Hébel Cavalcanti Galvão

This retrospective study aims to investigate the prevalence and the clinicopathological characteristics of oral thrombus (OT) in a Brazilian population. Sociodemographic and clinical data were obtained from biopsy records, and histological sections were reviewed for all cases diagnosed as OT at a referral center for Oral Pathology (1967–2024). The fibrin content of the specimens was evaluated using scores, and the thrombus surface area was determined by morphometric analysis. The data collected were submitted to descriptive analysis, and Mann–Whitney, Kruskal–Wallis, Pearson's chi-square, Fisher's tests, and Spearman's correlation tests were applied ( p ≤ 0.05). OT accounted for 0.16% ( n = 33) of all lesions diagnosed at the center. There was a slight predominance of female patients (51.5%), and the most affected site was the lower lip (33.3%). Clinically, the lesions typically presented as nodules (90.6%), and histopathologically, a balanced mixture of red blood cells and fibrin was predominant (51.5%). In addition, the thrombi area was significantly associated with the histological evolution phase ( p = 0.019) and showed a positive correlation with fibrin concentration ( p = 0.026). Understanding the clinicopathological features of OT is crucial for improving the identification of this rare condition's profile. This understanding enables dental clinicians to make an early and accurate differential diagnosis, implement appropriate management of these lesions, and improve their patients' prognosis.

Aim: Secretory carcinoma (SC), also known as mammary analogue secretory carcinoma, is a rare malignant neoplasm of the salivary glands, named for its histological and molecular resemblance to mammary secretory carcinoma. The aim of this study is to present a new case of SC occurring in the lower lip, initially diagnosed as a mucocele, and to provide a comprehensive review of reported cases in minor salivary glands. Materials and Methods: A 40‐year‐old woman presented with a nodular lesion of the lower lip clinically diagnosed as a mucocele. An excisional biopsy was performed, and histopathological and immunohistochemical analyses confirmed the diagnosis of SC. The patient was referred to an oncology referral centre for therapeutic planning. In addition, a literature review was performed. Results: Identifying 55 articles published between 2010 and 2025 and documenting 96 cases of SC in minor salivary glands. SC showed a slight female predominance (48.9%, n = 47), with a mean age of 46.27 ± 17.47 years, and most commonly affected the lip (34.3%, n = 33). Local recurrence (44.7%, n = 43) and metastasis (41.6%, n = 40) were infrequently reported, and most patients remained alive without evidence of disease at follow‐up (55.2%, n = 53). Conclusion: SC is a rare malignant tumour with overlapping clinical and histological features that may mimic other soft tissue lesions. This case, combined with data from the literature, highlights the importance of considering SC in the differential diagnosis of nodular lesions of the oral mucosa and emphasises the need for accurate diagnosis and long‐term follow‐up.

The SHH signaling regulates cell proliferation in the ectomesenchyme, thus controlling tooth morphogenesis, while TGF-ß and bone morphogenetic proteins (BMPs) have been associated with reactionary and reparative dentinogenesis. The aim of this study was to investigate the role of signaling proteins in odontogenesis and odontoma formation. In this retrospective cross-sectional study, we analyzed the immunohistochemical expression of TGF-ß, BMP4, and SHH pathway proteins in 23 compound odontomas, 21 complex odontomas, and 17 tooth germs. The results demonstrated immunoexpression of BMP4, especially in the ectomesenchyme of complex odontomas (median=33.7; P P P =0.029). Similarly, TGF-ß exhibited higher immunoexpression in the epithelium of tooth germs ( P P =0.002). SHH was more immunoexpressed in the ectomesenchyme of odontomas and in the inner enamel epithelium of tooth germs. Furthermore, SHH and BMP4 were significantly correlated. In developing teeth, the highest concentrations of these proteins were found in the odontogenic epithelium during the bud and cap stages. Differential expression occurred mainly in the ectomesenchyme of tumors, indicating that this component is indeed more proliferative.

