Impact of the COVID-19 pandemic on head and neck cancer patients: systematic review and meta-analysis

OBJECTIVES

This manuscript presents a systematic review of the impact of the COVID-19 pandemic on head and neck cancer (HNC) patients. A meta-analysis was made to compare the number of treated/operated HNC patients in pre-COVID-19 era (PCE) versus COVID-19 era (CE). This investigation is based on previous reports showing a delay in the diagnosis and treatment of new cases of cancer during the pandemic. Worsening in cancer prognosis would be expected as a result of the delayed treatments.

METHOD AND MATERIALS

An electronic search was conducted using the PubMed/MEDLINE, Embase, Web of Science, Scopus and The Cochrane Library databases. Relevant articles were selected based on specific inclusion criteria.

RESULTS

A total of 8942 HNC patients were included. A higher prevalence in male (1873) in comparison to female (1695) was observed considering 3568 patients. Regarding staging, the majority of cases were stage III-IV. The treatment type more frequently described was surgery. Positive diagnosis for COVID-19 in the pre oncologic treatment was reported for 242 patients, and for post oncologic treatment in 119 patients. Mortality by COVID-19 was reported for 27 HNC patients. The meta-analysis revealed a significantly smaller number of surgeries/oncologic treatments of HNC patients performed (2666) in the CE when compared to PCE (3163) (M-H OR = 0.81, 95% CI = 0.65 to 1, P = 0.05).

CONCLUSION

The impact of the COVID-19 pandemic on HNC patients occurred mainly in the number of surgeries/oncologic treatments, showing a significantly smaller number of surgeries/oncologic treatments performed in the CE rather than the PCE.

Photobiomodulation of gingival lesions resulting from autoimmune diseases: systematic review and meta-analysis

Objectives

To evaluate the effects of photobiomodulation (PBM) in gingival lesions resulting from autoimmune diseases; to compare PBM and topical corticosteroid (CS) treatment; and to assess PBM outcome over time of follow-up.

Materials and methods

A comprehensive electronic search was performed in four electronic databases. Treatment effects were measured through visual analog scale of pain (VAS) and clinical evolution of lesion (Thongprasom scale for oral lichen planus (OLP)). Meta-analysis was performed to compare PBM with topical corticosteroid treatment and to evaluate PBM effect over time of follow-up.

Results

Seventeen studies were included in this review, of which six were used for the meta-analysis. Meta-analysis results showed no significant differences between PBM and topical CS in pain reduction at baseline (MD = 0.20, 95% CI =  − 0.92, 1.32, p = 0.72) and 60-day follow-up (MD = 0.63, 95% CI =  − 3.93, 5.19, p = 0.79); however, VAS showed significant pain reduction when compared before and after PBM at 30-day (MD =  − 3.52, 95% CI =  − 5.40, − 1.64, p = 0.0002) and 60-day (MD =  − 5.04, 95% CI =  − 5.86, − 4.22, p < 0.00001) follow-up. Thongprasom clinical scale for OLP also showed significant improvement at 30-day follow-up (MD =  − 2.50, 95% CI =  − 2.92, − 2.08, p < 0.00001) after PBM.

Conclusion

PBM led to significant reduction of pain and clinical scores of the lesions, not having shown significant differences when compared to topical CS.

Clinical relevance

PBM has been used in the treatment of autoimmune gingival lesions, but so far there is little strong evidence to support its use.

Oral Paracoccidioidomycosis affecting women: A systematic review

Paracoccidioidomycosis (PCM) is an infection caused by fungi of the genus Paracoccidioides and is marked by a strong predilection for men; nevertheless, some women have had developed PCM and have presented oral involvement by the disease.

OBJECTIVES

To review all published cases until August 2020 of oral PCM in women, with emphasis on the presence of systemic changes, deleterious habits (tobacco and alcohol) and oral manifestation features through a systematic review.

