Flávia Sirotheau Correa Pontes

Objectives: This study aimed to investigate the clinicopathological features of malignant odontogenic tumors (MOTs) and to provide a comprehensive characterization that enhances the current understanding of this disease group. Methods: MOTs were retrieved from six Brazilian oral pathology services between 2007 and 2025. Demographic, clinical and radiographic data were collected from the charts, and the histological H&E-stained sections were revised by two blinded pathologists; previously available immunohistochemical and molecular findings were retrieved and reviewed in selected cases and the diagnosis was established according to the 2022 World Health Organization classification. Results: A total of 53 malignant odontogenic tumors were identified, predominantly affecting the mandible (83%), with a slight male predominance (male-to-female ratio, 1.12:1) and a mean age of 41.4 years. Ameloblastic carcinoma was the most frequent subtype (58.5%), followed by clear cell odontogenic carcinoma (18.9%), ameloblastic fibrosarcoma (13.2%), primary intraosseous carcinoma (7.5%), and ghost cell odontogenic carcinoma (1.9%). Conclusions: This multicenter review summarizes the main features of malignant odontogenic tumors. Although rare, these tumors often exhibit locally aggressive behavior, highlighting the need for early diagnosis, accurate histopathological evaluation, and standardized reporting with long-term follow-up.

Lesions exhibiting characteristics of different pathologies within the same lesion, known as hybrid lesions, have been reported in the literature. The aim of this article is to report a case of a rare hybrid lesion of Peripheral giant cell granuloma (PGCG) associated with Peripheral ossifying fibroma (POF) and to discuss its clinical, imaging, and histopathological characteristics. We report the case of 49-year-old man with a lesion that presented clinical, histological and radiological characteristics of PGCG and POF. In conclusion, hybrid lesions involving PGCG and POF are rare and, although they share etiological factors, they may represent variations in the biological response of the affected tissues.

Chondrolipoma is a rare benign soft tissue neoplasm, being more common in adulthood, approximately 20% occur in the head and neck region and only 1 to 5% in the oral cavity. We present the case of a 62-year-old female patient who presented with an increase in volume in the floor of the mouth, with a five-year evolution. On clinical examination, the patient presented a painless sessile lesion with well-defined borders, located on the right side of the floor of the mouth, measuring approximately 3 cm in diameter. An excisional biopsy was performed, which revealed variable amounts of cartilaginous tissue surrounded by adipocytes arranged in lobules, confirming the diagnosis of chondrolipoma. A literature review was carried out, indicating that the most common location of chondrolipomas in the head and neck region was the tongue (46.4%), followed by the lower lip (14.3%), oropharynx (14.3%), floor of the mouth (10.7%), nasopharynx (7.1%), masseter muscle (3.6%) and sternocleidomastoid muscle (3.6%). Chondrolipomas have an undefined etiology and histogenesis, are more frequently observed in adult patients, and predominantly affect the head and neck region. The most affected areas are the tongue and lower lip, which together account for 60.7% of cases.

Oral Squamous Cell Carcinoma (OSCC) is the most common malignant tumor of the oral cavity. It can be preceded by Oral leukoplakia (OL), the most prevalent potentially malignant disorder, which presents a malignant transformation rate which varies from 1,1 to 40,8%, found most commonly in tongue lesions. Smoking is a well-established risk factor for both OL and OSCC. In this study we aimed to investigate loss of heterozygosity (LOH) as well as the frequency and patterns of the mutations in the PTEN, AKT and TP53 genes in OL and tongue squamous cell carcinoma (TSCC) samples of smokers and non-smokers patients. Tissue specimens were obtained from 73 patients: 35 cases of TSCC and 38 cases of high grade OL occurring in the lateral border of the tongue, and PTEN, AKT e TP53 gene mutations were investigated through Fluorescence In Situ Hybridization and genotyping. Differences between the genetic changes studied in the TP53, PTEN and AKT genes in smoking and non-smoking patients were detected. Changes in the TP53 gene did not occur significantly in the OL stage in either smoking or non-smoking patients, whereas changes in the PTEN gene were observed in both OL and OSCC, with a statistically significant difference between smokers and non-smokers. Furthermore, changes in the AKT gene did not occur with high frequency in either OL or carcinomas, regardless of smoking status, suggesting that disruptions in the critical PI3K pathway are primarily due to genetic changes in PTEN rather than in the AKT gene.

