiety Scale vascular tumor in infancy, characterized by a phase of rapid (MDAS), and salivary cortisol level alterations. The aim of this growth and expansion. These lesions have predilection in head study was evaluate cortisol levels in third molar surgery. and neck region. IH of the lips are of special concern because the Study design: Twenty-eight patients filled MDAS, prior consequences that treatment can cause such as scar, contour traumatic event (PTE) and demographic questions. Saliva was deformity and disfigurement. We report a case of 6-month-old collected 1 week before, 5 minutes before and 1 week after the girl with bleeding purplish swelling on the upper lip that was procedure. Patients also rated postoperative pain intensity. causing difficulty for oral intake. It was revealed that the lesion Results: Three patients were dentally anxious and four re- was present since her birth and had been gradually increasing for lated PTE, there was no difference between this group and the last 1 month. The treatment of choice was sclerotherapy with non-anxious group in relation to gender (␹2,pϭ0.38) and pain ethanolamine oleate (Ethamolin®) in a hospital under general intensity (t, pϭ0.74). Cortisol was not different relating to gender anesthesia. The lesion showed successful resolution after several on the three moments (KW, pϭ0.65). Cortisol was lower on sections and the patient remains in clinical follow-up. This kind OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e49 of treatment may be considered as an option for treatment, Patient made two incisional biopsies with actinic cheilitis diag- particularly in cases where surgery can cause undesirable conse- nosis before the final biopsy of SCC. Oncologic surgery was quences. performed and patient has no disease or metastases in a six mouths follow up. Continuous follow up allowed to yearly diag- PERIPHERAL CLEAR CELL VARIANT OF CALCIFYING nosis and treatment with good prognosis for patient. EPITHELIAL ODONTOGENIC TUMOR IN A HIV POSI- TIVE PATIENT Esteves CMD1, Miguita L1, Caramez RHF1, 1 1 EWING’S SARCOMA: CASE REPORT MANDIBLE MIM- Martins MT - UNIVERSITY OF SAO PAULO ICKING AMELOBLASTOMA Lima CF1, Kaminagakura E1, Calcifying epithelial odontogenic tumor (CEOT) is a rare, Deco CP2, Sousa SCOM3, Chulam T4, Carvalho YR1, benign neoplasm, accounting for approximately 1% of all odon- Almeida JD1 - 1UNESP - UNIV ESTADUAL PAULISTA, SÃO togenic tumors. Clinically, intraosseous CEOT usually presents JOSÉ DOS CAMPOS DENTAL SCHOOL - DEPARTMENT slow growing, often causing expansion of the jaw and displace- OF BIOSCIENCES AND ORAL DIAGNOSIS, 2UNESP - ment and resorption of associated teeth. CEOT has an intraosse- UNIV ESTADUAL PAULISTA, SÃO JOSÉ DOS CAMPOS ous and extraosseous localization. One of variants of CEOT DENTAL SCHOOL - POSTGRADUATION PROGRAM IN related in literature includes peripheral CEOT with clear cells, 3 which was first described in 1967, with only 8 cases reported in ORAL BIOPATHOLOGY, USP - UNIVERSITY OF SÃO 4 English-language literature since then. It is characterized micro- PAULO - DEPARTMENT OF ORAL PATHOLOGY, HOS- scopically by polyhedral epithelial cells alternating with large PITAL AC CAMARGO - DEPARTMENT OF SURGERY AND epithelial cells with a clear, foamy cytoplasm; distinct cell bor- OTORHINOLARYNGOLOGY ders; moderated variation in nuclear size; some vacuolated nuclei Ewing’s sarcoma is a malignant round-cell tumour belonging and no extreme hyperchromatism or bizarre nuclei. We report a to the group II neuroectodermal tumor that usually occurs in long case of peripheral CEOT with clear cells occurring in a HIV bones, ribs and pelvis. It is rare in head and neck. A male patient, positive patient. Immunohistochemical reactions showed positiv- 14 years, Caucasian, complained of paresthesia and swelling in ity for cytokeratin pan, CK7 and CK14, and the amyloid-like the right mandibular body with evolution of two and a half material presented positivity to a Congo red under polarized light. months, came to the outpatient clinic of the School of Dentistry FOSJC-UNESP. The panoramic radiograph showed multilocular CLINICAL AND EPIDEMIOLOGICAL ANALYSIS IN UN- radiolucent lesion and the differential diagnosis was ameloblas- toma. Incisional biopsy was performed and the histopathological SUSPECTED ORAL LESIONS OF SYPHILIS Siqueira CS, Saturno JL, Sousa SCOM, Silveira FRX examination showed malignant mesenchymal neoplasm com- posed by monotonous small round cells. Immunohistochemical Background: Early diagnosis of syphilis is essential. How- studies showed positive staining for CD99, vimentin and pancy- ever, as oral lesions may be present in different clinical forms tokeratin. Examination through scintigraphy showed increased they can be misdiagnosed. uptake at pelvis. The patient underwent chemotherapy and is Objectives: The aim of the present study was to show the being prepared for surgery. The present case shows the impor- various clinical forms of a series of posteriorly confirmed as oral tance of rapid diagnosis and knowledge of the characteristics of syphilis, which clinical impression was other than syphilis. Ewing’s sarcoma for better prognosis of each case. Study design: A retrospective analysis of 13 samples was made. Results and conclusion: The study revealed a predominance EXPRESSION OF MAST CELLS, S-100 PROTEIN, EMA of male and Caucasian subjects and one month was the most AND CD34 IN ORAL NEUROFIBROMAS AND A CLIN- prevalent time perceived. The average age was 42.53 years and ICOPATHOLOGIC REVIEW OF 127 CASES REPORTED the predominant anatomical site was the labial mucosa. The most IN THE LITERATURE Oliveira FAF1, Fernandes CP1, Silva common critical injury was the presence of an ulcer. Clinically PGB1, Chaves FN1, Mota MRL1, Sousa FB1, Alves APNN1 - the cases had been provisionally diagnosed by the clinicians as 1UNIVERSIDADE FEDERAL DO CEARÁ hystoplasmosis, viral infection, lymphoma, pemphigus or pem- Objective: To evaluate the expression of different markers phigoid, erosive lichen planus, SCC, oral leukoplakia and sar- in oral neurofibromas (ONs) and review epidemiologic data coma. The study shows the contribution that stomatologists and reported in the literature. pathologists can give in diagnosing syphilis. Study design: Clinicopathological, immunohistochemical (markers S-100, EMA, CD34) and histochemical (modified Ziehl- LIP CANCER PRECEDED BY PERSISTED ACTINIC LE- Neelsen method) studies were performed in 8 cases of ON. Addi- SION IN RENAL TRANSPLANT PATIENT: CASE REPORT tionally, the literature was searched for studies on case series of ON. 1 1 1 1 Oliveira FAF , Fernandes CP , Silva MRFS , Teófilo CR , Results: ONs represent 0.2% of the oral lesions within this Mota MRL1, Alves APNN1, Sousa FB1 - 1UNIVERSIDADE case series diagnosed in the past 16 years, and the buccal mucosa FEDERAL DO CEARÁ tended to be the most commonly affected site (71.4%). Seven Lip cancer incidence in kidney transplanted patients used to (87.5%) and 8 (100.0%) cases were positive for S-100 and CD34, be 65 higher than general population because immunosuppres- respectively, and none exhibited positive EMA staining. The sion. Immunomodulators use and immune deregulation intensify intensity and extent of staining was variable within samples. Mast carcinogenic factors action and contribute to worse clinical cells were identified in 7 cases (87.5%). course and aggressive biologic behavior in lip carcinoma, with Conclusion: ONs are rare lesions that usually affect oral soft metastases and recurrence. This case presents evolution of actinic tissues as solitary tumors. The identification of S-100- and CD34- cheilitis to lower lip squamous cell carcinoma (SCC) in a male, positive tumor cells in addition to mast cells proved to be of great 58 years old patient after 9 years from kidney transplantation. value as a diagnostic tool. ORAL MEDICINE OOOO e50 Abstracts October 2012

PREVALENCE OF ORAL CANDIDIASIS IN PATIENTS roquine for 10 years. On physical examination was observed WITH SYSTEMIC LUPUS ERYTHEMATOSUS Leite CA1,2, pigmented macules in the arm and leg. Intra-oral exam showed Galera MF3, Silva OG1, Fernandes V1, Lima PRTL1, Briez- pigmented macules-irregularly shaped in the hard palate surface. inski JP1, Dias EP2 - 1UNIVERSIDADE DE CUIABÁ, UNIC - The diagnosis of chloroquine-induced oral pigmentation was CUIABÁ/MT, 2UNIVERSIDADE FEDERAL FLUMINENSE, performed according to medical history and clinical features. The UFF - NITERÓI/RJ, 3UNIVERSIDADE FEDERAL DE chosen treatment was conservative and the patient was instructed MATO GROSSO, UFMT to follow sporadically in our department. These drugs may have Background: Systemic lupus erythematosus (SLE) is an reversible side effects witch can solve with the discontinuity of autoimmune disease and these patients have an increased risk for the drug. Therefore, the knowledge of this clinical manifestation infection due the treatment with immunosuppressives. is important to the differential diagnosis of melanoma. Aim: Determine the prevalence of oral candidiasis in pa- tients with systemic SLE using oral cytopathology. EXPRESSION IMMUNOHISTOCHEMISTRY OF PRO- Study design: Prospective observational study with 43 pa- TEIN GLUT-1 AND HIF-1␣ IN VASCULAR LESIONS OF tients. Clinic examination was realized, scraps from the lesions ORAL MUCOSA Oliveira DHIP1, Silveira EJD1, Medeiros and on lateral borders of the tongue were obtained, fixed and AMC1, Andrade ALDL1, Vasconcelos RC1, Oliveira PT2, stained by Papanicolaou and PAS technique. 1 1 Results: Oral candidiasis (OC) were found in 54% of the Queiroz LMG - UNIVERSIDADE FEDERAL DO RIO evaluations. Sites affected: lateral borders of the tongue (70%), GRANDE DO NORTE - PROGRAMA DE PÓS-GRADU- 2 palate (20%), other sites (10%). (26%) were associated with AÇÃO EM PATOLOGIA ORAL, UNIVERSIDADE FED- prosthesis. All cases of OC in lateral border of tongue, patients ERAL DO RIO GRANDE DO NORTE - ODONTOLOGIA had no lesions clinically detected. Background: The correct histological diagnosis of vascular Conclusion: OC is a frequent diagnosis (54%) in patients lesions in the oral mucosa is critical. with SLE. Cytopathology was an effective method in the diag- Objectives: Investigate the accuracy immunohistochemical nosis of infections, especially oral candidiasis, in patients with or expression of GLUT-1 to reclassify vascular lesions. In addition, without clinically detectable lesions. evaluated the immunohistochemical expression of HIF-1␣. Study design: Analyzed 30 cases with histological diagnosis of hemangioma (HEM) and 30 cases of oral pyogenic granuloma FREQUENCY OF ORAL SQUAMOUS CELL CARCI- (PG). NOMA AND ORAL EPITHELIAL DYSPLASIA: IREPO, Results: Of the 30 lesions initially classified as HEM, only UNIVERSITY OF CHILE, 1990-2009 Adorno D1, Martínez 7 showed immuno-positivity for GLUT-1, remaining with the C1, Hernández M1 - 1UNIVERSITY OF CHILE - PATOLOGY initial diagnosis. The remaining 23 were reclassified as vascular Objective: To determinate the frequency of hyperkeratosis, malformation (VM) (13 cases) and PG (10 cases). All cases with mild, moderate and severe oral epithelial dysplasia, in situ car- an initial diagnosis of PG were negative for GLUT-1. Concerning cinoma and squamous cell carcinoma of the oral mucosa from to the immunoexpression of HIF-1␣, the Mann-Whitney test Chilean population. revealed a statistically significant difference between the cases of Study design: This is a descriptive study from Chilean GP and MV (pϽ0,05%). population between 1990 and 2009. A total of 399 cases were Conclusion: So, this study showed that a histological diag- selected according to their histopathological diagnosis, this is nosis alone is not always sufficient for the correct diagnosis and hyperkeratosis, oral epithelial dysplasia, in situ carcinoma and that HIF-1␣ participates in the pathogenesis of vascular lesions. squamous cell carcinoma. Data was analyzed with the software Sysat 13. Results: Most of the cases turned out to be squamous cell EXTRANODAL NATURAL KILLER (NK)/T-CELL LYM- carcinoma (44.1%), which is first recognize clinically as cancer PHOMA, NASAL TYPE: CASE REPORT Guimarães DM1, (78.41%), followed by hyperkeratosis (36.8%) and mild epithe- FONSECA FP2, PAVANELLO KC1, BRAZAO SILVA MT, lial dysplasia (10.5%), which are clinically diagnosed as leuko- PONTES FSC3, PONTES HAR3 - 1UNIVERSIDADE DE SAO plakia. PAULO, 2UNIVERSIDADE ESTADUAL DE CAMPINAS, Conclusions: Oral cancer is diagnosed mainly when their 3UNIVERSIDADE FEDERAL DO PARA classical characteristics are already present, therefore early diag- Extranodal natural killer (NK)/T-cell lymphoma (ENKTL), nosis should improve. nasal type is recognized as a unique clinicopathologic sub type of non-Hodgkin’s lymphoma (NHL), is a rare disease occurring in CHLOROQUINE-INDUCED ORAL PIGMENTATION adults, with a male predominance. with prevalence in Asians, 1 MISDIAGNOSED AS MELANOMA Pereira DL , Duarte Mexicans, Central and South Americans of American Indian 1 1 1 1 1,2 NT , Verrone JR , Lopes RN , Jaguar GC , Alves FA - descent. It is universally associated with EBV, and genetic fac- 1HOSPITAL AC CAMARGO - STOMATOLOGY, 2FOUSP - tors play a role in susceptibility to the disease. ENKTL is gen- STOMATOLOGY erally considered to be a very aggressive lymphoma. This work Chloroquine is an antimalarial drug considered a disease- reports a case of 42 years old female, with chef complain gingival modifying, which has also been used for decades in the treatment bleeding being diagnosed initially as aggressive periodontitis. of lupus erythematosus and rheumatoid arthritis. It is indicated The incisional biopsy revealed a variable lymphoid infiltrate with when anti-inflammatory non-steroids appears ineffective in the subtle-to-extensive necrosis, the neoplastic cells showed cyto- treatment of symptoms of rheumatic diseases. logic spectrum predominantly medium-sized cells. The immuno- A 70 year-old-man was referred to suspicion of melanoma. histochemical analysis was positive for LCA, CD3 granzyme B, His medical history revealed rheumatoid arthritis treated by chlo- CD43, CD45RO, CD30, CD56, Ki-67 and CD34, leading to OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e51

diagnosis of ENKTL. The patient died after three days of inci- motherapy is considered the standard treatment for those patients. sional biopsy. The purpose was to evaluate the cytotoxic effect of a new chemotherapy regime in combination with radiotherapy in oral GINGIVAL CANDIDIASIS IN PERIODONTAL DISEASE: carcinoma cell lines. A HISTOPATHOLOGICAL STUDY PERMINIO DJDG1, Study design: A dose-response curve compared the cytotox- Miranda AMO1, Ferrari TM, Andrade RM, Werneck JT, icity of Cisplatin and a chemotherapy regime of Paclitaxel, Cis- Goldemberg DC, Dias EP - 1UFF platin and 5-Fluorouracil (PCF) in SCC-25 and SCC-9 cell lines, Background: Up to 50% of adult patients harbor Candida from tongue carcinoma, and in normal keratinocytes (HaCat). To ssp in their mouth, occasionally at the dental biofilm. test the concurrent use of PCF and radiation, cells were treated ␮ Objective: to evaluate the prevalence of gingival candidiasis with the drugs at concentration of 50 g/mL, and then irradiated in patients with chronic periodontitis. at a dose rate of 2.0Gy/min. After 24/48h, cell death was assessed Material and methods: gingival biopsy was performed in by MTT assay. ␮ 60 patients with chronic periodontitis and periodontal pockets Results: The PCF regime, at 50 g/mL, caused 42% and deeper than 5 mm (30 from subgingival manual scaling and 30 36% of cell death in SCC-9 and SCC-25 cells respectively. The from open-field surgery). The specimens were fixed in 10% radiation induced a supra-additive effect when combined with formalin, embedded in paraffin and the slides stained with he- chemotherapy regimes in all cell lines. matoxylin-eosin and periodic acid-Schiff. The diagnostic crite- Conclusion: Our results showed that the new chemotherapy rion was the identification of hyphae of Candida spp. regime, associated with radiation, might be a promising option to Results: candidiasis was diagnosed in 17 (28.34%) cases, of treat oral cancer. which eight (13.34%) were detected in material from manual subgingival scaling and 9 (15%) from open-field surgery. EPITHELIAL PRECURSOR LESIONS AND SQUAMOUS Conclusion: Their participation in the pathogenesis of peri- CELL CARCINOMA PREVALENCE FOR A PERIOD OF odontitis is controversial and the findings of this study in patients 5-YEARS IN THE STOMATOLOGY SERVICE OF THE with chronic periodontitis indicate the need for further research UNIVERSITY HOSPITAL Moriel Tavares KM1, Alencar by Candida spp as a periodontopathogen. FSL1, Picciani BLS1, Pessoa TM1, Silva-Junior GO1, Canti- sano MH1 - 1UERJ DESMOID TUMOR OF THE MOUTH – CASE REPORT Oral squamous cell carcinoma (OSCC) represents approxi- 1 1 2 2 Rivero ERC , Meurer MI , Rau LH , Ribas Filho JO , Santos mately 90% of all oral malignancies and in some cases can be LRM, Di Giunta G1 - 1UNIVERSIDADE FEDERAL DE preceded by lesions considered epithelial precursor lesions SANTA CATARINA - DEPARTAMENTO DE PATOLOGIA, (EPL). The objective of this study is to present the prevalence of 2HOSPITAL INFANTIL JOANA DE GUSMÃO EPL and OSCC at the Stomatology Service, in the last five years. Desmoid tumors are uncommon neoplasms with a musculoapo- A total of 1048 oral lesions were found and evaluated. The EPL neurotic origin. These tumors usually appear as well-differentiated represented 39% of the oral biopsies, while the OSCC 61%. locally aggressive neoplasms with infiltrative behavior and a ten- Leukoplakia was the most prevalent clinical aspect among the dency for recurrence. We describe a case of desmoid tumor in a EPL and ulcers with areas leukoerythroplastic clinically corre- 4-year-old male, presenting a painless submandibular swelling with sponded to 81% of malignant lesions. The white patients in their an 8-month evolution. Intra-oral examination revealed a well-cir- fiveties were the most affected and the tongue was the most cumscribed swelling on the left submandibular region. Computed common anatomic localization. The patients with EPL and with tomography images showed bone-erosion with a periosteal reaction. OSCC were smokers in its majority. Early diagnosis of these Histological analysis revealed a desmoid tumor. The treatment lesions and intervention at an early stage constitute keys to employed involved complete surgical removal of the tumor reduce mortality, morbity and expenses with oral cancer treat- with marginal mandibulectomy. The gross examination ment. showed a well-circumscribed mass measuring 8.0x6.5x3.0cm. Mi- croscopic examination revealed connective tissue proliferation EVALUATION OF CD8؉ AND NATURAL KILLER CELLS mainly comprised of spindle cells and collagen fibers arranged in DEFENSE IN ORAL AND OROPHARYNGEAL SQUA- a storiform-fascicular pattern with rare mitotic figures. These MOUS CELL CARCINOMA Matos FR1, Santos EM2, Costa findings confirmed the diagnosis of a desmoid tumor. The patient ALL1, Pinto LP1, Galvão HC1, Lucena HF1, Freitas RA1 - was completely asymptomatic eight months after surgery. 1UFRN - ODONTOLOGIA, 2UFRN Background/objectives: The aim of this study was to eval- ASSOCIATION OF PACLITAXEL, CISPLATIN, 5-FLUO- uate the population of CD8ϩ and natural killer (NK) cells in ROURACIL AND RADIATION FOR ORAL CAVITY CAR- 1 2 1 samples of oral cavity (OCSCC) and oropharyngeal (OSCC) CINOMA CELL LINES Elias ST , Amorim DA , Borges GA , squamous cell carcinoma. 3 2 2 4 Pinto Jr DS , Matos Neto JN , Abrel WC , Guerra E - Study design: Fifty-four of SCC (42 OCSCC and 12 OSCC) 1 2 UNIVERSIDADE DE BRASÍLIA - ODONTOLOGIA, UNI- were immunohistochemically treated by CD8 and CD57 monoclo- VERSIDADE DE BRASÍLIA - HOSPITAL UNIVERSITÁRIO nal antibodies. It was evaluated the relationship of CD8ϩ and NK 3 DE BRASÍLIA, UNIVERSIDADE DE SÃO PAULO - ES- cells with tumor size, lymph node metastasis (LNM), clinical staging TOMATOLOGIA, FACULDADE DE ODONTOLOGIA, (CS), overall survival (OS) and disease-free survival (DFS). 4UNIVERSIDADE DE BRASÍLIA - ODONTOLOGIA Results: Only CD8 was higher expressed in OCSCC and Background/objectives: Patients with squamous cell carci- OSCC T1 and T2 than T3 and T4, as well as in tumours without noma of the head and neck (SCCHN) present with locoregionally LNM and with CS II or III (P Ͻ 0.05). There is no association advanced disease. Surgery coupled with radiotherapy and/or che- with OS and DFS of both biomarkers. ORAL MEDICINE OOOO e52 Abstracts October 2012

Conclusion: These findings suggest that the differential crease of the left or both ventricles. Erythema migrans is a CD8ϩ cells infiltration in OCSCC and OSCC might reflect a condition that affects mostly the tongue, normally diagnosed in distinctive tumor microenvironment with a favorable local cyto- routine exams. It rarely spreads to different areas besides the toxic immune response against neoplastic cells. tongue but when it does, the preferred areas are the oral and labial mucosa. This report attempts to describe the following case of a white patient, 14 years old, female, complaining about burning ORTHODONTIC-SURGICAL CONSERVATIVE TREAT- tongue during ingestion of citrus foods. In extraoral exam it has MENT IN PATIENT WITH DENTIGEROUS CYST Pedreira not been detected any cutaneous lesion and in intraoral exam FRO1, Carli ML1, Dias NNO1, Oliveira TI1, Guimarães EP1, were detected erythematous areas surrounded by white border, Pereira AAC1, Hanemann JAC1 - 1UNIFAL-MG - DEPAR- lightly elevated at dorse and vente r of the tongue, soft palate and TAMENTO DE CLÍNICA E CIRURGIA bilateral jugal mucosa, allowing erythema migrans diagnoses. A 14-year-old teenager was referred to the Stomatology The patient was instructed about her condition and the case is Clinic of the Unifal-MG, presenting an asymptomatic, radiolu- under attendance. cent and unilocular lesion, associated to the crown of tooth 37, which was not erupted. An incisional biopsy was performed, and the histological examination showed a thin fibrous cystic wall LICHEN SCLEROSUS ET ATROPHICUS IN MAXILLARY lined of 2-3 layer thick nonkeratinized stratified squamous epi- ALVEOLAR MUCOSA: AN IMMUNOHISTOCHEMICAL 1 1 2 thelium with islands of the odontogenic epithelium. The connec- APPROACH Xavier FC , Gurgel CAS , Ramos EAG , Prates 1 1 1 tive tissue showed a slight inflammatory cell infiltrate. The diag- AA, da Silva SRL, Ramalho LMP , Santos JN - FAC- nostic was Dentigerous Cyst. Extraction of the 36 and 46 teeth ULDADE DE ODONTOLOGIA/UFBA - PROPEDÊUTICA E was accomplished, along with cystic decompression and place- CLÍNICA INTEGRADA, 2FIOCRUZ / BA ment of an acrylic drain, remaining for 70 days. One month after Lichen sclerosus et atrophicus (LSA) is a mucocutaneous the removal of the drain, a significant reduction of the lesion and disease with uncommon oral involvement. A 47-year-old man eruption of the 38 tooth were observed. An orthodontic traction sought a dentist with complaint of white lesion in the mouth. of the 37 and 47 teeth was performed using a button and orth- Intraoral examination revealed asymptomatic white plaque with odontic wire activated by bending the bow. (Financial support: reddish areas. They were located on the maxillary alveolar mu- FAPEMIG) cosa extending to labial mucosa. No history of trauma neither medication usage were reported. Microscopic examination re- vealed mucosal with atrophic epithelium exhibiting hydropic PRIMARY ORAL MUCOSAL MELANOMA (POMM): RE- degeneration of basal cells and cleft-like spaces. The connective PORT OF A CLINICAL CASE AND 17 CASES OF AN tissue showed homogenization of the collagen, only a few nuclei RODRI- ORAL PATHOLOGY SERVICE (IREPO, CHILE) and areas with lymphedema displacing the chronic inflammatory GUEZ-CASTRO F1, Escobar E2, Ortega A3, Peñafiel C4 - 1 infiltrate. Immunostaining for tenascin and absence of fibronectin UNIVERSIDAD DEL DESARROLLO - ORAL PATHOL- suggested a reorganization of extracellular matrix. Immunostain- 2 3 OGY, UNIVERSIDAD DE CHILE - IREPO, UNIVERSI- ing for elastin indicated loss of elastic fibers. Marked mast cell 4 DAD DE CHILE - FACULTY OF DENTISTRY, UNVERSI- expression suggested a role in the collagen synthesis. Low Ki-67 DAD DE CHILE - IREPO and p53 index were also observed. This study reports oral LSA as Introduction: The POMM is a rare malignancy (from 1% to the initial manifestation of the disease, highlighting its immuno- 2% of all melanomas) with an aggressive biological behavior. histochemical features. Cases report: 42-year-old male Is referred for evaluation of painless gingival lesion. On examination a large pigmented lesion EFFECTS OF FASN INHIBITION ON THE IMMUNE RE- is seen on buccal gingiva extending from tooth 1.6 to 2.6 extend- SPONSE AGAINST MELANOMA Mariano FS1, Almeida ing to the hard palate bilaterally. Incisional biopsy is performed LY1, Bastos DC1, Colleta RD1, Graner E1 - 1FACULDADE delivering a diagnosis of oral mucosal melanoma. In the study period (1976-2010) there were 17 cases of primary DE ODONTOLOGIA DE PIRACICABA-FOP/UNICAMP - oral mucosal melanoma among 33,381 oral biopsies, corresponding DIAGNÓSTICO ORAL, PATOLOGIA to 0.05%. 9 cases were male and 8 cases were female. The most Background/objectives: Melanomas show increased fatty anatomical affected site were the palatal mucosa in 9 cases (52.9%), acid synthase (FASN) expression. It’s inhibition with orlistat followed by the gum with 4 cases (23.5%). reduces metastases, cell proliferation and promotes apoptosis in Conclusion: The POMM are extremely rare malignant le- experimental melanomas and B16-F10 respectively. Here, we sions. In this study, the primary oral melanomas mainly affected evaluated whether orlistat affects the immune response against patients in the seventh decade of life, being the most affected melanoma cells. anatomic site the palatal mucosa. Study design: Leukocytes from tumors and metastases, plas- matic nitric oxide (NO), as well Cramp and MMP-9 were eval- uated in orlistat-treated mice. ERYTHEMA MIGRANS IN A PACIENT WITH DILATED Results: Orlistat treatment reduced macrophages and CD4ϩ 1 CARDIOMYOPATHY: CASE REPORT Almeida FSPJ , T cells, but increased CD25ϩCD4ϩ T cells in primary tumors. 1 2 2 2 Soares BN , Bahia TPS , Pontes JRM , Maciel RM , Ramos Metastases had CD4ϩ T cells only decreased. No differences in 2 2 1 MEB , Israel MS - UERJ - FACULDADE DE ODONTO- the neutrophil population were observed. High plasmatic NO and LOGIA, 2UERJ - DEPARTAMENTO DE DIAGNÓSTICO expression of MMP9 in neutrophils mRNA were observed in ORAL E CIRURGIA treated mice. Dilated cardiomyopathy is a progressive primary myocardial Conclusion: FASN inhibition may change immune response disease, with unknown origin, characterized by contractility de- against melanoma. OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e53

ACCURACY OF THE MICRONUCLEUS TEST IN THE revealed neonatal jaundice that persisted until liver transplanta- DIAGNOSIS OF MALIGNANT LESIONS OF THE ORAL tion at eight-year-old and mental retardation. The differential CAVITY Medella JR FAC1, Vargas RJA2, Munerato MC1, diagnosis of green teeth includes extrinsic and intrinsic discolor- Bozzetti MC2 - 1UNIVERSIDADE FEDERAL DO RIO ation. The final diagnosis of bilirubin pigmentation is usually GRANDE DO SUL - ESTOMATOLOGIA - HCPA, 2UNIVER- based on a clinical history of jaundice combined with green teeth SIDADE FEDERAL DO RIO GRANDE DO SUL - HOSPI- discoloration and less often enamel hypoplasia. TAL DE CLINICAS DE PORTO ALEGRE - RS Background/aim: The use of biomarkers of chromosomal ADENOMATOID ODONTOGENIC TUMOR: CYSTIC damage (CD) to screen high-risk individuals for oral cancer is LESION WITH LARGE EXTENSION Lima GMG1, Colombo imperative. Oral cancer is a serious global healthcare problem CE2, Machado ACP2, Guimarães Filho R2, Americo MG1, due to its rising incidence and common late-stage presentation. Anbinder AL1, Carvalho YR1 - 1UNESP/SÃO JOSÉ DOS This study aimed at assessing the sensitivity and specificity of CAMPOS - BIOCIÊNCIAS E DIAGNÓSTICO BUCAL, (MN) frequency - in exfoliated buccal mucosa cells - for detect- 2UNIVERSIDADE DE TAUBATÉ - UNITAU ing malignant or potentially malignant oral cavity lesions, having Adenomatoid odontogenic tumor (AOT) is composed of biopsy (histopathologic) as the reference standard. odontogenic epithelium in variable patterns embedded in mature Study design: The micronucleus (MN) test is used as an connective tissue. It affects preferentially young females, in indicator of CD and an increased MN’s frequency is related to the anterior maxilla. development of oral cancer. The present study aimed at assessing Case report: a 16 year-old black male, with a painless the sensitivity and specificity of micronucleus test frequency for nodule under the left nostril. Clinical examination revealed a detecting malignant or potentially malignant oral cavity lesions. bony-hard 5 cm swelling in left maxilla recovered by intact We carried out a cross-sectional study with 48 participants pre- mucosa. Radiographically, there was a well-defined unilocular senting oral cavity lesion, who were indicated to undergo surgery radiolucency around an unerupted permanent tooth, with ra- biopsy. Eleven patients (22.9%) presented malignant or poten- diopaque foci. Excisional biopsy was carried out with the diag- tially malignant oral cavity lesions. The MN’s frequencies higher nostic hypotheses of TOA. Histologically it was seen a cystic than 0.0005 had a sensitivity of 63.6% and a specificity of 43.2% cavity lined by cuboidal epithelia with localized thickenings and in samples of perilesional area. The predictive positive (PPV) and projections to the lumen. In these areas epithelial cells were negative (PNV) values were 25% and 80% respectively. arranged in nests, strands and rosettes in a vascularized stroma. Results: A total of 146 patients were submitted to biopsy of Within the cellular masses there were duct-like structures lined oral cavity lesion in the Stomatology Clinic from HCPA between by a single row of cuboidal or columnar cells. The final diagnosis February and December of 2010. The majority of the 146 patients was Adenomatoid Odontogenic Tumor. Tumor was removed and submitted to biopsy had a previous diagnosis of oral cancer and the patient is being followed. had followed a treatment. Only 50 out of 146 patients met the inclusion criteria. All patients were submitted to biopsy as we ORAL EXPRESSION OF DIFFUSE LARGE CELL LYM- aimed at verifying the sensitivity and specificity of the micronu- Alpaca GHG1, Menezes cleus test for detection of malign or potentially malign oral cavity PHOMA IN PATIENTS WITH HIV J2, Arce JPA3 - 1PREFEITURA MUNICIPAL DO RIO DE lesions. 2 Conclusion: These results may be due to some study’s JANEIRO, MINISTÉRIO DA SAÚDE- - HOSPITAL FED- 3 limitations. Despite of them, we believe that the methodological ERAL DOS SERVIDORES DO ESTADO, MINISTÉRIO DA issues raised in our study indicate some relevant directions for SAÚDE - HOSPITAL DOS SERVIDORES DO ESTADO future research. Summary: The lymphoma diffuse large B-cell (DLBCL) is the most common subtype of non-Hodgkin lymphoma (NHL). In individuals infected with human immunodeficiency virus (HIV), GREEN TEETH ASSOCIATED WITH PROLONGED HY- the incidence of non-Hodgkin’s lymphoma is 100-200 times than PERBILIRUBINEMIA: CASE REPORT Campos EJ1, Silva 2 2 3 3 in the general population. The non-Hodgkin’s lymphoma is an LR , Conceição JS , Costa LA , Azevedo FC , Marchionni AIDS-defining illness. In 3-5% of cases is the initial manifesta- 3 1 1 AM , Martins GB - UNIVERSIDADE FEDERAL DA BA- tion. Although these lymphomas are often of B cells in these 2 HIA - INSTITUTO DE CIÊNCIAS DA SAÚDE, UNIVERSI- patients, the reports about the oral manifestations are few .The DADE FEDERAL DA BAHIA - CENTRO DE ESTUDOS EM Objective this work is reporting a case of non-Hodgkin B cell GASTROENTEROLOGIA E HEPATOLOGIA PEDIÁTRICAS, lymphoma of the oral cavity in patients with acquired immuno- 3ESCOLA BAHIANA DE MEDICINA E SAÚDE PÚBLICA - deficiency syndrome CURSO DE ODONTOLOGIA Case report: Patient RAS, 25, female, came to dental care The presence of hyperbilirubinemia during enamel and den- by presenting nodular, granulomatous, in the anterior maxilla tin formation results in dental pigmentation, due to accumulation affecting the upper incisors, without other systemic manifesta- of intrinsic staining by bilirubin. The extent and intensity of tions. The lesion was resected. Histological diagnosis and immu- discoloration are directly related to the duration and severity of nohistochemical study confirmed the secondary form of lym- the pathology. Considering that green staining of dental hard phoma, because the serological investigation revealed positive tissues is such uncommon condition, this case report presents an serology for HIV. At the time the CD4 cell count was 52mm3 and unusual case of a patient underwent liver transplantation and had viral load of 2853. Being started chemotherapy associated with green pigmentation of all deciduous and permanent teeth associ- HAART. Five months after therapy, the patient was in remission ated with hyperbilirubinemia caused by biliary atresia. An fif- from lymphoma, with a significant reduction in viral load. The teen-year-old girl was referred to Dental School for treatment CD4 count was 247 cells/mm3 and viral load of 59mm3. Final from Pediatric Gastroenterology Service. The medical history Thoughts This case reveals that the early recognition and diag- ORAL MEDICINE OOOO e54 Abstracts October 2012 nosis of oral lesions enable appropriate treatment, favoring the MUNOHISTOCHEMICAL STUDY Santos HT1, Montalli prognosis, as observed in our case. The immunohistochemical VAM2, Mariano FV1, Altemani A2 - 1UNIVERSIDADE ES- study was fundamental for the differential diagnosis. TADUAL DE CAMPINAS - FACULDADE DE ODONTOLO- GIA DE PIRACICABA - DIAGNÓSTICO ORAL - PATOLO- THE IMPORTANCE OF PSYCHOLOGICAL INTERVEN- GIA, 2UNIVERSIDADE ESTADUAL DE CAMPINAS - TION IN PATIENTS WITH EOSINOPHILIC ULCER FACULDADE DE CIÊNCIAS MÉDICAS - ANATOMIA PA- Soares GR1, Ferreira LL1, Gonçalves GM1, Bernabé DG1, TOLÓGICA Soubhia AMP2, Biasoli ER1, Miyahara GI1 - 1FACULDADE Background/objective: To verify the quantity of cytoplas- DE ODONTOLOGIA DE ARAÇATUBA - UNESP - CENTRO mic lipid droplets (CLDs) in salivary carcinomas due to its DE ONCOLOGIA BUCAL, 2FACULDADE DE ODONTO- association with tumor aggressiveness. LOGIA DE ARAÇATUBA - UNESP - PATOLOGIA E Study design: in 68 salivary carcinomas (17 adenoid-cystic, PROPEDÊUTICA CLÍNICA 12 epithelial-myoepithelial, 11 mucoepidermoid, 10 acinic cell, 6 Eosinophilic ulcer of the oral mucosa is characterized by an polymorphic low-grade and 5 salivary duct) the CLDs were ulcer with raised and hardened edges, rare, which has a benign stained for adipophilin. The quantity of CLDs in tumor cells was Ͼ course and uncertain pathogenesis. The aim of this work is to classified as absent (0%-5%), focal ( 5%-50%) and diffuse Ͼ present a case of eosinophilic ulcer, emphasizing clinical fea- ( 50%). tures. A 33-year-old man attended the Oral Oncology Center Results and conclusion: 11.7% of the carcinomas presented complaining of ”sore mouth” that had periods of exacerbation CLDs in more than 50% of tumor cells as follows: myoepithelial and remission. Oroscopy showed two ulcers, one in the right (57%), acinic cell (30%) and epithelial-myoepithelial (8.3%). In buccal mucosa region and the other one in the left side of the soft 53% of the tumors, CLDs were not detected. In acinic cell carcino- palate, measuring 2cm and 4cm in diameter respectively, covered mas, the increased number of CLDs was associated with vacuolated with necrotic tissue and painful to the touch. Biopsy was per- appearance of the tumor cells. In salivary carcinomas, CLDs are not formed, and the patient was treated with Decadron in mouthwash a common event and its occurrence is not necessarily associated with form and sent for psychological evaluation. The diagnosis was high grade carcinomas. In acinic cell carcinomas, the upregulated eosinophilic ulcer. The patient is anxious and has family rela- lipogenesis reflects in the tumor morphology. tionship problems. Therefore, he does not attend regularly in both scheduled appointments, dental and psychological. NODULAR LEUKOPLAKIA AND SQUAMOUS CELL CARCINOMA Lima HG1, Pagin O2, Del Neri NB2, Lara EXACERBATION OF CENTRAL GIANT CELL LESION AF- VS1, Santos PSS2 - 1BAURU SCHOOL OF DENTISTRY, 1 1 1 TER BIOPSY Momesso GAC , Machado T , Furuse CF , UNIVERSITY OF SÃO PAULO - DEPARTMENT OF STO- 1 1 1 Mattar NJ, Demathé A, Miyahara GI , Biasoli ER - UNI- MATOLOGY, AREA OF PATHOLOGY, 2BAURU SCHOOL VERSIDADE PAULISTA JULIO DE MESQUITA FILHO OF DENTISTRY, UNIVERSITY OF SÃO PAULO - DEPART- Patient referred to the Oral Oncology Center - UNESP for MENT OF STOMATOLOGY evaluation and management of a lesion in the lower jaw. He A 66-year-old man reported that a white lesion on inferior lip reported the appearance of this lesion for about six months and was previously biopsied, receiving microscopic diagnosis of involved teeth were getting mobility. Oral exam presented sub- chronic stomatitis with lichenoid pattern. Our examination re- mucosal nodular lesion at region of free and inserted gingival was vealed a single, non-removable lesion of many white noduli observed in oroscopy, bulging gingivolabial inferior region, in- separated by red areas, involving inferior lip, oral commissure volving the premolars affecting until lower right premolars of the and buccal mucosa. Another incisional biopsy was taken on opposite side. Biopsy was performed and the histopathological buccal mucosa and microscopic analysis revealed hyperparakera- exam was compatible with central giant cell lesion. Blood were totic epithelium with surface papillary and mild cytological normal for parathyroid function. An interesting fact occurred 15 changes confined to lower third. There were islands of epithelial days after the biopsy, the lesion has exacerbated by increasing in cells, suggestive of microinvasion or pseudoepitheliomatous hy- size compared to the examination before the biopsy. The new perplasia. Associated with clinical aspects and history, the final physical exam showed a protuberant lower lip and the lesion was diagnosis was nodular leukoplakia, with malignant transforma- repelled and externalizing it. The patient was treated as soon as tion, but this was not microscopically conclusive. A second immediately after the pre-operative exams got ready and cur- biopsy in three strategic areas evidenced squamous cell carci- rently is being monitored. noma. This case highlights the importance of selecting the area Hubácek M, Dostálová T, Bartonová M, Kozák J, Seydlová for biopsy and the interaction between professionals for final M. Giant cell reparative granuloma in the mandible case report diagnosis; moreover it reports a possible nodular leukoplakia, and review of the literature. Acta Chir Plast. 2008;50(2):59-63. which progressed to a malignant transformation. KABAN, L. B.; TROULIS, M. J.; EBB, D.; AUGUST, M.; HORNICEK, F. J.; DODSON, T. B. Antiangiogenic Therapy with Interferon Alpha for giant cell lesions of the jaws. Journal of ND:YAG LASER TREATMENT OF ORAL HEMANGIO- Oral Maxillofacial Surgery 2002;60:1103-1111. MAS: A DESCRIPTIVE STUDY Henrique IHM1, Andrade Bahar Sezer, Banu Koyuncu, Murat Gomel, Tayfun Günbay. SC1, Carvalho AAT1, Fonseca DDD1, Faria ABS1, Gueiros The Turkish Journal of Pediatrics 2005; 47:75-81. Injeção intral- LAM1, Leão JC1 - 1UFPE - PROGRAMA DE PÓS GRADU- esional de corticosteróides para o granuloma de células gigantes AÇÃO EM ODONTOLOGIA centrais: Relato de caso e revisão de literatura. The aim of the present study was to describe the treatment of oral hemangiomas using Nd:YAG laser. Ten patients (ranging LIPID DROPLETS IN SALIVARY CARCINOMAS: AN IM- from 36 to 77 years of age, 2 male and 8 females) diagnosed with OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e55 oral hemangiomas were treated with a single session of Nd:YAG Conclusion: The diagnosis of the female carriers provided laser (4W, 20s, 100j/cm2) followed by unfocused laser biostimu- genetic counseling to affected families and adequate treatment as lation (1,25W, 50s, 93,75j/cm2). Moderate pain was reported well following of these patients. until 48 hours following treatment, and after 7 days all patients presented with an asymptomatic necrotic area. Partial healing INTRAORAL PRIMARY MELANOMA: CASE REPORT was noted after 15 days, and complete resolution of the lesions Almeida JD1, Kaminagakura E2, Rodrigues LM2, Acay R3, after 3 to 4 weeks. None of the patients reported the need for Rosa LEB2, Carvalho YR2, Prado RF2 - 1FACULDADE DE taking analgesics following the procedures, despite lesion size or ODONTOLOGIA DE SÃO JOSÉ DOS CAMPOS UNESP - location. In conclusion, a single-session Nd:YAG laser treatment DEPARTAMENTO DE BIOCIÊNCIAS E DIAGNÓSTICO is an effective therapeutic option for the management of oral BUCAL, 2FACULDADE DE ODONTOLOGIA DE SÃO hemangiomas, associated with clinical resolution and few ad- JOSÉ DOS CAMPOS -UNESP - DEPARTAMENTO DE BIO- verse side effects. CIÊNCIAS E DIAGNÓSTICO BUCAL, 3FACULDADE DE ODONTOLOGIA DE SÃO JOSÉ DOS CAMPOS -UNESP - HISTOLOGICAL STUDY OF GUIDED BONE REGENER- PROGRAMA DE PÓS GRADUAÇÃO EM BIOPATOLOGIA ATION WITH THE USE OF A POLYPROPYLENE BUCAL, FACULDADE DE ODONTOLOGIA DE SÃO JOSÉ 1 1 1 MEMBRANE Weinfeld I , Lucca L - UNIVERSIDADE DE DOS CAMPOS-UNESP SANTO AMARO - ODONTOLOGIA A 55-year-old, Asian woman was referred from an acquain- Background: A challenge in bone lesions is the cavity left tance of her and saw the lesion informally. Patient reported that after their removal. 2 months earlier, she started feeling pain in hard palate. She Objective: The purpose of the present study was to evaluate sought a dentist for root canal treatment in her maxillary left first the use of a non-reabsorbable polypropylene membrane, com- molar with no resolution of the pain. She also reported abnormal mercially known as Bone Heal®, as a barrier utilized in these local bleeding after flossing the area. Intraoral examination re- situations. vealed a 5-centimeter-wide asymmetric black macula, with irreg- Study design: Calvarial defects were prepared in 16 New ular borders and areas of proliferation of red color, located at hard Zealand female rabbits, covered (test group) or not (control palate and gingiva in left maxilla. Patient underwent incisional group) with polypropylene membrane, in order to evaluate bone biopsy and histopathological examination of the specimen re- repair. After 21 and 42 days histological specimens were ob- vealed melanocytic malignant neoplasia, featured by atypical tained and studied (HE – Mallory). epithelioid melanocytes showing nuclear alterations and melanin Results: Both groups showed the same pattern of inflamma- granules, and arranged in nests both within the epithelium, and in tory response, yet the test group presented lower invasion of depth within the connective tissue. The diagnosis was then con- fibrous connective tissue and faster osteogenesis. clusive for malignant melanoma. The patient was immediately Conclusion: Thus the polypropylene membrane appeared as referred to a high-complexity hospital for proper management of a biocompatible material able to promote guided bone regenera- the lesion. tion. IMMUNOHISTOCHEMICAL ANALYSIS OF KI-67 AND OROFACIAL FEATURES OF HYPOHIDROTIC ECTO- MCM-2 IN SQUAMOUS CELL CARCINOMAS OF THE DERMAL DYSPLASIA Flores IL1, Aquino SN1, Paranaíba TONGUE BETWEEN YOUNG AND OLDER PATIENTS LMR2, Swerts MSO3, Coletta RD1, Martelli DRB, Júnior Pereira JS1, Barroso KMA1, Nonaka CFW1, Pinto LP1, Souza HM,3 - 1PIRACICABA DENTISTRY SCHOOL - FOP/UNI- LB1 - 1UNIVERSIDADE FEDERAL DO RIO GRANDE DO CAMP - ORAL DIAGNOSIS DEPARTMENT, 2ALFENAS NORTE - PATOLOGIA ORAL DENTISTRY SCHOOL - UNIFENAS - CENTER FOR REHA- Objectives: to evaluate the immunoexpression of Ki-67 and BILITATION OF CRANIOFACIAL ANOMALIES, 3MONTES Mcm-2 in squamous cell carcinoma of the tongue between young CLAROS DENTISTRY SCHOOL - UNIMONTES - CLINICAL and older patients and to correlate it with prognostic indicators. STOMATOLOGY Study design: Sample was composed of 20 cases under 40 Background: Ectodermal dysplasia is a rare group of inher- years and 20 over 50 years. Clinical staging and histological ited disorders characterized by aplasia or dysplasia of tissues of grade of malignancy were obtained. Cell proliferation was eval- ectodermal origin, such as hair, nails, teeth and skin. Hypo- uated through labeling indices (LI). hidrotic ectodermal dysplasia (HED) is perhaps the most known Results: Most young patients were stages III/IV (nϭ12- genodermatosis between the dysplasia ectodermal syndromes 66.6%) and most older patients were stages I/II (nϭ11-68.8%) characterized by the abnormal development of sweat glands, (pϽ.05). Mean Ki-67 LI in young and older patients was 43.8% teeth and hair. The most prevalent form is X-linked HED which and 42.5%, respectively (pϾ.05). Mean Mcm-2 LI was higher in is associated with mutations in the EDA gene. older (65.9%) than in young patients (55.9%) (pϽ.05). We found Objective: The aim of this study is describe a family with no significant association between this immunoexpression and XLHED with emphasis on differences in orofacial features be- prognostic indicators. tween members. Conclusions: No differences in cell proliferation were ob- Study design: Careful clinical examination was realized and served between age groups, even though young patients pre- five males affected presented classic phenotype of XLHED, as sented more aggressive lesions. Ki-67 LI and Mcm-2 LI were not dental abnormalities, hypohydrosis, and craniofacial dysmor- associated with prognostic indicators. phologies. Results: Dental agenesis of the lateral maxillary incisors was EXPRESSION OF C-JUN AND P-C-JUN IN POTEN- principally feature in nine female heterozygous carriers. TIALLY MALIGNANT LESIONS IN SMOKERS AND ORAL MEDICINE OOOO e56 Abstracts October 2012

NONSMOKERS Lima JS1,2,3,4,5 - 1USP - PATOLOGIA BU- SCHOOL, UNIVERSITY OF SÃO PAULO - ESTOMATOL- CAL, 2LUCIANA CORRÊA - PATOLOGIA BUCAL, 3MARIA OGY, 2DENTISTRY SCHOOL, UNIVERSITY METROPOLI- DE FÁTIMA KLINGBEIL - PATOLOGIA BUCAL, TAN OF SANTOS - ESTOMATOLOGY, 3DENTISTRY 4GUSTAVO RABELO - PATOLOGIA BUCAL, 5SUZANA C. SCHOOL, UNIVERSITY OF SÃO PAULO - ORAL PATHOL- ORSINI MACHADO DE SOUSA - PATOLOGIA BUCAL OGY, 4DENTISTRY SCHOOL, UNIVERSITY METROPOLI- Background: Oral leukoplakia (OL) is a white lesion related TAN OF SANTOS - DENTAL PROSTHESIS to malignant transformation. Smoking has been considered a risk A 60-year-old Caucasian male patient, presented with an factor for OL. c-Jun expression and activation positively regulate asymptomatic nodule of 2.5 cm, with yellowish coloration and the cell cycle. firm consistence, in the right lingual border, with 2 years of Objectives: This study evaluated through immunohisto- evolution. The clinical diagnosis was lipoma and an excisional chemistry technique the relationship between c-Jun expression biopsy was performed. The histopathological examination re- and activation in leukoplakia from smokers and non-smokers. vealed a proliferation of adipocytes, and in some specific areas, Study design: Seventy-three cases were selected and divided spindle cells with hyperchromatic/peripheric nuclei and some according to its histological analysis: with or without epithelial small vesicles in the cytoplasm, interpreted as atypical lipoblasts. dysplasia in smokers and non-smokers (total four groups). Histolog- Also, there was a capsule lining the lesion and a fragment of ical sections of each lesion were submitted to the immunohisto- normal stratified epithelium. The immunohistochemical analysis chemistry method of streptavidin/biotin for c-Jun and p-c-Jun detec- revealed a weak and focal positivity to MDM2/CDK4/CPM and tion and semi-quantitative analysis were performed. negativity to Ki67. The final diagnosis was atypical lipoma. The Results: The results showed that there was a trend of ex- patient remains in clinical control and at 1 year follow-up pres- pression for c-Jun in dysplastic smokers and p-c-Jun in non- ents no clinical evidence of recurrence and free of disease. dysplastic non-smokers, however, without statistical significance (pϭ1.431) and (pϭ1.425) respectively, possibly due to the num- ber of cases studied. CLASSIFICATION OF INFLAMMATORY CYSTS OF THE Conclusion: We could conclude that these proteins may play JAWS, NEW PROPOSAL Martínez B1, Rebolledo J2, Mar- a role in malignant transformation of patients with OL. tínez C3, Araya C4 - 1ORAL PATHOLOGY - DENTAL SCHOOL, UNIVERSIDAD MAYOR, CHILE., 2ORAL PA- THOLOGY - DENTAL SCHOOL, UNIVERSIDAD MAYOR, ASSESSMENT OF KNOWLEDGE AND CONDUCT FOR CHILE, DENTAL SCHOOL, UNIVERSIDAD SAN SE- PREVENTION OF INFECTIOUS ENDOCARDITIS DEN- BASTIÁN, CHILE., 3ORAL PATHOLOGY - DENTAL TISTS MANAUS BETWEEN ACADEMIC AND THE FAO / SCHOOL, UNIVERSIDAD SAN SEBASTIÁN, CHILE., 1,2,3,4,5 1 UFAM Domingues JEG - UFAM - FACULDADE DE 4DENTAL SCHOOL, UNIVERSIDAD MAYOR, CHILE. 2 ODONTOLOGIA, GABRIELA DE FIGUEIREDO MEIRA Background: Inflammatory cysts of the jaws (ICJ) have (MEIRA, GF) - UFAM - FACULDADE DE ODONTOLO- been classified as radicular cysts (radicular or residual), but 3 GIA, KLISSIA DALLIANNA COSTA RIBEIRO (RIBEIRO, inflammatory cells can be found in the wall of some odontogenic KDC) - UFAM - FACULDADE DE ODONTOLOGIA, 4ME- cysts, such as dentigerous (DC) or keratocyst (OKC). Although LISSA SAMPAIO LEAL (LEAL, MS) - UFAM - FACULDADE there is agreement regarding the designation of the DC and OKC DE ODONTOLOGIA, 5NIKEILA CHACON DE OLIVEIRA as odontogenic cysts, others like paradental cyst and follicular CONDE (CONDE, NCO) - UFAM - FACULDADE DE OD- inflammatory cyst, have also been classified as ”developmental ONTOLOGIA cyst”, but their pathogenesis is related to inflammation of the Objective: To evaluate the knowledge and practices for the follicle of the erupting teeth. prevention of infective endocarditis (IE) among dental profes- Objective: To propose a new classification of inflammatory sionals and graduates of the city of Manaus jaws cysts. Study design: It was formed two groups: Fifty dentists in the Conclusions: Proposed Classification: city of Manaus and fifty-eight students from the Faculty of 1. Associated with periapical inflammation, due to pulpal Dentistry (UFAM) answered a questionnaire about the definition necrosis. of infectious endocarditis, risks related to patients’ conditions, 2. Associated with inflammation during eruption of the tooth. risk dental procedures and protocols used in drug prophylaxis The latter group, those associated with eruption of the tooth Results: Risk procedures for IE tooth extraction recognized: are not clearly identified in the literature. This may be due to the scaling, root planing and reimplantation of avulsed teeth. The confusing terminology that exists on these cysts and sometimes drug protocol was statistically significant (p ϭ 0.0169) of the they are not treated properly. students. 42% of dentists and 71.93% of students correctly indi- cated the dosage, with significant difference between groups (p ϭ 0.0063). SOCIO- DEMOGRAPHIC FACTORS AS PROGNOSTIC Conclusion: Is need for lifelong learning opportunities, be- INDICATORS OF ORAL CANCER Honorato J1, Camisasca cause there were significant differences between the two groups DR1, Dias FL2, REBELO MS3, Lourenço SQC1 - 1UNIVER- for knowledge of risk mitigation in the management of special SIDADE FEDERAL FLUMINENSE - PATOLOGIA -UFF, patients in clinical practice. 2INSTITUTO NACIONAL DO CÂNCER - SERVIÇO DE CABEÇA E PESCOÇO, 3INSTITUTO NACIONAL DO ATYPICAL LIPOMA OF THE TONGUE Assunção Jr CÂNCER - DIVISÃO DE IMFORMAÇÃO JNR1,2, Rabelo GD3, Nagata GS3, Barbosa JS1,4, Esteves Background: Oral Squamous cell carcinoma (OSCC) is the CMD3, Lemos-Junior CA1, Sousa SCOM3 - 1DENTISTRY most common tumor in cavity and its profile is well recognized– OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e57 elder Caucasian men, with low social-economic situation diag- were reagents and secondary syphilis was confirmed. Treatment nosed in advanced stages. consisted of penicillin G benzathine 2.4 million IU/IM for 4 Objective: Investigate whether socio-demographic factors weeks. Both oral and skin lesions had complete remission. (SDF) influence survival of OSCC patients Conclusion: The present case illustrates that syphilis should Study design: Prognostic study of 480 records of OSCC be suspected in old patients with oral atypical lesions. patients surgically treated at National Cancer Institute from 1999 to 2003. Survival was analyzed by the Kaplan-Meyer (KM) method and Cox proportional hazard model was used to verify COMPARISON OF PANORAMIC RADIOGRAPHY AND independence BONE DENSITOMETRY IN THE SCREENING OF OS- Results: KM revealed that marital status (MS) and Body TEOPOROSIS IN DOWN SYNDROME Kitamura KT1,Ki- Mass Index (BMI) are good prognosticators. Multivariate analy- tamura DH2, Vilela MCN1, Arita ES3, Raitz R, Gallottini sis revealed on MS (pϭ0.01) that those who were married had a MHC1, Rezende NPM1 - 1FOUSP - DISCIPLINA DE PATO- higher survival probability than single (Relative Risk (RR): 0. 74, LOGIA BUCAL E CENTRO DE ATENDIMENTO À PACI- ϭ ϭ p 0.18), and divorced patients (RR: 0.61, p 0.07), however ENTES ESPECIAIS, 2FESO - MEDICINA, 3FOUSP - DIS- ϭ widows showed a lower probability (RR:1.35, p 0.28). In addi- CIPLINA DE RADIOLOGIA tion, in BMI (pϽ0.001) patients, those with a lower BMI were Objective: Compare panoramic radiography (PR) with dual- less prone to survival than ideal BMI (RR:2.89, pϽ 0.001) and energy X-ray absorptiometry (DEXA) to identify osteoporosis higher BMI groups (RR: 1.24, pϭ0.25). (OP) at Down syndrome (DS). Conclusion: SDF should be considered when developing the Study design: We evaluated 22 patients with DS-CAPE/ treatment plan for OSCC patients. FOUSP, aged from 25 years, whose parents agreed and signed the Informed Consent (CEP-FOUSP 79/2009). We collected data PREVALENCE OF DENTURE STOMATITIS IN USERS OF from medical history, performed PR, and DEXA of radius and REMOVABLE DENTURE ASSISTED OF DENTISTRY OF ulna. We measured the width and evaluated the shape of the THE FEDERAL UNIVERSITY OF AMAZONAS Pereira JV1, mandibular cortical at PR and compared with the result of Falcão LS1, Vieira JMR1, Parente RCP2, Rebelo MAB1 - DEXA. 1UFAM - FAO, 2UFAM - ICE Results: We analyzed 13 males and 9 females, mean age was Objective: Evaluate the prevalence of Denture Stomatitis 32,7. The mean mandibular cortical width was 3.79 mm. 4 (DS) in users of denture assisted at Federal University of Ama- patients had mandibular cortical shape of C1, 10/C2 and 8/C3. zonas (UFAM). The DEXA showed an average T-score of: 2.55 (13/osteopenia Study design: Application of a questionnaire about oral and 9/osteoporosis). hygiene, the exam of the mucous and the prosthesis. Conclusion: The screening of OP in DS patients should be Results: Sixty-four patients were included, 75% of the fem- based on clinical evaluation and radiographic, since the changes inine sex, in the range of 30 to 50 years old (67,2%) and 56,9% of the bone structure of these patients difficult to compare with of all carriers of upper denture presented DS, of these, 46,5% values previously established. used their dentures for a period from 1 to 5 years and 90,9% use them during the night. Among the patients, non carriers of DS, 40% presented degree of good hygiene. While among the carriers THE IMPORTANCE OF A CAREFUL RADIOGRAPHIC of DS 18,2% and 45,4% presented good and poor hygiene degree, ANALYSIS IN THE DIAGNOSIS OF STAFNE’S BONE respectively, with no significant statistic association (pϾ0,05). DEFECT: REPORT OF THREE CASES Moriel Tavares KM1, Conclusion: The prevalence of DS in the patients assisted in Diaz TCI1, Elblink D1, Bahia TPS2, Maciel RM2, Ramos UFAM was elevated, even so it didn’t present significant relation MEB2, Israel MS2 - 1UERJ - FACULDADE DE ODONTO- with the degree of hygiene of the dentures. LOGIA, 2UERJ - DEPARTAMENTO DE DIAGNÓSTICO ORAL E CIRURGIA COULD SILDENAFIL USE MAKE ELDERLY MORE SUS- The Stafne’s bone defect shows a well-circumscribed radi- CEPTIVE TO INFECTIOUS DISEASE? Piragine J1, Silva olucent image with an esclerotic margin, asymptomatic, located PVR1, Miniello TG1, Jaguar GC1, Osório CAT2, Alves FA1 - below the mandibular canal, in the retromolar region. The aim of 1HOSPITAL AC CAMARGO - STOMATOLOGY, 2HOSPI- this study is to emphasize the importance of a careful radio- TAL AC CAMARGO - PATHOLOGY graphic analysis, associated to patient’s history and physical Background: Syphilis seems to be resurging mainly in examination, for the correctly diagnosis of this lesion. Three young. However, the sildenafil use by elderly can become them cases of the Stafne’s bone defect were found in routine pan- more susceptive to infectious diseases. oramic radiographies of white male patients, between 36 and 46 Objective: To present a case of oral syphilis in an old years old. The objective to report this case was to emphasized the patient. importance of careful radiographic analysis for an accurate diag- Case report: An 83-year-old man was referred due to burn- nosis of this lesion, and the exclusion of other possible lesions ing mouth. His medical history revealed papular lesions on chest that could suggest wrong diagnosis and to avoid unnecessary and penis glans diagnosed and treated as scabiosis 2 months ago. invasive procedures. The intra-oral examination showed erosive and patches lesions 1 2 on bilateral lip commissure, palate and border of the tongue. PLASMOCYTOMA IN MANDIBLE Tomita GA , Cesare G , Initially, herpes infections were suspected. However, serological Piñera K2 - 1CIRURGIA E TRAUMATOLOGIA BUCOMAX- test and cytology were negative. Then, syphilis was hypothe- ILOFACIAL DO HOSPITAL REGIONAL SUL - CIRURGIÃO sized. Non-treponemic (VDRL) and treponemic tests (FTA-ABS) VISITANTE NO CENTER CORRETIVE JAW SURGERY, ORAL MEDICINE OOOO e58 Abstracts October 2012

SANTA BARBARA, CA- USA, 2LABORATÓRIO DIAGNÓS- Study design: Thirty-two (15 follicular, 9 plexiform and 8 TIKA - SP - PATOLOGIA BUCAL unicystic) ameloblastomas were immunohistochemically ana- S. F. S., female, 29 years old, from São Paulo, Brazil, went lyzed with anti-human Ki-67 and PCNA antibodies. The PCNA to the Department of Maxillofacial Surgery in Hospital Luz, Vila and Ki-67 labeling index were determined by percentage of Mariana district, in January 2012, with signs of swelling in the positive peripheral odontogenic cells. The association between region of right hemifacial 15 months ago. The patient had no the immunoreaction of both antibodies was verified by Spear- painful symptoms and the area of the lesion was without secre- man’s correlation test. tion. In the intraoral examination it was observed the 47 tooth Results: The mean labeling index was higher in plexiform destroyed by decay and bulging buccally. When radiography was ameloblastomas (Ki-67ϭ 3.49%; PCNAϭ69.57%) followed by taken, the panoramic one, we observed expansive lesion, multi- unicystic (Ki-67ϭ 2.81%; PCNAϭ58.95%), and follicular (Ki- loculated in the angle, ramus and condyle of the mandibule. In 67ϭ 1.54%; PCNAϭ52.06%) types. There was statistically sig- the CT scan we noted a large cortical bone erosion. This training nificant correlation between PCNA and Ki-67 immunostaining material was filled by soft tissue attenuation. Incisional biopsy (pϭ0.031, rϭ0.38) was performed under local anesthesia and sedation. The result of Conclusion: These results suggest that Ki-67 and PCNA are histopathological examination with immunohistochemical proce- adequate to assess the proliferative activity in ameloblastomas. dures, was Plasmacytoma, a malignancy of plasma cells. All the events are documented in the form of clinical photographs, im- EVALUATION OF CLINICAL EFFECTIVENESS OF LOW- aging and pathology exams. The result of the immunohistochem- istry is presented descriptively. LEVEL LASER, VITAMIN E (ALPHA-TOCOPHEROL) AND PHARMACOLOGICAL PROTOCOL IN THE MANAGE- MENT OF RADIATION INDUCED ORAL MUCOSITIS THE EFFICACY OF PHOTODYNAMIC THERAPY IN AC- Fernandes KS1, Queiroz PM1, Freitas EM2, Pires MBO2, TINIC CHEILITIS: CASES REPORT Fontes KBFC1,2, Cunha Bonan PRF3, Ito FA1 - 1UNIVERSIDADE ESTADUAL DE KSG2, Teixeira MKS1, Issa MCA3, Miranda AMO2, Dias EP2, LONDRINA, 2UNIVERSIDADE ESTADUAL DE MONTES Kurachi C4 - 1UNIVERSIDADE FEDERAL FLUMINENSE - CLAROS, 3UNIVERSIDADE FEDERAL DA PARAÍBA FORMAÇÃO ESPECÍFICA, 2UNIVERSIDADE FEDERAL Background/objective: Oral mucositis is the most impor- FLUMINENSE - PROGRAMA DE PÓS-GRADUAÇÃO EM tant acute side effect due to radiotherapy treatment on head and PATOLOGIA, 3UNIVERSIDADE FEDERAL FLUMINENSE - neck. The aim of this study was to assess the clinical effective- DERMATOLOGIA, 4UNIVERSIDADE DE SÃO PAULO - ness of low-level laser therapy, vitamin E and pharmacological INSTITUTO DE FÍSICA protocol as forms of treatment for radiation-induced oral mucosi- Photodynamic therapy (PDT) consists of generation of reac- tis on grades 2 and 3 through a randomized clinical trial per- tive oxygen species through interactions of photosensitizer, light formed with 41 patients. and oxygen used to treat several conditions. We report three Study design: Oral mucositis was evaluated according to the patients with clinically severe actinic cheilitis (AC) and epithelial WHO criteria and dry mouth, salivary flow changes, taste, smell, dysplasia (ED) who were submitted to one session of PDT. The muscle movement and pain was performed by visual analogue lower lip was treated with 160 mg of 5-aminolevulinic acid scale. methyl ester (MAL, PDT-pharma) and then covered with an Results: There was no significant decline regarding the occlusive dressing. After 3 hours, the conversion of MAL was mucositis grade (Pϭ0,34), however, patients submitted to treat- confirmed and the irradiation was performed in three distinct ment with low-level laser had greater reduction in the severity of areas for 11 minutes using LED red light source (630nm, 40 J/cm mucositis when compared to other groups. and 75mW) (Lince, MMoptics). All patients showed a significant Conclusion: Laser therapy and pharmacological protocol, clinical improvement of AC. Histopathological examination aided significantly in reducing pain intensity; nevertheless laser demonstrated that the gradation of ED reduced after PDT. In one therapy, proved to be more effective throughout treatment period, patient, moderate ED reduced for mild ED and in two patients with higher pain reduction. with mild ED there was no ED after PDT. PDT seems to be an effective treatment for AC. CLINICAL-PATHOLOGICAL STUDY OF ORAL PERIPE- HERAL NERVE SHEATH TUMORS AND IMMUNOHIS- KI-67 OR PCNA TO EVALUATE THE PROLIFERATIVE TOCHEMICAL ANALYSIS OF S-100 AND CD57 ANTI- ACTIVITY OF AMELOBLASTOMAS? Tjioe KC1, Damante GNES IN DIFFERENT TYPES OF LESIONS Muniz LB1, JH2, Soares CT3, Oliveira DT1 - 1BAURU SCHOOL OF Rodrigues TS2, Borges FC3, Andrade TV3, Freitas Filho DENTISTRY / UNIVERSITY OF SÃO PAULO - DEPART- SAJ3, Franco T1, Cardoso SV1 - 1UNIVERSIDADE FED- MENT OF STOMATOLOGY - AREA OF PATHOLOGY, ERAL DE UBERLÂNDIA - LABORATÓRIO DE PATOLO- 2BAURU SCHOOL OF DENTISTRY / UNIVERSITY OF SÃO GIA ORAL, 2UNIVERSIDADE FEDERAL DE UBERLÂN- PAULO - DEPARTMENT OF STOMATOLOGY, 3LAURO DIA - FACULDADE DE BIOMEDICINA, 3UNIVERSIDADE DE SOUZA LIMA INSTITUTE - DEPARTMENT OF PA- FEDERAL DE UBERLÂNDIA - FACULDADE DE ODON- THOLOGY TOLOGIA Objectives: The Ki-67 and proliferating cell nuclear antigen Background/objective: To review a series of oral peripheral (PCNA) are widely used as proliferation markers. However there nerve sheath tumors (PNST) and to compare them according to are few studies comparing its expressions in ameloblastomas. immunohistochemical reactivity for nerve-related antigens. Thus our aim was to verify if Ki-67 and PCNA can be used to Study design: PNST diagnosed from 1978 to 2010 in a evaluate the proliferative ability of this tumor. single institution were identified and reviewed according to re- OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e59 cent criteria. Demographic and clinical data were retrieved. Im- tongue against his lower lip. Habit termination, avoiding hot munohistochemistry was performed to detect S-100 and CD57 drinks, spicy food and applying of artificial saliva were recom- antigens. mended. One month later lesion was slightly increased and the Results: There were 29 PNST: 6 traumatic neuromas (TN), guideline was kept. Then, total healing was observed and para- 7 neurofibromas (NF), 7 Schwannomas (SW), 5 granular cell functional habit diagnosis was given. tumors (GCT) and 4 palisaded encapsulated neuromas (PEN). There was no sex predominance, most patients were young RECONSTRUCTION OF BILATERAL MAXILLA WITH adults, the tongue was the most affected anatomical site, and the MICROVASCULAR FIBULA FLAP: VARIABLE IX Sassi tumors were usually asymptomatic. All tumors showed diffuse LM1,2,3, Pedruzzi PAG4, Guebur MI5, Silva AB6, Dissenha reactivity for S-100. Reactive nerve fibers permeated NF, GCT JL5, Groth AK7, Ramos GHA8, Oliveira BV9 - 1CHEFE DO and PEN, in different pattern, and were absent within SW cases. SERVIÇO DE CIRURGIA BUCO-MAXILO-FACIAL, 2HOS- Conclusions: Schwann cells do not reach complete differ- PITAL ERASTO GAERTNER DE CURITIBA, 3CHEFE DO entiation in PNST. Nerve fibers arrangement is useful to differ- SERVIÇO DE CIRURGIA BUCO-MAXILO-FACIAL DO entiate PNST. HOSPITAL ERASTO GAERTNER, 4HOSPITAL ERASTO GAERTNER - SERVIÇO DE CIRURGIA DE CABEÇA E METASTASES TO THE MAXILARY SINUS FROM COLON PESCOÇO, 5HOSPITAL ERASTO GAERTNER - SERVIÇO ADENOCARCINOMA Ramos LMA1, Sabino-Bezerra JR2, DE CIRURGIA BUCO-MAXILO-FACIAL, 6UFPR; HOSPI- Esteves SCB3, Vargas PA4, Almeida OP, Lopes MA2 - 1PI- TAL ERASTO GAERTNER - SERVIÇO DE CIRURGIA RACICABA DENTAL SCHOOL, STATE UNIVERSITY OF PLASTICA, 7HOSPITAL ERASTO GAERTNER - CHEFE DO CAMPINAS, PIRACICABA, SÃO PAULO, BRAZIL - ORAL SERVIÇO DE CIRURGIA PLASTICA, 8UFPR; HOSPITAL DIAGNOSIS/ORAL SEMIOLOGY, 2PIRACICABA DENTAL ERASTO GAERTNER - SERVIÇO DE CIRURGIA DE SCHOOL, STATE UNIVERSITY OF CAMPINAS, PIRACI- CABEÇA E PESCOÇO, 9HOSPITAL ERASTO GAERTNER - CABA, SÃO PAULO, BRAZIL - ORAL DIAGNOSIS/ORAL CHEFE DO SERVIÇO DE CIRURGIA CABEÇA E SEMIOLOGY, 3ONCOLOGY CENTER, HFC - RADIO- PESCOÇO THERAPY, 4PIRACICABA DENTAL SCHOOL, STATE UNI- The experience of each surgical team counts a lot in such VERSITY OF CAMPINAS, PIRACICABA, SÃO PAULO, situations. BRAZIL - ORAL DIAGNOSIS/ORAL PATHOLOGY Objective: Rebuilding case submitted to bilateral maxillec- A 32-year-old woman presented to the radiotherapy depart- tomy because squamous cell carcinoma. ment for palliative treatment of a maxillary tumor. Extraoral Method: Patient underwent maxillectomy with immediate exam showed a swelling corresponding to maxillary and lateral reconstruction Microvascular fibula flap. two osteotomies were nose region. Intraorally there was a painful enlargement on the performed resulting in three bone segments to remake the alve- hard palate. The medical history revealed that the patient had a olar region of left anterior and right maxillary alveolar ridge, primary colon adenocarcinoma two years ago. Histological fea- which were fixed together with titanium miniplates and fixed tures of the slides obtained from maxillary biopsy showed ade- segments the zygomatic bone with a titanium miniplate and nocarcinoma infiltrating bone. Immunochemistry panel was pos- screws and one on each side. Is required at the ends of the itive for CDX2 and AE1/AE1 cytokeratin, confirming the segments on each side with a fixing screw in a 90 ° angle with the hypothesis of metastatic colon adenocarcinoma. Image exams segment that has remade the trailing edge of the maxilla. were performed and showed other lesion in T1 vertebra. After Results: The flap, and close the wound, provides a basis for three months of the palliative treatment the patient died because oral rehabilitation by dental implants. After one year underwent of disseminate disease. Metastases to the maxillary sinus from dental implants and overdenture later. colon adenocarcinoma is uncommon and the patient generally Conclusion: The patient had satisfactory evolution, aesthet- has a poor prognosis. ics, function and phonation were recovered.

