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Mattos da Silva PQ, Ballardin BS, Torres-Pereira CC. Cancer in buccal mucosa in patients with Fanconi anemia: Report of six cases. Spec Care Dentist 2024; 44:472-477. [PMID: 37400941 DOI: 10.1111/scd.12899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 06/17/2023] [Accepted: 06/19/2023] [Indexed: 07/05/2023]
Abstract
INTRODUCTION Fanconi anemia (FA) is a recessive hereditary disease characterized by bone marrow failure, and the treatment is hematopoietic stem cell transplantation (HSCT). Patients diagnosed with FA are more predisposed to develop oral squamous cell carcinoma (SCC), and this risk increases in transplant patients. The clinical characteristics of the oral manifestations of SCC in this group of patients do not differ from the lesions present in patients without the disease; however, they can be diagnosed in young patients and less common locations, such as, for example, in the buccal mucosa. OBJECTIVE To report a case series of patients diagnosed with FA with oral SCC. METHOD Included in this case series are six patients diagnosed with SCC in the buccal mucosa with similar clinical characteristics. FINAL CONSIDERATIONS There are still difficulties in establishing the natural history of oral lesions in patients with FA. Thus, disclosing a series of cases with similar changes may be relevant to improving and refining the multidisciplinary team's clinical view of suspected SCC or oral potentially malignant disorders (OPMD), providing surveillance and timely management.
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Affiliation(s)
- Priscila Queiroz Mattos da Silva
- Multiprofessional Residency Program in Oncology and Hematology, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Bárbara Soldatelli Ballardin
- Multiprofessional Residency Program in Oncology and Hematology, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
- Post Graduate Program in Dentistry, Department of Stomatology, Universidade Federal do Paraná, Curitiba, Brazil
| | - Cassius Carvalho Torres-Pereira
- Multiprofessional Residency Program in Oncology and Hematology, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
- Post Graduate Program in Dentistry, Department of Stomatology, Universidade Federal do Paraná, Curitiba, Brazil
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Ballardin BS, Rosa CAL, Vendruscolo JL, Torres-Pereira CC. MANEJO ODONTOLÓGICO DE PACIENTE COM DISFIBRINOGENEMIA ASSOCIADA A DIVERSAS COMORBIDADES: RELATO DE CASO. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ballardin BS, Mobile RZ, Schussel JL, Torres-Pereira CC. ATYPICAL ORAL MANIFESTATION ASSOCIATED WITH CANDIDA COLLICULOSA IN A PEDIATRIC HEMATOLOGICAL PATIENT. Oral Surg Oral Med Oral Pathol Oral Radiol 2022. [DOI: 10.1016/j.oooo.2022.01.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Schussel JL, de Araújo AMM, Ballardin BS, Pereira CCT. Antimicrobial Photodynamic Therapy as a treatment option for inoperable cases of medication-related Osteonecrosis of the jaws. Photodiagnosis Photodyn Ther 2022; 39:102947. [PMID: 35667576 DOI: 10.1016/j.pdpdt.2022.102947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/22/2022] [Accepted: 06/01/2022] [Indexed: 10/18/2022]
Abstract
The present study aims to report conservative treatment of an extreme case of MRONJ in a patient illegible for surgical treatment. A 69-year-old female patient, diagnosed with Multiple Myeloma underwent treatment with bisphosphonate. After a turbinectomy, she was referred to a dental clinic with painful oral symptoms, presence of necrotic and suppurative bone exposures in maxilla compatible with MRONJ. As surgery was not indicated, the treatment of option was to control infection and pain. PENTO protocol, antibiotic therapy and photodynamic therapy were instituted. The patient has been under dental follow-up for more than 1 year, with an important reduction in the areas of bone exposure, absence of active infection and painful symptoms, characterizing a significant improvement in the oral condition. The conservative approach achieved satisfactory results for the case, where the patient is ineligible for a surgery due to local and general conditions, and quality of life being prioritized.