This study aimed to evaluate the contribution of oral and maxillofacial pathology laboratories (OMPLs) in Brazilian public universities to the diagnosis of lip, oral cavity, and oropharyngeal squamous cell carcinoma (SCC). A cross-sectional study was performed using biopsy records from a consortium of sixteen public OMPLs from all regions of Brazil (North, Northeast, Central-West, Southeast, and South). Clinical and demographic data of patients diagnosed with lip, oral cavity, and oropharyngeal SCC between 2010 and 2019 were collected from the patients’ histopathological records. Of the 120,010 oral and maxillofacial biopsies (2010-2019), 6.9% (8,321 cases) were diagnosed as lip (0.8%, 951 cases), oral cavity (4.9%, 5,971 cases), and oropharyngeal (1.2%, 1,399 cases) SCCs. Most cases were from Brazil’s Southeast (64.5%), where six of the OMPLs analyzed are located. The predominant profile of patients with lip and oral cavity SCC was Caucasian men, with a mean age over 60 years, low schooling level, and a previous history of heavy tobacco consumption. In the oropharyngeal group, the majority were non-Caucasian men, with a mean age under 60 years, had a low education level, and were former/current tobacco and alcohol users. According to data from the Brazilian National Cancer Institute, approximately 9.9% of the total lip, oral cavity, and oropharyngeal SCCs reported over the last decade in Brazil may have been diagnosed at the OMPLs included in the current study. Therefore, this data confirms the contribution of public OMPLs with respect to the important diagnostic support they provide to the oral healthcare services extended by the Brazilian Public Health System.

The aim of this study is to report an original case series of synchronous jawbone diseases. Data of patients seen over 13 years were extracted from the files of three Oral Radiology and Pathology diagnostic centers in Brazil. The clinical, radiographic, and laboratory characteristics were tabulated and analyzed by the authors; the patients were described according to lesion type. Seventy-two synchronous jawbone diseases were included in this study. Florid osseous dysplasia, Gorlin-Goltz syndrome, and cherubism were the most frequent disorders reported in this case series. In addition, the posterior mandible area was the main site of manifestation. Florid osseous dysplasia and Gorlin-Goltz syndrome represented two-thirds of our samples. With the utilization of adequate demographic, clinical, and radiologic information, it is possible to diagnose most of the synchronous lesions of jawbones. Sometimes, however, we need complementary exams, such as histopathologic and biochemical analysis or dosing of calcium, phosphorus, and alkaline phosphatase.

Purpose: To investigate and compare the demographic data, occurrence of recurrence and metastasis, and survival prognosis between ameloblastic carcinoma (AC) and metastasizing ameloblastoma (MA), based on appropriate and currently accepted eligible diagnostic criteria, in a systematic review of the literature.Methods: An electronic search was undertaken, last updated in December 2021. Eligibility criteria included publications having enough clinicopathological information to confirm the diagnosis of these tumors.Results: Seventy‐seven publications reporting 85 ACs and 43 MAs were included. Both tumors were more frequent in mandible and showed different clinical profiles regarding patients' sex and age. There was no difference in the estimated cumulative survival between patients diagnosed with these tumors. Metastases mainly affected the lungs, followed by cervical lymph nodes. The mean time between the first metastasis and the last follow‐up was higher for MA (p = 0.021). In addition, MA patients remained alive longer than AC patients after the first metastasis diagnosis (p = 0.041). Considering only the cases that metastasized, a higher ratio of AC patients died in comparison to MA patients (p = 0.003). The occurrence of recurrence was associated with a conservative primary treatment with both AC (p < 0.001) and MA tumors (p = 0.017). Multiple recurrent events were associated with conservative primary therapies with MA (p < 0.001) but not with AC (p = 0.121).Conclusion: In addition to some demographic differences, ACs that metastasize present a worse prognosis than MA. As conservative procedures are associated with multiple recurrent events, this treatment modality should be avoided for both tumors.

Objetivo: Avaliar a influência das ações realizadas pelo Programa de Educação pelo Trabalho (PET-Saúde) no trabalho e conhecimento em saúde bucal de Agentes Comunitários de Saúde (ACS). Método: Para a análise da influência do conhecimento em saúde bucal do ACS pela foi realizado estudo transversal desenvolvido em dois distritos administrativos municipais através de instrumento validado. Os dados obtidos foram analisados estatisticamente pelo SPSS. Resultados: Os ACS eram em maioria do sexo feminino com idade entre 30 a 39 anos, e renda familiar de um a três salários, a maioria residia na comunidade há mais de seis anos e atua na comunidade entre 1 e 3 anos, abrangendo cerca de 500 a 599 indivíduos na sua microárea. Observou-se que a maioria dos ACS não realiza atividade de educação em saúde bucal por não terem recebido capacitação para tal, com exceção dos ACS do distrito administrativo sob área de cobertura da Universidade Federal do Pará. Sobre o conhecimento em saúde bucal, os ACS dos distritos DAGUA e DASAC obtiveram nível moderado. Conclusões: O PET-Saúde proporcionou construção coletiva do conhecimento para os ACS retornando em mudanças positivas sobre o cuidado em saúde bucal para as comunidades. Percebeu-se maior nível de conhecimentos relacionados à saúde bucal entre os ACS do DAGUA, apesar de não ter havido grande diferença entre os distritos analisados. As atividades do PET deveriam ser incorporadas nos projetos pedagógicos, dos cursos de graduação e ter caráter de continuidade nas comunidades fortalecendo as ações de integração ensino-serviço-comunidade.