PARAFUNCTIONAL HABIT LESION: A DIAGNOSTIC EXTENSIVE JUVENILE OSSIFYING FIBROMA: A CASE CHALLENGE Nicolielo LFP1, Pagin O1, Bravo-Calderón REPORT Figueiredo LMG1, Oliveira TFL2, Valente ROH3, DM2, Oliveira DT2, Santos PSS1 - 1FACULDADE DE OD- Costa WRM4, Almeida ECB5, Lisboa JFC6, Sarmento VA7,8 - ONTOLOGIA DE BAURU - USP - ESTOMATOLOGIA, 1UNIVERSIDADE FEDERAL DA BAHIA - MESTRANDO- 2FACULDADE DE ODONTOLOGIA DE BAURU - USP - INSTITUTO DE CIÊNCIAS DA SAÚDE, 2FACULDADE DE PATOLOGIA ODONTOLOGIA DE BAURU- USP - DOUTORANDA EM A 26-year old man, complaining about rough, dry and peel- ESTOMATOLOGIA, 3HOSPITAL GETULIO VARGAS - ing sensation in the lower lip mucosa for two months, was using CIRURGIA BUCO-MAXILO-FACIAL, 4INSTITUTO DE ME- topical corticosteroid by himself. Oral examination revealed DICINA INTEGRAL PROFESSOR FERNANDO FIGUEIRA - slight edematous lower lip with normal mucosa. Parafunctional 5 habits were not found. As toothpaste allergy was suggested, CIRURGIA BUCO-MAXILO-FACIAL, UNIVERSIDADE neutral toothpaste was prescribed and corticosteroid withdrawal. FEDERAL DE PERNAMBUCO - DOUTORANDA EM 6 Within six weeks of presentation, the mucosa displayed a wrin- CLÍNICA INTEGRADA, UNIVERSIDADE FEDERAL DE kled aspect of two centimeters long. Histological analysis after PERNAMBUCO - PROFESSOR ADJUNTO DE PATOLO- 7 biopsy revealed oral mucosa with focus of intraepithelial leuko- GIA ORAL, UNIVERSIDADE FEDERAL DA BAHIA - PRO- cytes and chronic inflammatory infiltrate in the subjacent con- FESSOR ASSOCIADO DE ODONTOLOGIA, 8UNIVERSI- nective tissue. Two-week follow-up no alteration was observed. DADE ESTADUAL DE FEIRA DE SANTANA-BAHIA - However, one discovered that patient frequently rubbed his PROFESSOR TITULAR ORAL MEDICINE OOOO e60 Abstracts October 2012

Introduction: The group of fibro-osseous lesions from the yellowish, very painful shallow ulceration on tongue ventral maxillofacial region is very heterogeneous. The term Juvenile surface, right side, 2.5cm, irregular margins, could be observed. Ossifying Fibroma has been used in the literature to describe two The patient has been treated of systemic lupus erythematosus histopathological variations of conventional Ossifying Fibroma. (SLE) for the past 10 years with prednisone and leflunomide. A These variations are Trabecular Juvenile Ossifying Fibroma and differential diagnosis of SLE manifestation, infectious disease Psammomatoid Juvenile Ossifying Fibroma. and carcinoma was suggested. Patient was referred to her rheu- Objective: Report a case study of Juvenile Ossifying Fi- matologist to rule out SLE oral lesion. Fifteen days after initial broma. exam, picture remained unchanged and patient was submitted to Case report: A four-year-old boy patient presented a per- a biopsy procedure. Standard histopathological examination sistent edema in the left hemiface and an absence of cutaneous along with PAS and Grocott stains concluded diagnosis of his- alteration or fluctuations. The extensive lesion in the body and toplasmosis. Treatment has been conducted with itraconazole left mandibular angle were detected in a panoramic radiograph of (400mg/day) showing a satisfactory outcome. This case report the maxillars. An incisional biopsy was performed was diagnosed suggests considering this opportunistic fungal infection in the as Fibrous Dysplasia. The patient was then submitted to surgery diagnosis of patients undergoing immunosuppressive treatment. for curettage of the lesion. The surgical piece was sent to second histopathologic examination. Diagnostic of this lesion occurs after the correlation of clinical, imaging and histopathological ORAL HEALTH STATUS AND TREATMENT NEEDS OF CIRRHOTIC PATIENTS IN LIST OF LIVER TRANSPLAN- findings. 1,2,3,4,5 Conclusion: Psammomatoid Juvenile Ossifying Fibroma TATION AND VIRAL HEPATITIS CARRIERS Lins L - 1 was confirmed. PAULO LISBOA BITTENCOURT - UNIT OF GASTROEN- TEROLOGY AND HEPATOLOGY, PORTUGUESE HOSPI- TAL, 2MARIA ISABEL SCHINNONI - SCHOOL OF MEDI- EVALUATION OF THE ORAL MUCOSAL CONDITIONS CINE OF THE FEDERAL UNIVERSITY OF BAHIA, IN ADULT BRAZILIAN INDIGENOUS FROM THE BA- 3RAYMUNDO PARANÁ - SCHOOL OF MEDICINE OF THE HIA REGION Porto LPA1, Nascimento MC1, Sobreira AC1, FEDERAL UNIVERSITY OF BAHIA, 4 Lopes H2, Ramalho LMP3, Cury PR4 - 1UNIVERSIDADE JORGE BASTOS - SCHOOL OF MEDICINE OF THE FEDERAL UNIVERSITY FEDERAL DA BAHIA - PÓS GRADUAÇÃO, 2UNIVERSI- OF BAHIA, 5 DADE FEDERAL DA BAHIA - ABO-BA, 3UNIVERSIDADE ANTÔNIO FERNANDO PEREIRA FALCÃO - FEDERAL DA BAHIA - DIAGNÓSTICO E TERAPÊUTICA, SCHOOL OF DENTISTRY OF THE FEDERAL UNIVER- SITY OF BAHIA 4UNIVERSIDADE FEDERAL DA BAHIA - CLÍNICA ODON- TOLÓGICA Infections are frequent causes of morbidity and mortality after liver transplantation (LT) and a major cause of decompen- Objective: Information on the prevalence of the oral mucosal sation in patients undergoing to LT. Cirrhotic patients with poor condition in Brazilian Indians is lacking. The aim of this study was oral health status may have an increased susceptibility to sys- to assess the prevalence of oral mucosal diseases and variations from temic infections in the pre and/or post-operative LT period. normality in Indians Kiriri from the Bahia region of Brazil. Objective: To compare the oral health status of LT patients Study design: The sample consisted of 226 individuals with chronic viral hepatitis carriers. (19-77years old). Calibrated examiners performed the oral exam- Methods: Sixty-six patients (18 waiting for LT and 48 inations following the World Health Organization criteria (1997). non-cirrhotic hepatitis patients: 16 Hepatitis C Virus carriers, 17 Results: in this population only 52 (23%) individuals had Hepatitis B Virus carriers and 15 non-HCV and non-HBV hep- oral lesion, including 15 types such as 12 alveolar abscess (23%), atitis) were evaluated at the Stomatology Service from Federal 10 traumatic ulcers (19.23%), 6 melanocytic nevis (11.53%) and University of Bahia from 2010 to 2011. Oral health status eval- 6 fibrosis (11.53%). It was identified seven variations from nor- uation was performed according to WHO Standards. mality, evidencing a high occurrence of melanin pigmentation, Results: LT group had more periodontal diseases (pϭ0.02) which was present in 129 cases (88.35%), followed by fissured and a slightly higher DMFT mean (19.11). tongue in 17 cases (11.64%). Conclusion: LT patients have poorer oral health compared Conclusions: The prevalence of oral mucosal lesions was to patients with less severe hepatitis. 23% and variations of normal was 64.60%. Then, this investiga- tion has essential role in determining the treatment needs of this population. DENTAL AND SYSTEMIC PHENOTYPES IN WAARDEN- Key words: Mouth Mucosa, Mouth disease, Prevalence, BURG SYNDROME Paranaiba LMR1,, Nasser LS, Gomes Indigenous Population. A3, Cardoso AF, Neto PES2, Frota AC4, Martelli-Junior H2 - 1UNIMONTES - ESTOMATOLOGIA, 2STATE UNIVERSITY ORAL HISTOPLASMOSIS IN A PATIENT WITH SYS- OF MONTES CLAROS, UNIMONTES - HEALTH SCIENCE TEMIC LUPUS ERYTHEMATOSUS Fernandes LG1, PROGRAMME, 3STATE UNIVERSITY OF MONTES CLA- Siqueira CS2, Sugaya NN1, Souza SCOM3, Nunes FD3, Alves ROS, UNIMONTES - DENTAL SCHOOL, 4STATE UNIVER- FA1 - 1UNIVERSITY OF SÃO PAULO - STOMATOLOGY, SITY OF MONTES CLAROS, UNIMONTES - FACULTY OF 2UNIVERSITY OF UBERLANDIA - ORAL PATHOLOGY, MEDICINE 3UNIVERSITY OF SÃO PAULO - ORAL PATHOLOGY The study describes the pattern of inheritance and the clinical Histoplasmosis is a fungal infection (Histoplasma capsula- features of a family with Waardenburg syndrome (WS), and tum) that usually affects immunosuppressed patients. Lungs are details the oral manifestations. To characterize the family, 29 the primary infection site and intra-oral lesions are rare. A 32- familial members were evaluated, including dermatologic, oph- year-old woman presented with a 2-month-old tongue lesion. A thalmologic, otorrynolaringologic, and orofacial examination. OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e61

The family pedigree with 29 members was constructed including heterogeneous, and it could represent distinct lineages and/or the 4 last generations and revealed an autosomal dominant mode functional stages. of transmission. We identified 16 family members affected by WS, with all of them showed strands white hair, stain white skin, ANALYSIS OF ACTINIC CHEILITIS BY MICRO SPEC- iris hypopigmentation, and dystopia cantorum. Two patients had TROSCOPY FT-IR AND PCA Carvalho LF1, Martinho H1, hearing loss. Dental alterations were identified in 3 members, Almeida J2 - 1FEDERAL UNIVERSITY OF ABC, 2FAC- including dental agenesis, conoid teeth and taurodontism. WS ULDADE DE ODONTOLOGIA DE SÃO JOSÉ DOS CAM- was transmitted by an autosomal dominant pattern with variable POS - UNESP expressivity, and equilibrated gender distribution. Genetic coun- seling in this syndrome affected families is important, because a Actinic cheilitis (AC) is a potentially precancerous lesion high percentage of descendants can have some kind of deafness, caused by chronic exposure to UV radiation. The FT-IR spec- mental retardation, dental anomalies and musculoskeletal altera- troscopy provides molecular information through optical proper- tions. ties by the vibration of its molecules. This technique has been used in biological studies for characterization of neoplastic tis- sues. There are few studies involving potentially cancerous pro- Sant’Ana LN, A RARE CASE OF ORAL MYOFIBROMA cesses. This study aimed to evaluate molecular changes on AC Sant’Ana Filho M, Martins MD, Heitz C, Scolari N., through micro FT-IR spectroscopy and principal components Machado HH, Berthold R analysis (PCA). 14 samples of AC and 14 samples of normal Myofibroma is a rare benign soft tissue neoplasm composed mucosa (NM), resulting in 5 spectra per sample, totaling 140 by myofibroblast. It has preference for the head and neck area, spectra were analyzed (70 from each group). The results demon- most common in mandible, lips, cheeks and tongue. An 14-years strated by PCA showed that the first ten principal components old male patient was referred complaining a painless swelling on (PCs) should be used in the analysis. The largest variations the left side of the mouth floor for a few months. The clinical observed by loading graph plot related to the vibrational modes diagnosis of benign neoplasm was performed. An incisional biopsy of collagen, nucleic acids, lipids and confined water. It was was done and the histopathological analysis revealed a tumor com- concluded that the micro FT-IR spectroscopy provides important posed of spindle-shaped cells arranged in a biphasic pattern with molecular features of AC. large elongated cells with tapering ends and interlacing fascicular arrangement of myofibroblast closely resembling smooth muscle tumor. Areas with hemangiopericytoma-like pattern of blood vessel CALCIFYING EPITHELIAL ODONTOGENIC TUMOR: A were observed. An Immunohistochemical analysis was realized and INTRAOSSEOUS AND BILATERAL PERIPHERAL SYN- 1 positivity to vimentin, HHF-35 and smooth muscle actin were CHRONOUS MANIFESTATION Barbosa de Paulo LF , 1 2 2 observed. Desmin and S-100 protein were negative. The myofi- Servato JPS , Oliveira MTF , Rodrigues AR, Silva CJ ,Hi- 3 4 1 broma was confirmed and the lesion was totally excised. The two raki KRN , Durighetto Jr. AF - FEDERAL UNIVERSITY years follow-up showed no recurrence of the lesion. OF UBERLÂNDIA - DEPARTMENT OF ORAL PATHOL- OGY, 2FEDERAL UNIVERSITY OF UBERLÂNDIA - ORAL AND MAXILOFACIAL SURGERY SERVICE, 3FEDERAL IMMUNOPHENOTYPIC CHARACTERIZATION AND UNIVERSITY OF UBERLÂNDIA - DEPARTMENT OF 4 DISTRIBUTION OF DENDRITIC CELLS IN ODONTO- MORPHOLOGY, FEDERAL UNIVERSITY OF UBERLÂN- GENIC CYSTIC LESIONS Almeida LY1, Feio PSQ1, Pinã DIA - DEPARTMENT OF ORAL DIAGNOSIS RA1, Almeida OP1, Léon JE2 - 1PIRACICABA DENTAL The calcifying epithelial odontogenic tumor (CEOT), also SCHOOL, STATE UNIVERSITY OF CAMPINAS (UNI- known as Pindborg tumor, is an extremely rare, locally invasive, CAMP) - ORAL DIAGNOSIS DEPARTMENT, 2SCHOOL OF benign neoplasm, accounting for approximately 1% of all odon- DENTISTRY OF RIBEIRÃO PRETO, UNIVERSITY OF SÃO togenic tumors. Peripheral CEOTs commonly resemble oral re- active lesions and are histologically similar to their intraosseous PAULO (USP) - DEPARTMENT OF MORPHOLOGY, STO- counterparts. We report an uncommon case of intraosseous and MATOLOGY AND PHYSIOLOGY - ORAL PATHOLOGY bilateral peripheral synchronous manifestation of CEOT. A 27- Background: Previous studies analyzed dendritic cells year-old male presented with bilateral soft, painless, swelling (DCs) in odontogenic cystic lesions (OCLs) only through the localized in canine areas of the maxillary gingiva and other hard immunoexpression of either S100 or CD1a. tissue enlargement in the mandible that radiographically, showed Objectives: Our study aimed to investigate the expression a mixed radiolucent radiopaque mass. The biopsy samples from and distribution patterns of immature DC (imDC) and mature DC all involved sites revealed similar histopathologic features con- (mDC) immunomarkers in radicular cysts (RCs), dentigerous sistent with CEOT. The masses were surgically excised and there cysts (DtCs) and keratocystic odontogenic tumors (KCOTs). is no clinical or radiographic evidence of recurrence 12 months Study design: Forty-nine OCLs (RCs, nϭ20; DtCs, nϭ15; after excision. The multifocal presentation is an unusual phenom- and KCOTs, nϭ14) were assessed using the following markers: enon for CEOT and has never been reported for intraosseous and S100; CD1a and CD207 for imDCs; and CD83 for mDCs. peripheral synchronous lesions. Results: Almost all cases were S100, CD1a and CD207 positive, while only 63% were CD83 positive. RCs presented greater number of immunostained cells, followed by DtCs and USE OF BUCCAL FAT PAD IN THE SURGICAL TREAT- KCOTs. Significant correlation was found between the thickness MENT OF BISPHOSPHONATES RELATED OSTEONE- epithelium with CD1aϩ and S100ϩ cells, and between inflam- CROSIS OF THE JAWS: CASE REPORT Duarte LFSM1, mation grade with CD83ϩ cells in RCs. Carrela LH2, Reis HB1, Mello MMP, Marques MAC3, Tucci Conclusion: DC populations in OCLs can be phenotypically R3, Dib LL3 - 1UNIVERSIDADE PAULISTA - PÓS GRADU- ORAL MEDICINE OOOO e62 Abstracts October 2012

AÇÃO, 2UNIVERSIDADE PAULISTA - INICIAÇÃO containing extravasated red blood cells was also observed. The CIENTÍFICA, 3UNIVERSIDADE PAULISTA ducts were positive for cytokeratin-7 and S-100, appearing Bisphosphonates are drugs used for oncology and bone met- unilayered, as observed by negative SMA and Calponin stain. abolic disorders due its angiogenesis and osteoclastic activity. Since 2003 an adverse effect has been reported as “Bisphospho- OCCULT METASTASIS IN ORAL SQUAMOUS CELL nates related osteonecrosis of the jaws” (BROJ). CARCINOMA Silami M1, Diblasi EV2, Camisasca DR2, Surgical treatment is one of the forms proposed as treatment Fonseca EC2, Faria P, Dias FL, Lourenço SQC2 - 1NA- of BROJ, which may cause, in some cases, deformities as oral TIONAL CANCER INSTITUTE (INCA), BRAZIL, 2FLUMI- sinus communications. An alternative for coating maxilla defects NENSE FEDERAL UNIVERSITY (UFF), BRAZIL is the buccal fat pad due its large blood supply and elasticity. Objective: The aim of this study was to reassess the pres- The aim of this study is to present a case report of a 58 years ence of neoplastic cells in cervical lymph nodes using hematox- old female with BROJ in the left maxilla caused by zoledronic ylin-eosin (HE) and immunohistochemistry (IHC) stains. acid for breast metastatic cancer, whereas the buccal fat pad was Study design: Semi-seriated HE-stained sections and immu- used for covering the oral sinus communication resulted from the nohistochemical reaction using pan-cytokeratin (AE1/AE3) were necrotic bone resection. performed in cervical lymph nodes of 29 patients diagnosed with Regarding the treatment of BROJ, more studies should be tongue and floor of mouth squamous cell carcinoma without performed, however, the buccal fat pad could be an alternative to metastasis at the National Cancer Institute in 2001. solve oral sinus communications related to BROJ. Results: Five (17.2%) patients had occult metastatic disease in cervical lymph nodes. Three were macrometastasis visualized THE IMPORTANCE OF A LONG-TERM FOLLOW UP: through HE/IHC, and two were micrometastasis visualized by CENTRAL GIANT CELL GRANULOMA IN A CHILD UN- IHC. All patients had initial clinical/pathological stage tumors, DER CONSERVATIVE TREATMENT AND A FULL LE- four in the tongue and one in the floor of mouth. Four patients did SION REPAIR AFTER 6 YEARS Sampieri MBS1, Yaedú not receive adjuvant radiotherapy, two of them presented regional RYF1, da Silva Santos PS1, Gonçales ES1, Sant’Ana E1, recurrence and three died. Consolaro A2, Cardoso LB1 - 1FACULDADE DE ODONTO- Conclusion: This study shows the high incidence of occult LOGIA DE BAURU - DEPARTAMENTO DE ESTOMATO- metastasis in oral cancer and the influence of this in therapeutic LOGIA, 2FACULDADE DE ODONTOLOGIA DE BAURU - planning and prognosis of these patients. DEPARTAMENTO DE PATOLOGIA BUCAL The central giant cell granuloma is a benign osteolytic con- CROHN’S DISEASE - ORAL MANIFESTATION IN PA- dition of the jaw. It is more prevalent in children and young TIENTS ON A CLINICAL REMISSION PHASE Kira ME1, adults and twice more frequent in the mandible than the maxilla. Araújo NS1 - 1SÃO LEOPOLDO MANDIC Radiographic images of central giant cell granuloma appear as Background: Crohn’s disease belongs to the inflammatory radiolucent unilocular or multilocular images. A swelling was bowel diseases group which etiopathogenesis include microbial, observed in the area of lower incisors and canines of a 9-year-old immunological, genetic and environment factors. It can manifest boy. A radiolucent unilocular image in the mandibular bone at any age, even in a childhood, but most commonly in young involving lower incisors teeth was noted. The histopathology adulthood, being characterized by remission and exacerbation of showed a Central Giant Cell Granuloma, so that the treatment gastrointestinal symptoms. Initially described as being an inflam- was performed with subcutaneous injections of calcitonin with- matory disease of the small bowel, it may involve any part of the out success. Then we treated the lesion with triamcinolone ace- gastrointestinal tract and also presents extraintestinal manifesta- tonide. Monthly follow-ups demonstrated good lesion reduction tions specially affecting the oral cavity. and the absence of any clinical symptoms during the first 2 years. Objective: The aim of this study was to evaluate the oral After 6 years of the first clinical exam the patient presented a full conditions of patients in clinical treatment of Crohn’s disease. lesion repair, but the follow up will be continued. Methods: A total of 16 patients with the diagnosis of Crohn’s disease were selected after applying inclusion and ex- A SALIVARY GLAND TUMOR COMPOSED BY CELLS clusion criteria. The family, medical and dental history of each WITH STRIATED DUCT PHENOTYPE: A ‘STRIATED patient was analysed and clinical oral mucosal findings were DUCT ADENOMA’? Brazão-Silva MT1, Pulino BFB1,Pa- recorded. vanello KC1, Guimarães DM1, Santos JFM2, Mantesso A1, Results: Of the 16 patients, 8 were men and 8 were women, Sousa SCOM1 - 1UNIVERSITY OF SÃO PAULO - ORAL with age ranging from 24 to 67 years old. Oral findings were PATHOLOGY, 2PRIVATE PRACTICE present in 15 patients and included edema, erythematous lesions, ulcers and hyperplastic folds known as cobblestoning. We report a case of a salivary gland neoplasm which the Conclusion: The results point out that oral lesions in morphological and immunohistochemical profile seemed to sug- Crohn’s disease may precede, coincide or follow the onset of gest differentiation towards striated ducts, or so-called ‘striated intestinal lesions, being an important signal of the disease. duct adenoma’. The lesion has involved the buccal mucosa next to lower lip of a 70-year-old black patient. It was painful and measured about 2 cm in diameter, with smooth and purple sur- MORPHOMETRICAL ANALYSIS OF LEFT MASSETER face. Histologically, it was seen a well-circumscribed tumor AND MEDIAL PTERYGOID MUSCLES, AFTER IPSILAT- comprising cuboidal to columnar eosinophilic cells with bland ERAL MANDIBULAR MOLARS EXTRACTION. AN EX- nuclei forming ductal structures similar to the striated duct. This PERIMENTAL MODEL Benigno MIM1, Liberti EA2, Cruz component was admixed with a variable number of cystic ductal PP3, Rodrigues KEL3, Conde JR AM3, Guerra SPL3, Amstal- spaces, with minimal intervening stroma. A large cystic space den EMI1 - 1UNIVERSIDADE ESTADUAL DE CAMPINAS - OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e63

UNICAMP - ANATOMIA PATOLÓGICA, 2UNIVERSIDADE Abstract: Secondary syphilis may involving different or- DE SÃO PAULO-USP-SP - ANATOMIA, 3UNIVERSIDADE gans (including the oral cavity), and mimicking several diseases, FEDERAL DO PIAUI - MORFOLOGIA thereby making diagnosis a challenge for clinicians. A 20-year- Occlusal changes are responsible for most temporo-mandib- old man was referred to the School of Dentistry of the Alfenas ular-junction disorders. Loss of molar teeth predisposes to alter- Federal University with a two-month history of painful tongue ations of the masticatory muscles. Objectives: to analyze the left ulcer. Venereal Disease Research Laboratory (VDRL) test was masseter and medial pterygoid muscles after extraction of the positive and the result was 1/32. Previous unsuccessful treatment ipsilateral mandibular molars. included topical antiseptics and non-steroidal anti-inflammatory Material/methods: Ten young male rats (Wistar) were di- drugs. Clinical examination showed painful ulcerated lesions, vided into two groups: submitted to exodontia l (nϭ5) and partially covered with white patches on the tongue and erythem- controls (nϭ5) and allowed to survive for 30 days. Muscles were atous plaques on the palate. In the mandibular anterior teeth had transversely sectioned, submitted to routine histological tech- gingival necrosis associated with large amounts of biofilm. Clin- niques and stained by H&E. Five 5␮m sections of each block ical features suggested an episode of secondary syphilis. The were cut. From each section 12 fibers were selected for area patient was treated with three doses of penicillin G (2 400 000 measurement under a 40x objective, using a Axion-vision® soft- IU) once a week. Forty days after treatment the oral lesions had ware. disappeared completely. Dental practitioners should consider sec- Results: No morphometrical area differences were found ondary syphilis in the differential diagnosis of oral lesions. between the experimental and control animals: medial pterygoid Key words: Diagnosis, oral, syphilis (pϭ0,221); masseter (pϭ1,000) (MANN-WITNEY test). Con- clusion: left masseter and medial pterygoid muscles do not pres- CHARACTERISTICS AND BEHAVIOUR OF LEUKOPLA- ent area changes of their fibres 30 days, after ipsilateral mandib- KIA: AN ANALYSIS OF FOLLOW-UP DATA IN A 10- ular molars extraction. YEAR CASE-SERIES Kamel MS1, Broadbent J2, Rich AM3 - 1 DOUBLE THYROGLOSSAL DUCT CYST INVOLVING FACULTY OF DENTISTRY, UNIVERSITY OF OTAGO, THE SUBLINGUAL GLAND AND FLOOR OF THE DUNEDIN, NEW ZEALAND - BACHELOR OF DENTAL 2 MOUTH REGION: A RARE PRESENTATION Lopes SURGERY (BDS) STUDENT (FINAL YEAR), FACULTY OF MLDS1, Sarmento DJS1, Araújo PPT1, Germano AR1, Sil- DENTISTRY, UNIVERSITY OF OTAGO, DUNEDIN, NEW veira EJD1 - 1UFRN - ODONTOLOGIA ZEALAND - SENIOR RESEARCH FELLOW, DEPART- 3 Double thyroglossal duct cysts (DTDC) are very rare. A MENT OF ORAL SCIENCES, FACULTY OF DENTISTRY, 30-year-old female was referred to department complaining of UNIVERSITY OF OTAGO, DUNEDIN, NEW ZEALAND - difficulty in deglutition and painful swelling in the right sublin- ASSOCIATE PROFESSOR OF ORAL PATHOLOGY, DE- gual area. Clinical examination revealed a slight increase in PARTMENT OF ORAL DIAGNOSTIC AND SURGICAL SCI- volume in the right floor of the mouth, with painful symptoms on ENCES palpation, intact oral mucosa and no cervical lymphadenopathy. Objectives: To define the characteristics and behavior of Magnetic resonance imaging showed 2 well-defined cystic le- leukoplakia in NZ. sions adjacently located in the midline from the sublingual area to Study design: Lesions diagnosed clinically as leukoplakia the anterior floor of the mouth on the geniohyoid muscles. The and histologically as epithelial keratosis (with or without dyspla- patient underwent surgery to remove the lesion in hospital under sia) through the Otago University Oral Pathology Diagnostic general anesthesia. Microscopic examination showed that both Service were reviewed for 1997-2006. Descriptive statistics were cysts and the connecting tract were lined with a squamous epi- conducted and dysplastic lesions were modeled using linear thelium with cylindrical and ciliated epithelial areas of respira- regression. tory type. A Thyroglossal tract or thyroid follicles and mucous Results: 565 (5.4%) accessions fulfilled the inclusion crite- glands can be observed in the capsule. The pathologic diagnosis rion, equating to 1.2% prevalence in NZ. 53% were male and was DTDC. There have been no signs of recurrence. average age was 54 years. Gingivae/sulcular mucosa was affected most (19%). Dysplasia was statistically more likely to occur in ORAL MANIFESTATIONS OF SYPHILIS: CASE REPORT floor-of-mouth and lateral-tongue lesions, and in patients with Santos MRG1, Garcia NG2, Carvalho LPF3, Taveira LAA4, oral squamous cell carcinoma (OSCC) history (pϽ0.01). Pro- Pereira5, Hanemann JAC - 1BAURU SCHOOL OF DEN- gression to dysplasia was observed in 4/107 (4%) of initially TISTRY, UNIVERSITY OF SÃO PAULO, BAURU, SÃO non-dysplastic lesions. Malignant transformation occurred in PAULO, BRAZIL. - DEPARTMENT OF STOMATOLOGY, 5/169 (3%) of lesions (3 mildly- and 2 moderately-dysplastic). AREA OF PATHOLOGY, 2BAURU SCHOOL OF DEN- None of the severely-dysplastic lesions progressed to OSCC. Conclusion: The absence of dysplasia in the initial biopsy TISTRY, UNIVERSITY OF SÃO PAULO, BAURU, SÃO does not preclude later progression. PAULO, BRAZIL. - ADEPARTMENT OF STOMATOLOGY, AREA OF PATHOLOGY,, 3UNIVERSITY OF JOSÉ DO ROSÁRIO VELLANO, ALFENAS, MINAS GERAIS, BRAZIL. - ORAL VERRUCIFORM XANTHOMA: CLINICOPATHO- DEPARTMENT OF INFECTOLOGY, 4BAURU SCHOOL LOGIC AND IMMUNOHISTOCHEMICAL STUDY OF 18 OF DENTISTRY, UNIVERSITY OF SÃO PAULO, BAURU, CASES Romañach MJ1, Piña AR2, León JE3, Pires FR4, SÃO PAULO, BRAZIL - DEPARTMENT OF STOMATOL- Benevenuto de Andrade BA2, Carlos R5, de Almeida OP2 - OGY, AREA OF PATHOLOGY, 5ALFENAS FEDERAL UNI- 1FEDERAL UNIVERSITY OF RIO DE JANEIRO (UFRJ), VERSITY, ALFENAS, MINAS GERAIS, BRAZIL - DEPART- BRAZIL - ORAL PATHOLOGY, 2STATE UNIVERSITY OF MENT OF CLINIC AND SURGERY, AREA STOMATOLOGY CAMPINAS (UNICAMP), PIRACICABA, SÃO PAULO, ORAL MEDICINE OOOO e64 Abstracts October 2012

BRAZIL - ORAL PATHOLOGY, 3STATE UNIVERSITY OF presence some showed sprouts. Chest radiographs showed no SÃO PAULO (USP), RIBEIRÃO PRETO, BRAZIL - ORAL pulmonary involvement. Hematological exams revealed good PATHOLOGY, 4STATE UNIVERSITY OF RIO DE JANEIRO health status. First treatment option is antifungal agents, however (UERJ), BRAZIL - ORAL PATHOLOGY, 5CENTRO patient is being treated at a public health service where medica- CLÍNICO DE CABEZA Y CUELLO/HOSPITAL HERRERA tion was unavailable, Sulfamethoxazole 400mg and trimethoprim LLERANDI, GUATEMALA - PATHOLOGY DIVISION 80mg were prescribed. Objective: The aim of this study was to evaluate the clini- Conclusion: Lesions remission was observed after 55 days, copathologic and immunohistochemical features of oral verruci- remaining oral fibrosis. Patient has been in treatment for 2 form xanthomas (VX). months with no signs of the lesions; therapy will be maintained Study design: The files of two oral pathology services were for six months. reviewed from 1985 to 2011. Eighteen cases of VX were evalu- ated through H&E staining and immunohistochemical reactions ODONTOGENIC LESIONS IN TURKISH PAEDIATRIC to CD68 (KP1 and PGM1), CD63, CD163, syndecan-1 (CD138), POPULATION OVER A 40-YEAR PERI˙OD Tekkesin MS1, S-100 protein, and cytokeratins (CK) 8, 14 and 19. Tuna EB2, Olgac V1, Aksakalli N1, Alatli FC1 - 1ISTANBUL Results: Oral VX preferably affected the gingiva and palate UNIVERSITY, INSTITUTE OF ONCOLOGY - DEPART- of adult male patients as yellowish papillary nodules. Most cases MENT OF TUMOUR PATHOLOGY, 2ISTANBUL UNIVER- presented papillary epithelial hyperplasia with neutrophilic exo- SITY, FACULTY OF DENTISTRY - DEPARTMENT OF PE- cytosis and sub-epithelial foamy cells, which were immunoposi- DODONTICS tive for CD68, CD63 and CD163. The orange parakeratin super- Background/objective: Odontogenic tumors and odonto- ficial layer exhibited loss of CK14 expression and a distinct genic cysts represent an important aspect of oral and maxillofa- pattern of positivity for CD138. S-100 protein, CKs 8 and 19 cial pathology. Odontogenic tumors are uncommon lesion, whereas were negative. odontogenic cysts are relatively common lesions in dental practice. Conclusion: The breakdown of the syndecan-1 cell mem- The aim of the study was to determine the characteristic features of branes can be involved in the distinct microscopic appearance of odontogenic lesions in children in Turkey. the parakeratin layer of VX. Study design: A total of 6020 cases of odontogenic lesions were received and analyzed during the 40-year period between THE IMPORTANCE OF THE CLINICAL EXAM IN THE 1971 and 2010. Pediatric cases (765 cases, 12.7%), up to 17 years DIAGNOSIS OF THROMBOCYTOPENIC PURPURA of age, were selected. The patients were divided into three age Gonçalves MV1, Vieira RR1, Soares GR1, Furuse CF1, Silva groups according to dentition periods: primary dentition period JZ1, Miyahara GI1, Biasoli ER1 - 1FACULDADE DE OD- (0-5 years), mixed dentition period (6-12 years), and permanent ONTOLOGIA DE ARAÇATUBA-UNESP - CENTRO DE ON- dentition period (13-17 years). The specimens were analyzed for COLOGIA BUCAL each diagnosis including number of samples, age range, female/ Idiopathic thrombocytopenic purpura is an acquired blood dis- male ratio, location and pathological diagnosis. order characterized by immune-mediated destruction of platelets. Results: Total of 765 cases, 596 specimens (78%) were The aim of this work is to present clinical features of purpura, diagnosed as odontogenic cysts and 169 specimens (22%) were showing the importance of clinical exam to diagnose systemic diagnosed as odontogenic tumours. The most frequent odonto- diseases with oral manifestations. A 26-year-old man attended the genic cyst was radicular cysts (48.4%), followed by dentigerous Oral Oncology Center directed by a dentist. The patient reported the cysts (16.7%). The most common odontogenic tumour was odon- appearance of red petechiaes on his arm that spread over his body in toma (7.8%). 3 days. At ectoscopy, there were reddish petechiaes on his arms, legs Conclusion: This study shows that all odontogenic lesions in and abdomen. The oroscopy showed spontaneous bleeding on mar- pediatric group are benign. Odontogenic tumours are relatively ginal gingiva and also two bluish-red petechiaes, one in the left rare in this age group. Overall, radicular cysts and odontomas are posterior buccal mucosa and the other one in the left side of soft the most commonly diagnosed odontogenic cyst and tumour, palate measuring about 5mm and 3mm, respectively. The diagnostic respectively. hypotheses were leukemia, dengue hemorrhagic and purpura. A complete blood count was requested, which showed 5,000 platelets. ORAL HISTOPLASMOSIS: CLINICAL JUDGMENT VER- The patient was directed to a hematologist. SUS LABORATORIES FINDINGS Onofre MA1, Andrade CR2, Delort S, FS Moreira, CM Navarro3, EMS Massucato4 - 1FAC- ORAL PARACOCCIDIOIDOMYCOSIS WITHOUT SYS- ULDADE DE ODONTOLOGIA DE ARARAQUARA - TEMIC MANIFESTATIONS Araujo MR1, Sandrin R, Souza UNESP - DEPARTAMENTO DE DIAGNÓSTICO E CIRUR- 2 GL, Valerio MPO - 1UNIVERSIDADE POSITIVO GIA, FACULDADE DE ODONTOLOGIA DE ARARA- 3 Objective: to present a case of oral paracoccidioidomycosis. QUARA UNESP - FISIOLOGIA E PATOLOGIA, FAC- A 49-year-old man, sugar cane cutter, presented facial asymme- ULDADE DE ODONTOLOGIA DE ARARAQUARA - 4 try, swelling on lips and face’s left side. Oral examination re- UNESP - DIAGNÓSTICO E CIRURGIA, FACULDADE DE vealed ulcerated mulberry-like granulomatous lesions in both ODONTOLOGIA DE ARARAQUARA - UNESP - DIAGNÓS- lips, inferior and superior alveolar mucosa and buccal mucosa. TICO E CIRUGIA Painful lesions were presented for one month and mouth opening The authors present a series of four cases of oral histoplas- limitation. Incisional biopsy was performed in superior lip mu- mosis attended at the Oral Medicine Service (OMS) FOAR- cosa, exhibiting oral mucosa coated with stratified squamous UNESP. The sample consisted of 3 men and one woman, mean epithelium with irregular acanthosis, spongiosis and foci of par- age 57.25 years (48-70). The main complaints are painful ulcer- akeratosis, an intense lymphocytic inflammatory infiltrate, fungi ations, decreased intake of oral nutrition, burning mouth, malaise, OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e65 weakness and weight loss. Emphysema, acute pneumonia, gas- NNHAMUNDÁ (AM) Povoa RCS1, Pinto LF2, Gusmão trointestinal disease and at least, one year of delay was observed. TA2, Santos CSF2, Maciel RM3, Ramos MEB3, Israel MS3 - Two patients lived on a farm or worked in contact with bird 1UERJ - FACULDADE DE ODONTOLOGIA, 2FAC- excreta. Oral examinations revealed painful ulcers with yellowish ULDADES SÃO JOSÉ - FACULDADE DE ODONTOLO- pseudomembranes (labial mucosa, hard palate, alveolar ridge, GIA, 3UERJ - DEPARTAMENTO DE DIAGNÓSTICO ORAL tongue and floor of the mouth). Serological tests (immunodiffu- E CIRURGIA sion, complement fixation), culture and cito/histopathology stain- Objectives: to evaluate the knowledge about Oral Medicine ing revealed various results and the diagnosis was based on in two Brazilians cities, Rio de Janeiro (RJ) and Nhamundá (AM) association of findings. HIV-infection was detected in 2 cases. and to verify what specialty the population looks for in cases of The patients were treated with a long-term anti-fungal drug oral lesions and the frequency of visits to dentist. (azoles). Our experience demonstrated the importance of persis- Study design: a thousand interviews were made. tence when the clinical judgment and laboratories findings did Results: concerning the knowledge about Oral Medicine, not converged. 96.5% of the population didn’t know it and 3.5% related the specialty to the mouth. About the professional they look for, 60% ROLE OF MAST CELL SUBTYPES AND MYOFIBRO- seek for a dentist, 30% for doctor and 10% answered other things, BLAST IN DENTURE-RELATED HYPERPLASIA Kiuchi M1, like another health professional or even home treatment. In Haga M2, Yamaura T3, Okudera M3, Ishigami T1, Komiyama respect of the frequency of the visits, 25% of the people inter- viewed informed that goes to the dentist in a period less than six K3 - 1NIHON UNIVERSITY SCHOOL OF DENTISTRY, TO- months, 25% semiannually, 25% annually and 25% when is KYO, JAPAN - DEPARTMENTS OF PARTIAL DENTURE necessary and/or almost doesn=t go or doesn’t go. PROTHODONTICS, 2NIHON UNIVERSITY SCHOOL OF Conclusion: more educative actions about Oral Medicine DENTISTRY, TOKYO, JAPAN - DEPARTMENTS OF ORAL are necessary. MAXILLOFACIAL SURGERY, 3NIHON UNIVERSITY SCHOOL OF DENTISTRY,TOKYO,JAPAN - DEPART- ADENOID CYSTIC CARCINOMA OF THE PALATE: A MENTS OF PATHOLOGY CASE REPORT Abrahim NMM1, Martins V2, Libório TN1, Background: Denture-related fibrous hyperplasia is a reac- Oliveira LC1, Medeiros JM3, Câmara J1 - 1FEDERAL UNI- tive inflammatory lesion of oral mucosal tissues due to stimula- VERSITY OF AMAZONAS - PATHOLOGY AND LEGAL tion with ill-fitting dentures. However, precise mechanism of MEDICINE, 2CLINICAL SURGERY, 3ONCOLOGY CEN- fibrosis in this lesion is not fully understood. Purpose of the study TER CONTROL FOUNDATION OF THE AMAZONAS is to clarify the presence of mast cell subtypes and myofibroblasts in relation to fibrotic disease formation. (FCECON) - HEAD AND NECK SURGERY Methods: Appearance of mast cells and myofibroblasts were A 47-year-old female was referred to a clinical surgery with examined in 33 cases of the DRFH and 10 controls by toluidine a 2-year history of a pain swelling in the palate. Intraoral clinical blue stain, immunostain and fluorescence immunostain. The examination revealed a sessile nodule, firm at palpation, involv- TUNEL assay performed to detect the apoptotic cells of myofi- ing the left posterolateral region of the hard palate, extending to broblast. soft palate with the same color of the normal mucosa. Panoramic Results: Number of mast cells was significantly increased in radiograph showed no involvement of the osseous portion. An the lesion. Trypataseϩ cells more frequently found than chy- incisional biopsy was performed with the hypothesis of a pleo- maseϩ cells in both peripheral and central parts of the lesion. morphic adenoma. Microscopic examination of hematoxylin and Myofibloblast found in 43% of the lesions, were mostly under- eosin-prepared slides revealed a malignant neoplasm of salivary gone apoptosis. gland, formed by the proliferation of multiple hipercromatic cells Conclusion: The results revealed the presence of tryptaseϩ islands, showing cribriform aspect and opening itself in micro- mast cells and myofibroblast could contribute to collagen syn- cystic spaces. The lesion spreads out widely without defined thesis and fibrosis of the lesion. limits, compatible with the diagnostic of adenoid cystic carci- noma. The patient was referred to an oncologist in a reference center and was submitted to an exeresis surgery. Currently the KNOWLEDGE ABOUT ORAL MEDICINE IN TWO BRA- patient showed no recurrence after 7 months and is under pros- ZILIANS CITIES, RIO DE JANEIRO (RJ) AND thetic rehabilitation. ORAL MEDICINE OOOO e66 Abstracts October 2012

Poster 2

PERIPHERAL COMPOUND ODONTOMA ERUPTING DADE FEDERAL DO AMAZONAS, 2UNIVERSIDADE FED- IN THE GINGIVA Garcia NG1, Santos MRG, Oliveira DT, ERAL DO AMAZONAS - FACULDADE DE ODONTOLO- Hanemann JAC2, Pereira AAC2 - 1BAURU SCHOOL OF GIA DENTISTRY, UNIVERSITY OF SÃO PAULO, BAURU, SÃO Objective: The aim of this study was to determine the PAULO, BRAZIL - DEPARTMENT OF STOMATOLOGY, prevalence of precancerous lesions in the oral mucosa of chronic AREA OF PATHOLOGY, 2ALFENAS FEDERAL UNIVER- alcoholics. SITY, ALFENAS, MINAS GERAIS, BRAZIL - DEPARTMENT Study design: The subjects answered a questionnaire with OF CLINIC AND SURGERY, AREA STOMATOLOGY socio-economic information and researched on the subject, such Abstract: Peripheral odontoma arising in the extraosseous as duration, amount and type of alcoholic beverage consumed. soft tissues is rare and if not removed early, may enlarge over They were examined to assess the presence of precancerous time and eventually erupt in the oral cavity. We report a case of lesions. The data collected were tabulated and submitted to 15-year-old girl presented with “denticles on the gingiva”. Dur- analysis, whichever is the Student t test and Mann-Whitney test. ing the intraoral examination, seven small tooth-like structures Results: The results showed that the male was the most Ϯ were found. These were exposed in the anterior left gingiva prevalent, with a mean age of 52.3 9.9 years. The mean Ϯ between the permanent maxillary lateral incisor and canine teeth. duration of exposure to ethanol was 23.9 8.7 years and about Radiographic examination revealed irregular tooth-like structures 13 (65%) subjects consumed alcohol daily. All subjects had some without evidence of bone involvement. The lesion was surgically type of oral lesion, but only 3 (15%) were diagnosed with removed, and the specimens were analyzed histopathologically suggestive precancerous lesions. which confirmed that it was a compound odontoma with enamel, Conclusion: The appearance of precancerous lesions was dentin, pulp chamber, and cementum in the same order of ar- higher when exposed to tobacco to alcohol. rangement as that of a normal tooth, surrounded by thin epithe- lium. According to English Literature, this is the twelfth reported HISTOPATHOLOGICAL CHARACTERIZATION OF PERIAPI- case of peripheral odontoma in the gingiva and the first one that erupted in the oral cavity. CAL GRANULOMAS SHOWING FOAMY MACROPHAGES Feio PSQ1, Almeida LY1, Piña AR1, Azevedo RS2, de Almeida Key words: Odontogenic tumors; odontoma; gingival neo- 1 3 4 1 plasms. OP , Carlos R , León JE - PIRACICABA DENTAL SCHOOL, UNIVERSITY OF CAMPINAS - DEPARTMENT OF ORAL DIAGNOSIS, ORAL PATHOLOGY SECTION, ORAL SYPHILIS LESIONS: IMMUNOHISTOCHEMISTRY 2SCHOOL OF DENTISTRY, FLUMINENSE FEDERAL UNI- AS A USEFUL TOOL IN THE HISTOPATHOLOGICAL VERSITY - ORAL PATHOLOGY, 3CENTRO CLÍNICO DE DIAGNOSIS Lascane NAS1, Moura RM1, Martins MT1, CABEZA Y CUELLO/HOSPITAL HERRERA LLERANDI - Sousa SCOM1 - 1UNIVERSITY OF SÃO PAULO - DENTAL ORAL PATHOLOGY, 4DENTAL SCHOOL OF RIBEIRÃO SCHOOL - ORAL PATHOLOGY PRETO, UNIVERSITY OF SÃO PAULO - DEPARTMENT Background: Syphilis is an infectious disease caused by the OF STOMATOLOGY, ORAL PATHOLOGY bacteria Treponema pallidum and its diversity of oral clinical Objective: manifestations raise difficulties to determine a nosologic diagno- To determinate the frequency of foamy macro- sis. Classically, syphilis diagnosis is achieved by serological phages mimicked Mikulicz cells in periapical granulomas (PG). Study design: studies and treponemic tests. Histopathologic analysis, usually, A review of 386 PGs was performed in our identifies a dense band-like layer of mononuclear inflammatory institution. Results: infiltrate and plasmacytic perivascular infiltrate. Exocytosis and Forty-four (11.4%) PGs, showing patchy to conflu- granulomatous inflammation can be found as well. ent aggregates of pale foamy macrophages, were selected. Of Objective: Demonstrate the usefulness in diagnosing syph- them, 13 PGs (3.3%) showed areas containing mixed inflamma- ilis performing immunohistochemistry. tory infiltrate admixed with Mikulicz cells-like foamy macro- ϭ Study design: Immunohistochemistry with antitreponemal phages. Moreover, hemosiderin-laden macrophages (n 15), for- ϭ antibody was performed in 4 cases with histopathologic aspects eign-body giant cell reaction (n 7), dystrophic calcification ϭ ϭ ϭ inclined to suspect of syphilis. (n 4), hyaline rings (n 4), crystal-like deposition (n 2), and Results: Spirochetes were detected, exhibiting an epitheli- one case each presenting Touton-like giant cell, vacuolated otrophic pattern of distribution in most of them. plasma cells, odontogenic epithelium, giant cell lesion-like areas, Conclusion: Immunohistochemistry using anti-T. pallidum Rosai-Dorfman-like area, and actinomyces-like granules were specific antibodies showed to be useful in diagnosing syphilis also observed. Conclusion: when there was no clinical suspicion and histopathologic aspects In this series, a low frequency of Mikulicz raised this thought. cells-like foamy macrophages in PGs was found. Moreover, a careful microscopic examination of PGs containing foamy mac- rophages might reveal remarkable morphological features. PREVALENCE OF PRECANCEROUS LESIONS IN THE ORAL MUCOSA OF CHRONIC ALCOHOLICS: PILOT STUDY Michiles I O1, Pereira JV2, Domingues JEG2, NEUROFIBROMATOSIS TYPE 1 ASSOCIATED WITH Figueiredo M L1, Lima PRE1, Conde NCO2 - 1UNIVERSI- CENTRAL GIANT CELL LESION OF THE MAXILLA AND OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e67

MANDIBLE Tobouti PL1, Santos APC2, Pavanello KC1, occurrence of oral epithelial precursor lesions and malignant Rodenbeck CM2, Sedassari BT1, Lemos-Junior CA2, Daumas neoplasias was investigated. F1 - 1UNIVERSITY OF SÃO PAULO - ORAL PATHOLOGY, Results and conclusion: thirteen patients has presented ep- 2UNIVERSITY OF SÃO PAULO - STOMATOLOGY ithelial precursor lesions, 9 cases of leukoplakia, 2 of actinic Neurofibromatosis type 1 (NF1) is an autosomal dominant, cheilitis, 1 of erythroleukoplakia and 1 of proliferative verrucous multisystem disorder affecting approximately 1 in 3500 people, leukoplakia. These lesions were more frequent in women, be- caused by a spectrum of mutations affecting the Nf1 gene. tween 50 and 81 years, average of 62.5 years, being mostly Central giant cell lesion affects fewer than 7% of all benign smoker. Regarding malignant tumors, 33 cases were observed, 25 tumor of the jaws and can develop in patients with neurofibro- (76%) of squamous cell carcinoma, 2 (6%) of verrucous carci- matosis. It is benign but sometimes aggressive osteolytic prolif- noma, 2 (6%) of lymphoma, 1 (3%) of melanoma and 3 (9%) eration consisting of fibrous tissue with hemorrhage and hemo- other lesions. These lesions were more frequent in men, between siderin deposits, presence of osteoclast-like giant cells and 29 and 97 years, average of 78.2 years, mostly smoker and/or reactive bone formation is present. A 39 years old, female, NF1 alcoholic. patient, revealed, in both maxilla and mandible, a sessile nodule of 5 cm in length, it also demonstrated to be painful and bleeding A PRELIMIARY STUDY OF THE USEFULNESS OF WIDE- to the touch. In the panoramic radiography, an intra-osseous mass FIELD OPTICAL IMAGING SYSTEM ON OBJECTIVE DE- could be notice. The serum levels of calcium and phosphate, TECTION OF ACTINIC CHEILITIS Takahama Júnior A1, alkaline phosphatase and parathormone were within the normal Cosci A2, Kurachi C2, Faustino ISP3, Camisasca DR1, Fontes range. The diagnostic of the both lesion was consistent with KBFC1, Azevedo RS1 - 1UNIVERSIDADE FEDERAL FLU- Central giant cell lesion. MINENSE, NOVA FRIBURGO/RJ, BRASIL - ESTOMATO- LOGIA E PATOLOGIA ORAL, 2UNIVERSIDADE DE SÃO SURGICAL TREATMENT WITH PRECEDING SCLERO- PAULO, SÃO CARLOS/SP, BRASIL - INSTITUTO DE 3 THERAPY OF RECURRENT ORAL PYOGENIC GRANU- FÍSICA DE SÃO CARLOS, UNIVERSIDADE FEDERAL LOMA ASSOCIATED WITH PORT WINE STAIN Rozza FLUMINENSE, NOVA FRIBURGO/RJ, BRASIL - FAC- RE1, Andrade RM2, Miranda AM, Cunha KSG, Dias EP, ULDADE DE ODONTOLOGIA Goldemberg DC, Coutinho ACA3 - 1UNIVERSIDADE FED- Background: Tissue autofluorescence approach is becoming ERAL FLUMINENSE - DEPARTAMENTE DE PATOLOGIA, an attractive non-invasive diagnostic tool to identify morpholog- 2UNIVERSIDADE FEDERAL FLUMINENSE - DEPARTA- ical and biochemical changes related to malignant progression. MENTO DE PATOLOGIA, 3UNIVERSIDADE FEDERAL Objectives: This study described the use and the capabilities FLUMINENSE - DEPARTAMENTO DE CIRURGIA BUCO- of wide-field optical imaging system on actinic cheilitis (AC) MAXILO FACIAL diagnosis. Study design: A preliminary algorithm, based on KMean Pyogenic granulomas (PG) are inflammatory lesions which clustering and average on local entropy, was developed for image frequently occur in the oral cavity and can be rarely associated classification for the lips from 51 patients with clinical and with arteriovenous haemangiomas. This study proposes an alter- microscopic diagnosis of AC and 42 volunteers. Microscopic native treatment for the surgical removal of an oral PG ipsilateral diagnosis of AC included at least mild epithelial dysplasia. to a facial port-wine stain (FPVS), suggesting the pathogenesis of Results: In general, fluorescence visualization in AC was this phenomenon may be associated with an increased angiogenic heterogeneous and included high and low fluorescence regions activity. A 26-year-old black woman presented with a gingival whereas in volunteers were homogeneous along the full lip. In nodule localized between upper left canine and premolar with a addition, classification algorithm was able to separate diseased 3-month history. This lesion recurred for 5 times. Sclerotherapy and healthy lips according to the number of spots and heteroge- with ethanolamine oleate was performed weekly in 4 sessions neity (entropy). with noticeable ischemia and slight reduction of the lesion. Sur- Conclusions: This wide-field optical imaging system pro- gical resection was performed to achieve optimal results. Histo- vided an 83.7 sensibility, an 81.0% specificity and an 86.3% pathological diagnosis was PG. Treatment was successful and predictive true positive for objective AC detection. patient continues to be followed up without recurrence for four months. Sclerotherapy of the lesion facilitated the surgical pro- cedure without incurring in specimen damage for the histopatho- THYROGLOSSAL DUCT CYST: CASE REPORT Pinheiro 1 2 3 4 logical diagnosis. LMA , Cavalcante RB , Teixeira RC , Osterne RLV , Araujo PM1, Nogueira RLM5 - 1UFC, 2UNIFOR - SURGERY, 3UNI- FOR - STOMATOLOGY, 4UNIFOR, 5UFC - SURGERY EPIDEMIOLOGICAL SURVEY (2010-2011) OF ORAL EP- A 07 years old male complained of painless swelling in the ITHELIAL PRECURSOR LESIONS AND MALIGNANT face and difficult swallowing and phonation. On inspection there 1 1 NEOPLASIAS FO-UERJ/HUPE Povoa RCS , Antero SAF , was an extraoral swelling in the sublingual and submandibular 2 2 3 3 Costa RC , Ritto F , Maciel RM , Ramos MEB , Israel MS - region to the left. Intraoral examination revealed elevation and 1 2 UERJ - FACULDADE DE ODONTOLOGIA, UERJ - HOS- retropositioning of the tongue. The lesion was soft and mobile, PITAL UNIVERSITÁRIO PEDRO ERNESTO, 3UERJ - DE- measuring 10cm on palpation. CT scan was requested, seeking to PARTAMENTO DE DIAGNÓSTICO ORAL E CIRURGIA clarify the limits and content of the lesion, which also ruled out Objectives: to investigate the occurrence of these lesions in the involvement of adjacent bony structures and showed that it the Oral Medicine clinic of the University of dentistry of UERJ was a well-defined lesion. Surgery for excision of the lesion was and surgery clinic of the Hospital Pedro Ernesto/UERJ. performed by intraoral access, without resection of the body of Study design: during the period of 2010 and 2011 the the hyoid bone. The piece was entirely removed, while maintain- ORAL MEDICINE OOOO e68 Abstracts October 2012 ing the integrity of the dish, but with the emptying of cystic 1UNIVERSIDADE DE FORTALEZA, 2HOSPITAL GERAL content. Microscopic examination was compatible with thyro- DE FORTALEZA glossal duct cyst. The patient is being followed for two years The ameloblastic fibro-odontoma (AFO) is an uncommon without complaints or signs of recurrence. benign odontogenic tumor with epithelial and mesenchymal com- ponents. It occurs more often in the posterior region of the SIMULTANEOUS OCCURRENCE OF DENTAL ANOMA- mandible as a painless swelling and radiographs show a well- LIES IN PATIENT NOT SYNDROMIC Cabús RP1,2,3,4,5,6, defined radiolucent area containing various amounts of ra- Franco AVM - 1CENTRO UNIVERSITÁRIO CESMAC, 2AU- diopaque material of irregular size and form. The treatment REA VALÉRIA DE MELO FRANCO - FRANCO AVM, modality in most cases involves conservative surgery with enu- 3CAMILA BEDER RIBEIRO - RIBEIRO CB, 4AMANDA cleation. We report a voluminous AFO in a 03-year-old boy with LAÍSA DE OLIVEIRA LIMA - LIMA ALO, 5FERNANDA a right mandibular and facial swelling. The panoramic radiograph BRAGA PEIXOTO - PEIXOTO FB, 6SÔNIA FERREIRA - and CT scan revealed a multilocular radiolucent lesion (10 cm) FERREIRA S with an impacted tooth that involved the ramus area and the angle It is important that every dentist knows observe the teeth and of the right mandible. Histological examination reveals connec- their surrounding healthy oral structures, so that when they en- tive tissue resembling the dental papilla, with epithelial strands or counter abnormal clinical and radiographic findings can accu- islands, as well as denticles and amorphous masses of enamel and rately obtain the diagnosis, treatment plan, build and make the dentin. Enucleation and curettage was performed with a good proper follow-up. The human species has a constant number of outcome. There was no recurrence at six months. teeth in the arches, both in permanent and in deciduous, decid- uous elements 20 or 32 permanent elements. When there are BONE RECONSTRUCTION FOR TREATMENT OF EX- disturbances in dental development can occur dental anomalies, TENSIVE AMELOBLASTOMA IN A YOUNG PATIENT one being the number of anomalies: agenesis occurs when the Stramandinoli-Zanicotti RT1, Schussel JL2, Dissenha JL2, body of a missing tooth and supernumerary when it exceeds the Pedruzzi PAG3, Silva AD4, Oliveira BV3, Sassi LM2 - 1FAC- normal number of teeth. These changes may occur alone or ULDADE DE MEDICINA DA USP - DOUTORADO EM associated with syndromes diagnosis and early treatment are ONCOLOGIA, 2HOSPITAL ERASTO GAERTNER - DEPAR- crucial to minimize the aesthetic and functional problems of TAMENTO DE CIRURGIA BUCOMAXILO-FACIAL, 3HOS- adjacent teeth. The aim of this study report a clinical case PITAL ERASTO GAERTNER - SERVIÇO DE ONCOLOGIA diagnosed and treated for dental anomalies concurrent and den- 4 tigerous cyst. EM CABEÇA E PESCOÇO, HOSPITAL ERASTO GAERT- NER - SERVIÇO DE CIRURGIA PLÁSTICA IMMUNOPHENOTYPIC CHARACTERIZATION OF T The purpose of this study is relate a case of a 19 year-old CELLS IN ORAL CHRONIC GRAFT-VERSUS-HOST DIS- male who was referred to our department with an asymptomatic 1 1 facial deformity, with 3 years of evolution. Extra-oral examina- EASE PATIENTS Resende RG , Correia-Silva JF , Souza tion revealed uniform hard expansion on the right side of the FTA1, Vieira ELM2, Dutra WO3, Almeida HC4, Gomez RS1 - mandible with facial asymmetry. The intra-oral mucosa was 1UFMG - DEPARTAMENTO DE CLÍNICA, PATOLOGIA E intact, with deletion of the bottom of the mandibular vestibule. CIRURGIA ODONTOLÓGICAS, 2UFMG - BIOQUÍMICA E The panoramic radiographic showed a radiolucent multilocular IMUNOLOGIA - ICB, 3UFMG - MORFOLOGIA - ICB, 4 lesion, extending from the right condyle to the first molar, shift- UFMG - DEPARTAMENTO DE ODONTOLOGIA RES- ing the second and the third molar to the base of the mandible. TAURADORA Histological examination after biopsy revealed the presence of Objectives: To analyze the T cells immunophenotypic pro- ameloblastics cells compatible with follicular ameloblastoma. file in oral chronic graft-versus-host disease (cGVHD). The patient underwent surgery for hemimandibulectomy, with a ϩ ϩ Study design: CD4 and CD8 T cells from peripheral fibular autogenous graft and microsurgery. The final histological blood expressing co-stimulatory molecules and cytokines were analyze confirmed the diagnosis of ameloblastoma. The 3-year- evaluated in patients with oral cGVHD, in different culture postoperative showed intact mucosa and skin, favorable facial conditions and using flow cytometry. aesthetics, with bone graft integration without signs of local ϩ Results: CD4 lymphocytes in cGVHD patients on stimu- recurrence. lated conditions presented increased expression of CD69, TNF-␣ and IL-10. Decreased expression of CTLA-4 and FoxP3 in CD4ϩ SEB stimulated lymphocytes. Decreased IL-17 expression SURGICAL TREATMENT OF BISPHOSPHONATE RE- was found in stimulated CD4ϩ lymphocytes from cGVHD pa- LATED OSTEONECROSIS OF THE JAWS Lopes RN1, tients. Increased IFN-␥ expression was observed in stimulated Rocha AC1, Kato GF1, Prado JD1, Jaguar GC1, Alves FA1,2 CD4ϩ and CD8ϩ lymphocytes from patients. Higher levels of - 1HOSPITAL AC CAMARGO - STOMATOLOGY DEPART- FoxP3 expression in CD4ϩ T cells were seen in cGVHD patients MENT, 2UNIVERSITY OF SÃO PAULO - SCHOOL OF after stimulus. The same were found for TNF-␣ for anti-CD3 DENTISTRY anti-CD28 and CD69 in SEB conditions. Background/objective: The treatment of bisphosphonate Conclusions: Our findings show altered expression of cyto- related osteonecrosis of the jaws (BRONJ) has not been eluci- kines and regulatory molecules associated with a pro-inflamma- dated and some cases shown unsatisfactory results. Treatments tory immune response in patients with oral cGVHD. described vary from conservative to radical surgery. However, few studies showed the success of surgical treatment. The objec- AMELOBLASTIC FIBRO-ODONTOMA: CASE REPORT tive of this study was to evaluate the response of surgical treat- Bastos DB1, Cavalcante RB1, Maia RN2, Santos ES1,2 - ment in patients with BRONJ. OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e69

Study design: We analyzed retrospectively 33 patients with lesion with cryotherapy, however, in a recent preoperative exam 46 areas of BRONJ treated by surgery, between 2004 and 2010. it was observed a reduction of the lesion, therefore we are Results: Complete healing rate was 87% and partial im- following the lesion behavior through clinical and radiographic provement (symptom control and reduction of area of exposed examinations. bone) was 7%, resulting in 94% of clinical benefit. Among the remaining regions, 4% showed no significant changes and 2% ANALYSIS OF RHEUMATOID ARTHRITIS MARKERS AND worsened compared to preoperative aspect, these cases were DISEASE ACTIVITY IN PATIENTS WITH SJÖGREN’S SYN- located in the posterior mandible region. DROME SECONDARY TO RHEUMATOID ARTHRITIS Conclusions: Our data demonstrate that surgical treatment Andrade SC1, Carvalho CN2, Oliveira HFL2, Duarte ALBP3, of BRONJ is effective with high rate of complete healing; how- Carvalho AAT2, Leão JC2, Gueiros LAM2 - 1UNIVERSIDADE ever, the posterior mandible region presents worst response. FEDERAL DE PERNAMBUCO - PÓS-GRADUAÇÃO, 2UFPE - PROGRAMA DE PÓS-GRADUAÇÃO EM ODONTOLOGIA, CLINICOPATHOLOGICAL ASPECTS OF GREEN TEETH 3HC-UFPE - SERVIÇO DE REUMATOLOGIA FROM PATIENTS WITH NEONATAL HYPERBILIRUBINEMIA The aim of the present study was to evaluate the clinical 1 2 3 3 Silva RN , Alves FA , Antunes ANG , Giannini M , Goes significance of rheumatoid arthritis (RA) markers in patients 3 1 1 1 MF , Lopes MA , Santos-Silva AR - STATE UNIVERSITY diagnosed with secondary Sjögrens syndrome (sSS) to RA. The OF CAMPINAS/PIRACICABA DENTAL SCHOOL - ORAL study comprised one hundred and eighteen patients divided into DIAGNOSIS DEPARTMENT/SEMIOLOGY, 2CANCER three groups: rheumatoid arthritis (nϭ46), RA with sSS (nϭ20) HOSPITAL A.C. CAMARGO - DEPARTMENT OF STOMA- and healthy controls (nϭ52). Clinical and serological character- TOLOGY, 3STATE UNIVERSITY OF CAMPINAS/PIRACI- istics, as well as microscopic features were compared. Anti-CCP CABA DENTAL SCHOOL - RESTORATIVE DENTISTRY and RF were similarly distributed among RA and sSS patients DEPARTMENT (pϭ0.181 and pϭ0,235, respectively). Disease activity according Objectives/study design: To describe clinicopathological to DAS28 was not different between the groups (pϭ0.134). features of 08 patients who developed green teeth due to chronic Interestingly, sSS patients showed higher frequency of xerosto- liver diseases of the childhood and to further characterize mor- mia (pϽ0,001), xeroftalmia (pϽ0,001), lower values of sialom- phological aspects of enamel, dentin and pulp chamber of 13 etry (pϽ0,001) and Schirmer test (pϽ0,001) when compared to teeth obtained from such patients by using polarized light mi- RA patients. Labial salivary gland biopsy showed similar results croscopy (PLM) and by periapical radiograph. between both groups (pϭ0.173). Anti-CCP and RF are not ca- Results: Patients age ranged from 7 to 11 years old, 50% pable of distinguishing RA and sSS. Significantly, after isolating were male. Biliary duct atresia, biliary duct hipoplasia and fa- sSS patients, RA patients have sialometry and Schirmer test milial cholestasis were the main cause of hyperbilirubinemia. results similar to healthy controls. Variable intensity of green discoloration was macroscopically detected, predominantly affecting the root cervical thirds (92.3%) THE STATUS OF ORAL HEALTH IN ORAL CANCER Von and dental crown (61.5%). Radiographically, 61.5% of the spec- Zeidler SLV1, Soares MS2, Melo EA3, Oliveira ZFL4, Podestá imens presented enlarged pulp chamber, PLM depictured green JRV5, Gouvêa SA6 - 1UNIVERSIDADE FEDERAL DO ES- incremental lines affecting the dentin of 66.6% specimens but no PÍRITO SANTO - DEPARTAMENTO DE PATOLOGIA, evidence of morphological changes could be seen in enamel or 2UNIVERSIDADE FEDERAL DE GOIÁS - FACULDADE dentin. DE ODONTOLOGIA, 3UNIVERSIDADE FEDERAL DO ES- Conclusion: Apparently, the deposition bilirubin was not PÍRITO SANTO - FACULDADE DE ODONTOLOGIA, able to impair the structural features of enamel and dentin. 4CRANIOFACIAL RADIOLOGIA, 5HOSPITAL SANTA RITA DE CÁSSIA - AFEEC - CIRURGIA DE CABEÇA E SPONTANEOUS REGRETION OF CENTRAL GIANT PESCOÇO, 6UNIVERSIDADE FEDERAL DO ESPÍRITO 1 1 CELL GRANULOMA Vieira RR , Gonçalves MV , Soares SANTO - DEPARTAMENTO DE CIÊNCIAS FISIOLÓGICAS 1 1 2 1 GR , Bernabé DG , Crivelini MM , Miyahara GI , Biasoli Background/objective: Effect of oral health on oral and 1 1 ER - FACULDADE DE ODONTOLOGIA DE ARAÇA- oropharingeal (OOC) cancer has been suggested. The aim of this TUBA - UNESP - CENTRO DE ONCOLOGIA BUCAL, study was to evaluate the oral health of individuals with OOC. 2FACULDADE DE ODONTOLOGIA DE ARAÇATUBA - Study design: A descriptive analysis of the epidemiological UNESP - PATOLOGIA E PROPEDÊUTICA CLÍNICA profile of the population with OOC was realized using the indi- Central giant cell granuloma is an uncommon bone pathol- cators: DMFT (average number of decayed, missing and filled ogy, characterized by non-neoplasic proliferative process. A 12- teeth), CPI (Community Periodontal Index), PIP (Index of Inser- year-old boy was directed to treatment of a radiolucent lesion in tion Loss Periodontal), denture wearing experience and treatment the jaw with diagnosis of fibrous dysplasia. In the oroscopy, a necessity. Data were analyzed by the SPSS software using the x2 line of scarring fibrosis located in the mucosa of the vestibular test (p Ͻ 0,05). fornix in the mandibular anterior region was noted. A radiolucent Results: Were analysed 150 individuals, being 72.6% males and well-defined lesion in the region of periapex of mandibular and 48.6% Caucasian. The DMFT index showed an average of anterior teeth was observed in the panoramic radiographic exam. 24.8 among men and 28.9 among women and the tooth loss was An incisional biopsy was performed to confirm the diagnosis. the highest component. Presence of bleeding, calculus and prob- The histopathological analysis suggested a central giant cell ing depth greater than 4mm were observed in the most sextants granuloma. Blood biochemical exam showed normal levels of analyzed. calcium and phosphorus. Alkaline phosphatase level showed Conclusion: The poor oral health status could be associated altered. The initially proposed treatment was excision of the with oral cancer development. ORAL MEDICINE OOOO e70 Abstracts October 2012

FIBROSIS AFTER SURGICALLY ASSISTED RAPID MAX- UNIVERSITY OF MONTES CLAROS - STOMATOLOGY ILLARY EXPANSION MIMICKING AN INCISIVE CANAL CLINIC, 4STATE UNIVERSITY OF MONTES CLAROS; CYST: CASE REPORT Kaba SCP1, Horikawa FK2, Seo J3, UNIVERSITY OF ALFENAS - STOMATOLOGY CLINIC; Ruiz MM4, Lemos-Junior CA5, Martins MT3, Shinohara EH6 CENTER FOR REHABILITATION OF CRANIOFACIAL - 1UNIVERSIDADE DE SAO PAULO - HOSPITAL UNIVER- ANOMALIES SITARIO, 2HOSPITAL REGIONAL DE OSASCO - ORAL KBG syndrome (MIM #148550) is a rare syndrome charac- AND MAXILLO FACIAL SURGERY, 3FACULDADE DE terized by macrodontia of the upper central incisors, distinctive ODONTOLOGIA DA UNIVERSIDADE DE SAO PAULO - craniofacial findings, skeletal anomalies and neurological delay. ORAL PATHOLOGY, 4HOSPITAL DA AERONAUTICA - A 3-year old boy was referred for evaluation and dental treat- ORAL AND MAXILLO FACIAL SURGERY, 5FACULDADE ment. The medical history revealed that patient was born at DE ODONTOLOGIA DA UNIVERSIDADE DE SAO PAULO preterm and he has dysgenesis of the corpus callosum with - STOMATHOLOGY, 6HOSPITAL ISRAELITA ALBERT neuromotor delay and seizures. The karyotype was normal as EINSTEIN - ORAL AND MAXILLO FACIAL SURGERY well as others routine tests. The patient has brachycephaly, broad/ A 20 years old male patient was referred for evaluation of a round face, low-set ear, low hairline, and mild synophrys. More- radiolucent lesion in the maxilla that was visualized in a post op over, we noted polydactyly of the hands and cryptorchidism. radiography of a surgically assisted rapid maxillary expansion Radiographs revealed the presence of thoracic lumbar scoliosis. (SARME) done one year previously. He denied any health prob- Intraoral examination showed macrodont maxillary central inci- lems and pain or symptoms in the region. The physical exami- sors, with cleft in both incisors. These clinical features are nation was within normal parameters, with oral mucosa and teeth compatible with KBG syndrome. The diagnosis of KBG syn- in excellent conditions. Computed Tomography of the maxilla drome is exclusively based on clinical findings, as no genetic test showed a 4mm diameter radiolucent area adjacent to the apical is currently available. In the present case, the dental findings were portion of the central incisors. Based on the data obtained a critical to diagnosis of KBG syndrome. presumptive diagnosis of incisive canal cyst was made. During surgical exploration the content of the incisive canal was re- GORLIN-GOLTZ SYNDROME IN TWINS - A CASE 1 1 1 moved and sent to histological examination. The final diagnosis REPORT Borges AR , Marchionni AMT , Medrado AP , 1 1 1 was of fibrosis. The patient is under yearly follow up without Veiga PC , Reis SRA - ESCOLA BAHIANA DE MEDICINA signs of recurrence. E SAÚDE PÚBLICA - MESTRADO EM ESTOMATOLOGIA Gorlin-Goltz syndrome or nevoid basal cell carcinoma syn- METASTASIS TO THE ORAL CAVITY: A CASE REPORT drome is a rare hereditary autosomal-dominant disorder charac- Bologna SB1, Teshima THN2, Lascane NAS2, Rocha AC3, terized by multiple basal cell carcinomas in young patients, Nico MMS, Lourenço SV4 - 1MEDICAL SCHOOL - UNIVER- keratocystic odontogenic tumours, calcification of the falx cerebri SITY OF SÃO PAULO - DEPARTMENT OF DERMATOL- and skeletal malformations. This syndrome is associated to OGY, 2DENTAL SCHOOL - UNIVERSITY OF SÃO PAULO PTCH1 mutation (patched homolog 1 in Drosophila), a tumor - DEPARTMENT OF ORAL PATHOLOGY, 3HOSPITAL suppressor gene. We report a case of adolescents, twins with Gorlin- Goltz syndrome without affected first degree relatives. In DAS CLÍNICAS - MEDICAL SCHOOL, UNIVERSITY OF both patients, there is a presence of multiple keratocystic odon- SÃO PAULO - MAXILLOFACIAL CLINIC, 4DENTAL togenic tumours, histologically confirmed. None of them have SCHOOL - UNIVERSITY OF SÃO PAULO - DEPARTMENT basal cell carcinomas, but both show skeletal anomalies. Marsu- OF GENERAL PATHOLOGY pialization was performed for all lesions in patients and keeps on Oral cavity is not a common route for metastatic dissemina- monitoring for 1 year and then be removed. It is intended to tion; accounting for approximately 1% of all oral malignant report these cases with emphasis on the results of histological and neoplasms. The diagnosis of metastatic lesions to the oral cavity genetic mapping of the family. is usually challenging to clinicians and pathologists, due to their complexity and rarity. We present a report of 1 case of metastatic COMPARATIVE IMMUNOHISTOCHEMICAL STUDY OF neoplasms to the oral cavity, which were detected previously of SUBSTANCE P, NK-1R AND KI-67 IN AMELOBLASTO- the diagnosis of the primary tumor. A male, 80 years-old pre- sented an infiltrative mass in the left jaw for one year, with an MAS AND MALIGNANT ODONTOGENIC TUMORS Lourenço SQC1, Otero D1, Sousa TS2, Faria PAS2, Bravo acute bleeding of the lesion with no other local or systemic 3 4 3 1 symptoms associated. Histopathology and immunohistochemical RAM , Ruiz-Ávila I , Gonzáles-Moles MA - UNIVERSI- 2 profile of the biopsied oral lesion were consistent with hepato- DADE FEDERAL FLUMINENSE - PATOLOGIA, INSTI- 3 cellular carcinoma. Three months later, a hepatocellular carci- TUTO NACIONAL DE CÂNCER, UNIVERSITY OF 4 noma was confirmed as a primary tumor; iliac metastasis was GRANADA, UNIVERSITY OF GRANADA - CLINICAL also detected. Misdiagnosis of a metastatic lesion as a benign UNIVERSITY HOSPITAL OF GRANADA reactive lesion may delay diagnosis and treatment. Objectives: Compare proliferative activity according to Ki-67 immunostain in ameloblastomas and malignant odonto- genic tumors and determine whether substance P (SP) and NK-1 KBG SYNDROME: CASE REPORT AND LITERATURE receptor (NK-1R) are related to cell proliferation in these tumors. 1 2 2 REVIEW Aquino SN , Barros LM , Machado RA , Martelli Study design: Immunohistochemistry was used to evaluate 3 2 4 1 DRB , Swerts MS , Martelli-Júnior H - STATE UNIVER- protein expression in 32 ameloblastomas and 12 malignant odon- SITY OF CAMPINAS - DEPARTMENT OF ORAL DIAGNO- togenic tumors. Immunohistochemistry was performed with anti- SIS, 2UNIVERSITY OF ALFENAS - CENTER FOR REHA- SP, anti-NK-1R and anti-ki-67 antibodies and clinicopathological BILITATION OF CRANIOFACIAL ANOMALIES, 3STATE data of patients with odontogenic tumors were evaluated. OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e71