METHODS

Observational studies (both prospective and retrospective) and case reports indexed in the Embase, PubMed, Scopus, Web of Science and LIVIVO databases were selected by two reviewers in a two-phase process following the pre-established PICOS criteria.

RESULTS

Twenty-five studies met the eligibility criteria and were selected for qualitative synthesis, of which 72 participants were enrolled. Brazilian White women between 40 and 50 years were the most affected and social history revealed them to be housewives or rural workers. Fifteen women (33.3% of the informed cases) presented any systemic change at the time of PCM diagnosis, namely pregnancy, HIV infection and/or depression. Moriform stomatitis was predominant and affected preferentially the gingivae and alveolar processes in the form of a single painful lesion. Most patients were treated with sulfamethoxazole + trimethoprim or itraconazole.

CONCLUSIONS

Oral PCM in women is rare; some cases showed systemic changes at the time of PCM diagnosis, namely HIV infection, pregnancy and depression. New studies should be conducted to elucidate the influence of systemic alterations on the development of oral PCM in women.

Pyogenic granuloma in the tongue of a patient with Down syndrome

Down syndrome (DS), a genetic disorder caused by chromosome 21 trisomy, is characterized by intellectual disability, congenital malformations, craniofacial alterations, and dentofacial anomalies. Although some oral lesions have been reported in patients with DS, this is the first reported case of a pyogenic granuloma affecting the tongue of a patient with DS. A 20-year-old man presented with a well-demarcated nodular lesion on the right lateral border of the tongue. The 2-cm lesion had a pedunculated base, flaccid consistency, and a superficial ulceration covered by a serofibrinous pseudomembrane. The patient's mother reported that the patient had a recurring habit of traumatizing the lateral border of the tongue. A similar lesion had been surgically removed from the site 1 month earlier, but the excised tissue had not been sent for pathologic analysis. Surgical excision of the new lesion was performed under local anesthesia, and microscopic analysis confirmed the diagnostic hypothesis of pyogenic granuloma, a nonneoplastic vascular hyperplasia of a reactive nature. There was another recurrence at the same site 2 months after the second surgical excision. The patient was given a mandibular silicone mouthguard for 1 month of nightly use to prevent further trauma to the site. Complete healing of the site was observed at the 18-month follow-up examination, and there was no sign of recurrence. Considering the high prevalence of oral alterations in patients with DS, dentists should be able to recognize, diagnose, and correctly manage oral pyogenic granuloma.

Erythema multiforme induced by fluconazole in an immunocompetent patient: a case report and review of the literature

Erythema multiforme (EM) is an acute hypersensitivity reaction that affects the skin and/or mucosa. EM induced by fluconazole is extremely rare, with only 2 previously published case reports. The aims of this article are to report a rare case of severe EM induced by fluconazole in an immunocompetent patient and to review all similar published cases. A 35-year-old man presented with multiple painful superficial ulcerated lesions on the lips, superficial ulcers on the right and left ocular mucosa, and erythematous macules on the right cervical region. Moreover, multiple painful superficial ulcers covered by a serofibrinous pseudomembrane were located on the oral mucosa. The lesions appeared after the initial oral use of fluconazole (100 mg) 3 weeks previously for the treatment of onychomycosis. The clinical diagnosis was EM associated with fluconazole. The antifungal medication was discontinued, and a single dose of intramuscular Diprospan (5 mg of betamethasone dipropionate/2 mg of betamethasone disodium phosphate) was prescribed. Complete healing of all lesions at the 7-day follow-up was observed.

Bell's palsy treated with photobiomodulation in an adolescent: Rare case report and review of the published literature

BACKGROUND

Bell's palsy represents a peripheral unilateral facial nerve paralysis, being an acute, idiopathic disorder, which can affect children and adolescents. Some therapeutic approaches have been proposed including facial exercises, biofeedback, photobiomodulation, electrotherapy, massage, and thermotherapy. The present report documents a rare case of Bell's palsy in an adolescent successfully treated with a new protocol of photobiomodulation, consisting of a short-term treatment.

