Anderson Tangerino Ferreira da Silva

Introduction Mesenchymal chondrosarcoma (MC) is a rare neoplasm representing about 3% of all chondrosarcomas and 0.1% of all head and neck cancers. To date, about 94 MCs affecting the jaws have been reported. Of them, 28 cases affected pediatric patients, which appear to have a favorable prognosis. Herein, we report an additional maxillary MC. Case Description: A 9-year-old boy was referred presenting an asymptomatic and expansive mass in the left maxilla with six months of evolution. CT scans revealed an expansile osteolytic lesion with granular irregularly shaped calcifications invading the nasal and orbital cavity and infiltrating the maxillary sinus with destruction of its posterolateral wall. Microscopic examination revealed dense sheets of small to medium-sized, poorly differentiated round cells arranged in hemangioperycitoma-like vascular pattern surrounded by nodules of mature cartilage. Immunopositivity for vimentin, S100, and CD99 were observed. Diagnosis and Treatment: The final diagnosis was MC. After neoadjuvant chemotherapy, partial maxillectomy was performed. Currently, with 13 years of follow-up, the patient remains well, with no evidence of recurrence or metastasis. Conclusion The current case emphasizes that MC affecting pediatric patients with maxillary location appears to be associated with an indolent course and favorable prognosis.

Background Necrotizing sialometaplasia (NSM) is a rare self-limiting inflammatory lesion, with most cases affecting the minor salivary glands, especially those located in the palate (70%). To date, about 261 cases of NSM have been reported. Of them, 7 cases affected the tongue; 37 cases occurred after surgery; and 17 cases showed association with neoplasms. Methods A 50-year-old male patient was diagnosed with squamous cell carcinoma (SCC) of the tongue. After surgical excision, the tumor diagnosis was well-differentiated SCC with a close surgical margin. Re-excision of the margin was indicated. Results Microscopically, the surgical margin showed neither residual SCC nor epithelial dysplasia. However, it was possible to observe 7 foci containing typical areas of NSM distributed throughout the surgical specimen, which, by immunohistochemistry, revealed a glandular nature with presence of myoepithelial cells. Conclusion We present here an unusual multifocal NSM affecting the tongue at the site of a prior resection for SCC with close margins, which, to the best of our knowledge, has not been reported to date.

Several cases of elastofibromatous lesion affecting the oral mucosa have been reported. Clinically, these lesions may appear as small exophytic lesions or less often as white lesions. Therefore, fibrous hyperplasia and leukoplakia are not uncommonly considered in clinical differential diagnosis. Microscopically, elastic and fibrous connective tissue deposition is seen. Rarely, elastofibromatous changes can be detected when assessing intraoral lesions, including cysts, salivary gland neoplasms, and epithelial dysplasia. Here we report two oral lesions showing elastofibromatous changes, expanding their clinicopathological spectrum. The first case was a 46-year-old man with a history of asymptomatic nodular lesion on the palate 1 year ago, diagnosed as giant cell fibroma with elastofibromatous changes. The second case was a 79-year-old woman who presented a pigmented and mildly symptomatic lesion on the mandibular alveolar mucosa several months ago, diagnosed as amalgam tattoo associated with elastofibromatous changes.