Results: We found significant association between a higher ECTRODACTYLY-ECTODERMAL DYSPLASIA-CLEFTING Ki-67 expression and malignant odontogenic tumors. Expression SYNDROME ASSOCIATED WITH AN EXUBERANT of SP and NK-1R was intense in nucleus and had correlated with ORAL WHITE SPONGE NEVUS: A CLINICAL-PATHO- higher expression of Ki-67 in malignant tumors. In cytoplasm, LOGICAL ANALYSIS OF TWO CASES Teshima THN1, the expression of both proteins was similar between two groups Bologna SB2, Lascane NAS1, Melo JN2, Nico MMS2, Lou- of tumors. renço SV3 - 1DENTAL SCHOOL - UNIVERSITY OF SÃO Conclusion: These findings suggest that lower expression of PAULO - ORAL PATHOLOGY, 2MEDICAL SCHOOL - UNI- Ki-67 in ameloblastomas indicates its slow growth. While higher VERSITY OF SÃO PAULO - DERMATOLOGY, 3DENTAL proliferative activity and NK-1R complex overexpression in ma- SCHOOL - UNIVERSITY OF SÃO PAULO - GENERAL lignant odontogenic tumors could be responsible to induce cell PATHOLOGY proliferation. The ectrodactyly-ectodermal dysplasia-clefting (EEC) syn- drome is a rare autosomal dominant characterized by the triad of ectrodactyly, ectodermal dysplasia, and facial clefting which can IMMUNOHISTOCHEMICAL EXPRESSION OF RANK, be related to lacrimal and urogenital tracts anomalies and con- RANKL, OPG, VEGF AND VWF IN DENTIGEROUS AND ductive hearing loss. Mutations in the DNA-binding domain of RADICULAR CYSTS Ferreira SJ1, Moraes M1, Matos FR1, the p63 gene have been considered as the molecular basis for Galvão HC1, Freitas RA1, Souza LB1, Costa ALL1 - 1UFRN EEC. We report two cases of EEC syndrome that exhibited - ODONTOLOGIA ectrodactyly and intraoral white plaques with papillomatous as- Background/objectives: The aim of this study was to com- pect from the buccal and labial mucosa to the lip vermilion as pare immunohistochemical expression of nuclear factor ␬appaB similar clinical findings. Besides syndactyly, macroglossia, ma- (RANK), RANK ligand (RANKL), and osteoprotegerin (OPG), crodontia, sparse hair, xerophthalmia and cleft palate were also vascular endothelial growth factor (VEGF) and angiogenic index observed. The histopathology of the incisional biopsies from both in radicular (RC) and dentigerous cysts (DC). patients showed hyperparakeratosis, exuberant acanthosis, hy- Study design: These proteins were evaluated in 20 RC and dropic degeneration, perinuclear eosinophilic condensations in DC by immunohistochemistry. Angiogenic index was deter- keratinocytes and normal underlying connective tissue, diagnos- mined by microvessel count (MVC) using anti-von Willebrand ing them as white sponge nevus. These lesions have also been factor antibody. linked to a genetic alteration and, although not defined yet, are Results: RANK and RANKL was higher in DC than RC in apparently associated to this syndrome. fibrous capsule. RC showed higher expression of VEGF in the epithelium and capsule. DC exhibited higher MVC (P Ͻ .05). Conclusion: Ours results suggest that RANK and RANKL DIAGNOSIS AND TREATMENT OF TEMPOROMAN- Nunes TB, Matteo play an important role in bone resorption in DC and the hemor- DIBULAR DISORDER: A CASE REPORT rhagic areas in the capsule of DC could be explained by increased RC Di, Luca CEP, Costa JES, Campana ACR, Witzel AL vessel’s number. The higher VEGF expression in RC might be Temporomandibular Disorder (TMD) refers to several dis- related to nature of these lesions, where the inflammatory process eases that involve the masticatory muscles and temporomandib- contributes significantly to these findings. ular joint. Female patient, 44 years, came to the Center of Oral Diagnosis, School of Dentistry, University of São Paulo (CDO- FOUSP) complaining of severe pain in the face and crooked bite. During the interview the patient reported that two years ago she PREVALENCE OF ORAL LESIONS ASSOCIATED WITH got headbutted and noticed swelling of his right cheek. Since then SEXUALLY TRANSMITTED INFECTIONS IN PATIENTS she underwent several dentists, but the therapeutic proposals as ATTENDING A SEXUAL HEALTH CENTRE IN CHILE multiple extractions and orthognathic surgery scared her. Clinical 1 1 1 1 Niklander S , Martinez R , Esguep A - UNIVERSIDAD examination and palpation of muscle and joint and examination ANDRÉS BELLO, CHILE - ORAL PATHOLOGY DEPART- of magnetic resonance imaging of the TMJ revealed bilateral MENT displaced disc without reduction, myalgia and arthralgia. The Objectives: Oral lesions associated to sexually transmitted patient was treated with occlusal stabilization appliance, the infections (STIs) are not normally investigated in patients con- mandible was repositioned and the pain disappeared. Correct sulting a Sexual Health Centre (SHC). This study was set up to diagnosis and treatment of TMD are essential to avoid iatrogenic investigate the prevalence of oral STIs in patients consulting a complications and restore quality of life for patients. SHC. Study design: 105 patients had their oral cavity examined after their normal medical assessment by a STIs medical special- IMUNOHISTOCHEMICAL STUDY OF AN ATYPICAL 1 ist. Variables such oral sex practice, were associated with the MALIGNANT ODONTOGENIC TUMOR Silva TS , 2 2 2 1 presence of oral lesion. The study was ethically approved. Camisasca DR , Otero D , Fonseca EC , Faria PAS , Dias 1 2 1 Results: 18% of the patients examined showed one or more FL , Lourenço SQC - NATIONAL CANCER INSTITUTE oral lesions associated with a STI. The most frequent infection (INCA), BRAZIL, 2FLUMINENSE FEDERAL UNIVERSITY was Candida Albicans followed by lesions associated to Epstein (UFF), BRAZIL Barr and Human Papilloma Virus. The practice of oral sex was The present case shows an unusual malignant odontogenic not directly associated with oral lesions. tumor. A 56-year-old Caucasian male reported a painful swelling Conclusion: This initial study showed the relevance of oral in the right side of his face, which was present for 5 years. He lesions in STI patients and the need to include oral examination also presented Gardner’s Syndrome. A radiolucent image with as a routine assessment in Sexual Health Centres. ill-defined borders was observed to invade maxillary sinus, nasal ORAL MEDICINE OOOO e72 Abstracts October 2012 cavity and palate. Microscopic analysis showed a solid tumor Financial support: FAPEMIG composed by nests, sheets or islands of odontogenic epithelium with ameloblastic differentiation demonstrating increased cellu- BONE NECROSIS RESULTING FROM THE USE OF larity and mitotic activity. The stroma was scant with some giant ZOMETA IN PATIENTS WITH BONE METASTASIS OF cells. The lesion recurred twice and the second recurrence in- PROSTATE CANCER Machado T1, Momesso GAC1, Fer- volved the base of skull. After one year the patient had died. reira LL1, Demathé A, Freitas SEN2, Miyahara GI2, Biasoli Cytokeratins, proliferation and resorption activity were assessed ER2 - 1FACULDADE DE ODONTOLOGIA DE ARAÇA- through immunohistochemistry. Substance P, NK-1R, p53, p63, TUBA-UNESP, 2FACULDADE DE ODONTOLOGIA DE Ki-67, CK14, CK18, RANK and RANKL were positive. The ARAÇATUBA-UNESP - CENTRO DE ONCOLOGIA BUCAL CK-7 and vimentin were negative. These markers can be useful - UNESP to classification and behavior of atypical malignant odontogenic Patient referred to the Oral Oncology Center- UNESP by tumors. oncologist for diagnosis of exposed bone in the right retro-molar region. At the medical history the patient was diagnosed with MULTIPLE LEUKOPLAKIAS AND SQUAMOUS CELL bone metastasis from primary prostate carcinoma and was under CARCINOMAS IN PATIENT NOT EXPOSED TO TOBAC- antineoplastic chemotherapy. Made use of Zometa for about a 1 1 CO: A CASE REPORT Nóbrega TG , Dillenburg CS , Mar- year to improve conditions of bone. The oroscopy presented an 1 1 1 1 tins MAT , Martins MD , Rados PV , Sant’Ana Filho M , area of exposed bone at the right retro-molar region, measuring Munerato MC1 - 1UNIVERSIDADE FEDERAL DO RIO approximately 3.0 ϫ 2.0 cm, surrounded by mucosa with a bluish GRANDE DO SUL - PATOLOGIA BUCAL red coloration and with two ulcers adjacent exposure on the Squamous cell carcinoma (SCC) in mouth affects mainly alveolar ridge measuring 0.1 ϫ 0.1 cm. He was being medicated men and tobacco is the principal etiologic factor. The genetic with gengilone and oncilon, but without getting a satisfactory condition is also identified as an etiological factor, but few cases response .Was requested to performing complementary tests for it is the main factor. A 54 years-old female patient, non-smoker diagnostic purposes and staging. The clinical aspect did not with family history of esophageal cancer showed white plaque present conclusive evidence for the diagnosis of bone metastasis, asymptomatic oral lesions. The clinical diagnosis was leukopla- being considered a definitive diagnosis of bisphosphonate osteo- kia and after incisional biopsy the histopathological diagnosis necrosis. Patient was submitted to hyperbaric oxygen therapy. was hyperplasia with chronic inflammation. Over 5 year the 1- AAOMS. American Association of Oral and Maxillofacial patient was evaluated periodically and lesion showed progression Surgeons Position Paper on Bisphosphonate – Related Osteone- to floor of the mouth and tongue belly. Right side lesion started crosis of the Jaws. J Oral Maxillo Fac Surg 2007; 65:369-376. present pain symptoms and new biopsy was performed showing 2- ADRAC. Bisphosphonates and osteonecrosis of the jaw. transformation to SCC. New white lesions appeared and some Aust Adv Drug React Bull 2005;24:3 became SCC. In skin, patient developed in this period two basal 3- Agrillo A, Petrucci MT, Tedaldi M, Mustazza MC, Ma- cell carcinoma. We discuss the importance of clinical monitoring rino SM, Gallucci C, Iannetti G. J Craniofac Surg. 2006; 17(6): of these patients that even without extrinsic risk factor to oral 1080-1083 cancer may have genetic predisposition to cancer development. 4- Anguita TC, Agurto JP, Roa IE, Laissle GC. Osteonecro- sis asociada al uso de bifosfonatos: A propósito de un caso METALLOTHIONEIN IS ASOCIATED TO METASTATIC clínico. Rev Méd Chile 2006; 134:1161-1165. BEHAVIOR IN ORAL SQUAMOUS CELL CARCINOMA Campos ACR1, Carvalho TA1, Muniz LB1, Rodrigues TS1, IMMUNOHISTOCHEMICAL EXPRESSION OF HYPOXIA Resende JVS1, Cardoso SV1 - 1UNIVERSIDADE FEDERAL MARKERS IN ORAL SQUAMOUS CELLS CARCINOMA 1 1 DE UBERLÂNDIA - FACULDADE DE ODONTOLOGIA/ OF THE TONGUE Silva-Filho TJ , Vasconcelos MG , Vas- 1 1 1 1 PATOLOGIA E DIAGNÓSTICO BUCAL concelos RG , Silveira EJD , Queiroz LMG - UFRN Objective: The aim of this work was to better understand the Background: The tumor hypoxia modulates a series of role of metallothionein (MT) in the development of oral squa- genetic changes related to adaptive development and metastasis mous cell carcinoma (OSCC). of various human cancers. Study design: Normal, hyperplastic, dysplastic, neoplastic Objective: analyze immunoexpression of HIF-1␣, GLUT-1 and metastatic epithelium of the oral mucosa were submitted to and CA-IX in 57 cases of tongue squamous cell carcinoma. immunohistochemistry (streptavidin-biotin-peroxidase tech- Study design: from each case 3 microns thickness sections nique) to detect MT expression. Reactivity was evaluated accord- were cut and mounted on glass salinized microscope slides and ing to subcellular compartmentalization, intensity and frequency were subjected to immunoperoxidase methods using antibodies: for each group. Results were compared with chi-square test. CA-IX, anti-HIF-1alpha and anti-GLUT-1. Results and conclusion: Reactivity for MT was observed in Results: It was observed that the intensity of expression of all samples. The prevailing pattern was concomitant nuclear and HIF-1␣ correlated with clinical staging (pϭ0.011) and histolog- cytoplasmic positivity, except for non-metastasizing carcinomas ical grading (pϭ0.002). The immunoexpression GLUT-1 showed where it was mainly restricted to the cytoplasm. Intensity of correlation with the clinical stage (pϭ0.002) and histological staining was constantly strong in all groups. Transition between grading (pϭ0.000). The immunoreactivity of CA-IX exhibited invasive carcinoma and non-invasive adjacent epithelium was correlation with histological grading (pϭ0.005). characterized by negative or mildly intense reactivity. Metasta- Conclusion: it can be concluded that there is a broad par- sizing primary tumors presented significantly more positive cells ticipation of these markers of hypoxia in oral carcinogenesis. than non-metastasizing ones. The results evidence association between MT expression and metastatic behavior in OSCC. INTERCALATED DUCT LESIONS OF SALIVARY GLAND: OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e73

CLINICOPATHOLOGICAL CHARACTERIZATION Mon- ically characterized by amelogenesis imperfecta, epilepsy and talli VAM1, Costa AF, Martinez EF2, Altemani A1 - 1UNI- progressive mental deterioration. The aim of this article is to VERSIDADE ESTADUAL DE CAMPINAS - FACULDADE describe an additional clinical case of this syndrome. DE CIÊNCIAS MÉDICAS - ANATOMIA PATOLÓGICA, Case report: A 9-year-old boy was referred for evaluation of 2INTITUTO E CENTRO DE PESQUISAS SÃO LEOPOLDO teeth pigmentation. With 8 years of age he presented generalized MANDIC - PATOLOGIA tonic-clonic seizure, treated with valproic acid. The boy also Background/objective: We aimed to characterize the clin- manifested mental deterioration and hyperactivity. On physical icopathologic features of intercalated duct lesions (IDLs) of examination he showed a symmetrical face with reduction in size salivary glands. of the lower third, slightly palpebral fissures, low ear and hair Study design: Seven patients with IDLs are presented. Non- implantation, coarse hair and hypertrichosis. The intraoral exam- encapsulated ductal proliferations were classified as hyperplastic ination displayed crowding teeth with generalized enamel de- IDL (HIDL) and those completely encapsulated as adenoma. fects, suggesting the clinical diagnosis of amelogenesis imper- Results: The patients ranged in age from 19 to 88 years. All fecta with a yellow-brownish coloration, a high incidence of IDLs were parotid lesions ranging from 1 to 9mm. In six cases (3 caries. HIDLs and 3 adenomas), the IDLs were unifocal lesions. In only Conclusions: It is important that dentists be able to recog- one case, the lesion (adenoma) was symptomatic leading to nize this syndrome for better management of the patients. surgical resection. In the remaining 6 cases, the parotid gland had been removed for other reasons and basal cell adenoma (BCA) AUTOFLUORESCENCE PATTERNS OF ORAL LESIONS: was the main disease in two of them. PRELIMINARY RESULTS Barcelos JS1, Azevedo RS1, Conclusion: Owing possibly to its small size, IDLs are Pereira LB1, Kurachi C2, Fontes KBFC1, Camisasca DR1, usually asymptomatic lesions. The association between IDLs and Takahama Júnior A1 - 1UNIVERSIDADE FEDERAL FLU- BCAS reinforces the hypothesis that IDLs could be precursor MINENSE - FACULDADE DE ODONTOLOGIA - PÓLO lesions of BCA. FAPESP grants: 2011/10366-7 and 11/51112-8. UNIVERSITÁRIO DE NOVA FRIBURGO, 2UNIVERSI- DADE DE SÃO PAULO - INSTITUTO DE FÍSICA DE SÃO DYSPLASIA AND MICROINVASIVE CARCINOMA IN A CARLOS BRAZILIAN ORAL MEDICINE SERVICE Valente VB1,2,3,4,5 Background: The autofluorescence is a non-invasive diag- - 1ARARAQUARA SCHOOL OF DENTISTRY - UNESP - nostic tool that has been used to facilitate the detection of DEPARTMENT OF DIAGNOSIS AND SURGERY, 2ELAINE premalignant or malignant changes of the oral mucosa. Different MARIA SGAVIOLI MASSUCATO - DIAGNOSIS AND SUR- patterns of fluorescence can be related to differences in biochem- GERY/ARARAQUARA SCHOOL OF DENTISTRY, 3MIRIAN ical composition of the tissue and malignant changes usually show loss of fluorescence. APARECIDA ONOFRE - DIAGNOSIS AND SURGERY/ARA- Objectives: The objective of this study is to determinate the RAQUARA SCHOOL OF DENTISTRY, 4CLEVERTON RO- patterns of autofluorescence of various types of oral lesions. BERTO DE ANDRADE - DIAGNOSIS AND SURGERY/ARA- 5 Study design: For this, all lesions indicated for surgical RAQUARA SCHOOL OF DENTISTRY, CLÁUDIA MARIA biopsy are visualized and photographed using a wild field device NAVARRO - DIAGNOSIS AND SURGERY/ARARAQUARA which emits blue light of 400 to 460 nm to excite green fluores- SCHOOL OF DENTISTRY cence in the oral tissues. The images were classified according to Objective: Clinicopathological evaluation of patients with the retention or emission of green fluorescence. dysplasia (D) and microinvasive oral carcinoma (MC). Results: Preliminary results indicate that most of lesions Study design: Retrospective study with files of patients with showed loss of fluorescence compared to normal tissue. D and MC attended at the Oral Medicine Service, Araraquara Conclusion: We can conclude that the loss of fluorescence is School of Dentistry (2009 to 2011). not specific for malignant changes. Results: Of 19 cases, 4 were MCs and 15 Ds, being the patients predominantly men (13), white (19) with an average age AMELOBLASTIC FIBRODENTINOMA: A RARE CASE IN of 55 years. The main anatomical sites were: lips (7), alveolar MAXILLA Gomes TG1, Silva RV2, Medeiros N2, Spyrides ridge (5) and buccal mucosa (4). It was observed exposure to KS2, Resende RFB2, Oliveira SP3, Alves ATNN2 - 1UNIVER- tobacco (9), alcohol (6) and solar radiation (7). Six patients had SIDADE GAMA FILHO - ODONTOLOGIA GRADUAÇÃO, a familiar history for cancer (breast, prostate, skin and mouth). 2 The main systemic diseases were hypertension (4), depression (3) UNIVERSIDADE GAMA FILHO - ODONTOLOGIA, 3 and diabetes (2). Leukoplakias (8), Actinic Cheilitis (4) and OCEX - ESTOMATOLOGIA Lichen Planus (3) were the most frequent clinical diagnosis. Ameloblastic fibrodentinoma (AFD) is a rare benign odon- Conclusion: It is emphasized, thus, the importance of early togenic tumor, is composed of proliferating odontogenic epithe- diagnoses of cancer avoiding mutilating treatments and poor lium in a cellular ectomesenchyme resembling dental papilla with quality of life. dentin or dentin-like formation. The present case report a 9-year- old male reported in dental school of Universidade Gama Filho. On extraoral examination we notice a painless swelling in right KOLSCHÜTTER SYNDROME – REPORT OF A NEW maxilla. Intraoral examination, an expansive swelling in buccal 1 2 CASE González-Arriagada WA , Carlos-Bregni R , Contre- vestibule was notice and teeth 26 were missing. The Orthopan- 2 1 1 1 ras E , Vargas PA , Lopes MA - FOP-UNICAMP - ES- tomograph revealed a radiolucency ill-defined and displaced of TOMATOPATOLOGIA, 2CENTRO CLÍNICO DE CABEZA Y unerupted permanents teeth. CT revealed a expansile lesion in CUELLO - CIUDAD DE GUATEMALA, GUATEMALA maxilla with diminute calcifications. Incisional biopsy was per- Introduction: Kolschütter Syndrome is a rare disorder clin- formed and submit for histopathological analysis. The epithelial ORAL MEDICINE OOOO e74 Abstracts October 2012 component of the tumour consists of anastomosing epithelial SÃO PAULO - DEPARTMENT OF STOMATOLOGY (ORAL strands and nest, resembles ameloblastoma. The stromal compo- PATHOLOGY), 3EVANDRO CHAGAS INSTITUTE - PAPIL- nent is an immature cell-rich myxoid tissue. Juxtaepithelial hy- LOMAVIRUS LABORATORY alinization was evident and amount of dentin or dentin-like Background/objective: The oral squamous cell carcinoma matrix also was seen. The proposed treatment consisted of enu- (OSCC) is the leading malignancy in the head and neck, with cleation and curettage. smoking as the major etiologic risk factor. The role of Human papillomavirus (HPV) in the etiology of this lesion is controver- A HIGH HIF-1〈 EXPRESSION GENOTYPES INCREASE sial, with some studies finding an important association. The RISK OF ORAL CANCER Sousa AA1, Fraga CAC2, Alves purpose of this study was to investigate HPV DNA types in this LR1, Bandeira GA3, Paula AMB1, Guimarães ALS - 1UNI- disease. Study design: The presence of HPV was investigated by MONTES - DEPARTMENT OF DENTISTRY, 2UNIMONTES polymerase chain reaction in 74 specimens of OSCC paraffin- - DEPARTMENT OF BIOLOGY, 3UNIMONTES - DEPART- embedded from a group of individuals diagnosed in amazon MENT OF MEDICINE population. Background: A single nucleotide polymorphism of C1772T Results: From 74 tissue samples of OSCC, only one (1.35%) ␣ and G1790A of HIF-1 was reported to modulate susceptibility was HPV 16 positive. The sample was from a lesion in the to cancer. oropharynx of a young female patient (Ͻ45 years) with no Objective: We investigated the role of these polymorphic smoking habit. variants in relation to the risk of oral cancer. Conclusions: The results obtained in our specific population Study design: Polymerase chain reaction-restriction frag- suggest that the HPV takes no part in the carcinogenesis of the ment length polymorphism (PCR-RFLP) analysis was used to OSCC. Future investigations will be needed to confirm our re- ␣ determine the HIF-1 polymorphisms in 42 patients with oral sults. squamous cell carcinoma (OSCC), 48 with oral leukoplakia (OL), as well as in 88 healthy control subjects. Results: TT and AA genotypes increased the risk of cancer. ORAL SQUAMOUS CELL CARCINOMA PROLIFERA- CT and GA genotypes were associated with OL risk, but not with TION AND INVASION UNDER LOW-LEVEL LASER IR- 1 epithelial dysplasia grading. We did not observe any difference in RADIATION: IN VITRO STUDY Henriques ACG , Pereira 1 1 2 1 2 allelic frequencies between HNSCC and tumor size, lymph node JS , Ginani F , Oliveira RM , Barboza CAG , Rocha HAO , 1 1 2 metastasis and survival. Freitas RA - UFRN - ODONTOLOGIA, UFRN - BIO- Conclusion: In conclusion, the presence of T and A alleles QUÍMICA might indicate a higher risk of leukoplakia progressing to cancer. Objectives: to evaluate the effect of low-level laser (LLL) on oral squamous cell carcinoma cell line (SCC25) proliferation and invasion. CENTRAL GIANT CELL GRANULOMA: REPORT OF Study design: Cultured cells were irradiated with an In- TWO CLINICAL CASES Delgado AM1, Brandão AAH1, 1 1 1 1 GaAIP diode laser, 660nm, 30mW using two energy densities Alves MGO , Marsi G , Almeida JD , Anbinder AL , Caval- 2 2 1 1 (0.5J/cm and 1.0J/cm ). Cell proliferation was assessed through cante ASR - UNESP - DEPARTAMENTO DE DIAGNÓS- Trypan Blue staining method and cyclin D1 expression by im- TICO E BIOCIÊNCIAS munofluorescence at 0, 24, 48, and 72 hours after irradiation. An Central giant cell granuloma (CGCG) is a benign prolifera- invasion assay was performed for 72 hours and the invasive cells tion of fibroblasts and multinucleated giant cells. It is usually were counted under light microscopy. seen in young adults. Mandible, anterior to the first molar, where Results: Proliferation curve demonstrated that SCC25 irra- the teeth have had deciduous predecessors, is the usual site. diated with 1.0J/cm2 had the highest proliferative rate when Clinical, histopathological and imaging features of two well compared to the control group (PϽ.05) and the group irradiated documented cases are presented. Case 1- A Caucasian boy, 10 with 0.5J/cm2 (PϽ.05) at the studied intervals. In addition, this years-old, came with his mother complaining of swelling on the same group expressed higher levels of cyclin D1 and significantly right side of mandible, asymptomatic, with about three years of higher potential for invasion (PϽ.001). evolution. Panoramic radiograph showed multilocular radiolu- Conclusion: Our results indicate that LLL has an important cent area. Case2–Ayoung Caucasian woman, 24 years-old, stimulatory effect on proliferation and invasion of oral SCC cells. attended the service, reporting that after the extraction of teeth 35 and 37, she noticed a swelling in the region, with a pain and MULTIPLE MYELOMA WITH EXTENSIVE MANDIBLE bleeding exophytic growth. Radiographic and tomographic im- ages of a radiolucent region, deepened toward to the mandible AND MAXILLARY INVOLVEMENT - A CASE REPORT base. Histopathological diagnosis was CGCG. Exams excluded Miranda AMMA, Pires FR, Almeida OP, Araújo AC, Baptista hyperparathyroidism in both cases. Surgery was the chosen treat- RL, Lucena SB, Queiroz C ment. Multiple myeloma is a malignant neoplasic proliferation of immunoglobulin-producing plasma cells, which can rarely pres- ent extensive gnathic involvement. A 58-year-old female, com- HUMAN PAPILLOMAVIRUS (HPV) FREQUENCY IN plaining of a painless “swelling beneath the prosthesis” lasting ORAL SQUAMOUS CELL CARCINOMA (OSCC) IN AM- one month was referred for oral evaluation. Medical history 1 1 1 AZON POPULATION Jesus AS , Abreu MC , Silva BTC , revealed arterial hypertension and type II diabetes. Oral exami- Pontes HAR1, Coracin FL2, Mello WA3, Silvestre RVD3 - nation revealed bilateral swelling in both sides of the maxilla and 1FEDERAL UNIVERSITY OF PARÁ - JOÃO DE BARROS mandible. Panoramic radiograph showed irregular hypodense BARRETO UNIVERSITY HOSPITAL, 2UNIVERSITY OF areas in a ”moth eaten” pattern diffusely, bilaterally in both OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e75 maxillary bones. CT scans showed hypodense areas also in the sinophilic cytoplasm, intercellular bridges, and uncommon pleo- skull. After medical evaluation the patient was submitted to an morphism. Amorphous material with Congo red positivity was incisional biopsy under local anesthesia in hospital. Histological also observed. Transmission electron microscopy showed that the examination showed a monotonous proliferation of pleomorphic neoplastic epithelial cells had few organelles and numerous se- plasma cells. Immunohistochemical analysis showed expression cretory granules with amyloid material, also presented in the of CD138, CD56, MUM-1 and VS38c, and monoclonality for extracellular matrix, between the collagen fibrils. In conclusion, Kappa chains. Final diagnosis was multiple myeloma. After the ultrastructural analysis confirmed the productive and secre- medical systemic evaluation, the patient was classified as stage tory nature of the tumor epithelial cells, characterized by the IIIA. She died 5 months after beginning of therapy. exuberant presence of cytoplasmic secretory granules.

INVESTIGATION OF LOSS OF HETEROZYGOSITY IN ANALYSIS OF MYOEPITHELIAL CELL MARKERS IN SAL- IVARY GLAND TUMOURS Almorabet H1, Torres-Rendon TUMOUR SUPRESSOR GENES IN PALISADED ENCAP- 1 1 1 SULATED NEUROMA Rodrigues LN1, Galvão CF1, Duarte A , Marques YM , Speight PM - UNIVERSITY OF SHEF- AP1, Gomes CC2, Gomez RS1 - 1UNIVERSIDADE FEDERAL FIELD - UNIT OF ORAL AND MAXILLOFACIAL PATHOL- DE MINAS GERAIS/ BRAZIL - DEPARTAMENTO DE OGY CIRURGIA E PATOLOGIA ORAL, 2UNIVERSIDADE FED- Objectives: To determine which antibodies are reliable ERAL DE MINAS GERAIS/ BRAZIL - DEPARTAMENTO DE markers of myoepithelial cells (MECs) in salivary tumours. Study design: We studied expression of S100, CK14, P63, PATOLOGIA SMA, calponin and CD109 in 7 pleomorphic adenomas (PA), 12 Background: The palisaded encapsulated neuroma is a be- polymorphous low grade adenocarcinomas (PLGA), 6 myoepi- nign reactive lesion with unknown etiology. theliomas (M), 3 myoepithelial carcinomas (MC) and 31 adenoid Aim: The aim of this study was evaluate LOH in microsat- cystic carcinomas (ACC). Percent positive cells were scored: ellite regions close to tumour suppressor genes in palisaded 0ϭNegative; 1ϭ1-25%; 2ϭ25-50%; 3ϭ50-75%; 4ϭ75-100%. encapsulated neuroma. Results: S100 and CK14 were expressed (score 4) in all Study design: Three samples were selected from the files. tumours except MC (2-3), but also stained ducts and acini. Normal and tumor areas were microdissected and DNA ex- CD109 and Calponin were only positive in PA (1). P63 was tracted. Nine markers located in the chromosomes 3p, 9p, 11p, positive in PA (4), ACC (3) and MC (2). SMA stained MEC in 11q, 17p were selected. PCR reactions were carried out for all tumours: PLGA (1), PA, M, MC (2), ACC (4). normal and tumour areas and after capillary electrophoresis LOH Conclusions: S100 and CK14 are expressed but not specific. was evaluated. SMA was a reliable marker and could distinguish PLGA from Results: LOH was observed in just one sample at ACC (Mann Whitney, pϽ0.05). P63 was good for distinguishing AFM238WF2 marker. PA from PLGA and ACC (pϽ0.05). Conclusion: The low frequency of LOH found in these samples suggest that LOH at these selected tumour suppressor genes areas are probably not a frequent event in the development CLEAR CYTOPLASMIC VACUOLATION CHANGE IN A 1 1 of this benign proliferative lesion. Support Fapemig and Prograd- LOWER LIP MUCOCELE Rumayor A , Almeida LY , Feio 1 1 2 1 UFMG. PSQ , de Andrade BAB , Soares UN , Almeida OP , León JE3 - 1PIRACICABA DENTAL SCHOOL, UNICAMP - DE- PARTMENT OF ORAL DIAGNOSIS, 2SCHOOL OF DEN- ULTRASTRUCTURAL FEATURES OF CALCIFYING EPI- TISTRY, UNIVERSITY OF RIBEIRÃO PRETO, UNAERP, THELIAL ODONTOGENIC (PINDBORG) TUMOR Gar- 3DENTAL SCHOOL, UNIVERSITY OF SÃO PAULO, USP - 1 1 2 3 cia AS , Bravo-Calderón DM , Gonçales ES , Damante JH , ORAL PATHOLOGY 4 5 1 1 Soares CT , Arana-Chavez VE , Oliveira DT - BAURU Oral mucocele is a common reactive lesion of the oral SCHOOL OF DENTISTRY, UNIVERSITY OF SÃO PAULO, mucosa. The typical microscopic appearance includes mucus BRAZIL - DEPARTMENT OF STOMATOLOGY - AREA OF extravasation surrounded by a wall of granulation tissue. Inter- 2 PATHOLOGY, BAURU SCHOOL OF DENTISTRY, UNI- estingly, unusual variants have been reported such as superficial VERSITY OF SÃO PAULO, BRAZIL - DEPARTMENT OF mucoceles, mucoceles with myxoglobulosis-like change, and STOMATOLOGY - AREA OF SURGERY, 3BAURU SCHOOL mucoceles with synovial metaplasia-like change. However, oral OF DENTISTRY, UNIVERSITY OF SÃO PAULO, BRAZIL - mucocele with a predominantly macrophage proliferation show- DEPARTMENT OF STOMATOLOGY, 4LAURO DE SOUZA ing clear vacuolated cytoplasm has not been reported. LIMA INSTITUTE OF DERMATOLOGICAL DISEASES, We herein report a 74-year-old man who presented an 5SCHOOL OF DENTISTRY, UNIVERSITY OF SÃO PAULO, asymptomatic translucent swelling on the lower labial mucosa, BRAZIL - DENTAL MATERIALS diagnosed as mucocele showing extensive clear cytoplasmic vac- Pindborg tumor is an epithelial odontogenic neoplasm, char- uolation change. acterized by the presence of eosinophilic epithelial cells and This unusual presentation, besides expand the microscopic amyloid material that become calcified. Ultrastructural analysis spectrum of the oral mucoceles, can potentially lead to diagnostic of a Pindborg tumor with exuberant granular cells is reported. A difficulties, particularly with either primary or metastatic clear 23-year-old man presented a progressive enlargement in the cell tumors of epithelial origin. In these cases, relevant clinical anterior mandible region over a period of seven years. Radio- information, histochemistry, and especially immunohistochemis- graphs revealed a radiolucent multilocular lesion causing root try, are helpful for arriving at an accurate diagnosis. displacement of the 31 and 41 teeth. Light microscopy revealed sheets of polyhedral epithelial cells with abundant granular, eo- SALIVA - A POSSIBLE METHOD FOR DIAGNOSIS OF ORAL MEDICINE OOOO e76 Abstracts October 2012

CYSTIC FIBROSIS? Gonçalves AC1, Mendonça RMH2,Ri- PROCEDURES? Bataglion CAN1,1, Komesu MC1, Foss-Frei- beiro JD3, Ribeiro AF3, Marson FAL4, Paschoal IA5, Levy tas MC2, Foss MC2, Motta ACF2 - 1FACULDADE DE OD- CE6 - 1UNICAMP - PATOLOGIA CLINICA/ SAÚDE DA ONTOLOGIA DE RIBEIRÃO PRETO/USP - MORFOLO- CRIANÇA E DO ADOLESCENTE, 2CENTRO INFANTIL GIA, ESTOMATOLOGIA E FISIOLOGIA, 2FACULDADE BOLDRINE - ODONTOLOGIA, 3UNICAMP - PEDIATRIA, DE MEDICINA DE RIBEIRÃO PRETO/USP - CLÍNICA 4UNICAMP - GENÉTICA/ SAÚDE DA CRIANÇA E DO MÉDICA/DIVISÃO DE ENDOCRINOLOGIA E METABO- ADOLESCENTE, 5UNICAMP - CLINICA MÉDICA, 6UNI- LOGIA CAMP - PATOLOGIA CLINICA Objective: This study evaluated the frequency of complica- Background: Patients with Cystic Fibrosis (CF) have a tions after invasive dental treatment in type 2 diabetic patients defect in ion transport through the membrane of the epithelial based on glycemic control, in order to suggest levels of fasting cells of various organs, including salivary glands. blood glucose (FBG) and glycated hemoglobin (HbA1c) consid- Objective: Compare level of chloride and sodium of saliva ered safe to avoid these complications. from CF patients and healthy individuals using a blood gas Study design: Type 2 diabetic patients and non-diabetic analyzer methodology and association with the genetic study of were divided in 3 groups: groupI–13type 2 diabetic patients CF patients. with adequate glycemic control (FBG Յ 140mg/dl e HbA1c Յ Study design: Cross sectional study of saliva samples of 84 7%); group II – 15 type 2 diabetic with inadequate glycemic CF patients and 84 healthy controls. Saliva was collected with control (FBG Ͼ 140mg/dl and HbA1c Ͼ 7%); and group III – 18 Salivet®. The amount of sodium and chloride was measured, in non-diabetics (FBG Ͻ 100mg/dl). Glycemic control was evalu- the saliva by ABL mod 835 Radiometer®. ated previously to dental procedure in all patients, and after 7 Results: Patients with CF presents increased levels of chlo- days, the frequency of outcomes was analyzed. ride (pϽ0,001) and sodium (pϽ0,001) compared to the control Results: Four patients (4/46; 8.6%) presented oral compli- group and there was no statistical difference and genetic muta- cation, and it was not association with the glycemic control. tions of CF. There was association between the outcomes and dental extrac- Conclusion: The levels of sodium and chloride in saliva of tions (P ϭ 0.02). patients with CF are increased, but we didn’t observed associa- Conclusion: Although oral complication has been associated tion between genetic mutations and salivary biochemical param- to dental extraction, it was not related to glycemic control of eters. diabetes.

THERAPEUTIC OPTIONS FOR ORAL LEUKOPLAKIAS 1 1 2 SYNCHRONOUS OSSIFYING FIBROMAS OF MAXILLA Messetti ACP , Humberto MAC, Rodrigues PC , Jorge R , 1 2 1 3 1 1 AND MANDIBLE Anbinder AL , Rocha AC , Alves MGO , Messetti LM , Bagordakis E - SCHOOL OF DENTISTRY, Prado RF1, Carvalho LFCS1, Pinto Júnior DS3, Almeida JD1 STATE UNIVERSITY OF CAMPINAS - DEPARTMENT OF - 1UNIV ESTADUAL PAULISTA -UNESP - SCHOOL OF ORAL DIAGNOSIS, 2CAMPINAS ASSOCIATION OF DEN- 3 DENTISTRY OF SÃO JOSÉ DOS CAMPOS/DEPARTMENT TAL SURGEONS - STOMATOLOGY, SCHOOL OF DEN- OF BIOSCIENCE AND ORAL DIAGNOSIS, 2UNIVERSITY TISTRY, STATE UNIVERSITY OF CAMPINAS - DEPART- OF SAO PAULO -USP - HOSPITAL DAS CLÍNICAS/ MED- MENT OF PUBLIC HEALTH DENTISTRY ICAL SCHOOL, 3UNIVERSITY OF SAO PAULO -USP - Background: Leukoplakia is a white lesion in the oral cavity SCHOOL OF DENTISTRY, SÃO PAULO/ DEPARTMENT with malignant potential. Its etiology is often related to smoking OF STOMATOLOGY and alcoholism. Although the diagnosis is based on clinical Occurrence of multiple synchronous Ossifying Fibromas aspects, histopathological features of the lesions are important to (OF) is rare in the jaws and to the best of our knowledge, only 12 treatment plan. Choosing the best treatment for leukoplakias is cases have been previously reported. A 28 year-old woman was difficult and it can be influenced by many factors, such as referred to our outpatient clinic because of a mandible lesion location and extension of the lesion, degree of epithelial dysplasia identified in a routine radiograph. Intraoral examination revealed and systemic condition of the patient, among others. a swelling in the left lower first molar region. The panoramic Aim: Compare different therapies for the treatment of oral radiograph showed a radiolucency involving the first and second leukoplakia. molars roots with internal opacities mimicking snowflakes. A Study design: We performed a review of literature (Pubmed, unilocular radiolucency was also seen between left upper premo- 2009-2011). lars, causing the displacement of teeth roots. Based on the hy- Results: Treatment options are surgery with a cold blade, pothesis of ameloblastic fibro-odontoma or calcifying cystic laser therapy, cryosurgery, electrocautery, photodynamic ther- odontogenic tumor, an incisional biopsy of the mandible lesion apy, chemical cauterization or administration of vitamin A. Fol- was performed. Fibro-osseous lesion compatible to OF was the low-up is extremely necessary, especially when smoking and microscopic diagnosis, confirmed after enucleation of both le- drinking are not quitted. sions. During the surgery, lesions showed delimitation and sep- Conclusion: Surgical treatment has been shown to be most aration from the surrounding bone. Patient has been monitored effective, although patients are not free of recurrence or second for one year, with no recurrence. lesions.

IMUNOEXPRESSION OF IL-17, TGF-␤1 AND FOXP3 IN ARE THERE LEVELS OF FASTING BLOOD GLUCOSE CHRONIC PERIAPICAL LESIONS Andrade ALDL1, AND GLYCATED HEMOGLOBIN PREDICTIVES TO Gordón-Núñez MA, Nonaka CFW2, Freitas RA1, Oliveira ORAL COMPLICATIONS AFTER INVASIVE DENTAL DHIP1, Galvão HC1 - 1UNIVERSIDADE FEDERAL DO RIO OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e77

GRANDE DO NORTE - PROGRAMA DE PÓS-GRADU- clear aetiology or pathogenesis. In this group of tumours, amelo- AÇÃO EM PATOLOGIA ORAL, 2UNIVERSIDADE ES- blastomas present a controversial B-catenin expression. TADUAL DA PARAÍBA Objective: To study the expression of B-catenin protein in Background/objectives: This study aimed to evaluate the solid ameloblastomas, unicystic ameloblastomas and dentigerous immunoexpressions of IL-17, TGF-␤1 and FoxP3 in periapical cysts. lesions correlating them with the type of lesion, intensity of the Study design: Immunolabeling of B-catenin in 8 biopsies of inflammatory infiltrate and thickness of the cystic epithelial lin- solid ameloblastomas, 8 unicystic ameloblastomas and 12 denti- ing. gerous cysts was done. Colon adenocarcinoma was used as Study design: 20 cases of periapical granulomas (GPs), 20 positive control. Mann-Whitney test was used for statistical anal- radicular cysts (RCs) and 10 residual radicular cysts (RRCs) were ysis. evaluated immunohistochemically and morphologically. Results: The median count of positive B-catenin cells was Results: Statistically significant differences were showed 221.5, 151.9 and 169.8 for 500 counted epithelial cells for solid between TGF-␤1 and FoxP3 immunoexpressions considering the and unicystic ameloblastoma, and dentigerous cysts respectively. type of lesion (pϭ0.002, pϽ0.001, respectively), as well as This difference was not statistically significant. between the analysis of lymphocytes FoxP3-positive with the Conclusion: ameloblastomas and dentigerous cysts pre- intensity of inflammatory infiltrate (pϭ0.003) and epithelial sented a similar expression of B-catenin. Project FIO-UChile thickness (pϭ0.009). It was observed in PGs, strong positive 09-11. correlation between FoxP3 and TGF-␤1 immunoexpressions (pϽ0.001), as well as moderate positive correlation between GRAFT VERSUS HOST DISEASE WITH ORAL MANIFES- IL-17 and TGF-␤1(rϭ0,503; pϭ0.024). TATION: REPORT OF TWO CASES Rados ARV1, Dillen- Conclusion: Th17 and Tregs cells seem to interact at the site burg CS1, Martins MAT1, Martins MD2, Carrard VC2, Rados of injury, suggesting the involvement of pro-inflammatory and 2 1 1 immunoregulatory cytokines in the pathogenesis of periapical PV , Munerato MC - FACULDADE DE ODONTOLOGIA/ lesions. HOSPITAL DE CLÍNICAS DE PORTO ALEGRE - ESTOMA- TOLOGIA, 2FACULDADE DE ODONTOLOGIA - DISCI- PLINA DE PATOLOGIA MALIGNANT BONE TUMOR SIMULATING CYSTIC LE- Graft versus host disease (GVHD) is a common complica- SION – CASE REPORT AND IMMUNOHISTOCHEMI- tion in bone marrow transplant (BMT) patients. It represents the CAL ANALYSIS Casaroto AR1, Sampieri MBS2, Soares CT3, outcome of donor’s T-lymphocytes reacting against recipient’s da Silva Santos PS2, Yaedú RYF2, Rubira-Bullen IRF2, Lara antigens. Case 1- A 28 year-old; male diagnosed with chronic VS1 - 1FACULDADE DE ODONTOLOGIA DE BAURU - DE- myeloid leukemia (CML) was submitted to BMT. After 30 days, PARTAMENTO DE ESTOMATOLOGIA (LABORATÓRIO DE patient exhibit white striae associated to erosive areas on oral PATOLOGIA BUCAL), 2FACULDADE DE ODONTOLOGIA mucosa. Biopsy was performed confirming diagnosis of GVHD. DE BAURU - DEPARTAMENTO DE ESTOMATOLOGIA, 3IN- Treatment consisted of corticosteroids. Patient died after 7 STITUTO LAURO DE SOUZA LIMA months. Case 2- A 40 years-old, female was diagnosed with A 16-year-old female presented mobility of the tooth 36. non-Hodgkin’s lymphoma (NHL) and submitted to allogeneic Radiographic imaging revealed osteolytic area and lingual corti- BMT and after two months first signs of GVHD started on skin. cal bone destruction. An empty cavity was surgically observed In oral mucosa was observed ulcerative erythematous lesion with with a suggestive diagnosis of Simple Bone Cyst. After thirty white striae on the dorsum of tongue. Histopathology revealed days, the patient presented a intraoral swelling with infection low grade dysplasia. GVHD was treated. Oral lesions in GVHD signs and symptoms. The cavity was surgically curetted with must be differentiated from other conditions (infectious or auto- hemorrhage and clinical diagnosis of Aneurysmal Bone Cyst. immune) occurring in the oral mucosa. The microscopic analysis showed tumor islands and strands constituted of small round cells with well-defined hyperchro- EXPRESSION OF SPLUNC 2A PROTEIN IN PATIENTS matic nuclei and poorly defined vacuolated cytoplasm character- UNDERGOING ALLOGENEIC HEMATOPOIETIC STEM izing primitive undifferentiated tumor cells. Areas of coagulative CELL TRANSPLANTATION: PRELIMINARY RESULTS necrosis and areas suggestive of tumor perivascular and in- Silva AA1, Ortega RM, Carvalho MA, Coletta RD, Correa traosseous invasion were observed. Immunohistochemical anal- MEP2, Bingle L3, Vargas PA - 1SCHOOL OF DENTISTRY ysis demonstrated diffuse and strong positivity for vimentin, OF PIRACICABA, CAMPINAS UNIVERSITY - FOP/UNI- S-100, neuron specific enolase (NSE) and CD99. The histopatho- CAMP - DEPARTMENT OF ORAL DIAGNOSIS, ORAL PA- logical and immunohistochemical features were consistent with 2 Ewing Sarcoma. The patient was submitted to a surgical resection THOLOGY SECTION, CAMPINAS UNIVERSITY - ORAL and chemotherapy. There is no sign of recurrent tumor at one MEDICINE AMBULATORY, BONE MARROW TRANS- 3 year postoperatively. PLANTATION UNIT, SCHOOL OF CLINICAL DEN- TISTRY, UNIVERSITY OF SHEFFIELD - DEPARTMENT OF ORAL PATHOLOGY IMMUNOLABELLING OF B-CATENIN IN SOLID Background/objective: The aim of this study was to ana- AMELOBLASTOMAS, UNICYSTICS AMELOBLASTOMAS lyze the expression of SPLUNC2A, the major PLUNC protein 1 1 AND DENTIGEROUS CYSTS Ortega A , Reyes MR ,Ca- family member secreted into saliva, in patients undergoing allo- nales CG1, Gallardo AN1, Rojas GA1, Escobar EL1 - 1UNI- geneic hematopoietic stem cell transplantation. VERSITY OF CHILE - PATHOLOGY Study design: Sixteen patients were selected for this study. Odontogenic tumours are generally benign lesions with un- Whole saliva samples were collected at 3 different time points. ORAL MEDICINE OOOO e78 Abstracts October 2012

The samples were analyzed by western blotting and densitome- CALCIFYING EPITHELIAL ODONTOGENIC TUMOR try. Clinical data was collected from medical records. AFFECTING MAXILLA AND MANDIBLE: REPORT OF A Results: SPLUNC2A was expressed in all patients and at all CASE Vasconcelos AC1, Martins MD2, Carrard VC2, time points; however, there were differences in the patterns of Sant’Ana Filho M2, Oliveira MG2, Hildebrand LC2, Martins expression. A significant reduction in SPLUNC2A level was MAT2 - 1UFRGS - PATOLOGIA, 2UFRGS - PATOLOGIA noted in those patients who had developed oral mucositis. BUCAL Conclusion: In this preliminary study SPLUNC2A was de- Objectives: Calcifying epithelial odontogenic tumor tected in all patient samples but a common side-effect of this (CEOT) is an extremely rare benign odontogenic lesion. It ac- treatment, oral mucositis, resulted in differential expression lev- counts to around 1% of all the odontogenic tumors and 96% of els. Further studies and additional samples will further verify our cases occurs as intraosseous primarily in the mandible. results and allow a better understanding of the role of Study design: A 33 years-old female patient was evaluated SPLUNC2A in maintaining oral health. and an asymptomatic swelling, no tender was noticed in the vestibular gingiva of right mandible. The radiographic examina- EXTENSIVE CUTANETOUS ENVOLVIMENT IN AN tion revealed a radiolucent lesion with a central radiopaque area. ATYPICAL PRESENTATION OF BEHÇET’S DISEASE Furthermore, another mixed lesion was observed in the premolar Barkokebas A1, Coelho J1, Silva IHM1, Fonseca D1, Gueiros region at right maxilla. The clinical diagnosis for both lesions LA1, Carvalho AT1, Leão JC1 - 1UNIVERSIDADE FEDERAL was ameloblastic fibrodontoma and central ossifying fibroma. DE PERNAMBUCO - DEPARTAMENTO DE CLÍNICA E Results: Excisional biopsies were performed in both lesions. ODONTOLOGIA PREVENTIVA The histopathological examination revealed sheets of polyhedral Behcet’s disease is a chronic, multisystem inflammatory epithelial cells. In addition, some epithelial cells presented clear disorder, characterized by relapsing oral and genital ulceration, cytoplasm, associated to hyaline material and areas of calcifica- ocular inflammation, erythema nodosum and folliculitis-like le- tion. sions of the skin, arthritis, and central nervous system involve- Conclusion: no evidence of recurrence was observed after ment. It is believed that both genetic and environmental factors one year of follow-up. contribute to the development of the disease. The aim of the present report was to detail the unusual features of a 38 year old male patient with a chief complaint of extensive erythematopapu- CLINICAL, RADIOLOGICAL AND HISTOPATHOLOGI- lar cutaneous lesions, oral ulcers and eyelash lesions clinically CAL FEATURES OF JUVENILE OSSIFYING FIBROMA: diagnosed a later confirmed with Behçet’s disease. Poor manage- CASE REPORT Franco AVM, Cabus RP, Peixoto F, Ferreira ment of the condition was obtained with the use prednisone, S, Ribeiro CB, Teixeira R, Murta G colchicine, and further etanercept was initiated. After 14 months, Juvenile ossifying fibroma is a benign lesion, recurrent, partial remission was noted, and despite of persistent oral ulcers affecting in its majority the maxillary bones. Clinically it is the patients reports no symptoms. He is currently being followed presented as an increased volume and facial asymmetry, also up with a partial but significant improvement in the clinical signs proptosis, nasal obstruction and occasional local pain. Histolog- and symptoms. ically it presents two variants the trabecular, characterized by fibrous stroma densely cellularized and psammomatoid structures SIALOBLASTOMA: REPORT OF A CASE WITH LONG- with calcified mass islands. Radiographically presents radiolu- TERM FOLLOW-UP Correia AL1, Kelner N2, Castro JFL1, cent areas alternating radiopaque areas. There are no clinical or Almeida OP3, Kowalski LP2, Perez DEC1 - 1UNIVERSI- radiological differences between the two variants. The case report DADE FEDERAL DE PERNAMBUCO - PROGRAMA DE is a male patient, 14 years, with a juvenile ossifying fibroma PÓS GRADUAÇÃO EM ODONTOLOGIA, 2HOSPITAL A. variant psammomatoid; involving the left maxilla. This paper aims to describe the clinical, radiographic and histopathologic C. CAMARGO - NÚCLEO DE CABEÇA E PESCOÇO, 3UNI- features of an ossifying fibroma juvenile house. CAMP - FACULDADE DE ODONTOLOGIA DE PIRACI- CABA Sialoblastoma is a very rare malignant salivary gland tumor HOXA1, HOXB7, KI67 AND ␣-SMA AS PROGNOSTIC that occurs congenitally or during the early infancy. This report MARKERS IN ORAL AND OROPHARINX SQUAMOUS describes the clinical and histopathological findings, the treat- CELL CARCINOMA Venegas BA1,2, González-Arriagada ment and follow-up of a case of sialoblastoma. An 11-month-old WA3, Coletta RD3, Almeida OP3, Vejar N4, Droguett D1, girl was referred to diagnosis of a swelling in the right parotid Kemmerling U5 - 1UNIVERSIDAD DE TALCA - ESTOMA- area, with approximately 6 months of evolution. Extraoral exam- 2 ination revealed a painless, deep polinodular tumor, which was TOLOGÍA, HOSPITAL CARLOS VAN BUREN, VAL- covered by non-adherent skin, with some protrusive areas and PARAÍSO-CHILE - UNIDAD DE CIRUGÍA MAXILOFA- 3 purplish color changes, measuring 6.0 cm of extension. Its sur- CIAL, UNIVERSITY OF CAMPINAS - SCHOOL OF 4 face was irregular, presented elastic consistency and appeared DENTISTRY, PIRACICABA, SAO PAULO-BRAZIL., UNI- fixed to the deep planes. A lymphoma or malignant mesenchymal VERSIDAD DE VALPARAISO - FACULTAD DE ODON- tumor were the main hypothesis of diagnosis. An incisional TOLOGÍA, 5UNIVERSIDAD DE CHILE - FACULTAD DE biopsy was performed, with histopathological diagnosis of sialo- MEDICINA blastoma. The patient was submitted to radiotherapy (1,600cGy) Background: TNM, differentiation degree and patient’s sta- and received 9 cycles of chemotherapy with adriamicin, vincris- tus are main factors involved in defining treatment for Oral tin, 5-FU and enduxan. There are no signs of tumor recurrence Squamous Cell Carcinoma (OSCC). Survival rates have re- after 30 years of treatment. mained below 50 % for decades. Most of diagnosis are concluded OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e79 in III or IV stage, which strongly diminishes patients survival ORAL HUMAN PAPILLOMAVIRUS IN HEALTHY INDI- opportunities and post treatment patient‘s life quality. VIDUALS - CONDYLOMA ACUMINATUM Vanderlei Objectives: To determine the expression of Hox A1, Hox BMS1, Omena ALCS1, Ferreira SMS1, Peixoto FB1, Franco B7, p53 and Ki67, as well as a specific isoform ␣ of smooth AVM1, Ribeiro CMB1 - 1CENTRO UNIVERSITÁRIO CES- muscle actin (␣-SMA), and its association with OSCC patient’s MAC survival. It is well documented that human papillomavirus (HPV) Study design: Retrospective analysis of 47 OSCC cases infection causes cervical cancer in women. However, HPV in- from Carlos van Buren Hospital, Chile. fection in men is also an important concern, for the disease Results: Preliminary results show a tendency to find asso- burden in men and the risk of transmission to women. A 46 year ciation between Ki67 and Hox proteins with survival rates. old male presented to the oral medicine clinic with a nontender, Conclusion: Ki67 and Hox proteins can be used as prog- 5x5x5mm exophytic, soft, pink, cauliflower-like nodular lesion nostic factors to improve results in OSCC patient’s diagnostic on the ventral tongue, of two year duration. The lesion was procedures and treatment. clinically diagnosed as condyloma acuminatum (CA). Histo- pathological results from biopsy showed parakeratinized hyper- plastic stratified squamous epithelium with blunted keratotic pap- EXPRESSION OF PCNA, P53 AND KI-67 IN DENTINO- illary projections. Koilocytes scattered in the spinous layer GENIC GHOST CELL TUMOR AND CALCIFYING CYS- 1 1 complemented the microscopic picture confirming the clinical TIC ODONTOGENIC TUMORS Pulino B , Esteves CMD , presumptive diagnosis of condyloma acuminatum. The patient 1 1 1 Siqueira CS , Sousa SCOM - UNIVERSIDADE DE SÃO was referred for screening for others STDs. Serology tests for PAULO - PATOLOGIA BUCAL syphilis, hepatitis B, and a test for antibody to human immuno- Background: Calcifying cystic odontogenic tumour deficiency virus were negatives. No other lesions, oral or genital (CCOT) is an uncommon benign odontogenic lesion that was first were observed. described in 1962. According to literature, the solid counterpart of CCOT, the dentinogenic ghost cell tumour (DGCT) is more PROSPECTIVE EVALUATION OF SALIVA IN ALLOGE- aggressive. NEIC-HEMATOPOIETIC STEM CELL TRANSPLANTION Objective: The aim of this study was to evaluate the prolif- (HSCT) RECIPIENTS Boer CC1, Correa MEP1, da Silva AA1, erative activity of DGCT comparing it to CCOT. Feio PSQ1, Aranha FPA1, de Souza CA1, Vigorito AC1 - Methods: Immunohistochemistry was performed using 1UNIVERSITY OF CAMPINAS - HEMATOLOGY AND PCNA, p53 and Ki-67 in three cases diagnosed as DGCT and ten BLOOD TRANSFUSION CENTER as CCOT simple unicystic pattern. Results: A strong positivity of PCNA in the basal layer of Objectives The allogeneic HSCT can affect the oral cavity the odontogenic epithelium. Immunostaining to p53 was weak in leading mucosal and salivary gland damage. The aim was to all cases with a few positive cells. Ki-67 expression was weak evaluate salivary condition in allogeneic HSCT patients. and mostly in the basal cells of odontogenic epithelium. Study design: The salivary condition was evaluated in allo- Conclusion: Our findings suggest that even though CCOT geneic HSCT patients. Oral health by the DMFT, Plaque and and DGCT present different clinical behavior, there were no Gingival indexes was prospectively monitored. Hyposalivation significant differences in the expression of the markers studied, was clinically determinate and quantified. probably due to their benign nature. Results: Among 33 patients evaluated, the median of DMFT, GI and PI indexes, before and after HSCT were similar, indicating regular dental condition with gingival inflammation USEFULNESS OF ORAL CYTOPATHOLOGY IN THE and plaque accumulation. Before transplant, salivary flow rate TREATMENT WITH LOW-LEVEL LASER THERAPY (LLLT) was normal in all 33 patients (0.5mL/min), 6 reported xerostomia FOR CHEMOTHERAPY INDUCED ORAL MUCOSITIS: and 26 (78.8%) had at least one clinical sign of hyposalivation. REPORT OF CASES Santos BM1, Picciani BLS1, Leite C1, At 8-10 days post-HSCT salivary flow rate was normal in 30 Silva-Júnior A1, Cunha KSG1, Dias EP1 - 1UNIVERSIDADE patients and one presented hyposalivation, 15 (48.4%) reported FEDERAL FLUMINENSE - PATOLOGIA xerostomia and 26 (83.9%) had clinical signs of hyposalivation. At 80-100 days, 18 evaluated patients presented normal salivary Introdution: Oral mucositis (OM) and viral infections are flow, however 7 had persisted with xerostomia, and 16 (88.8%) an important collateral effect of chemotherapy. had clinical signs of hyposalivation. Cases report: Two patients were hospitalized due to oral Conclusion: Clinical hyposalivation and xerostomia were complications of chemotherapy. Oral examination revealed observed, despite normal flow rate. Oral health status has not symptomatic ulcers and red patches on the tongue and the inferior changed significantly. labial mucosa. Scraps from the lesions of all patients were ob- tained using a cytobrush. The final diagnosis was HSV associated with candidiasis. LLLT was initiated for treatment of remaining MULTIPLE PAINFUL ORAL ULCERS AS EXCLUSIVE 1 oral lesions. After the first laser irradiation session, decreases in MANIFESTATION OF SECONDARY SYPHILIS Gallo CB , 2 1 1 pain were reported; however, a more significant improvement Rabelo GD , Siqueira CS, Sugaya NN , Alves FA - 1 was seen after four sessions. Oral cytopathology can be used to SCHOOL OF DENTISTRY OF UNIVERSITY OF SAO 2 diagnose HSV infection. The cases reported show the importance PAULO - STOMATOLOGY DEPARTMENT, SCHOOL OF of cytopathology in patients with OM due to its capacity to detect DENTISTRY OF UNIVERSITY OF SAO PAULO - ORAL secondary infections that may aggravate OM lesions. Moreover, PATHOLOGY DEPARTMENT it allows that LLLT is not performed in patients with HSV A 27-year-old Caucasian man was referred to the Stomatol- infection, which would lead to the worsening of the ulcerations. ogy Department complaining about painful oral lesions. Clinical ORAL MEDICINE OOOO e80 Abstracts October 2012 examination revealed multiple painful ulcers surrounded by ery- Conclusion: The correct diagnosis of pain is complex and thematous rolled border in tongue, palate, labial and buccal requires knowledge, accuracy and appropriate clinical ability. mucosa. The patient also presented submandibular lymphadenop- athy. The past medical history was noncontributory and there was AMPLIFICATION OF HOMEOBOX GENES IN ORAL none complaint/presence of skin lesions. The hypothesis of syph- SQUAMOUS CELL CARCINOMA Esteves CMD1, Xavier ilis, herpes, HIV and autoimmune disease were considered and FCA2, Nunes FD1 - 1UNIVERSITY OF SÃO PAULO, 2FED- serological tests for the infectious hypothesis were requested. The ERAL UNIVERSITY OF BAHIA results showed positivity to syphilis (CMIAϩ and RPRϩ 1/32) Background: and were negative for herpes and HIV. During the second ap- Homeobox genes are regulators of morpho- pointment, the patient revealed history of anal chancre in the genesis and cellular differentiation during embryo development. previous month, inferred as the primary syphilitic lesion. The It is well known that the production of multiple copies of a DNA patient was referred to the physician and treated with Benzathine sequence, or DNA amplification, plays a role in cancer cells. Objective: penicillin. Oral ulceration may be the exclusive manifestation of The aim of this study was analysed the amplifi- secondary syphilis, which must be included at the differential cation status of six Homeobox genes in oral squamous cell diagnosis of atypical ulcers even with painful symptoms. carcinoma (OSCC). Methods: This study evaluates the amplification status of HOXD10, HOXD11, HOXC13, IRX4, PROX1 and ZHX1 by A REACTIVE LYMPHOID HYPERPLASIA MIMICKING A qPCR. 1 2 NEOPLASIC LESION Gomes CBF , Nogueira AS , Léon Results: The all genes showed values below the cut-off, 3 1 1 JE , Almeida OP - PIRACICABA DENTAL SCHOOL, UNI- what is in accordance with their mRNA expression profile. How- 2 VERSITY OF CAMPINAS - ORAL DIAGNOSIS, BAURU ever, with HOXD10, HOXC13 and IRX4 values amplification DENTAL SCHOOL, UNIVERSITY OF SÃO PAULO - STO- was significantly increased in tumors when comparing to margin. MATOLOGY, 3RIBEIRÃO PRETO DENTAL SCHOOL, UNI- When associating gene amplification with clinical parameters a VERSITY OF SÃO PAULO - ORAL PATHOLOGY higher chance of death was seen in those patients with absence of A 35-year-old male had a history of treated lymphoma in the PROX1 and IRX4 amplification. left clavicle. Five years after, was observed a swelling in the right Conclusion: Our findings suggests that PROX1 and IRX4 amygdale associated with persistent cough and hoarseness. Com- amplification can be used as markers of clinical behavior of puted tomography (CT) showed a mass with uptake homoge- OSCC. neous’s contrast and imprecise limits in pharynx region. Addi- tionally, FDG PET-CT showed a marked uptake activity in the ORAL MANIFESTATIONS OF PEMPHIGUS VULGARIS - Waldeyer’s ring region. This exam is an established imaging A PRESENTATION OF EIGHT CASE REPORTS Silva modality that has been proved to bring beneficial in the manage- CAB1, Silva AD2, Meurer MI3, Modolo F3, Grando LJ3 - ment of aggressive neoplasm. Thus, based on clinical history and 1INSTITUTO E CENTRO DE PESQUISAS SÃO LEOPOLDO imaging exams, a metastatic lesion was suspected and an inci- MANDIC - PATOLOGIA BUCAL, 2UNIVERSIDADE FED- sional biopsy was performed. However, histopathological diag- ERAL DO RIO GRANDE DO SUL - PATOLOGIA BUCAL, nosis was a reactive lymphoid hyperplasia, confirmed for immu- 3 nohistochemical analysis. It is important emphasize that soft UNIVERSIDADE FEDERAL DE SANTA CATARINA - PA- tissues masses mimicking malignant lesions may represent reac- TOLOGIA BUCAL tive process. Additionally, the correlation of clinical medical Pemphigus Vulgaris is a chronic autoimmune mucocutane- history, imagenological, histopathological and immunohisto- ous disease, which oral lesions could be the first observed site, chemical exams are essential to achieve the precise diagnosis. despite skin and other membranes mucosa also could be affected. Clinically, the lesions are characterized by many painful blisters that rapidly rupture resulting in erosions and/or multiple ulcers in DIAGNOSIS AND MAPPING OF PAIN IN DENTAL oral mucosa and skin, which can be difficult to differentiate from EMERGENCIES Domaneschi C1, Domingos MCM, Lanfredi 1 1 1 1 1 other vesiculobullous or ulcerative disorders. Most patients can CB , Sampaio RM , Tortamano IP , Buscariolo IA - FAC- be misdiagnosed and improperly treated for a long time. It is ULDADE DE ODONTOLOGIA DA UNIVERSIDADE DE considered a serious chronic disease and the treatment represents SÃO PAULO - ESTOMATOLOGIA a real therapeutic challenge. We present 8 case reports of the The aim of this study was to identify, collect and map pemphigus vulgaris, which a thorough evaluation was made, pain-related urgencies. recording patient age and sex, the location and extent of the Study design: In 424 patients who were attended at the lesions, their signs, symptoms and treatment, placing an emphasis Emergency Center complaining of pain, were performed clinical in the difficult of the diagnosis and clinical management of these examination, specific questionnaire, VAS scale and facial dia- patients. gram to identify the areas affected by pain. Results: Only two hundred patients had a confirmed clinical diagnosis of pain, of these 42% reported no recurrent pain, and ASSESSMENT OF TP53 MUTATIONS IN BENIGN AND 42% had visited the dentist recently. In the anamnesis 61% MALIGNANT SALIVARY GLAND NEOPLASMS Gomes 1 2 2 2 3 2 reported moderate/ severe pain, the night being the period of CC , Diniz MG , Orsine LA , Silva TF , Conn BI , Pereira CM , 2 1 greatest intensity. The irreversible pulpitis was diagnosed in 31% Gomez RS - UNIVERSIDADE FEDERAL DE MINAS GERAIS, 2 and 28% pulp necrosis. The lower molars (42%) and upper (25%) BRAZIL - PATHOLOGY, UNIVERSIDADE FEDERAL DE MI- were the main triggers of pain. The pain was irradiated (68%) to NAS GERAIS, BRAZIL - ORAL SURGERY AND PATHOLOGY, other areas, such as antagonist quadrant and/or hemiface inter- 3ROYAL INFIRMARY OF EDINBURGH,SCOTLAND - PATHOL- fering the identification of the affected tooth. OGY OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e81

Objectives: We assessed whether TP53 mutations are rele- involved by the lesion exhibiting a floatation aspect. An exci- vant to salivary gland neoplasms (SGN) pathogenesis together sional biopsy was done and histopathology revealed a prolifera- with its impact on protein expression. tion of blood vessels associated to chronic inflammatory infiltrate Study design: 18 benign and 18 malignant SGN samples compatible to pyogenic granuloma. No evidence of recurrence were investigated. Two microsatellite markers at the TP53 ge- was observed after one year of follow-up. netic locus were selected to assess LOH. PCR of all coding TP53 exons was carried out and all products were direct sequenced. Results: The frequency of TP53 LOH was low. We found LOSS OF HETEROZYGOSITY (LOH) IN TUMOUR SUP- 1 two missense mutations in exon 7 (pleomorphic adenoma and PRESSOR GENES IN ORAL MYOFIBROMA Galvão CF , polymorphous low grade adenocarcinoma), another in exon 8 Gomes CC2, Barbosa NRA1, Duarte AP1, Souza PEA3,Go- (carcinoma ex pleomorphic adenoma) and a fourth missense in mez RS1 - 1UNIVERSIDADE FEDERAL DE MINAS GERAIS exon 10 (mucoepidermoid carcinoma). In addition, a nonsense - DEPARTMENT OF ORAL SURGERY AND PATHOLOGY, mutation was found in exon 8 of an adenoid cystic carcinoma. SCHOOL OF DENTISTRY, 2UNIVERSIDADE FEDERAL Several SNPs were detected. While most malignant samples DE MINAS GERAIS - DEPARTMENT OF PATHOLOGY- showed p53 immunopositivity, 37% of the benign samples ex- INSTITUTE OF BIOLOGICAL SCIENCES, 3PONTIFÍCIA hibited such positivity. UNIVERSIDADE CATÓLICA DE MINAS GERAIS - LABO- Conclusion: TP53 mutations are not a frequent event in RATORY OF ORAL BIOLOGY-SCHOOL OF DENTISTRY SGN and p53 immunopositivity might not reflect sequence mu- Background: Myofibroma is a benign spindle cell neoplasm tations in SGN. Support FAPEMIG, CNPq and CAPES. composed mainly of myofibroblasts that usually affects children and adults. Few studies have investigated the molecular patho- OSTEOCHONDROMA AND ITS RELATION TO THE LIM- genesis of oral myofibromas, relying almost exclusively on im- ITATION OF MOUTH OPENING: A CASE REPORT BASED munohistochemistry. LOH studies allow the identification of ON A COMPLETE DIAGNOSTIC INVESTIGATION Mussi genomic instability in different lesions, which may contribute to MCM1, Pigatti FM1, Pimenta-Souza D, Pinto Jr DS1 - the neoplastic growth. 1SCHOOL OF DENTISTRY - UNIVERSITY OF SÃO PAULO Objectives: The purpose of this study was to investigate - ORAL PATHOLOGY LOH samples of myofibroma. Osteochondroma is a benign cartilage-tipped protuberance Study design: We evaluated the LOH on 3p, 9p, 11p, 11q that affects the metaphysis of long bones, however is relatively and 17p chromosomes loci in four samples of myofibroma. rare in the facial skeleton. Unilateral enlargements of the man- Results and conclusion: All the samples showed LOH in at dibular condyle are uncommon and may result in reduced mouth least one locus. The most frequently genetic loci that exhibited opening and deviation toward the unaffected side. These lesions LOH were p53 (17p13, 62%), CHRNB1 (17p13, 55%) and are radiopaque with distinct borders and easily recognized on D3S1293 (3p24.3). Chromosomal regions 9p22-p21, 11q13.4 computed tomography and on plain radiography. This is a case and 11p15.5 did not show LOH. Our results suggest that LOH at report of 39 years-old man with mandibular dislocation in the left the 17p and 3p regions might be relevant to oral myofibroma condyle, crossbite to the contralateral side, changes in condylar pathogenesis. Supported by CAPES and FAPEMIG. morphology and limitation of mouth opening. The histological examination revealed hyaline cartilage and osteochondral transi- CARCINOMA EX-PLEOMORPHIC ADENOMA: A CASE tion area, associated to mature bone. Based on clinical examina- Arruda CFJ1, Assunção Jr JNR2, Lemos-Junior tion, histological study, computed tomography and radiograph REPORT CA2, Nunes FD1 - 1SCHOOL OF DENTISTRY OF SÃO analysis, the final diagnosis was osteochondroma. Condylec- 2 tomy, osteotomy of the tumor and fixation of residual condyle PAULO UNIVERSITY - ORAL PATHOLOGY, SCHOOL OF were performed. Recognition of osteochondroma clinical appear- DENTISTRY OF SÃO PAULO UNIVERSITY - STOMATOL- ances and its variants usually allows prospective diagnosis. OGY Pleomorphic adenoma is the most common benign tumor arising in salivary glands, sometimes it can undergo malignant EXACERBATED PYOGENIC GRANULOMA IN RENAL transformation becoming a carcinoma ex-pleomorphic adenoma. TRANSPLANT PATIENTS Dillenburg CS1, Dias LG1, A female patient, 83 years old, non-withe, came to the clinic Selbach BJ1, Martins MAT1, Sant’Ana Filho M2, Martins 2 1 1 showing a nodule in the transition between hard and soft palate, MD , Munerato MC - UNIVERSIDADE FEDERAL DO 1,5 cm in diameter and referring no pain. An incisional biopsy RIO GRANDE DO SUL - HOSPITAL DE CLÍNICAS DE was performed with a histopathological diagnosis of pleomorphic 2 PORTO ALEGRE - ESTOMATOLOGIA, UNIVERSIDADE adenoma with foci of atypia. Tumor was excised and the histo- FEDERAL DO RIO GRANDE DO SUL - PATOLOGIA logical examination showed a small portion with areas of typical A 48 years-old male patient with medical history of hyper- benign pleomorphic adenoma and among the neoplastic cells tension, renal transplant and ex-smoker was referred to Stoma- areas of malignant degeneration of the epithelial component. tology Department complaining of oral lesion. The clinical ex- These areas were characterized by cellular pleomorphism and amination revealed a vegetative nodule in the right maxillary abnormal mitotic activity. The final diagnosis was of carcinoma gingiva, sessile base, reddish, bleeding and painless on palpation, ex-pleomorphic adenoma. extending from tooth 13 to 17 which had grade III mobility and After six months of follow-up there was no sign of recur- fibrous consistency. The diagnostic hypotheses were pyogenic rence. granuloma, peripheral giant cell lesion and drug induced gingival hyperplasia. Panoramic radiographic exam showed large crest alveolar bone resorption on the right maxilla and teeth that are LIP SQUAMOUS CELL CARCINOMA MIMICKING ORAL MEDICINE OOOO e82 Abstracts October 2012