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Affiliation(s)
- Juliana Lucena Schussel
- Post Graduate Program in Dentistry, Universidade Federal do Paraná, Av. Pref. Lothário Meissner, 632, 80210-170, Curitiba-Brazil; Multiprofessional Residency Program in Oncology and Hematology, Clinic Hospital Complex, Universidade Federal do Paraná, Rua Gen. Carneiro, 181, 80060-900, Curitiba-Brazil.
| | - Arthur Magno Medeiros de Araújo
- Multiprofessional Residency Program in Oncology and Hematology, Clinic Hospital Complex, Universidade Federal do Paraná, Rua Gen. Carneiro, 181, 80060-900, Curitiba-Brazil
| | - Bárbara Soldatelli Ballardin
- Multiprofessional Residency Program in Oncology and Hematology, Clinic Hospital Complex, Universidade Federal do Paraná, Rua Gen. Carneiro, 181, 80060-900, Curitiba-Brazil
| | - Cassius Carvalho Torres Pereira
- Post Graduate Program in Dentistry, Universidade Federal do Paraná, Av. Pref. Lothário Meissner, 632, 80210-170, Curitiba-Brazil; Multiprofessional Residency Program in Oncology and Hematology, Clinic Hospital Complex, Universidade Federal do Paraná, Rua Gen. Carneiro, 181, 80060-900, Curitiba-Brazil
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Ballardin BS, Mobile RZ, Coracin FL, Ribeiro LL, Bonfim CMS, Schussel JL, Carvalho Torres-Pereira C. A case series of medication-related fibrovascular hyperplasia following hematopoietic stem cell transplantation for Fanconi anemia. Pediatr Transplant 2021; 25:e13947. [PMID: 33350561 DOI: 10.1111/petr.13947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/18/2020] [Accepted: 11/24/2020] [Indexed: 11/29/2022]
Abstract
Systemic medications categorized as diphenylhydantoin, calcineurin inhibitor and calcium channel blocker may have effects on the oral cavity by modifying the inflammatory and immune response and causing undesired tissue proliferative reactions. Calcineurin inhibitors are medications commonly used for long periods in patients undergoing allogeneic hematopoietic stem cell transplant (HSCT) and solid organ transplantation. Medication-related fibrovascular hyperplasia (MRFH) is an extra gingival hyperplastic nodular growth associated with medications use. This study reports five cases of pediatric patients (6 to 12-years-old) diagnosed with Fanconi anemia (FA) after HSCT who presented similar oral mucosal lesions associated with the use of cyclosporine, phenobarbital and amlodipine. After excision of the lesions, histopathological analysis described them as pyogenic granuloma (PG). As the aetiology of the lesions manifested by the patients was associated with the use of medications, the final diagnosis was MRFH. Despite the clinical and histopathological similarity between PG and MRFH, it is fundamental to know the aetiological agent for achieving definitive diagnosis and correct management. Considering the etiologic agent (medication) and histopathological findings, it is suggested that the most appropriate term for this manifestation should be "medication-related fibrovascular hyperplasia". The correct nomenclature related to extra gingival hyperplastic lesions identified in patients on medications with potential to induce hyperplastic reactions should be adopted to facilitate scientific communication and improve the treatment.
