Igor Mesquita Lameira

A apresentação tardia ao diagnóstico da infecção pelo HIV permanece um importante desafio para a saúde pública, pois compromete o início oportuno do tratamento e pode contribuir para a progressão da doença e a transmissão viral. Este estudo objetiva analisar os fatores associados à apresentação tardia ao diagnóstico da infecção pelo HIV na América Latina, com ênfase no contexto brasileiro. Trata-se de uma revisão sistemática da literatura, desenvolvida por meio de buscas nas bases MEDLINE/PubMed, BVS/LILACS, SciELO e Europe PMC, com busca complementar no Semantic Scholar. Foram identificados 3.665 registros nas bases principais, dos quais 410 eram duplicados, permanecendo 3.255 registros únicos. Após as etapas de triagem e elegibilidade do conjunto priorizado, 16 estudos permaneceram compatíveis com a síntese qualitativa desta versão. Os estudos analisados apontaram como fatores recorrentes idade mais elevada, menor escolaridade, vulnerabilidade socioeconômica, baixa percepção de risco, estigma e barreiras relacionadas ao acesso e à utilização dos serviços de testagem. Conclui-se que a apresentação tardia ao diagnóstico do HIV possui caráter multifatorial, reforçando a necessidade de ampliar a oferta oportuna de testagem e desenvolver estratégias de prevenção e diagnóstico direcionadas às populações mais vulneráveis.

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.

Solitary Fibrous Tumor (SFT) is a rare mesenchymal neoplasm, account approximately 3% of mesenchymal tumors in the oral cavity. We present the case of a 65-year-old female patient with a painless swelling in the left upper lip. Clinical examination revealed a firm, smooth-surfaced submucosal lesion without ulceration, non-tender on palpation, and exhibiting a slightly yellowish hue. Computed tomography demonstrated a well-defined, isodense mass measuring 25 mm in diameter, with no evidence of bone invasion. The lesion was surgically excised, and histopathological analysis confirmed the diagnosis of SFT, supported by positive immunohistochemical staining for CD34 and STAT6. The tumor was classified as low risk for metastasis, and the patient demonstrated favorable postoperative recovery. The patient remains under follow-up with the medical team and has been recurrence-free for 07 months. This case underscores the rarity of oral cavity SFT and emphasizes the importance of comprehensive differential diagnosis to guide effective management and reduce recurrence risk.