KERATOACANTHOMA Roberto1,2,3,4,5,6,7 - 1FOAR - OF PATHOLOGICAL ANATOMY, 3DR. FELIX BULNES UNESP - FISIOLOGIA E PATOLOGIA, 2MARIO FRAN- CLINICAL HOSPITAL - DEPARTMENT OF INFECTOL- CISCO REAL GABRIELLI - DIAGNÓSTICO E CIRURGIA, OGY, 4SCHOOL OF DENTRISTRY, UNIVERSITY OF 3ELAINE MARIA SGAVIOLI MASSUCATO - DIAGNÓS- CHILE - ASSOCIATE PROFESSOR IREPO TICO E CIRURGIA, 4MIRIAN APARECIDA ONOFRE - DI- Actinomyces species, a gram-positive anaerobic filamentous AGNÓSTICO E CIRURGIA, 5PAULO FERMINO DA bacteria, have been related to persistent periapical lesions pre- COSTA NETO - GRADUANDO (FOAR), 6VITOR AUGUSTO senting tissue destruction, osteolysis and tumor-like shape. Di- LEITE - RESIDENTE CIRURGIA, 7EWERSON RAPHAEL agnosis should be based mainly on clinical history and the WATANABE - RESIDENTE CIRURGIA identification of “sulfur granules” during macroscopic examina- Squamous cell carcinoma, the most common type of lip tion of the biopsied specimen. We present a 33-years-old female, cancer (95%), is initially asymptomatic and manifests as leuko- history of facial trauma during adolescence, who referred to our plakic or erythroplakic atrophic plaques, crusty indurated or department with a right maxillar swelling in relation to a persis- ulcerated lesion. Keratoacanthoma is a rapid growth, followed by tent oral sinus tract at tooth 1.2 endodontically treated, complain- slow, spontaneous involution over several months and the mature ing of effervescence-like sensation inside the maxillary bone and lesion is usually bud or dome-shaped and it is brownish or posterior nasal discharge. Images show an apical radiolucent slightly reddish. MIDV, a 63 year-old white female was referred circumscribed lesion and cortical involvement of the maxillary to the Department of Diagnosis and Surgery of FOAR-Unesp for sinus floor. Total enucleation of the lesion was performed and treatment of a lesion in the lower lip. She had a long history of then sent to histopathologic study, which reported “apical cyst exposure to solar radiation. This was a 1.5 cm diameter lesion of with presence of actinomyces”. A 4 weeks high-doses antibiotics rapid growth, being first noticed by the patient 60 days previ- protocol achieved remission of acute symptoms. Chronic evolu- ously. It was exophytic, containing a central keratin-filled crater. tion of the disease is currently controlled and treated by a long- The patient also referred spontaneous pain and discomfort. The term maintenance dose. clinical diagnosis was Keratoacanthoma, but incisional biopsy revealed squamous cell carcinoma. Treatment was surgical re- FASN INHIBITION AFFECTS THE PROLIFERATION section with safety margins. AND MIGRATION OF LYMPHATIC ENDOTHELIAL Financial support: Univ Estadual Paulista, Fundunesp CELLS IN THREE-DIMENSIONAL CULTURES Bastos DC1, (00472/12-DFP). Paupert J, Maillard C2, Seguin F1, Agostini M1, Nöel A2, Graner E1 - 1SCHOOL OF DENTISTRY OF PIRACICABA, UNIVERSITY OF CAMPINAS (UNICAMP) - DEPARTMENT OF ORAL DIAG- IMMUNOEXPRESSION OF GLUCOSE TRANSPORTERS 2 1 AND 3 IN LOWER LIP SQUAMOUS CELL CARCI- NOSIS, UNIVERSITY OF LIÈGE - GROUPE INTERDISCIPLIN- NOMA AND ITS RELATIONSHIP WITH CLINICOPATH- AIRE DE GÉNOPROTÉOMIQUE APPLIQUÉ-CANCER (GIGA- OLOGICAL PARAMETERS Carvalho CHP2,1, Demeda CF1, CANCER) Aquino ARL1,3, Nonaka CFW4, Souza LB1, Pereira Pinto L1 Background: FASN enzyme is essential for lipogenesis in - 1UFRN - ODONTOLOGIA, 2UFCG - UACB, 3UERN - tumor cells. Human malignancies, such as melanoma, exhibit elevated FASN levels. We have previously shown that FASN ODONTOLOGIA, 4UEPB - ODONTOLOGIA inhibition with orlistat reduces the number of mediastinal lymph Objective: This study evaluated, through immunohisto- node metastasis following the implantation of B16-F10 mouse chemistry, the expression of glucose transporters (GLUTs) 1 and melanoma cells in the peritoneal cavity of C57BL/6 mice. 3 in the lower lip squamous cell carcinoma (LLSCC). Objective: This work aimed to investigate the effects of Study design: The percentages of immunostained were eval- FASN inhibitors in lymphangiogenesis in three-dimensional cell uated in 20 cases of LLSCC with regional nodal metastasis and cultures. 20 LLSCC without metastasis. Study design: For the in vitro assay, HDLEC-hTERT cells Results: There was a moderate positive correlation between were seeded in a methylcellulose solution to form spheroids cytoplasmic/membranous and nuclear immunoexpressions of which were treated with orlistat or cerulenin. For the ex vivo GLUT 1 in invasion front and in the tumor center (p Ͻ0.001). For assay, the lymphatic duct of C57BL6 mice was removed and the GLUT 3, was also observed a moderate statistically significant explants cultivated under hypoxic conditions in the presence of positive correlation between cytoplasmic/membranous expres- orlistat or cerulenin. Images were acquired and analyzed with the sion in tumor invasion front and in tumor center (p Ͻ0.001). The aid of the ImageJ program. immunoreactivity for GLUT 1 was higher than GLUT 3 in Results: FASN inhibition with cerulenin or orlistat reduced invasion front (p Ͻ0.001) and tumor center (p Ͻ0.001). the proliferation and/or migration of lymphatic endothelial cells Conclusions: This study suggests that tumor hypoxia is a in ‘lymphatic ring assay’. Lymphatic cell branching in the spher- remarkable characteristic of the LLSCC and GLUT 1 may be oid in vitro assay with conditioned medium from both cerulenin- responsible for glucose uptake into the interior of the malignant and orlistat-treated B16-F10 cells was also reduced when com- cells. pared to the controls. Conclusion: These results suggest that FASN inhibitors APICAL MAXILLARY CYST ASSOCIATED WITH ACTI- affect the cell migration and/or proliferation in three-dimensional NOMYCES: CASE REPORT Sierra A, Segovia D1, Troncoso lymphatic cell cultures. P2, Bustos M3, Lobos N4, Valenzuela P1, Lisboa D - 1DR. FELIX BULNES CLINICAL HOSPITAL - DEPARTMENT LARGE SOLITARY FIBROUS TUMOR OF THE ORAL OF DENTISTRY AND MAXILLOFACIAL SURGERY, 2DR. CAVITY – REPORT OF A CASE Oliveira DHIP1, Nonaka FELIX BULNES CLINICAL HOSPITAL - DEPARTMENT CFW2, Germano AR3, Silva JSP3, Assis GM3, Queiroz LMG1 OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e83

- 1UNIVERSIDADE FEDERAL DO RIO GRANDE DO HOSPITAL A. C. CAMARGO, SÃO PAULO, BRAZIL - DE- NORTE - PROGRAMA DE PÓS-GRADUAÇÃO EM PATO- PARTMENT OF HEAD AND NECK SURGERY AND OTO- LOGIA ORAL, 2UNIVERSIDADE ESTADUAL DA PARAÍBA RHINOLARYNGOLOGY, 5SÃO PAULO STATE UNIVER- - ODONTOLOGIA, 3UNIVERSIDADE FEDERAL DO RIO SITY (UNESP), BAURU, BRAZIL - DEPARTMENT OF GRANDE DO NORTE - CIRURGIA E TRAUMATOLOGIA COMPUTING, SCHOOL OF SCIENCES BUCO-MAXILO-FACIAL Objectives: Evaluate the expression of the ␤2-adrenergic Solitary fibrous tumor (SFT) is an uncommon spindle-cell receptor (␤2-AR) in surgical margins of oral squamous cell neoplasm of uncertain histogenesis which most often occurs in carcinoma (OSCC). the pleura. SFT is a rare tumor of the head and neck region and, Study design: The immunohistochemical expression of to date, most lesions have been observed in the buccal mucosa, ␤2-AR in the surgical margins and in the invasive tumor front of nasal cavity, pharyngeal area, and tongue. This case refers to a 62 OSCC was statically analyzed relative to the clinicopathologic 44-year-old man which presented for evaluation of a painless variables using the Chi-square test. mass located in the left buccal mucosa. The mass measured 4.0 Results: ␤2-AR expression was observed in all surgical cm in diameter and had been noted by the patient 10 years earlier. margins. A comparative analysis revealed that in 29% of the Histopathologic analysis revealed a well circumscribed lesion invasive tumor front there was a decrease of the ␤2-AR expres- characterized by a patternless pattern of round- to spindle-shaped sion when compared to the surgical margin. The strong ␤2-AR cells in a collagenous background. Focally prominent staghorn expression in the surgical margins was significantly associated vessels could also be observed. Immunohistochemical analysis with simultaneous consumption of alcohol and tobacco disclosed positivity for CD34 (diffuse) and Bcl-2 (focal). There (pϭ0.046) and T stage (pϭ0.03). was no immunoreactivity to ␣-smooth muscle actin, desmin, or Conclusions: These results suggest that the ␤2-AR is con- S-100 protein. The definitive diagnosis was SFT. The patient stitutively expressed in oral epithelium and that its expression can continues to be under careful follow-up. be decrease in OSCC, reinforcing the warranty of further studies to elucidate the functions of this protein by malignant cells in oral ORAL CANCER SCREENING: A SUCCESSFUL EXPERIENCE cancer. Cavalcanti D1, Oliveira R2, Alves JC3, Alves ME3 - 1CEN- Financial support: FAPESP:2011/11630-0 and CNPq TRO DE ESPECIALIDADES ODONTOLÓGICAS DE SU- 142790/2011-7. ZANO - ESTOMATOLOGIA, 2SECRETARIA DA SAUDE DE SUZANO - SAUDE BUCAL, 3SECRETARIA MUNICIPAL PARACOCCIDIOIDOMYCOSIS IN WOMEN: A CASE DE SAÚDE DE SUZANO - COORDENAÇÃO DE SAÚDE 1 1 1 REPORT Capella DL , Tenuti JGB , Pensin LA , Durigon BUCAL A.S.1, Bortoluzzi MC1 - 1UNOESC Background/objective: Suzano is a city in the State of São Paracoccidioidomycosis (PCM) is the most important sys- Paulo, with a population of 304.414 inhabitants. In this city, the temic mycosis in Brazil. The mortality rate is the eighth most Screening for the Prevention and Early Detection of Oral cancer common cause of death among infectious diseases1,2. Epidemi- have been held since the year 2005, as part of the Annual ological studies indicate that PMC is about 11 to 30 times more Campaign Against Influenza in the Elderly. The main objective common in adult males despite equal frequencies of exposure to of these campaigns is to identify patients with oral cancer, and the this fungus by both genders3. Studies suggest that female hor- diagnosis and preservation of potentially malignant disorders of mones inhibit the transition of Paracoccidioides brasiliensis of the oral mucosa. mycelia or conidia to yeasts, thus making females less suscepti- Study design: Were presented details of these screenings in ble4,5. This report describes a rare case of PMC in a non- the period of 2005 to 2011 and comparing them on the index menopause female patient, 32 years old, with the blood tests examined and confirmed cases observed in the State of Sao within normal limits and HIV negative. Clinical examination Paulo. revealed multiple ulcerative lesions in hard palate and left gin- Results: In Suzano, 9247 patients were evaluated in 2010 (6 giva that ranged 2 cm in diameter and are presented for about 5 confirmed cases of oral cancer, 76 cases of potentially malignant months. There are no signs of important systemic damage. The disorders) and 9310 patients in 2011 (70 cases of potentially diagnosis was confirmed through incisional biopsy (H&E and malignant disorders). PAS). The patient is under treatment with fluconazole. Conclusion: We conclude that the oral cancer screenings are Bibliography important for prevention and early detection of oral cancer. 1. Coutinho ZF, Silva D, Lazera M, Petri V, Oliveira RM, Sabroza PC et al. Paracoccidioidomycosis mortality in Brazil (1980-1995). Cad Saude Publica. 2002.Sep-Oct;18(5):1441-54. BETA-2 ADRENERGIC RECEPTOR EXPRESSION IN 2. Meneses-García A, Mosqueda-Taylor A, Morales-de la SURGICAL MARGINS OF ORAL SQUAMOUS CELL Luz R, Rivera LM. Paracoccidioidomycosis: report of 2 cases CARCINOMA Bravo-Calderón DM1, Lauand GA1, 2 3 4 5 mimicking squamous cell carcinoma. Oral Surg Oral Med Oral Nonogaki S , Carvalho AL , Kowalski LP , Marana AN , Pathol Oral Radiol Endod. 2002 Nov;94(5):609-13 1 1 Oliveira DT - BAURU SCHOOL OF DENTISTRY, UNI- 3. Shankar J, Restrepo A, Clemons KV, Stevens DA. Hor- VERSITY OF SÃO PAULO, BAURU, BRAZIL - DEPART- mones and the resistance of women to paracoccidioidomycosis. MENT OF STOMATOLOGY, AREA OF PATHOLOGY, Clin Microbiol Rev. 2011 Apr;24(2):296-313. 2 ADOLFO LUTZ INSTITUTE, SÃO PAULO, BRAZIL - PA- 4. Aristizabal BH, Clemons KV, Cock AM, Restrepo A, THOLOGY DIVISION, 3FUNDAÇÃO PIO XII-CANCER Stevens DA. Experimental paracoccidioides brasiliensis infection HOSPITAL OF BARRETOS, BARRETOS, BRAZIL - DE- in mice: influence of the hormonal status of the host on tissue PARTMENT OF HEAD AND NECK SURGERY, 4CANCER responses. Med Mycol. 2002 Apr;40(2):169-78. ORAL MEDICINE OOOO e84 Abstracts October 2012

5. Aristizabal BH, Clemons KV, Stevens DA, Restrepo A. extending from the mandibular right second premolar to the Morphological transition of Paracoccidioides brasiliensis conidia coronoid process of a 25 years old man submitted to marsupial- to yeast cells: in vivo inhibition in females. Infect Immun. 1998 ization. After six months, CT scan revealed that the radiolucent Nov;66(11):5587-91. area in the coronoid process was isolated from the entire lesion and became larger. Complete excision was performed with re- moval of the coronoid process, second molar and cortical of the ROLE OF MISMATCH PROTEINS IN LOWER LIP ramus until the first molar. After 6 months a new circumscribed CARCINOGENESIS Sarmento DJS1, Godoy GP2, Miguel radiolucent lesion was removed from first molar region. The MCC1, Queiroz LMG1, Medeiros AMC1, Silveira EJD1 - 8-years follow-up revealed no sign of recurrence and rehabilita- 1UNIVERSIDADE FEDERAL DO RIO GRANDE DO 2 tion with dental implants was planned. This report emphasizes NORTE, UNIVERSIDADE ESTADUAL DA PARAÍBA the role of the correct management of recurrent lesions, as KOT. Background/objective: Investigate the immunoexpression We believe that the marsupialization was too small, leading to the of hMLH1 and hMSH2 proteins in lower lip squamous cell entrapment of part of the KOT in the coronoid region. carcinomas (SCC) and actinic cheilitis (AC). Study design: Sample: SCC – 40 cases; AC – 40 cases. For immunohistochemical analysis the data were evaluated quantita- PLEOMORPHIC ADENOMA OF ORAL MINOR SALI- tively. Comparative analysis of biomarker expression were per- VARY GLANDS: INVESTIGATION OF NEOPLASTIC PO- formed “t” student, one-way ANOVA tests. TENTIAL BASED ON CELLULAR PROLIFERATION, AP- Results: We observed that for both hMLH1 and hMSH2 OPTOSIS AND MUCOSECRETORY ACTIVITY Mendonça protein, the average of positive epithelial cells decreased as the EF1, Batista AC2, Morais MO3, Ferreira JCB3, Elias MRA4, lesion was graded at later stages (pϽ0.001): ACs without dys- Leles CR5 - 1UNIVERSIDADE FEDERAL DE GOIÁS - DE- plasia or with mild dysplasia - hMLH1 ϭ 721.23 Ϭ 88.116; PARTAMENTO DE CIÊNCIAS ESTOMATOLÓGICAS, hMHS2 ϭ 781.50 Ϭ 156.93; The ACs with moderate or severe 2UNIVERSIDADE FEDERAL DE GOIÁS - DEPARTA- dysplasia - hMLH1 ϭ 532,86 Ϭ 197,72; hMHS2 ϭ 611,14 Ϭ MENTO DE CIENCIAS ESTOMATOLÓGICAS, 3UNIVERSI- ϭ Ϭ 172,48; SSCs of the lower lip - hMLH1 255,03 199,47; DADE FEDERAL DE GOIÁS - CIENCIAS ESTOMA- ϭ Ϭ hMHS2 518,38 265,68. TOLÓGICAS, 4UNIVERSIDADE FEDERAL DE GOIÁS - Conclusion: Our data support the hypothesis that changes in CIÊNCIAS ESTOMATOLOGICAS, 5UNIVERSIDADE FED- immunoexpression of these proteins is related to the process of ERAL DE GOIÁS - DEPARTAMENTO DE REABILITAÇÃO carcinogenesis of the lower lip. ORAL Objective: to study the neoplastic potential of the pleomor- RARE ORAL MANIFESTATION OF NON-HODGKIN phic adenoma (PA) of minor oral salivary glands measured by LYMPHOMA Zen Filho EV1, Damante JH1, da Silva Santos mucosecretory activity (MUC1), apoptosis (Bcl-2, Bax, p53) and PS1, Soares CT2, Ikoma MRV3 - 1BAURU SCHOOL OF cellular proliferation (Ki-67). DENTISTRY - DEPARTMENT OF STOMATOLOGY, Study design: 31 cases of PA and 4 controls (C) from oral 2LAURO DE SOUZA LIMA INSTITUTE - DEPARTMENT minor salivary glands were analyzed by immunohistochemistry OF PATHOLOGY, 3AMARAL CARVALHO HOSPITAL - DE- to measure percent of marked cells. Non-parametric comparison PARTMEN OF ONCOLOGY and correlation tests were used for analysis. Non-Hodgkin Lymphoma comprises approximately 5% of Results: Ki-67 was lower than 2% for both PA and C. head and neck malignancies, and 3,5% of intraoral malignant Expression in PA were significantly lower (pϽ0.001) than Con- tumors. The mantle cell lymphoma is a variant of Non-Hodgkin trol for MUC1 (PAϭ13.1%; Cϭ82.4%), Bax (PAϭ22.7%; lymphoma that rarely involves intraoral sites. Only 10 cases Cϭ97.7%) and p53 (PAϭ0.3%; Cϭ79.9%). Association be- reported in the English literature. We present a case of a 76 years tween the cellular markers showed weak positive correlation only old man, with a diffuse swelling in the hard palate and firm between Bcl-2 and Bax (rϭ0.36; pϭ0.045). There was no dif- nodules in the floor of the mouth with 18 months of evolution. An ference in cellular expression with regards to clinical variables incisional biopsy of the palate and of the bone marrow showed a (pϾ0.05). lymphocytic infiltrate composed of small lymphocytes with a Conclusion: The neoplastic potential of PA is represented slightly irregular nucleus contour. The immunohistochemical by low cellular proliferation when compared to apoptosis and that exam showed CCND1ϩ, CD5ϩ, and CD43ϩ. The data were mucosecretory cellular activity has low significance in this neo- compatible with mantle cell lymphoma. The patient was treated plasm. with chemotherapy only and had total remission of the enlarge- ment of the hard palate and floor of the mouth. ORAL MANIFESTATIONS OF PATIENTS WITH THE SUSPECT OF SJÖGREN’S SYNDROME: A PRELIMINARY EXTENSIVE AND RECURRENT KERATOCYST ODON- STUDY Viana ECB1, Hayden JA1, Epifânio D2, Conde TOGENIC TUMOR: AN 8-YEAR FOLLOW-UP CASE NCO1, Passos LFS2, Camara J3, Liborio TN3 - 1FEDERAL REPORT Tolentino ES1, Zen Filho EV1, Ferreira Jr O1, UNIVERSITY OF AMAZONAS - SCHOOL OF DENTISTRY, Sant’Ana E1, Lara VS1, Rubira CMF2, Damante JH1 - 1FAC- 2FEDERAL UNIVERSITY OF AMAZONAS - REUMATO- ULDADE DE ODONTOLOGIA DE BAURU - UNIVERSI- LOGIC SERVICE OF ARAUJO LIMA AMBULATORY, DADE DE SÃO PAULO, 2UNIVERSIDADE FEDERAL FLU- 3FEDERAL UNIVERSITY OF AMAZONAS - PATHOLOGY MINENSE AND LEGAL MEDICINE The aim of this work is to report an 8-year follow-up case of Objective: This study aimed to evaluate oral manifestations an extensive and recurrent keratocyst odontogenic tumor (KOT) of patients with suspect of Sjögren’s Syndrome (SS). OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e85

Study design: It was a prospective study of patients over 18 clinical diagnosis of epidermoid cyst the excisional biopsy was years old treated in a Reference Center for Reumatologic Dis- carried out. Microscopically, it was characterized as a cyst lined eases in Amazonas from august 2011 to march 2012. Patients by 6 cell layers, with columnar basal cells and corrugated para- were analyzed based on the American- European Consensus keratinized surface. Immunohistochemical reactions for bcl-2, Group criteria and submitted to Schirmer, salivary flow test and mTOR, K17 and K19 were performed. minor salivary gland biopsy. Results: All cases were strongly positive for these antibod- Results: Most patients (70.4%) had an autoimmune disease, ies. in which 94.7% of them reported oral symptoms, specially dry Conclusions: The keratocyst of the buccal mucosa is mor- lips (21,7%), erythematous (20%) and swollen gums (18,3%). phologically and shows an immunoprofile similar to intraosseous The female was prevalent (92.6%) with a mean age of 47.1 years. KOT. Most patients (92.6%) reported xerostomia, 51.9% xerophthalmia and 33.33% swallowing difficulty. Autoantibodies were detected CLINICAL AND EPIDEMIOLOGICAL FEATURES OF in 7,4% of patients, 29.6% had hyposalivation and 37% xeroph- 1 thalmia. Histopathology of salivary gland (18,5%) showed a ORAL AND OROPHARYNGEAL CANCER Zeidler SV , 2 3 4 focal chronic sialadenitis. Melo EA , Oliveira ZFL , Podestá JRV , Soares AG, Gouvea 5 1 Conclusion: Oral manifestations were probably prevalent in SA - UNIVERSIDADE FEDERAL DO ESPÍRITO SANTO - secondary SS. PHD ORAL PATHOLOGY, DEPARTAMENTO DE PATO- LOGIA, CENTRO DE CIÊNCIAS DA SAÚDE, 2UNIVERSI- 3 EXTENSIVE TERATOID CYST IN THE FLOOR OF THE DADE FEDERAL DO ESPÍRITO SANTO, AEV, VITÓRIA/ MOUTH: A CASE REPORT de Araújo Lima EN1, Novaes ES. - MS RADIOLOGY, RADIOLOGIA CRANIOFACIAL, 4 MM1, Nonaka CFW2, Germano AR1, Pereira Pinto L1, Souza HOSPITAL SANTA RITA DE CÁSSIA - AFEEC - MD HEAD LB1 - 1UNIVERSIDADE FEDERAL DO RIO GRANDE DO AND NECK SURGERY, PROGRAMA DE PREVENÇÃO E NORTE - DEPARTAMENTO DE ODONTOLOGIA, 2UNI- DETECÇÃO PRECOCE DO CÂNCER BUCAL, SETOR DE 5 VERSIDADE ESTADUAL DA PARAIBA - DEPARTA- CIRURGIA DE CABEÇA E PESCOÇO, UNIVERSIDADE MENTO DE ODONTOLOGIA FEDERAL DO ESPÍRITO SANTO - PHD PHYSIOLOGICAL Dermoid cysts are malformations rarely observed in the oral SCIENCES, DEPARTAMENTO DE CIÊNCIAS FISIOLÓGI- cavity. Histologically, they can be further classified as epider- CAS, CENTRO DE CIÊNCIAS DA SAÚDE moid, dermoid or teratoid. Oral teratoid cyst is unusual and has Background/objective: The incidence of oral and oropha- the highest incidence in children. The aim of this study is to ryngeal cancer (OOC) remains high. The aim of this study was to report a case of extensive teratoid cyst in a 5-year-old patient, evaluate the clinical and epidemiological profile and risk factors with emphasis on surgical technique and histopathological anal- of individuals with OOC. ysis. Intraoral examination showed asymptomatic volume of Study design: Epidemiological study of cross-section be- about 3 cm with floating consistency. Magnetic resonance imag- tween 2006-2010, in which 192 individuals were analyzed ac- ing suggested the diagnosis of dermoid cyst and the lesion was cording to age, gender, ethnicity, symptoms and evolution, habits surgically excised. Microscopic examination revealed a dermoid (tobacco and alcohol), stage and primary site. Data were analyzed 2 cyst associated with oral heterotopic gastrointestinal cyst (tera- by the SPSS software using the x test (p Ͻ 0,05). toid cyst). After 2 months of follow-up, the lesion had not Results: The analyzed population presented average of 58.6 recurred. This report shows the possible occurrence of rare le- years-old, being 75% males. Squamous cell carcinoma repre- sions in the oral cavity, requiring close attention by dentists to sented 93.7% of the cases, being 67,8% in the oral cavity. The establish the correct diagnosis and appropriate treatment. clinical evaluation showed 73.3% of advanced disease and the diagnosis has taken 9.5 months. Alcoholism and smoking were KERATOCYST OF THE BUCCAL MUCOSA: REPORT OF reported, respectively, in 74.5% and 85.6% of the cases. CASE AND COMPARATIVE STUDY WITH INTRAOSSE- Conclusions: Delay in diagnosis, predominance of advanced disease and significant correlation with the risk factors, smoking OUS KERATOCYSTIC ODONTOGENIC TUMOR Kami- and drinking, were noticed. nagakura E1, Carvalho R, Almeida JD1, Carvalho RY1, Soares FA2, Rocha R2, Kowalski LP3 - 1SÃO JOSÉ DOS CAMPOS DENTAL SCHOOL, UNESP - DEPARTMENT OF ACTINIC CHEILITIS: CLINICAL ANALYSIS IN 182 BIOSCIENCES AND ORAL DIAGNOSIS, 2AC CAMARGO CASES Guidetti E1, Saraiva CC2, Cesar JN1, Turatti E1 - HOSPITAL - DEPARTAMENT OF ANATOMIC PATHOL- 1UNIVERSIDADE DE FORTALEZA - UNIFOR - CURSO DE OGY, 3AC CAMARGO HOSPITAL - DEPARTAMENT OF ODONTOLOGIA, 2CURSO DE ODONTOLOGIA - UNIVER- HEAD AND NECK SURGERY AND OTORHINOLARYN- SIDADE DE FORTALEZA GOLOGY Actinic cheilitis (AC) is a precancerous lesion affecting Objectives: to describe a new case of keratocyst of the mainly the lower lip caused by chronic and prolonged exposure buccal mucosa and compare its immunohistochemical features to to direct sunlight with the potential to progress to squamous cell 12 intraosseous Keratocystic Odontogenic Tumor (KOT). carcinoma (SCC). The purpose of this retrospective study was to Case report and study design: A male complained about an determine the clinical presentation of 182 cases of actinic chei- enlargement on the left buccal mucosa was referred to Stomatol- litis in a very sunlight region from 6841 cases accessioned from ogy Clinic of São José dos Campos Dental School. Clinical August 1999 to March 2012. For each case, the clinical informa- examination revealed a solitary submucosal nodule, tender on tion supplied by the submitting practitioner were evaluated. The palpation, posterior to parotid papilla. The ultrasonographic exam mean age at the time of diagnosis was 55 years. Men were showed a hypoechoic, unilocular well delimited lesion. Under affected far more frequently than women (81,4% vs 17,5%). The ORAL MEDICINE OOOO e86 Abstracts October 2012 patients were white (61,7%) and dark-skinned (26,3%) people. accurate procedures for the assessment of patients with oral The lesions was in all cases on the lower lip. The clinical carcinomas. The aim of our study was to examine the clinical and diagnosis was actinic cheilitis (76,5%), leukoplakia (9,3%) and cytological features of oral carcinoma cases which were cyto- squamous cell carcinoma (6,0%). These findings reflects clinical pathologically diagnosed by fine needle aspiration and brushing. features of actinic cheilitis and suggests that practitioners were Study design: The study included 22 oral carcinoma cases able to recognize this entity. cytopathologically diagnosed between years 2006-2012 in Onco- logical Cytology Department of Istanbul University, Institute of Oncology. Cases were investigated due to age, gender, localiza- MCCUNE-ALBRIGHT SYNDROME: CONTRIBUTION tion, clinical diagnosis and cytopathological features. OF THE DENTAL EXAM IN ITS DIAGNOSIS FWGC1, Results: Microscopic features of the tumor cells were kera- Bezerra TP2, Fernandes CP2, Ribeiro TR2, ARPQ3, Alves tinized/non-keratinized cytoplasm, hyperchromatic, enlarged/py- APNN2, Soares ECS2 - 1UNIVERSIDADE FEDERAL DO knotic nuclei, necrotic cellular debris and single cells/clumps. 14 CEARÁ- CAMPUS SOBRAL - ODONTOLOGIA, 2UNIVER- 3 cases were diagnosed as squamous cell carcinoma (SCC), 5 cases SIDADE FEDERAL DO CEARÁ - ODONTOLOGIA, UNI- suspected of SCC, 2 cases metastatic SCC and 1 case undiffer- VERSIDADE FEDERAL DO CEARÁ - MEDICINA entiated carcinoma. Fibrous dysplasia (FD) is a rare skeletal disease caused by Conclusion: FNA and brushing cytology help to avoid in- postzygotic activating mutations of the GNAS1 gene. Dissemi- cisional biopsy for oral SCC the diagnosis of when the cytolog- nation of GNAS1 mutations to other tissues may present as the ical features are well established. McCune–Albright syndrome (MAS), a triad of polyostotic FD, cafe -au-lait skin hyperpigmentation and autonomous endocrine dysfunction. The aim of this report was to describe an interesting STUDY OF CLINICAL FEATURES IN ACTINIC CHEILITIS case of MAS. A 27-year-old female was diagnosed with MAS AND LIP SQUAMOUS CELL CARCINOMA Modolo F1, during a routine dental visit by clinical, radiographic and histo- Pilati SFM1, Bianco BC1, Vieira DSC1 - 1UNIVERSIDADE logical findings. We addressed the importance of a careful dental FEDERAL DE SANTA CATARINA - DEPARTAMENTO DE evaluation in its diagnosis, as well as the management. The PATOLOGIA importance of dental examinations should be pointed out, among Actinic cheilitis (AC) is a potentially malignant disease that others, as a means of reaching a presumptive diagnosis, whose must be diagnosed early to prevent its progression to lip squa- confirmation is critical to the patient. mous cell carcinoma (LSCC), a malignant disease with a poor prognosis. This study aimed to determine the clinical profile of ADULT ORAL RHABDOMYOMA PRESENTED AS A patients diagnosed with AC and LSCC at the Federal University SLOW GROWING MASS IN THE FLOOR OF THE of Santa Catarina from 1998 to 2009. Clinical information pres- MOUTH Passador-Santos F1, Souza AA1, Menezes J2, ent in patient files and biopsy records of 64 cases of AC and 70 Araujo NS1, Araujo VC1, Soares AB1 - 1SÃO LEOPOLDO cases of LSCC was evaluated using statistical analysis. Both MANDIC INSTITUTE AND RESEARCH CENTRE - DE- diseases had affected white men exposed to the sun predomi- PARTMENT OF PATHOLOGY, 2TOCANTINENSE INSTI- nantly. The mean age of AC patients was 50.39 years old with a TUTE PRESIDENTE ANTONIO CARLOS - DEPARTMENT reported evolution time of 37.5 months and for LSCC patients, 56.1 and 21.66. The AC lesions were plaques of 11.94mm and OF PATHOLOGY the LSCC lesions, ulcers measuring 16.85mm. This data largely Rhabdomyomas are rare benign tumors originating from matched that found in the literature studied. striated muscle and classified as cardiac and extracardiac. In this study we report a case of an adult rhabdomyoma originating in the floor of the mouth. A forty years old woman was referred for THREE CASES OF PAINFUL SWELLING OF FOLIATE diagnosis of a painless lump noticed six months before consul- PAPILLAE WITH DIFFERENT FINAL DIAGNOSES Me- tation localized in the floor of the mouth interfering with masti- della Jr FAC1, Curra M, Martins MAT2, Matins MD2, Car- cation and swallowing. The lesion was freely movable and cov- rard VC2, Sant’Ana Filho M2, MUNERATO MC2 - 1UFRGS ered by normal mucosa. Clinical diagnoses included pleomorphic - FACULDADE DE ODONTOLOGIA, 2UNIVERSIDADE adenoma, mucoepidermoid carcinoma and benign soft tissue FEDERAL DO RIO GRANDE DO SUL - FACULDADE DE tumor. An incisional biopsy was performed and the histopatho- ODONTOLOGIA logic analyses showed a proliferation of large ovoid or polygonal cells with granular, eosinophilic cytoplasm containing vacuoles Foliate papillae appear as an area of vertical folds and located mainly in the periphery of the cytoplasm. The tumor cells grooves located on the extreme posterior-lateral surface of the were positive for desmin, S100 and HHF35 by immunohisto- tongue. Three patients were evaluated at Stomatology Depart- chemistry. The treatment consisted of complete excision under ment complaining soreness and swelling in the tongue in the general anesthesia and the patient remained free of recurrence foliate papillae area. During the clinical examination was noticed after two months follow up. a mild inflammatory aspect of these structures. Trauma was ruled out. Therefore, excisional biopsies were done followed by histo- pathological analysis to establish a definitive diagnosis. We had CYTOPATHOLOGICAL DIAGNOSIS OF ORAL 03 different diagnosis with different prognosis. The patients are 1 1 CARCINOMAS Mutlu S , Güler SD, Alatli FC - ISTAN- being followed. Oral lesions at this site are very rare however, BUL UNIVERSITY, INSTITUTE OF ONCOLOGY - DE- these three cases revealed the importance of the clinic and his- PARTMENT OF ONCOLOGICAL CYTOLOGY topathological investigation of the alterations observed in foliate Background/objectives: Fine needle aspiration biopsy papillae because they could represents many lesions with differ- (FNA) and brushing cytology are simple, non-invasive, highly ent treatment and behavior. OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e87

HYALINIZING CLEAR CELL CARCINOMA Lima GMG1, tumors. The case of a 36-year-old woman who presented a hard Silva CMOM2, Colombo CED2, Arisawa EALS2, Diniz PA1, mass in the right inferior jaw, associated with pain and gingival Sousa SCOM3, Carvalho YR1 - 1UNESP/SÃO JOSÉ DOS bleeding is reported. The radiography showed an unilocular ra- CAMPOS - BIOCIÊNCIAS E DIAGNÓSTICO BUCAL, diolucent lesion with sclerotic borders and focal radiopacities. 2UNIVERSIDADE DO VALE DO PARAÍBA, 3FOUSP - ES- The histological examination of biopsy revealed an epithelial TOMATOLOGIA proliferation arranged in islets of basaloid cells, some component Hyalinizing clear cell carcinoma is a rare salivary gland of clear cells organized in follicles and peripheral columnar cells malignancy. The peak occurrence is in patients in the 40-70 year in palisade. Pleomorphism, hyperchromasie, mitoses and evident age range, with primary location in minor salivary glands of nucleoli were also observed. After a diagnosis of a carcinoma of palate. A monomorphous population of polygonal to round cells odontogenic origin, the patient underwent a surgical partial re- with clear cytoplasm characterizes clear cell carcinomas. section of the mandible and the microscopic exam of the entire Case report: a 65 year-old Caucasian male complaining of lesion confirmed the diagnosis of ameloblastic carcinoma. The a painless nodule between hard and soft palate covered by intact treatment consisted of neck dissection, mandible reconstruction mucosa and with approximately 1 year of evolution. Histologi- with a titanium plate and postoperative radiotherapy. The histo- cally, there was an ill-delimited salivary gland malignancy in pathological diagnosis of ameloblastic carcinoma remains a chal- lamina propria with islands and strands of clear cytoplasm cells lenge. with eccentric nuclei and a variety of PAS positive granules with eosinophilic polygonal cells on periphery. Between the nests A CASE OF LICHEN PLANUS IN A PEDIATRIC PATIENT: there was hyaline stroma. The lesion was tangent of the covering CLINICAL PRESENTATION AND MANAGEMENT Ol- epithelia. Immunostaining showed positive cells for cytokeratin 7 iveira GMR1, Cantisano MH1, Pereira HSC1, Ramos TR1, and 14. Tumor was removed and healed but patient remained Oliveira AV1 - 1UERJ - UNIVERSIDADE ESTADUAL DO with oronasal communication covered by removable prosthesis. RIO DE JANEIRO Lichen planus is a mucocutaneous disease of unknown eti- EPIDEMIOLOGICAL PROFILE OF LUPUS INTRAORAL ology that is relatively common in adults but rarely present in IN ORAL MEDICINE SERVICE AT ARARAQUARA childhood. It is believed a cell-mediated immune condition. The 1,2,3,4 1 female-to-male ratio is approximately 3:1. The aim of this study SCHOOL OF DENTISTRY Ohata G - ARARAQUARA is to report the rare case of a pediatric patient. An 11 years old SCHOOL OF DENTISTRY - UNESP - DIAGNOSIS AND melanoderm boy, forwarded to stomatology by his dermatologist SURGERY, 2ELAINE MARIA SGAVIOLI MASSUCATO - DI- with definitive diagnosis of cutaneous lichen planus for evalua- AGNOSIS AND SURGERY/ARARAQUARA SCHOOL OF tion of aggressive ulcers of lower lip and gingival erosive aspects. DENTISTRY, 3 MIRIAN APARECIDA ONOFRE - DIAGNO- These lesions are resistant to treatment even with administration SIS AND SURGERY/ARARAQUARA SCHOOL OF DEN- of systemic corticosteroids and immunosuppressant drugs. We 4 TISTRY, CLÁUDIA MARIA NAVARRO - DIAGNOSIS AND proposed to include topical corticosteroids, antifungal, antibiotic SURGERY/ARARAQUARA SCHOOL OF DENTISTRY and analgesic with improvement of the clinical condition in 15 Objective: Evaluate cases intraoral lupus to establish an days. The antimicrobials were used due to the secondary infec- epidemiological profile. tion presence. Study design: It consisted of a retrospective study based on clinical files of patients attended at the Oral Medicine Service of METASTATIC RENAL CARCINOMA TO MANDIBLE, A the Araraquara Dental School, between 1999 and 2011. CASE REPORT Meza-García G1,2, Tafoya-Ramírez F3, Results: The sample was composed by 13 patients with in- Leyva-Bohórquez P4 - 1UNIVERSIDAD REGIONAL DEL traoral lupus, being predominantly women (12), white (8) with the SURESTE - ORAL PATHOLOGY, 2SERVICIOS DE SALUD mean age of 39 years old. The main intraoral locations were lip 3 vermilion (6), buccal mucosa (7), tongue (5) and hard palate (5). DE OAXACA - ORAL PATHOLOGY, HOSPITAL RE- Among the laboratory exams were LE cells (1 was positive) and GIONAL DE ALTA ESPECIALIDAD DE OAXACA - PA- 4 ANA (4 were positive). The fundamental lesions more prevalent THOLOGY, INSTITUTO MEXICANO DEL SEGURO SO- were: ulcer (5), plates (5), patches (4), erythema (3), besides erosion, CIAL - PATHOLOGY hyperplasia, nodules, vesicle and striae. The main systemic diseases Metastases to oral cavity are rare, is estimated to comprise were depression (5), fibromyalgia (4) and diabetes (1). only 1% of all malignancies, renal cell carcinoma is one of the Conclusion: The intraoral lupus occurs mainly in depressive malignancies that can have this behavior. Case report: a 56 year’s white women complaining of oral pain accompanied of fibromy- old woman with a painful tumor in the left mandible; she had algia. taken antibiotics and analgesics without seeing improvement. A sample tissue was taken by incisional biopsy. Microscopic ex- amination showed clear polygonal large cells with round nuclei AMELOBLASTIC CARCINOMA IN MANDIBLE RESEM- grouped in nests and separated by vascular channels, clear cells 1 2 BLING A BENIGN LESION Nagata G , Nardis AC , Gon- infiltrate bone tissue, immunohistochemistry was requested with 2 2 2 1 çalves S , Kaba SCP , Almeida PA , Martins MT - the following results: CKAE1/E3 (ϩϩϩ), CD 10 (ϩϩϩ), 1 SCHOOL OF DENTISTRY - UNIVERSITY OF SÃO PAULO vimentin (ϩ/Ϫ), CD 34 (Ϫ), S100 (Ϫ), chromogranin and si- 2 - ORAL PATHOLOGY, VILA PENTEADO GENERAL HOS- naptofiscin (Ϫ); ACT was made showing tumor in kidney, so we PITAL - ORAL AND MAXILLO FACIAL SURGERY AND conclude as a metastatic renal carcinoma in the mandible. TRAUMATOLOGY Conclusion: The metastases in oral cavity are rare lesions Ameloblastic carcinoma is a rare odontogenic tumor that but must be known in working diagnosis in painful diseases, exhibits malignant histological features in primary and secondary immunohistochemistry is helpful for diagnosis. ORAL MEDICINE OOOO e88 Abstracts October 2012

HEALING PROCESS OF AUTOGRAFTS AND ALLO- diagnosis is solely based on histopathological features. The aim GRAFTS IN RABBITS’ ILIAC CREST Weinfeld I1, Carrilho of this study is to report a case of oral focal mucinosis and discuss GPB2 - 1UNISA, 2INSTITUTO IMPLANTEPERIO clinicopathological features and different diagnosis of myxoma- The use of allografts as bone substitutes has increased in tous lesions of the oral cavity. A 42 year-old women had a large implant dentistry despite its lack of scientific evidence. This epulis on gingiva that kept growing for 2 months. The oral study compared bone healing dynamics of onlay allografts and examination showed a nodule, with normal color, smooth sur- autografts. Ten rabbits were submitted to an autograft and an face, hard in the consistency, with no symptoms, had a size of 2 allograft at the iliac crest. Over the following 18 weeks, intravital centimeters and was located in gingival between the elements 24 staining with four different fluorochromes was performed. Then, and 25. The biopsy allowed the focal mucinosis diagnosis. After grafts were prepared for sectioning for further fluorescence micros- 1 year no signs of recurrence were noted. copy analysis and histometric evaluation. Bone density (BD) and bone to fixation screw contact (BIC) were analyzed. Autografts A HISTOPATHOLOGICAL AND HISTOCHEMICAL presented the following results for fluorochrome labeling: 0.24Ϯ STUDY OF APPEARANCE OF MUCOUS CELLS IN THE 0.41% (AL), 3.76Ϯ0.93% (CB), 3.24Ϯ0.89% (CA) and 1.25Ϯ SALIVARY DUCT EPITHELIUM SURROUNDING MU- 1.21% (OT), and allografts: 0.24Ϯ0.45% (AL), 3.80Ϯ1.12% (CB), COUS CYSTS Takanashi H1, Utsunomiya T2, Yamamoto H2 3.21Ϯ1.71% (CA) and 1.25Ϯ0.75% (OT). BD was 55.90Ϯ7.00% - 1NIHON UNIVERSITY SCHOOL OF DENTISTRY AT Ϯ and 44.72 6.53% for autografts and allografts, respectively. BIC MASTUDO - ORAL PATHOLOGY, 2NIHON UNIVERSITY Ϯ Ϯ was 47.04 15.85% for autografts and 44.55 13.71% for allografts. SCHOOL OF DENTISTRY AT MATSUDO - ORAL PATHOL- Allografts and autografts showed slower osteogenic activity at the OGY initial healing stages. Although allografts and autografts presented (Objective) The purpose of this study was to histopatholog- similar BIC and fluorochrome incorporation values, allograft BD ically and histochemically investigate the localization of mucous was statistically poorer. cells in the salivary glands surrounding mucous cysts (26 cases) compare to the normal salivary glands. IMPACT OF BOLUS USED IN THE TREATMENT OF IR- (Study design) Mucous cysts, definitively diagnosed at our REGULAR FACIAL SURFACE IN RADIATION THERAPY department (26 cases), were observed with hematoxylin-eosin Rodrigues GHC1, Alves FA1, Prado JD1, Pellizzon CAP2, and PAS-alcian blue pH 2.5 stainings and the rates of the mucous Boccaletti K2, Marcicano A2, Jaguar GC1 - 1HOSPITAL AC cells were calculated. CAMARGO - ESTOMATOLOGIA, 2HOSPITAL AC CA- (Results and conclusion) Histopathologically, mucous cells MARGO - RADIOTERAPIA with slightly hematoxylic cytoplasm were observed in the sali- Background: Radiation treatment involving irregular facial vary duct epithelium surrounding mucous cysts. The rates of contours is complex because the isodoses lines become skewed. mucous cells, bluish stained with alcian blue, pH 2.5 were higher The use of bolus as a tissue-equivalent field compensation is than those of the normal salivary glands. The rates of mucous discussed in the literature. This material is made to fit the irreg- cells were also peaked at seventh decade women. The results ular surface compensating the topology and creating an even suggested that the appearance of mucous cells, involved sulfo- area. mucin, might be resulted from a metaplastic change of the duct Objective: To evaluate the effects of a wax bolus as a epithelium associated with local environment of the formation of compensator material during radiotherapy. mucous cysts. Study design: A 70-year-old man with an extensive irregu- lar facial topography due to a resection of left external ear canal GINGIVAL LOW-GRADE MYOFIBROBLASTIC SARCO- carcinoma infiltrating parotid gland was submitted to computed MA: CASE REPORT González JS1, Valdéz CAM2, Morán tomography for radiation treatment planning with and without the SC3, Meza GA4 - 1UNIVERSIDAD QUETZALCÓALT EN use of the bolus. IRAPUATO - PATHOLOGY, 2INSTITUTO NACIONAL DE Results: Dosimetric analysis showed that the irradiation CANCEROLOGÍA - PATHOLOGY, 3UNIVERSIDAD QUET- dose in the tumor volume was more precise with the use of this ZALCÓATL EN IRAPUATO - ORAL AND MAXILLOFACIAL device. SURGERY, 4HEAD AND NECK ONCOLOGY SURGERY Conclusions: This study showed that the wax bolus is a Introduction: Low-grade myofibroblastic sarcoma (LGMS) simple and useful device to treat nonplanar surface and empha- is a neoplasm of atypical myofibroblasts which has only recently sized the importance of multidisciplinary team during radiother- become clearly defined. It represents a rare entity with a predi- apy. lection for the head and neck region. The differential diagnosis of LGMS includes a number of benign and malignant spindle cell 1 ORAL FOCAL MUCINOSIS: CASE REPORT Pereira HSC , neoplasms. Lack of obvious cytological atypia may complicate 1 2 2 2 Póvoa RC , Pires FR , Bahia TP , Maciel RM , Ramos the diagnostic process. 2 2 1 MEB , Israel MS - UERJ - FACULDADE DE ODONTO- Case report: A 53 years old woman was evaluated for a LOGIA, 2UERJ - DEPARTAMENTO DE DIAGNÓSTICO E painless swelling in her right mandibular gingiva. An excisional CIRURGIA biopsy was done and the histological diagnostic was myofibroma. Oral focal mucinosis, an oral counterpart of cutaneous focal After four months a recurrent nodule appeared, as a result of mucinosis, is a rare disease of unknown etiology. Its pathogenesis histological and immunohistochemical re-examination the origi- may be due to overproduction of hyaluronic acid by fibroblast at nal tumor was subsequently classified as a LGMS. The patient the expense of collagen production, resulting in focal myxoid underwent a segmental osteotomy of the mandibular body for degeneration of connective tissue primarily affecting the mucosa complete excision. overlying bone. It has no distinctive clinical features, since the Conclusion: Recognition of LGMS and appropriate man- OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e89 agement with close follow-up is essential to prevent late recur- molecular profile, however the significance of this data needs to rence or metastases. be further evaluated. Financial Support: CNPq, CAPES. ASSOCIATION BETWEEN EXPRESSION LEVELS OF MI- CRORNAS AND HISTOPATHOLOGIC FEATURES OF ASSESSMENT OF KNOWLEDGE ON ORAL CANCER PA- DYSPLASIA IN ORAL LEUKOPLAKIA Brito JA1, Gomes TIENTS IN THE SCHOOL OF DENTISTRY FEDERAL UNI- CC2, Silva TF1, de Paula AMB3, Gomez RS1 - 1UNIVERSI- VERSITY OF AMAZONAS Domingues JEG1,2,3,4 - 1UFAM DADE FEDERAL DE MINAS GERAIS, BELO HORIZONTE, - FACULDADE DE ODONTOLOGIA, 2THAMAYRA DA BRAZIL - DEPARTMENT OF ORAL SURGERY AND PA- SILVA GEAN (GEAN, TS) - UFAM - FACULDADE DE THOLOGY, 2UNIVERSIDADE FEDERAL DE MINAS ODONTOLOGIA, 3KLEYVER DO NASCIMENTO SO- GERAIS, BELO HORIZONTE, BRAZIL - DEPARTMENT OF BRINHO (SOBRINHO, KN) - UFAM - FACULDADE DE PATHOLOGY, 3UNIVERSIDADE ESTADUAL DE MONTES ODONTOLOGIA, 4JULIANA VIANNA PEREIRA (PEREIRA, CLAROS - UNIMONTES, MONTES CLAROS, BRAZIL - DE- JV) - UFAM - FACULDADE DE ODONTOLOGIA PARTMENT OF ORAL SURGERY AND PATHOLOGY Objective: Assess knowledge of patients of the school of Background and objective: The grading of dysplasia in oral Dentistry, Federal University of Amazonas on oral cancer, leukoplakia (OL) has been made relying on histopathologic find- Study design: Hundred thirty patients answered question- ings, but the molecular pattern of each parameter used to grade naires about etiological factors, symptoms associated, preventive lesions has not been established. The aim of the present study was measures and which forms of media and information about oral to investigate the association of each cytological and architectural cancer by population. alteration with the expression of three potentially cancer-related Results: 73.85% answered that know about the existence of microRNAs (mir21, mir345 and mir181). oral cancer and 25.38% were unaware of the disease, 31.54% Study design: We evaluated the microRNAs expression by answered that they perform self-examination of the oral cavity qPCR in sixteen samples of OL and six normal oral mucosa and 66.92% didn’t perform, 82.31% considered tabagism the samples. main factor of oral cancer, 80.77% reported non-healing wounds Results: We found high expression of mir21 and mir181 in as the main symptoms associated with oral cancer, 79.23% re- OL with high grade of dysplasia, especially in the cases that ported brushing their teeth is the main preventive measure to presented drop-shaped rete ridges and cellular and nuclear pleo- prevent diseases and 55.38% had been informed about oral can- morphism. High expression of mir345 was observed in OL with cer. hypercromasia and increased number and size of nucleoli. Conclusion: The study population has a low level of knowl- Conclusions: Our study shows that some cytological and edge of oral cancer, being necessary to promote educational histologic parameters used to grade dysplasia exhibit a different activities to promote awareness of the disease in society. ORAL MEDICINE OOOO e90 Abstracts October 2012

Poster 3

OLFACTORY NEUROBLASTOMA. HISTOPATHOLOGI- LABIAL FRENECTOMY WITH ND: YAG LASER: A COM- CAL AND IMMUNOHISTOCHEMICAL REPORT OF 2 PARATIVE STUDY Xavier JC1, Medeiros Junior R1, Car- CASES Aguirre-Echebarria P1, Estefano-Rodríguez JJ2, valho C1, Silva IH2, Carvalho A2, Gueiros LA2, Carneiro Ruiz-Diaz I1, Silva-Carmona MJ1, Aguirre-Urizar JM3 - Leao J2 - 1UFPE - PÓS GRADUAÇÃO EM ODONTOLO- 1HOSPITAL DONOSTIA. DONOSTIA. SAN SEBASTIAN - GIA, 2UFPE - CENTRO DE ENSINO E PESQUISA DE DEPARTAMENTO DE ANATOMIA PATOLÓGICA, 2HOS- LASER EM ODONTOLOGIA (CEPLO) PITAL DONOSTIA. DONOSTIA. SAN SEBASTIAN - DE- Background/aim: Labial frenulum are sagittal fibrous folds PARTAMENTO DE ORL, 3UNIVERSIDAD DEL PAÍS or oral mucosa that extend from the lips to the alveolar or VASCO/EHU. LEIOA - UNIDAD DE PATOLOGÍA ORAL Y gingival mucosa. The aim of the present study was to compare MAXILOFACIAL clinical parameters related to labial frenectomies performed by Olfactory neuroblastoma (ONB) is an uncommon malignant conventional surgery technique with a Nd:YAG laser. neuroectodermal nasal tumor that can histologically mimic many Study design: Forty patients (aged 8 to 51 years of age, 16 tumors, making recognition of this neoplasm important. males and 24 females) with clinical indication of labial frenec- Case 1: A 33 year-old man with a long-standing epistaxis, tomy were divided into two groups: G1 - conventional surgery presents a neoplasm in the left nasal cavity. Surgical removal was (n ϭ 22) and G2 – Nd:YAG laser surgery (n ϭ 18). Frenulum performed, and was diagnosed as a ONB stage II of Hyam. insertion, bleeding, surgical time, suturing, preoperative fear and Inmunohistochemistry: (ϩ) chromogranin; neuron-specific eno- postoperative discomfort were evaluated. lase; vimentine, S-100. Results: Papillary or transpapilar insertion was observed in Case 2: A 65 year-old man with a months-standing epiphora, 36 patients (90%). Nd:YAG laser intervention did not require presents with a neoplasm in the left nasal cavity with extension to suture and were associated with reduced trans-operative bleeding the etmoid and maxillary sinus. Partial surgical removal was (p Ͻ0.001), resulting in a shortened surgical time (p Ͻ0.001). performed and diagnosed as a ONB stage II of Hyam. Immune Preoperative fear, postoperative pain and oral function were profile similar to that of case 1. The tumor has spread to the similar between the groups. lacrimal duct, and now is receiving radiotherapy. Conclusion: Nd: YAG laser can be considered a better tool Conclusion: In this poster we describe 2 cases of this infre- when compared with conventional surgery technique for under- quent neoplasm, and discuss the histological differential diagno- taking frenectomies. sis and the immunohistochemical findings.

COMPLEX ODONTOMA MIMICKING CEMENT- MULTIPLE CUTANEOUS METASTASES FROM A HYPO- 1 2 3 OBLASTOMA Seo J , Horikawa FK , Kaba SCP , Ruiz PHARYNGEAL SQUAMOUS CELL CARCINOMA Sabino- MM4, Nunes FD1, Sugaya NN1, Shinohara EH3 - 1FAC- Bezerra JR1, Esteves SCB2, Vargas PA3, Coletta RD3, San- ULDADE DE ODONTOLOGIA DA UNIVERSIDADE DE tos-Silva AL3 - 1PIRACICABA DENTAL SCHOOL, STATE SÃO PAULO - ORAL PATOLOGY, 2OMF HOSPITAL RE- UNIVERSITY OF CAMPINAS - ORAL DIAGNOSIS, SEMI- GIONAL DE OSASCO - ORAL AND MAXILLO FACIAL OLOGY AND ORAL PATHOLOGY, 2ONCOLOGY CENTER SURGERY, 3HOSPITAL ISRAELITA ALBERT EINSTEIN - - HFC - RADIOTHERAPY AND ONCOLOGY, 3PIRACI- ORAL AND MAXILLO FACIAL SURGERY, 4HOSPITAL DA CABA DENTAL SCHOOL, STATE UNIVERSITY OF CAMPINAS - ORAL DIAGNOSIS, SEMIOLOGY AND ORAL AERONÁUTICA - ORAL AND MAXILLO FACIAL SUR- PATHOLOGY GERY Metastases to the skin are rare and account for less than A 48-years-old male patient was referred for evaluation of 1% of patients with squamous cell carcinoma (SCC) of the mandibular radiopaque image. He had panoramic radiograph head and neck. Although metastases to the skin from the image showing globular, 20 mm in greatest diameter located in larynx have been reported there are a few reported cases from the root of the tooth 48. In the center of the radiopaque mass there the hypopharynx. We present a rare case of a heavily smoker was radiolucent image that suggested the mandibular nerve pas- and drinker 54-year-old man diagnosed with SCC of left sage. Computed tomography excluded the nerve’s transfixing. piriform fossa (T2N1M1) who was treated with total laryn- With a presumptive diagnosis of cementoblastoma we opted for gectomy associated with left neck dissection and radiotherapy. surgical removal via sagittal mandibular osteotomy. Histopatho- However, he abandoned the radiotherapy after 14 sessions and logical examination showed odontogenic neoplasm characterized reappeared 6 months later with a palpable left ulcerated cer- by mineralized material consisting mostly of cementum, dentin, vical lymph node and multiple cutaneous nodules affecting his and permeated into the enamel matrix, compatible with complex back, face and right upper limb. Biopsy confirmed multiple odontoma. The differential diagnosis of complex odontoma are cutaneous metastases from the undertreated hypopharyngeal fibro-osseous lesions as cementoblastoma, however odontoma SCC and computed tomography scans also revealed metastasis usually presents nonhomogeneous radiopacity and histologically affecting his lungs and liver. Unfortunately, the patient died is composed of dentin, enamel and cementum. In the revised due to the advanced disease 3 weeks after the diagnosis of literature, this would be the second case of complex odontoma cutaneous metastases. mimicking cementoblastoma. OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e91

REPLACEMENT OF ANTI-MALARIAL THERAPY AFTER microscope examination, the lesion displayed a variably sized PIGMENTED ORAL LESIONS IN AN ATTEMPT TO PRE- islands and cords of odontogenic epithelial cells distributed in a VENT AN ADVANCE OF EYE INJURIES: A CASE REPORT fibrous stroma with pattern similar to solid intraosseous amelo- Pinto JV1, Rodrigues RB1, Weber A1, Ferrazzo KL1, Payeras blastoma. Treatment of such lesions typically involves complete MR1 - 1CENTRO UNIVERSITÁRIO FRANCISCANO - UNI- wide excision and the recurrence has been observed infrequently. FRA Chloroquine is an anti-malarial, widely used in the treatment DIRECT EFFECTS OF RADIATION ON THE DENTAL of rheumatoid arthritis, whose use may cause pigmentary changes PULP OF HEAD AND NECK CANCER PATIENTS Faria in oral mucosa, ocular and skin. This paper reports the case of a KM1, Santos-Silva AR1, Rosa GAB2, Arruda FF3, Nadalin patient, female, 71 years, with rheumatoid arthritis for 12 years, W3, Almeida OP4, Brandão TB2 - 1PIRACICABA DENTAL period that she used chloroquine. In addition, the patient had SCHOOL UNIVERSITY OF CAMPINAS, PIRACICABA, SÃO visual deficiency due to the history of toxoplasmosis. The inci- PAULO, BRAZIL - ORAL DIAGNOSIS/SEMIOLOGY, 2IN- sional biopsy followed by pathological examination revealed STITUTO DO CÂNCER DO ESTADO DE SÃO PAULO deposition of melanin in the basal layer of epithelial tissue, OCTAVIO FRIAS DE OLVEIRA, SÃO PAULO, BRASIL. - confirming the case as a pigment by chloroquine. The patient was SERVIÇO DE ODONTOLOGIA ONCOLÓGICA, 3INSTI- referred to the rheumatologist, which opted for the replacement TUTO DO CÂNCER DO ESTADO DE SÃO PAULO OC- of medication, in an attempt to prevent an advance of eye TAVIO FRIAS DE OLVEIRA, SÃO PAULO, BRASIL. - injuries. We highlight the importance of the dentist in diagnosing SERVIÇO DE RADIOTERAPIA, 4PIRACICABA DENTAL oral diseases, as well as the realization of a multidisciplinary SCHOOL STATE UNIVERSITY OF CAMPINAS, PIRACI- approach to prevent the development and worsening of clinical CABA, SÃO PAULO, BRAZIL - ORAL DIAGNOSIS/ORAL situations presented by patients. PATHOLOGY Recent clinical data suggest that the normal blood flow and ACTINIC PRURIGO OF THE LOWER LIP: A CASE 1 1 1 sensitivity of dental pulp are impaired in patients undergoing REPORT Karin KSG , Miranda AMO , Ferrari TM , Wer- head and neck radiotherapy. However, little is known about the 1 1 2 1 1 neck JT , Silva Júnior A , Lourenço SV , Dias EP - UNI- direct effects of radiation on pulp morphology. VERSIDADE FEDERAL FLUMINENSE - PROGRAMA DE Objectives/study design: A descriptive histological study 2 PÓS-GRADUAÇÃO EM PATOLOGIA, UNIVERSIDADE assessed morphological aspects of the microvasculature and in- DE SÃO PAULO nervation of 30 dental pulps obtained from patients who under- Actinic prurigo is a disease caused by an abnormal reaction went head and neck radiotherapy and 20 control dental pulps. to sunlight. We report a case of actinic prurigo of the lip, also Results: There was no evident differences between irradi- known as follicular cheilitis. A 63 year-old Afro-American fe- ated and control pulps regarding the morphology of blood ves- male, Indian descendent, demonstrated lesions on the lower lip, sels; morphology of nerve bundles; presence of odontoblasts; with bleeding complain and ten months of evolution. There were patterns of inflammatory infiltration; amount of calcification or ulceration, yellow crusts and swollen on the lower lip. Cytopa- fibrosis. thology, photos, and videoroscopy were performed, which helped Conclusion: The histological features of microvasculature in the selection of the biopsy area. Debridement and incisional and innervation are preserved in the dental pulp of head and neck biopsy were done and the histopathologic exam demonstrated cancer patients who underwent radiotherapy. Thus, direct effects follicular cheilitis. Triamcinolone acetonide cream, lip balm with of radiation on teeth are not able to change the dental pulp UV protection and gauze compresses with cold physiological morphology. saline solution were prescribed. Complete remission of the le- sions was observed after one month of treatment. The patient has ORAL MELANOMA: A CASE REPORT Kignel S, Mistro F1, been followed up for eight months. The importance of this case Piñera K2 - 1UNIARARAS, 2LABORATÓRIO DIAGNÓSTIKA is the low prevalence of this condition in the population and the -SP difficulty in establishing the correct histopathologic diagnosis. Patient O.R.C. presented with complaints of swelling in the gum for 20 days. During the history of present illness patient PERIPHERAL AMELOBLASTOMA: CASE REPORT Fer- reports that dentures began to feel “wobbly” about 45 days. The 1 2 1 1 nandes KS , Cavalcanti D , Martins MT - FACULDADE treatment oncilom tried in either base and propolis without suc- DE ODONTOLOGIA - USP - ESTOMATOLOGIA - DISCI- cess. Regarding personal history, denies smoking and drinking PLINA DE PATOLOGIA BUCAL, 2CENTRO DE ESPE- and refers angioplasty (STENT) for 3 years. Extra oral examina- CIALIDADES ODONTOLÓGICAS DE SUZANO tion showed no palpable lymph nodes. The intra oral examination Peripheral ameloblastoma (PA) is a rare benign odontogenic showed the presence of blackened spot on the alveolar region of tumor, derived from odontogenic epithelium. The lesion repre- about 0.8 to 26 cm Ø and continue for distal surface. In the tuber sents approximately 1.3% to 10% of all cases of ameloblastoma region of about 2.0 cm Ø was ulcerated. The clinical diagnosis and it is differentiated from the intraosseous counterpart by its was melanoma. Incisional biopsy was performed (removal of part extraosseous location and less aggressive behavior. It should be of all stain and ulceration) and the fragment referred to histo- considered in the differential diagnosis of peripheral reactive pathological examination. The result of the pathological exami- lesion, including peripheral giant cell lesion, peripheral odonto- nation revealed malignant neoplasm of the nodular type and genic fibroma, peripheral ossifying fibroma, pyogenic granuloma presence of adjacent intraepithelial component, pleomorphism, and fibroma. We describe a case of PA in the lingual gingivae. hyperchromatism and atypical mitosis. Area of pigment. was also The patient was a 55-year-old female with an asymptomatic present. All the events are documented in the form of photo- sessile nodule, which had grown slowly for 14 months. Upon graphs. ORAL MEDICINE OOOO e92 Abstracts October 2012

FINE NEEDLE ASPIRATION CYTOLOGY OF 247 SALI- Intra-oral examination revealed bony hard buccal swelling from VARY GLAND TUMORS IN AN BRAZILIAN POPULA- 12-27 tooth. Imaginological exams showed a well-circumscribed TION: A 10 YEAR RETROSPECTIVE STUDY WITH CY- radiolucency containing radiopaque foci involving the left alve- TOHISTOLOGICAL CORRELATION Díaz KP1, Gerhard olar ridge, maxillary sinus, and nasal cavity. Microscopical anal- R2, Domingues RB2, Martins LAL2, Carneiro PC2, Vargas ysis of the excisional biopsy revealed areas with highly cellular PA1 - 1PIRACICABA DENTAL SCHOOL, UNIVERSITY OF fibrous connective tissue with several blood vessels. Other re- CAMPINAS (UNICAMP) - ORAL DIAGNOSIS, 2CLINICS gions presented loosely arranged myxoid stroma permeated by HOSPITAL, MEDICINE SCHOOL, SÃO PAULO UNIVER- multinucleated giant cells, and extravasated erythrocytes. Irreg- SITY (HC-FMUSP) - PATHOLOGY ularly shaped bony trabeculae were found. The diagnosis was central CGCL associated with benign fibro-osseous lesion. The Objectives: To assess the efficacy and reproducibility of the patient is under follow-up. Due to the rarity of reported cases, Fine Needle Aspiration Cytology (FNAC) for diagnosing sali- little is known about the behavior of this lesion. Thus, close vary glands tumors. follow-up is recommended. Study design: A retrospective analysis of 247 salivary gland tumors from the Division of Pathology of the Clinics Hospital of São Paulo and from Piracicaba Dental School was performed. GINGIVAL CYST OF THE ADULT: REPORT OF A CASE 1 1 1 1 The results were submitted to statistical analysis by the Qui- Rodrigues LM , Tango EK , Diniz PA , Campos GE , Santos 1 1 1 1 square test of Pearson and the concordance inter-examining for ELS , Brandão AAH , Almeida JD - FOSJC - UNESP Kappa. Gingival cyst in adults is an uncommon disease found Results: Cyto-histopathological correlation was carried out mainly at the canines and premolars, usually in the region of in 185 (74.89%) cases. The current results showed 88.9% of gingiva or alveolar mucosa. A 75-year-old Caucasian woman was sensitivity, 100% of specificity and 94% of diagnostic accuracy. seen at the Stomatology out-patient clinic with the history of a The reproducibility of the inter-observer cytological analysis lesion in the gingival observed one year ago. Clinical examina- showed a significant statistical concordance (pϽ0.0001). tion revealed a submucosal nodule measuring about 5mm in Conclusions: FNAC is an effective diagnostic tool for sal- diameter, consistent to palpation, located in the gingiva. Radiog- ivary gland tumors and shows high sensibility, specificity and raphy revealed no abnormalities. Differential diagnose was lat- accuracy when performed by experienced pathologists. FNAC eral periodontal cyst. An excisional biopsy was performed. His- also allowed a proper pre-surgical planning and treatment. topathological examination showed fragments of mucosa lined by stratified squamous epithelium with areas of parakeratinized duplication of the basal layer, exocytosis, spongiosis and degen- A LARGE ANEURYSMAL BONE CYST IN PEDIATRIC PA- eration. Lamina propria consisted of dense fibrous connective TIENT: REPORT CASE AND DIFERENTIAL DIAGNOSIS tissue with mild inflammatory infiltration, hemorrhagic areas and 1 1 2 2 Pavanello KC , Guimarães DM , Pontes FSC , Pontes HAR various blood vessels. Epithelium showed some signs of thick- - 1FOUSP - ESTOMATOLOGIA, 2UFPA - HOSPITAL UNI- ening containing clear cells. Lobules of clear cells were also seen VERSITÁRIO JOAO DE BARROS BARRETO in the underlying connective tissue. The aneurysmal bone cyst (ABC) of the jaws is characterized as a pseudocyst as it has no epithelial lining. ABC is a benign COLLAGEN AND TGF␤ IN WOUND HEALING OF IR- lesion composed of hemorrhagic spaces separated by connective RADIATED ORAL MUCOSA Pereira LC1, Mariano TA1, tissue septa containing fibroblasts, bone rational immature and Pereira MCMC2, Prezeres AG3, Reis SRdeA4, Figueiredo multinucleated giant cells can be observed. This lesion represents MAZde5, Martins GB6 - 1ESCOLA BAHIANA DE MEDICINA approximately 1.5% of non-epithelial and non-odontogenic cysts E SAÚDE PÚBLICA - MESTRADO EM ESTOMATOLOGIA, affecting the jaw. It is most prevalent in young adults, shows no 2UNIVERSIDADE DE CAMPINAS - DOUTORADO EM ES- predilection for gender and affects the mandible and maxilla in a TOMATOLOGIA, 3UNIVERSIDADE FEDERAL DO 3:1 ratio. The present paper report a uncommon case of large size RECONCAVO BAHIANO - DOUTORADO EM FITOPATO- ABC in a 14 years old girl which was referred to service of oral LOGIA, 4ESCOLA BAHIANA DE MEDICINA E SAÚDE pathology with chief complaint swelling in right hemiface. In 5 panoramic radiography was observed osteolytic lesion in body PÚBLICA - CURSO DE ODONTOLOGIA, PONTIFICIA and ramous of mandible, in computed tomography was noted UNIVERSIDADE CATOLICA DO RIO GRANDE DO SUL - cystic lesion extending of angle of mandible to temporal process. SERVIÇO DE ESTOMATOLOGIA DO HOSPITAL SÃO LU- 6 After incisional biopsy the microscope evaluation was ABC. CAS, UNIVERSIDADE FEDERAL DA BAHIA - INSTIT- TUTO DE CIENCIAS DA SAUDE The aim of this study was evaluate quantitatively the expres- HYBRID LESION WITH CENTRAL GIANT CELL LESION sion of TGF-␤ in irradiated oral mucosa correlated with collagen 1 AND FIBRO-OSSEOUS COMPONENTS Tjioe KC , Bravo- production in wound healing. Paraffin blocks (nϭ20) were used 1 2 1 1 Calderón DM , Toleto MC , Oliveira DT - BAURU containing rats tongue’s tissue and were divided into four groups SCHOOL OF DENTISTRY / UNIVERSITY OF SÃO PAULO (nϭ5). Animals of groups 3 and 4 received 6000 cGy of radio- - DEPARTMENT OF STOMATOLOGY - AREA OF PA- therapy and groups 2 and 4 had the tongue with ulcers on the 19th THOLOGY, 2PRIVATE CLINIC / JAÚ day. The expression of TGF-␤ was observed by immunohisto- Hybrid lesions with central giant cell lesion (CGCL) and chemical staining and collagen fibers with picrosirius analyzed fibro-osseous components affecting jaws are rare, with approxi- by morphometric quantification. The group that underwent radio- mately 10 cases reported. A 19-year-old girl had a one-year therapy and ulceration presented greater production of collagen tumefaction in the left nasolabial region. She reported paresthesia and TGF-␤ (21% and 9.44% respectively) compared with the involving the tissue innervated by ipsilateral infra-orbital nerve. other groups. There were no statistical differences in expression OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e93 of TGF-␤ and no positive correlation between TGF-␤ and col- LS2, Maniglia JV, Pavarino EC, Goloni-Bertollo EM - 1SÃO lagen (pϾ 0.05) which suggests that the presence of collagen and JOSÉ DO RIO PRETO MEDICAL SCHOOL (FAMERP) - expression of TGF-␤ is increased in tissue repair of ulcers un- GENETICS AND MOLECULAR BIOLOGY RESEARCH dergoing radiotherapy compared to radiotherapy or ulcer alone. UNIT (UPGEM), DEPARTMENT OF MOLECULAR BIOL- OGY, 2SÃO JOSÉ DO RIO PRETO MEDICAL SCHOOL STUDY OF AN EDUCATIONAL VIDEO TO IMPROVE (FAMERP) - OTORHINOLARYNGOLOGY AND HEAD THE UNDERSTANDING OF RADIOTHERAPY SIDE EF- AND NECK SURGERY DEPARTMENT FECTS ON HEAD AND NECK CANCER PATIENTS Ramos Background: Polymorphisms in genes involved in metabo- LMA1, González-Arriagada WA2, Andrade MAC3, Sabino- lism folate may affect folate status due to their involvement in Bezerra JR2, Esteves SCB4, Santos-Silva AR2, Lopes MA2 - DNA methylation and synthesis and, therefore, the risk of head 1PIRACICABA DENTAL SCHOOL, STATE UNIVERSITY and neck cancer (HNSCC). OF CAMPINAS, PIRACICABA, SÃO PAULO, BRAZIL - Objectives: To investigate associations of 11 polymor- ORAL DIAGNOSIS/ORAL SEMIOLOGY, 2PIRACICABA phisms (MTHFR C677T and A1298C, MTR A2756G, MTRR DENTAL SCHOOL, STATE UNIVERSITY OF CAMPINAS, A66G, RFC1 A80G, MTHFD1 G1958A, CBS 844ins68, TC2 C776G and A67G, SHMT C1420T and BHMT G742A) in HN- PIRACICABA, SÃO PAULO, BRAZIL - ORAL DIAGNOSIS/ SCC risk. ORAL SEMIOLOGY, 3BRAZILLIAN NAVY, RIO DE JA- Study design: A case-control study of 265 HNSCC cases and 466 NEIRO, BRAZIL - ODONTOCLINICA, 4ONCOLOGY CEN- non-cancer controls, using PCR-RFLP and Real Time-PCR. TER, HFC - RADIOTHERAPY Results: We found that age Ն 49 years (pϽ0.001), male Objectives: The aim of this study was to assess the effect of an gender (pϭ0.03), tobacco habit (pϽ0.001), MTHFR 1298AC/CC educational video to improve the understanding of the collateral effects (Pϭ0.028), MTR 2756AG/GG (Pϭ0.010) and RFC1 80AG/GG on head and neck cancer patients submitted to radiotherapy. (Pϭ0.015) variant genotypes were associated with an increased Study design: A 6-minutes video about head and neck HNSCC risk. radiotherapy side effects was produced. A randomized study was Conclusions: Our data provide evidence that folate metab- ϭ performed with two groups, control group (N 12), which re- olism genetic polymorphisms associated with variables as ad- ϭ ceived verbal information, and video group (N 12), which re- vanced age, male gender and tobacco abuse increase HNSCC ceived verbal information and watched the video. A question- development. naire with 14 items was applied in both groups. Results: Twenty-four patients were included in the study. Eighty-nine percent had less than a high school education. All BROWN TUMOR IN A PATIENT WITH SECONDARY patients of the video group showed to have knowledge about the HYPERPARATHYROIDISM Ferreira LL1, Gonçalves MV1, radiotherapy side effects, meanwhile only 57% of the control Vieira RR1, FURUSE CF1, Mattar NJ2, Biasoli ER1, Miya- group answered accurately. hara GI1 - 1FACULDADE DE ODONTOLOGIA DE ARA- Conclusions: The present study showed that an educational ÇATUBA- UNESP - CENTRO DE ONCOLOGIA BUCAL, video may improve the patient understanding of head and neck 2INSTITUTO DE PATOLOGIA DE ARAÇATUBA radiotherapy side effects despite their education level. Brown tumor is a rare and benign bone lesion, found in primary, secondary and tertiary hyperparathyroidism. The aim of PLEOMORPHIC ADENOMA OF THE BUCCAL MUCO- this study is to report a case of brown tumor and discuss about the SA: CASE REPORT Pereira LB1, Azevedo RS, Fontes treatment and clinical and radiographic features. A 24-year-old KBFC1, Carvalho Neto LGMC1, Camisasca DR1, Takahama man, with nephropathy, attended the Oral Oncology Center com- Júnior A1 - 1UNIVERSIDADE FEDERAL FLUMINENSE - plaining that ”his teeth were moving” and that presence of pain in FACULDADE DE ODONTOLOGIA - PÓLO UNIVERSI- the jaw for three months. At clinical examination, we observed a TÁRIO DE NOVA FRIBURGO tumefaction in the lower right vestibular fornix, between the elements 45 and 48, measuring approximately 3.5 cm, flaccid The pleomorphic adenoma is the most common salivary gland consistency, purple and painful to palpation. Incisional biopsy tumour, accounting for about 60% of all salivary neoplasms. The was performed and the histopathological diagnosis was central minor salivary glands are affected in about 10% of the cases, mainly giant cell lesion. After the blood test and the definitive diagnosis in the hard palate region. We report a case of a pleomorphic of brown tumor of hyperparathyroidism, the surgical removal of adenoma arising in the buccal mucosa. A 45-year-old female patient the lesion was performed in a hospital environment. The patient was referred for evaluation of a painless nodular mass inside the left has been followed for three years. buccal mucosa observed for about two years. On clinical examina- tion the mass was mobile on palpation and measured about two centimeters in diameter. With the main hypothesis of a benign SINGLE CELL GEL ELECTOPHORESIS ON PERIPHERAL salivary gland tumor the mass was excised. The histopathological BLOOD LEUKOCYTES OF PATIENTS WITH ORAL analysis showed an encapsulated proliferation of epithelial and LEUKOPLAKIA Vinod KRB, Kumar GS2, Rakesh S1, Mahija myoepithelial cells with ductal structures formation and a hyaline J1, Vindhya S, PriyaKN-1AMRITA SCHOOL OF DEN- stroma, determining the diagnosis of pleomorphic adenoma. After TISTRY, KERALA, INDIA - ORAL PATHOLOGY & MICRO- one year of follow-up, no sign of recurrence was observed. BIOLOGY, 2K S R INSTITUTE OF DENTAL SCIENCES AND RESEARCH CENTER, TIRUCHENGOD - ORAL PA- GENETIC POLYMORPHISMS IN FOLATE METABOLIZ- THOLOGY & MICROBIOLOGY ING GENES AND HEAD AND NECK CANCER RISK Peripheral blood leukocytes of twenty six oral leukoplakia Arantes LMRB1, Galbiatti ALS1, Ruiz-Cintra MT1, Raposo patients were subjected to Single Cell Gel Electrophoresis assay, ORAL MEDICINE OOOO e94 Abstracts October 2012 probably known as Comet assay, and the single strand breaks of basal cells were well-defined, compatible with a keratocyst odon- DNA damage were analysed. Statistically significant difference togenic tumor. In one year of follow-up the lesion has radio- in DNA damage levels were found between healthy controls and graphically decreased and the area will be enucleated in the next in patients with non dysplastic and mild dysplastic epithelium. step. The relevance of this case is related to the unusual local- Statistical analysis of DNA damage levels in patients with mod- ization and the clinical exuberance. erately and severely dysplastic epithelium could not be done because of insufficient number of cases. However, a step wise increase in DNA damage levels from healthy controls, through FREQUENCY OF ORAL LICHEN PLANUS BETWEEN IM- patients with non-dysplastic epithelium to varying grades of MUNOLOGICAL DISORDERS PRESENT IN BUCCAL 1 1 dysplasia suggest like sensitivity in future, of this technique, in MUCOSA. IREPO 1980–2010 Farías M , Maturana A , dealing DNA damage in Leukoplakic patients. A systemic host Aitken JP1, Iriarte M1, Adorno D1 - 1UNIVERSIDAD DE response in premalignancy also suggested. Based on the findings CHILE - PATOLOGY an extensive study is suggested for definite conclusion. Objective: To determinate the frequency of oral lichen pla- Keywords: Comet assay, leukoplakia, DNA damage nus (OLP), and other immunological disorder including: lichen- oide reaction, pemphigus, pemphigoid, recurrent oral ulcers TONGUE AND/OR FLOOR OF MOUTH SQUAMOUS (ROU), in buccal mucosa biopsies of Oral Pathology Reference CELL CARCINOMA IN INITIAL CLINICAL STAGE: SUR- Institute of Universidad de Chile (IREPO). VIVAL ANALYSIS Buexm LA1, Diblasi EV2, Honorato J1, Study design: 514 cases were selected according to their Camisasca DR3, Lourenço SQC2, Dias FL1 - 1INCA - CIRU- histopathological diagnosis, from which data was obtained such as age, gender, location and clinic diagnostic. Data was analyzed RGIA DE CABEÇA E PESCOÇO, 2UFF - PATOLOGIA, with the software Stata V10. 3UFF - ESTOMATOLOGIA Result: Most of the cases turned out to be OLP 42, 4% and Objective: Analyze overall survival (OS) and disease-free ROU 39, 5%. The average age of immunologic injuries is 50 survival (DFS) in patients with tongue and/or floor of mouth years with a tendency to the female gender. carcinoma (SCC) in initial clinical stage diagnosed between Conclusion: It could be determined that significant differ- 1999-2006. ences exist between the different disorders that were studied, Study design: All patients underwent surgery followed by where the most frequent are the OLP and the URO. neck dissection and had free surgical margins. Records from 142 patients were analyzed and submitted to bivariate (X2) and sur- vival (Kaplan-Meier) analysis. ORTHOGNATHIC SURGERY FOR CORRECTION OF Results: White males, older than40 years, who drink and FACIAL DEFORMITY IN A PATIENT WITH ARTHRO- smoke were most affected. 50 cases of recurrence were identified. GRYPOSIS MULTIPLEX CONGENITA (AMC) Sampieri Median OS was 69.5 months. Tongue SCC group showed sig- MBS1, Sant’Ana E1, Yaedú RYF1, Maria RL2, Maria P2, ϭ nificantly lower OS than the others (logrank/p 0.029). Patients Madeira MFC1, de Oliveira TFL1 - 1FACULDADE DE OD- with moderately-differentiated tumors had significantly shorter ONTOLOGIA DE BAURU - DEPARTAMENTO DE ES- OS than those with well/poorly-differentiated tumors (logrank/ TOMATOLOGIA, 2UNIVERSIDADE FEDERAL DE FOR- pϭ0.006). Those who recurred had significantly shorter OS TALEZA - DEPARTAMENTO DE CIRURGIA E TRAU- (logrank/pϽ0.0001), as well as the ones who underwent adju- MATOLOGIA BUCOMAXILOFACIAL vant-treatment (logrank/pϽ0.0001). Conclusion: SCC of tongue and mouth floor even in initial Arthrogryposis is a physical sign observed in many specific stage reveal high rates of recurrence and low OS suggesting more medical conditions. The Greek language translates arthrogryposis improvement to understand and control this disease. as “curved joint”. The term “arthrogryposis multiplex congenita” (AMC) refers to a congenital disorder first described by Otto in 1841 that is characterized by the contracture of multiple joints, KERATOCYST ODONTOGENIC TUMOR ON THE AN- 1 1 2 dimpling of the skin over the affected areas, cylindrical-shaped TERIOR MAXILLA Cardoso LB , Pagin O , Gonçales ES , extremities, and an increase in the fibrous tissue content of the 3 1 1 1 Consolaro A , Santos PSS , Capelozza ALA - FAC- muscles. In AMC patients with maxillofacial involvement, man- ULDADE DE ODONTOLOGIA DE BAURU - ESTOMATO- ifestations may include micrognathia, limited jaw opening, high 2 LOGIA, FACULDADE DE ODONTOLOGIA DE BAURU - vaulted and/or cleft palate, and weakness of the muscles of 3 CIRURGIA, FACULDADE DE ODONTOLOGIA DE mastication. A 19-year-old female patient diagnosed with AMC, BAURU - PATOLOGIA presenting class 2 malocclusion, facial asymmetry, big esqueleti- A male patient, 35 years-old, complaining about gingival cal open bite and sleep apnea was referred to the Oral and swelling in the anterior region of the maxilla three years ago and Maxillofacial Surgery service of the Federal University of For- was asymptomatic. Intraoral examination showed maxillary vol- taleza with the complaints of dissatisfaction with facial aspect, ume enlargement in the alveolar mucosa between the upper difficulty in breathing and in mastication. Orthognathic surgery canines. A panoramic radiography evidenced unilocular radiolu- was performed to improve these conditions. cent lesion circumscribed by radiopaque line extending from the right canine up to the second left premolar. No root resorption was observed but some teeth roots were displaced. Aspiration RHO GTPASES EXPRESSION IN ORAL SQUAMOUS 1 puncture was performed and brownish-yellow material was col- CELL CARCINOMA Marinho MAO , Marinho EO, Lemos lected and marsupialization was realized. The histopathological ACA, Fachinelli RL, Savarese LG, Crema VO - 1UNIVERSI- features revealed cystic cavity lined by parakeratinized stratified DADE FEDERAL DO TRIÂNGULO MINEIRO - DEPARTA- squamous epithelium with five to ten cell layers and palisaded MENTO DE CIRURGIA OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e95

