Elastofibromatous Lesion in The Oral Mucosa

ORAL AND MAXILLOFACIAL PATHOLOGY e154 Abstracts multidisciplinary treatment were done. The patient underwent plastic surgery and is still being followed up. Odontogenic neoplasms composed of predominantly clear cells are quite unusual and represent a diagnostic challenge. PE-111 - DIFFUSE LARGE B CELL NON-HODGKIN LYMPHOMA: A RARE CASE IN LOWER LIP. ITALO CORDEIRO DE TOLEDO, ALEXANDRE BELLOTTI, ENEIDA FRANCO VENCIO, REJANE FARIA RIBEIROROTTA. UNIVERSIDADE FEDERAL DE GOIÁS. Lymphoma of mucosa-associated lymphoid tissue (MALT) is classified by the World Health Organization as B-cell lymphoma of extranodal marginal zone MALT. Most of these nonHodgkin’s lymphomas (NHL) occur in adults and are rare in the mouth. The asymptomatic insidious course impairs early detection. A case report presented the clinical features and diagnosis process of a lower lip NHL. Woman, 68, reported good general health but complained about a lump in her lower lip that had developed over a 1-month period. The nodular lesion was painless, firm to palpation, and covered by normal mucosa. The clinical hypothesis was pleomorphic adenoma. The histopathological report and immunohistochemical panel established the final diagnosis of diffuse large B-cell NHL of a minor salivary gland. The patient underwent eight chemotherapy cycles within 6 months and had a positive clinical response. She is being followed-up by a multidisciplinary team. PE-112 - DISPLACEMENT OF DENTAL IMPLANT INTO THE FOCAL OSTEOPOROTIC BONE MARROW DEFECT. AGNES ASSAO CARVALHO, MÁRCIA MARIA DALMOLIN BARROS, FRANCISCO BÁRBARA ABREU GARCIA, NATÁLIA GALVÃO OLIVEIRA, DENISE TOSTES. UNIVERSIADE DE SÃO PAULO - FACULDADE DE ODONTOLOGIA DE BAURU. Focal osteoporotic bone marrow defects of the jaws are asymptomatic radiolucent lesions that occur predominantly in the molar region of middle-aged women. Woman, 83, was referred to a private clinic for an implant rehabilitation treatment. Radiographically, a radiolucent area around the implant in the molar region was observed. A biopsy specimen underwent histopathological analysis, which revealed hematopoietic bone marrow characterized by granulocytes, monocytes, and lymphocytes. In addition, megakaryocytes, erythrocytes, fat cells, and irregular fragments of bone tissue were also detected. Based on clinical, radiographic, and microscopical features, the definitive diagnosis was focal osteoporotic bone marrow. According to the etiopathogenesis of focal osteoporotic bone marrow defect, previous trauma could induce deficiencies in bone repair. In this case, it is probably related to tooth extraction or implant placement. PE-113 - DOUBLE LIP WITH BLEPHAROCHALASIS: CASE REPORT OF A PATIENT WITH ASCHER’S SYNDROME. GUSTAVO EIDT, LEO KRAETHER NETO, MICHELE GASSEN KELLERMANN. UNIVERSIDADE DE SANTA CRUZ DO SULeUNISC. This case report documents the diagnosis and treatment of a patient with Ascher’s syndrome. Double lip, blepharochalasis, and nontoxic thyroid enlargement are the triad found in this entity. Young man, 16, complained about his upper lip. The double lip condition was most obvious when he laughed. The patient also presented bilateral blepharochalasis on his upper eyelids. The OOOO February 2014 third sign of the syndrome, thyroid gland enlargement, is not constant and was not present in this case. Despite of the absence of functional problems, the double lip condition was treated because of its disfiguring effect on smiling. Treatment consisted of simple excision using an electric scalpel and wound closure by primary sutures. Wound repair was uneventful. Both the young patient and his parents were content with the outcome of surgery and decided to have the eyelids corrected at a later date. PE-114 - ECTODERMAL DYSPLASIA: LITERATURE REVIEW AND CASE REPORT. ANTONIONE SANTOS BEZERRA PINTO, MOARA E SILVA CONCEIÇÃO PINTO. FATECI. The current report reviews the literature addressing the clinical, genetic, diagnostic, treatment, radiographic, and histopathological features of hypohidrotic ectodermal dysplasia and documents a patient with this disease. Ectodermal dysplasia is one of a rare group of related changes characterized by aplasia of ectodermal tissues such as hair, nails, teeth, and skin. The dentist should be aware of this condition to ensure a correct choice of treatment. Diagnosis