Caroline Alfaia Silva

Background: Oral metastases from lung cancer are exceedingly rare and often mimic primary oral lesions, posing significant diagnostic challenges. Case Presentation: We report a patient under oncological care for pulmonary adenocarcinoma who developed a rapidly enlarging 3‐cm mandibular gingival mass. An incisional biopsy was performed to investigate suspected malignancy. Histopathological analysis revealed a poorly differentiated, infiltrative epithelial neoplasm. Immunohistochemistry demonstrated diffuse positivity for cytokeratin (AE1/AE3) and strong nuclear expression of thyroid transcription factor‐1 (TTF‐1). Negative markers, including p63, CD45, PAX8, and S100, successfully excluded primary oral squamous cell carcinoma and other mimics, confirming metastatic pulmonary adenocarcinoma. The patient received palliative care but deteriorated rapidly. Conclusion: Metastatic lung cancer must be considered in the differential diagnosis of atypical gingival lesions. Prompt biopsy combined with targeted immunohistochemistry, particularly TTF‐1, is essential for accurate diagnosis and guiding appropriate palliative management.

Gallic acid (GA) is a plant-derived polyphenol with recognized anticancer activity, but in vivo evidence, especially in mesenchymal solid tumors, remains limited. This study investigated the antitumor effects and mechanistic pathways of GA in the murine Sarcoma 180 (S-180) model. Fifty male Swiss mice bearing S-180 tumors received oral GA (10, 25, or 50 mg/kg/day), 5-fluorouracil (5-FU; 25 mg/kg, intraperitoneal), or vehicle for seven days. Tumor weight and growth inhibition were assessed, along with histopathology and immunohistochemistry for proliferation (Ki-67, a proliferation marker), apoptosis (cleaved caspase-3 and caspase-8, Bcl-2-associated X protein [Bax], and B-cell lymphoma 2 [Bcl-2]), nuclear factor kappa B (NF-κB), and systemic toxicity markers (hematological, hepatic, and renal). GA at 50 mg/kg significantly reduced tumor weight and proliferation, decreased Ki-67 and NF-κB expression, increased Bax, reduced Bcl-2, and enhanced cleaved caspase-3, indicating predominant activation of the intrinsic (mitochondrial) apoptotic pathway. Caspase-8 levels remained unchanged. Although 5-FU produced greater tumor inhibition, it induced leukopenia and splenic atrophy, whereas GA preserved hematological, hepatic, and renal parameters. These findings support GA as a promising candidate for adjuvant cancer therapy.

Background: Actinic cheilitis is a precursor to lip squamous cell carcinoma. How ultraviolet‐induced stromal degeneration relates to invasion‐related extracellular matrix markers remains unclear. This study investigated basophilic degeneration of collagen, solar elastosis, fibronectin, tenascin‐C, and podoplanin in both lesions. Methods: Specimens of actinic cheilitis ( n = 28) and lip squamous cell carcinoma ( n = 28) were analyzed. Collagen degeneration, elastosis, and the immunoexpression of fibronectin, tenascin‐C, and podoplanin were quantified using digital image analysis. Associations were evaluated using mixed‐effects models. Results: Collagen degeneration and elastosis areas were significantly greater in actinic cheilitis ( p < 0.001). Lip squamous cell carcinoma exhibited higher stromal fibronectin and podoplanin ( p < 0.001), whereas epithelial tenascin‐C was higher in actinic cheilitis ( p < 0.001). Notably, in both lesions, areas with pronounced collagen degeneration and elastosis were inversely associated with the expression of these invasion‐related proteins. Conclusions: Actinic cheilitis features marked actinic stromal degeneration, whereas lip squamous cell carcinoma exhibits tumor‐driven extracellular matrix remodeling with increased invasion‐related markers. These findings highlight distinct stromal microenvironment profiles associated with pre‐neoplastic and neoplastic lip lesions.

Background: Oral squamous cell carcinoma (OSCC) is the most common malignancy of the oral cavity. However, its synchronous occurrence with lesions of a different nature is exceedingly rare, particularly arising at the same anatomical site. Heterotopic gastrointestinal cysts (HGICs) are developmental anomalies containing ectopic gastrointestinal epithelium, typically observed in pediatric patients and rarely reported in adults. Objectives: This report describes an unprecedented case of synchronous OSCC and HGIC of the mouth floor, underscoring the critical role of thorough histopathological evaluation for accurate diagnosis and appropriate management. Description: A 62-year-old man presented with an ulcerated lesion on the right mouth floor. Incisional biopsy followed by histological analysis revealed two distinct lesions: one characterized by a proliferation of atypical squamous cells, consistent with OSCC, and the other by a cystic cavity lined with tall columnar epithelial cells showing basally located nuclei and apical microvilli (brush border), consistent with the diagnosis of HGIC. Definitive treatment included tumor resection and ipsilateral neck dissection. The patient remains under clinical follow-up. Conclusion: To the best of our knowledge, this is the first reported case of synchronous OSCC and HGIC at the same site, highlighting the need for individualized therapeutic planning based on the biological behavior of each lesion. KEYWORDS Choristoma; Dentistry; Mouth Neoplasms; Oral Pathology; Squamous Cell Carcinoma of Head and Neck.

Objectives This multicenter study aimed to evaluate cases of non-syndrome and syndromic odontogenic keratocyst, as well as cases of recurrence within these two groups. Methods This descriptive, analytical, retrospective cross-sectional study evaluated the sex, age and presence of multiple lesions in 1,169 individuals seen at 10 Brazilian oral and maxillofacial pathology centers. Of these, 1,341 odontogenic keratocysts were analyzed regarding clinical diagnosis, size, site, imaging appearance, signs and symptoms, type of biopsy, treatment, and recurrence. Results There was a similar distribution by sex. The median age of non-syndromic and syndromic patients was 32 and 17.5 years, respectively. The posterior mandible was the site most affected by small and large lesions in both groups and in recurrent cases. Unilocular lesions were more frequent, also in recurrent cases. Mainly small lesions showed this imaging appearance. Signs and symptoms were absent in most cases. Conservative treatment was the most frequent modality in all age groups, regardless of the patient’s condition and recurrence. Recurrences were uncommon. Conclusion This study showed a higher frequency of non-syndromic keratocysts in the population. Clinicopathological features related to the involvement of multiple sites, age, and recurrence may differ between syndromic and non-syndromic cases. Furthermore, we found an association between lesion size and some clinical features and between the time interval to recurrence and the syndromic spectrum. Clinical relevance To contribute to a better understanding of the distribution and association between clinical, imaging, and sociodemographic characteristics in each spectrum of the lesion.

O ensino da anatomia através da dissecção de cadáveres humanos foi, por séculos, a base pedagógica fundamental para a formação de médicos e outros profissionais de saúde. No entanto, apesar de a prática acompanhar a história da medicina desde seus primórdios, até o presente momento não há, na formação do médico, um foco adequado sobre os aspectos éticos relacionados à realização desse procedimento. Tais questões são complexas e envolvem desde a obtenção do cadáver, seu método de preservação, manuseio diário e posterior descarte adequado. Porém, a questão ética central a ser debatida é se a pessoa cujo corpo será fonte para atividades apresentou consentimento para tal. O presente trabalho tem por finalidade realizar breve revisão da história da dissecção humana, os princípios éticos que cercam o tema, seus potenciais conflitos e aspectos legais sobre a utilização de cadáveres para a formação do profissional de saúde.