Rho GTPases regulate various biological processes, such as short stature, osteosclerosis with multiple fractures, mandibular tumorigenesis. This study aimed to evaluate the distribution of hypoplasia, obtuse mandibular angle, delayed closure of cranial Rho GTPases in oral squamous cell carcinoma (OSCC). Immu- sutures, abnormal tooth formation, dysplasia of clavicles and nohistochemistry by avidin-biotin-peroxidase was performed for aplasia of terminal phalanges. Case report: Patient RPN, male, 12 RhoA, Cdc42 and Rac1, also intensity of stain quantified in 81 years old, with pycnodysostosis, attended the Special Care Den- cases of OSCC (classified according to World Health Organiza- tistry Center complaining of difficulties in chewing. On extraoral tion: well differentiated, moderately differentiated and poorly physical examination we observed short stature, aplasia of the differentiated). The expression pattern of RhoA varied in direct terminal phalanges, macrocephaly with prominent frontal bossing proportion to tumor differentiation (p Ͻ0.0001), suggesting their and brachycephaly. On intra oral examination, we observed: involvement in the regulation of differentiation. The less differ- anterior and posterior cross bite and mouth opening limitation. entiated the lesion and the greater the potential for proliferation CT imaging with 3D reconstruction showed hypoplasia of the increased expression of Cdc42 (p Ͻ0.0001), suggesting their maxilla and mandible with obtuse mandibular angle and crowed involvement in regulation of cell proliferation. Cells expressed tooth. The treatment plan included a rapid maxillary expansion Rac1 at the migratory front, indicating its involvement in the for correction of posterior crossbite and a face mask for the regulation of cell migration. The expression of RhoA, Cdc42 and correction of the anterior cross bite. Rac1 suggests that Rho GTPases may participate in signal trans- duction pathways regulating biological processes involved in the ASSESSMENT OF RISK FACTORS FOR THE OCCUR- pathogenesis of OSCC. RENCE OF ORAL LESIONS IN HIV-POSITIVE ADULTS FROM PORTO ALEGRE, BRAZIL Petruzzi MNMR1, Salum 2 2 2 1 HODGKIN’S LYMPHOMA DIAGNOSED IN A YOUNG FG , Cherubini K , Figueiredo MAZ - PONTIFICAL PATIENT UNDERGOING ROUTINE DENTAL CARE CATHOLIC UNIVERSITY OF RIO GRANDE DO SUL (PU- Sena-Filho M1, Fonseca FP1, Correa MB2, Mariano FV3, CRS) - POSTGRADUATE PROGRAM IN DENTISTRY, 2 Jorge J4, Vargas PA4, Santos-Silva AR4 - 1FACULDADE DE PONTIFICAL CATHOLIC UNIVERSITY OF RIO GRANDE ODONTOLOGIA DE PIRACICABA / UNIVERSIDADE ES- DO SUL (PUCRS) - ORAL MEDICINE UNIT, SÃO LUCAS TADUAL DE CAMPINAS - ESTOMATOPATOLOGIA / HOSPITAL DOUTORANDO, 2HOSPITAL DOS FORNECEDORES DE Objective: To assess the risk factors for oral manifestations CANA DE PIRACICABA - CIRURGIÃO DE CABEÇA E occurrence in HIV-positive adults. PESCOÇO, 3FACULDADE DE ODONTOLOGIA DE PI- Study design: A retrospective and descriptive-analytical RACICABA / UNIVERSIDADE ESTADUAL DE CAMPINAS survey was conducted in 534 medical/dental records. Socio- - ESTOMATOPATOLOGIA, 4FACULDADE DE ODONTO- demographical, clinical and laboratory data were collected from 6 month before and after the onset of oral lesions. Definitive LOGIA DE PIRACICABA / UNIVERSIDADE ESTADUAL diagnosed pathologies were included and classified according to DE CAMPINAS - ESTOMATOPATOLOGIA / PROFESSOR the criteria of ECC on Oral Problems Related to HIV infection. ASSOCIADO Cross-tabulations, Chi-squared tests and logistic regression mod- The purpose of this presentation is to report the case of a els were conveniently applied. 17-year-old female patient who was undergoing routine dental Results: A higher risk for oral candidiasis was associated to care in our Dental School when two fixed and hard on palpation the female gender (ORϭ0.66; CIϭ0.45-0.96; pϭ0.031), alcohol neck swellings, ranging from 3 to 5 cm in diameter, affecting the ϩ use (ORϭ2.38; CIϭ1.22-4.67; pϭ0.011) and CD4 Ͻ350cells/ left cervical region were noticed by an undergraduate student. mm3 (ORϭ3.82; CIϭ2.16-6.77; pϽ0.001). Hairy leukoplakia The patient was referred to our Oral Medicine Clinic where ϩ was associated to CD4 Ͻ350cells/mm3 (ORϭ8.48; CIϭ1.10- further examination included ultrasonography, which revealed a 65.54; pϭ0.040), viral loadϾ5000copies/mm3 (ORϭ8.02; deep conglomerate of enlarged lymph nodes, and a fine needle CIϭ2.04-31.52; pϭ0.003) and smoking (ORϭ2.85; CIϭ1.38- aspiration cytology (FNAC), which suggested the diagnosis of 5.88; pϭ0.005). lymphoma. An incisional biopsy was performed, confirming the Conclusion: Oral lesions strongly associated to HIV tended diagnosis of Hodgkin’s Lymphoma (further immunohistochemi- ϩ to occur in patients with low CD4 counts and detectable viral cal studies demonstrated positivity for LCA, CD20, MUM1, loads, females, smokers and alcohol users, independently of the CD30 and Ki-67). The patient was referred for medical treatment use of antiretroviral therapy. and is currently alive and free of the disease. The current case highlights the importance of systematic head and neck examina- tions during routine dental treatment. RECURRENT ADENOID CYSTIC CARCINOMA OF MAX- ILLARY SINUS Carvalho MV1, Fonseca FP1, Correa MB1, Silva ARS1, Vargas PA1, Almeida OP1, Lopes MA1 - 1PI- CRANIO-FACIAL CHARACTERISTICS OF PYCNODYS- RACICABA DENTAL SCHOOL, UNIVERSITY OF CAMPI- 1 2 OSTOSIS: CASE REPORT Vilela MCN , Carvalhaes CLL , NAS - ORAL DIAGNOSIS 2 2 2 1 Kitamura KT , Gallottini MHC , Rezende NPM - FAC- Adenoid cystic carcinoma (ACC) is an unusual tumor of ULDADE DE ODONTOLOGIA DA UNIVERSIDADE DE maxillary sinus. A 56-year-old woman was referred with 4-month SÃO PAULO, 2FACULDADE DE ODONTOLOGIA DA UNI- history of a non-ulcerated and painful nodule on the palate VERSIDADE SÃO PAULO impairing fit of the upper complete denture. Computed tomogra- Pycnodysostosis was described in 1962 by Maroteaux and phy showed a mass in the maxillary sinus. An incisional biopsy Lamy. It is a rare skeletal disease caused by a genetic autosomal was performed and histopathological diagnosis was adenocarci- recessive inheritance, with no predilection for sex, and related to noma. The patient was referred to head and neck surgeon who consanguineous families in 30% of cases. It is characterized by performed a surgical resection followed by radiotherapy. The ORAL MEDICINE OOOO e96 Abstracts October 2012 diagnosis of the surgical specimen was solid ACC. The patient shortened teeth and enlarged pulp space. A rare microform of remained well for two years when was observed recurrence in the bilateral cleft lip was identified. During childhood was noted floor of the right orbit. Fine needle cytology was performed and learning disabilities and difficulty in sweating with occasional the diagnosis was adenocarcinoma. The patient is in evaluation elevations in body temperature. for other surgical intervention. Maxillary sinus tumor is normally Conclusion: The microform of orofacial clefting is an un- diagnosed in advanced stage and may manifest as palatal swell- common CLPED1-associated feature that was recognized in our ing. The differentiation among adenocarcinoma NOS, salivary patient. This case expands the phenotypic spectrum of CLPED1 duct carcinoma and solid adenoid cystic carcinoma may be syndrome and is the first case in Brazil. challenging. MULTIPLE MYELOMA PRESENTING IN YOUNG ADULT MALIGNANT AMELOBLASTOMA: A CASE REPORT OF PATIENT – A CASE REPORT Lima MHA1, De Farias AC1, A RARE PRESENTATION OF THIS ODONTOGENIC Ferreira SMS1, Peixoto FB1, Barbosa APF2, Meeks VI3 - 1 1 1 2 TUMOR Andrade MF , Servato JP , Paulo LFB , Silva AM , 1CENTRO UNIVERSITÁRIO CESMAC, 2UNIVERSIDADE 3 4 1 1 da Silva SJ , Durighetto Jr. AF , Loyola AM - UFU - FEDERAL DE ALAGOAS, 3UNIVERSIDADE DE MARY- LABORATÓRIO DE PATOLOGIA ORAL E MAXILO FA- LAND CIAL DA FACULDADE DE ODONTOLOGIA DA UFU, Multiple Myeloma (MM) is a neoplastic proliferation of 2 UFU - LABORATÓRIO DE PATOLOGIA GERAL DA FAC- malignant plasma cells in the bone marrow producing defective ULDADE DE MEDICINA DA UFU, 3UFU - DEPARTA- immunoglobulins that release osteoclastic-activating factors re- MENTO DE CIRURGIA DE CABEÇA E PESCOÇO DA sulting in lytic bone lesions and pain. This is a case report of MM FACULDADE DE MEDICINA DA UFU, 4UFU - ÁREA DE presenting in a 29 year old Brazilian male that presented to the DIAGNÓSTICO ESTOMATOLÓGICO DA FACULDADE oral medicine clinic for evaluation of a “tumor” in his mouth. He DE ODONTOLOGIA DA UFU also complained of body aches and fever. Extraoral examination Malignant ameloblastoma is a rare tumor of odontogenic was significant for facial asymmetry on left side of the mandible origin with a metastatic focus. The literature shows that most and subepidermal nodule lesions throughout the body. Intraoral cases of malignant ameloblastoma involve a disease-free period examination revealed a red nodular, hemorrhagic exophytic le- from primary tumor extirpation to the discovery of metastasis. sion of the left mandible. The Diagnostic images (CT scan; bone This well documented report describes the case of a 42-year- scintigraphy and X-ray) showed a radiolucent “moth-eaten” im- old man presenting with bilateral cervical metastasis of amelo- age and disseminated lytic bone lesions. He died 40 days after the blastoma of the jaw. The first diagnosis was done 18 years before first visit. The immunohistochemistry from the bone marrow and the metastatic disease and the patient also presented a recurrence oral biopsy was diagnostic for plasmacytoma/MM-restricted of the primary lesion 8 years after the initial diagnosis. Surgical lambda chain, confirming the clinical presumptive diagnosis. resections of primary and distant disease are recommended and were performed in this case with success. Chemotherapy and CUTANEUOS LEISHMANIASIS IN LOWER LIP Lawall radiation may play a role in palliation when resection of meta- MA1, Sousa GLC2, Leitão ECV3, Soubhia AMP4 - 1UNIVER- static disease is not feasible, but the prognostic remain uncertain. SIDADE DE SÃO PAULO - PATOLOGIA BUCAL, 2UNI- Our case, although its rarity, showed the importance of a long VERSIDADE DE SÃO PAULO, 3HOSPITAL REGIONAL DA term preservation of the patients with ameloblastomas. ASA NORTE - HRAN - SERVIÇO DE ESTOMATOLOGIA, 4FACULDADE DE ODONTOLOGIA DE ARAÇATUBA - UNCOMMON PHENOTYPE IN CLEFT LIP AND/OR FOA/UNESP - PATOLOGIA E PROPEDÊTICA CLÍNICA PALATE-ECTODERMAL DYSPLASIA SYNDROME: BRA- Leishmaniasis is a parasitic disease caused by a protozoon ZILIAN CASE REPORT Melo Filho MR1, Paranaíba LMR1, (Leishmania) with diverse clinical forms, considered a public Aquino SN2, Coletta RD2, Santos LAN3, Martelli-Junior H1 - health problem in Brazil. Oral lesions are uncommon and usually 1STATE UNIVERSITY OF MONTES CLAROS, UNIMON- involve the palate. A 34-years-old man was admitted to the TES, MONTES CLAROS, MINAS GERAIS STATE, BRAZIL - Dental Clinic of HRAN – Brasília with complaints of a swelling of three month’s duration, which involved the right side of the HEALTH SCIENCE PROGRAMME, 2SCHOOL OF DEN- lower lip. The swelling was slightly erythematous with ulcer- TISTRY, STATE UNIVERSITY OF CAMPINAS, PIRACI- ation, crusts and scaling. The lesion was asymptomatic and CABA, SÃO PAULO STATE, BRAZIL - DEPARTMENT OF progressively increased in size. There were no changes in general ORAL DIAGNOSIS, 3 STATE UNIVERSITY OF MONTES health. A clinical diagnosis of squamous cell carcinoma was CLAROS, UNIMONTES, MONTES CLAROS, MINAS made and an incisional biopsy was performed. Histopathologic GERAIS STATE, BRAZIL - DEPARTMENT OF DENTISTRY examination showed a chronic inflammatory infiltrate. Several Objective: The study describes the clinical features of a 12 Leishmania spp. amastigotes were observed in the cytoplasm of year-old boy affected by Cleft lip and/or palate-ectodermal dys- macrophages, which led us to the diagnosis of leishmaniasis. The plasia syndrome (CLPED1; #MIM 225.060). patient was treated with N-methylglucamine antimonite, with Study design: Were evaluated clinical, dermatologic, orofacial, complete remission in approximately 8 weeks. During follow-up radiographic and cone beam tomography examination to the case. of 8 months, no relapses were observed. Results: Unusual facie, dry and wiry hair, dry and hyper- keratotic skin of the hands, legs, and face, onychodystrophy of the finger and toe nails, hypotrichosis in legs. Oral manifestations PRIMARY ORAL SQUAMOUS CELL CARCINOMA were characterized by malocclusion and several dental anomalies WITH SIGNET RING CELLS Alves MGO1, Marsi G, Ro- such as agenesis teeth, enamel hypoplasia, pulpar calcifications, drigues TW, Tera TM, Sousa SCOM2, Carvalho YR, Almeida OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e97

JD - 1UNESP - UNIV. ESTADUAL PAULISTA - BIOCIÊN- Results: the erosive form was most prevalent(57.1%) and CIAS E DIAGNÓSTICO BUCAL, 2UNIVERSIDADE DE SÃO symptoms were reported by 45.7% of the patients. Most cases PAULO - ESTOMATOLOGIA were non-smoker(97,3%) and none was drinker; 10,8% and Oral squamous cell carcinoma is the most common malig- 16,2% were diabetic and hypertensive, respectively. Only one nancy in oral cavity and it can present a great morphological was HCV-seropositive and 78,4% had moderate levels of anxi- variety, however, the signet ring variant is extremely unusual. An ety. There was no significant association of variables studied with 54-year-old man complained of pain and difficulty to open the clinical form or symptomatology of the lesions. mouth. The patient seek for the outpatient clinic after he has Conclusions: in this study, presence of local and systemic visited eighteen dentists. No professional made a diagnosis. Oral factors, as well as levels of anxiety were not associated with exam showed that there was a mass in the submandibular gland and clinical characteristics of OLP. an ultrasound was requested. Incisional biopsy was obtained, and the histopathology revealed the presence of malignant glandular neo- UNICYSTIC AMELOBLASTOMA WITH MURAL PRO- plasm, in which it could be noted a continuity normal excretory duct, LIFERATION Garcia NG1, Rodrigues MT2, Garcia AS1, Bra- hyperplastic tissue, with hyperchromatic nuclei, loss of polarity and vo-Calderón DM1, Oliveira DT1 - 1BAURU SCHOOL OF cohesion, with irregular epidermoid cells that infiltrate the adjacent DENTISTRY, UNIVERSITY OF SÃO PAULO, BAURU, SÃO connective tissue, interposed to hyperchromatic cells with the ap- PAULO, BRAZIL - DEPARTMENT OF STOMATOLOGY, pearance of signet ring. The final diagnosis was squamous cell AREA OF PATHOLOGY, 2DENTIST, PRIVATE PRACTICE, carcinoma with signet ring cells. This case illustrates the importance RORAIMA, BRAZIL of oral examination, including palpation. Abstract: The unicystic ameloblastoma often is diagnosed clinically as dentigerous cyst. We report the case of a 19-year-old KNOWLEDGE OF TWO BRAZILIANS CITIES (RIO DE girl that during a routine radiographic examination showed a JANEIRO, RJ AND NHAMUNDA, AM) ABOUT ORAL unilocular radiolucent lesion in the right mandibular ramus, and SELF-EXAMINATION AND IDENTIFICATION OF THREE involving the impacted tooth 48. There was no associated pain COMMON ORAL LESIONS Moriel Tavares KM1, Souza and was not observed expansion of the cortical bone. The dentist TT1, Pinto LF2, Gusmão TA2, Santos CSF2, Ramos MEB3, suggested as a possible diagnosis, dentigerous cyst. The lesion Israel MS3 - 1UERJ - FACULDADE DE ODONTOLOGIA, was enucleated, and the material was sent for analysis. Micro- scopically was observed cystic cavity lined by epithelium which 2FACULDADES SÃO JOSÉ - FACULDADE DE ODONTO- the basal cells were columnar, hyperchromatic, and palisaded. LOGIA, 3UERJ - DEPARTAMENTO DE DIAGNÓSTICO Underlying the fibrous capsule was noted proliferation of neo- ORAL E CIRURGIA plastic cells with areas of squamous metaplasia. The final diag- Objectives: To evaluate the knowledge about oral self- nosis established was of unicystic ameloblastoma with mural examination in two Brazilians cities, Rio de Janeiro (RJ) and proliferation. Despite the great similarity clinical and radio- Nhamundá (AM) and the recognition of three common oral graphic with dentigerous cyst, ameloblastoma unicystic has 10- lesions: minor aphta, labial herpes and chronic erythematosus 20% of recurrence. Therefore, histopathological examination is candidiasis. of great importance for definitive diagnosis. Study design: A thousand interviews were made, 800 in Rio Key words: dentigerous cyst; odontogenic; unicystic amelo- de Janeiro (RJ) and 200 in Nhamunda (AM). blastoma Results: Concerning the knowledge of oral self-examination 56% of the population didn’t know it. About the oral lesions, almost all the people (96%) interviewed has recognized a lesion in the EVALUATION OF P53 AND P63 EXPRESSION AND photographs. However, no one could diagnose them correctly. THEIR CORRELATION WITH HPV VIRUS IN ORAL 1,2,3,4,5 1 Conclusion: more educative actions about oral medicine are DYSPLASTIC LESIONS Kargahi N - UFES - DE- 2 necessary to improve the knowledge of oral health among the PARTAMENTO DE PATOLOGIA, DR. MASHHADI ABBAS 3 4 population. FATEMEH, DR. MOSHREF MOHAMMAD, DR. NADJI SEYED ALI REZA, 5DR. KHARAZI FARD MOHAMMAD JAVAD CLINICAL STUDY AND LEVELS OF ANXIETY IN A SERIE Abstract 1 OF CASES OF ORAL LICHEN PLANUS Barbosa NG , Background and aim: Approximately 94% of all oral ma- 1 1 2 Medeiros AMC , Silveira EJD , Oliveira PT , Queiroz lignancy is Squamous Cell Carcinoma. Multiple factors can in- 1 1 2 1 LMG , Lima ENA , Araújo EMA - UNIVERSIDADE FED- crease risk of malignancy. According to this, it is mentioned to ERAL DO RIO GRANDE DO NORTE - PROGRAMA DE roles of tumor suppressor genes as P53 and its family such as P63 PÓS-GRADUAÇÃO EM PATOLOGIA ORAL, 2UNIVERSI- and HPV virus in facilitating of malignant transforming. P53 DADE FEDERAL DO RIO GRANDE DO NORTE protein is one of malignant transforming markers and P63 can Objective: to associate local factors, systemic diseases and play an important role in developing epithelial dysplastic levels of anxiety with clinical characteristics of Oral Lichen changes. Also HPV may be correlated with early stages of cancer Planus(OLP). development in oral cavity. Study design: thirty-seven patients with OLP were assessed The aim of this study is assessment of P53 and P63 expres- for the presence of smoking, alcohol consumption, diabetes mel- sion and their correlation with presence of HPV in oral dysplastic litus, hypertension and hepatitis C virus infection. Anxiety was lesions. measured by Spielberger’s Stai-Trait Anxiety Inventory. These Material and method: In this descriptive-analytic study variables were associated with clinical form and symptomatology forty paraffin blocks were collected from oral and maxillofacial of the lesions(chi-square/Fisher’s-exact test). pathology department of Shahid Beheshti dental school. They ORAL MEDICINE OOOO e98 Abstracts October 2012 were included thirty samples with histopathologic reports of performed and the histopathological examination revealed cellu- dysplastic lesions (mild, moderate, severe) and ten ones with lar nests within the connective tissue stroma. In the center of mucocele diagnosis. these nests, cells were arranged sparsely similar to the stellate Immunohistochemical staining with Envision method was reticulum of the enamel organ, whereas in the periphery cells performed against P53 and P63 markers and Polymerase Chain were columnar with reverse polarity and aligned. Also, follicles Reaction (PCR) method was used for detection of HPV virus. presenting squamous metaplasia and cells presenting vacuolated Statistical analysis was down with SPSS software and Kruskul- or clear cytoplasm were observed. The diagnosis was then con- Wallis, Dunn, Mann-Whitney U and Spearman tests. clusive for acantomathous ameloblastoma and the patient was Findings: In this research the expression of nuclear P53 and immediately referred to a high-complexity hospital for surgical P63 staining was predominant in basal/parabasal layers of epi- treatment. thelium. There was a significant difference in P53 staining only between mucocele and mild dysplasia (PϽ0.05) .A significant NECROTIZING SIALOMETAPLASIA OF PALATE: A CASE difference in P63 staining between mucocele and all dysplastic REPORT Silva PVR1, Pereira DL1, Rodrigues GHC1, Silva Ͻ lesions (mild, moderate, severe) was also seen. (P 0.05) HPV AP1, Lopes RN1, Prado JD1 - 1HOSPITAL AC CAMARGO - virus was detected in all groups and there is no significant STOMATOLOGY difference between them. Necrotizing Sialometaplasia (NS) is an inflammatory lesion Conclusion: We concluded that there is no statistically sig- involving the salivary glands, not very common, which presents nificant correlation between P53, P63 expression and presence of self-limiting nature. It affects principally the minor salivary HPV virus in oral dysplastic lesions but significant correlation glands of palate (80%) and its etiology is currently attributed to between P53, P63 intensity and expression in two layers was vascular ischemia, which can be caused by trauma. Both clini- seen. cally and histopathologically, it mimics malignant neoplasms. The aim of this work was to report a case of NS in a 46-year-old EVALUATION OF FLUORESCENCE SCREENING IN THE man. A driver patient, smoker for 30 years, showed up with an DETECTION OF ORAL PRE- AND MALIGNANT ulcerative lesion on the palate, reporting its appearance two LESIONS Aksakalli N1, Yalcinkaya S2, Dumlu A, Ozbayrak S months ago, in the form of lump. Reported also that he was been - 1UNIVERSITY OF ISTANBUL INSTITITUDE OF ONCOL- submitted to a drainage attempt. We carried out an incisional OGY - TUMOUR PATHOLOGY, 2MARMARA UNIVERSITY biopsy with diagnostic hypotheses of Squamous Cell Carcinoma - ORAL DIAGNOSIS AND RADIOLOGY and NS. The client has progressed well and on postoperative Objectives: To evaluate the accuracy of a fluorescence showed a crateriform scar completely epithelialized and persis- screening system (VELscope, LED Dental, British Columbia, tent. This report strengths the importance of correct diagnosis for Canada) and its ability to diagnose the dysplasia and malignancy client’s tranquility. comparing to cyto- and histopathological examination. Study design: A total of 96 patients (57 males and 48 METASTATIC ADENOCARCINOMA OF THE BREAST 1 females, mean age 59.5Ϯ12 years) with 115 suspicious oral PRESENTING AS A PERIAPICAL ABSCESS Giannini PJ , white, red or mixed patches were investigated with a standard Narayana N1, Casey JH1, Shetty KV, Henriksen BJ2 - 1UNI- conventional examination and then with VELscope, followed by VERSITY OF NEBRASKA MEDICAL CENTER COLLEGE smear and/or biopsy. The cases of fluorescence retain, increase or OF DENTISTRY - ORAL BIOLOGY, 2PRIVATE PRACTICE loss were photographed. IN ORAL AND MAXILLOFACIAL SURGERY Results: 29 patients had leuko- and erthro-plakia, 26 had This is a rare case of a metastatic adenocarcinoma presenting oral lichen planus, 22 hyperkeratosis, 10 cancer, 5 actinic chei- as a periapical abscess in a 58-year-old Caucasian female with no litis, 2 pemphigoid, 2 hyperplastic candidiasis. Sensitivity and previous history of cancer. specificity were 76 % and 70 % respectively. The patient presented with a periapical abscess and bony Conclusions: Based on research data, there are a couple of sequestrum in association with the apex of #31 measuring 1.0 x issues which raised regarding the efficacy in identifying individ- 1.0 cm. Paresthesia of the right inferior alveolar nerve was ual lesions. The examiner calibration was difficult and the system reported. The lesion was curetted. Intimate involvement of the has not showed the expected diagnostic accuracy. lesion with the inferior alveolar nerve was noted at surgery. Radiographically the lesion presented as a well-defined non- ACANTOMATHOUS AMELOBLASTOMA: CASE REPORT corticated radiolucency at the apex of #31. The clinical differen- Diniz PA1, Lima CF1, Tango EK1, Santos LM1, Acay R1, tial diagnosis included periapical abscess or periapical granuloma Machado MC1, Brandão AAH1 - 1FACULDADE DE ODON- with early osteomyelitis. Histopathologic examination revealed a TOLOGIA DE SÃO JOSÉ DOS CAMPOS UNESP - DEPAR- neoplasm comprised of atypical epithelial cells forming occa- TAMENTO DE BIOCIÊNCIAS E DIAGNÓSTICO BUCAL sional glands and set within a desmoplastic stroma. Immunohis- A Caucasian 63-year-old female presented with chief com- tochemical staining was positive for BRST-2, estrogen receptor, plaint of painful, gradual gingival enlargement at the inferior and cytokeratin 7; and negative for cytokeratin 20 and TTF-1. premolars region after undergoing endodontic treatment. In- The diagnosis rendered was metastatic breast adenocarcinoma traoral examination revealed a sessile, firm, pale-pink nodular based on the immunohistochemical profile. lesion, measuring near 2cm. Radiographically, the lesion pre- sented as a multilocular radiolucent area misplacing roots of the RHINOCEREBRAL MUCORMYCOSIS: CASE REPORT correspondent premolars. Computerized tomography scan Povoa RCS1, Costa RC2, Malière D2, Falheiro D2, Alfaya showed areas of cortical expansion and areas of bone destruction TA3, Israel MS4, D’Albuquerque Medeiros PJ4 - 1UERJ - and infiltration to surrounding soft tissues. Incisional biopsy was FACULDADE DE ODONTOLOGIA, 2UERJ - HOSPITAL OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e99

UNIVERSITÁRIO PEDRO ERNESTO, 3UFF - MESTRANDA DATION OF AMAZONAS (HEMOAM), 3FEDERAL EM CLÍNICA ODONTOLÓGICA, 4UERJ - DEPARTA- UNIVERSITY OF AMAZONAS - PATHOLOGY AND LEGAL MENTO DE DIAGNÓSTICO ORAL E CIRURGIA MEDICINE Mucormycosis is a deep opportunist fungal infection and Objective: The purpose of this study was to clinically eval- when is rhinocerebral have an unfavorable prognostic. It mani- uate oral mucositis (OM) after chemotherapy in patients with fests as a large tissue destruction, facial swelling, secretion and onco-hematological diseases treated in the Hematology and He- nasal obstruction, and can lead to blindness. The mode treatment matotherapy Foundation of Amazonas from August 2011 to is the radical surgical debridement of infected tissue associated March 2012. with intravenous antifungal. The purpose of this study is to report Study design: Patients were submitted to intra-oral exami- a clinic case of a female patient, 28 years, black, decompensated nation for identification and description of OM according to diabetes mellitus. Clinical features were observed facial man- WHO classification and then related to clinical and treatment data gling with flattening of the tip and nose dorsum, and extensive collected from medical records. necrotic lesion in anterior hard palate bringing a communication Results: Sixty seven patients were examined and 15% of oronasal. The CT with contrast showed brain abscesses. The them presented OM, in which 100% had leukemia (80% acute patient was treated in medical and surgical way. This case report lymphoblastic and 20%, acute myeloid), 40% had grade 4, 30% of rhinocerebral mucormycosis with oral manifestations is most grade 1 and 30% grade 3 according to WHO classification. There interest because it did not progressed rapidly to a fatal termina- were a variety of chemotherapeutics agents used in the OM tion, and the reason what determined the success of this case was presented patients (especially MTX and MADIT), but most of the immediately identification and aggressive intervention. them (80%) were in the induction phase of treatment. Conclusion: OM seems to be a common consequence espe- cially in leukemia patients using chemotherapy agents. A CLINICOPATHOLOGIC DESCRIPTIVE STUDY OF 69 CASES OF ACTINIC CHEILITIS USING AUTOFLUORES- CENCE IMAGING SYSTEMS AS AUXILIARY DIAGNOS- CLINICAL AND HISTOLOGICAL DIAGNOSED KAPO- 1 2 3 SI’S SARCOMA WITH NO EXPRESSION OF HUMAN TIC TOOLS Faustino ISP , Takahama Júnior A , Pires FR , 1 4 2 2 2 HERPESVIRUS 8 Moura RM , Costa CR, Martins MT - Kurachi C , Camisasca DR , Fontes KBFC , Azevedo RS - 1 1UNIVERSIDADE FEDERAL FLUMINENSE, NOVA FACULDADE DE ODONTOLOGIA DA USP - DEPARTA- FRIBURGO/RJ, BRASIL - FACULDADE DE ODONTOLO- MENTO DE PATOLOGIA GIA, 2UNIVERSIDADE FEDERAL FLUMINENSE, NOVA The Kaposi’s sarcoma is a vascular neoplasm that occurs in FRIBURGO/RJ, BRASIL - ESTOMATOLOGIA E PATOLO- different population groups, especially in patients with compro- mised immune system, being the most common cancer in HIV- GIA ORAL, 3UNIVERSIDADE DO ESTADO DO RIO DE infected untreated individuals. Clinically, in oral mucosa, pres- JANEIRO, RIO DE JANEIRO/RJ, BRASIL - PATOLOGIA ents as macules, plaques or purple nodules. Its etiopathogenesis is ORAL, 4UNIVERSIDADE DE SÃO PAULO, SÃO CARLOS/ not it well clear yet, and several studies have been undertaken in SP, BRASIL - INSTITUTO DE FÍSICA DE SÃO CARLOS an attempt to identify the causative agent of these lesions. Actu- Objectives: The aim of this study was to present the clini- ally, Kaposi’s sarcoma has been associated with herpesvirus copathologic features of actinic cheilitis (AC) with the use of (KSHV; also known as human herpesvirus 8 (HHV8) and con- autofluorescence imaging systems as diagnostic tools. sidered the infectious cause of this neoplasm Alpha. The World Study design: Clinical and microscopical characteristics of Health Organization (WHO) recommends that the diagnosis of 69 cases of AC diagnosed using wide-field optical imaging Kaposi’s sarcoma must always be related to the HHV8 presence. system and fluorescence spectroscopy were detailed described. However, the Department of Oral Pathology at the School of Results: 50.7% were male, 89.9% had 42 years or older and Dentistry, University of São Paulo, received two cases of Kapo- 68.1% had skin color types I, II or III. Cases involved lower si’s sarcoma in HIV positive patients diagnosed clinically and (100%) and upper (13%) lips. Blurred vermilion border demar- histologically, but were negative for HHV8 immunohistochemi- cation (97.1%), swelling (78.3%) and red areas (69.6%) were the cal analysis. The patients responded successfully to anticancer main clinical features; and epithelial atrophy (42.1%), hyperker- treatment. atosis (43.5%), intense vascularization (38.6%) and inflammation (27.6%) the main microscopical changes. One case was diag- BIFID AND TRIFID CONDYLE: REPORT OF A CASE nosed as squamous cell carcinoma, and as having mild (44.8%), 1 moderate (34.5%) or intense (8.3%) dysplasia. AND RADIOGRAPHIC DIAGNOSIS Raitz R , di Matteo 2 2 1 Conclusions: The use of optical tests clinical assistance in AC , Shimura E, Fenyo-Pereira M - INSTITUTO SÃO 2 the diagnosis of AC improved accuracy on identification of LEOPOLDO MANDIC - POS GRADUAÇÃO, FOUSP - microscopical characteristics associated with a possible malig- ESTOMATOLOGIA nant transformation. Background/objectives: The bifid condyle is a very rare and uncertain pathology. Our aim is to report a case of a 25 years old patient who suffered trauma 5 years ago. ORAL MUCOSITIS IN PATIENTS WITH ONCO-HEMA- Study design: The panoramic radiograph, requested for den- TOLOGICAL DISEASES TREATED WITH CHEMOTHER- tal treatment, showed bifurcation of the right condyle and trifur- APY IN THE HEMATOLOGY AND HEMOTHERAPY cation of the left condyle as well as remodeling of the mandibular 1 FOUNDATION OF AMAZONAS Santos RTN , Bastos fossa. Although there was little limitation of mouth opening and MMB1, Ferreira CMB2, Camara J3, Liborio TN3 - 1FED- deviation, no pain and popping were observed. ERAL UNIVERSITY OF AMAZONAS - SCHOOL OF DEN- Results: Volumetric tomography showed a larger anterior TISTRY, 2HEMATOLOGY AND HEMATOTHERAPY FOUN- lobe and a smaller posterior lobe in the right condyle. On the left ORAL MEDICINE OOOO e100 Abstracts October 2012 condyle it was found a fork head divided into anterior and Osteoradionecrosis (ORN) is a severe and devastating late posterior lobes and this last one had another inferoposterior lobe. complication of radiotherapy in patients with head and neck Conclusions: The bone remodeling patterns of the left side cancer. Progression of the condition may lead to pathologic suggests that the patient initially presented a fork bilateral con- fracture, intraoral and/or extraoral fistula formation, and local, dyle of embryological origin and suffered fracture, which caused spreading or systemic infection. The current article reports an metaplasia of fibroblasts, bone remodeling and development of a interesting case of ORN in an irradiated patient, which evolved third lobe with large joint remodeling. into pathological fracture of the jaw. The patient was rehabili- tated in other service, with the use of reconstruction plates, without adjuvant hyperbaric oxygen therapy, progressing to a PERIPHERAL CALCIFYING CYST ODONTOGENIC TU- fistula formation and bone exposure. The patient was referred to MOR: A CASE REPORT Rosa EA1, Curado MM, Morais our service, with an extensive bone and plate exposure, with KP2, Lawall MA, AMORIM RFB3 - 1UNIVERSIDADE DE signs of severe ORN. After the adequacy of the oral environment, BRASÍLIA - PÓS-GRADUAÇÃO EM CIÊNCIAS MÉDICAS, the patient underwent surgery for necrotic bone and reconstruc- 2UNIVERSIDADE DE BRASÍLIA - RESIDÊNCIA MULTI- 3 tion plate resection, with a primary closure of the skin and PROFISSIONAL EM SAÚDE, UNIVERSIDADE DE BRASÍ- intraoral mucosa. The post- operative clinical and radiographic LIA - PATOLOGGIA - FACULDADE DE MEDICINA examinations performed after 12 month showed no signal of The peripheral calcifying cyst odontogenic tumor is a rare ORN recurrence. benign cystic neoplasm of odontogenic origin. It accounts for less than 25% of the calcifying cyst odontogenic tumor and usually PEPTIDE EGF REGULATES MIGRATION AND MMPS appears as a pink circumscribed elevated mass. A 42-year-old was referred to a privet stomatotologist for evaluation of an ACTIVITY OF A HUMAN SALIVARY GLAND ADENOID CYSTIC CARCINOMA CELL LINE Cecim RL1, Carreira asymptomatic, pink, smooth surfaced nodule in the vestibular 1 2 region of teeth 12 and 13 measuring 1,4cm. Computer tomogra- ASD , Rosa MRP, Pinto LCD , Aquime JRHS, Kataoka 1 1 1 phy showed horizontal bone loss and saucerization. A biopsy was MSS , Pinheiro JJV - FEDERAL UNIVERSITY OF PARÁ- performed and the microscopic examination showed an odonto- UFPA - POSTGRADUATION IN DENTISTRY - PPGO, 2 genic cystic lesion lined by ameloblastoma-like epithelium, con- FEDERAL UNIVERSITY OF PARÁ-UFPA - GRADUATION taining numerous ghost cells. Delicate surgical excision was IN DENTISTRY performed and after 6 months of follow up there was no clinical Background/objective: Adenoid cystic carcinoma (ACC) is or radiographic sign of recurrence. This case presents a new a slow-growing but aggressive neoplasm with a remarkable ca- peripheral calcifying cyst odontogenic tumor and provides more pacity for recurrence. Growth factors are thought to be involved evidences of non-aggressive behavior of the lesion in formation and progression of cancer, and also up-regulate matrix metalloproteinase (MMPs), such as MMP2 and MMP9. MMPs are downstream targets of epidermal growth factor recep- AMELANOTIC MELANOMA OF THE MAXILLA: A CASE tor (EGFR). EGF is a ligand for EGFR and has been shown to REPORT Rosa RR1, Souza ACP, Freitas Filho SAJ, Oliveira enhance the invasive and metastatic potential of various human MTF, Durighetto Jr. AF, Hiraki KR, Loyola AM - 1UNIVER- cancers. We studied the role played by peptide EGF on migration SIDADE FEDERAL DE UBERLÂNDIA - ÁREA DE PATO- of cells (CAC2) from human ACC. LOGIA ORAL Study design: Immunofluorescence analyzed expression of A 63 years-old male was referred for evaluation of an ex- MMP2, MMP9, EGF, and EGFR in CAC2 cells. Migratory pansive lesion in the palate. It was painless and the patient was activity of EGF-treated CAC2 cells was investigated by mono- not aware of the evolution time of the lesion. The patient reported layer wound assays and in chemotaxis chambers. previous history of lower limb thrombosis, chronic smoking and Results: This cell line expressed, EGF, EGFR, and showed intense weight loss in the last month. Clinical inspection revealed MMPs activity. CAC2 cells treated with EGF showed increased a large fibrous mass involving the entire hard palate, lobulated migration activity. and covered by ulcerated mucosa, with apparent extension to the Conclusion: These results suggest that these growth factors nasal cavity. CT scan evidenced extension to both maxillary may be involved in the tumorigenic process of ACC. sinuses. After incisional biopsy, histopathological examination Key words: adenoid cystic carcinoma; growth factors; ma- informed a malignant neoplasm of unknown histogenesis. It was trix metalloproteinases reactive for melan A and S100 on immunohistochemistry, and the diagnosis was then concluded as amelanotic melanoma. The patient was referred to treatment, but died three weeks after CLINICAL FEATURES AND DENTAL MANAGEMENT OF A LATE DIAGNOSED CONGENITAL HYPOTHYROID- diagnosis. 1 1 1 Apoio: FAPEMIG, UFU, CAPES, CNPQ. ISM: A CASE REPORT Rodrigues RB , Pinto JV , Weber A , Mezomo MB1, Payeras MR1, Ferrazzo KL1 - 1UNIFRA Congenital hypothyroidism (CH) is a disease caused by a AN INTERESTING CASE OF EXTENSIVE OSTEORADIO- change in the thyroid gland, with irreversible consequences if the NECROSIS OF THE MANDIBLE WITH NECROTIC BONE disease is not early diagnosed and properly treated. The diagnosis AND RECONSTRUCTION PLATE EXPOSURE Straman- is established by newborn exams, which is part of the neonatal 1 2 2 dinoli-Zanicotti RT , Schussel JL , Dissenha JL , Zanferrari screening of all newborns. This study reports a case of CH late 2 2 2 2 1 FL , Giustina JCD , Cesa TS , Sassi LM - FACULDADE diagnosed and the consequences in dental development. Female DE MEDICINA DA USP - DOUTORADO EM ONCOLOGIA, patient with 18 years old, light weight and short stature. Delayed 2HOSPITAL ERASTO GAERTNER - DEPARTAMENTO DE in motor and language development, school learning disability CIRURGIA BUCOMAXILO-FACIAL and attention deficit were reported. Oral examination revealed OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e101 retention of deciduous teeth, oligodontia, periodontal disease and SIALOLITH IN PAROTID GLAND AND SUBLINGUAL caries. Restorative, periodontal and surgical treatments were per- GLAND: CASE REPORT Carvalho H1, Akra I1, Gomes W1, formed. After this, the patient was referred for orthodontic treat- Bahia TPS2, Maciel RM2, Ramos MEB2, Israel MS2 - 1UERJ ment. Early diagnosis as well as treatment and control of the - FACULDADE DE ODONTOLOGIA, 2UERJ - DEPARTA- patient’s hormone levels are important to avoid complications in MENTO DE DIAGNÓSTICO ORAL E CIRURGIA several organ and systems. Late diagnosed CH is associated with Sialoliths are most common in submandibular gland. Sialo- changes in dental development. liths in parotid and sublingual glands are uncommon. The aim of this study to report two cases of sialoliths, affecting the parotid and another affecting sublingual gland. Case 1- A 80 year-old REACTIVE POST-RADIOTHERAPY BONE FORMATION Caucasian man had a week painful swelling on mouth floor, IN THE MAXILLA: A CASE REPORT OF AN UNUSUAL blocking the use of the prosthesis. The physical examination Mariano FV1, Gondak RO1, Santos-Silva PRESENTATION showed the presence of painful palpable lymph nodes and a AR1, Corrêa MB2, Almeida OP1, Lopes MA1 - 1FOP/UNI- 2 swelling with red surface on mouth floor. The panoramic and CAMP - DIAGNÓSTICO ORAL, HOSPITAL DOS FOR- occlusal radiographs showed the sialolith, which was surgically NECEDORES DE CANA - CABEÇA E PESCOÇO removed. Case 2- A 56 year-old black woman had a swelling Objective: High-dose radiation therapy affects bone metab- with no symptoms in parotid gland region that kept growing for olism and therefore post-radiotherapy bone formation is an un- 1 year. The oral examination showed a swelling on the parotid common finding. This case describes an unusual ossification in papilla, with hard consistency. The panoramic radiograph the maxillary region identified after head and neck radiotherapy. showed the sialolith, which was surgically removed. After one Study design, results: A 45 year-old female patient was year no sign of recurrence were noted in both cases. submitted to maxillary surgical resection and orbital exenteration due to squamous cell carcinoma. Radiotherapy post surgery was 〈 performed because of compromised surgical margins. After four IMMUNOEXPRESSION OF 2-INTEGRIN AND HSP47 IN months of the conclusion of radiotherapy, the patient presented a HEREDITARY GINGIVAL FIBROMATOSIS AND GINGI- bone exposition at surgical site. Surprisingly, the oral examina- VAL FIBROMATOSIS-ASSOCIATED DENTAL tion and computed tomography revealed a new formation of the ABNORMALITIES Borges-Pêgo SP1, Vieira Júnior JR, San- right palatine vault and bone formation filling nasal and orbital tos CO, Costa CD1, Paranaíba LMR1, Coletta RD2, Martelli- cavity. The incisional biopsy discarded residual disease or osteo- Junior H1 - 1UNIVERSIDADE ESTADUAL DE MONTES radionecrosis and showed normal tissue. CLAROS - UNIMONTES - ODONTOLOGIA, 2UNIVERSI- Conclusion: To the best of the authors’ knowledge, this is DADE ESTADUAL DE CAMPINAS - UNICAMP the first case of wide bone formation as an early effect of head The purpose of the study was to investigate the expression of and neck radiotherapy. The current patient continues being ac- the ␣2-integrin subunit and heat shock protein 47 (Hsp47). Im- companied monthly. munohistochemistry was performed in specimens from two un- related families with hereditary gingival fibromatosis and from one family with a gingival fibromatosis-associated dental abnor- MOUSE B16-F10 MELANOMA CELLS PROLIFERATION 1 mality. Normal gingival (NG) were used for comparison. Immu- IS DEPENDENT ON FATTY ACID SYNTHASE Ortega R , ␣ 2 3 1 noreactivity for 2-integrin and Hsp47 was observed in the Agostini M , Bastos DC , Graner E, Zecchin KG - PIRACI- nucleus of epithelial cells of both the basal and suprabasal layer CABA DENTAL SCHOOL, UNIVERSITY OF CAMPINAS and a more discreet signal was noted in connective tissue in all 2 (UNICAMP) - DIAGNÓSTICO ORAL, SCHOLL OF DEN- samples. Our results confirmed the heterogeneity of gingival TISTRY, FEDERAL UNIVERSITY OF RIO DE JANEIRO fibromatosis (GF), such that similar patterns of expression of the (UFRJ) - DEPARTMENT OF PATHOLOGY AND ORAL condition may show differences in the expression of proteins DIAGNOSIS, 3PIRACICABA DENTAL SCHOOL, UNIVER- such as Hsp47. Although no difference in ␣2-integrin expression SITY OF CAMPINAS (UNICAMP) - ORAL DIAGNOSIS was observed between GF and NG groups, future studies are Objectives: The aim of this work was to investigate the necessary to determine the exact role of this protein in the various effects fatty acid synthase (FASN) inhibitors over mouse B16- forms of GF and whether it contributes to GF pathogenesis. F10 melanoma cells proliferation. Study design: After treatment with cerulenin or C75, we METASTASIS OF HEPATOCELULLAR CARCINOMA TO analyzed cell viability, proliferation rate, apoptosis and the levels of proteins related to G0/G1 phase of cell cycle. THE ORAL CAVITY: CASE REPORT AND REVIEW OF THE LITERATURE Kang SR1, Choi EJ1, Kim HS2,3, Kim J2,3, Results: Both FASN inhibitors significantly reduced in vitro 1,3 1 melanoma cells proliferation in a dose dependent manner, as well Kim HJ - COLLEGE OF DENTISTRY, YONSEI UNIVER- as increased the apoptotic rate. Cell cycle arrest was evidenced by SITY, SEOUL, SOUTH KOREA - DEPARTMENT OF ORAL 2 a significant increase in G0/G1 phase in comparison with un- AND MAXILLOFACIAL SURGERY, COLLEGE OF DEN- treated cells. Western blotting analysis of cerulenin or C75- TISTRY, YONSEI UNIVERSITY, SEOUL, SOUTH KOREA - 3 treated cells showed a significant accumulation of the tumor DEPARTMENT OF ORAL PATHOLOGY, COLLEGE OF suppressor proteins p21WAF1/Cip1 and p27Kip1, together with de- DENTISTRY, YONSEI UNIVERSITY, SEOUL, SOUTH KO- creased amounts of Skp2, essential for the proteasomal degrada- REA - ORAL CANCER RESEARCH INSTITUTE tion of p27Kip1. Metastatic malignant neoplasms to the oral cavity accounts Conclusions: Taken together, these findings demonstrate for 1% or more of all malignant oral lesions. These metastases that B16-F10 melanoma cells proliferation is dependent on usually arise from a breast, lung, kidney, colon, adrenal gland or FASN. Supported by FAPESP (10/52635-1). prostate primary carcinoma, leaving the liver as a rare primary ORAL MEDICINE OOOO e102 Abstracts October 2012 site of metastasis to the oral cavity. Hepatocellular carcinoma clinic reporting an increase in volume of gingiva for 5 months. (HCC), the fifth most common cancer and the third leading cause Intra-oral examination revealed a 2.5cm erythematous nodule in of cancer-related deaths worldwide, has a tendency to develop the left alveolar ridge. An excisional biopsy was performed. The extrahepatic metastasis in more than half of the cases. When tumor showed of proliferation of cell of varying sizes showing distant metastases occur, the lung is the most frequent site, vesicular nuclei and nucleoli evident and some atypical mitosis. followed by abdominal lymph nodes, bone and adrenal glands. Tumor cells were positive for CD45 and CD68, but negative for However, metastatic disease of HCC to either soft or hard tissues CD3, CD20, CD31, CD34, CD117, CD163, CK20, CKAE1/AE3, of the oral and maxillofacial region without lung metastasis is myeloperoxidase, chromogranin A, Von Willebrand factor and known to be extremely rare. The authors report a case of primary S-100 protein. Immunohistochemically, Ki-67 showed high pro- HCC metastasis to the buccal cheek, hard palate and mandible in liferation rate (25-50%), thus confirming HS. The patient is a 52-year old male patient with several multiple metastatic sites undergoing chemotherapy. It is important to exclude other lym- (adrenal glands and skeleton) but without lung involvement, who phomas, according to morphological features and immunohisto- expired few days after evaluation and biopsy of a rapidly growing chemical pattern in order to diagnose such a rare malignant intraoral mass. Review of the relevant literature will be discussed neoplasm. as well. COMPARATIVE STUDY OF THE EXPRESSION OF PARTIAL REMISSION OF A MANDIBULAR GIANT CELL RANKL AND OPG IN ODONTOGENIC KERATOCYSTS 2,1 LESION AFTER INCISIONAL BIOPSY Kaba SCP1, OF MANDIBLE AND MAXILLA Niklander S , Martinez 1 1 1 Horikawa FK2, Seo J3, Ruiz MM4, Lemos-Junior CA5, Mar- R , Esguep A - UNIVERSIDAD ANDRÉS BELLO, CHILE - 2 tins MT6, Shinohara EH7 - 1UNIVERSIDADE DE SAO ORAL PATHOLOGY DEPARTMENT, FACULDADE DE PAULO - HOSPITAL UNIVERSITARIO, 2HOSPITAL RE- ODONTOLOGIA DE ARAÇATUBA - UNESP - PATOLOGIA GIONAL DE OSASCO - ORAL AND MAXILLO FACIAL E PROPEDÊUTICA CLÍNICA SURGERY, 3FACULDADE DE ODONTOLOGIA DA UNI- Background: The Odontogenic Keratocyst (OKC) can reach VERSIDADE DE SAO PAULO - ORAL PATOLOGY, 4HOS- a large size before being diagnosed, a situation that most fre- PITAL DA AERONAUTICA - ORAL AND MAXILLO FA- quently affects the mandible than the maxilla. CIAL SURGERY, 5FACULDADE DE ODONTOLOGIA DA Objective: The aim of this study was to compare the ex- UNIVERSIDADE DE SAO PAULO - STOMATOLOGY, pression of RANKL and OPG in QQ located in the mandible and 6FACULDADE DE ODONTOLOGIA UNIVERSIDADE DE maxilla. Study design: The expression of RANKL and OPG was SAO PAULO - ORAL PATHOLOGY, 7HOSPITAL ISRA- assessed by immunohistochemistry in 9 cases of mandibular and ELITA ALBERT EINSTEIN - ORAL AND MAXILLO FACIAL 8 cases of maxillary OKC. SURGERY Results: There was a preponderance in the expression of A 22 year old female patient was referred for evaluation of RANKL in 6 cases of mandibular (66.7%) and 5 cases of max- a radiolucent lesion localized in the anterior portion of her illary (62.5%) OKC, with no difference in the expression of mandible, discovered during an orthodontic evaluation. Intra oral RANKL at both locations. examination revealed normal appearing mucosa with teeth in Conclusion: Our research shows that the bone reabsorption excellent conditions. Between the tooth 33 and the 43 a small and associated with OKC growth is due, among other factors, to painless bone swelling could be noted. Mandibular sensitivity predominance expression of RANKL, regardless of the location was preserved. On a Panoramic radiography a regular radiolucent of the lesion. lesion, extending from 33 to 43, maintaining the integrity of the mandibular basal cortical was visualized. An incisional biopsy was made with a diagnosis of Central giant cell lesion. Her KILLIAN POLYP IN THE MAXILLARY SINUS OF A FE- 1 2 2 parathormone dosage was normal. After 3 month it was noted MALE TEENAGER Liborio TN , Silva MS , Fernandes MA , 1 1 1 1 almost 95% regression of the original lesion. The residual lesion Abrahim NMM , Ferreira LCL , Câmara J - FEDERAL was submitted to surgical curettage and the bone defect treated UNIVERSITY OF AMAZONAS - PATHOLOGY AND LEGAL 2 with criospray. The post operatory was uneventful and the patient MEDICINE, OTORRINOLARINGOLOGY - GETULIO is under annual control. VARGAS UNIVERSITY HOSPITAL A 16-year-old white female presented a 1-year history of right nasal obstruction and progressive rhinorrhea which evolved HISTIOCYTIC SARCOMA OF THE ALVEOLAR RIDGE: into bilateral nasal obstruction, fatigue, dysphagia, episodes of CASE REPORT Oliveira SP, Buexm LA2, Bastos JCC1, Lou- 3 4 5 3 epistaxis and weight loss of ten kilograms in six months. In renço SQC , Azevedo RS , Camisasca DR , PIRES ARC - oroscopy there was a polypoid mass in the oropharynx, causing 1 ODONTOCLÍNICA CENTRAL DO EXÉRCITO (OCEX) - anterior bulging of the soft palate. Computed tomography iden- 2 ESTOMATOLOGIA, INSTITUTO NACIONAL DO CÂNCER tified heterogeneous lesion occupying the right maxillary sinus 3 (INCA), UNIVERSIDADE FEDERAL FLUMINENSE (UFF) and nasopharynx. The patient was referred to the Department of 4 - PATOLOGIA, UNIVERDADE FEDERAL FLUMINENSE Otolaryngology and underwent endoscopic sinus surgery with (UFF) - PATOLOGIA ORAL, 5UNIVERSIDADE FEDERAL complete excision of the lesion without complications. Micro- FLUMINENSE (UFF) - ESTOMATOLOGIA scopic examination revealed proliferation of vascular spaces of Histiocytic sarcoma (HS) is a malignant neoplasm showing cavernous appearance, areas with mucoid cell degeneration, and morphological and immunophenotypic features of mature histio- with myxoid appearance, chronic inflammatory infiltrate and cytes. Reported herein is a case of HS of the alveolar ridge. A regions with pseudo-stratified epithelial cells. The lesion was 50-year-old male HIV-positive patient attended the stomatology diagnosed as antral-choanal inflammatory polyp - Killian Polyp. OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e103

The patient has been followed up monthly, with no signs of oral metastasis. A male patient, 47 years old, presenting renal recurrence two months after the procedure and also obtained CCC with pulmonary metastasis, undergoing chemotherapy, weight gain of five kilograms. came to Stomatology Department referring intraoral painless swelling, with progressive growth for about 25 days. At clinical examination it was noted nodular lesion involving buccal gingiva AN 18 MONTHS FOLLOW-UP OF RARE BILATERAL and hard palate in the right maxilla, measuring approximately DENTIGEROUS CYSTS IN A NON-SYNDROMIC 3cm. Panoramic x-ray doesn’t showed bone alterations. It was PATIENT Imada TSN1, Tieghi-Neto V1, Bravo-Calderón performed an incisional biopsy and histopathological examina- DM2, Oliveira DT2, Santos PSS1, Rubira-Bullen IRF1, Gon- tion revealed a metastasis of CCC. The patient underwent chemo- çales ES3 - 1BAURU SCHOOL OF DENTISTRY - UNIVER- 2 radiotherapy and lesion completely regressed. No clinical evi- SITY OF SÃO PAULO - STOMATOLOGY, BAURU dence of recurrence was observed after 5 month follow-up. SCHOOL OF DENTISTRY - UNIVERSITY OF SÃO PAULO Although oral metastasis of renal CCC is extremely rare, it must 3 - PATHOLOGY, BAURU SCHOOL OF DENTISTRY - UNI- be considered in deferential diagnosis. VERSITY OF SÃO PAULO - SURGERY A 42-years-old Caucasian woman was referred for evalua- tion of two asymptomatic, bilateral cystic lesions in mandible. EVALUATION OF INTERLEUKIN-6, INTERLEUKIN-10, There were no intraoral signs and no association with syndromes. TUMOR NECROSIS FACTOR-ALPHA AND INTERFER- Radiographically, it showed two well- defined unilocular radio- ON-GAMMA GENE POLYMORPHISMS IN PATIENTS lucent areas surrounded by thin sclerotic border associated to WITH SECONDARY SJÖGREN SYNDROME TO RHEU- 1,2 3 unerupted third mandibular molars. On the right side it has MATOID ARTHRITIS Souza TR , Duarte ALBP , Car- 23.64mm ø and almost reached the inferior border and on the left valho AAT1, Leão JC1, Gueiros LAMG1 - 1UNIVERSIDADE side it has 16.57mm ø, both third molars were displaced, the right FEDERAL DE PERNAMBUCO - SERVIÇO DE ESTOMA- one more severely and apparently involving the distal root of the TOLOGIA. DEPARTAMENTO DE CLÍNICA E ODONTO- second molar. Surgical enucleation of both cysts and excision of LOGIA PREVENTIVA, 2PROGRAMA DE PÓS-GRADU- the associated teeth were the treatment choice. The histopatho- AÇÃO EM ODONTOLOGIA/ FACULDADE DE logic features confirmed dentigerous cyst in both sides. The ODONTOLOGIA DE PIRACICABA-UNICAMP - DEPAR- patient is on 18 months follow-up with favorable osseous forma- TAMENTO DE ODONTOPEDIATRIA, 3UNIVERSIDADE tion with no radiographic evidence of recurrence. Only 22 cases FEDERAL DE PERNAMBUCO - SERVIÇO DE REUMATO- were reported on literature about multiple dentigerous cysts not LOGIA DO HOSPITAL DA CLÍNICAS DA UNIVERSIDADE associated with syndromes. FEDERAL DE PERNAMBUCO Objective: The purpose of this study was to investigate the INTRAORAL SURGICAL APPROACH OF LARGE DER- association of IL-6, IL-10, TNFa and IFNg gene polymorphisms MOID CYSTS IN FLOOR OF MOUTH Oliveira TFL1, in rheumatoid arthritis (RA) and secondary Sjögren syndrome Madeira MFC1, Cardoso LB1, Consolaro A2, Sant’Ana E3, (sSjS). Ferreira Júnior O3, Rubira-Bullen IR1 - 1FOB - USP - Study design: A study sample, comprised 138 Brazilian ESTOMATOLOGIA E RADIOLOGIA, 2FOB - USP - PATO- patients, was submitted to clinical evaluation and serological LOGIA, 3FOB - USP - CIRURGIA tests; genomic DNA was obtained from oral mucosa cells and Dermoid cysts are uncommon, benign congenital tumors of submitted to genotyping (RFLP and sequence-specific primers ectodermal origin that can occur in any region of the body. PCR). Nearly 7% occur in the head and neck region and 1.6% occur on Results: Genotypes and allele frequencies of cytokines the floor of the mouth. The etiology includes accidental or sur- genes were similar in sSjS and RA, but IL-6 and TNFa polymor- gical events in which the epithelium is traumatically implanted phisms differed significantly among rheumatoid arthritis patients Ͻ within deeper structures. We hereby report a case of a large and controls (p 0.05). IL-6 G and TNF-a A carriers were sig- dermoid cyst on the floor of the mouth of a 13-year-old boy. He nificantly associated with RA, but not sSjS. In addition, IL-6 was complaining of a bulge on the bottom of his mouth. Although polymorphism was associated with salivary gland lymphocytic he experienced no painful symptoms, he reported the lump grow- infiltration, Schirmer’s Test and anti-CCP, while TNF-a GA ing over two months and noticed changes in his speech. The genotype was associated with anti-CCP, anti-SSA and C-reactive Ͻ lesion was a smooth, soft, asymptomatic, exophytic, sessile le- protein(p 0.05). sion without trauma history, measuring 4 cm at its greatest Conclusion: In summary, IL-6 -174GC and TNF-a -308GA diameter and causing changes in speech. The presumptive diag- gene polymorphisms are associated with susceptibility to RA but nosis was lipoma. The patient underwent an excisional intraoral not to sSjS. biopsy and the histopathological diagnosis was dermoid cyst. MICROSCOPIC EVALUATION OF THE TOPICAL CLEAR CELLS CARCINOMA OF THE KIDNEY WITH TREATMENT WITH PHYTOTHERAPIC GELS OF AR- ORAL METASTASIS: A CASE REPORT Miniello TG1, Ver- NICA MONTANA, PANAX GINSENG AND CHAMO- rone JR1, Guollo A1, Lopes RN1, Osório CAT1, Prado JD1 - MILLA RECUTITA ON SECOND INTENTION WOUND 1HOSPITAL AC CAMARGO - ESTOMATOLOGY REPAIR IN RATS Pinheiro TN1, Carneiro MA2, Carneiro 2 2 3 1 About 30% of all renal cancer patients present metastatic PA , Alves IA , Tietz RG - UNIVERSIDADE ESTADUAL disease; however, oral metastases are rare. Clear Cell Carcinoma DO AMAZONAS - ODONTOLOGIA, 2PRIVATE PRACTICE (CCC) is the most common subtype and presents the worst PHARMACEUTICAL, 3LABORMÉDIC - QUALITY CON- prognosis. The objective of this work is to report a case of CCC TROL ORAL MEDICINE OOOO e104 Abstracts October 2012

Objective: To evaluate the influence of phytotherapic car- pharyngeal and cervical). Associations were analyzed (Chi2/Fish- bopol gels of Arnica, Ginseng and Camomile, at 10% concen- er’s exact two-tailed tests) and Cohen’s kappa were calculated. tration, on the inflammatory response, due to second intention Results: Forty women (30-CC and 10-OC), median age 51.2 wounds, in rats. years, were included. HPV-DNA was amplified in at least one of Study design: Sixty rats were divided into four groups of 15 the sites on 11 (36.7%) CC and 6 (60%) OC patients (HPV-16: animals, one control group and one for each phytotherapic. Each 96%, HPV-18: 4%). In CC-women, the concordance between group had 5 rats under 7, 14 and 21 days of topical treatment. A cervical and oral/oropharyngeal HPV-16 presence was 42% (OR: 3cm square dorsal transepithelial wound was performed. Topical 12, 95%CI:1.05-136.8). In OC patients, the concordance was injury treatment followed every 8 hours during the experiment. 57% (RM:16.2, IC 95%:15-20.3). Microscopic evaluation aimed type and intensity of inflamma- Conclusions: The high concordance of HPV-16 found in 3 tion, vascularity and fibrosis. Statistics include Kappa, one way different sites in HPV-associated cancer might suggest the pos- ANOVA and Tukey, pϭ0,05. sible sexual transmission of the virus. Results: Camomile featured significantly worst results re- garding vascularity (T7, T21) and fibrosis (T21). Ginseng HODGKIN/REED-STERNBERG-LIKE CELLS IN ORAL showed significant fibrosis at T21. Arnica had significant vascu- DIFFUSE LARGE B-CELL LYMPHOMA: HISTOPATHO- larity at T7. LOGICAL, IMMUNOHISTOCHEMICAL AND IN SITU Conclusions: Arnica has its potential use on small well HYBRIDIZATION STUDY Toral-Rizo VH1, Delgado-Aza- vascularized wounds such as oral mucosa lesions, and ginseng on ñero W2, Mosqueda-Taylor A3, Vassallo J4, Soares FA5, chronic wounds. Almeida OP6, León JE - 1PIRACICABA DENTAL SCHOOL, UNIVERSITY OF CAMPINAS-UNICAMP - ORAL PATHOL- SYPHILIS DIAGNOSIS THROUGH ORAL MANIFESTA- OGY SECTION, DEPARTMENT OF ORAL DIAGNOSIS, 1 1 TIONS – CASE REPORT Santos VCB , Picciani BLS , San- 2FACULTAD DE ESTOMATOLOGIA, UNIVERSIDAD CAY- 1 1 2 1 tos BM , Rocha RSSD , Garrido RQG , Silva Júnior A , Dias ETANO HEREDIA, LIMA, PERÚ - ORAL PATHOLOGY 1 1 EP - UNIVERSIDADE FEDERAL FLUMINENSE - PATO- AND ORAL MAXILLOFACIAL SURGERY DEPARTMENTS, 2 LOGIA, UNIVERSIDADE FEDERAL DO RIO DE JA- 3UNIVERSIDAD AUTÓNOMA METROPOLITANA- NEIRO - INFECTOLOGIA XOCHIMILCO, MEXICO CITY, MEXICO - ORAL PATHOL- Syphilis is an infectious and transmitted disease produced by OGY LABORATORY, HEALTH CARE DEPERTMENT., Treponema pallidum which is still increasing in Brazilian popu- 4STATE UNIVERSITY OF CAMPINAS, CAMPINAS, BRA- lation. Thirty-seven years old, male, Hispanic, HIV positive ZIL. - DEPARTMENT OF PATHOLOGY OF FACULTY OF patient which was not using any medication was referred by the MEDICAL SCIENCES., 5AC CAMARGO HOSPITAL, SÃO infectologist for oral lesions evaluation. The main complaint of PAULO, BRAZIL - DEPARTMENT OF ANATOMIC PA- the patient was aphthous lesions which partially resolve in 3 THOLOGY, 6PIRACICABA DENTAL SCHOOL, UNIVER- months period. An intra oral exam depicted smooth ulcerations SITY OF CAMPINAS UNICAMP, PIRACICABA, SÃO with slightly raised borders and granular center and erythematous PAULO BRAZIL - ORAL PATHOLOGY SECTION, DE- patches. The clinical diagnosis was a deep mycosis. Biopsies were performed on the tongue and labial mucosa and histopa- PARTMENT OF ORAL DIAGNOSIS. thology was suggestive of syphilis. Although a previously VDRL Objective: Describe the presence of Hodgkin/Reed-Stern- was negative another exam was required which was also nega- berg (HRS)-like cells in oral diffuse large B-cell lymphoma tive. His physician introduced a penicillin treatment and solicited (DLBCL). Compare the characteristics of these cells with those a FTA-ABS test which was positive. After the treatment the oral present in classical Hodgkin lymphoma (cHL) by immunohisto- lesions completely resolved. This case demonstrated the impor- chemistry. Discuss the results with cases of primary oral/oropha- tance of the stomatologist helping in the systemic disorders ryngeal HL reported in the literature. diagnosis by oral manifestations. Study design: Seven cases of oral DLBCL presenting Hodg- kin/Reed-Sternberg (HRS)-like cells and 8 cases of cHL were analyzed by immunohistochemistry using a large panel of anti- CONCORDANCE HPV-16 IN THREE MUCOSAL SITES bodies: CD3, CD15, CD20, CD30, CD43, CD45RO, CD45RB, OF WOMEN AFFECTED WITH ORAL AND CERVICO- CD79a, CD83, EMA, MUM-1, PAX5, perforin, granzyme B, UTERINE CANCER Esmeralda Rodríguez-Alvarado1, Gabri- 1 2,3 FASN, Ki-67, LPM-EBV and in situ hybridization for EBV ela Anaya-Saavedra , García-Carrancá A , Irigoyen-Cama- (EBER1/2). 1 2,3 1 cho E , Guido-Jiménez M , Ramírez-Amador V - Results HRS-like cells in oral DLBCL were positive for 1 UNIVERSIDAD AUTÓNOMA METROPOLITANA - HEALTH CD20 (86%), CD45RB (86%) and CD79a (100%), while in cHL 2 CARE, UNIVERSIDAD NACIONAL AUTÓNOMA DE these markers were negative. Considering the markers CD30, MÉXICO - INSTITUTO DE INVESTIGACIONES BIOMÉDI- CD15 and EBER1/2 the HRS cells in cHL were positive in 100%, CAS, 3INSTITUTO NACIONAL DE CANCEROLOGÍA - UNI- 62% and 75% of cases respectively. In oral DLBCL the positivity DAD DE VIRUS Y CÁNCER for these markers was smaller, corresponding to 71%, 0% and Objective: To establish the concordance of HPV-16 in oral, 43% respectively. The differences with other markers were not oropharyngeal and cervico-uterine mucosa in oral (OC) and significant. cervico-uterine cancer (CC). Conclusion HRS-like cells in oral DLBCL share similarities Study design: Cross-sectional, observational and analytical with the cells of cHL, but express less frequently CD30 and study. Women with OC and CC were included. DNA purifica- EBER1/2 and are negative for CD15. Cases of cHL involving the tion, PCR (PCO4/6H20, MY09/MY11 and GP5ϩ/GP6ϩ) and mouth should be carefully reviewed, considering the differential sequentiation were done from 3 cytological-brushings (oral, oro- diagnosis of DLBCL. OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e105

LPLUNC2 IS EXPRESSED IN PERITUMORAL MAST [4] Nonaka CF, Pereira KM, Miguel MC. Oral vascular CELLS OF MUCOEPIDERMOID CARCINOMAS OF SAL- leiomyoma with extensive calcification areas. Braz J Otorhino- IVARY GLANDS González-Arriagada WA1, Santos-Silva laryngol 2010 Jul-Aug;76(4):539. AR1, Silva AA1, Vargas PA2, Bingle L3, Speight P3, Lopes 1 1 2 MA - FOP-UNICAMP - ESTOMATOPATOLOGIA, F- EXTENSIVE LABIAL NECROSIS AS INITIAL MANIFESTA- 3 ESTOMATOPATOLOGIA, UNIVERSITY OF SHEFFIELD - TION OF ACUTE LYMPHOBLASTIC LEUKEMIA Oliveira ORAL PATHOLOGY DT1, Garcia AS2, Andrea MLM1, Oliveira DT2 - 1DARCY Background: Recently was reported the LPLUNC2 immu- VARGAS CHILDREN HOSPITAL - PEDIATRIC ONCOL- nohistochemical expression of mast cells in mucoepidermoid OGY, 2BAURU SCHOOL OF DENTISTRY, UNIVERSITY OF carcinoma (MEC). SÃO PAULO, BRAZIL - DEPARTMENT OF STOMATOL- Objectives: The aim of this study was to compare the OGY - AREA OF PATHOLOGY expression of LPLUNC2 and trypsine of mast cells in MEC of A ten year-old girl sought medical care by lesion in the salivary glands. inferior lip associated to local trauma and cervical lymphadenop- Study design: The immunohistochemical expression of athy. After one day, there was increase of the signs including, LPLUNC2 and trypsine was evaluated in 30 MECs. The evalu- local edema and cervical/submandibular lymphadenopathy. The ation considered the number and patterns of distribution of the patient was submitted to pharmacological treatment with ibupro- positive cells. fen and hexamidine. Two days later the patient was hospitalized Results: LPLUNC2 showed specific positivity in cells that presenting labial necrosis, petechiae in the body, pancytopenia, resemble mast cells in 83.33% of the samples. Subsequently, coagulation abnormalities and prostration. She received blood immunohistochemistry for trypsine was performed, showing pos- transfusion and evolved with gastric and labial bleeding. Due the itivity in the LPLUNC2-positive cells. persistence of pancytopenia by five days, a myelogram was Conclusions: The expression of LPLUNC2 in mast cells is performed and revealed 90% of the blasts presented lymphoid L3 a previously unrecognized event. We suggest that LPLUNC2 can aspect. Then established the diagnosis of acute lymphoblastic be considered as a new potential marker that aids in the identi- leukemia (ALL). The patient underwent treatment for ALL in fication of mast cells and that this protein may play a role in the according to the ALL-BFM-02 protocol with disease remission function of these cells in the host tumoral immune response. and total regression of the lip lesion.