CASE REPORT

A 13-year-old girl presented absence of facial movement on the right side when smiling, inability to close the right eye and to raise the right eyebrow, intense painful symptoms on the right side of the face, difficult in chewing and talking, and sialorrhea. She was diagnosed with an idiopathic facial paralysis or Bell's palsy associated with right masseter myalgia, and treated with three sessions of photobiomodulation using infrared laser, 100 mW output power, 100 J/cm² of energy density, 28 seconds per point, applied at the origin and insertion of the right superficial masseter muscle. The patient presented complete regression of paralysis, improvement of speech and chewing, and absence of muscular pain.

CONCLUSION

Photobiomodulation was effective to treat Bell's palsy in a pediatric patient, being a true noninvasive approach and with no side effects, although there is still no established definitive protocol.

Fatal primary diffuse large B-cell lymphoma of the maxillary sinus initially treated as an infectious disease in an elderly patient: A clinicopathologic report

OBJECTIVE

To report a case of primary diffuse large B-cell lymphoma (DLBCL) of the maxillary sinus in an 82-year-old Caucasian woman.

BACKGROUND

Diffuse large B-cell lymphoma of the maxillary sinus has non-specific signs and symptoms that may be confused with benign inflammatory conditions and upper respiratory infections.

METHODS

An incisional biopsy was performed. CD20⁺ /CD3^- /Ki-67: 95% cells were observed.

CONCLUSION

A good medical history, clinical and imaging evaluations and immunohistochemical reactions are crucial to establish a correct and early diagnosis of DLBCL.

Primary oral melanoma: A clinicopathologic review and case presentation

OBJECTIVE

The purpose of this manuscript is to present a clinicopathologic review of the literature concerning all the detailed cases of primary oral melanoma (OM) that were confirmed by immunohistochemistry. In addition, a pertinent case presentation is addressed.

DATA SOURCES

An extensive electronic search of the literature was performed using PubMed/Medline from 1953 to 2017. Relevant articles were selected based on specific inclusion criteria. Statistical analyses were conducted by the Shapiro-Wilk, Fisher's exact, chi-square, and Z tests (α = .05).

RESULTS

Forty-nine cases of primary OM reported in the literature plus the current case were analyzed; patient ages ranged from 17 to 89 years with a mean of 60.8 years; male to female ratio was 1.5:1; Caucasian patients were the most affected and the most frequent locations were maxillary alveolar mucosa and palate; the majority of the lesions were pigmented (62%); differences among the proportions of positivity to S-100, HMB-45, Melan-A, NKFC3, vimentin, tyrosinase, CK, microphthalmia transcription factor (MITF), and Ki-67 were found (P < .0001), especially when comparing with vimentin (P < .05) and CK (P < .01); recurrence was reported in 11.6% and mortality in 54.8%. The case presented is of a 71-year-old mixed-race woman who presented multiple pigmented lesions over the maxillary alveolar mucosa and palate. Positivity for S-100, HMB-45, Melan-A, and Ki-67 confirmed the diagnosis of primary OM.

CONCLUSION

Primary OM is rare and very aggressive, with only 49 detailed cases confirmed by immunohistochemistry existing within the English literature, in addition to the present case. S-100 and HMB-45 are excellent markers to confirm the diagnosis of primary OM, although the use of adjuvant specific markers such as Melan-A, tyrosinase, and MITF should be also encouraged.