is based on a thorough medical history and additional tests as indicated. PE-115 - ECTOPIC TOOTH ANKYLOSED IN THE LATERAL BONE WALL OF THE MAXILLARY SINUS. LILIAN CALDAS QUIRINO, LUIS EDUARDO PAGOTTO, DÉCIO DOS SANTOS PINTO JÚNIOR, FÁBIO DAUMAS NUNES, JULIANA SEO, JOÃO AGUSTO COLOMBINI. FACULDADE DE ODONTOLOGIA USP. Ectopic teeth erupting in the maxillary sinus are rarely reported. Woman, 38, demonstrated radiographic evidence of ectopic tooth in the right maxillary sinus that had been growing for 8 years. Radiographic examination showed a radiopaque mass linked to the lateral wall of the maxillary sinus in intimate contact with the third molar’s root but causing no sinus pathology or obstruction. Surgical management via Caldwell-Luc access was performed under general anesthesia. The ectopic third molar with the calcified mass was easily removed from the bone wall with a chisel. Histopathological examination showed dental tissue fragment displaying mostly dentinal tissue, basophilic line adjacent to the root, bone tissue, and amorphous eosinophilic mineralized mass. The patient is being followed-up. The causes of eruption of a tooth into the maxillary sinus are unclear, but several hypotheses are offered in the literature, such as developmental disturbances (cleft palate), trauma, cyst, infection, genetic factors, and dense bone. PE-116 - ELASTOFIBROMATOUS LESION IN THE ORAL MUCOSA. ANA TEREZINHA MARQUES MESQUITA, MAURÍCIO DA ROCHA DOURADO, PRISCILLA BARBOSA DINIZ, JOÃO LUIZ DE MIRANDA, ESMERALDA MARIA DA SILVEIRA, JORGE ESQUICHE LEÓN. UNIVERSIDADE FEDERAL DOS VALES DO JEQUITINHONHA E MUCURI. Elastofibromas are tumor-like lesions composed of elastic and fibrous connective tissue and often associated with local trauma. Although solar elastosis is routinely seen in actinic cheilitis cases, intraoral trauma-induced elastosis, usually referred as elastofibromatous lesions, is rarely reported. Woman, 63, was referred for management of a lesion located in the right buccal mucosa that had been detected during routine oral examination. The patient reported no local trauma or prior surgery. Intraoral examination disclosed a whitish-translucent plaque. Histopathological examination revealed epithelial hyperplasia and OOOO Volume 117, Number 2 connective tissue composed of scattered strands of irregular, amphophilic fibers of variable size, thickness, and shape. Histochemical analysis confirmed the presence of elastic fibers admixed with collagenous fibers, consistent with oral elastofibromatous lesion. The patient is being followed-up with no signs of local recurrence. PE-117 - ENCEPHALOTRIGEMINAL ANGIOMATOSIS: REPORT OF TWO CASES. NATHALIA DE ALMEIDA FREIRE, FLÁVIA SOUZA PEREIRA DE JESUS ALMEIDA, THAÍS PIMENTEL, SARAH APARECIDA ANTERO, MARCELO FIGUEREIDO, ROSEMIRO DE MENEZES MACIEL, MÔNICA ISRAEL. UERJ. Encephalotrigeminal angiomatosis, also known as SturgeWeber syndrome, is a congenital neurocutaneous disorder characterized by vascular malformation associated with leptomeningeal angiomas overlaid on ipsilateral cerebral cortex. Clinically there is a unilateral port-wine stain distributed over the trigeminal nerve. This study presents two case reports, both involving female patients, whose hemifacial hemangioma was diagnosed as a non-hereditary developmental condition. The purpose is detail clinicopathological features and discuss appropriate therapy. PE-118 - EPITHELIAL ISLANDS ASSOCIATED WITH MANDIBULAR NERVES IN THE SURGICAL SPECIMEN. FERNANDA DOS SANTOS MOREIRA, LUCIANA YAMAMOTO DE ALMEIDA, ALEXANDRE ELIAS TRIVELLATO, CASSIO EDVARD SVERZUT, JORGE ESQUICHE LEÓN. FACULDADE DE ODONTOLOGIA DE PIRACICABA-UNICAMP; FACULDADE DE ODONTOLOGIA DE RIBEIRÃO PRETO-FORP/USP. Perineural involvement by epithelial tissue is usually observed in malignant neoplasms, especially carcinomas. However, it can also be seen in benign neoplasms such as melanocytic nevi, capillary hemangiomas, and granular cell tumors. Intraosseous odontogenic epithelial rests of Malassez, dental lamina, and remnants of nasopalatine ductal epithelium have been found intraneurally. These may be misinterpreted as neural invasion by neoplastic epithelial cells if the cytologic details are not carefully considered. Man, 33, was diagnosed with ameloblastoma affecting the body of the mandible. Microscopic examination of the medial surgical margin