HEAD AND NECK VASCULAR LEIOMYOMA IN A BRA- KERATOACANTHOMA IN THE LOWER LIP - CASE ZILIAN POPULATION Alves AM1, Gomes APN1, Etges A1, REPORT Paiva K1, Ferreira SMS1, Farias AC1, Albuquerque Furuse C1, Vasconcelos ACU1, Tarquinio SBC1 - 1UNIVER- ECS1, Vasconcelos MLAA1, Beder C1 - 1CENTRO DE ES- SIDADE FEDERAL DE PELOTAS - SEMIOLOGIA E TUDOS SUPERIORES DE MACEIÓ - ODONTOLOGIA CLÍNICA The keratoacanthoma is a benign tumor of rapid growth that Objective: the aim of this study was to determine the prev- has clinical and pathologic features similar to squamous cell alence of head and neck vascular leiomyoma and their clinical carcinoma. In most cases affects older patients with white skin and epidemiological characteristics from Center of Diagnosis photosensitivity in areas exposed to the face and upper extrem- Oral Diagnosis – Pelotas/Brazil. ities. This paper reports a case of keratoacanthoma in the lower Study design: biopsies files from CDOD were evaluated in lip. Patient E.S.S., female, 61 years old, attended the dental the period between 1959 and 2012. Data about sex, age, site and specialty center complaining of a ”sign in your mouth.” The lesion were collected and submitted to descriptive analysis. lesion is approximately one month in duration, is painless, raised Results: from a total of 20,022 biopsies analyzed, 13 (0.1%) borders and rapidly growing. The extra-oral examination showed were vascular leiomyoma, being male 61.5% of the patients. The nodular reddish, firm, painless, bleeding surface, one measuring average age was 44.2 years (varying from 14 to 73 years-old). In 1.0 cm x 0.5 cm in the lower lip. The treatment was surgical order of prevalence, were found 4 cases in lower lip (30.7%), 2 excision of the entire lesion, which provided definitive histo- in upper lip (15.4%), 2 in buccal mucosa (15.4%), 2 in palate pathological diagnosis beyond the cure of disease. (15.4%), 1 in ear (7.7%), 1 in maxillary sinus (7,7%), and 1 in lower gutter (7.7%). HRPT2 AND CYCLIN D1 MOLECULAR INVESTIGA- Conclusion: head and neck vascular leiomyomas are very TION IN FIBROUS DYSPLASIA, OSSIFYING FIBROMA uncommon lesions, and the most affected site was lower lip. AND OSTEOSARCOMA OF THE JAWS Netto ACM1,Go- References: mez RS1, Silva TF1, Diniz MG1, Campos K1, Carlos R2, [1] Brooks JK, Nikitakis NG, Goodman NJ, Levy BA. Clin- Gomes CC3 - 1DEPARTMENT OF ORAL SURGERY AND icopathologic characterization of oral angioleiomyomas. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002 Aug;94(2): PATHOLOGY, SCHOOL OF DENTISTRY, UNIVERSIDADE 221-7. FEDERAL DE MINAS GERAIS, BELO HORIZONTE-MG, 2 [2] Wang CP, Chang YL, Sheen TS. Vascular leiomyoma of MINAS GERAIS, BRAZIL, CENTRO CLÍNICO DE CABEZA the head and neck. Laryngoscope 2004 Apr;114(4):661-5. Y CUELLO / HOSPITAL HERRERA-LLERANDI, GUATE- 3 [3] Gaitan Cepeda LA, Quezada Rivera D, Tenorio Rocha F, MALA, DEPARTMENT OF PATHOLOGY, BIOLOGICAL Leyva Huerta ER, Mendez Sanchez ER. Vascular leiomyoma of SCIENCES INSTITUTE, UNIVERSIDADE FEDERAL DE the oral cavity. Clinical, histopathological and immunohisto- MINAS GERAIS, BELO HORIZONTE-MG, MINAS GERAIS, chemical characteristics. Presentation of five cases and review of BRAZIL the literature. Med Oral Patol Oral Cir Bucal 2008 Aug;13(8): Background: Studies demonstrate genetic alterations of the E483-8. HRPT2 gene in ossifying fibroma (OF). Inhibition of cyclin D1 ORAL MEDICINE OOOO e106 Abstracts October 2012 was pointed as a mechanism of HRPT2 to produce antiprolifera- that made it difficult to breastfeed. There was no history of tive effects. congenital anomalies in her family. Extraoral examination Objectives: The present study raised the hypothesis of showed depression on the upper lip suggesting a malformation. whether or not similar alterations would in fact represent one of Intraoral examination was observed a exophitic lesion on max- the underlying alterations of fibrous dysplasia (FD) and osteo- illary anterior alveolar ridge, painless, pedicellate, normal colour, sarcoma (OS). fibrous on palpation, and measuring 2.0 cm in diameter. The Study design: Samples of FD, OF and OS were included in clinical diagnosis were hamartoma, congenital epulis, chon- the study. HRPT2 was investigated at DNA level assessing loss droma, and teratoma. The mass was resected under general of heterozygosity (LOH), mRNA level (RT-PCR, direct sequenc- anesthesia and submitted for histopathological and immunohis- ing and qRT-PCR) and at protein level (immunohistochemistry). tochemical staining. Histopathological findings showed prolifer- Cyclin D1 mRNA and protein were investigated. ating mesenchymal components containing mainly smooth mus- Results: LOH of HRPT2 was found in 3 FD, 6 OF, and 2 OS cle admixed with collagen fibres, nerve fibres, and small vessels. cases. However, mutation was found only in the OF. The immunohistochemical staining findings for smooth-muscle Conclusion: HRPT2 DNA alterations can be detected in OF, actin, desmin, and CD34 were all positive. From these findings, FD and OS, however, the mutation or LOH of the HRPT2 gene the lesion was diagnosed as a leiomyomatous hamartoma. The does not necessarily impact mRNA or protein expression. patient showed a good postoperative course at 1 month, and no Support: CAPES. recurrence has been observed after a follow-up of 2 years.

ORAL FOREGUT DUPLICATION CYST IN A NEONATE: HISTOPATHOLOGIC IDENTIFICATION OF CANDIDI- A RARE PRESENTATION Rosa AC1,2, Hiramatsu DM3,Mo- ASIS IN THE GINGIVA OF PERIODONTALLY HEALTHY raes FR4,2, Soares JA4, Passador-Santos F1, de Araújo VC1, PATIENTS UNDERGOING SURGERY FOR RECOVERY Soares AB1 - 1SÃO LEOPOLDO MANDIC INSTITUTE AND OF BIOLOGICAL SPACE AND GINGIVECTOMY Dias 1 1 2 1 1 RESEARCH CENTER, CAMPINAS, SÃO PAULO, BRAZIL - EP , Miranda AMO , Ferrari TM , Diniz DJ , Rozza RE , 1 1 1 2 ORAL PATHOLOGY, 2FEDERAL UNIVERSITY OF TO- Cunha KSG , Costinha LHAC - UFF - PATOLOGIA, UFF CANTINS, PALMAS, TOCANTINS, BRAZIL - HEALTH SCI- Background: Although about 50% of the adult population ENCES, 3GENERAL PUBLIC HOSPITAL OF PALMAS, TO- show Candida spp as part of the normal oral flora, it is believed CANTINS, BRAZIL, 4DONA REGINA PUBLIC MATERNITY that candidiasis is rarely seen in periodontally healthy patients. HOSPITAL, PALMAS, TOCANTINS, BRAZIL Objectives: The aim of this study was to evaluate the can- didiasis prevalence in the gingiva of periodontally healthy pa- Oral foregut duplication cysts are congenital anomalies that tients who were submitted to surgical procedure for marginal originate from heterotopic rests of foregut-derived epithelium in periodontium repair or gingivectomy. oral cavity. In this study, we report a rare case of a 1-day-old boy Study design: Thirty-five gingival biopsies were obtained referred for evaluation of feeding difficulty caused by a sublin- from periodontally healthy patients and fixed using 10% formal- gual cystic lesion noticed at birth, extending superficially from dehyde and embedded in paraffin. The glass slides were stained the ventral tongue to the anterior left floor of the mouth, displac- with hematoxylin and eosin and periodic acid-Schiff. The main ing the tongue superiorly. Clinical diagnoses were dermoid cyst, diagnostic criterion of candidiasis was the identification of Can- epidermoid cyst, mucous retention cyst and lymphangioma. The dida spp. hiphae. treatment of choice consisted of complete excision under general Results: Candidiasis was found in eight (22,85%) cases. anesthesia. Histopathologic analyses showed a cystic lesion with Conclusion: The prevalence of candidiasis in healthy gin- pseudostratified columnar ciliated epithelium with numerous giva was higher than reported in the literature, indicating the need goblet cells. Immunohistochemistry showed epithelial cells pos- to further investigate the association of candidiasis with clinical itive to CK7 and TTF1 and negative to CK20, resulting in the or subclinical gingivitis. final diagnosis of the oral foregut duplication cyst. Three weeks after surgery, the tongue was well-healed with good mobility and breast feed could be established. No recurrence was present in HISTOLOGICAL AND ULTRAESTRUCTURAL ENAMEL two month follow-up. ABNORMALITIES FROM THREE CHILEAN FAMILIES AF- FECTED BY HYPOMINERALISED AMELOGENESIS IMPERFECTA Ortega A1, Martínez C1, Plaza A2, Franco ORAL LEIOMYOMATOUS HAMARTOMA ASSOCIATED ME1, Morales IB2, Lozano C2, Urzúa BO - 1UNIVERSITY OF WITH UPPER LIP MIDLINE MALFORMATION: CASE RE- CHILE - PATHOLOGY, 2UNIVERSITY OF CHILE - BASIC Mes- PORT WITH IMMUNOHISTOCHEMICAL STUDY AND COMMUNITY SCIENCE quita AT1, Falci SGM1, Romañach MJ2, Silveira EM1, Lima Objective: To compare histological and ultrastructural char- NL1, Santos CRR1, Almeida OP3 - 1UNIVERSIDADE FED- acteristics of enamel from three Chilean non-consanguineous ERAL DOS VALES DO JEQUITINHONHA E MUCURI - families affected by Hypomineralised Amelogenesis Imperfecta UFVJM, DIAMANTINA, MINAS GERAIS, BRAZIL - DEN- (HMAI) with normal enamel. 2 TISTRY, FACULDADE DE ODONTOLOGIA - UNIVERSI- Study design: after the informed consent a clinical and DADE FEDERAL DO RIO DE JANEIRO - UFRJ, RIO DE radiographic study resulted in a provisional diagnosis of HMAI. 3 JANEIRO, RJ, BRAZIL - ORAL DIAGNOSIS, PIRACICABA Affected and normal patients donated deciduous teeth or thirds DENTAL SCHOOL, UNIVERSITY OF CAMPINAS - UNI- molars. These teeth were processed for current histopathologic CAMP, PIRACICABA, SÃO PAULO, BRAZIL. - ORAL DI- technique and scanning electron microscopy (SEM). AGNOSIS Results: Three cases were compatible with autosomal reces- A newborn, Caucasian, male, presented with an oral lesion sive inheritance. Clinically the teeth were soft and sensitive and OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e107 radiographically showed less radiodense enamel. Histopatholog- CITY, GUATEMALA - DIVISION OF ORAL AND MAXILL- ical evaluation showed persistence of organic matrix and SEM OFACIAL PATHOLOGY, 4SCHOOL OF DENTISTRY, revealed a prismatic structure of enamel. STATE UNIVERSITY OF RIO DE JANEIRO (UERJ) - DE- Conclusion: The histopathological and SEM analysis PARTMENT OF DIAGNOSIS AND SURGERY showed correlation with the clinical and radiographic observa- Objective: We performed sequencing analysis of the tions. SH3BP2 gene in 8 patients with cherubism, and discussed the Project: FIOUCh09-1. craniofacial and genetic features of this disease. Study design: All exons and splice junctions were se- ORAL INVOLVEMENT OF MULTIPLE MYELOMA: 2 quenced using genomic DNA from oral cells. Physical, radio- CASE REPORTS Guollo A1, Silva AP1, Andrade VP2, Pir- graphic and histopathological examination was performed. agine J1, Rocha AC1, Prado JD1 - 1HOSPITAL AC CA- Results: Sequencing analysis revealed 2 different mutations MARGO - ESTOMATOLOGIA, 2HOSPITAL AC CAMARGO within SH3BP2, which were represented by the heterozygous Ͼ Ͼ - ANATOMIA PATOLÓGICA missense mutations c.1505G A and c.1514C A. In one patient, no mutation was found. Although patients demonstrated similar Multiple myeloma (MM) is a multicentric bone malignancy clinical, radiographic and histopathological features, a wide vari- which involves the jaw bones in 30% of the cases. The objective ation in the extension and progression of the facial swelling was this report is present two cases of MM with maxillofacial in- observed in individuals with identical gene mutation. Clinical volvement. Case 1: a 58-years-old male complaining of intraoral progression even in the adulthood, growth stagnation with per- painless swelling. His medical history showed larynx plasmacy- sistence of the lesions and complete remission of the lesions were toma treated 9 years ago. Oral examination presented nodular detected in cherubism patients. lesion in the inferior alveolar ridge measuring 3cm, firm to Conclusion: The findings suggest that not only the genotype palpation. On panoramic x-ray was observed a radiolucent lesion but also environmental and epigenetic factors might regulate the causing tooth resorption. Case 2: a 73-years-old female with MM progression of the lesions in cherubism. had a swelling in maxilla. Intra-oral examination showed reddish mass with ulcerated surface, measuring 5cm. Computed tomog- raphy revealed a heterogeneous expansive lesion, involving hard EXPRESSION OF PLUNC FAMILY MEMBERS IN PA- palate and maxillary sinus floor. Both patients underwent inci- TIENTS WITH ORAL GRAFT-VERSUS-HOST-DISEASE: 1 sional biopsy and histopathological examination evidenced dif- PRELIMINARY RESULTS Silva AA , Feio PSQ, Schaira 2 1 3 fuse infiltrate of well differentiated plasma cells compatible with VRL , Correa MEP, Coletta RD , Bingle L , Vargas PA - 1 MM. Intraoral swelling in patients with MM should be investi- SCHOOL OF DENTISTRY OF PIRACICABA, CAMPINAS gated due to possibility of oral manifestation of the disease. UNIVERSITY FOP/UNICAMP - DEPARTMENT OF ORAL DIAGNOSIS, ORAL PATHOLOGY SECTION, 2CAMPINAS UNIVERSITY - ORAL MEDICINE AMBULATORY, BONE EXTENSIVE VERRUCOUS CARCINOMA IN MAXILLA - 3 1 MARROW TRANSPLANTATION UNIT, SCHOOL OF CASE REPORT Sant’Ana LN, Sant’Ana Filho M , Rados ARV2, Martins MD1, Heitz C3, Scolari N3 - 1FACULDADE CLINICAL DENTISTRY, UNIVERSITY OF SHEFFIELD - DE ODONTOLOGIA UFRGS - PATOLOGIA BUCAL, DEPARTMENT OF ORAL PATHOLOGY 2FACULDADE DE ODONTOLOGIA / HOSPITAL DE Background/objective: The aim of this study was to ana- CLÍNICAS DE PORTO ALEGRE - ESTOMATOLOGIA, lyze the expression of PLUNC proteins, putative host-defense proteins, in patients diagnosed with oral graft-versus-host-disease 3HOSPITAL SÃO LUCAS PUCRS (GVHD). Verrucous carcinoma is a highly differentiated variant of Study design: Whole saliva from eight patients diagnosed squamous cell carcinoma that exhibit slow growing, locally de- with oral GVHD was collected. Western blotting was performed structive behavior and rarely metastasizes. The most common using a LPLUNC1 antibody and two SPLUNC 2 antibodies; one sites of occurrence in oral cavity are mandibular alveolar bone raised to an internal peptide (SPLUNC 2B) and another to an crest, buccal mucosa and hard palate. A 63-years old male patient epitope at the c-terminus (SPLUNC 2A). Clinical data were was indicated to the Maxillofacial Surgery Department with a collected from medical records. painless lesion on the right side of the maxilla surface. The Results: PLUNC expression was found in all patients, how- clinical examination showed an extensive exophytic white lesion ever, there was a statistical difference in expression levels when with a papillary surface. The clinical diagnosis was verrucous we compared LPLUNC with SPLUNC 2A (pϭ 0.035) and carcinoma and an incisional biopsy was performed. The histo- LPLUNC with SPLUNC 2B (pϭ 0.044). pathological analysis confirmed the verrucous carcinoma diagno- Conclusion: PLUNC proteins are differentially expressed in sis. The patient was referred to the head and neck medical service the saliva of patients with oral GVHD. Further studies are needed but disappeared without treatment. to better understand the biological processes involved in PLUNC expression and the significance of the differential expression MUTATION ANALYSIS OF THE SH3BP2 GENE IN patterns. CHERUBISM Bufalino A1, Alves DBM2, Carlos R3, Silva ARS, Lopes MA, Coletta RD, Pires FR4 - 1PIRACICABA SYPHILIS DIAGNOSIS BY ORAL MANIFESTATIONS: A DENTAL SCHOOL, UNIVERSITY OF CAMPINAS (UNI- CASE REPORT Nigri AP1, Ribeiro CFP1, Akra IP1, Maciel CAMP) - ORAL DIAGNOSIS, 2 PIRACICABA DENTAL RM1 - 1UERJ SCHOOL, UNIVERSITY OF CAMPINAS (UNICAMP) - Syphilis is a sexually transmitted disease, caused by a bac- ORAL DIAGNOSIS, 3CENTRO CLÍNICO DE CABEZA Y teria, that mimics others that are unrelated. The aim of this study CUELLO/HOSPITAL HERRERA LLERANDI, GUATEMALA is to report a case in which there were no more clinical signs ORAL MEDICINE OOOO e108 Abstracts October 2012 besides the oral manifestations related to the secondary stage of ODONTOGENIC KERATOCYSTIC TUMOUR – REGRES- the disease. Female patient, 46 years old, feoderm, reported the SION AFTER BIOPSY PROCEDURE Freo B1, Acay R2, appearance of several aphthous lesions on the oral mucosa and Rabelo GD, Sousa SCOM, Patricio EF1, Sugaya NN1 - 1UNI- inflammation of the palate. On the physical examination, the VERSIDADE DE SÃO PAULO-FACULDADE DE ODON- presence of irregular erythematous lesions with leukoplasic areas, TOLOGIA - ESTOMATOLOGIA-DISCIPLINA DE ESTOMA- moriform aspect and raised edges were observed on the soft TOLOGIA CLÍNICA, 2UNIVERSIDADE DE SÃO PAULO- palate. After clinical, histopathological, and laboratorial exam- FACULDADE DE ODONTOLOGIA - ESTOMATOLOGIA- s,which included FTA-ABS and VDLR, the diagnosis of syphilis DISCIPLINA DE PATOLOGIA BUCAL was given. The patient was referred to the nearest health center. A 12-year-old girl was referred to our clinic due to a man- The knowledge of the several manifestations related to the infec- dibular lesion disclosed in a routine radiograph. A radiolucent tion by syphilis is necessary to the clinician. lesion with scalloped margins located in the area of lower left lateral incisor and canine, which were vital, causing some root dislocation could be observed in the panoramic radiograph. There GLANDULAR ODONTOGENIC CYST IN THE were no symptoms, deformity or any other sign suggesting an MANDIBLE Torrezani A1, Milani B de A1, Souza AMM1, underlying pathology. A differential diagnosis of odontogenic Rabelo GD2, SOUSA SCOM3, Lemos-Júnior CA1, Jorge WA1 keratocystic tumor vs central giant cell lesion elicited an inci- - 1UNIVERSITY OF SÃO PAULO - STOMATOLOGY, 2UNI- sional biopsy procedure. Microscopic examination concluded the VERSITY OF SÃO PAULO, 3UNIVERSITY OF SÃO PAULO diagnosis of odontogenic keratocystic tumor. Patient’s parents - ORAL PATHOLOGY refused the surgical approach proposed as treatment. Since then a clinical and radiographic follow-up regimen was established. Glandular odontogenic cyst (COG) is an uncommon cyst of Twenty-two months after biopsy procedure the area showed specific behavior that may be mistaken radiographically by var- complete healing that remained so up to now, two years ahead. ious benign or malignant diseases. A 30-year-old female patient Patient showed no other signs that could suggest a basal cell presented a radiolucent area in the posterior mandible with 4 cm nevus syndrome and has been periodically followed-up. of diameter, without any symptoms or clinical swelling. A biopsy was performed and the histological analysis revealed a cystic GEOGRAPHIC TONGUE OR ORAL PSORIASIS? Picciani capsule lined by variable thickness of stratified epithelium. Eo- 1 2 3 4 sinophilic cuboidal cells and clear cells were present in this BLS , Carneiro S , Cantisano MH , Avelleira JCR , Azulay DR4, Pinto JMN5, Dias EP1 - 1FLUMINENSE FEDERAL epithelialium. Immunohistochemistry revealed positivity to CK7, 2 CK8 and Ki67. A diagnosis of COG was made and the treatment UNIVERSITY - PATHOLOGY, FEDERAL UNIVERSITY OF 3 proposed was the curettage and the maintenance of the patient RIO DE JANEIRO - DERMATOLOGY, STATE UNIVER- 4 with radiographic control. At 14 months of follow-up the radio- SITY OF RIO DE JANEIRO - STOMATOLOGY, SANTA 5 graphic evaluation revealed no lesions and signs of recidive. CASA DA MISERICÓRDIA - DERMATOLOGY, FLUMI- NENSE FEDERAL UNIVERSITY - DERMATOLOGY Psoriasis is a common inflammatory skin disease. The presence of specific oral manifestations of psoriasis has been a subject of ANALYSIS OF TH17 RESPONSE IN ORAL LICHEN controversy, where geographic tongue (GT) may be an oral mani- PLANUS Monteiro BVB1, Pereira JS1, Nonaka CFW2, festation of psoriasis. The purpose of this study was to analyze the Godoy GP2, Freitas RA1, Silveira EJD1, Miguel MCC1 - 1 association between GT and psoriasis, through histopathology and UNIVERSIDADE FEDERAL DO RIO GRANDE DO immunohistochemistry. GT fragments of eight psoriatic patients and NORTE - PROGRAMA DE PÓS-GRADUAÇÃO EM PATO- non-psoriatic patients, and four skin fragments from psoriatic pa- 2 LOGIA ORAL, UNIVERSIDADE ESTADUAL DA PARAÍBA tients were selected. The material were stained with hematoxylin- - PROGRAMA DE PÓS-GRADUAÇÃO EM ODONTOLO- eosin and tested by using anti-CD4, CD8, CD20, CD68, S100 and GIA Ki-67. The histopathological findings were similar in cases of pso- Objectives: To assess the immunoexpression of interleu- riasis and GT; and the parakeratosis, epithelial hypoplasia suprapap- kin-17 (IL-17) and interleukin-23 (IL-23) in oral lichen planus illary, crests in a club, and exocytosis were the most prevalent. The (OLP) lesions compared to inflammatory fibrous hyperplasia pustule of Kogoj was common in GT, particularly in patients with (IFH) and between clinical forms reticular and erosive of OLP. pustular psoriasis. Analysis immunohistochemistry were similar in Study design: The sample included 41 cases of OLP and 10 GT and psoriasis. Histopathological and immunohistochemistry cases of IFH. Five fields with strong immunoreactivity for IL-17 findings support the hypothesis that GT can be an oral manifestation and IL-23 were photomicrographed and lymphocytes exhibiting of psoriasis. cytoplasmic immunostaining were counted. For each case, a mean was established. Results: There was no statistically significant difference in IMPORTANCE OF MINOR SALIVARY GLANDS BIOPSY the number of IL-17ϩ and IL-23ϩ lymphocytes among the OLP TO DIAGNOSIS OF SJÖGREN’S SYNDROME Vanderlei 1 1 2 and IFH group, however a larger amount of IL-17ϩ lymphocytes BMS , Farias Ac, Omena ALCS , Ferreira SMS , Peixoto FB, was found in OLP (p ϭ 0.079). A significantly higher number of Ribeiro CMB3 - 1CENTRO UNIVERSITÁRIO CESMAC, IL-23ϩ lymphocytes was found in erosive OLP group (p ϭ 2CENTRO UNIVERSITÁRIO CESMAC - ESTOMATOLO- 0.019). Furthermore, a marked epithelial immunopositivity for GIA, 3CENTRO UNIVERSITÁRIO CESMAC - PATOLOGIA IL-17 was observed in OLP lesions. BUCAL Conclusion: These study findings suggest a possible role of Sjögren’s Syndrome (SS) is a chronic autoimmune disease Th17 lineage in the pathogenesis of OLP. characterized by progressive injury to exocrine glands associated OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e109 to diverse extra-glandular manifestations. Dry mucosas (eyes, versely associated with the prevalence of caries, whereas house- mouth, skin, nose and vagina) are typical clinical features of hold crowding was directly associated with a higher prevalence patients with SS. The diagnosis is based on a combination of well of caries. A viral load Ͼ100,000 copies/ml and manifesting documented clinical and laboratory findings related to ocular, severe symptom of aids also associated with poorer dental status. oral, glandular, and immune manifestations. This study reports a Conclusion: The study revealed low prevalence of oral case of 61 years-old woman, which after 4 years with a diagnosis lesions, which suggests that antiretroviral therapies may have of burning mouth syndrome associated with xerostomia was been effective to improve the status of oral mucosa and children referred to an oral medicine center complaining of burning and affected by aids presented a higher prevalence of untreated caries. grooves in her tongue and dry mucosas. A biopsy was performed on patient’s lower lip and a lymphocytic infiltrate among salivary EXPRESSION OF CYSTEINE PROTEASE CATHEPSIN K glands tissue was observed. Currently, patient’s symptoms have BY ORAL TONGUE SCCS IN VIVO AND IN VITRO Bitu improved and she still in observation. It is important to empha- CC1, Kauppila J2, Teppo S3, Vilen SV4, Nyberg P3, Salo T5 - size that early diagnosis could have a positive impact on patient 1 quality of life. UNIVERSITY OF OULU, FINLAND - DEPARTMENT OF DIAGNOSTICS AND ORAL MEDICINE, INSTITUTE OF DENTISTRY, 2UNIVERSITY OF OULU, FINLAND - DE- TASTE ACUITY AND GUSTATORY PAPILLAE DENSITY PARTMENTS OF PATHOLOGY, INSTITUTE OF DIAG- IN PATIENTS WITH CHRONIC DISEASES Patricio EFS1, NOSTICS AND DEPARTMENT OF SURGERY, INSTITUTE Gallo CB1, Pellegrini VD, Sugaya NN - 1SCHOOL OF DEN- OF CLINICAL MEDICINE, UNIVERSITY OF OULU, FIN- TISTRY OF UNIVERSITY OF SAO PAULO - STOMATOL- LAND, 3UNIVERSITY OF OULU, FINLAND - DEPART- OGY DEPARTMENT MENT OF DIAGNOSTICS AND ORAL MEDICINE, INSTI- Objective: Evaluate taste acuity and gustatory papillae den- TUTE OF DENTISTRY, 4UNIVERSITY OF OULU AND sity of patients with chronic diseases (burning mouth syndrome - BMS, diabetes mellitus - DM, hypertension - Hyp) in comparison UNIVERSITY OF HELSINKI, FINLAND - 1DEPARTMENT to a control group (CG). OF DIAGNOSTICS AND ORAL MEDICINE, INSTITUTE Study design: 96 patients (27 BMS, 21 DM, 20 Hyp, 28 CG) OF DENTISTRY, 3 DEPARTMENTS OF CELL BIOLOGY had their taste acuity evaluated for the basic tastes through OF ORAL DISEASES, INSTITUTE OF DENTISTRY, BIO- aqueous solutions in different concentrations. MEDICUM HELSINKI AND ORAL AND MAXILLOFACIAL 5 Results: Salty and sweet tastes were more accurately recog- DISEASES, UNIVERSITY OF OULU, FINLAND - 1DE- nized in higher concentrated solutions in all groups. Statistical PARTMENT OF DIAGNOSTICS AND ORAL MEDICINE, difference (p Ͻ 0,05) was observed between CG and DM for low INSTITUTE OF DENTISTRY, UNIVERSITY OF OULU, AND salty, medium and high sour; between SAB and DM for medium OULU UNIVERSITY HOSPITAL and high sour, and high bitter; and between DM and Hyp for high Objective: Our goal was to elucidate the role of CTSK in bitter. DM also presented the lower gustatory papillae concen- Oral Tongue Squamous Cell Carcinoma (OTSCC) development tration. and progression. Conclusions: DM patients presented higher impairment of Study design: A total of 121 OTSCCs tumors and 10 lymph taste acuity, which may be related to the reduced gustatory nodes were evaluated for CTSK in tumor epithelium, invasive papillae density nevertheless pathogenesis needs further investi- stroma and expression pattern in tumor epithelium and tumor gation. stroma. The expression of CTSK was evaluated in monolayer, myoma organotypic model and in microdissected HSC-3 cells PREVALENCE OF ORAL COLONIZATION AND INFEC- through semi quantitative RT-PCR, Western blot and immuno- TION BY CANDIDA AND UNTREATED CARIES IN PE- histochemistry. DIATRIC PATIENT WITH AIDS Domaneschi C1, Massar- Results: Weaker expression of CTSK by OTSCCs at the ente DB, Ruiz LS2, Andrade SB3, Borsatti MA1, Migliari DA1, invasive front correlated to increased recurrence and mortality. Antunes JLF4 - 1FACULDADE DE ODONTOLOGIA DA The cysteine proteinase inhibitor E64 reduced the invasion of UNIVERSIDADE DE SÃO PAULO - ESTOMATOLOGIA, HSC-3 cells. Also, CTSK was detected in HSC-3 cells, myoma 2INSTITUTO DE CIÊNCIAS BIOMÉDICAS DA UNIVERSI- tissue fibroblasts and also in HSC-3 cells microdissected from myoma tissue. DADE DE SÃO PAULO - MICROBIOLOGIA, 3INSTITUTO Conclusions: Cysteine proteases, especially CTSK, ex- DA CRIANÇA DA FACULDADE DE MEDICINA DA UNI- pressed in OTSCC tissue might be an important factor of OTSCC VERSIDADE DE SÃO PAULO - INFECTOLOGIA, 4 FAC- progression and a potential therapeutic target to inhibit the inva- ULDADE DE SAÚDE PÚBLICA DA UNIVERSIDADE DE sion of oral cancer. SÃO PAULO - EPIDEMIOLOGIA Study design: The prevalence of oral colonization and in- fection by Candida was evaluated among 117 children, and EVALUATION OF MAST CELLS DENSITY IN ORAL DYS- dental treatment needs among 125. The statistical analysis used PLASIA AND SQUAMOUS CELL CARCINOMA Teófilo 1 2 1 1 Poisson regression. CR , Batista AC , Silva MRFS , Cavalcante GM , Mota Results: Prevalence of oral colonization by C. albicans was MRL1, Sousa FB1, Alves APNN1 - 1UNIVERSIDADE FED- 80% and untreated dental caries affected 58%. Clinical manifes- ERAL DO CEARÁ, 2UNIVERSIDADE FEDERAL DO GOIÁS tation of oral candidosis was 7%. Candida colonization was Background: Mast cells (MC), originate from the bone directly associated with untreated dental caries; an inverse asso- marrow, are immune cells that participate in physiological and ciation was observed with the use of antiretroviral therapies. pathological processes. Being attended by high school graduated caregivers was in- Objective: Evaluate the MC density (MCD) in fibrous hy- ORAL MEDICINE OOOO e110 Abstracts October 2012 perplasia (control), dysplasia and squamous cell carcinoma salivary glands with intense lymphocytic inflammatory infiltrate (SCC). around the remaining ducts. One of the salivary ducts was dilated Study design: Seventy-two cases were selected and submit- with squamous metaplasia and amorphous content, interpreted as ted to immunohistochemistry, with MC-tryptase antibody. Two formed by light sialolito. The sialolithiasis of minor salivary methods were evaluated: the higher density and the average of gland is not uncommon, but is often misdiagnosed. three fields with highest MCD. Results: The MCD, considering 1 and 3 fields, respectively, were 34.00/25.74 in hyperplasia group, 32.04/24.71 in dysplasia ARTIFICIAL FINGERNAIL IN THE PALATE OF INFANTS, 1 1 and 22.34/16.15 in SCC, with difference between SCC compared IS THIS REALLY SO UNUSUAL? Torrezani A , Santos AP , 1 2 1 to hyperplasia and dysplasia (pϭ0.0092, pϭ0.0038). Assunção Jr JNR , Braga MM , Silveira FRX , Lemos-Júnior Conclusion: The lowest MC concentration in the oral SCC CA1 - 1UNIVERSITY OF SAO PAULO - STOMATOLOGY suggests that this cell does not work as a promoter of malignant DEPARTMENT, 2UNIVERSITY OF SAO PAULO - DEPART- neoplasm in the oral cavity and that, in such cases, it may be MENT OF PEDIATRIC DENTISTRY more related to immune function, and therefore the mutant cell A foreign body found in the palate of infants seems to be proliferate in environments with low concentration of mast cells. more common that we thought. We report a 10-month-old girl infant referred to our oral medicine ambulatory with a whitish ORAL SQUAMOUS CELL CARCINOMA ASSOCIATED “plaque” in the hard palate. Two other healthy services (medical TO GRAFT VERSUS HOST DISEASE Dillenburg CS1, Dias and dental) diagnosed the lesion as a “torus palatinus”; one of LG1, Selbach BJ1, Martins MAT1, Rados PV2, Martins MD2, them recommended an exploratory surgery. The baby showed Munerato MC1 - 1UNIVERSIDADE FEDERAL DO RIO feeding difficulty at least 10 days prior the consultation with GRANDE DO SUL - HOSPITAL DE CLÍNICAS DE PORTO signs of discomfort and distress. The infant was in good health ALEGRE - ESTOMATOLOGIA, 2UNIVERSIDADE FED- and well hydrated. Physical examination revealed a 1.5 cm x 1 ERAL DO RIO GRANDE DO SUL - PATOLOGIA cm, firm, fixed, nonpulsatile whitish “mass” in the middle of the hard palate. All the other anatomical areas of the mouth were Graft versus host disease (GVHD) affects patients who un- normal. The differential diagnosis was a foreign body embedded derwent Bone Marrow Transplantation (BMT) and often involves in the oral cavity. Using a lecron instrument we could remove an the oral cavity. GVHD has also been associated with the devel- artificial finger nail with no difficulty at all. opment of precancerous and malignant lesions. We report a case of a 57 year-old male patient that underwent to BMT after non Hodgkin lymphoma. The patient developed chronic GVHD pre- ORAL METASTASIS OF CARDIAC ANGIOSARCOMA: senting mucous-cutaneous and hepatic lesions. Several oral le- CASE REPORT Fernandes CP1, Oliveira FAF1, Viana TSA1, sions were observed and among them some with leukoplastic Almeida DRMF1, Mota MRL1, Sousa FB1, Alves APNN1 - aspect. A worsening of oral health was noted with appearance of 1UNIVERSIDADE FEDERAL DO CEARÁ lichenoid and erosive lesions. A biopsy of a whitish plaque with Primary cardiac angiosarcoma is a rare malignant tumour. erythematous spots in the right buccal mucosa was performed. Distant metastases are common at the time of diagnosis, in spite The histological diagnosis was well-differentiated squamous cell of never being reported in the maxillaries. A 45-year-old female carcinoma. Patient was referred to surgical treatment. The aim of patient with primary cardiac angiosarcoma was referred to dental this report is to highlight the variability of oral manifestations of care due to pain in the mandibular alveolar ridge. Oral examina- GVHD and the necessity of intensive clinical follow-up of these tion revealed a red-violet lesion soft on palpation, first noticed 3 patients. months previously. Histological analyses showed vascular chan- nels and immunohistochemical panel (the same used for the SIALOLITHIASIS OF MINOR SALIVARY GLAND OFF diagnosis of the cardiac tumour) was strongly positive for CD31, THE UPPER LIP: CLINICO-PATHOLOGICAL REPORT CD34, Actin, and Alpha-actin, but negative for Desmin, S-100 1 1 OF TWO CASES Lima CF , Kitakawa D, Kaminagakura E , protein and AE1/AE3. Immunoexpression of Ki-67 (20,0%) was 1 2 1 1 1 Oliver C , Deco CP , Carvalho YR , Almeida JD - UNESP observed, compatible with the diagnosis of secondary oral angio- - UNIV ESTADUAL PAULISTA, SÃO JOSÉ DOS CAMPOS sarcoma. The patient died of multiple metastases. It is important DENTAL SCHOOL - DEPARTMENT OF BIOSCIENCES for the clinicians and oral pathologists to realize that metastases AND ORAL DIAGNOSIS, 2UNESP - UNIV ESTADUAL of cardiac angiosarcomas to the maxillaries can occur, so that PAULISTA, SÃO JOSÉ DOS CAMPOS DENTAL SCHOOL - they can provide correct diagnosis and proper care. POSTGRADUATION PROGRAM IN ORAL BIOPATHOL- OGY The sialolithiasis of minor salivary glands is rare especially LOW LEVEL LASER THERAPY IN PATIENTS WITH SYS- in the upper lip, where salivary gland tumours are more com- TEMIC LUPUS ERYTHEMATOSUS: A THERAPEUTIC AP- monly diagnosed. This is a report of two cases located in the PROACH IN MANAGEMENT OF XEROSTOMIA AND 1,2 3 1 upper lip. Both cases occurred in female patients, Caucasian, HYPOSALIVATION Leite CA , Galera MF , Silva OG , 1 1 1 2 complaining of a submucosal nodule in the upper lip. Patients Garcia CPMG , Fernandes V , Briezinski JP , Dias EP - 1 2 were 65 and 30 years old, respectively. In one case the patient UNIVERSIDADE DE CUIABÁ, UNIC - CUIABÁ/MT, UNI- reported an increase in volume with exudate. At palpation, there VERSIDADE FEDERAL FLUMINENSE, UFF - NITERÓI/ was a round nodule measuring 0.45 cm on average. Excisional RJ, 3UNIVERSIDADE FEDERAL DE MATO GROSSO, biopsies were performed with a differential diagnosis of salivary UFMT gland tumour. In these cases the histopathological examination Background: Systemic lupus erythematosus (SLE), a com- showed non-specific chronic sialadenitis with atrophic lobules of mon systemic autoimmune disorder affecting several organs. OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e111

Salivary changes might reflect a multisystemic presentation of FREQUENCY OF REACTIVE HYPERPLASTIC LESIONS the disease. (RHL) OF ORAL MUCOUS: IREPO, UNIVERSITY OF Aim: Analyze the effectiveness of low level laser therapy CHILE, 2000-2011 Aitken JP1, Maturana A1, Canales C1, (LLLT) in patients with xerostomia and hyposalivation. Study Farías M1, Adorno D1 - 1UNIVERSITY OF CHILE - PATOL- design: LLLT was realized in 10 patients (808 nm, 100 mW, 2.0 OGY J/cm2) in major salivary glands. Before and after each session, Objective: To determinate the frequency of focal fibrous Xerostomia Inventory (IX) was used for xerostomia evaluation, hyperplasia (FFH), pyogenic granuloma (PG), peripheral ossify- non-stimulated sialometry (SNS) and stimulated sialometry (SS) ing fibroma (POF), peripheral giant cell granuloma (PGCG), and to evaluate hyposalivation. traumatic neuroma (TN) of the oral mucosa from Chilean popu- Results: Increase in production of saliva ranged from 25 to lation. 233% (media 87.5%) in SNS and 43 to 72% (media 42%) in SS, Study design: The material included the biopsies of all RHL IX revealed: after LLLT, patients who used liquids to eat food of the IREPO of (2000- 2011). RHL were selected according to and drink water at night decreased, no one related more dry eyes. their histopathological diagnosis, this is FFH, PG, POF, PGCG, Conclusion: The results indicate that LLLT seems to be TN. Lesions were analyzed according to their location and to the effective in improving the quality of life in patients SLE by patients’ age and gender. Data was analyzed with the software modify xerostomia and hyposalivation. Stata V10. Results: There were 1422 RHL that comprised 22,3% of the 6369 accessed biopsies. FFH was the most common (70%), followed by PG (21,2%). RHL were more common in women (57,7%), tended to affect patients between 40 and 70 years old in QUERCETIN DOES NOT REDUCE INCIDENCE AND SE- the regions of gingival, cheeks and tongue. VERITY OF 4-NITROQUINOLINE 1-OXIDE INDUCED Conclusions: This study determined that exist significant 1 ORAL SCAMOUS CELL CARCINOMA Droguett D , Cas- differences between the different RHL that were studied. tillo C2, Duaso J2, Theoduloz C3, Venegas BA1,4, Schmeda- Hirschmann G5, Kemmerling U2 - 1UNIVERSIDAD DE LOW-LEVEL LASER THERAPY AS A COADJUVANT IN TALCA - FACULTAD DE CIENCIAS DE LA SALUD, DE- THE TREATMENT OF DEAFFERENTATION PAIN: CASE PARTAMENTO DE ESTOMATOLOGÍA, UNIDAD DE PA- 1 2 3 2 REPORT Nobre DL , Cunha KSG , Teixeira MKS , Taka- TOLOGÍA ORAL, UNIVERSITY OF CHILE - FACULTY OF hama Júnior A4, Azevedo RS, Carvalho Neto LGDM4, Fontes MEDICINE, INSTITUTE FOR BIOMEDICAL SCIENCES, KBFDC4 - 1UNIVERSIDADE FEDERAL FLUMINENSE - 3 UNIVERSIDAD DE TALCA - FACULTAD DE CIENCIAS PATOLOGIA, 2PROGRAMA DE PÓS-GRADUAÇÃO EM DE LA SALUD, DEPARTAMENTO DE BIOQUÍMICA PATOLOGIA- UNIVERSIDADE FEDERAL FLUMINENSE - 4 CLÍNICA, LABORATORIO DE CULTIVO CELULAR, HOS- PATOLOGIA, 3FACULDADE DE ODONTOLOGIA- POLO PITAL CARLOS VAN BUREN - SERVICIO BUCOMAXILO- UNIVERSITÁRIO DE NOVA FRIBURGO- UNIVERSIDADE FACIAL, 5UNIVERSIDAD DE TALCA - INSTITUTO DE FEDERAL FLUMINENSE, 4FACULDADE DE ODONTO- QUÍMICA DE LOS RECURSOS NATURALES LOGIA- PÓLO UNIVERSITÁRIO DE NOVA FRIBURGO- Background: The flavonoid quercetin has been proposed as UNIVERSIDADE FEDERAL FLUMINENSE a chemo-preventive agent against cancer. The treatment of differentiation pain (DP) is a challenge and Objective: To determine the possible chemo-preventive ef- the low-level laser therapy (LLLT) becomes an important option. fect of quercetin against 4-nitroquinoline-1-oxide (4-NQO) in- We report a 76-year-old female patient who presented pain in the duced oral squamous cell carcinoma (OSCC) in mice. right upper and lower posterior teeth. After physical examination, Study design: OSCC was induced in mice, CF-1 strain, periapical and panoramic radiographs the diagnosis of DP was with a 100 ␮g/ml propyleneglycol/4-NQO solution solubilized established. It was prescribed a mixture of capsaicin 0.025% with in drinking water during 16 weeks in presence and absence of lidocaine 3% in a tray and amitriptyline 10mg/day for 30 days. two concentrations of quercetin (10 mg/kg/day; 100 mg/kg/ Since the pain persisted, amitriptyline was suspended and initi- 2 day). Mice were sacrificed after 28 weeks. Incidence was ated LLLT with 808 nm (GaAlAs, 142J/cm , 4J and 100 mW). determined by presence or absence of OSCC in tongues and The patient reported significant improvement. However, she did severity of lesions was studied according to the International not return for follow-up for 18 months. The pain returned and all Histological Classification of Tumors (WHO) and Bryne’s teeth in pain area were extracted in another oral health center. The patient started to use capsaicin and LLLT. Currently, she Histological Malignancy Grading System for the Invasive reported no pain in the maxilla and sporadic pain in the man- Tumor Front. dibula. LLLT is an alternative or coadjuvant treatment for DD. Results: Incidence (pϭ0,67 Kruscall-Wallis analysis) as well as severity of OSCC (pϭ0,724 Fisher exact test and pϭ0,598 ANOVA respectively) was not statistically different PLASMABLASTIC LYMPHOMA IN HIV INFECTION: A between quercetin-treated and non-quercetin treated mice. CASE REPORT Cavalcanti DR1,2,3, Bastos RM2, Nunes FD4, Conclusion: Quercetin cannot be considered as a chemo- Silveira FRX4, Sugaya NN4 - 1CENTRO DE ESPECIALI- preventive agent for 4-NQO-induced-OSCC. DADES ODONTOLOGICAS - ESTOMATOLOGIA, 2FAC- Financed by FONDECYT Project N°1120230, CONICYT- ULDADE DE CIÊNCIAS DE GUARULHOS - ODONTOLO- PBCT Anillo ACT 112, Chile (to UK) and found of “Desarrollo GIA, 3UNIVERSIDADE BRAZ CUBAS - ODONTOLOGIA, de Productos Bioactivos” of the Instituto de Quimica de los 4UNIVERSIDADE DE SAO PAULO - ESTOMATOLOGIA Recursos Naturales, Universidad de Talca (to GS). Background/objective: Plasmablastic lymphoma (PL) is an ORAL MEDICINE OOOO e112 Abstracts October 2012 aggressive type of non-Hodgkin lymphoma that often manifests worked in the sun, 50% had clinical appearance of white lesions in the oral cavity. It is a lymphoma variant strongly associated and 40% no dysplasia. We tried to associate sex (pϭ1.00), age with immunosuppression. A 56 year-old white woman, HIV- (pϭ1.00) and clinical aspect (pϭ0,467) with histological grading infected, was referred to Stomatology clinic presenting a fast of ACs, there was no significant association. growing mass (30 days) in her mouth and a toothache complaint. Conclusion: The clinicopathological profile of ACs was Initial examination disclosed a 50mm granulomatous swelling on from males, whites, older than 40 years, clinical appearance of anterior mandibular ridge presenting superficial ulcerated areas. white lesions without dysplasia and grade was not associated Study design: A differential diagnosis of lymphoma vs with sex, age or appearance. sarcoma elicited a biopsy procedure. Microscopic examination revealed large cells with large and eccentrically nuclei along with a high mitosis level. EXOPHYTIC LESION IN ORAL CAVITY AS FIRST SYMP- Results: A diagnosis of plasmablastic lymphoma was estab- TOM OF HAEMORRAGIC DENGUE Guimarães DM1,Pa- lished. At this time the tumor measured 120mm in extension. vanello KC1, Nunes FD1, Pontes FSC2, Pontes Har2 - 1UNI- Chemotherapy produced major tumor regression but the patient VERSIDADE DE SAO PAULO, 2UNIVERSIDADE died 11 months later due to HIV-related complications. FEDERAL DO PARA Conclusion: The oral PL should be more widespread among Dengue is an important viral disease, caused by a retrovirus infectious disease physicians, because it is often mistaken for that belongs to the group B arbovirus, family Flaviviridae, genus other dental diseases, which may affect the diagnosis and the Flavivirus. These viruses is transmitted by the mosquito Aedes treatment. sp. female through the bite and infect about 50 to 100 million people per year around the world and causes the hospitalization ADENOID CYSTIC CARCINOMA OF THE MAXILLARY of 500,000 people experiencing severe and potentially fatal dis- SINUS WITH ORAL INVOLVEMENT Bravo-Calderón ease. The most common symptoms of the disease are fever, DM1, Carvalho TS2, Jacinto AA2, Rodrigues MTV3, Oliveira myalgia and thrombocytopenia in some cases bleeding may occur DT1 - 1BAURU SCHOOL OF DENTISTRY, UNIVERSITY OF leading to shock and multiple organ failure. The present paper SÃO PAULO, BAURU, BRAZIL - DEPARTMENT OF STO- report a cases of 20 years old man with chief complaint a painless MATOLOGY, AREA OF PATHOLOGY, 2FUNDAÇÃO PIO exofitic mass in anterior region of maxilla present for two days, XII-CANCER HOSPITAL OF BARRETOS, BARRETOS, in clinical examination was observed petechiae in oral cavity, BRAZIL, 3SÃO LUCAS SCHOOL, PORTO VELHO, BRAZIL eyes and legs. The haemogram was solicited and reveal throm- A 38-year-old woman presented a painful buccosinusal com- bocytopenia and the patient was referred to hematological center munication in the right posterior alveolar ridge, with past history that diagnosed as hemorrhagic dengue. of extraction of the 16 tooth two years ago. Computed tomogra- phy revealed partial opacification of the right maxillary sinus. An PLEOMORPHIC ADENOMA OF THE HARD PALATE incisional biopsy was performed and the specimen was sent to the Guimarães EP1, Carli ML1, Pedreira FRO1, Oliveira TI1, Bauru School of Dentistry Oral Pathology Service of the Uni- Pereira AAC1, Hanemann JAC1 - 1UNIFAL-MG - DEPAR- versity of São Paulo. Microscopic analysis revealed diverse TAMENTO DE CLÍNICA E CIRURGIA cribriform and tubular structures composed by hyperchromatic A 18-year-old male was referred to the Stomatology Clinic basaloid epithelial cells, with occasional presence of mucoid of the Unifal-MG complaining of a painless nodular mass on the material in the lumen. Perineural infiltration and mitotic figures palate for several years. Intraoral examination revealed a 2.0-cm were scarce. The diagnosis of adenoid cystic carcinoma arising in painless firm, nodular mass with defined borders, slightly pur- the maxillary sinus was established. The patient was referred to plish color and covered by intact mucosa, located in the posterior surgical treatment in the Cancer Hospital of Barretos. The ex- region of the hard palate in the midline. There were no radio- cised specimen confirmed the previous diagnosis of adenoid graphic changes. A fine needle aspiration was negative for liquid cystic carcinoma. Currently, the patient is under adjuvant radio- contents, then a incisional biopsy was performed. The histologic therapy and has not shown signs of locoregional recurrence. aspects revealed a well-circumscribed, encapsulated tumor which Financial support: CNPq 142790/2011-7 is composed of a mixture of glandular epithelium and myoepi- thelial cells within a mesenchyme-like background. The diagno- CLINICAL AND MORPHOLOGIC PROFILE IN A SERIE sis was pleomorphic adenoma. After three weeks, surgical exci- OF CASES OF ACTINIC CHEILITIS Sarmento DJS1, Miguel sion of the lesion was performed. Microscopic analysis of the MCC1, Queiroz LMG1, Godoy GP2, Silveira EJD1 - 1UNI- specimen confirmed the diagnosis of pleomorphic adenoma. The VERSIDADE FEDERAL DO RIO GRANDE DO NORTE, patient shows no evidence of recurrence and complete healing of 2UNIVERSIDADE ESTADUAL DA PARAÍBA the operated region five months after surgery. (Financial support: FAPEMIG). Background/objective: Was evaluated the clinical-patho- logical profile of cases of actinic cheilitis (ACs) diagnosed in a Brazilian Service. Study design: Sample: 40 cases of QA. We evaluated the THE CORRELATION BETWEEN THE PROLIFERATION variables gender, age, race, clinical aspect, professional activity INDEX, MMPS AND ALPHA-SMA IN KERATOCYSTIC 1 and histological grading of ACs. For the morphological study, we ODONTOGENIC TUMORS (KCOT) Rivero ERC , Ramos 2 3 1 1 1 used HE technique and gradation of ACs was performed accord- GO , Costa A , Vieira DSC , Meurer MI - UNIVERSI- ing to WHO. DADE FEDERAL DE SANTA CATARINA - DEPARTA- Results: The AC sample was composed for 75% male pa- MENTO DE PATOLOGIA, 2UNIVERSIDADE FEDERAL DE tients (pϭ0.002), 80% older than 40 years, 65% white, 60% SANTA CATARINA - PROGRAMA DE PÓS GRADUAÇÃO OOOO ORAL ABSTRACTS Volume 114, Number 4 Abstracts e113

EM ODONTOLOGIA, 3UNIVERSIDADE FEDERAL DE UNDESIRABLE EFFECT OF COSMETIC LIP AUGMENTA- SANTA CATARINA - HOSPITAL UNIVERSITÁRIO TION WITH AUTOLOGOUS FAT TISSUE. CASE Objective: The objective of this study was to evaluate the REPORT Kaminagakura E1, Rosa JA1, Carvalho RY1, Car- correlation between the proliferation index, matrix metallopro- valho RY1, Silva de Carvalho LP1, Rosa LE1, Almeida JD1 - teinases (MMPs) and the presence of myofibroblasts (MF) in 1SÃO JOSÉ DOS CAMPOS DENTAL SCHOOL, UNESP - KCOT. DEPARTMENT OF BIOSCIENCES AND ORAL DIAGNOSIS Study design: Immunohistochemistry was carried out to A 61 year-old female was attended at department complain- evaluate the antigens ki-67, MMP-1, 2 and 9 (parenchyma and ing about an unesthetic “fold” on her upper lip when smiling and stroma) and alpha-SMA (for MF identification in stroma) in 23 talking. She reported a history of cosmetic augmentation of the cases of KCOT. Results were evaluated using the Spearman upper lip. Twelve years ago, she was submitted to an injection of correlation test. autologous fat tissue in this area. Physical examination revealed Results: Positive correlation between the Ki-67 antigen and bilateral submucosal enlargement of the upper lip, which was soft MMP-1 was observed in parenchyma as well as between MF and on palpation and showed no color alteration of the mucosa. She MMP-1 (parenchyma). The MMPs also showed significant cor- was submitted to surgery based on the diagnostic hypotheses of relation in stroma and parenchyma. dislocation of fat graft or double lip. Microscopically, the spec- Conclusions: The increased proliferative activity in KCOT imen was composed of muscle fibers and mature adipocytes. The was found to be associated with increased MMP-1 production in final diagnosis was based on clinical exam and microscopic parenchyma. This can influence the growth of the lesion in evidence. Nowadays, esthetic treatments are widely performed, association with an increase of myofibroblasts in the stroma. The especially in the perioral area. In some cases, undesirable effects correlation between MMPs indicates interaction between them: can occur and the clinician should be familiar with such compli- MMP-1 activates MMP-2 which in turn activates MMP-9. cations in order to diagnose and manage them correctly. CONSERVATIVE MANAGEMENT OF LARGE DENTI- GEROUS CYST IN A 10-YEAR-OLD CHILD: A CASE 1 2 2 CLEAR CELL VARIANT OF CALCIFYING EPITHELIAL REPORT de Araújo Lima EN , Gurgel AC , Carvalho MGF , 2 1 1 1 ODONTOGENIC TUMOUR (PINDBORG TUMOR): Maia CADM , Queiroz LMG , Oliveira PT , Medeiros AMC 1 1 2 1 CASE REPORT Turatti E , Brasil J , Romanach MJ , - UNIVERSIDADE FEDERAL DO RIO GRANDE DO 3 1 2 Almeida OP - UNIVERSIDADE DE FORTALEZA - UNI- NORTE - DEPARTAMENTO DE ODONTOLOGIA, UNI- 2 VERSIDADE POTIGUAR - DEPARTAMENTO DE ODON- FOR - CURSO DE ODONTOLOGIA, FACULDADE DE TOLOGIA ODONTOLOGIA DE PIRACICABA - DEPARTAMENTO DE 3 The dentigerous cyst is a developmental odontogenic cyst, DIAGNÓSTICO ORAL, FACULDADE DE ODONTOLO- which apparently develops by accumulation of fluid between GIA DE PIRACICABA - UNICAMP - DEPARTAMENTO DE reduced enamel epithelium and the tooth crown of an unerupted DIAGNÓSTICO ORAL tooth. We report the case of a 10-year-old boy who sought the Calcifying epithelial odontogenic tumor (CEOT) known as dental clinic presenting permanence of deciduous teeth 51, 52, Pindborg’s tumor is a rare benign neoplasm of the jaws, account- and 53, with the first showing intense change in color and evident ing for approximately 1% of all odontogenic tumors. A 25-year- pulp disturbance. Panoramic radiograph and computed tomogra- old female presented with asymptomatical cortical expansion in phy showed extensive cystic lesion involving the teeth 11, 12 and left premolars areas of the mandible with evolution of two 13 included. Diagnosis of dentigerous cyst was confirmed by months. Panoramic radiograph revealed a well-defined unilocular incisional biopsy. The therapeutic approach was enucleation of radiolucency. The clinical diagnosis was lateral periodontal cyst. the lesion, extraction of deciduous teeth and maintenance of the The lesion was surgically excised under local anesthesia with permanent ones. After 2 years of follow-up, the impacted teeth bone curettage. Histopathologic and immunohistochemical tests are positioning spontaneously toward its eruption. The present revealed clear cell variant of calcifying epithelial odontogenic case report is unique as it enclosed three permanent maxillary tumor. There is no clinical or radiographic evidence of recurrence teeth that could be maintained during enucleation of the cyst. 1 year after excision. ORAL MEDICINE OOOO e114 Abstracts October 2012

Poster 4

SALIVA AND BLOOD INTERFERON GAMMA LEVELS surgical treatment, histopathological features and differential di- AND IFNG GENOTYPES IN ACUTE GRAFT-VERSUS- agnosis of lymphangiomas. HOST DISEASE Souza FTA1, Resende RG1, Correia-Silva JF1, Campos K1, Silva MES2, Abreu MHNG3, Gomez RS1 - IMMUNOHISTOCHEMICAL EXPRESSION OF RANKL 1UNIVERSIDADE FEDERAL DE MINAS GERAIS - DE- AND OPG IN ODONTOGENIC CYSTS AND TUMOURS PARTMENT OF ORAL SURGERY AND PATHOLOGY, Silva EBN1, Matos FR1, Moraes M1, Henriques ACG1, Costa SCHOOL OF DENTISTRY, 2UNIVERSIDADE FEDERAL ALL1, Galvão HC1, Freitas RA1 - 1UFRN - ODONTOLOGIA DE MINAS GERAIS - DEPARTMENT OF RESTORATIVE Background/Objectives: The aim of this study was to com- DENTISTRY, SCHOOL OF DENTISTRY, 3UNIVERSIDADE pare immunohistochemical expression of receptor activator nu- FEDERAL DE MINAS GERAIS - DEPARTMENT OF COM- clear ␬appaB- ligand (RANKL) and osteoprotegerin (OPG) in MUNITY AND PREVENTIVE DENTISTRY, SCHOOL OF radicular (RC) and dentigerous cysts (DC), solid ameloblastoma DENTISTRY (SA) and keratocystic odontogenic tumour (KOT). Objectives: To investigate the association between IFN-␥ Study design: Twenty RC, DC, KOT, 14 dental follicle (DF) levels in saliva and blood and IFNG polymorphisms and the and 18 SA were selected for analysis of the immunoexpression of occurrence of acute graft-versus-host disease (aGVHD) in allo- RANKL and OPG. genic hematopoietic stem cell transplantation (HSCT). Results: The DF, KOT and SA showed higher expression of Study design: Fifty-eight consecutive allogenic HSCT re- RANKL than RC and DC in capsule and epithelium (P Ͻ .05). cipients and their donors were prospectively studied. IFN-␥ lev- OPG was higher expressed in DF, KOT and DC in capsule and els in saliva and blood were assessed by ELISA. Saliva and/or epithelium (P Ͻ .05). The ratio OPG Ͻ RANKL was more blood samples were obtained from the recipients and donors to frequent in SA (P Ͻ .05) and OPG Ͼ RANKL in DC (P Ͻ .05). determine IFNG gene polymorphisms. Conclusion: Our results suggest differences in RANKL and Results: Increased saliva and blood IFN-␥ levels were ob- OPG expression in odontogenic cysts and tumours and this could served in patients that developed aGVHD. A significant associ- contribute to the differential bone/tooth resorption activity be- ation was found between the recipients IFNG genotypes and the tween these lesions. IFN-␥ levels in their blood, in the day ϩ14 after HSCT. No association was seen between IFNG gene polymorphisms and the PAPILLARY CYSTADENOMA LYMPHOMATOSUM (WAR- aGVHD. THIN’S TUMOR) IN PAROTID GLAND: CASE REPORT Conclusion: Our study shows that the genetic background of Pigatti FM1, Franchim GH2, Naclério-Homem MG2, Pinto recipients can influence the production of IFN-␥ and as this Junior DS1 - 1FACULDADE DE ODONTOLOGIA DA USP - cytokine may be a useful predictor of aGVHD. PATOLOGIA BUCAL, 2FACULDADE DE ODONTOLOGIA Financial support: CAPES, FAPEMIG and CNPq. DA USP - PRÓTESE, CIRURGIA E TRAUMATOLOGIA MAXILO-FACIAIS CAVERNOUS LYMPHANGIOMA OF THE TONGUE: A Papillary cystadenoma lymphomatosum is a benign tumor of CASE REPORT Tekkesin MS1, Atikler M2, Ergun S, Alatli the salivary gland most frequently located in the parotid gland, FC1 - 1ISTANBUL UNIVERSITY, INSTITUTE OF ONCOL- first described by Scott Aldred Warthin in 1929 (Warthin’s OGY - TUMOUR PATHOLOGY, 2ISTANBUL UNIVERSITY, tumor). It is the second most common benign tumor of the parotid DENTISTRY FACULTY - ORAL MEDICINE AND SURGERY gland after pleomorphic adenoma. A 56-year-old male patient presented to the School of Dentistry of University of São Paulo Lymphangiomas are benign tumours that occur predomi- with a non-phlogistic three months enlargement in the left parot- nantly in the head and neck area. These lesions are common in id-masseteric region and a history of surgical cyst treatment in pediatric populations. Oral lymphangiomas may occur at various the same region for over three years. Histological examination sites but are most frequent on the dorsum of the tongue, resulting revealed proliferation of papillary projections of ductal epithe- macroglossia. There are three types of lymphangioma: capillary, lium toward the cystic spaces, partially filled with mucoid ma- cavernous and cystic. The treatment of lymphangioma usually terial, red blood cells and inflammatory cells. The stroma was consists of surgical surgery but in some cases the treatment is composed of a dense lymphoid tissue with homogeneous and problematic because of large size or involvement of vital struc- hyperchromatic cells. Warthin’s tumor is an uncommon benign tures. Recurrence is common, especially for cavernous lymphan- tumor of the parotid gland, which treatment and definitive diag- gioma. nosis is made by surgery followed by histopathologic examina- A 15-year-old male patient was referred to the Dental Med- tion. icine and Surgery Clinic with the complaint of an irregular nodularity at the dorsum of the tongue mass with grey, pink, grapelike projections which has been present since his birth. An ODONTOGENIC FIBROMA (OF): REPORT OF 4 CASES incisional biopsy was performed. Histopathologically, the lesion FROM AN ORAL PATHOLOGY SERVICE (IREPO, CHILE) 1 2 3 2 was composed of thin-walled, dilated lymphatic vessels of dif- Rodriguez-Castro F , Enrico E , Ortega A , Peñafiel C - ferent size, which were lined by a flattened endothelium. Many 1UNIVERSIDAD DEL DESARROLLO - ORAL PATHOL- lumens were large and contained proteinaceous fluid and a few OGY, 2UNIVERSIDAD DE CHILE - IREPO, 3UNIVERSI- lymphocytes. The purpose of this poster was to highlight the DAD DE CHILE - FACULTY OF DENTISTRY OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e115

Introduction: The POMM is a rare malignancy (from 1% to samples and margins was performed by qRT-PCR. Differential 2% of all melanomas) with an aggressive biological behavior. expression was calculated based on expression ratio according to Cases report: 42-year-old male Is referred for evaluation of Pfaffl method, considering the tumor median as cut-off values. painless gingival lesion. On examination a large pigmented lesion Results: Although Nanog was down-regulated in tumors is seen on buccal gingiva extending from tooth 1.6 to 2.6 extend- compared to margins, more aggressive cases exhibited higher ing to the hard palate bilaterally. Incisional biopsy is performed expression level of this transcript. Conversely, CD44 and CD133 delivering a diagnosis of oral mucosal melanoma. showed a trend to be up-regulated in OSCC, with decreased and In the study period (1976-2010) there were 17 cases of increased expression, respectively, in more aggressive tumors. primary oral mucosal melanoma among 33,381 oral biopsies, Interestingly, CD44 up-regulation resulted in significantly lower corresponding to 0.05%. 9 cases were male and 8 cases were (pϭ0.01) global survival rates. female. The most anatomical affected site were the palatal mu- Conclusion: Differential expression of CSC markers might cosa in 9 cases (52.9%), followed by the gum with 4 cases contribute to tumor progression and survival rates. (23.5%). Conclusion: The POMM are extremely rare malignant le- sions. In this study, the primary oral melanomas mainly affected MULTIPLE KERATOCYSTIC ODONTOGENIC TUMOR - patients in the seventh decade of life, being the most affected CASE REPORT Barros FBA1, Garcia NG, Oliveira DT, Lima anatomic site the palatal mucosa. EM2, Couto Filho CEG2, Pereira AAC2, Hanemann JAC2 - 1BAURU SCHOOL OF DENTISTRY, UNIVERSITY OF SÃO DIAGNOSIS OF LEPROSY THROUGH AN ORAL PAULO, BAURU, SÃO PAULO, BRAZIL - DEPARTMENT MANIFESTATION Modolo F1, Grando LJ1, Daniel FI1, OF STOMATOLOGY, AREA OF PATHOLOGY, 2ALFENAS Meurer MI1, Camargo AR2, Novaes FC3, I-Ching L3 - 1UNI- FEDERAL UNIVERSITY, ALFENAS, MINAS GERAIS, BRA- VERSIDADE FEDERAL DE SANTA CATARINA - DEPAR- ZIL - DEPARTMENT OF CLINIC AND SURGERY, AREA TAMENTO DE PATOLOGIA, 2UNIVERSIDADE FEDERAL STOMATOLOGY DE SANTA CATARINA - DEPARTAMENTO DE ODONTO- Abstract: The keratocystic odontogenic tumors have an LOGIA, 3UNIVERSIDADE FEDERAL DE SANTA CA- aggressive behavior including high rates of recurrence. We report TARINA - HOSPITAL UNIVERSITÁRIO a case of 14-year-old boy presented with complaints of recurrent A 27-year-old white man was referred for evaluation of a inflammation in the posterior region of the mandible on both four-month-old asymptomatic oral lesion in the palate. Intraoral sides. During the intraoral examination was observed the pres- examination revealed a superficially granulomatous ulcer cover- ence of a drainage point, on the distal of tooth 46. Radiographic ing the posterior part of the hard palate, the soft palate and the examination revealed unilocular radiolucent lesions, involving bilateral tonsil pillars. Moreover, both lips were swollen and the impacted teeth 28, 38 and 47. Also, was observed a similar rubbery. A previous videolaryngoscopy had shown the ulcer lesion in the posterior region of the right maxilla, involving the affecting the oropharynx down to the vocal cords. The patient’s maxillary sinus and extending to the orbital floor. The diagnoses medical history revealed a diagnosis of antiphospholipid syn- suggested were keratocystic odontogenic tumors and dentigerous drome (APS) - treated with sodium warfarin, 5mg/day - and clear cysts. An incisional biopsy was performed. Thus, were performed skin spots diagnosed as mycosis. With the clinical suspicion of an enucleations of the lesions. The histopathological diagnosis es- autoimmune nonspecific disease, an incisional biopsy was per- tablished was keratocystic odontogenic tumor. In cases of mul- formed and the histopathological diagnosis was “granulomatous tiple keratocystic odontogenic tumors, it is necessary to investi- inflammatory process with acid-alcohol-resistant bacillus”, sug- gate whether there are other manifestations of Gorlin syndrome. gesting tuberculosis or leprosy. The patient was reassessed and, Key words: Keratocystic; Enucleation; Oral surgery. due to the skin spots, loss of skin sensitivity, ear- and lip-swelling Apoio: cnpq and the absence of lung problems, leprosy was diagnosed and the patient is under treatment. ANALYSIS OF SNPS IN METALLOPROTEASE-RELATED DIFFERENTIAL EXPRESSION OF CANCER STEM CELL GENES IN HEAD AND NECK SQUAMOUS CELL CAR- 1 2 MARKERS IN ORAL SQUAMOUS CELL CARCINOMA CINOMA PATIENTS Gleber-Netto FO , Dias THG , 3 4 4 Xavier FC1, Morais NS, Destro MFS2, Rodini CO3, Nunes Wünsch-Filho V , Curioni OA , Carvalho MB , GENCAPO, 5 1 1 1 FD2, Tajara EH4, GENCAPO HNP - 1UFBA - ESTOMATO- Tajara EH , Nunes DN , Dias-Neto E - CIPE/HOSPITAL LOGIA, 2UNIVERSIDADE DE SÃO PAULO - PATOLOGIA AC CAMARGO - LABORATÓRIO DE GENÔMICA 2 BUCAL, 3UNIVERSIDADE DE SÃO PAULO - HISTOLO- MÉDICA, FACULDADE DE MEDICINA - UNIVERSI- GIA E EMBRIOLOGIA, 4FACULDADE DE MEDICINA DE DADE DE SÃO PAULO - LABORATÓRIO DE NEURO- SÃO JOSÉ DO RIO PRETO - DEPARTAMENTO DE BIO- CIÊNCIAS (LIM-27) - INSTITUTO DE PSIQUIATRIA, 3 LOGIA MOLECULAR FACULDADE DE SAÚDE PÚBLICA - UNIVERSIDADE Cancer stem cells (CSC) subpopulation has been related to DE SÃO PAULO - DEPARTAMENTO DE EPIDEMIOLO- 4 the initiation, growth, recurrence and metastasis of oral squamous GIA, HOSPITAL HELIÓPOLIS - DEPARTAMENTO DE 5 cell carcinoma (OSCC). CIRURGIA DE CABEÇA E PESCOÇO, FACULDADE DE Objectives: To investigate the differential expression of the MEDICINA DE SÃO JOSÉ DO RIO PRETO - DEPARTA- CSC markers CD133, CD44 and Nanog, OSCCs were compared MENTO DE BIOLOGIA MOLECULAR to tumor-free margins. Data was correlated to clinical-patholog- Background/Objective: Matrix metalloproteases (MMPs) ical and survival parameters. have been associated with aggressiveness in some cancers. We Study design: Transcript relative quantification in 24 OSSC investigated possible associations of SNPs in MMPs genes and ORAL MEDICINE OOOO e116 Abstracts October 2012 tumor-stage/nodal-metastasis in head and neck squamous cell the lesion under local anesthesia, and its histopathology compat- carcinoma (HNSCC). ible with the presence of actinic keratosis and cutaneous horn Study design: Leukocyte DNA was extracted of HNSCC associated with injury. patients and SNPs with higher chances of functional effects were evaluated using TaqMan assays in an ABI7500. A total of 318 patients samples were investigated with four genes/SNPs: LOSS OF HETEROZYGOSITY (LOH) IN TUMOUR SUP- MMP14, rs1042703 – SER8PRO – nsSNP; MMP16, rs2616490 PRESSOR GENES IN ORAL GRANULAR CELL TUMOUR – ILE415VAL –nsSNP; MMP25 (MMPL1), rs10431961 – sSNP; Silva TF1, Correa GTB1, Campos K1, Amaral FM2, Gomes and TIMP-3, rs1065314 – 3’ UTR. SPSS 17.0 was used for CC3, Gomez RS4 - 1UNIVERSIDADE FEDERAL DE MINAS statistical analysis. GERAIS - DEPARTAMENT OF MOLECULAR MEDICINE, Results: Advanced tumors (T3-T4) were present in 156 2UNIVERSIDADE FEDERAL DE MINAS GERAIS - DEPAR- patients (49%) and 158 patients (49.6%) presented nodal metas- TAMENT OF BIOLOGY, 3UNIVERSIDADE FEDERAL DE tasis. Allelic/genotypic frequencies showed no correlation to MINAS GERAIS - DEPARTAMENT OF PATHOLOGY, clinical aspects of HNSCC. 4UNIVERSIDADE FEDERAL DE MINAS GERAIS - DEPAR- Conclusion: Besides the importance of MMPs for the pro- TAMENT OF ORAL SURGERY AND PATHOLOGY - gression of HNSCC, the SNPs studied here showed no statistic SCHOOL OF DENTISTRY correlation with more or less aggressive HNSCC. Objective: The objective of this study was to investigate loss of heterozygosity (LOH) in regions of tumor suppressor genes in CLINICAL INTRAORAL PROFILE OF SECONDARY oral granular cell tumor (GCT). SYPHILIS IN ORAL MEDICINE SERVICE AT ARARA- 1,2,3,4 1 Study design: LOH was assessed in eight samples of oral QUARA SCHOOL OF DENTISTRY Ohata G - ARA- GCT using polymorphic microsatellite markers at the chromo- RAQUARA SCHOOL OF DENTISTRY - UNESP - DIAGNO- some regions 3p, 9p, 11p, 11q and 17p (markers D3S1029, 2 SIS AND SURGERY, ELAINE MARIA SGAVIOLI D3S1293, D9S157, D9S162, D9S171, D11S1369, AFM238WF2 MASSUCATO - DIAGNOSIS AND SURGERY/ARARA- and P53) related to tumor suppressor genes. 3 QUARA SCHOOL OF DENTISTRY, MIRIAN APARECIDA Results: Five samples showed LOH in three markers at ONOFRE - DIAGNOSIS AND SURGERY/ARARAQUARA chromosomes 9p and 17p (markers TP53, AFM238WF2 and SCHOOL OF DENTISTRY, 4CLÁUDIA MARIA NAVARRO - D9S162) with fraction of allelic loss of 42.8% for each of these DIAGNOSIS AND SURGERY/ARARAQUARA SCHOOL OF markers. Moreover, no allelic loss was identified in any other DENTISTRY chromosome. The objective of this study was to assess cases of secondary Conclusion: The results suggest that loss of heterozygosity syphilis to establish a clinical intraoral profile. This was a retro- at chromosomes 9p and 17p may be relevant to the pathogenesis spective study based on clinical files of patients attended at the of oral GCT. Oral Medicine Service of the Araraquara Dental School, between Support: CAPES, CNPq, FAPEMIG 1981 and 2012. The sample was composed by 7 patients with intraoral secondary syphilis serologically confirmed, being 4 cases diagnosed in 2012. The patients were predominantly men SOLITARY FIBROUS TUMOUR OF PALATE, A CASE (6), with the mean age of 32 years old. The main complaints are: REPORT Martínez-Martínez EA1, Meza-García G2, Cano- oral lesions (5) and burning mouth (3) associated to skin rash two Valdés AM3, Domínguez-Malagón H3 - 1UNIVERSIDAD AU- months before the exam (5) and cervical lymphadenopathy (2). TÓNOMA ”BENITO JUÁREZ” DE OAXACA - FACULTAD The main anatomical sites affected were: labial mucosa (5) and DE ODONTOLOGIA, 2UNIVERSIDAD REGIONAL DEL tongue (5). The Intraoral Secondary Syphilis occurs mainly in SURESTE/SERVICIOS DE SALUD DEL ESTADO DE OAX- white men, mean age 32 years, in the era of highly active ACA - ORAL PATHOLOGY, 3INSTITUTO NACIONAL DE antiretroviral therapy. CANCEROLOGÍA DE MÉXICO - PATHOLOGY Solitary fibrous tumour (SFT) is a spindle-cell mesenchymal A CASE OF CUTANEOUS HORN ASSOCIATED WITH neoplasm, has been reported in various locations but the oral cavity INJURY OCCURRING ON THE VERMILION BORDER is a distinctly uncommon region. Case report: a female patient, 30 1 2 OF THE LOWER LIP Oliveira GMR , Thomé EC , Ramos years old with a painful tumour the lesion measured approximately 1 1 2 2 1 TR , Pereira HSC , Resende RFB , Meirelle MS - UERJ - 4 cm; computed tomography showed a heterogeneous large mass in UNIVERSIDADE ESTADUAL DO RIO DE JANEIRO, palate extending to oral cavity preserving osseous tissue; an inci- 2DENTAL OFFICE sional biopsy was performed; histopathological examination dem- Cutaneous horn is a morphological description of a highly onstrated a circumscribed lesion composed mainly of hyalinized conic and circumscribed keratotic lesion found in both sexes and fibrous connective tissue with intermittent paucicellular and hy- occur most commonly in light-skinned patients over 50 years. percellular areas and a hemangiopericytoma-like vasculature The surface can be white or yellowish and that can hide benign, were noted. Immunohistochemically: were strongly positive for premalignant or malignant lesions. This impressive retention of CD34, bcl-2 and vimentin but negative for S-100 protein, cal- keratin is unknown. It’s most frequently caused by sun-exposed ponin, CD-99. CD-21, CD-23, CD-35, Fascin and EMA; a diag- skin. Histopathologically, shows a compact, diffuse hyperkera- nosis of solitary fibrous tumor was made. The tumour was treated tosis and parakeratosis. The aim of this study is to report the case by complete surgical excision; no recurrence was noted at a of a 51 years old Caucasian man presenting an exophytic lesion, 4-year follow-up. rigid palpation and sessile base and about 3 cm in diameter after Conclusion: Because of the rarity and unpredictable biolog- 2 years of evolution. The patient underwent excisional biopsy of ical behavior of these tumors, long-term follow-up is necessary OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e117