Low-level laser therapy stimulates the oxidative burst in human neutrophils and increases their fungicidal capacity

Low-level laser therapy (LLLT) is known to enhance mitochondrial electron transfer and ATP production; thus, this study asked whether LLLT could stimulate the oxidative burst in human neutrophils (PMN) and improve their ability to kill microorganisms. Blood from healthy human subjects was collected and PMN were isolated from the samples. PMN were treated in vitro with 660 nm or 780 nm CW laser light at 40 mW power and increasing energies up to 19.2 J and were subsequently incubated with Candida albicans cells. Generation of hydroxyl radicals, hypochlorite anions and superoxide anions by PMN were checked using fluorescent probes and chemiluminescence assays; a microbicidal activity assay against C. albicans was also performed. LLLT excited PMN to a higher functional profile, which was translated as superior production of reactive oxygen species (ROS) and increased fungicidal capacity. The most efficacious energy was 19.2 J and, interestingly, the 660 nm light was even more efficacious than 780 nm at increasing the respiratory burst of PMN and the fungicidal capacity. Human neutrophils (PMN) were stimulated in vitro with 660 nm or 780 nm CW laser light at 40 mW of power and a total energy of 19.2 J. Low-level laser therapy (LLLT) excited PMN to a higher functional profile, which was translated as a superior production of reactive oxygen species (ROS) such as hydroxyl radicals (HO^• ) and hypochlorite anions (ClO^- ) (Figure) and increased fungicidal capacity against Candida albicans cells.

Oral Paracoccidioidomycosis Granulomas are Predominantly Populated by CD163+ Multinucleated Giant Cells

Multinucleated giant cells (MGC) are considered to be a hallmark of granulomatous inflammation; thus, they may play an essential role in the host response against pathogens, particularly Paracoccidioides brasiliensis. This study characterizes the MGC found in oral paracoccidioidomycosis and assesses the correlation of MGC with the amount of fungi within oral tissues. Twenty-six cases were included. They were classified as loose or dense granulomas, and the total MGC, including foreign-body and Langhans giant cells, besides the total and intracellular fungi, were taken into consideration. CD163 immunoexpression was performed, and CD163+ multinucleated giant cells were also quantified. Dense granulomas revealed more foreign-body type and total giant cells than loose granulomas (P < 0.05). Total giant cells showed a positive linear correlation with the CD163+ cells (P = 0.003; r = 0.56) and intracellular fungi quantification (P = 0.045; r = 0.40). Oral paracoccidioidomycosis lesions contain MGC that mainly belong to a CD163+ phenotype, also showing both Langhans and foreign-body arrangements. Additionally, the higher the presence of MGC, the higher the amount of phagocytized fungi.

Giant keratoacanthoma of the lower lip: case report and review of the published literature

Keratoacanthoma (KA) is an epithelial tumor mainly located on the sun-exposed skin of the face and hands of elderly patients. The giant form of KA affecting the lower lip is relatively rare, and only 2 of 9 recently reported cases were in women. This report describes a case of giant KA of the lower lip in a 62-year-old white woman and discusses clinical and histologic diagnosis and the therapeutic approach to this lesion. The patient reported a 2-month evolution of a nodule characterized by a brownish central plug of keratin and measuring approximately 2.0 cm in its greatest diameter. Keratoacanthoma may present some histopathologic features similar to those of squamous cell carcinoma, and careful attention is required to avoid an incorrect diagnosis. Following histopathologic confirmation of giant KA, complete excision of the lesion was performed. A 17-month follow-up examination revealed complete healing of the area and no signs of recurrence. Because giant KA of the lower lip may impair normal function and esthetics, surgical excision is the best choice for treating this lesion.

M2 macrophages and inflammatory cells in oral lesions of chronic paracoccidioidomycosis

BACKGROUND

Paracoccidioidomycosis (PCM) is a systemic fungal infection caused by Paracoccidioides brasiliensis (Pb) and associated with deficient cellular immune response, which is modulated by inflammatory cells, mainly macrophages, and cytokines. Recently, the comprehension of the macrophage polarization mediated by Th1 and Th2 cytokines has contributed to elucidate the immune response that takes part in some diseases. Thus, the aim of this study was to assess the presence of Th1- and Th2-immune response and also Pb counting in oral lesions of chronic PCM.