showed epithelial rests adjacent to and within the nerve bundles. The histomorphologic examination of the epithelial nests was entirely consistent with odontogenic rests, excluding the possibility of compromised surgical margin by ameloblastoma. This benign occurrence may be misinterpreted microscopically as neural invasion by an odontogenic or malignant neoplasm. PE-119 - EPITHELIOID HEMANGIOMA LOCATED IN THE BUCCAL MUCOSA: CASE REPORT. MANUELA TORRES ANDION VIDAL, CLARISSA ARAÚJO GURGEL, ÁGUIDA CRISTINA GOMES HENRIQUES LEITÃO, EDUARDO ARAÚJO GONÇALVES RAMOS, FLÁVIA CALÓ DE AQUINO XAVIER, LUCIANA MARIA PEDREIRA RAMALHO, JEAN NUNES DOS SANTOS. FACULDADE DE ODONTOLOGIA DA UNIVERSIDADE FEDERAL DA BAHIA. Epithelioid hemangioma (EH) is an uncommon vasoproliferative benign neoplasm that usually occurs in middle-aged adults as multiple red nodules. Man, 52, presented a nodular lesion measuring 3 cm in the left buccal mucosa that had ABSTRACTS Abstracts e155 developed over the course of 1 year. The clinical hypothesis was lipoma. A specimen obtained through excisional biopsy showed a circumscribed lesion composed of lobules of vessels with or without perceptible or poor lumina associated with a prominent inflammatory infiltrate consisting of eosinophils, histiocytes, and chronic inflammatory cells. The endothelial cells that compose the lesion showed epithelioid morphology, with abundant eosinophilic cytoplasm. Immunohistochemical reactions were tested for CD34, factor VIII, laminin, actin, and mast cells along with histochemical staining for Weigert van Gieson factor. Vascular proliferations of soft tissues are a diverse and morphologically complex group of lesions that can cause diagnostic difficulty. This study reports an oral EH, highlighting relevant immunohistochemical features that could help distinguish EH from other neoplasms. PE-120 - EROSIVE LICHEN PLANUS: MALIGNANT POTENTIAL AND CASE REPORT. KAROLINE DE SOUZA CHINASSO TULIO, ANA PAULA RIBEIRO BRAOSI. UNIVERSIDADE POSITIVO. Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous disease of unknown etiology, whose onset and progression are influenced by many factors. Its current clinical classification comprises reticular and atrophic-erosive forms with erythematous, ulcerated, and painful areas. This study presents a clinical case of erosive OLP that illustrates its malignant potential. Man, 37, was referred to the Stomatology Center in Universidade Positivo complaining of pain and burning in the mouth. On examination, reticular and erythematous ulcerative areas were seen in the oral mucosa and gingiva. After incisional biopsy, histopathological analysis confirmed the clinical impression. Simultaneously, the dermatologist requested serological tests aiming to detect other autoimmune diseases. The lesion and pain regressed after a week of using topical/systemic corticosteroids. However, due to erosive etiology, follow-up is essential. Stomatodermatological lesions with autoimmune characteristics require rapid diagnosis and a multidisciplinary treatment approach to control the disease and symptoms. PE-121 - EROSIVE ORAL LICHEN PLANUS: DIAGNOSIS AND TREATMENT: CASE REPORT. THAÍSE GOMES E NÓBREGA, VIVIANE PALMEIRA DA SILVA, ARTUR CUNHA VASCONCELOS, FERNANDA VISIOLI, LAURA CAMPOS HILDEBRAND, MANOEL SANT’ANA FILHO, MÁRCIA GAIGER DE OLIVEIRA. UFRGS - UNIVERSIDADE FEDERAL DO RIO GRANDE DO SUL. Oral lichen planus is an autoimmune disease of unknown etiology and varying clinical manifestations. Erosive lichen planus (ELP) is more painful and debilitating than the nonerosive types and is characterized by multifocal white lines with erosive or ulcerated areas. This clinical manifestation is rarer than other types and causes diagnostic difficulty. In addition, ELP requires topical or systemic treatment for healing and pain control. Woman, 43, complained of oral lesions that compromised food intake and phonetic function. Oral examination revealed extensive, painful ulcers with reticular keratotic components in different areas of the oral mucosa. The patient had previously been diagnosed with chronic inflammation caused by dental prosthesis trauma. Incisional biopsy allowed a definitive diagnosis of ELP and proper treatment following a topical corticosteroid protocol. After 2 months, the ulcers were healed. This case report discusses better management