Carla Isabelly Rodrigues-Fernandes

The World Health Organization (WHO) periodically updates the classification of head and neck lesions, including odontogenic tumors (OT). This study aimed to report the frequency of OT diagnosed in an oral pathology unit according to the latest WHO edition and describe the classifications’ historical context. All clinicopathological records and microscopic slides of OT specimens diagnosed between 2000 and 2024 were retrieved from the files of an oral pathology unit in Brazil. Diagnoses were re-assessed, and the tumors were classified following the 5th WHO Classification of head and neck tumors. A total of 153 cases were evaluated. OT were predominant in women (80 cases; 52.3%), and the patients were mostly diagnosed in the fourth decade of life. Most of OT belonged to the epithelial group. Conventional ameloblastoma (CA) was the most prevalent tumor (68 cases; 44.4%), followed by odontoma (48 cases; 31.4%). Two cases of CA were re-classified as adenoid ameloblastoma. Systems’ classifications of OT have been based on tooth growth phase, tumor histogenesis, biological behavior, and immunohistochemical and molecular analyses. The current edition did not describe any significant changes. We verified that OT are uncommon and that further classifications will rely on specific genetic and molecular profiles.

Nodular fasciitis is a pseudosarcomatous, self-limited lesion composed of fibroblasts and myofibroblasts. Craniofacial lesions are more common in pediatric patients. This report presents a rare case of nodular fasciitis involving the face of an adult patient. A 32-year-old woman presented with a painless subcutaneous mass at the right zygomatic region, with one year of duration. The diagnostic hypotheses were epidermoid cyst and neurofibroma. An excisional biopsy was performed, and the microscopic examination exhibited an admixture of spindle-shaped cells and acellular areas associated with prominent collagen bands. No cellular atypia was observed. Immunohistochemical findings demonstrated positivity for alpha-SMA, HHF35, and beta-catenin. Tumor cells were negative for STAT6. The final diagnosis was nodular fasciitis. The patient has not presented any recurrences so far. Clinicians and pathologists must be capable to distinct nodular fasciitis and malignant tumors to avoid misdiagnosis and overtreatment.

Background: Rhabdomyosarcoma (RMS), a rare malignant tumor, frequently affects pediatric patients, with 35%–40% occurring in the head and neck. This study analyzes the clinicopathologic profile of pediatric head and neck rhabdomyosarcomas from Brazil, Guatemala, Mexico, and South Africa.Methods: We reviewed 44 cases from 10 Oral and Maxillofacial Pathology services, conducting immunohistochemical analyses of desmin, myogenin, Myo‐D1, and Ki67, with quantification via QuPath software. Cases with ≥ 50% myogenin expression were tested for fusion status using AP2β, NOS‐1, and HMGA2. Statistical analyses included the Kruskal–Wallis test for age and marker expression comparisons, Fisher's exact test for categorical variables, Spearman's rank correlation for marker relationships, and multinomial logistic regression to assess fusion status likelihood.Results: Cases were predominantly from Brazil (40.9%), followed by South Africa (27.3%), Guatemala (22.7%), and Mexico (9.1%). Two‐thirds of patients were diagnosed in their first decade with no gender predilection. Nonparameningeal sites (45.5%) were more affected than parameningeal (40.9%) and orbital sites. Microscopically, embryonal RMS (77.3%) was most common, followed by alveolar (18.2%) and spindle cell (2.3%) tumors. Immunohistochemistry revealed positivity for myogenic markers, with significant differences in myogenin expression between embryonal and alveolar RMS variants (p < 0.05). Fusion status prediction identified two potential fusion‐positive alveolar RMS cases, while all embryonal RMS and one alveolar RMS case appeared fusion‐negative. Significant correlation with positive fusion status was found only between AP2β and NOS1 (p < 0.05).Conclusion: Although there are slight clinical‐demographic variations among pediatric head and neck rhabdomyosarcomas in these regions, identifying fusion status through immunohistochemistry remains a diagnostic challenge.