METHODS

Forty-eight cases of chronic PCM oral lesions were included. All cases were classified as loose or dense granulomas. S100 protein, IL-1β, IL-6, TNF-α, CD163 and CD68 immunoexpressions, and Pb localization were evaluated. The fungi present in the tissue were quantified by anti-Pb antibody.

RESULTS

Most patients were white men with mean age of 47 years old and showed higher incidence of multiple lesions. Loose granulomas were predominant and exhibited a great amount of M2 macrophages, which were visualized with anti-CD163 antibody. The expression for CD163 and CD68 was similar (P = 0.05), highlighting the predominance of M2 macrophages in PCM. IL-1β, IL-6, and TNF-α immunoexpression did not significantly change with CD163, CD68, and S100 protein. The number of fungi was significantly higher in cases with intense IL-1β immunoexpression (P = 0.003).

CONCLUSIONS

M2-activated macrophages were the majority among inflammatory cells in chronic PCM, characterizing the action of a Th2-immune response. Nevertheless, Th1 cytokines were also found; mainly IL-1β, which was associated with fungi counting in oral lesions.

Rare oral cartilaginous choristoma: a case report and review of the literature

Cartilaginous choristomas are extraosseous benign tumors. They occur in abnormal sites that usually do not contain chondrocytes. The oral variant of this entity is considered to be very rare, with only 38 cases currently published in the literature. This article presents a case of an oral cartilaginous choristoma lesion. In addition to presenting clinical and histological diagnoses, this article compares the present case to recently reported cases. Special attention was given to analyzing cells of the oral cartilaginous choristoma, which appear as well-differentiated chondrocytes with a pale blue cytoplasm surrounded by a light basophilic stroma and no evidence of malignity. Following surgical excision, the lesion did not recur, which is similar to other reported cases of oral cartilaginous choristomas.

Expression of E-cadherin and β-catenin in basaloid and conventional squamous cell carcinoma of the oral cavity: are potential prognostic markers?

Background

Basaloid squamous cell carcinoma presents with a preference for the head and neck region, and shows a distinct aggressive behavior, with frequent local recurrences, regional and distant metastasis. The alterations in the cadherin-catenin complex are fundamental requirements for the metastasis process, and this is the first study to evaluate the immunostaining of E-cadherin and β-catenin in oral basaloid squamous cell carcinoma.

Methods

Seventeen cases of this tumor located exclusively in the mouth were compared to 26 cases of poorly differentiated squamous cell carcinoma and 28 cases of well to moderately differentiated squamous cell carcinoma matched by stage and tumor site. The immunostaining of E-cadherin and β-catenin were evaluated in the three groups and compared to their clinicopathological features and prognosis.

Results

For groups poorly differentiated squamous cell carcinoma and basaloid squamous cell carcinoma, reduction or absence of E-cadherin staining was observed in more than 80.0% of carcinomas, and it was statistically significant compared to well to moderately differentiated squamous cell carcinoma (p = .019). A strong expression of β-catenin was observed in 26.9% and 20.8% of well to moderately differentiated squamous cell carcinoma and poorly differentiated squamous cell carcinoma, respectively, and in 41.2% of basaloid squamous cell carcinoma. The 5-year and 10-year overall and disease-free survival rates demonstrated no significant differences among all three groups.

Conclusions

The clinical and biological behavior of three groups of the oral cavity tumors evaluated are similar. E-cadherin and β-catenin immunostaining showed no prognostic value for basaloid and conventional squamous cell carcinomas.

Paracoccidioidomycosis mimicking squamous cell carcinoma on the dorsum of the tongue and review of published literature

INTRODUCTION

Paracoccidioidomycosis is a disease that is endemic to southern and southeastern Brazil, caused by the fungus Paracoccidioides brasiliensis. The most common clinical oral manifestation is the presence of multiple granulomatous ulcers with hemorrhagic dots, located mainly on the lips, palate, and buccal mucosa. However, the disease can manifest atypically as a single ulcer, mimicking oral squamous cell carcinoma (SCC) or tuberculosis.