This study aimed to investigate the clinicopathological characteristics of thrombi in the oral and maxillofacial region. A cross-sectional study was conducted in nine reference centers for oral and maxillofacial pathology diagnosis in Brazil, from which biopsy records were obtained. The data were analyzed descriptively. A total of 93,036 biopsies from the oral and maxillofacial region were evaluated, 187 (0.2%) of which were diagnosed as thrombi. The highest occurrence was in females, with a mean age of 52.4 ± 17.7 years. The lip was the most frequently affected anatomical location. A clinical diagnostic hypothesis of thrombus was considered in 4.2% of cases. Oral thrombi were uncommon lesions in the studied population, with a higher occurrence among females in the seventh decade of life. This study provides a clinicopathological profile of oral and maxillofacial thrombi and offers information that may assist clinicians in establishing a diagnosis.

Background: The identification of molecular markers that could be involved in the pathogenesis of fibro-osseous lesions of the jaws may help to understand the different biological behaviors of such group. Aims: The aim of the present study was to compare the immunohistochemical expression levels of Cripto-1 (CR-1) in a series of cases diagnosed microscopically as benign or malignant bone tumors to see if it can help in distinguishing them. Place and Duration of Study: Brazil, Department of Dentistry of Federal University of Rio Grande do Norte, between January 2020 and July 2023. Methodology: Thirty fibrous dysplasias (FD), twenty-eight central ossifying fibromas (COF) and five osteosarcomas (OS) were randomly selected and submitted to immunohistochemical analysis using anti-CR-1 antibody, according to the percentage of immunopositive cells, immunostaining intensity and final immunoreactive score. Results: Analysis of the percentage of cells immunostained for CR-1 revealed a predominance of score 4 for COFs and OSs, whereas most cases of FDs exhibited score 2 (p <0.001). With respect to the immunostaining intensity for CR-1, a higher prevalence of score 3 was observed for COFs and OSs, while most cases of FD showed score 1 (p <0.001). Regarding the final immunoreactive score, a predominance of a strongly positive pattern was identified in COFs and OSs, while a moderate pattern was verified in FDs (p <0.001). Conclusion: Our findings suggest the participation of CR-1 in the pathogenesis of COFs and OSs, as well as the use of this protein as a potential molecular biomarker for clinical investigation, differential diagnosis between COFs and FDs, and, subsequently, for the indication of the appropriate therapy for these lesions. These findings contribute to the diagnosis of fibro-osseous jaw lesions and may guide clinical decision-making.

Purpose Measure associations between clinicopathological and immunohistochemical human Mut-L homologue 1 (hMLH1) gene, and human Mut-L homologue 2 (hMSH2) genes, variables in recurrent AMBs. Methods This study consisted of a research retrospective, observational case-control study consisting of 22 cases of recurrent AMB and 22 non-recurrent cases. Cases of AMB with more than one year of follow-up were included in the study. Quantitative immunohistochemical analysis was performed considering the cellular location (nuclear) of the proteins studied. The McNemar test was used to compare variables between primary and recurrent AMBs. Recurrence-free survival was analyzed by the Kaplan-Meier method and survival functions were compared according to the variables using the log-rank test. Results The posterior mandible was the most affected site in the recurrent (n = 18, 81.8%) and non-recurrent groups (n = 16, 72.8%). Recurrence-free survival was 50.0 (34.5–63.6) months. The following factors were significantly associated with AMB recurrence: presence of cortical bone expansion (p = 0.01), absence of bone reconstruction (p = 0.02), conservative treatment (p = 0.02), loss of hMSH2 (p = 0.01) and hMLH1 (p = 0.04) immunoexpression, and strong Ki-67 immunoexpression (p = 0.03). The risk factors for AMB recurrence were anatomical location (OR = 3.31), locularity (OR = 1.07), cortical expansion (OR = 6.17), cortical perforation (OR = 2.10), bone resorption (OR = 1.52), tooth impaction (OR = 1.86), jaw reconstruction (OR = 6.92), and immunoexpression of hMSH2 (OR = 10.0) and hMLH1 (OR = 4.50). Conclusion Radiographic appearance, treatment modality, and immunoexpression of mismatch repair proteins can be used as predictors of AMB recurrence.