DIFFERENCES IN BONE CHANNELS NETWORK IN aim of study is to evaluate the malignant transformation by TWO DIFFERENT REGIONS OF THE MANDIBLE Rabelo multiplex ligation dependent-probe amplification (MLPA). GD1, Beletti ME2, Oliveira MA1, Gallottini MHC1, Siqueira Study design: Eighteen cases of CXPA (classified according CS2, Travençolo BAN2, Silveira FRX1 - 1UNIVERSITY OF to invasiveness and to histopathological subtype), 10 pleomor- SÃO PAULO, 2FEDERAL UNIVERSITY OF UBERLÂNDIA phic adenoma (PA), and 9 cases of PA in CXPA were studied. Aim: Evaluate differences in bone channels network in two Copy number changes in 24 different genes by MLPA was different areas of the cortical bone in mandible. analysed in all the cases. Values lower than 0.7 were interpreted Study design: Twenty-one mandibles of Wistar rats were as losses, higher than 1.3 as gains and 2.5 or higher as amplifi- Ͻ histologically processed. Histological images were taken in two cations. P-values 0.05 were considered significant. regions: superior area (surrounding the root of the first molar) and Results and conclusion: Different pattern of loss was found inferior area (vicinity of the incisor of continuous growth). The among groups. We observed that there was a different genomic histological images were accessed and had their bone channels profile in different phases, from PA to frankly invasive CXPA. segmented and called regions of interest (ROI). The images were According to progression of the tumor phases, an increase of loss analyzed through developed algorithms using the SCILAB math- of copy number reflected higher aggressive behavior. ematical environment, accessing the percentage of bone matrix, ROI areas, ROI perimeters, their standard deviations and lacu- USE OF OCCLUSIVE TOPIC CORTICOSTEROID FOR narity. DESQUAMATIVE GINGIVITIS TREATMENT: AN EFFEC- Results: Significant differences in bone matrix, area and TIVE OPTION Pereira HSC, Oliveira GMR, Picciani BLS, perimeters of the channels and lacunarity were found (Mann Silva-Junior GO, Pessôa TM, Oliveira AV, Cantisano MH Ͻ Whitney and t test - p 0.0001). Background: The treatment of gingival lesions vesicu- Conclusion: The bone channels network is different in the lobullous and autoimmune diseases generally requires the use of superior and inferior mandible regions, with inferior area reveal- topic corticosteroids, but there are difficulties to keep the medi- ing more homogeneity in size, shape and distribution of the cation in contact with the lesion. Some authors suggest the use of channels. occlusive therapy to minimize this problem, with the application of corticosteroids through the trays. MDM2/CDK4/CPM IMMUNOHISTOCHEMICAL FEA- Objectives: The aim of this study is demonstrate efficacy of occlusive therapy for desquametive gingivitis caused by vesicu- TURES OF LIPOMA AND LIPOSARCOMA OF THE lobullous and autoimmune diseases. Study design: Two cases of HEAD AND NECK Rabelo GD1, Esteves CMD1, Rocha LA1, pemphigus, one of pemphigoid and one of lichen planus were Nunes FD1 - 1UNIVERSITY OF SAO PAULO selected. All the cases had histopathological diagnoses and gin- Aim: Evaluate the immunohistochemical (IHQ) profile of gival lesions. The oral examination showed desquamative and MDM2/CDK4/CPM in head and neck lipomas (LP) and liposar- erythematous lesions involving upper and lower gingival. After comas (LPS). the histopathological diagnoses, individual trays of silicone that Study design: IHC staining was performed on representative cover entire gingiva were made. Patients were instructed to fill paraffin blocks of 4 LPS, 2 lipomas with focus of atypic cells the tray with a 1% of hydrocortisone and 0,5% lidocaine gel and (LFAC) and 5 LP. Cases were stratified into four patterns of use them three times on a day, for 30 minutes after oral hygiene. staining: 1-diffuse positivity, when 30% of cells were strongly Results and conclusion: Significant regression of lesions immunoreactive; 2-moderate positivity, when 10–29% of cells was noted two weeks after starting treatment. After one year were moderate to strongly immunoreactive; 3-focal positivity, follow-up, the patients showed improvement of the lesions, al- with 10% immunoreactive; and 4-negative. lowing in some cases reduce the use of corticosteroids. Results: MDM2 immunoreactivity was seen in 4 LPS (score 1), in 2 LFAC (score 2 and 3) and 2 LP (score 3). CDK4 immunoreactivity was seen in 3 LPS (score 1) and in 1 LFAC IMMUNOHISTOCHEMICAL ANALYSIS OF CYTOKERA- (score 3). CPM immunoreactivity was seen in 4 LPS (score 1), in TINS OF GINGIVAL CYST OF ADULT: PHENOTYPIC 2 LFAC (score 2 and 3) and 2 LP (score 3). SIMILARITY WITH DUCTS OF SALIVARY GLANDS Lima Conclusion: IHQ strong expression of MDM2/CDK4/CPM HG1, Soares CT2, Lara VS1 - 1BAURU SCHOOL OF DEN- points to malignancy in adipocytic tumors. TISTRY, UNIVERSITY OF SÃO PAULO - DEPARTMENT OF STOMATOLOGY, AREA OF PATHOLOGY, 2LAURO DE SOUZA LIMA INSTITUTE - SECTION OF ANATOMI- LOSS AND GAIN OF GROWTH FACTORS GENES IN CAL PATHOLOGY MALIGNANT PROGRESSION OF CARCINOMA EX- Objective: Evaluate the presence of cytokeratins (CKs) in PLEOMORPHIC ADENOMA USING MULTIPLEX LIGA- gingival cyst of adult (GCA) to better understand the pathogen- TION-DEPENDENT PROBE AMPLIFICATION Mariano 1 1 1 1 2 esis of these lesions. FV , Santos HT , Gondak RO , Coletta RD , Altemani A , Study design: Two paraffin-embedded GCA were analyzed 1 3 1 Almeida OP , KOWALSKI LP - UNIVERSITY OF CAMPI- by immunohistochemistry and histochemistry. NAS, PIRACICABA DENTAL SCHOOL - ORAL DIAGNO- Results: Luminal cells of the cystic epithelial lining, includ- 2 SIS, UNIVERSITY OF CAMPINAS, MEDICAL SCIENCES ing the focal thickenings, were positive for CK7, CK19, 35␤H11, 3 FACULTY - DEPARTMENT OF PATHOLOGY, AC CA- CK8/18, while the most superficial cells of this lining were MARGO HOSPITAL, SÃO PAULO - DEPARTMENT OF immunoreactive for 34␤E12. The cystic lining was negative for HEAD AND NECK AND OTORHINOLARYNGOLOGY CK20, and focally immunopositive for CK5 and CK6. In addi- Background/Objective: The carcinogenesis process of car- tion, the luminal cells and the contents of the cystic lumen cinoma ex pleomorphic adenoma (CXPA) remains unclear. The showed positivity to PAS with or without diastase. Only one case ORAL MEDICINE OOOO e118 Abstracts October 2012 showed positive staining for Alcian blue in the cystic content of NORTE - DEPARTAMENTO DE PATOLOGIA, 2UNIVERSI- the lumen. DADE FEDERAL DO RIO GRANDE DO NORTE - PATO- Conclusion: This immunoprofile of the cystic epithelial lin- LOGIA ORAL ing observed here is similar to duct-like structures, suggesting a Warthin tumor was first described in 1895 and is almost glandular phenotype for GCA. We are inclined to believe that the restricted to the parotid gland and the periparotid lymph nodes. GCA may represent heterotopic glandular tissue. Since its description, approximately sixteen cases have been reported in the submandibular gland. A 72-year-old man was ORAL MANIFESTATION OF GASTROINTESTINAL referred to a surgical service complaining of a swelling below the DISEASE Flores IL1, Sena Filho M1, Elias RA1, Almeida right side of the jaw, adjacent to submandibular salivary gland. OP1, Jorge Júnior J1, Lopes MA1 - 1PIRACICABA DEN- He smoked for 59 years and had stopped smoking for one year. The patient had a firm, painless, nodular mass, with approxi- TISTRY SCHOOL - FOP/UNICAMP - ORAL DIAGNOSIS mately 35-mm in diameter. Clinical diagnosis was cervical DEPARTMENT lymphadenopathy. An excisional biopsy was performed. Histo- Gastrointestinal diseases can lead to effects on oral mucosa pathologic examination revealed a benign neoplasm composed of because of secondary systemic alterations. In our case report, a an epithelial component, with two layers of cells, and a lymphoid 46-year-old Caucasian man was referred to Orocentro Piracicaba stroma. It is difficult to diagnosis Warthin tumor from subman- Dental School with a chief complaint of red patches on the dibular gland because of its rarity, in addition, professionals must tongue associated to burning sensation for one year. Oral exam- not confuse these lesions with those from the anterior tail of the ination revealed multiple areas of intense erythema scattered on parotid or from periparotid lymph nodes. the oral mucosa. Incisional biopsy was performed and showed subepithelial inflammatory infiltrate of mononuclear cells. Sub- sequently, constipation and gastric discomfort were related. He- IMMUNOLOCALIZATION OF WNT-1A, ␤ETA- matologic tests displayed a megaloblastic anemia and vitamin CATENIN AND C-MYC IN BASAL CELL ADENOMAS B12 deficiency. Anti-endomysium and anti-transglutaminase tests AND BASAL CELL ADENOCARCINOMAS OF SALIVARY were normal. The patient was referred to gastroenterologist and GLANDS Servato JPS1, Mendes G1, Dias FL2, Eisenberg irritable bowel syndrome (IBS) was diagnosed. Medical treat- ALA3, Loyola AM1, de Faria PR4, Cardoso SV1 - 1FEDERAL ment was instituted and resolution of the oral lesions was ob- UNIVERSITY OF UBERLANDIA - AREA OF PATHOLOGY, served. This case illustrate development of oral lesion associated SCHOOL OF DENTISTRY, 2BRAZILIAN NATIONAL CAN- to malabsorption as a result of IBS. CER INSTITUTE - HEAD AND NECK SURGERY SERVICE, 3BRAZILIAN NATIONAL CANCER INSTITUTE - DIVISION WHITE PLAQUE ON THE TONGUE IN AN AMYLOID- OF PATHOLOGY, 4FEDERAL UNIVERSITY OF UBER- OSIS PATIENT Correia-Silva JF1, Resende RG1, Souza LANDIA - DEPARTMENT OF MORPHOLOGY, BIOMEDI- FTA1, Conn B2, Salomão UE3, Mesquita RA1, Gomez RS1 - CAL SCIENCES INSTITUTE 1UFMG - DEPARTMENT OF ORAL SURGERY AND ORAL Objectives: To test whether nuclear localization of beta- PATHOLOGY, SCHOOL OF DENTISTRY, 2DEPARTMENT catenin is related to Wnt-1 and c-Myc expression in basal cell OF ORAL PATHOLOGY - ROYAL FREE & UNIVERSITY adenoma (BCA). COLLEGE MEDICAL SCHOOL, 3UFMG - DEPARTMENT Study design: Immunohistochemistry was performed to de- OF RESTORATIVE DENTISTRY,SCHOOL OF DENTISTRY tect beta-Catenin, Wnt-1 and c-Myc expression in 28 BCA and 4 A 48-year-old man was referred by Stem Cell Transplanta- basal cell adenocarcinomas (BCAC). Proportion and intensity of tion Unit, Hospital das Clínicas, Universidade Federal de Minas reactive cells as well as compartmentalization were assessed. Gerais, Belo Horizonte, Brazil to the Oral Medicine Clinic of the Results: Nuclear reactivity for beta-Catenin was observed in School of Dentistry to evaluate an asymptomatic white plaque on 27 cases of BCA (mainly in abluminal/myoepithelial cells), but in tongue. Intra-oral inspection revealed a presence of a white none BCAC. Wnt-1 reactivity was found in the cytoplasm of 14 adherent plaque on the lateral borders of the tongue with exten- BCA and in 3 BCAC. Cytoplasmic reactivity of variable intensity sion to the ventral and dorsal surfaces. The previous medical for c-Myc was observed in 20 cases of BCA and in 3 BCAC. history revealed systemic amyloidosis. Considering the clinical Beta-Catenin and Wnt-1 or c-Myc expression were not signifi- presentation, localization of the lesion and patient’s medical cantly associated. history, the differential diagnosis included amyloidosis, uremic Conclusion: Beta-Catenin expression is not associated to stomatitis, chronic hyperplastic candidiasis, hairy leukoplakia, activation of the canonical Wnt pathway, and c-Myc is not an drug-induced lichenoid reactions, hairy tongue, and idiopathic effector of the neoplastic effects of nuclear beta-Catenin. Immu- leukoplakia. An incisional biopsy was performed and the histo- nolocalization of beta-Catenin is useful to differentiate BCA and pathological findings were suggestive of hairy leukoplakia. The BCAC. diagnosis was confirmed by Immunohistochemistry and in-situ hybridization for Epstein Barr Virus. Oral hairy leukoplakia ADENOMATOID ODONTOGENIC TUMOR: A RARE should be considered in the differential diagnosis of white LOCATION Tinoco-Araujo JE1, da Silva Santos PS1, patches occurring in all immunocompromised patients. Nogueira AS2, Tavares RN2, Turatti E3, Cavalcante RB3 - 1BAURU SCHOOL OF DENTISTRY/UNIVERSITY OF SAO WARTHIN TUMOR IN AN UNUSUAL SITE: A CASE PAULO - DEPARTMENT OF STOMATOLOGY, 2FEDERAL REPORT Pereira JS2,1, Machado SSF1, Henriques ACG2, UNIVERSITY OF CEARA, 3UNIVERSITY OF FORTALEZA Silveira EJD2, Lima FP1, Guerreiro MPL1, Miguel MCC2 - Adenomatoid odontogenic tumor (AOT) is an uncommon 1UNIVERSIDADE FEDERAL DO RIO GRANDE DO benign and noninvasive tumor composed of odontogenic epithe- OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e119 lium with duct-like structures and varying degrees of inductive Results: The Campaign for Prevention and Early Detection change in the connective tissue. It accounts for 2-7% of all of Oral Cancer was mainly composed of women, who did not odontogenic tumors and has predilection for the anterior maxilla, smoke or drink that is not the high risk population of oral cancer. usually associated with an unerupted canine. A 19-year-old fe- The proportion of oral cancers detected was higher in the Project male presented with swelling in the lateral-canine area of upper Active Search of Oral Lesions, Malignant and Potentially Malig- left jaw, deformation of the left nostril and prolonged deciduous nant Lesions of Oral Cavity FOP-UNICAMP (4,14% versus incisor tooth retention, a rare location. Histological features were 1,80%, respectively). proliferation of epithelial cells forming nests and cords in a Conclusion: The active search for oral lesions is directed to fibrous stroma; tubular structures similar to ducts with eosino- higher risk group and it seems more efficient for early detection philic contents and deposition of calcified material. After an one of oral cancer. year follow up we decided to prosthetic rehabilitation using implant. HUGE NASOPALATINE DUCT CYST TREATED WITH PIEZOSURGERY Seo J1, Horikawa FK2, Kaba SCP3, Ruiz 4 1 1 3 1 ORTHOKERATINIZED ODONTOGENIC CYST: REPORT MM , Sousa SCOM , Sugaya NN , Shinohara EH - FAC- OF 3 CASES González-Galván MC1, Garcia A2, Anitua E3, ULDADE DE ODONTOLOGIA DA UNIVERSIDADE DE 2 Martínez-Conde R4, Aguirre JM5 - 1UNIVERSITY OF THE SÃO PAULO - ORAL PATOLOGY, OMF HOSPITAL RE- BASQUE COUNTRY/EHU *BECARIA ITAIPÚ BINACIO- GIONAL DE OSASCO - ORAL AND MAXILLO FACIAL 3 NAL-PARAGUAY - MASTER OF ORAL PATHOLOGY. SURGERY, HOSPITAL ISRAELITA ALBERT EINSTEIN - 4 ORAL AND MAXILLOFACIAL PATHOLOGY UNIT. UFI ORAL AND MAXILLO FACIAL SURGERY, HOSPITAL DA 11/25, 2UNIVERSITY OF SANTIAGO DE COMPOSTELA - AERONÁUTICA - ORAL AND MAXILLO FACIAL SUR- ORAL AND MAXILLOFACIAL SURGERY, 3CLINICA DEN- GERY TAL ANITUA. VITORIA. GAZTEIZ, 4UNIVERSITY OF THE A 24-years-old female patient was evaluated by complaining BASQUE COUNTRY/EHU - MASTER OF ORAL PATHOL- of jaw volumetric increased with growth of 01 month. On ex- OGY. ORAL SURGERY UFI 11/25, 5UNIVERSITY OF THE traoral examination was noted swelling at the base and elevation BASQUE COUNTRY/EHU - MASTER OF ORAL PATHOL- of the right wing of nose, painful and fibrous-elastic consistency, without signs of inflammation. Intra-oral examination, the mu- OGY. ORAL AND MAXILLOFACIAL PATHOLOGY UNIT. cosa was stained, elastic and moist, with a tumor protruding from UFI 11/25 the caliper body with dark blue color, painful to the touch and Ortokeratinized Odontogenic Cyst (OOC) is rare develop- involving from the tooth 13-23 with 05cm in diameter. Computed mental cyst that was considered a variant of keratocyst odonto- tomography showed vestibular cortical loss and resorption of genic tumor (KCOT) until Wright (1981) defined it. The treat- nasal, sinus and palatal wall. The presumptive diagnosis of na- ment of this pathology is surgical and not recurrences have been sopalatine duct cyst was confirmed by incisional biopsy. Aiming reported and no association with Gorlin-Goltz syndrome. The to preserve the integrity of nasal mucosa and maxillary sinus, was main clinicopathologic features of this pathology are analyzed in carried out enucleation of the cyst with ultrasonic tip originally this poster, presenting 3 clinical cases. designed for surgeries that preserve the integrity of the sinus Case 1: A 73 year old woman with light right mandibular mucosa. Patient under follow-up and no evidence of recurrence swelling associated with well-defined unilocular radiolucent le- of the lesion. sion. Case 2: A 27 year old woman with painful mandibular swelling associated with unilocular radiolucent distal to 4.8. MUCOUS MEMBRANE PEMPHIGOID VERSUS DRUG- Case 3: A 61 year old male with an incidental finding of an INDUCED PEMPHIGOID REACTION: A CASE REPORT 1 1 1 1 unilocular radiolucent lesion distal to 4.8. Pinto JV , Weber A , Rodrigues RB , Payeras MR , Ferrazzo 1 1 Conclusion: The OOC is a specific clinicopathological KL - CENTRO UNIVERSITÁRIO FRANCISCANO - UNI- odontogenic cyst and must be differentiated from KCOT as it FRA presents a completely different biological behavior. Mucous membrane pemphigoid (MMP) is an autoimmune disease that makes differential diagnosis with other bullous dis- eases. Moreover, pemphigoid lesions can be triggered by using COMPARATIVE ANALYSIS OF RESULTS OF PREVEN- certain drugs, such as captopril. This paper reports a case of a TION CAMPAIGNS AND SCREENING PROGRAMS OF 79-year-old woman, who used captopril daily and had intraoral 1 2 ORAL CANCER Sabino-Bezerra JR , Andrade MAC , bullous lesions. Perilesional biopsy was performed and histo- 1 1 1 1 González-Arriagada WA , Ramos LMA , Lopes MA - PI- pathological examination revealed subepithelial blisters consis- RACICABA DENTAL SCHOOL, STATE UNIVERSITY OF tent with MMP. Direct immunofluorescence for IgG, IgM, IgA, CAMPINAS - ORAL DIAGNOSIS, SEMIOLOGY AND ORAL and C3 was negative. After therapy with corticosteroids for 4 PATHOLOGY, 2BRAZILIAN NAVY - ODONTOCLINIC weeks and recurrence of injury, drug associated pemphigoid Objectives: Compare two current strategies of prevention lesions were suspected. Captopril was discontinued and oral and early detection of oral cancer. corticosteroids were used again for 30 days with disappearance of Study design: Medical records of patients of OROCENTRO, all lesions. The patient was followed for 01 year without recur- FOP-UNICAMP that were referred from the Campaign for Pre- rence. Direct immunofluorescence has been the gold standard for vention and Early Detection of Oral Cancer, from Piracicaba and differential diagnosis of bullous lesions. Despite this, the test can region, and data compiled by the Project Active Search of Oral often be false-negative. In such cases, clinical and histological Lesions, Malignant and Potentially Malignant Lesions of Oral findings usually allow institution of appropriate therapy for these Cavity FOP-UNICAMP were reviewed and compared. patients. ORAL MEDICINE OOOO e120 Abstracts October 2012

MICRO-COMPUTED TOMOGRAPHY ASPECTS OF DENTAL SCHOOL, UNIVERSITY OF CAMPINAS (UNI- CLINICALLY INCIPIENT RADIATION-RELATED CARIES CAMP) - ORAL DIAGNOSIS, 2FEDERAL UNIVERSITY OF Faria KM1, Santos-Silva AR1, Ribeiro ACP2, Brandão LG3, RIO DE JANEIRO (UFRJ) - ORAL PATHOLOGY, 3UNI- Cernea CR3, Lopes MA1, Brandão TB2 - 1PIRACICABA VERSITY OF PLANALTO CATARINENSE (UNIPLAC) - DENTAL SCHOOL UNIVERSITY OF CAMPINAS, PIRACI- ORAL SURGERY CABA, SÃO PAULO, BRAZIL - ORAL DIAGNOSIS/SEMI- Malignant peripheral nerve sheath tumor (MPNST) is a OLOGY, 2INSTITUTO DO CÂNCER DO ESTADO DE SÃO malignant tumor that exhibits nerve sheath differentiation with PAULO OCTAVIO FRIAS DE OLVEIRA, SÃO PAULO, poor prognosis. We would like to present a case of a MPNST BRASIL. - SERVIÇO DE ODONTOLOGIA ONCOLÓGICA, affecting the lower lip of a 67-year-old male patient without 3INSTITUTO DO CÂNCER DO ESTADO DE SÃO PAULO association to NF-1. Intraoral examination revealed a painful OCTAVIO FRIAS DE OLVEIRA, SÃO PAULO, BRASIL. - multilobulated whitish swelling in the lower lip mucosa, measur- ϫ SERVIÇO DE CIRURGIA DE CABEÇA E PESCOÇO ing 3 3 cm in the greatest diameter. The patient was submitted Diffuse brown discoloration of teeth has been recently de- to an incisional biopsy and microscopical features revealed spin- scribed as incipient manifestation of radiation-related caries dle tumor cells with wavy nuclei, exhibiting dense fascicles in a (RRC). plexiform pattern, mitotic figures and nuclear pleomorphism. Objectives: To analyze the patterns of RRC progression by Tumor cells were immunopositive for S-100 protein, CD56 and using conventional radiography (CR) and micro-computed to- Ki-67 (20%). The final diagnosis was of MPNST. The patient mography (MCT). was submitted to the surgical excision of the tumor and no Study design: Fifteen teeth affected by incipient RRC were recurrence was detected after 2 years of follow-up. MPNST is a placed in a standard position for CR and MCT (coronal, trans- rare aggressive soft tissue tumor that might sporadically affects axial and sagittal sections) images acquisition. Lesions were the oral cavity of non-syndromic patients. classified according to the depth of invasion and relationship with enamel, dentin and pulp. ORAL SQUAMOUS CELL CARCINOMA IN 14 YEARS Results: CR detected 20% of the lesions restricted to OLD PATIENT: CASE REPORT Pavanello KC1, Guimarães enamel, 73% compromising both enamel and dentin and no case DM1, Brazão-Silva MT1, Pontes FSC2, Pontes HAR2 - of pulp invasion. In MCT, no case was restricted to enamel, 87% 1FOUSP - ESTOMATOLOGIA, 2UFPA - HOSPITAL UNI- affected both enamel and dentin and 13% presented extension to VERSITÁRIO JOAO DE BARROS BARRETO the pulp. Oral cancer is the sixth most common in the world, including Conclusion: MCT was more accurate to demonstrate that oral carcinoma cell thorny (OSCC) is the most prevalent, totaling incipient RRC may behave more aggressively than the clinical 95% of cases. It occurs more in developing countries, has a aspects suggest and post-radiation brown discoloration of teeth higher incidence in males and its etiology is related to smoking should be promptly treated. and excessive alcohol consumption. On the other hand a small group of young people, approximately 1:1000 develop this can- cer, it is believed that this tumor is completely different because PHOTODYNAMIC THERAPY: TREATMENT OF CHOICE the main etiological factors are not involved. The literature is FOR ACTINIC CHEILITIS? Fontes KBFC1,2, Teixeira controversial and there are few published by the rarity of this MKS1, Takahama Júnior A1, Azevedo RS1, Camisasca DRB1, disease in young, but many clinicians believe that this tumor is Kurachi C3 - 1UNIVERSIDADE FEDERAL FLUMINENSE - 2 more aggressive and is associated with a worse prognosis for the FORMAÇÃO ESPECÍFICA, UNIVERSIDADE FEDERAL patient. This work report a case of OSCC in 14 years old boy FLUMINENSE - PROGRAMA DE PÓS-GRADUAÇÃO EM which presented painless ulcerated lesion in left side of hard 3 PATOLOGIA, UNIVERSIDADE DE SÃO PAULO - INSTI- palate with 3 months of evolution and after 6 months of surgery TUTO DE FÍSICA and radiotherapy no signs of recurrence. Photodynamic Therapy (PDT) is a promising treatment for actinic cheilitis (AC). We report four patients with clinically PHENYTOIN AND PHENOBARBITAL INDUCED RIDGE severe AC who were submitted to one or two sessions of PDT. OVERGROWTH WITHOUT DENTURE WEAR: A CASE The lower lip was curetted and a thick layer of 5-aminolevulinic 1 2 1 REPORT Dhingra K , Prakash S - N.S.V.K SRI VEN- acid methyl ester (PDT-pharma) cream was applied. The lip was KATESHWARA DENTAL COLLEGE, BANGALORE, KAR- covered with an occlusive dressing and aluminum foil for 3 NATAKA, INDIA - PERIODONTICS, 2COLLEGE OF DEN- hours. The fluorescence was confirmed and the lip was irradiated TAL SCIENCES, DAVANGERE, KARNATAKA, INDIA - for 8 minutes in three distinct areas, with LED red light source PERIODONTICS (630nm, 40 J/cm and 100mW) (Lince, MMoptics). All patients showed a significant improvement in physical exam and some Objective: This report highlights the case findings of a patients showed alteration in the gradation of epithelial dysplasia 60-year-old female who presented to Department of Periodontics (ED) after PDT. In one patient, severe ED changed for no ED, reporting generalized gingival overgrowth and mobility of teeth, two patients with moderate ED changed for mild ED and one from past 5 years following treatment with phenytoin and phe- mild ED did not changed. Further studies are needed for assess- nobarbital drugs for tonic-clonic seizures. ment of the efficacy of PDT in AC. Study design: Patient had no other systemic disease and was partially edentulous with no history of prosthodontic treatment. Intraoral examination revealed abundant calculus, depressible MALIGNANT PERIPHERAL NERVE SHEATH TUMOR OF mobility of teeth along with lobulated and fibrotic consistency THE LOWER LIP: CASE REPORT Díaz KP1, Agostini M2, gingival overgrowth in dentate and edentulous regions of upper Valiati R3, de Almeida OP1, Romañach MJ2 - 1PIRACICABA and lower arches. For treatment, full mouth extraction and sur- OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e121 gical excision of overgrowths was performed along with drug oral squamous cell carcinoma (OSCC) tumorigenesis, in vitro replacement with sodium valproate. and in vivo. Results: Histologically, the lesion showed fibro-epithelial Study design: SET knockdown was stably obtained in hyperplasia. Clinical results after six months demonstrated al- HN12 cells. Cell migration and invasion were analyzed through most complete resolution of gingival overgrowth. Boyden chamber assay and proliferation through BrdU. In vivo, Conclusions: The findings of present case suggest that gin- Balb/C nude mice (nϭ10) were injected in the flank with shCon- gival overgrowth can occur even in partially edentulous ridges trol or shSET HN12 cells to obtain xenograft tumors. These (not exposed to denture wear) that could be due to persistence of tumors were characterized histopathologically and analyzed by gingival overgrowth, which may not resolve completely follow- immunohistochemistry for SET, E-cadherin and alpha-SMA. ing tooth extraction or occurs because of incorporation of specific Results: SET knockdown increased HN12 cell migration subpopulation of gingival fibroblasts in alveolar ridge mucosa. and invasion but did not affect cell proliferation in vitro. Xeno- graft tumors derived from shSET HN12 cells showed fast grow- ing with large amount of necrosis and were histopathologically PREVENTION AND EARLY DETECTION OF ORAL CAN- more aggressive than ones derived from shControl. CER IN BRAZIL-PARANA STATE BETWEEN 2008-2011: Conclusion: SET levels have implication in tumor differen- Sassi LM1,2, Dissenha JL1, Guebur MI1, Zanfer- PERIOD: V tiation in OSCC. rari FL1 3 4 5 1 - , Nascimento L , Oliveira BV , Orlandi D - HOS Financial support: FAPESP and CNPq. PITAL ERASTO GAERTNER DE CURITIBA - SERVIÇO DE CIRURGIA BUCO-MAXILO-FACIAL/HOSPITAL ERASTO GAERTNER, 2HOSPITAL ERASTO GAERTNER DE CU- METHYLATION PROFILE OF CCNA1, P16, HIC1, RITIBA - CHEFE DO SERVIÇO DE CIRURGIA BUCO- TIMP3, MGMT AND DCC GENES IN HEAD AND NECK MAXILO-FACIAL, 3HOSPITAL ERASTO GAERTNER/ CANCER Arantes LMRB1, de Carvalho AC2, Tajara EH1, UFPR - SERVIÇO DE CIRURGIA BUCO-MAXILO- Carvalho AL3, Goloni-Bertollo EM1, GENCAPO - 1SÃO FACIAL/HOSPITAL ERASTO GAERTNER, 4HOSPITAL JOSÉ DO RIO PRETO MEDICAL SCHOOL (FAMERP) - ERASTO GAERTNER DE CURITIBA - CHEFE DO DEPARTMENT OF MOLECULAR BIOLOGY, 2FEDERAL SERVIÇO DE CIRURGIA CABEÇA E PESCOÇO, 5HOSPI- UNIVERSITY OF SÃO PAULO (UNIFESP) - LABORATORY TAL ERASTO GAERTNER DE CURITIBA - ESTATISTICA/ FOR MOLECULAR CANCER BIOLOGY, DEPARTMENT REGISTRO HOSPITALAR OF BIOCHEMISTRY, 3BARRETOS CANCER HOSPITAL- Preventing oral cancer in the period 1989 to 2011, broken out PIO XII - CENTER FOR RESEARCH IN MOLECULAR of 5 in 5 years. ONCOLOGY Objectives: Prevention of cancer in the community. Background: Head and neck carcinomas are among the Method 21,018 patients in 98 Municipalities in Paraná ex- most frequent tumor types worldwide with around 200,000 new amined between 1989 to 2011. This period from 2008 to 2011. cases diagnosed per year. The most common variant is squamous Results: We studied 4.240 individuals, 61,3% female 82,5% cell carcinoma (HNSCC), representing 90% of these malignan- Caucasian, family income Ͻ2 minimum (Under-paid (U$ cies. Activation of proto-oncogenes and inactivation of tumor 300.00) wages was reported by 60,2%; Poorly-educated (primary suppressor genes are the major genetic alterations involved in school or below, 465(59,8%), illiterate, 102(13,1%), High School carcinogenesis. Several tumor suppressor genes and genes regu- 143(16,4%), University 48(19,8%). Were found and sent to mu- lating growth and development are silenced in cancer by aberrant nicipal ambulatories 778(18,3%) patients with lesions aged be- gene methylation. tween 31 and 70 were 76%. Of these, 206(26,5%)were inflam- Objective: To determinate the hypermethylation profile of matory, trauma 336(43,2%), and 52(6,7%), leukoplakia, other CCNA1, P16, HIC1, TIMP3, MGMT and DCC. 76(9,8. Dentist Frequency With pain 209(26,9%), Don’t go Study design: Nine DNA samples from HNSCC tumors 181(23,3%), Without teeth 149(19,2%), 1x/year 139(17,9,1%), were evaluated using Q-MSP. 1x /2year 67(8,6%), 35,9% Regular oral hygiene, alcoholism Results: HIC1 showed promoter hypermethylation in 78%, 17.0%; smoking 24.5%; 42,8% consumption of matei; Had never MGMT in 75%, TIMP3 in 63%, CCNA1 in 44%, DCC in 37% undergone preventive exams 54(6,9%), Make 78(10%), Didn’t and P16 in 11% of the tumors. 615(79,0%). Conclusion: These results show that the methylation of Conclusion: New health care policies should be made tumor suppressor genes is a common event in HNSCC. More samples should be evaluated to suggest an association with clinical features. POTENTIAL ROLE OF SET PROTEIN IN ORAL SQUA- MOUS CELL CARCINOMA TUMORIGENESIS Sobral LM1, Sousa LO1, Coletta RD2, Gutkind S3, Leopoldino AM1 - DETECTION OF HPV IN FRESH TISSUE SAMPLES, SA- 1FAC. DE CIÊNCIAS FARMACÊUTICAS DE RIBEIRÃO LIVA, PLASMA AND ORAL EXFOLIATED CELLS EX- PRETO- USP - DEPARTAMENTO DE ANÁLISES CLÍNI- TRACTED FROM PATIENTS WITH ORAL LEUKOPLAKIA CAS, TOXICOLÓGICAS E BROMATOLÓGICAS, 2FAC. DE Ferreira LL1, Soares GR1, Veronese LA2, Nunes CM3, Bern- ODONTOLOGIA DE PIRACICABA-UNICAMP - DEPAR- abé DG1, Biasoli ER1, Miyahara GI1 - 1FACULDADE DE TAMENTO DE DIAGNÓSTICO ORAL, PATOLOGIA ORAL, ODONTOLOGIA DE ARAÇATUBA- UNESP - CENTRO DE 3NATIONAL INSTITUTE OF DENTAL AND CRANIOFA- ONCOLOGIA BUCAL, 2VERONESE PATOLOGIA E CITO- CIAL RESEARCH, NATIONAL INSTITUTES OF HEALTH - LOGIA, 3FACULDADE DE MEDICINA VETERINÁRIA DE ORAL AND PHARYNGEAL CANCER BRANCH ARAÇATUBA- UNESP - DEPARTAMENTO DE APOIO, Objectives: To assess the potential role of SET protein in PRODUÇÃO E SAÚDE ANIMAL ORAL MEDICINE OOOO e122 Abstracts October 2012

Background: The oral leukoplakia is considered as a pre- ODONTOLOGIC URGENCY AFTER TOOTH EXTRAC- malignant lesion for the development of the oral squamous cell TION IN A PATIENT WITH PLATELET HYPOAGGREGA- carcinoma, and several risk factors can be related to this carci- TION: CASE REPORT Alexandre CN, Silveira EO, Assunção nogenesis, including the human papillomavirus (HPV). MCS, Queiroz PRK, Silva JF, Teixeira L, Rego LCB Objectives: The aims of this study was to detect the pres- The platelets disorders causes signals and symptoms charac- ence of HPV DNA in fresh tissue samples, plasma and oral teristic of hemostasis defects and it can cause abnormal bleeding exfoliated cells extracted from patients with oral leukoplakia. during the surgical procedure, for example tooth extraction. Pa- Study design: These biological materials sources were an- tient, male, 14 years old, was forwarded to a dental assessment in alyzed through the technique of nPCR and make a comparison a reference Center to Treatment of Hematological Diseases, with among them from 8 patients with oral leukoplakia. It was per- alveolar bleeding intense, immediately after being submitted of a formed the amplification of the human ␤-globin gene in all extraction lower molar. It was done local hemostatic maneuvers samples to confirm the presence and integrity of DNA. as urgency procedure by simple suture stabilizing clot associated Results: Nested PCR assays revealed the presence of HPV to tranexamic acid in paste form (1 pill 250mg crushed in in 37.5% of fresh tissue, 50.0% of plasma, 62.5% of oral exfo- solution 250mg/5mL) which was placed under the surgical liated cells extracted from patients. wound. These measurements were sufficient to provide the con- Conclusion: HPV could potentially be an etiologic co-factor trol of bleeding site. Blood tests were required to analyze a in the pathogenesis of oral leukoplakia. possibility of coagulations disorders. The hematologic exams showed: normal hemogram and normal platelet count, moreover a normality of factories V, VIII, IX, X, XII, Von Willebrand, however the aggregation test (plates aggregate with adrenaline) PROTEOMIC PROFILE IN SERUM OF HAMSTER DUR- showed platelet hypo aggregation. ING DMBA-INDUCED ORAL SQUAMOUS CELL REFERÊNCIAS: LM Lin1,2,3,4,5,6,7 - 1LI-MIN LIN - KA- CARCINOGENESIS Luz Ld, Sankarankutty A, Passos E, Rizoli S, Fraga GP, OHSIUNG MEDICAL UNIVERSITY HOSPITAL, DEPART- Nascimento Jr B. Tranexamic acid for traumatic hemorrhage. MENTS OF ORAL PATHOLOGY AND ORAL AND MAXIL- Rev. Col. Bras. Cir. 2012; 39(1): 77-80. 2 LOFACIAL IMAGING CENTER, YAN-HSIUNG WANG - Adeyemo TA, Adeyemo WL, Adediran A, Akinbami AJ, 3 SCHOOL OF DENTISTRY, WEN-CHEN WANG - DEPART- Akanmu AS. Orofacial manifestations of hematological disor- MENTS OF ORAL PATHOLOGY AND ORAL AND MAXIL- ders: anemia and hemostatic disorders. Indian J Dent Res. 2011; LOFACIAL IMAGING CENTER, 4ANDY TENG - SCHOOL 22(3):454-61. OF DENTISTRY, 5SHIH-HSIEN CHEN - DEPARTMENTS Lambert MP. What to do when you suspect an inherited OF RADIOLOGY, 6CHING-YI CHEN - DEPARTMENTS OF platelet disorder. Hematology Am Soc Hematol Educ Program. ORAL PATHOLOGY AND ORAL AND MAXILLOFACIAL 2011; 2011:377-83. IMAGING CENTER, 7YUK-KWAN CHEN - DEPARTMENTS Brasil. Manual de Tratamento das Coagulopatias Heredi- OF ORAL PATHOLOGY AND ORAL AND MAXILLOFA- tárias. Ministério da Saúde, Secretaria de Atenção à Saúde, CIAL IMAGING CENTER Departamento de Atenção Especializada. Ministério da Saúde. 2006 Background: In our previous report, we found that some Brasil. Manual de Atendimento Odontológico a Pacientes proteomic biomarkers like transthyretin & paraoxonase 1 were com Coagulopatias Hereditárias. Ministério da Saúde, Secretaria strongly decrease after tumor inoculation in the serum during the de Atenção à Saúde, Departamento de Atenção Especializada. development of Vx2-induced rabbit OSCC. Ministério da Saúde. 2008 Objectives: The purpose of study is to use a proteomic analysis in serum of hamsters during DMBA-induced OSCC carcinogenesis in order to observe the difference between early ANALYSIS OF THE EFFECTS OF ORLISTAT ON THE and late stage of tumors, ultimately to identify novel-invasive IMMUNE RESPONSE AGAINST EXPERIMENTAL serum biomarkers of OSCC. MELANOMAS Almeida LY1, Mariano FS1, Coletta RD1, Study design: Twelve adult Syrian golden hamsters were Agostini M2, Bastos DC1, Seguin F1, Graner E1 - 1PIRACI- divided into one control and three experimental groups, each CABA DENTAL SCHOOL, STATE UNIVERSITY OF group containing three animals. In the experimental groups, 0.5% CAMPINAS (UNICAMP) - ORAL DIAGNOSIS DEPART- DMBA in heavy mineral oil was painted at hamster right cheek MENT, 2SCHOOL OF DENTISTRY, FEDERAL UNIVER- pouches for 4, 9 and 13 weeks period respectively. All serum SITY OF RIO DE JANEIRO (UFRJ) - DEPARTMENT OF samples were collected and stored at Ϫ80 °C before 2D gel PATHOLOGY AND ORAL DIAGNOSIS electrophoresis analysis. Fifteen protein spots were visualized by Background: Orlistat (Xenical®) has anti-neoplastic prop- silver staining and identified by liquid chromatography/tandem erties by irreversibly inhibiting fatty acid synthase (FASN). mass spectrometry, such as C-reactive protein, complement fac- Objective: Our work aimed to study the effect of Orlistat on tor B, complement C3, immunoglobulin kappa-chain, liver car- the percentage and activation of CD8ϩ T lymphocytes boxylesterase, and haptoglobin. (CD8ϩTL), natural killer (NK) and dendritic cells (DC) present Results and conclusion: The protein level of C-reactive in the primary tumors (PT) and their metastases to mediastinal protein and haptoglobin were decreased at 4 weeks and then lymph nodes (mLN) in a B16F10 melanoma-mouse model. increased at 9 and 13 weeks treatment. Other proteins were Study design: Flow cytometric immunophenotyping was decreased with time. The relationship between these biomarkers performed to analyze CD8ϩTL, NK and DC cells present in the and OSCC development remains to be further tested in cancer PT and metastatic mLN. patients. Results: Control PT had a low percentage of CD8ϩTL OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e123

(0.36%) and NK (0.27%), which were not detected in the treated COWDEN SYNDROME: A DIAGNOSIS TO CONSIDER PT. In treated metastatic mLN, there was a slight increase of IN PATIENTS WITH ORAL PAPILLOMATOSIS Aranda- DCs, associated with a lower expression of costimulatory pro- Romo S1, Tejeda-Nava FJ1, Goldaracena-Azuara MP2, Fal- ϩ teins. CD8 TLs and NK cells were reduced and less activated in con-Escobedo R3, Rosales-Martínez S4, Nava-Zárate N5 - the metastases from the treated mice. 1UASLP - ORAL PATHOLOGY, 2UASLP - PROSTHETIC Conclusion: Our results indicate that inhibition of FASN DEPARTMENT, 3HOSPITAL CENTRAL ”DR. IGNACIO with Orlistat might exert immunosuppressive effects. MORONES PRIETO” - PATHOLOGY, 4HOSPITAL LOMAS DE SAN LUIS - DENTISTRY, 5UASLP - ORAL RADIOLOGY EFFECT OF AGE ON THE ASSOCIATION BETWEEN Abstract: Cowden Syndrome is a rare genodermatosis, POLYMORPHISM OF THE P16INK4A IN HEAD AND which is inherited as an autosomal dominant disorder, character- NECK CARCINOMA AND PATIENT SURVIVAL Marques- ized by multiple hamartomas and a high risk for development of Silva L1, Pinheiro UB2, Fraga CAC2, Mendes DC2, Corrêa cancers. Cardinal features, which often lead to the diagnosis, GTB1, De Paula AMB2, Guimarães ALS2 - 1UNIVERSIDADE include mucocutaneous papillomatous papules and trichilemmo- FEDERAL DE MINAS GERAIS - ODONTOLOGIA, 2UNI- mas. We present the case of a 30-year old female patient diag- VERSIDADE ESTADUAL DE MONTES CLAROS - ODON- nosed with Cowden syndrome after consultation for papilloma- TOLOGIA tous oral lesions of long evolution. At 26 years she had been Background: A single nucleotide polymorphism of diagnosed with papillary thyroid carcinoma and was treated with p16INK4A was reported to modulate susceptibility to cancer. total thyroidectomy, supplemented with radioactive iodine and Study design: We investigated the role of this polymorphic hormone replacement therapy. Her father and brother have oral variant in young and older of 96 patients with HNSCC matched papillomatous lesions. The correct diagnosis of pathology of the by TNM staging system, together with its impact on patient’s oral mucosa can allow the identification of patients at risk for survival. Also, allelic frequencies were compared to a control malignant disorders and to take actions for the early detection of group of healthy patients. The C540G polymorphism of the p16 common neoplastic diseases associated with this syndrome. gene was analyzed using PCR–RFLP. Results: We did not observe any difference in allelic fre- H2O2 INDUCES NFKB SIGNALING PATHWAY, MMP quencies between HNSCC and control samples. Although the ACTIVITY AND CELL MIGRATION IN HUMAN PERI- presence of the allele C of the polymorphism p16INK4A was ODONTAL LIGAMENT FIBROBLASTS (PDLF) Osorio C1, associated with tumor size and presence of lymph node metas- Cavalla F1, Díaz G2, García-Sesnich J1, Paredes R3, tasis in older patients, no association was observed in young Hernández M4,1 - 1FACULTY OF DENTISTRY, UNIVER- patients. Analyzing all patients, we noticed that larger tumor size SIDAD DE CHILE - LABORATORIO DE BIOLOGÍA and presence of lymph node metastasis had a negative impact on 2 survival. PERIODONTAL, FACULTY OF CHEMICAL AND Conclusion: The association of p16INK4A polymorphism PHARMACEUTICAL SCIENCES, UNIVERSIDAD DE 3 with metastasis and tumoral size is dependent on age. CHILE, ESCUELA DE MEDICINA VETERRINARIA, FACULTAD DE ECOLOGÍA Y RECURSOS NATURALES, UNIVERSIDAD ANDRÉS BELLO, 4FACULTY OF DEN- PODOPLANIN IMMUNOSTAINING IN ORAL LEUKO- TISTRY, UNIVERSIDAD DE CHILE - PATHOLOGY PLAKIA AND IN ORAL EPITHELIA ADJACENT TO ORAL 1 2 Objective(s): To determine the effect of H2O2 in NF␬B SQUAMOUS CELL CARCINOMA Buexm LA , Miranda R , pathway, MMP activity, pro-inflammatory cytokines levels and Camisasca DR3, Oliveira SP4, Fonseca EC2, Dias FL1, Lou- cell migration in PDLF. renço SQC2 - 1INCA - CIRURGIA DE CABEÇA E Study design: Experimental; PDLF primary cultures from PESCOÇO, 2UFF - PATOLOGIA, 3UFF - ESTOMATOLO- 4 extracted third molars from three healthy subjects were exposed GIA, OCEX - ESTOMATOLOGIA to sublethal doses of H2O2, catalase and/or SN50-NF␬B-inhib- Background: Podoplanin is a lymphatic endothelial marker itor peptide. Nuclear translocation of NF␬B p65-subunit, MMP-2 highly expressed in oral squamous cell carcinoma (OSCC) and and MMP-9 activity were determined by immunofluorescence oral epithelial precursor lesions. and gelatin zymography, respectively. VEGF-A, IL-1␤, IL-6 and Objective: This study evaluated the podoplanin immuno- TNF␣ and cell migration were assayed by immunowestern blot- staining in oral leukoplakia (OL) and in oral epithelia adjacent to ting, Flowcytomix® and wound healing assays, respectively and oral squamous cell carcinoma (EAOSCC). analyzed with stata v.11 and ANOVA test. Study design: Podoplanin expression was analyzed in 43 Results: H2O2 up to 5 ␮M induced nuclear translocation of biopsies from OL and 19 surgical specimens of EAOSCC. Sta- p65-subunit and increased activity of MMP-2 and MMP-9 tistical analysis was performed through qui-square test. (pϽ0.05), whereas no differences were found for cytokine levels Results: White males over 60 years old and nonsmokers (pϾ0.05). MMP-induced activity by H2O2 stimulated PDLF were more affected. Mean follow-up of patients was 33.69 migration (pϽ0.05). months. 22 (35.5%) patients expressed podoplanin in the su- Conclusion(s): Increased gelatinolytic MMP activity in re- prabasal layer and were classified as podoplanin positive. Dys- sponse to H2O2 is mediated, at least in part, by NF␬B. H2O2 plasia was noted in 51 (82.3%) cases. The presence of dysplasia induces cell migration, partially throughout MMP activation. was significant EAOSCC and OL (pϽ0.0001). Both the presence of recurrence and exocytosis were significant in EAOSCC (pϽ0.0001). EXPRESSION OF PLUNC PROTEIN (SPLUNC2) IN HIV Conclusion: The podoplanin pattern of expression is similar PATIENTS: PRELIMINARY REPORTS Carvalho1, Silva AA1, in OL and AEOSCC. Bingle L2, Vargas PA1 - 1UNICAMP - ORAL DIAGNOSIS/ ORAL MEDICINE OOOO e124 Abstracts October 2012

PATHOLOGY, 2UNIVERSITY OF SHEFFIELD - ACA- TADUAL DE CAMPINAS - ESTOMATOPATOLOGIA/PRO- DEMIC UNIT OF ORAL AND MAXILLOFACIAL PATHOL- FESSOR ASSOCIADO OGY The aim of this research was to evaluate the immunohisto- Objectives: The aim of this study was to analyze the ex- chemical expression and total in situ gelatinolytic activity (ISGA) pression of SPLUNC2, the major PLUNC protein family member of matrix metalloproteinases (MMP) 2 and 9, with the integrity of secreted into saliva, in HIV patients and to correlate expression the basal lamina (BL) through the expression of collagen IV in with stage of disease. Oral Leukoplakia (OL) and Oral Squamous Cell Carcinoma Study design: Salivary samples from 24 patients with HIV (OSCC). Immunohistochemical, immunofluorescent and in situ and 24 patients without HIV were analysed by Western blotting. zymography reactions were carried out in 5 normal oral epithe- The t test was used for statistical analysis. lium, 31 OL’s and 14 OSCC’s. MMP-2 expression was higher in Results: Differential protein expression was noted between epithelium without dysplasia. MMP-9 was more expressed in the the two groups studied, with a slight increased expression in the stroma of severe epithelial dysplasias and OSCC’s. ISGA was HIV group. The differences were not, however, statistically sig- higher in normal epithelium, co-localizing only with MMP-2. nificant (t TestϾ0,05). OSCC and OL’s with severe epithelial dysplasia showed discon- Conclusions: SPLUNC2 expression is slightly increased in tinuity of the BL, revealing co-localization of MMP-2 and Ϫ9 HIV patients when compared to non HIV patients. This increased with ISGA in these regions. The results suggest that MMP ex- expression was not significantly due to the small number of pressed in the stroma of the lesions is more related with the lesion individuals evaluated. Further studies are needed to validate the progression than the MMP expressed in the lesional parenchyma. changes in SPLUNC2 levels and to fully understand the biolog- ical processes involved in PLUNC expression in HIV patients. MICRORNAS IN SALIVARY RINSE AS BIOMARKERS FOR RECURRENCE DETECTION OF HEAD AND NECK GRANULAR CELL TUMOR OF ORAL CAVITY Brazão- 1 SQUAMOUS CELL CARCINOMA Horst MA , de Carvalho Silva MT1, Guimarães DM2, Pavanello KC2, Mistrob FZ3, AC1, Maia DCC1, Pelarin MFA1, Carvalho AL2, Kowalski Kignel S3 - 1UNIVERSITY OF SÃO PAULO - UNIVERSITY LP3, Vettore AL1 - 1UNIFESP - LABORATORY FOR MO- OF SÃO PAULO, 2UNIVERSITY OF SÃO PAULO - ORAL LECULAR CANCER BIOLOGY, DEPARTMENT OF BIO- PATHOLOGY, 3FUNDAÇÃO HERMÍNIO OMETTO/UNI- LOGICAL SCIENCES, 2HOSPITAL DO CÂNCER DE BAR- ARARAS - ORAL DIAGNOSIS RETOS - DEPARTMENT OF HEAD AND NECK SURGERY, Granular cell tumor (GCT) is an uncommon benign neo- 3HOSPITAL AC CAMARGO - DEPARTMENT OF HEAD plasm of soft tissue that characteristically affects the oral cavity, AND NECK SURGERY with increased frequency in the tongue. We present a well- Background: Head and neck squamous cell carcinomas documented case of an old woman with an oval overgrowth on (HNSCC) constitute the fifth most common malignancy world- the ventral tongue. She noted the lesion by months ago, with any wide. Late diagnosis and frequent locoregional relapse are the history of trauma. The lesion has a smooth surface and a fibrous major causes of morbidity and mortality. MicroRNAs (miRNAs) consistence. An excisional biopsy was performed with a careful are small, noncoding RNA molecules that function as posttran- surgical procedure. Microscopic examination showed large poly- scriptional gene regulators, might also function as tumor suppres- hedral neoplastic cells with eosinophilic granular cytoplasm and sors and oncogenes. small vesicular or hyperchromatic nuclei separated by fibrous Objectives: To evaluate the miRNA expression profile in collagen bundles in numerous nests and strands. The cytoplasmic salivary rinse samples from HNSCC patients and investigate the granules are PAS-positive, diastase resistant, and the neural ori- significance of miRNA as biomarker for tumor recurrence detection. gin of the lesion could be confirmed by S100 positivity. We have Study design: The expression of 762 miRNAs was evalu- not found any of the criterions of malignancy for malignant ated by qRT-PCR. granular cell tumor. This case represents a typical presentation of Results: A preliminary result selected 101 candidates. Two its uncommon disease, accompanied by excellent image regis- downregulated miRNA could better distinguish HNSCC patient tries. salivary rinse from control samples. Conclusion: In the future, the validated candidates will be IN SITU GELATINOLYTIC ACTIVITY AND IMMUNOEX- evaluated in salivary rinses that are being collected each six PRESSION OF METALLOPROTEINASES 2 AND 9 IN months during the follow-up of 100 patients included in the study. So that we can evaluate their usefulness as markers for ORAL LEUKOPLAKIA AND ORAL SQUAMOUS CELL HNSCC relapses. CARCINOMAS Sena-Filho M1, Teofilo JM2, Lopes MA3, Almeida OP3, Gerlach RF4, Jorge J5 - 1FACULDADE DE ODONTOLOGIA DE PIRACICABA/UNIVERSIDADE ES- BRONJ VERSUS MULTIPLE MYELOMA: A DIAGNOSTIC TADUAL DE CAMPINAS - ESTOMATOPATOLOGIA/DOU- CHALLENGE Madeira MFC1, Santos PSS, Hungri VTM2, TORANDO, 2UNIVERSIDADE DE RIBEIRÃO PRETO, Tinoco-Araujo JE1, Carvalhaes CLL3, Sant’Ana E1 - 1FAC- 3FACULDADE DE ODONTOLOGIA DE PIRACICABA/ ULDADE DE ODONTOLOGIA DE BAURU - DEPARTA- UNIVERSIDADE ESTADUAL DE CAMPINAS - ES- MENTO DE ESTOMATLOGIA, 2FACULDADE DE CIÊN- TOMATOPATOLOGIA/PROFESSOR TITULAR, 4FAC- CIAS MÉDICAS DA SANTA CASA DE SÃO PAULO - ULDADE DE ODONTOLOGIA DE RIBEIRÃO PRETO/ DEPARTAMENTO DE ESTOMATOLOGIA, 3FACULDADE UNIVERSIDADE DE SÃO PAULO - MORFOLOGIA, DE ODONTOLOGIA DA UNIVERSIDADE DE SÃO PAULO ESTOMATOLOGIA E FISIOLOGIA, 5FACULDADE DE - DEPARTAMENTO DE ESTOMATLOGIA ODONTOLOGIA DE PIRACICABA/UNIVERSIDADE ES- Multiple myeloma is a malignant neoplasm of plasma cell OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e125 origin and widespread bone involvement, affecting the jaws in (pϭ0.001) and stress (pϭ0.004) scores. Cortisol levels 30% of the cases. Patient with exposed bone in the region of (16) (pϭ0.001) and cortisol/DHEA ratio (pϭ0.007) were significantly after extraction, with ulceration in the alveolar mucosa, edges higher in the RAS patients with active lesions comparing with the swollen with inflammatory aspects, showing area of necrotic remission phase, nevertheless did not differ significantly between tissue and covered by biofilm, associated with the (17). Areas RAS and control group. There was no significant difference in with white patches on the hard palate and papules in the vestib- DHEA concentrations between the groups. ular region of the maxilla. CT image showing extensive hy- Conclusions: Stress, anxiety and increased salivary cortisol podense area in right maxillary sinus. In use of Zometa ® for 5 levels may be involved in RAS pathogenesis. months, we decided to treat as bisphosphonate related osteone- crosis of the jaw (BRONJ), without results after 2 months. The NODULAR FASCIITIS IN THE HARD PALATE: CASE biopsy showed histological features of connective tissue with 1 2 3 plasmocytes immunohistochemistry positive to Plasmacell, REPORT Santos MRG , Anjos-Soria EM , Giglio FPM , Tav- 1 4 1 Kappa and Lambda. Conclusive diagnosis of multiple myeloma eira LAA , Soares CT - BAURU SCHOOL OF DEN- and the patient referred for oncohematologic treatment. The TISTRY, UNIVERSITY OF SÃO PAULO, BAURU, SÃO patient died due to myeloma. PAULO, BRAZIL - DEPARTMENT OF STOMATOLOGY, AREA OF PATHOLOGY, 2BAURU SCHOOL OF DEN- IMMUNOHISTOCHEMICAL EXPRESSION OF THE PRO- TISTRY, UNIVERSITY OF SÃO PAULO, BAURU, SÃO TEIN IFN-␥ AND TGF-␤1 IN RADICULAR CYSTS AND PAULO, BRAZI - DEPARTMENT OF STOMATOLOGY, 3 DENTIGEROUS CYSTS Lopes MLDS1, Rocha Neto PC1, AREA OF PATHOLOGY, DENTIST, PRIVATE PRACTICE, 4 Moraes M1, Matos FR1, Lucena HF1, Costa ALL1 - 1UFRN - SOROCABA, BRAZIL, MEMBER OF THE INSTITUTE OF ODONTOLOGIA ANATOMOPATHOLOGY AND CYTOPATHOLOGY OF Background/Objectives: The aim of this study was to eval- BAURU AND OF THE LAURO SOUZA LIMA INSTITUTE uate and compare the immunohistochemical expression of inter- OF DERMATOLOGICAL DISEASES, BAURU, SÃO feron-gamma (IFN-␥) and transforming growing factor-beta PAULO, BRAZIL. - DEPARTMENT OF PATHOLOGY (TGF-␤1) between radicular cyst (RC) and dentigerous cyst Abstract: Nodular fasciitis is a rapidly proliferating fibro- (DC). blastic lesion that presents as a tumour-like mass. It rarely pres- Study design: Twenty RC and DC were selected for analysis ents in the oral cavity. We present a case of a 43-year-old white of the immunoexpression of IFN-␥ and TGF-␤1 in the epithelium man complaining of painless nodule located in the hard palate for and capsule of these cysts. approximately 45 days. Examination revealed a circumscribed Results: No differences were observed in cell reactivity in soft-tissue mass of the right hard palate, located in the molar the lining epithelium and capsule of the cysts. There was a region. An excisional biopsy was performed. The histological tendency of a higher expression of TGF-␤1 in the capsule of DC. examination revealed a well-demarcated but not encapsulated Conclusions: Our results suggest that the presence of these mass with proliferation of plump cells in a myxoid stroma. two cytokines in RC and DC, where IFN-␥ plays a role in bone Immunopositivity was noted to both muscle actin and to smooth resorption, which would be counterbalanced by the osteoprotec- muscle actin; reaction to desmin, CD34, S-100 were negative. tive action of TGF-␤1. Moreover, suggest the predominance of The cell proliferation index Ki67 was Ͻ5%. The histopatholog- immunoregulatory mechanisms and repair processes in the CD ical and immunohistochemical findings were consistent with the group when compared to the CR. diagnosis of nodular fasciitis. Because of the rarity of the lesion and non-specific clinical and imaging features, special caution is CORTISOL AND DEHYDROEPIANDROSTERONE SALI- imperative in order to obtain accurate diagnosis and appropriate VARY LEVELS, STRESS AND ANXIETY IN PATIENTS treatment. Key words: Nodular fasciitis, oral cavity, soft tissue tumors. WITH RECURRENT APHTHOUS STOMATITIS Petruzzi MNMR1, Michel AR1, Cherubini K2, Figueiredo MAZ2, Luz C3, Wudarcki S3, Salum FG2 - 1PONTIFICAL CATHOLIC CHRONIC SUPPURATIVE OSTEOMYELITIS IN UNIVERSITY OF RIO GRANDE DO SUL (PUCRS) - POST- MAXILLA Carli ML1, Pedreira FRO1, Oliveira TI1, Ribeiro GRADUATE PROGRAM IN DENTISTRY, 2PONTIFICAL Junior NV1, Pereira AAC1, Hanemann JAC1 - 1ALFENAS CATHOLIC UNIVERSITY OF RIO GRANDE DO SUL (PU- FEDERAL UNIVERSITY - CLINIC AND SURGERY/ STO- CRS) - ORAL MEDICINE UNIT, SÃO LUCAS HOSPITAL, MATOLOGY 3PONTIFICAL CATHOLIC UNIVERSITY OF RIO GRANDE A 38-year-old woman was referred to the Stomatology DO SUL (PUCRS) Clinic of the Unifal-MG, presenting gingival necrosis and ex- Objective: To assess anxiety, stress, salivary levels of cor- posed bone tissue in the right front maxilla region caused by a tisol and dehydroepiandrosterone (DHEA) in patients with recur- physical trauma. Patient is a smoker, does not use any kind of rent aphthous stomatitis (RAS). medication and has no significant systemic alterations. Clinical Study design: Sixty individuals were divided in two groups examination showed extensive areas of necrotic bone, with a (RAS/control) matched by sex and age. Stress and anxiety were purulent liquid draining and teeth involved (11 to 14) with assessed using the Lipp’s Inventory of Stress Symptoms and the mobility. Radiographic examination showed a diffuse bone de- Beck’s Inventory of Anxiety. Saliva specimens were collected in struction on the maxilla. Based on clinical and radiographic the morning and afternoon and analysed by radioimmunoassay. findings, the suggested diagnosis was chronic suppurative osteo- In the RAS group, the specimens were collected in the presence myelitis. Patient was medicated properly and then submitted to of lesions and after remission. surgery. The surgery, performed under local anesthesia, removed Results: The RAS patients exhibited higher anxiety the whole lesion of necrotic bone and also the teeth 11 to 15. ORAL MEDICINE OOOO e126 Abstracts October 2012

Microscopic analysis of the removed material identified necrotic Júnior JG4 - 1UNIVERSIDADE PAULISTA (UNIP); INSTI- bone, Haversian canals, and microbial colonies; aspects that TUTO FLORENCE DE ENSINO - DEPARTAMENTO DE confirm the clinical diagnosis of chronic suppurative osteomyeli- PATOLOGIA, 2UNIVERSIDADE FEDERAL DO MARAN- tis. (Financial support: FAPEMIG). HÃO - DE ODONTOLOGIA II, 3UNIVERSIDADE PAULISTA UNIP, 4UNIVERSIDADE PAULISTA UNIP - MALIGNANT ODONTOGENIC TUMORS: CLINICO- CIRURGIA PATHOLOGICAL AND IMMUNOHISTOCHEMICAL Lipomas are benign soft tissue neoplasms of mature adipose STUDY OF 25 CASES Martínez MM1, Mosqueda-Taylor A2, tissue. They are infrequent tumors in the oral cavity, in particular Carlos-Bregni R3, Rumayor-Piña A4, Paes de Almeida O4 - those of intramuscular subtype. Oral intramuscular lipoma gen- erally presents as an asymptomatic not-well-circumscribed nod- 1FOP-UNICAMP - PATOLOGÍA, 2UNIVERSIDAD AU- ule characterized by infiltrating adipose tissue and muscle atro- TÓNOMA METROPOLITANA XOCHIMILCO, MÉXICO. - phy. The recurrence rate of these lesions is infrequent. We herein CIENCIAS CLINICAS, 3CENTRO CLÍNICO DE CABEZA Y report a case of a 54-years-old man that was referred to GAAAC CUELLO/HOSPITAL HERRERA LLERANDI, GUATE- 4 Oral Surgery Service with complaints of a recurrent, painless, not MALA. - PATOLOGIA ORAL, FOP-UNICAMP - PATOLO- well circumscribed mass in the buccal mucosa. The patient re- GIA ported a previous surgery for removal of a lipomatous lesion. An Background/Objectives: Malignant odontogenic tumors incisional biopsy was performed and the histopathologic exami- (MOT) are uncommon, comprise less than 7% of all odontogenic nation showed an unencapsulated lipomatous tumor composed of tumors (OT). Its etiology is unknown, representing the malignant mature adipocytes diffusely infiltrating muscles. A surgery was counterpart of benign lesions, malignant transformation of odon- performed and the lesion was removed. After six months, there togenic cyst epithelium or de novo development. The aim of this was a local recurrence and a less conservative surgery was study was to analyze histopathological features of MOT. performed. The patient is without evidence of recurrence at a Study design: We studied 2140 OT, from 1979 to 2011, of 12-month follow-up period. which 25 (1. 16%) were MOT. Results/Conclusion: It preferably affected mandible poste- rior region of male patients with a mean age of 43.3 years. Seven A RARE ODONTOGENIC TUMOUR: CENTRAL ODON- cases were ameloblastic carcinoma, 6 ameloblastic fibrosarco- TOGENIC FIBROMA Tekkesin MS1, Cakarer S2, Olgac V1 - mas, 5 primary intraosseous squamous carcinomas, 3 clear cell 1ISTANBUL UNIVERSITY, INSTITUTE OF ONCOLOGY - odontogenic carcinomas, 3 ghost cell odontogenic carcinomas DEPARTMENT OF TUMOUR PATHOLOGY, 2ISTANBUL and 1 case of metastasizing ameloblastoma. Immunoprofile fea- UNIVERSITY, FACULTY OF DENTISTRY - DEPARTMENT tures were positive for CK5 and 14. Almost all cases were OF ORAL & MAXILLOFACIAL SURGERY positive for CD138, E-cadherin and B-catenin with variable lost The odontogenic fibroma is a rare, benign odontogenic neo- expression. Ki-67, p53 and p63 labeling index showed values plasm derived from the dental mesenchymal tissues. Two vari- compatible to the aggressive behavior of the tumors. ants of odontogenic fibroma can be distinguished: the central and peripheral types. Central odontogenic fibroma is a slow persistent CHONDROBLASTIC OSTEOSARCOMA IN A PREG- growing tumour. NANT PATIENT – THE DIFFICULTIES OF A RAPID A 14-year old male patient was referred to the clinic pre- DIAGNOSIS Lima MHA1, Soares BMV1, Ferreira SMS1, senting a swelling in the premolar site of mandible. Radiologi- Dos Santos VCB2, Dias EP2, Cabús B3 - 1CENTRO UNIVER- cally, a unilocular radiolucency with sclerotic borders between SITÁRIO CESMAC, 2UNIVERSIDADE FEDERAL FLUMI- the lateral roots of the right mandibular canine and first premolar NENSE - DEPARTAMENTO DE PATOLOGIA ORAL, teeth were observed. The lesion was treated by conservative 3SCAN - CENTRO DE DIAGNÓSTICO DA FACE curettage. Histopathological examination revealed the non-en- Osteosarcoma is a malignant tumor derived from mesenchy- capsulated tumour consisting of fibroblast cells with wavy cyto- mal cells, capable of producing immature bone. This is a case plasm. A few nest of odontogenic epithelium and foci of calcified report of chondroblastic osteosarcoma (CO) of the mandible material were shown in some areas. Eight months of follow-up affecting a 38-year-old pregnant woman, illustrating the difficul- has not shown any signs of recurrence. Long-term follow-up ties of a rapid diagnosis. Reporting the lesion has been present for studies are not enough so it is suggested that the patients should five months, the patient presents with jaw pain and earache. The follow at least 5 years after surgical intervention. patient reports a history of a lesion removed from the same area without histopathologic diagnosis. Extraoral examination showed mandibular left facial asymmetry. The lesion was located on the THE FATTY ACID SYNTHASE INHIBITOR ORLISTAT RE- right mandibular alveolar ridge, measuring 3x3x2cm, normal DUCES TUMOR GROWTH AND LYMPH NODE METAS- mucosal color, but firm and painful to palpation. Clinical diag- TASIS IN AN ORTHOTOPIC MURINE MODEL OF ORAL 1,2 nosis was central giant cell lesion. CT scan showed bone destruc- SQUAMOUS CELL CARCINOMA Agostini M , Bastos tion and hyperdense images adjacent to a previous extraction site. DC1, Seguin F1, Zecchin KG1, Raposo HF3, Coletta RD1, Preliminary histopathologic diagnosis was myxoma. After refer- Graner E1 - 1STATE UNIVERSITY OF CAMPINAS (UNI- ral to the University Pathology Department, a definitive diagnosis CAMP), SCHOOL OF DENTISTRY OF PIRACICABA - DE- of Chondroblastic Osteosarcoma was reached. PARTMENT OF ORAL DIAGNOSIS, 2FEDERAL UNIVER- SITY OF RIO DE JANEIRO (UFRJ), SCHOOL OF RECURRENT ORAL INTRAMUSCULAR LIPOMA Lawall DENTISTRY - DEPARTMENT OF ORAL DIAGNOSIS AND MA1, Pareira EM2, Araújo RR3, Naves-Neto VA3, Bugarin- PATHOLOGY, 3STATE UNIVERSITY OF CAMPINAS (UNI- OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e127