CASE REPORT

A 65-year-old male patient presented with a complaint of a single ulcerated lesion on the dorsum of the tongue; the lesion had evolved over 6 months. The diagnostic hypotheses were SCC and oral manifestation of tuberculosis. An incisional biopsy was performed, and histopathological analysis of the specimen revealed pseudoepitheliomatous hyperplasia, a granulomatous structure of epithelioid histiocytes, multinucleated giant cells, and lymphocytes in the connective tissue. Grocott staining confirmed the presence of the fungus in the lesion, and a diagnosis was made of paracoccidioidomycosis. The patient was treated with 200 mg/day of itraconazole for 12 months and now shows no signs or symptoms of recurrence of the disease.

CONCLUSION

Correct diagnosis is essential for a successful therapeutic approach and resolution of the lesion.

Correlation between inflammatory infiltrate and epithelial lining in 214 cases of periapical cysts

The aim of this study was to evaluate the prevalence of periapical cysts, identify their clinical and microscopic features and correlate their microscopic features with the inflammatory infiltrate present in the lesion site. A total of 214 cases were collected over a 10-year period. Clinical data, including gender, age, race, symptoms and location of the lesion, were recorded. Two independent examiners with no prior knowledge of the patients' clinical data conducted the microscopic evaluations. Statistical analyses were performed using Fisher's or chi-square tests at a 5% level of significance. The results showed that periapical cysts were more prevalent in white women, with a mean age of 35 years, and in the anterosuperior region. The majority of the lesions were lined by atrophic cystic epithelium, which was associated with moderate inflammatory infiltrate in the cystic capsule (p < 0.01), with a diffuse localization pattern (p = 0.03) and absence of neutrophils (p = 0.01). Our findings suggest that periapical cysts lined by atrophic epithelium are related to the presence of moderate mononuclear inflammatory infiltrate.

Noninvasive treatment choice for an aged down syndrome patient presenting a residual periapical cyst

AIM

This is the first report to illustrate the marsupialization as an effective treatment for a Down Syndrome (DS) patient presenting a residual periapical cyst.

BACKGROUND

These cysts occur within the alveolar ridge, usually at the local site of a previously extracted tooth that did not received proper curettage; usually the surgical excision of a cyst and also the vigorous curettage of a socket is very simple, if not for the fact that mentally disabled patients require rapid and non-stressful procedures.

CASE DESCRIPTION

The 54-year-old DS patient represented herein received a minimally invasive marsupialization under local anesthesia. Due to the large extent of the lesion, the acrylic resin drain was maintained for 30 days. Through the following period, a daily irrigation of the cystic cavity with saline solution was carried out to prevent a secondary infection within the cystic cavity. A follow-up of 16 months showed no signs of recurrence.

CONCLUSION

Marsupialization of residual periapical cyst is completely effective and safe, even for a DS patient that is considered to be at an advanced age.

CLINICAL SIGNIFICANCE

Marsupialization poses as a minimally invasive choice for mentally disabled patients, even when presenting advanced ages; treatment success was stated by the easy clinical conduct, uneventful postoperative situation and the lack of recurrence along 16 months of follow-up.

Endodontic retreatment of dens invaginatus presenting with gutta-percha overfilling at the attached gingiva and chronic apical periodontitis: unusual clinical report

AIM

This work describes the retreatment of an unusual case of dens invaginatus with gutta-percha overfilling at the gingival mucosa and chronic apical periodontitis in a 34-year-old woman. Initial periapical radiograph showed the presence of type II dens invaginatus with poor quality obturation, root perforation and chronic apical periodontitis of tooth 22.