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Affiliation(s)
- Bárbara Soldatelli Ballardin
- Multiprofessional Residency Program in Oncology and Hematology, Clinic Hospital Complex, Federal University of Parana, Curitiba, Brazil
| | - Rafael Zancan Mobile
- Post-Graduate Program in Dentistry, Department of Stomatology, Federal University of Parana, Curitiba, Brazil
| | | | - Lisandro Lima Ribeiro
- Service of Bone Marrow Transplant, Clinic Hospital Complex, Federal University of Parana, Curitiba, Brazil
| | - Carmem Maria Sales Bonfim
- Service of Bone Marrow Transplant, Clinic Hospital Complex, Federal University of Parana, Curitiba, Brazil
| | - Juliana Lucena Schussel
- Multiprofessional Residency Program in Oncology and Hematology, Clinic Hospital Complex, Federal University of Parana, Curitiba, Brazil.,Post-Graduate Program in Dentistry, Department of Stomatology, Federal University of Parana, Curitiba, Brazil
| | - Cassius Carvalho Torres-Pereira
- Multiprofessional Residency Program in Oncology and Hematology, Clinic Hospital Complex, Federal University of Parana, Curitiba, Brazil.,Post-Graduate Program in Dentistry, Department of Stomatology, Federal University of Parana, Curitiba, Brazil
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Leidens N, Ballardin BS, Leal GA, de Araújo AMM, Sessenta-Junior CF, Torres-Pereira CC, Schussel JL. Graft-versus-host disease and herpes simplex virus oral injuries in onco-hematological patient: Case report. Spec Care Dentist 2021; 42:91-96. [PMID: 34358367 DOI: 10.1111/scd.12640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/05/2021] [Accepted: 07/14/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Graft-versus-host disease (GVHD) is a systemic complication that can affect patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) and the mouth is one of the places affected by the disease (oGVHD). Topical corticosteroids are used to control the painful symptoms, causing a local immunosuppression and increasing the risk for opportunistic infections. OBJECTIVE This study aims to report a case of a 42-year-old woman, diagnosed with Chronic Myeloid Leukemia, who developed oGVHD and herpes simplex virus (HSV) infection after HSCT. CASE REPORT oGVHD was confirmed by incisional biopsy and viral infection by HSV types 1 and 2 was confirmed by PCR. Topical and systemic corticotherapy and antiviral therapies were instituted. The immunosuppression intensified viral infection and antimicrobial photodynamic therapy (aPDT) was instituted as an adjuvant treatment. aPDT application, along with the patient's immune recovery, antivirals and corticosteroids resulted in clinical improvement of oral lesions. FINAL CONSIDERATIONS This study highlights aPDT as an effective adjunct therapy in the local treatment of opportunistic infections in onco-hematological patients.
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Affiliation(s)
- Natali Leidens
- Multiprofessional Residency Program in Oncology and Hematology, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.,Post Graduate Program in Dentistry, Department of Stomatology, Universidade Federal do Paraná, Curitiba, Brazil
| | - Bárbara Soldatelli Ballardin
- Multiprofessional Residency Program in Oncology and Hematology, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.,Post Graduate Program in Dentistry, Department of Stomatology, Universidade Federal do Paraná, Curitiba, Brazil
| | - Gustavo André Leal
- Multiprofessional Residency Program in Oncology and Hematology, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Arthur Magno Medeiros de Araújo
- Multiprofessional Residency Program in Oncology and Hematology, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Claúdio Freire Sessenta-Junior
- Multiprofessional Residency Program in Oncology and Hematology, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Cassius Carvalho Torres-Pereira
- Multiprofessional Residency Program in Oncology and Hematology, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.,Post Graduate Program in Dentistry, Department of Stomatology, Universidade Federal do Paraná, Curitiba, Brazil
| | - Juliana Lucena Schussel
- Multiprofessional Residency Program in Oncology and Hematology, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.,Post Graduate Program in Dentistry, Department of Stomatology, Universidade Federal do Paraná, Curitiba, Brazil
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Ballardin BS, Rodrigues SAC, Feres M, Torres-Pereira CC, Soares GMS. Periodontal Attachment Loss in Children with Amegakaryocytic Purpura: Case Reports of Two Male Siblings. J Int Acad Periodontol 2020; 22:182-186. [PMID: 32980831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
AIMS To report the periodontal condition of two siblings (ages 2 and 4) diagnosed with congenital Amegakaryocytic Purpura (AP), who underwent allogeneic hematopoietic stem cell transplant (HSCT) and developed graft-versus-host disease (GVHD) with oral manifestations. METHODS Clinical history was obtained through physical examination and medical records. Patients received clinical and microbiological assessment at 2 months post-HSCT, when they started to show signs and symptoms of GVHD and were monitored at 8/15-months post-transplant. They were treated by means of prophylaxis and oral hygiene instruction. Two supragingival biofilm samples were collected from each patient and analyzed by Checkerboard DNA-DNA hybridization. RESULTS Patients developed severe periodontal clinical attachment loss (CAL) in deciduous dentition associated with recession of the periodontal tissues. They also presented GVHD lesions in the oral mucosa, lips and tongue. Caries lesions, gingivitis, and heavy biofilm deposits were identified. The microbiological profile of biofilm samples presented high levels and proportions of periodontal pathogens, such as Aggregatibacter actinomycetemcomitans. CONCLUSION The cases presented suggested that severe periodontal CAL in children with AP may be an atypical manifestation associated with AP and/or GVHD, which may be aggravated by the presence of a dysbiotic biofilm containing periodontal pathogens, especially A. actinomycetemcomitans.