CAMP), INSTITUTE OF BIOLOGY - DEPARTMENT OF was unproductive and during incisional biopsy it was observed an PHYSIOLOGY AND BIOPHYSICS empty cavity with smooth and bright walls. Based on surgical Background/Objective: This study aimed to investigate findings, the differential diagnosis was simple bone cyst. Histo- whether the inhibition of the lipogenic enzyme fatty acid syn- pathologic examination revealed a fragment of tissue showing thase (FASN) with orlistat could impact oral squamous cell inflammation and adjacent neoformed bone trabeculae, compat- carcinoma (OSCC) metastatic spread. ible with simple bone cyst. The patient is examined frequently Study design: We developed an orthotropic model of OSCC and bone formation is evident. through the implantation of SCC-9 ZsGreen LN-1 cells into the tongue of BALB/c nude mice, which generate orthotropic tumors ORAL INFLAMMATORY MIOFIBROBLASTIC TUMOR: that spontaneously metastasize to the cervical lymph nodes. AN UNUSUAL CASE REPORT Barbosa NG1, Oliveira PT2, Twenty four hours after implantation the animals started to be Medeiros AMC1, Queiroz LMG1, Carvalho MG3, Gurgel AC3 treated with orlistat or its vehicle. - 1UNIVERSIDADE FEDERAL DO RIO GRANDE DO Results: Inhibition of FASN activity with orlistat or specific NORTE - PROGRAMA DE PÓS-GRADUAÇÃO EM PATO- siRNAs significantly reduces the proliferation and promotes ap- LOGIA ORAL, 2UNIVERSIDADE FEDERAL DO RIO optosis in SCC-9 cells in vitro. Mice treated with orlistat showed GRANDE DO NORTE, 3UNIVERSIDADE POTIGUAR Ͻ a decrease in the volume (p 0.001) and proliferation indexes Inflammatory Myofibroblastic Tumor (IMT) is an uncom- Ͻ (p 0.05) of the primary tumors and had 43% less metastatic mon benign lesion, with unknown etiology, composed of myo- Ͻ lymph nodes than the controls (p 0.01). fibroblasts cells and varying numbers of inflammatory cells. We Conclusion: FASN may be a potential molecular target for present the case of a 12-year-old boy with pedunculated soft the chemotherapy treatment of OSCC patients. tissue painless nodule located on lingual surface of left alveolar ridge next to teeth numbers 36 and 37 with 3 months evolution. A FIBROUS DYSPLASIA CHARACTERIZATION BASED There was no bleeding in the area. The clinical diagnosis was 1 ON LACUNARITY ANALYSIS Cordeiro MS , Durighetto peripheral giant cells. Panoramic radiography showed alveolar Jr. AF2, Backes AR3, Gonçalves EG4, Oliveira JX1 - 1UNI- bone resorption. An incisional biopsy was performed and the VERSIDADE DE SÃO PAULO - DIAGNÓSTICO BUCAL, histopathological examination showed fibroblastic or myofibro- 2UNIVERSIDADE DE UBERLÂNDIA - DIAGNÓSTICO BU- blastic plump or spindle cells in fibrous vascular background with CAL, 3UNIVERSIDADE DE UBERLÂNDIA - FACULDADE an infiltrate of chronic inflammatory cells. Diagnosis was IMT DE COMPUTAÇÃO, 4UNIVERSIDADE DE UBERLÂNDIA - and the patient underwent enucleation of the lesion. The case FACULDADE DE MEDICINA continues under follow-up and has shown no evidence of recur- Background: Fibrous dysplasia (FD) is a developmental rence. As IMT in oral cavity may be confused with malignant anomaly in which the normal medullary space of the affected tumors, it is important to recognize the distinction among them to bone is replaced by fibro-osseous tissue. The lacunarity analysis, provide adequate treatment. have enabled to quantify objectively the visual attributes obtained during the process of image analysis. The aim of this study was HYPOHIDROTIC ECTODERMAL DYSPLASIA Dias to characterize the fibrous dysplasia by analyzing the lacunarity. NNO1, Junqueira MA1, Carli ML1, Pedreira FRO1,DeOl- Study design: We evaluated 10 patients by lacunarity anal- iveira DSB1, Hanemann JAC1 - 1ALFENAS FEDERAL UNI- ysis, used an axial and coronal view CT and then were selected VERSITY - CLINIC AND SURGERY/ STOMATOLOGY the regions of interest in the areas of dysplastic and contralateral A 8 year-old male patient, attended to the Stomatology normal bone by means of MATLAB® software. Clinic of UNIFAL-MG, complaining about the absence of many Results: The lacunarity was lower in the areas of dysplastic teeth. He was diagnosed with hypohidrotic ectodermal dysplasia. region in relation to normal bone, namely the first presented a The diagnosis had been made at the age of 10 months. The hair more uniform texture than the second. Thus, the cross-validation was blond, sparse and thin, there was a reduced density of technique leave-one-out was possible to separate the groups with eyelashes and eyebrows and protuberance of lips and periocular high accuracy (94.75%). hyperpigmentation. Intraoral examination showed the absence of Conclusion: The lacunarity is a contributory method of all lower teeth and of several superiors. The teeth present had image analysis to characterize the FD. microdontia and all the anterior were conical in shape. After the diagnosis, extraction of the 52 and 62 teeth, an orthodontic SIMPLE BONE CYST IN THE RIGHT BRANCH OF removable appliance space maintainer and a denture lower were MANDIBLE Alves MGO1, Caris AR, Carvalho BFC, Santos made. After the eruption of the maxillary central incisors conical NC, Prado RF, Cavalcante ASR, Almeida JD - 1UNIV. ES- in shape, they were reconstructed with resin composite. The TADUAL PAULISTA - BIOCIÊNCIAS E DIAGNÓSTICO patient is still being treated, and currently, he is using a remov- BUCAL able orthodontic appliance for distalization of canines and den- Simple bone cyst is a benign cavity in the bone empty or ture lower. (Financial support: FAPEMIG). containing fluid that is free of lining epithelium. The location is exclusively mandibular and the most frequent is the second PADRÃO DE EXPRESSÃO DAS PAKS NA QUEILITE premolar and symphysis region. An 16-year-old white girl seek ACTÍNICA E CARCINOMA EPIDERMOIDE ORAL Nero for the outpatient clinic with no pain complaints, referred by NRDD1 - 1UFTM orthodontists who detected through routine radiography image a The PAKs proteins participate in signal transduction path- radiolucent area in the right branch of the mandible. On clinical ways that regulate various biological processes, such as cellular examination there was no change; computed tomography showed proliferation and cytodifferentiation. Immunohistochemical reac- a lytic lesion with regular contours and homogeneous. Puncture tions were performed for phosphoPAKs1/2, phosphoPAKs4/5/6 ORAL MEDICINE OOOO e128 Abstracts October 2012

(active forms) and KI-67 in eight cases of Actinic Cheilitis (AC) sunscreen (85.41%). Prevalence of actinic cheilitis was 37.5%, and 36 cases of oral squamous cell carcinoma (OSCC). In the being 86.11% classified as light, 11.11% as moderate and 2.78% epithelium of the margin of OSCC, the basal cell layer expressed as severe. phosphoPAKs1/2, while the more superficial keratinocytes ex- Conclusion: Actinic cheilitis presented a high prevalence in pressed the phosphoPAKs4/5/6. In AC, phosphoPAKs1/2 and the fishermen population studied. phosphoPAKs4/5/6 were not expressed. In OSCC, phospho- PAKs1/2 was not expressed; however phosphoPAKs4/5/6 was expressed in areas of degeneration and cell death. The PAKs1/2 PREVALENCE OF ORAL MUCOSA ALTERATIONS IN and PAKs4/5/6 in its active form showed no similar pattern of PATIENTS WITH DIABETES MELLITUS Sobrinho KN1, expression with the proliferation marker KI-67. These results Gean TS1, Pereira JV1, Conde NCO2 - 1UNIVERSIDADE suggest that protein PAKs1/2, group I, may not participate in the FEDERAL DO AMAZONAS - FACULDADE DE ODONTO- regulation of cell proliferation and AC and OSCC, while PAKs4/ LOGIA, 2UNIVERSIDADE FEDERAL DO AMAZONAS - 5/6, group II, could be involved in regulation of cell death in COORDENAÇÃO ACADÊMICA OSCC. Objective: The aim of this study was to investigate primary Authors: lesions and alterations presents in oral mucosa of patients with Nayara Rúbio Diniz Del Nero diabetes mellitus. Nanci Mendes Pinheiro Study design: Forty three patients treated at Ambulatory of Leopoldo Henrique Martins Barboza Endocrinology in Federal Amazon University were evaluated Ana Cristina de Araújo Lemos about type of diabetes, duration of disease, oral complaints and Virgínia Oliveira Crema prevalence of alterations and lesions in the oral mucosa by Keywords: PAKs, Actinic Cheilitis; Oral Squamous Cell clinical examination. The results were evaluated using descrip- Carcinoma tive statistics. Results: Of the 43 individuals, 44% were male and 66% GORLIN-GOLTZ SYNDROME: FOLLOW-UP OF 14 were female with mean age of 53 years. Of the total sample, 9% MONTHS WITH INCIPIENT FINDINGS OF NEW KER- had diabetes type 1 and 91%, type 2, with 8,4 years of duration 1 ATOCYSTIC ODONTOGENIC TUMORS Lascane NAS , of disease and the oral complaint more frequent was xerostomia Thomaz LA2, Silva MV2, Santos MVM2, Freitas ALS2, Tes- (60,4%) Most frequent alterations were: Fordyce granules hima THN1, Mautoni MC2 - 1UNIVERSITY OF SÃO PAULO (65.2%), melanin pigmentation (37.2%) and lesions were gingi- - DENTAL SCHOOL - ORAL PATHOLOGY, 2SANTA CECÍ- val inflammation (32,5%) and gingival recession (30,2%). LIA UNIVERSITY - DENTAL SCHOOL - DISCIPLINE OF Conclusion: Patients with diabetes mellitus showed an in- STOMATOLOGY creased prevalence of oral mucosa alterations and pathologic Gorlin-Goltz syndrome, also known as nevoid basal cell car- lesions which demonstrates the importance of regular clinical cinoma syndrome, is an autosomal dominant inherited disease, exams. which shows high level of penetrance and variable expressivity. Keratocystic odontogenic tumors (KCOT) of the jaws, multiple basal cell carcinoma and skeletal abnormalities characterize this MASSON’S TRICHROME (MT) AND AGNOR STUDY OF syndrome. It might be diagnosed by a routine radiographic exam by FIBROUS DYSPLASIA (FD) AND OSSIFYING FIBROMA a dentist due to KCOTs are often one of the first manifestations. We (OF) IN LAGOS UNIVERSITY TEACHING HOSPITAL- report a case of a 12-year-old boy with Gorlin-Goltz syndrome (LUTH) PATIENTS Effiom OA1, Soyele OO2, Odukoya O1 - complaining about his teeth position. Orthopantomographic radiog- 1COLLEGE OF MEDICINE UNIVERSITY OF LAGOS - raphy revealed 3 multilocular radiolucency with well-defined mar- ORAL PATHOLOGY AND ORAL BIOLOGY, 2LAGOS UNI- gins in mandible which were treated by decompression and marsu- VERSITY TEACHING HOSPITAL - ORAL PATHOLOGY pialization followed by surgical enucleation and bone curettage. Objective: Differentiating FD from OF . Follow-up of 14 months showed still incomplete bone formation and Study design: 40 each from 134 FD and 157 OF cases were 4 new radiotransparent areas in maxilla. This episode highlighted the randomly selected from LUTH oral biopsy archives. Three 3-5␮ importance of an early diagnosis and a long-term follow-up, which thick paraffin sections/case were stained with H&E (diagnosis can provide a better prognosis for the patient. reconfirmation), MT (bone trabeculae type [BTT] demonstration) and AgNOR (positive black dots demonstration). Proportions of PREVALENCE OF ACTINIC CHEILITIS OF FISHERMEN BTT and mean AgNOR score for both lesions were analyzed for 1 1 1 IN MANAUS-AM Lima NG , Maciel RP , Silva GD , Conde ␹2 and Tstatistics respectively, using Epi-info statistical package. NCO1, Barreiros ALC2, Domingues JEG1, Pereira JV1 - Results: Lamella BTT proportion in OF(52.5%) was signif- 1UFAM, 2SEMSA icantly higher than in FD(30%);mixed BTT proportion in Objective: Evaluate the prevalence of labial modifications in FD(70%) was significantly higher than in OF(50%)(pϽ0.05). a fishermen population of Manaus/AM. Woven BTT proportion in FD(60%) was not significantly higher Study design: Application of a questionnaire about general than in OF(55%). Mean AgNOR score for OF (130.4069Ϯ32.3392/ health and exam of the mucous. The injuries were characterized 100cell) was significantly higher than that of FD(92.3369Ϯ27.4207/ in light, moderate and severe degree. 100cell) (pϽ0.05). Results: Ninety-six patients were included, 53.12% female Conclusion: Lamella and mixed BTT proportions and mean and 46.88% male, predominantly in age group from 45 to 60 AgNOR score are important in distinguishing FD from OF. years old (54.17%). Most patients examined used hat as a pre- Woven BTT proportion is a poor indicator. This is the first ventive method (88.54%); however, most of them did not use demonstration of mixed BTT in distinguishing FD from OF. OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e129

FACTITIAL ORAL LESIONS IN A PAEDIATRIC PATIENT ing VELscope (tissue autofluorescence) imaging and oral exfo- Feio PSQ1, Pedroso EG1, Totti V1, Graner KM1, Gomes liative cytology using brush biopsy techniques to collect cells for CBF1, Ramos LMA1, Lopes MA1 - 1PIRACICABA DENTAL analysis. The aim of this study was to assess the efficacy of such SCHOOL, UNIVERSITY OF CAMPINAS - DEPARTMENT techniques in establishing diagnoses. OF ORAL DIAGNOSIS, OROCENTRO Methods: Following ethical approval and informed consent, An 8-year-old boy was referred by his physician to our new patients with PMDs attending Dysplasia Clinics enrolled in diagnosis service for evaluation of 2-month history of multiples the study. All underwent standardized management protocols aphthous ulcer on the oral mucosa. His mother reported an with conventional oral examination supplemented by VELscope increase in frequency, extension and pain of these lesions, also an imaging and Orcellex® brush biopsy, followed by incision bi- intestinal constipation was reported. On oral examination, there opsy for histopathological diagnosis. VELscope, cytology and was an ulcer, measuring 2,0 ϫ 1,0, on the lower lip and another histopathology were thus directly compared for each PMD. smaller ulceration on the upper lip mucosa. The lesions did not Results: 34 patients (10 males, mean 49.4yrs and 24 fe- resolve with topical clobetasol propionate 0,05 %. Coagulation males, mean 60.3yrs) were examined. 25 leukoplakias, 7 eryth- blood test and complete blood count showed no alterations. roleukoplakias and 2 erythroplakias were identified on: ventro- Absence of positive pathergy, no deficiency of vitamin B12, lateral tongue (10), floor of mouth (9), alveolar/gingival mucosa normal folate and iron levels were observed. After one month of (5), labiobuccal mucosa (4), palate (3) and tongue dorsum (3). follow-up the diagnosis of a self-induced injury was established. Histopathological diagnoses included hyperkeratosis (14), mild Patient’s mother was advised by a psychologist. Factitious injury (9), moderate (4) and severe dysplasias (5), carcinoma in situ (1) of the oral mucosa may present a confusing clinical picture and and squamous cell carcinoma (1). Brush cytology coincided best the diagnosis may be challenging particularly in children. with histopathology, with VELscope examination less reliable; both were more efficient in recognizing severe dysplasias or carcinoma. ACTIVATED WNT SIGNALING PATHWAY IS NOT IN- Conclusions: Diagnostic adjuncts cannot replace ‘gold stan- FLUENCED BY ABSENCE OF GALECTIN-3 IN MICE dard’ incision biopsy and histopathology and are most useful in DURING TONGUE MALIGNANT TRANSFORMATION identifying severe disease. Souza MVR1, Lopes MLC, Chammas R3, Santana JMA, San- 4 2 1 tos DO, Loyola AM , Faria PR - UNIVERSIDADE FED- ORAL, OROPHARYNGEAL AND GASTROINTESTINAL ERAL DE UBERLÂNDIA - FACULDADE DE MEDICINA, MUCOSITIS IN PATIENTS UNDERGOING AUTOLO- 2 UNIVERSIDADE FEDERAL DE UBERLÂNDIA - INSTI- GOUS STEM CELL TRANSPLANTATION Queiroz PM1, 3 TUTO DE CIÊNCIAS BIOMÉDICAS, UNIVERSIDADE DE Fernandes KS1, Rumiato AC2, Faune CC2, Trigo FC2, Gor- 4 SÃO PAULO - FACULDADE DE MEDICINA, UNIVERSI- dan LN2, Ito FA3 - 1STATE UNIVERSITY OF LONDRINA, DADE FEDERAL DE UBERLÂNDIA - FACULDADE DE 2UNIVERSITY HOSPITAL - STATE UNIVERSITY OF LON- ODONTOLOGIA DRINA - UNIT OF BONE MARROW TRANSPLANTATION, Background/Objective: To study cyclin D1 and APC ex- 3STATE UNIVERSITY OF LONDRINA - ORAL PATHOL- pression in lesions developed in tongues from galectin-3 deficient OGY Ϫ/Ϫ ϩ/ϩ (GAL3 ) and wild-type (GAL3 ) mice. Objective: This study evaluates the frequency and severity Ϫ/Ϫ ϩ/ϩ Study design: 60 GAL3 and GAL3 mice were of oral, oropharyngeal and gastrointestinal mucositis in patients treated with 4NQO for 16 weeks and killed at week 16 and week undergoing autologous stem cell transplantation. 32. Tongues were removed and sections were stained with H&E Study design: Clinical data from patients treated between to diagnosis of dysplasias and carcinomas. An immunohisto- 2010 and 2011 were gathered from files. All patients received chemical assay was employed. oral hygiene instructions, cryotherapy and low-level laser as oral Results: Oral carcinogenesis occurred in both groups mucositis prevention. Ͼ (p 0.05). Cyclin D1-positive cells in dysplasias and carcinomas Results: Of the 22 patients, 7 (31.8%) presented oral mu- Ϫ/Ϫ from GAL3 was 36% each, and 28% and 34%, respectively, cositis, 7 (31.8%) had oropharyngeal mucositis and all patients ϩ/ϩ Ͼ Ϫ/Ϫ in GAL3 mice (p 0.05). In dysplasias from GAL3 mice, developed gastrointestinal mucositis. Most cases of oral mucosi- the intensity for APC ranged from weak (31.7%) to strong tis (85%) presented as asymptomatic erythema (WHO grade 1 (2.4%), and from weak (48.1%) to strong (7.4%) in carcinomas. mucositis). Topical lidocaine spray was used for symptomatic ϩ/ϩ In dysplasias from GAL3 mice predominated a weak expres- relief of oropharyngeal mucositis. Gastrointestinal mucositis was sion (59.4%) and in carcinomas ranged from weak (50%) to treated with dietary supplementation of glutamine 20g/day. Ͼ moderate (40%) (p 0.05). Conclusion: Mucositis has been associated with increased Conclusion: Activated Wnt signaling was observed in both incidence of serious clinical outcomes and with excess resource groups of mice (FAPEMIG). utilization among patients who receive myelosuppressive chemo- therapy. Therapies are needed to reduce the incidence and miti- ORAL POTENTIALLY MALIGNANT DISORDERS – EFFI- gate the severity of this common problem. CACY OF DIAGNOSTIC ADJUNCTS Elzubier S, Goodson ML, Thomson PJ1 - 1NEWCASTLE UNIVERSITY - ORAL & STUDY OF CCND1 AMPLIFICATION AND P16 EXPRES- MAXILLOFACIAL SURGERY SION IN CENTRAL GIANT CELL LESION OF THE JAWS 1 2 3 Introduction: Management of oral potentially malignant Nogueira RLM , Faria MHG , Osterne RLV , Cavalcante disorders (PMD) requires clinical recognition of mucosal RB4, Ribeiro RA5, Nonaka CFW6, Rabenhorst SHB7 - 1FED- changes and interpretation of incision biopsy specimens. A range ERAL UNIVERSITY OF CEARA SCHOOL OF DENTISTRY, of diagnostic adjuncts have been proposed in recent years includ- FORTALEZA, BRAZIL - DEPARTMENT OF DENTAL ORAL MEDICINE OOOO e130 Abstracts October 2012

CLINIC, DISCIPLINE OF ORAL AND MAXILLOFACIAL the specimen confirmed the previous diagnosis. Four months SURGERY AND STOMATOLOGY, 2SCHOOL OF MEDI- later, total bone recovery was observed. CINE, FEDERAL UNIVERSITY OF CEARÁ - MOLECULAR GENETICS LABORATORY - LABGEM, DEPARTMENT OF BUCCAL BIFURCATION CYST: CASE REPORT Araujo PATHOLOGY AND FORENSIC MEDICINE, 3UNIVERSI- PM1, Osterne RLV2, Cavalcante RB2, Teixeira RC3, Pinheiro DADE DE FORTALEZA, 4UNIVERSITY OF FORTALEZA - LMA, Nogueira RLM1 - 1UFC - SURGERY, 2UNIFOR - DEPARTMENT OF ORAL AND MAXILLOFACIAL PA- PATOLOGY, 3UNIFOR - RADIOLOGY THOLOGY, 5FEDERAL UNIVERSITY OF CEARA SCHOOL A six years old male, leukoderm, complaining of swelling in OF MEDICINE, FORTALEZA, BRAZIL - DEPARTMENT the right mandibular region after trauma causing facial asymme- OF PHYSIOLOGY AND PHARMACOLOGY, 6STATE UNI- try was submitted to clinical examination which showed a painful VERSITY OF PARAIBA - CENTER FOR BIOLOGICAL AND and floating lesion. After palpation, swelling in the buccal region HEALTH SCIENCES, 7FEDERAL UNIVERSITY OF CEARA of tooth 46 was found. A history of trauma in the region two SCHOOL OF MEDICINE, FORTALEZA, BRAZIL - DE- months earlier was reported with a quick increase of volume, PARTMENT OF PATHOLOGY AND FORENSIC MEDI- painless and without remission. CT scan revealed well-defined CINE lesion, hypodense, with approximately 2.0cm in its largest diam- Objective: To analyze CCND1 gene amplification and the eter. Resorption of cortical bone was observed. Lesion aspiration expression of p16INK4a in central giant cell lesions. showed a yellowish-white liquid. Surgical excision was per- Methods: Analysis of the CCND1 was performed using formed and microscopy examination showed a cystic capsule chromogenic in situ hybridization. Immmunohistochemistry was lined by stratified squamous epithelium, not showing keratinized used to identify p16INK4a protein levels. Statistical analysis cor- foci of hyperplasia nor arciform projections and inflammatory related the two biomarkers with clinical behavior and between mononuclear cell infiltrates concentrated under the epithelium. each other. From the association of clinical and histopathological features the Results: Twenty-four lesions were included, being 11 ag- diagnosis of cyst of the bifurcation was established. A three-year gressive and 13 non-aggressive. Moderate/high-level CCND1 follow up showed no signs of recurrence. amplification was found in 12 lesions. Also, immunoreactivity for p16INK4a was present in 12 cases. There was a significantly GARRÉ’S OSTEOMYELITIS - CASE REPORT Cabús RP, 1,2,3,4,5 1 higher level of p16INK4a expression in mononuclear cells of Cabús RP - AUREA VALERIA DE MELO FRANCO - 2 3 non-aggressive lesions and lesions with moderate/high-level FRANCO AVM, FERNANDA LINS - LINS F, CAMILA CCND1 amplification in mononuclear cells. BEDER RIBEIRO - RIBEIRO CB, 4SYLVIA ROGERS - ROG- Conclusion: It could be speculated that some central giant ERS S, 5RAFAELLA VIANA MONTEIRO - MONTEIRO RV cell lesions may develop as a true benign neoplasm. The higher Garré’s osteomyelitis is an exuberant periosteal response to expression of p16INK4a in non-aggressive lesions and in cases inflammation, characterized by an acute phase, which may affect with moderate/high-level CCND1 amplification may show that people under 25 years of age, having greater predilection for these molecules have a role in central giant cell lesions. the mandible, rapid emergence, pain, swelling of adjacent soft tissues, fever and lymphadenopathy. A female patient, 8 years old, attended the University Center Cesmac dental clinic com- MARSUPIALIZATION IN AN ORTHOKERATINIZED plaining of pain, fever and swelling in the posterior mandible. ODONTOGENIC CYST: CASE REPORT Acay R1, Alves The clinical examination showed an increase in volume in the MGO1, Caris AR1, Cardoso M1, Rodrigues LM1, Almeida lateral posterior border of the mandible body, firm in consis- JD2, Carvalho YR2 - 1UNESP/FOSJC - PROGRAMA DE tency, normochromic, increasing over a period of approxi- PÓS-GRADUAÇÃO EM BIOPATOLOGIA BUCAL, mately six months, causing facial asymmetry. Panoramic, 2UNESP/FOSJC - DEPARTAMENTO DE BIOCIÊNCIAS E periapical and occlusal radiographs were requested, where DIAGNÓSTICO BUCAL pulp involvement was observed in the lower right first molar and a buccal bone expansion with layered onion peel appear- A Caucasian 15-year-old boy was referred from his ortho- ance. The treatment was endodontic therapy with antibiotics dontist who had observed, in the pre-treatment orthopantography, and the condition regressed favorably. We can conclude that a radiolucent, unilocular, well-defined lesion at the left mandib- the diagnosis of Garré’ s osteomyelitis is essentially clinical, ular ramus. Cone-beam computed tomography showed a hy- radiographic, and laboratorial, considering the radiographic podense image, compatible with the radiographic findings. In- analysis essential for determining the diagnosis traoral examination showed expansion of the cortical vestibular bone in the correspondent area, with no damage to the adjacent teeth and mucosa. Puncture aspiration was per- EPIDERMOID CYST IN THE LOWER LIP – AN ATYPICAL 1,2 formed, collecting caseous-like material, followed by inci- CLINICAL PRESENTATION Amorim RFB , Rosa EA, 1 sional biopsy with marsupialization of the lesion and instruc- Lima RBA, Stypulkowski RP, Cunha GLQA - UNIVERSI- tions for irrigation with physiological saline solution. DADE DE BRASÍLIA - PATOLOGGIA - FACULDADE DE Histopathological examination revealed cystic capsule frag- MEDICINA, 2RENATA PORTO STYPULKOWSKI ments, delimited by squamous orthokeratinized epithelium, The epidermoid cyst is a common benign cyst of the skin, showing several keratin debris in the lumen. Hence, the diag- lined by a squamous epithelium similar to the epiderm. The usual nosis was conclusive for orthokeratinized odontogenic cyst. location sites are the neck, head and back. In the facial region it Monthly follow-up was made and evident osseous neoforma- appears mostly in the midline floor of the mouth or submental tion was noticed in panoramic radiographs. After 10 months, region. This work describes an epidermoid cyst in a very unusual the lesion was excised and histopathological examination of site. A 46-year-old male, was referred to the Oral and Maxillo- OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e131 facial Service with a small nodule, firm and mobile lesion at the DEPARTMENT/SEMIOLOGY, 2FEDERAL UNIVERSITY lower lip. There was no pain or history of local trauma. Clinical OF ALFENAS - CLINICAL AND SURGICAL DEPART- diagnosis was glandular tumor. The lesion was removed by MENT, 3HERRERA LLERANDI HOSPITAL - CLINICAL surgical excision, showing a grayish color. Histological exam CENTER OF HEAD AND NECK/ORAL PATHOLOGY SEC- was consistent with an epidermoid cyst. Only five reports of TION, 4STATE UNIVERSITY OF CAMPINAS/PIRACICABA epidermoid cysts in the lips have been published in the literature, DENTAL SCHOOL - ORAL DIAGNOSIS DEPARTMENT/ most of them associated with trauma. Thus, the present work ORAL PATHOLOGY shows an interesting clinical case and hypothesis about its patho- Proteus syndrome (PS) is a rare congenital disorder with genesis progressive asymmetric overgrowth. Oral alterations have been rarely reported, however, oral manifestations of PS may include IMMUNOHISTOCHEMICAL EXPRESSION OF P16 AND malocclusion, primary dentition abnormalities, bone and soft MLH1 IN ORAL SQUAMOUS CELL CARCINOMA Mar- tissue overgrowth, among others. The current work report 2 cases tins PVF1, Rabenhorst SHB2, Nogueira RLM2, Lima MAP2, of localized PS which were diagnosed through oral manifesta- Cavalcante RB1 - 1UNIVERSIDADE DE FORTALEZA, tions in 2 different countries. Both cases affected children who 2UNIVERSIDADE FEDERAL DO CEARÁ were referred to our Clinic due to aesthetic complaint associated Objective: The present study aimed to evaluate the immu- with congenital and progressive facial and perioral asymmetry. nohistochemical expression of the tumor suppressor p16 and the Both patients presented overgrowth leading to left-sized facial repair enzyme MLH1 as well as their correlations between clin- hemihypertrophy affecting bone, soft tissue and teeth in associ- ical features and prognosis in Oral Squamous Cell Carcinoma ation with multiple oral soft tissue hamartomas composed with (OSCC). neural and vascular tissue. Health-related professionals should Study design: A hundred cases of OSCCs were examined by recognize oral manifestations of PS in order to avoid misdiagno- immunohistochemistry using the avidin-biotin-peroxidase method sis and overtreatment. Importantly, facial hemihypertrophy in and the proteins expression and intensity of staining were deter- association with multiple oral soft tissue nodules should be mined using the labeling index and H-score. The statistical anal- recognized as a potential manifestation of PS. Multidisciplinary ysis used the Pearson’s chi-squared test. approach is mandatory for patients with PS. Results: The expression of p16 and MLH1 was absent in and 69% of the cases, respectively. There was an increase of DEPLETION OF CD1A؉ AND CD83؉ DENDRITIC 64% ϭ -negative cases for MLH1 in male (p 0,009), in the age group CELLS IN THE LINGUAL HERPE3S (HSV-1؉) FROM PA ϭ from 15 to 64 (p 0,005) and with the progress of the clinical TIENTS WITH ADVANCED-STAGE ACQUIRED IM- ϭ staging (p 0,009). In the poorly differentiated tumors it was MUNE DEFICIENCY SYNDROME Gondak R1, Mariano ϭ identified a slight increase of p16 positive cases (p 0,047). FV1, Mauad T2, Almeida OP1, Vargas PA1 - 1FOP/UNI- Conclusion: Aging was an important factor in the decrease CAMP - DIAGNÓSTICO ORAL, 2FMUSP/USP - PATOLO- of these proteins. GIA Objective: To quantify and compare the expression of den- OSTEOBLASTOMA OF THE MANDIBLE: REPORT OF dritic cells (DCs) in the tongue of AIDS patients with herpes, and TWO CASES Rosa RR1, Oliveira MTF, Silva CJ, Freitas from AIDS and non-AIDS patients with normal tongues, using Filho SAJ, Durighetto Jr. AF, Faria PR, Loyola AM - 1UNI- autopsy material. VERSIDADE FEDERAL DE UBERLÂNDIA - ÁREA DE PA- Study design: CD83, CD1a and HSV-1 antibodies were TOLOGIA ORAL used to identify mature DCs, immature DCs and herpes simplex Osteoblastoma is a benign bone-forming neoplasm with po- respectively by immunohistochemistry in tongue tissue of 20 tential for aggressive growth, characterized by osteoblastic rim- AIDS patients (10 with lingual herpes and 10 with no lesions) ming of woven bony trabeculae. It represents 1% of tumors and 10 tongues from HIV-negative patients. Quantification was affecting the skeleton and only 10% of these tumors are found on performed by conventional morphometry and the results were the face. This paper presents two cases of osteoblastoma of the expressed as positive cells per area. mandible. Both patients presented an expansive and painful le- Results: AIDS patients presented a lower density of sion in the first molar region, with history of prior extraction of CD83ϩcells (PϽ0.001) and CD1aϩcells (PϽ0.001) compared this tooth. One case affected a 26-year-old woman, in the right to the non-AIDS control group. However, no differences of the side of her mandible, and was a 4cm predominantly radiolucent DCs markers were found when AIDS patients with herpes were lesion. The other patient was a 25-year-old man, affected the left compared with AIDS patients without tongue infection. side of his mandible, was 2.5cm width, and depicted mixed Conclusion: HIV infection induces cytopathic changes in aspect on radiographic exam. Both were treated by surgical DCs, contributing to their depletion regardless of the presence of exeresis without signs of recurrence 11 and 4 months after herpes virus. treatment, respectively. IMMUNOHISTOCHEMICAL EXPRESSION OF WNT/␤- LOCALIZED PROTEUS SYNDROME AFFECTING THE CATENIN SIGNALING PATHWAY PROTEINS IN HEAD AND NECK: REPORT OF TWO CASES WITH EM- AMELOBLASTOMA AND CALCIFYING CYSTIC ODON- PHASIS TO ORAL LESIONS Silva RN1, Ferraz FC1, Hane- TOGENIC TUMOR Moraes SN1, Pires FR2, Dias LA2, mann JAC2, Bregni RC3, Almeida OP4, Lopes MA1, Santos- Azevedo RS3 - 1UNIVERSIDADE ESTADUAL DE CAMPI- Silva AR1 - 1STATE UNIVERSITY OF CAMPINAS/ NAS, PIRACICABA/SP, BRASIL - FACULDADE DE ODON- PIRACICABA DENTAL SCHOOL - ORAL DIAGNOSIS TOLOGIA, 2UNIVERSIDADE ESTÁCIO DE SÁ, RIO DE ORAL MEDICINE OOOO e132 Abstracts October 2012

JANEIRO/RJ, BRASIL - PATOLOGIA ORAL, 3UNIVERSI- SITY OF SÃO PAULO - DEPARTMENT OF GENERAL DADE FEDERAL FLUMINENSE, NOVA FRIBURGO/RJ, PATHOLOGY BRASIL - ESTOMATOLOGIA E PATOLOGIA ORAL Pemphigus vulgaris (PV) is an autoimmune disease charac- Background/Objectives: Wnt/␤-catenin signaling pathway terized by epithelial blistering affecting cutaneous and/or muco- is involved in odontogenesis, however, changes in expression of sal surfaces. Oral manifestation of PV can be erythema, erosion, its proteins have been identified in ameloblastoma (AME) and and blistering of the attached and marginal gingiva, indicating calcifying cystic odontogenic tumor (CCOT), thus, the aim of desquamative gingivitis. We report 2 cases of desquamative this study was to evaluate and compare the immunohistochemical gingivitis that were positive for Nickolsky’s sign and suspected expression of some of these pathway proteins in AME and of PV. Both cases were previously examined with the technique CCOT. of reflectance confocal microscopy, a noninvasive diagnostic Study design: Wnt1, Wnt5a and ␤-catenin immunohisto- method that has been used in the diagnostic processes of many chemical expression was analyzed in 17 cases of solid AME and dermatological conditions; the exam revealed acantholytic cells 6 cases of CCOT. at the lower aspect of mucosal epithelium. Incisional biopsy was Results: Overexpression of Wnt1 and Wnt5a was observed performed and histopathological findings showed suprabasal cleft in all cases of CCOT and included ghost cells, but it was focally and acantholysis. Direct immunofluorescence showed intercellu- observed in AME. ␤-catenin stabilization was identified in the lar deposits of IgG. We conclude that reflectance confocal mi- cytoplasm of AME and in the cytoplasm and the nucleus of croscopy aspects are associated with the histological aspects of CCOT. PV, and, as it is a noninvasive diagnostic method, it is an Conclusion: Wnt1 and Wnt5a expression seem to have a interesting tool for the exam gingiva, especially in cases of role in CCOT development and may contribute to ghost cells blistering diseases. histogenesis and AME development, and nuclear ␤-catenin sta- bilization seems to be involved in CCOT development. ASYMMETRY DERMATOGLYPHICS IN ORAL CLEFT Aquino SN1, Leite BGL2, Martelli DRB3, Swerts MSO4, Mar- telli-Júnior H5 - 1STATE UNIVERSITY OF CAMPINAS - ORAL MANIFESTATION OF METASTATIC ADENOCAR- DEPARTMENT OF ORAL DIAGNOSIS, 2STATE UNIVER- CINOMA OF THE COLON AND RECTUM: A CASE 1 2 3 SITY OF MONTES CLAROS - CENTER FOR BIOLOGICAL REPORT Von Zeidler SLV , Melo EA , Bourguinon A ,Po- 3 4 5 1 AND HEALTH SCIENCES, STATE UNIVERSITY OF MON- destá JRV , Gouvêa SA - UFES - DEPARTAMENTO DE 4 PATOLOGIA, 2UNIVERSIDADE FEDERAL DO ESPÍRITO TES CLAROS - STOMATOLOGY CLINIC, UNIVERSITY 3 OF ALFENAS - CENTER FOR REHABILITATION OF SANTO - FACULDADE DE ODONTOLOGIA, HOSPITAL 5 EVANGÉLICO DE VILA VELHA - CIRURGIA BUCOMAX- CRANIOFACIAL ANOMALIES, STATE UNIVERSITY OF ILOFACIAL, 4HOSPITAL SANTA RITA DE CÁSSIA - MONTES CLAROS; UNIVERSITY OF ALFENAS - STOMA- AFEEC - CIRURGIA DE CABEÇA E PESCOÇO, 5UNIVER- TOLOGY CLINIC; CENTER FOR REHABILITATION OF SIDADE FEDERAL DO ESPÍRITO SANTO - DEPARTA- CRANIOFACIAL ANOMALIES MENTO DE CIÊNCIAS FISIOLÓGICAS Objective: Analyze the digital and palmar asymmetry of parents and individuals with clef lip and/or palate. Colorectal cancers result from the accumulation of genetic Study design: we analyzed a sample of 303 people divided mutations that lead to transformation of the normal colonic into two groups, case, with 51 trios consisting of fathers, mothers epithelium. Metastasis to the oral region is rare, and occurs more and children affected by oral cleft, since the control group was frequently to the bone of the mandible. The authors describe a composed of 50 trios also shaped by normal individuals. We rare presentation of an uncommon metastatic adenocarcinoma of made the fingerprints and palm prints of each participant, then the colon and rectum. This case reports a female, 53 years-old, calculated the dermatoglyphic patterns, ridge count the digits and who developed significant swelling in the left anterosuperior palmar angles (atd, tda, tad). alveolar mucosa and had moderate tooth mobility. On intraoral Results: We observed a statistically significant difference examination there was a gingival nodular lesion, with purple between the atd angles of the fathers, and dermatoglyphic pat- color, presenting spontaneous bleeding associated with osteolytic terns of the mothers of those affected by cleft, with a significantly bone lesion. Surgical resection was performed and pathological greater number of arches in the case group (pϭ0.01). examination revealed a malignant epithelial neoplasm not con- Conclusion: The mechanisms responsible for deviations in nected to the surface epithelium of the mucosa, invading the asymmetry of atd angles in fathers and dermatoglyphic patterns surrounding structures. The diagnosis of metastatic adenocarci- in mothers may be associated with the factors responsible for the noma of the colon and rectum in the oral region is always formation of oral cleft. challenging, both to clinician and to the pathologist, due to its Supported by: Fapemig. rarity and complexity.

KAWASAKI DISEASE IN A CHILD - CASE REPORT Perez REFLECTANCE CONFOCAL MICROSCOPY IN THE IN AS1, Marchionni AMT1, Pedreira AA1, Hoshi R1, REIS SRA1 VIVO EVALUATION OF DESQUAMATIVE GINGIVITIS: - 1ESCOLA BAHIANA DE MEDICINA E SAÚDE PÚBLICA 1 PATTERNS IN PEMPHIGUS VULGARIS Bologna SB , Tes- - MESTRADO EM ESTOMATOLOGIA 2 2 1 1 hima THN , Lascane NAS , Alessi SS , Nico MMS , Lourenço Kawasaki disease (KD), also termed mucocutaneous lymph 3 1 SV - MEDICAL SCHOOL, UNIVERSITY OF SÃO PAULO node syndrome, is an acute febrile vasculitis of unknown etiology - DEPARTMENT OF DERMATOLOGY, 2DENTAL that mainly affects children under five years of age, particularly SCHOOL, UNIVERSITY OF SÃO PAULO - DEPARTMENT males. Despite being self-limited it’s highly important to estab- OF ORAL PATHOLOGY, 3DENTAL SCHOOL, UNIVER- lish the diagnosis promptly, since possible complications can OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e133 develop such as coronary artery aneurysms, ischemic heart dis- was sent for histopathological examination. Presence of collagen ease and even death. Nevertheless, its diagnosis may be very fibers intermingled with proliferation of amphophilic fibers of difficult because KD shares many clinical features with other variable thickness, shape and size was observed. Some of the illnesses, and so it is based primarily on clinical criteria and fibers exhibited a wrinkled pattern and serrated margins. Ver- differential diagnosis for exclusion of other diseases. Although hoeff-van Gieson staining revealed the elastic nature of the there is no specific diagnostic assay for KD, some laboratorial amphophilic fibers, which stained dark blue, confirming the di- tests may be helpful. The disease is characterized by fever for at agnosis of elastofibroma. The present patient continues under least five days, nonexudative conjunctivitis, erythema of the lips follow-up and no new changes have so far been observed. and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy. This is a case report of Kawasaki disease in an 8-year old boy with a history of several recurrent episodes of oral PLEOMORPHIC ADENOMA WITH EXTENSIVE SQUA- aphthous ulcers, all over the oral mucosa since age three years. MOUS METAPLASIA IN MINOR SALIVARY GLAND 1 2 His disease has been diagnosed after hospitalization due to car- Vilardi TMR , Goulart MCV, Freitas-Faria P, Goulart GR , 3 4 5 1 diovascular problems. To the present moment, the patient is Carlos-Bregni R , Soares CT , Lara VS - FACULDADE being constantly followed up for both systemic and oral mani- DE ODONTOLOGIA DE BAURU - UNIVERSIDADE DE festations of the disease. SÃO PAULO - DEPARTAMENTO DE ESTOMATOLOGIA ÁREA DE PATOLOGIA BUCAL, 2PRTÁTICA PRIVADA, 3 PAGET’S DISEASE OF THE MAXILLA: CASE REPORT Ol- CENTRO CLÍNICO DE CABEÇA E PESCOÇO, CIDADE iveira SP1, Buexm LA2, Coutinho CF1, Sother MD, Camisasca DA GUATEMALA - DEPARTAMENTO DE PATOLOGIA, 4 DR3, Azevedo RS4, Lourenço SQC5 - 1ODONTOCLÍNICA INSTITUTO LAURO DE SOUZA LIMA E INSTITUTO 5 CENTRAL DO EXÉRCITO (OCEX) - ESTOMATOLOGIA, 2IN- ANATOMOPATOLÓGICO DE BAURU, FACULDADE DE STITUTO NACIONAL DO CÂNCER (INCA), 3UNIVERSI- ODONTOLOGIA DE BAURU - UNIVERSIDADE DE SÃO DADE FEDERAL FLUMINENSE (UFF) - ESTOMATOLO- PAULO - DEPARTAMENTO DE PATOLOGIA GIA, 4UNIVERSIDADE FEDERAL FLUMINENSE (UFF) - Pleomorphic adenoma (PA), the most common salivary PATOLOGIA ORAL, 5UNIVERSIDADE FEDERAL FLUMI- gland tumor, accounts for 54% to 65% of all salivary gland NENSE (UFF) - PATOLOGIA neoplasias and 80% of the benign salivary gland tumors. It most Paget’s disease (PD) is a chronic progressive disease of the frequently affects the parotid gland, followed by the submandib- bone characterized by abnormal bone resorption and deposition ular and the minor salivary glands. Microscopically, mucous, affecting either single or multiple bones. A case of PD involving sebaceous, oncocytic and squamous metaplasia, sometimes with only the maxilla is reported. A 64-years-old female patient at- the formation of keratin pearls, may be present, but the latter tended the stomatology clinic reporting an increase in volume of rarely results in the formation of extensive keratin-filled cysts maxilla, which prevented use of upper prosthesis. Intra-oral ex- lined by squamous epithelium. Extensive squamous metaplasia amination revealed a hardened swelling in maxilla, involving can be mistaken for malignancy, including mucoepidermoid car- both left alveolar ridge and hard palate, with tooth mobility and cinoma and squamous cell carcinoma. Here, we present an un- bone expansion. Panoramic radiography showed a mixed and usual case of PA with extensive squamous metaplasia and keratin diffuse image throughout the maxilla associated with root resorp- cyst formations in a minor salivary gland, and discuss its micro- tion. An incisional biopsy was performed with histopathologic scopic features, including the immunohistochemical characteris- diagnosis of PD. Alkaline phosphatase enzyme (ALP) levels tics, and differential diagnosis of this uncommon presentation. (1284U/L) were much above the normal range (35-104U/L). Calcium, phosphorus and urinary hydroxyproline serum levels GRANULAR CELL TUMOR OF THE TONGUE AT THE were normal, confirming the diagnosis. The patient was referred FIRST DECADE OF LIFE Teshima THN1, Bologna SB2, Las- to a rheumatologist. This report is a classic case of PD in which cane NAS1, Nico MMS2, Lourenço SV1 - 1SCHOOL OF oral manifestations directed the diagnosis. DENTISTRY - UNIVERSITY OF SÃO PAULO - ORAL PA- THOLOGY, 2SCHOOL OF MEDICINE - UNIVERSITY OF ELASTOFIBROMA OF ORAL MUCOSA: A RARE ENTITY SÃO PAULO - DERMATOLOGY Ferreira SJ, Monteiro BVB, Pereira JS, Aguiar-Junior JNM1, 2 3 1 1 The granular cell tumor is an uncommon lesion that usually Costa DA , Nonaka CFW , Miguel MCC - UNIVERSI- appears in middle or older aged adults and rarely shows up at the DADE FEDERAL DO RIO GRANDE DO NORTE - PRO- first decade of life. About 50% of all cases affect the head and GRAMA DE PÓS GRADUAÇÃO EM PATOLOGIA ORAL, neck region and tongue and buccal mucosa are the most prevalent 2 HOSPITAL MEMORIAL WALFREDO GURGEL - CIRUR- intraoral sites. The histological origin of this lesion remains 3 GIA ORAL E MAXILOFACIAL, UNIVERSIDADE ES- unclear and so far no specific marker could elucidate this matter. TADUAL DA PARAÍBA - PROGRAMA DE PÓS GRADU- We report a case of an eight-year-old girl, who presented a AÇÃO EM ODONTOLOGIA yellowish, painless, fibrous and single plaque on the right lateral Elastofibromas are slow-growing soft tissue tumor-like le- border of the tongue discovered three months earlier. An exci- sions whose etiopathogenesis remains unclear. These lesions are sional biopsy was performed and the histopathological findings very rare in oral cavity, with only seven cases being reported in showed no pseudoepitheliomatous hyperplasia while polygonal the English literature. A 66-year-old black man sought a dental cells full of eosinophilic granular content and hyperchromatic service for examination of a yellowish, sessile, asymptomatic and nuclei were profusely detected from the mucosal epithelium to non-bleeding nodular mass with a smooth surface on the border deep striated muscle bundles. This lesion was finally diagnosed of the tongue. The diagnostic hypothesis was a traumatic fibroma. as a granular cell tumor and no recurrence was detected after An excisional biopsy of the lesion was obtained and the specimen one-year follow-up. ORAL MEDICINE OOOO e134 Abstracts October 2012

LARGE OSSIFYING FIBROMA OF MAXILLA INVOLV- TAL DE CLÍNICAS DE PORTO ALEGRE - ESTOMATOLO- ING MAXILLARY SINUS Imada TSN1, Nogueira AS1, Alves GIA APNN2, Soares ECS3, Medeiros JR3, Turatti E4, Santos PSS1 Systemic lupus erythematosus (SLE) is a chronic autoim- - 1BAURU SCHOOL OF DENTISTRY - UNIVERSITY OF mune disease associated with significant morbidity and mortality. SÃO PAULO - STOMATOLOGY, 2FEDERAL UNIVERSITY Different studies of oral lesions in the course of LE have shown OF CEARÁ - STOMATOLOGY, 3FEDERAL UNIVERSITY a frequency varying from 9 to 45% in systemic disease. We OF CEARÁ, 4UNIVERSITY OF FORTALEZA described two cases of SLE with oral manifestation. Case1-A Ossifying Fibromas has a definite female and maxilla predi- female patient, 32 years-old was diagnosed with SLE in 1997. lection. We present a rare case of a large ossifying fibroma of the The intraoral examination showed multiple ulcers located in soft right posterior maxilla in a 38-year-old feoderm man. On in- and hard palate, buccal mucosa bilaterally and attached gingiva. traoral examination, our patient showed a hard swelling expand- Clobetasol propionate was prescribed associated with Nystatin ing from vestibular plate to mid-line palate covered by subtle 100,000 IU. Case 2- A female patient was diagnosed with SLE in ischemic skin. The swelling started 10 years ago and increased 2011. The examination revealed a malar rash, arthralgias, and gradually; initially it was asymptomatic but had become painful Cushing’s syndrome. During examination showed mucosal de- due to occlusion trauma. Panoramic radiograph and CBCT re- hydrated, pale and intact. Both patients were treated with a vealed a 4cmø large, well-defined mixed radiolucid and mainly combination of immunosuppressors with remission of oral man- radiopaque lesion extending from first pre-molar to tuber region ifestations. Careful examination of the oral cavity may reveal of right maxilla in an edentulous area. Incisional biopsy was findings indicative of an underlying systemic condition as SLE. performed and the histopathologic features showed well-circum- scribed fibrous connective tissue with mineralization areas, con- LOSS OF HETEROZYGOSITY IN REGIONS OF TUMOR firming Ossifying Fibroma diagnosis. Therefore, Le Fort I os- SUPPRESSOR GENES IN ORAL LEUKOPLAKIA Fonseca- teotomy technique was performed to access and remove the Silva T1, Galvão CF1, Gomez RS1, Gomes CC2 - 1UNIVER- entirely lesion. Currently, the patient is on 3 years follow-up with SIDADE FEDERAL DE MINAS GERAIS, BELO HORI- no radiographic evidence of recurrence. ZONTE, BRAZIL - DEPARTMENT OF ORAL SURGERY AND PATHOLOGY; SCHOOL OF DENTISTRY, 2UNIVER- RESECTION OF CENTRAL GIANT CELL LESION IN THE SIDADE FEDERAL DE MINAS GERAIS, BELO HORI- JAW WITH GRAFT AND REHABILITATION WITH DEN- ZONTE, BRAZIL - DEPARTMENT OF PATHOLOGY; IN- TAL IMPLANTS: 8-YEAR FOLLOW UP Oliveira TFL1, STITUTE OF BIOLOGICAL SCIENCES Figueiredo LMG2, Pontes C3, Carneiro Júnior B4, Lamberti Objectives: The objective of this study was to investigate PLR5, Sarmento VA5, Azevedo RA6 - 1FOB - USP - ESTOMA- loss of heterozygosity (LOH) in regions of tumor suppressor TOLOGIA E RADIOLOGIA, 2UNIVERSIDADE FEDERAL genes in oral leukoplakia samples and its association with histo- DA BAHIA - UFBA, 3UNIVERSIDADE FEDERAL DA BA- logical grading. HIA - RESIDENTE EM CIRURGIA BUCOMAXILOFACIAL, Study design: LOH was assessed using microsatellite mark- ers (D3S1029, D3S1293, D9S157, D9S162, D9S171, D11S1369, 4UNIVERSIDADE FEDERAL DA BAHIA - UFBA - CIRUR- D11S1883, AFM238WF2 and P53).The 18 patients were previ- GIA, 5UNIVERSIDADE FEDERAL DA BAHIA - UFBA - ously submitted to two biopsies in the same lesion site with a ESTOMATOLOGIA E RADIOLOGIA, 6UNIVERSIDADE minimal of 6 months of intervals, resulting in a total of 36 FEDERAL DA BAHIA - CIRURGIA samples. These samples included 22 mild dysplasias, 9 moderate, Central giant cell lesion is an uncommon benign jaw lesion 2 severe and 3 showed oral squamous cell carcinomas. with uncertain etiology and variable clinical behavior. We hereby Results: LOH was detected in 32 samples in at least one report a case of central giant cell lesion in a 27-year-old woman marker and the frequency of allelic loss was associated with with an asymptomatic increased in the right region of the man- histological grading of dyplasia and with some cytological ab- dible and who had undergone previous surgery. Panoramic and normalities. computed tomography demonstrated the presence of a multiloc- Conclusions: The results show that LOH in regions of tumor ular lesion in the basilar region of the mandible. The patient suppressor genes in oral leukoplakias represent a frequent event underwent an incisional biopsy and the histopathological diag- and are associated with architectural and cytological alterations. nosis was central giant cell tumor. A partial resection of the Support: CAPES, CNPq, FAPEMIG. mandible was performed with a bone graft from the iliac crest. After four months, osseointegrated implants were placed in the grafted bone to improve the patient’s appearance and rehabilitate SQUAMOUS CELL CARCINOMA OF THE TONGUE: A Silva-Filho TJ1 her mastication ability; after 6 months, a fixed prosthesis was HISTOLOGICAL STUDY OF 57 CASES , placed on the implants to permit the return of full mastication Vasconcelos MG, Vasconcelos RG, Silveira EJD, Queiroz 1 function. The patient was monitored for eight years without signs LMG - UFRN of recurrence. Background: Oral squamous cell carcinoma is a malignant tumor of epithelial origin that accounts more than 90% of the cancers occurring in the oral cavity. ORAL MANIFESTATIONS OF SYSTEMIC LUPUS ERY- Objective: evaluate and correlate the incidence of clinical 1 THEMATOSUS: REPORT OF TWO CASES Nóbrega TG , and morphological data on cases of tongue squamous cell carci- 2 2 2 2 Dillenburg CS , Selbach BJ , Dias LG , Martins MAT , Mar- noma (TSCC). tins MD1, Munerato MC2 - 1UNIVERSIDADE FEDERAL DO Study design: it was selected 57 tissue specimens of TSCC, RIO GRANDE DO SUL - PATOLOGIA BUCAL, 2UNIVER- embedded in paraffin, cut into 5mm thickness, stained with SIDADE FEDERAL DO RIO GRANDE DO SUL - HOSPI- hematoxylin-eosin and subjected to histological studies using OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e135 light microscopy. A statistic analysis of pathological features and are benign, however we cannot ignore the amount of malignant histological grading of malignancy due to invasion of the lesions tumours, particularly squamous cell carcinoma. was made (Qui2 test). Results: we found that metastasis was statistically correlated PRKAR1A: A POSSIBLE LINK TO AMELOBLASTIC FI- ϭ ϭ to the upshot disease (p 0.000) and clinical stage (p 0.001). BROMA PATHOGENESIS Bernardes VF1, Sousa SF1, Cor- The relationship between clinical staging and histological grad- rea GTB1, Gomes CC2, Gomez RS1 - 1FACULDADE DE ing showed that there were significant differences between these ODONTOLOGIA - UNIVERSIDADE FEDERAL DE MINAS groups analyzed (pϭ0.006). GERAIS - CLÍNICA, PATOLOGIA E CIRURGIA ODON- Conclusion: the clinical staging associated with the histo- TOLÓGICAS, 2INSTITUTO DE CIÊNCIAS BIOLÓGICAS - logical grading can be a predictive tool for the information of UNIVERSIDADE FEDERAL DE MINAS GERAIS - PATO- prognosis of TSCC. LOGIA Background: Ameloblastic fibroma is an uncommon odon- TOLL-LIKE RECEPTOR 5 IS A PROGNOSTIC MARKER IN 1,2 1 togenic tumour with aggressive behavior and potential for ma- ORAL TONGUE CANCER Kauppila JH , Mattila AE , lignant transformation. Despite studies investigating the patho- 1,3 4,3 1 Karttunen TJ , Salo T - UNIV OF OULU, OULU, FIN- genesis of odontogenic tumours, the origin of the ameloblastic 2 LAND - DEPARTMENT OF PATHOLOGY, DEPARTMENT fibroma is still uncertain. The identification of molecules in- 3 OF ANATOMY AND CELL BIOLOGY, OULU UNIV HOS- volved in the mechanisms of development of this lesion requires 4 PITAL, OULU, FINLAND, UNIV OF OULU, OULU, FIN- further exploration. The PRKAR1A is a suppressor gene enrolled LAND - INSTITUTE OF DENTISTRY in cell differentiation and proliferation. Introduction: Toll-like receptor 5 (TLR5) is an innate im- Objective: The aim of this study was to investigate the mune receptor recognizing bacterial flagellin. TLR5 activation immunohistochemical expression of the protein PRKAR1A and has been shown to affect cancer invasion. Considering that oral the loss of heterozygosis (LOH) in ameloblastic fibroma. bacterial flora may be involved in malignant transformation, we Study design: The PRKAR1A expression was analysed by studied TLR5 expression in oral tongue squamous cell carcinoma immunohistochemistry and the LOH was assessed by 5 micro- (OTSCC) and its association with clinical outcome. satellite markers: D17S2182, D17S1882, D17S940, D17S942, Study design: TLR5 was analyzed in 119 patients with and PRKAR1A in paraffin-embedded samples of ameloblastic OTSCC using immunohistochemistry. The staining intensities fibroma. and the percentage of positive cells were assessed. For statistical Results: Lack of protein expression in the ectomesenchymal analyses Chi-square-test, the Kaplan-Meier method and Cox pro- component and LOH were identified in both epithelial and ecto- portional hazards model were used. mesenchymal components. Results: TLR5 expression was increased in OTSCC com- Conclusion: The results indicate that PRKAR1A could be pared to normal epithelium (pϽ0.001). High TLR5 expression related to the pathogenesis of this odontogenic tumour. was associated to reduced disease-free survival (pϽ0.001) and This study was supported by Conselho Nacional de Desen- increased cancer mortality (pϽ0.01). volvimento Científico e Tecnológico (CNPq), Brazil. Conclusion: TLR5 has a role in the pathophysiology of OTSCC and might represent a link between bacterial exposure IMMUNOHISTOCHEMICAL EVALUATION OF ANGIO- and cancer. TLR5 could be considered as a marker for predicting GENESIS AND TRYPTASE-POSITIVE MAST CELLS INFIL- recurrence or survival of OTSCC patients. TRATION IN PRIMARY NODAL HODGKIN LYMPHOMA AND PRIMARY ORAL DIFFUSE LARGE B-CELL LYM- A SURVEY OF ORAL AND MAXILLOFACIAL PATHOL- PHOMA WITH HODGKIN/REED-STERNBERG-LIKE CELLS OGY SPECIMENS FROM A BRAZILIAN POPULATION Toral-Rizo VH1, Carlos-Bregni R2, Delgado-Azañero W3, 1 1 OVER AN 11-YEAR PERIOD Mariano VC , Souza LS , Mosqueda-Taylor A4, Soares FA5, Vassallo J6, Almeida OP7 - 1 1 1 Fernandes KS , Ito FA - UNIVERSIDADE ESTADUAL DE 1PIRACICABA DENTAL SCHOOL, UNIVERSITY OF CAMPI- LONDRINA NAS-UNICAMP - ORAL PATHOLOGY SECTION, DEPART- Objective: Epidemiological surveys of oral lesions are im- MENT OF ORAL DIAGNOSIS, 2CENTRO CLÍNICO DE portant to be aware of the incidence, prevalence and distribution CABEZA Y CUELLO, GUATEMALA CITY, GUATEMALA, of various oral diseases. This study carried out a survey of oral 3FACULTAD DE ESTOMATOLOGIA, UNIVERSIDAD CAY- and maxillofacial pathology specimens submitted for diagnosis. ETANO HEREDIA, LIMA, PERÚ - ORAL PATHOLOGY AND Study design: All entries for specimens during the 11-year ORAL MAXILLOFACIAL SURGERY DEPARTMENTS, 4UNI- period from 1998 to 2008 were retrieved and compiled into 11 VERSIDAD AUTÓNOMA METROPOLITANA-XOCHIMILCO, diagnostic categories. MEXICO CITY, MEXICO - ORAL PATHOLOGY LABORA- Results: During the study period, 3090 specimens were 5 analysed. The diagnostic category with the largest number of TORY, HEALTH CARE DEPERTMENT, AC CAMARGO specimens was mucosal pathology (56.5%), followed by salivary HOSPITAL, SÃO PAULO, BRAZIL - DEPARTMENT OF AN- 6 gland disease excluding neoplasms (10.7%) and odontogenic ATOMIC PATHOLOGY, STATE UNIVERSITY OF CAMPI- cysts and tumours (6.6%). Benign tumours accounted for 6.6% of NAS, CAMPINAS, BRAZIL. - DEPARTMENT OF PATHOL- 7 all specimens and malignant tumours 4.7%. Fibrous hyperplasia OGY OF FACULTY OF MEDICAL SCIENCES, PIRACICABA was the most frequent diagnosis (48.3%), followed by mucocele DENTAL SCHOOL, UNIVERSITY OF CAMPINAS UNICAMP, (9.7%), squamous papilloma (3.9%) and squamous cell carci- PIRACICABA, SÃO PAULO BRAZIL - ORAL PATHOLOGY noma (3.8%). SECTION, DEPARTMENT OF ORAL DIAGNOSIS Conclusion: This study showed that most of the diagnoses The initiation and progression of cancer has an important ORAL MEDICINE OOOO e136 Abstracts October 2012 point in angiogenesis. Moreover, as most tumors contain inflam- stained histological slides; and syndecan-1 expression was eval- matory cell infiltrates, the possible contribution of mast cells uated in 3-␮m histological sections labeled by a monoclonal (MCs) to angiogenesis and tumor development has progressively antibody using the peroxidase technique. Results: syndecan-1 been emerging. It has been proposed that angiogenesis is an was mostly expressed on the cells resembling stellate reticulum important key for development, treatment and follow-up of pa- and stromal cells from the fibrous capsule, especially in solid tients with lymphoproliferative disorders. The aim of the current variants. study was comparatively to analyze the microvessel density and Conclusion: syndecan-1 expression in ghost-cell containing microvessel area measured through the immunoexpression of odontogenic tumors was more evident in solid than cystic tumors/ CD31, CD34, CD105, D2-40, FVIII, and VEGF and the MCs regions, suggesting that this molecule can play a role in their density measured through the immunoexpression of tryptase in morphological pattern and, possibly, in their biological behavior. primary nodal classical HL (nϭ8) with primary oral diffuse large B-cell lymphoma (DLBCL) presenting Hodgkin/Reed-Sternberg ORAL VERRUCIFORM XANTHOMA: A CASE REPORT (HRS)-like cells (nϭ7). The differential expression and distribu- AND LITERATURE REVIEW Rodrigues BCS1, Andrade CR2, tion patterns of the immunomarkers in relation to pathophysiol- Spolidório LC2, Navarro CM3, Sousa SCOM4, Marques ogy are analyzed and discussed in detail, especially aimed at YMFS2 - 1UNIVERSIDADE ESTADUAL PAULISTA - recognizing of patterns that may eventually be used for prognos- UNESP (FOAR) - DIAGNÓSTICO E CIRURGIA, 2UNIVER- tic purposes. SIDADE ESTADUAL PAULISTA - UNESP (FOAR) - FISIO- LOGIA E PATOLOGIA, 3UNIVERSIDAE ESTADUAL CORE NEEDLE BIOPSY FOR THE DIAGNOSIS OF PLEO- PAULISTA - UNESP (FOAR) - DIAGNÓSTICO E CIRUR- 1 2 MORPHIC ADENOMA Wagner VP , Costa DML , Amaral GIA, 4UNIVERSIDADE DE SÃO PAULO - USP (FOUSP) - 2 3 4 5 FB , Martins MAT , Domingues M , Maciel AC , Munerato PATOLOGIA ORAL 3 1 2 MC - UFRGS, HOSPITAL DE CLÍNICAS DE PORTO Oral verruciform xanthoma represents a rare entity, which ALEGRE - SERVIÇO DE OTORRINOLARINGOLOGIA, affects mainly oral mucosa. A 73-years-old woman presented an 3 HOSPITAL DE CLÍNICAS DE PORTO ALEGRE - asymptomatic soft tissue mass on the tongue. Physical examina- 4 SERVIÇO DE ESTOMATOLOGIA, UNIVERSIDADE FED- tion of oral mucosa revealed a well-circumscribed, sessile nodule ERAL DO RIO GRANDE DO SUL - PATOLOGIA BUCAL, with a fibrous consistency and whitish verrucous surface fixed to 5HOSPITAL DE CLÍNICAS DE PORTO ALEGRE - the lateral edge of the tongue. These findings were suggestive of SERVIÇO DE RADIOLOGIA verruca vulgaris. Histopathological examination revealed a par- Pleomorphic adenoma is the most prevalent benign salivary tial parakeratosis with uniform elongated epithelial ridges, para- gland tumor, and it occurs most commonly in parotid or subman- keratin plugs and exocytosis. The connective tissue was com- dibular glands. It may arise, infrequently, from the minor salivary posed by uniform papillae filled by large vacuolated foam. The glands. We received in our Stomatology department a 60-years Periodic Acid-Shiff reaction exhibited positivity on granules in- old, female patient refereeing a painless swelling on palate for 9 side the foam cells and immunohistochemical reaction to CD-68 months. Clinical examination revealed a firm swelling, on the antibody revealed a strong and uniform staining of all the sub- right side of soft palate covered with normal mucosa. A tomog- epithelial foamy macrophages. These findings were consistent raphy was requested and showed an expansive lesion on the right with the diagnosis of verruciform xanthoma. The differential side of soft palate, determining the compression and displace- diagnosis usually includes lesions with similar characteristics ment to the left of part of the rinofaringe and orofaringe. An especially the rough surface, such as squamous papilloma, ver- incisional biopsy was performed and the diagnosis was inconclu- ruga vulgaris, verrucous leukoplakia and verrucous carcinoma. sive. A core needle biopsy was performed hoping to obtain a Financial support: Univ Estadual Paulista, Fundunesp (00472/12- sample of tissue from a deeper part of the lesion. Histopatholog- DFP) ical analysis revealed a pleomorphic adenoma. The patient was referred to the head and neck medical service and the entire INTRAOSSEOUS VERRUCOUS CARCINOMA ARISING tumor was excised. FROM AN INFECTED DENTIGEROUS CYST – A CASE REPORT Huang YF1,2, Lee YH2,YuCH2,1 - 1COLLEGE OF SYNDECAN-1 IMMUNOHISTOCHEMICAL EXPRES- ORAL MEDICINE, CHUNG SHAN MEDICAL UNIVERSITY SION IN GHOST CELL-CONTAINING ODONTOGENIC - DEPARTMENT OF DENTISTRY, 2CENTER OF ORAL TUMORS Silva WG1, Santos TCRB1, Cabral MG2, Pires FR1 MEDICINE, CHUNG SHAN MEDICAL UNIVERSITY HOS- - 1STATE UNIVERSITY OF RIO DE JANEIRO - SCHOOL PITAL - DIV. OF ORAL PATHOLOGY AND DIAGNOSIS 2 OF DENTISTRY, ORAL PATHOLOGY, FEDERAL UNI- Intraosseous verrucous carcinoma arising from an odonto- VERSITY OF RIO DE JANEIRO - SCHOOL OF DEN- genic cyst is extremely rare. Only 3 cases have been reported in TISTRY, ORAL PATHOLOGY the English literature up to date. In this article, we presented an Background: Ghost cell-containing odontogenic tumors intraosseous verrucous carcinoma arising from an infected den- share some common histological characteristics but can show tigerous cyst in a 74-year-old male patient. The patient presented different biological behavior. with a left mandibular swelling with recurrent pus discharge from Objective: as cell adhesion is a major step in neoplastic the lingual gingiva of tooth #35. Although antibiotic medication process in several tumors, the aim of this study was to evaluate was given to the patient, the swelling persisted. The patient the profile of syndecan-1 expression in ghost cell-containing finally visited our hospital for treatment. The mandibular occlusal odontogenic neoplasms. radiograph revealed a prominent lingual cortical plate expansion Study design: clinical data were retrieved from the patient’s from tooth #33 to #35. Panoramic radiography demonstrated an records; microscopic analysis was performed in 5-␮m HE- impacted tooth #34 with a large well-defined, radiolucent lesion OOOO ORAL ABSTRACT Volume 114, Number 4 Abstracts e137 surrounding the crown of tooth #34. The clinical diagnosis was Objective: Several studies have demonstrated that HNSCCs an infected dentigerous cyst. Surgical excision of the cyst to- show a heterogeneous cell population, which exhibits different gether with extraction of the impacted tooth #34 was performed. patterns of proliferation, invasion, and metastasis. Here, we Histopathological examination of the surgical specimen showed sought to study the influence of histone acetylation over the proliferation of hyperparakeratotic stratified squamous cyst lining invasion behavior of HNSCCs and its effect over the cancer stem epithelium and down-growth of broad and bulbous epithelial cells-like population. ridges with pushing border invasion into the fibrous cystic wall. Study design: HNSCC cell lines (HN6 and HN13) were A verrucous carcinoma arising from an infected dentigerous cyst treated with Trichostatin A (TSA), and further analyzed for the was diagnosed. The patient recovered uneventfully after surgery. activity levels of the progenitor cell markers Aldehy dehydroge- Mandibular occlusal and panoramic radiographies showed a nase (ALDH), invasion ability, and orospheres formation. well-healed surgical bone defect and no recurrence of the tumor Results: HN6 and HN13 showed decrease of ALDH levels 5 months after surgery. Although the pathogenesis of intraosse- upon TSA treatment followed by increased invasiveness. TSA ous squamous cell or verrucous carcinoma is still unknown, we treatment also resulted in progressive disruption of the orosphere suggest that it may arise from the lining epithelium of an odon- from HN6 and HN13 cells. togenic cyst after long-term stimulation from a chronic inflam- Conclusion: This study demonstrates the presence of cancer matory process induced by repeated infections. stem cells-like cells among the HNSCC cell lines. In addition, the mechanisms involved in chromatin acetylation can interfere with the aggressiveness behavior and cancer stem cell content. BRCA/FA AND NF⌲B SIGNALING: MECHANISMS OF CHROMATIN REMODELING AND CHEMICAL RESISTANCE Almeida LO1,2, Abrahao AC3, Kauer LR1, Zagni PERIOSTIN: A NOVEL PROTEIN FOUND DEREGULATED C1, Leopoldino AM3, Squarize CH1, Castilho RM1 - 1 LABO- IN HNSCC ENHANCES KERATINOCYTE MIGRATION ME- RATORY OF EPITHELIAL BIOLOGY, DEPARTMENT OF DIATED BY THE MTOR SIGNALING PATHWAY Rosselli- PERIODONTICS AND ORAL MEDICINE, UNIVERSITY OF Murai LK1, Galindo P1,3, Almeida LO1,2, Zagni C1, Squarize MICHIGAN SCHOOL OF DENTISTRY, ANN ARBOR, MI, CH1, Castilho RM1 - 1 Laboratory of Epithelial Biology, USA; 2 DEPARTMENT OF CLINICAL ANALYSIS, TOXICOL- Department of Periodontics and Oral Medicine, University of OGY AND BROMATOLOGY, SCHOOL OF PHARMACY, Michigan School of Dentistry, Ann Arbor, MI, USA; 2 De- UNIVERSITY OF SAO PAULO, RIBEIRAO PRETO, SP, BRA- partment of Clinical Analysis, Toxicology and Bromatology, ZIL; 3 DEPARTMENT OF PATHOLOGY AND ORAL DIAG- School of Pharmacy, University of Sao Paulo, Ribeirao Preto, NOSIS, FEDERAL UNIVERSITY OF RIO DE JANEIRO SP, Brazil; 3 Department Oral Surgery and Implant Den- SCHOOL OF DENTISTRY, RIO DE JANEIRO, RJ, BRAZIL tistry, University of Granada School of Dentistry, Granada, Objective: Many genomic instability pathways like the FA/ Spain BRCA are characterized by a defective DNA repair system as Objective: In this work, we focused on periostin, a secreted observed in HNSCC. Here, we sought to study the correlation extracellular matrix protein found to be overexpressed in HN- between the FA/BRCA pathway and the NF␬B signaling in SCC, in which its molecular signaling remains unknown. HNSCC chemoresistance. Study design: Normal oral keratinocytes (NOK-SI) were Study design: Microarrays were used to identify changes of used to study the effects of periostin over cellular migration, the FA/BRCA and NF␬B pathways in HNSCC. Further, modu- proliferation, and viability. Following we explored the involve- lation of the NF␬B pathway was mediated by TNF-␣ and siRNA ment of the PI3K signaling pathway in the periostin driven for I␬B kinase (IKKs). phenotype. Results: We found that downregulation of BRCA1, Results: We found that recombinant periostin accelerates FANCA, FANCC genes are associated to increased activity of cell migration, in addition to increase cellular viability and pro- NF␬B and chemoresistance to cisplatin. Interestingly, cisplatin liferation determined by MTS assay. Furthermore, activation of resistance was associated to chromatin deacetylation evident by periostin, by the administration of recombinant periostin in the acetyl-histone H3 levels. Interfering with the NF␬B pathway culture media, resulted in the activation of the mTOR pathway using siRNA resulted in chromatin acetylation, upregulation of demonstrating a potential interaction between expression of BRCA1, and sensitization of the HNSCC. periostin and the Pi3K/mTOR pathway. Conclusion: These findings indicate that disruption of FA Conclusion: These findings indicate that the periostin/ signaling components, often found in HNSCC, is associated to mTOR axis is suitable target for therapeutic intervention aiming NF␬B upregulation followed by chromatin deacetylation and HNSCC. chemotherapy resistance. GENETICALLY DEFINED AND ORAL SPECIFIC ANIMAL CHANGES IN THE CHROMATIN ORGANIZATION MODEL FOR HNSCC Squarize CH1,2, Castilho RM1,2, DIRECTLY IMPACTS THE POPULATION OF CANCER Abrahao AC4, Molinolo A2, Lingen MW3, Gutkind JS2 - STEM CELLS IN HNSCC Giudice FS1,2, Pinto Jr DS2, 1LABORATORY OF EPITHELIAL BIOLOGY, DEPART- Squarize CH1, Castilho RM1 - 1 LABORATORY OF EPITHE- MENT OF PERIODONTICS AND ORAL MEDICINE, UNI- LIAL BIOLOGY, DEPARTMENT OF PERIODONTICS AND VERSITY OF MICHIGAN, ANN ARBOR, MI, USA; 2OPCB, ORAL MEDICINE, UNIVERSITY OF MICHIGAN SCHOOL NATIONAL INSTITUTE OF DENTAL AND CRANIOFA- OF DENTISTRY, ANN ARBOR, MI. USA; 2 DEPARTMENT CIAL RESEARCH, NATIONAL INSTITUTES OF HEALTH, OF ORAL PATHOLOGY, DENTAL SCHOOL, UNIVERSITY BETHESDA, MD, USA; 3DEPARTMENTS OF PATHOL- OF SÃO PAULO, SÃO PAULO, SP, BRAZIL OGY, THE UNIVERSITY OF CHICAGO, CHICAGO, IL, ORAL MEDICINE OOOO e138 Abstracts October 2012

USA; 4DEPARTMENT OF PATHOLOGY AND ORAL DIAG- cells (mucosa and tongue). Conditional knockout mice and con- NOSIS, FEDERAL UNIVERSITY OF RIO DE JANEIRO trols were exposed to a tobacco surrogate 4NQO (4-nitroquino- SCHOOL OF DENTISTRY, RIO DE JANEIRO, RJ, BRAZIL line-1 oxide). Objective: Tumor suppressor PTEN and PI3K oncogene are Results: Detailed in vivo and histological analysis revealed deregulated and mutated in head and neck squamous cell carci- tumor formation upon PTEN deletion/PI3K activation when as- noma (HNSCC). Here we investigate the in vivo role of PI3K/ sociated to 4NQO. HNSCC tumors formed in the lateral border PTEN deregulation in HNSCC tumor development and progres- and ventral part of the tongue, along the floor of the mouth. sion. Conclusion: Our unique animal model combines genetic al- Study design: A oral specific HNSCC animal model were terations and risk factor/carcinogen (tobacco exposure/4NQO) that developed using the k14 promoter-Cre recombinant system, in together lead to the development and progression of HNSCC reca- which Pten was deleted and Pi3k was activated in oral epithelial pitulating the biology and anatomical sites of human HNSCC.