Myoepithelioma is a benign salivary gland tumor. Central myoepitheliomas are very rare. The aim of this report was to describe a case of maxillary myoepithelioma. A 14-year-old female patient presented with an multilocular lesion in the anterior maxilla, with nearly 8 months of duration. The lesion was asymptomatic, and the patient’s dental history was unremarkable. The diagnostic hypothesis was an odontogenic tumor. Biopsy specimen consisted of nests of plasmacytoid cells in a myxoid stroma without duct formation. No cellular atypia or bone and cartilage formation were noted. The neoplastic cells were positive for Pan-cytokeratin, S100, CK7, and CK8. The final diagnosis was myoepithelioma. The patient was treated by surgical excision followed by bone curettage, and no signs of recurrence were found after 8 years of treatment.

Inverted ductal papilloma is an uncommon benign papillary endophytic tumor. This report aimed to present a case of inverted ductal papilloma of the oral cavity. A 54-year-old female patient presented with an asymptomatic nodular lesion on the lower lip. Time of duration was undetermined. The diagnostic hypotheses were fibrous hyperplasia and benign mesenchymal neoplasm. An excisional biopsy was performed, and microscopic examination showed an endophytic proliferation of squamous cells with the presence of microcysts, and goblet cells arranged in nest and islands. No cellular atypia was observed. The neoplastic cells were positive for CK7, and CK14. Proliferation index, demonstrated by Ki-67, was positively restricted to the basal tumor layer. The final diagnosis was oral inverted ductal papilloma. No signs of recurrence were found after surgery. Key words:Inverted papilloma, intraductal papilloma, oral papilloma.

In the modern world, cancer is a growing cause of mortality, but archeological studies have shown that it is not exclusive to modern populations. The aim of this study is to examine the epidemiologic, social, and clinicopathologic features of head and neck cancers in ancient populations. To do this, we extracted all records that described malignant lesions in the head and neck region available in the Cancer Research in Ancient Bodies Database (CRAB). The estimated age, sex, physical condition of the remains (skeletonized, mummified), anatomic location of tumors, geographic location, chronology, tumor type, and methods of tumor diagnosis were collected. One hundred and sixty-seven cases were found, mostly originating from Europe (51.5%). Most records were of adults between 35 and 49 years of age (37.7%). The most involved site was the skullcap (60.4%), and the most common malignancies were metastases to the bone (65.3%) and multiple myeloma (17.4%). No primary soft tissue malignancies were registered. The results of our study indicate that head and neck cancers were present in ancient civilizations, at least since 500,000 BCE. The available data can help to improve the current understanding of the global distribution of head and neck cancer and its multidimensional impacts on populations in the contemporary world.

Altered metabolic fingerprints of Diffuse large B-cell lymphoma, not otherwise specified (DLBCL NOS) may offer novel opportunities to identify new biomarkers and improve the understanding of its pathogenesis. This study aimed to investigate the modified metabolic pathways in extranodal, germinal center B-cell (GCB) and non-GCB DLBCL NOS from the head and neck. Formalin-fixed paraffin-embedded (FFPE) tissues from eleven DLBCL NOS classified according to Hans' algorithm using immunohistochemistry, and five normal lymphoid tissues (LT) were analyzed by high-performance liquid chromatography-mass spectrometry-based untargeted metabolomics. Partial Least Squares Discriminant Analysis showed that GCB and non-GCB DLBCL NOS have a distinct metabolomics profile, being the former more similar to normal lymphoid tissues. Metabolite pathway enrichment analysis indicated the following altered pathways: arachidonic acid, tyrosine, xenobiotics, vitamin E metabolism, and vitamin A. Our findings support that GCB and non-GCB DLBCL NOS has a distinct metabolomic profile, in which GCB possibly shares more metabolic similarities with LT than non-GCB DLBCL NOS.