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Affiliation(s)
- Bárbara Soldatelli Ballardin
- Multiprofessional Residency Program in Oncology and Hematology, Hospital de Clínicas, Federal University of Parana, Curitiba, Brazil
| | - Suelen aCroline Rodrigues
- Multiprofessional Residency Program in Oncology and Hematology, Hospital de Clínicas, Federal University of Parana, Curitiba, Brazil
| | - Magda Feres
- Dental Research Division, Department of Periodontology, Guarulhos University, Guarulhos, Brazil
| | - Cassius Carvalho Torres-Pereira
- 1Multiprofessional Residency Program in Oncology and Hematology, Hospital de Clínicas, Federal University of Parana, Curitiba, Brazil; and Post Graduate Program in Dentistry, Department of Stomatology, Federal University of Parana, Curitiba, Brazil
| | - Geisla Mary Silva Soares
- Multiprofessional Residency Program in Oncology and Hematology, Hospital de Clínicas, Federal University of Parana, Curitiba, Brazil; and Post Graduate Program in Dentistry, Department of Stomatology, Federal University of Parana, Curitiba, Brazil. E-mail:
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Ballardin BS, Mobile RZ, Torres-Pereira CC, Schussel JL. Medication-related fibrovascular hyperplasia lesion in tongue: Case report. Spec Care Dentist 2020; 40:506-510. [PMID: 32691895 DOI: 10.1111/scd.12497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/30/2020] [Accepted: 07/03/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The objective of this study is to report the case of a patient who underwent hematopoietic stem cell transplantation for Hodgkin's lymphoma treatment and developed multiple tongue lesions during recovery. METHODS AND RESULTS This is the case report of a patient who developed ulcerated lesions with areas of depapillation on the border and dorsum of the tongue. The ulcer evolved to a reddish fibrous hyperplastic nodule, similar to adjacent mucosa. The patient was using a series of medications, such as antifungals, antibiotics, antivirals, corticosteroids, and analgesics in addition to immunosuppression with cyclosporine. Considering the medical history of the patient, a biopsy was performed. Histopathological analyses describe hyperplasia, granulation tissue, vascular proliferation, and intense inflammatory infiltrate, and the diagnosis was of medication-related fibrovascular hyperplasia (MRFH). CONCLUSION Patients in use of cyclosporine are at risk to develop oral lesions, such as MRFH. The correct diagnosis is important, so the adequate treatment and follow-up are instituted even considering the immunosuppression protocol.
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Affiliation(s)
| | | | - Cassius Carvalho Torres-Pereira
- Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.,Department of Stomatology, Universidade Federal do Paraná, Curitiba, Brazil
| | - Juliana Lucena Schussel
- Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.,Department of Stomatology, Universidade Federal do Paraná, Curitiba, Brazil
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Ballardin BS, Kellermann MG, Dallemole DR, Ellwanger JH, Neto LK. Adenoid Cystic Carcinoma in the Maxillary Sinus: the Importance of Early Diagnosis. Oral Surg Oral Med Oral Pathol Oral Radiol 2018. [DOI: 10.1016/j.oooo.2018.02.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kellermann MG, Ballardin BS, Pollo Renner JD, Dallemole DR, Ellwanger JH, Neto LK. Chronic Lichenoid Inflammatory Process with Hyperplasia: a Case Report. Oral Surg Oral Med Oral Pathol Oral Radiol 2018. [DOI: 10.1016/j.oooo.2018.02.299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Ballardin BS, Rost MM, Kellermann MG, Dallemole DR, Ellwanger JH, Neto LK. Cryptococcosis in A Patient with Primary Immunodeficiency Due to IL-12 Receptor Deficiency. Oral Surg Oral Med Oral Pathol Oral Radiol 2018. [DOI: 10.1016/j.oooo.2018.02.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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