BACKGROUND

Dens invaginatus is a tooth malformation caused by infolding of the dental papilla during tooth development. This anomaly has been associated with increased prevalence of pulpal and periapical diseases.

CASE DESCRIPTION

Conventional endodontic retreatment was performed using rotary files and calcium hydroxide paste as intracanal dressing. After 7 days, root canal was filled with guttapercha points and Sealapex® sealer. Obturation was radiographically followed and, after 3 years, absence of fistula and periapical radiolucency was observed, thus conventional endodontic therapy proved to be successful.

CONCLUSION

Conventional endodontic retreatment of type II dens invaginatus has been successful for a 3-year period, showing a better treatment alternative.

CLINICAL SIGNIFICANCE

Conservative endodontic retreatment of dens invaginatus should be considered to promote periapical healing with complete reconstitution of bone and periodontal ligament regeneration without signs of recurrence over a period of 3 years. Moreover, it preserves the entire tooth.

Candida albicans isolation from buccal mucosa of patients with HIV wearing removable dental prostheses

PURPOSE

The aim of this study was to evaluate the influence of complete or partial removable dental prostheses (RDPs) on the frequency of Candida albicans isolated from the mouth and the presence of oral candidiasis in human immunodeficiency virus-positive (HIV+) patients correlated with CD4 levels.

MATERIALS AND METHODS

One hundred ninety-three HIV+ patients were evaluated; 68 had RDPs and 125 did not. CD4 cell count was obtained after blood sampling and performed on the day of clinical examination. The material was collected from the buccal mucosa for isolation of yeasts with a sterile swab and seeded onto Sabouraud dextrose agar with chloramphenicol. C albicans strains were identified by testing germ tubes and chlamydospore formation and biochemical (zymogram, auxanogram) characteristics. The results were subjected to the Fischer exact test and chi-square tests.

RESULTS

C albicans were isolated from 45 (66.17%) patients who had RDPs and 48 (38.4%) who did not (P = .0003). The presence of oral candidiasis was observed in 14 patients (7.25%), and 10 of the 14 (71.43%) were RDP users. The absence of candidiasis occurred in 121 (67.59%) nonusers and 58 (32.40%) users of RDPs (P = .0065). The mean CD4 cell count was lower in patients with oral candidiasis regardless of the use of RDPs.

CONCLUSION

The use of RDPs was an important factor in the isolation of C albicans among HIV+ patients, and CD4 level seems to play a role in the presence of oral candidiasis.

Características Clínicas, Epidemiológicas e Microscópicas do Câncer Bucal Diagnosticado na Universidade Federal de Alfenas

O presente trabalho teve por objetivo caracterizar e comparar as características clínicas e demográficas dos pacientes portadores de câncer bucal e avaliar os aspectos microscópicos de cada neoplasia, baseando-se na graduação histopatológica de malignidade. Foi realizado um levantamento de todas as neoplasias malignas diagnosticadas e arquivadas no Laboratório de Anatomia Patológica da Universidade Federal de Alfenas desde janeiro de 1998 até dezembro de 2006 e constatou-se um número de 49 tumores. Os resultados demonstraram que, dessas 49 lesões, 43 eram carcinomas espinocelulares, três eram neoplasias malignas de glândulas salivares e os demais eram carcinomas in situ, microinvasivos e verrucosos. Os tumores foram mais prevalentes em pacientes leucodermas, com idades entre 51 e 60 anos, e do gênero masculino. As lesões se localizavam com maior frequência em borda lateral de língua e se apresentavam na forma de úlceras infiltrativas. Constatou-se também que os tumores, em sua maioria, eram carcinomas espinocelulares bem diferenciados e apresentavam um índice de graduação histopatológica de malignidade entre 4 e 8. Concluiu-se que o câncer bucal ainda é uma lesão bastante prevalente e que tem uma predileção por pacientes leucodermas, acima de 50 anos de idade e do gênero masculino.