This study aimed to detect, quantify and compare the immunohistochemical expression of EGFR and VEGF and microvessel count (MVC) in oral lipomas, and to correlate the findings with clinical and morphological characteristics of the cases studied. The sample consisted of 54 oral lipomas (33 classic and 21 non-classic) and 23 normal adipose tissue specimens. Cytoplasmic and/or nuclear immunohistochemical staining of EGFR and VEGF was analyzed. The angiogenic index was determined by MVC. Cells were counted using the Image J® software. The Statistical Package for the Social Sciences was used for data analysis, adopting a level of significance of 5% for all statistical tests. A statistically significant difference in EGFR immunoexpression (p=0.047), especially, between classic lipomas and normal adipose tissue. There was a significant difference in MVC between non-classic lipomas and normal adipose tissue (p=0.022). In non-classic lipomas, only VEGF immunoexpression showed a significant moderate positive correlation (r=0.607, p=0.01) with MVC. In classic lipomas, the number of EGFR-immunostained adipocytes was directly proportional to the number of VEGF-positive cells, demonstrating a significant moderate positive correlation (r=0.566, p=0.005). The results suggest that EGFR, VEGF, and angiogenesis participate in the development of oral lipomas but are not primarily involved in the growth of these tumors.

Tooth development depends on a series of reciprocal signaling interactions between the oral epithelium and ectomesenchyme. This study aimed to investigate the role of CK14, a protein involved in Wnt-1/β-catenin signaling, in odontogenesis and the development of odontomas. This cross-sectional, retrospective, immunohistochemical study analyzed 30 compound odontomas, 30 complex odontomas, and 17 tooth germs. Higher immunoexpression of CK14 was observed in odontogenic epithelial cells of tooth germs (p < 0.001) and odontogenic epithelial cells of odontomas (p < 0.001). There was higher immunoexpression of Wnt-1 and β-catenin proteins in epithelial cells of tooth germs (p = 0.002 and p < 0.001, respectively), as well as in the ectomesenchyme of odontomas (p = 0.003 and p < 0.001, respectively). β-Catenin was moderately and significantly correlated with CK14 in the membrane of reduced enamel epithelial cells in odontomas (p = 0.007). Higher immunoexpression of CK14 was observed in the odontogenic epithelium during the bud and cap stages and lower immunoexpression in the internal enamel epithelium during the bell stage. In odontomas, lower expression of Wnt-1/β-catenin and higher immunoexpression of CK14 were found in odontogenic epithelial cells, especially adjacent to the mineralized material resembling the tooth formed in these lesions.

Introduction Odontogenic cysts are a heterogeneous group of lesions with varied clinical behavior. Objective To analyze the expression of the epidermal growth factor receptor (EGFR), Cyclin D1, and transcription factor SOX2 in the odontogenic epithelium evaluating the cell cycle control and cystic expansion. Methods This was a cross-sectional study including 40 cases, 20 odontogenic keratocysts (OKC), 10 botryoid odontogenic cysts (BOC), and 10 glandular odontogenic cysts (GOC). Results All cases of OKC, BOC, and GOC were positive for EGFR in all layers of the cyst lining. The highest expression of nuclear Cyclin D1 was observed in the suprabasal layer of OKCs and in the basal and suprabasal layers of GOC and BOC (p < 0.001). In addition, SOX2 was only expressed in the suprabasal layer of OKCs. Conclusion The high expression of EGFR in the cyst membrane suggests that EGF stimulates epithelial proliferation in BOCs, and the high expression of SOX2 in OKCs may be related to the presence of stem cells in the lesion. Cyclin D1 is related to cell cycle disruption in G1-S contributing to stimulates epithelial proliferation of OKCs and GOCs and BOCs.

Autops Case Rep, vol.12, e2021360, 2022