A retrospective study of 30 basal cell adenomas of the salivary gland in a Brazilian population and literature review

PURPOSE

The present study aimed to provide the clinicopathological data of Brazilian patients with basal cell adenoma (BCA).

METHODS

Records of BCA cases were retrospectively gathered from the Brazilian National Cancer Institute database between 1996 and 2006. All cases were histopathologically reviewed, and the clinicopathological data were collected from the patients' medical files. In addition, an English literature review about this tumor is also presented.

RESULTS

Of 1127 salivary gland tumors identified, 30 were BCAs (2.7%). Women were more affected than men (70.0% vs. 30.0%), and the majority (60.0%) were elderly (> 65 years old). The parotid gland was the most frequent location affected (93.3%), followed by the upper lip (3.3%) and submandibular gland (3.3%). Fine-needle aspiration was the main procedure applied to establish a preoperative diagnosis of tumor; however, the results were not always consistent. Histopathologically, the trabecular pattern was the most common type seen (50.0%) among our BCA samples. Most patients underwent superficial or partial parotidectomy. Frey's syndrome was reported only in one case during the follow-up. No recurrence was noted in the present series. The literature review revealed a total of 213 reported cases of BCA in the period investigated.

CONCLUSIONS

This is the first case series of BCA reported in Brazil. As occurred in other previously reported series, the clinicopathological data of BCAs are similar and confirm that this type of tumor is rare, develops predominantly in the parotid gland, frequently affects older women, has an indolent behavior, and the affected patients have an excellent prognosis.

An unusual clinical manifestation of oral melanocytic nevus

Melanocytic nevi are acquired or congenital benign neoplasms, often found in skin but rarely in the oral mucosa. This article reports an atypical case of oral hypopigmented melanocytic nevus in a 39-year-old woman referred for evaluation of a well-circumscribed papule with discrete brownish spots in the buccal mucosa. An excisional biopsy was performed, the results of which led to a clinical diagnosis of inflammatory fibrous hyperplasia. The histopathologic analysis resulted in a diagnosis of hypopigmented intramucosal melanocytic nevus. This unusual clinical manifestation of melanocytic nevus reinforces the importance of including nonpigmented or hypopigmented melanocytic nevi in the differential diagnosis of papules arising in the oral mucosa. A biopsy and subsequent histologic examination of the specimen are recommended to establish an accurate diagnosis.

Atypical angiofibroma in a patient with compromised general health: A case report

Introduction

The nasopharyngeal angiofibroma (NA) is a benign tumor that originates from the pterygopalatine fossa and extends to the adjacent anatomical structures and affects frequently young individuals. The basic treatment for NA is surgical resection, but in some cases the tumor is surgically inaccessible.

Case presentation

We describe the case of a 45-year-old male with respiratory difficulty after the appearance of a soft palate lesion. The clinical appearance of NA was not specific.

Discussion

There are still discussions about the best therapeutic strategy and controversies about performing incisional biopsy. To our knowledge, this is the first report of a NA in an adult patient in which the general health conditions prevented the therapeutic approach, besides the extension of the lesion and its complications.

Conclusion

Our case shows that NA may reach high proportions and its involvement in older patients should be considered. In this report, we showed the limitation of the therapeutic strategy for advanced cases of NA.

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A 45-year-old man with soft palate injury and respiratory distress.

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Imaging examination showed involvement of the nasal cavity, nasopharynx and soft palate.

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Initially, an intraoral incisional biopsy was performed under general anesthesia.

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Surprisingly it was a nasopharyngeal angiofibroma.

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General health status and extent of the lesion limited therapeutic intervention.

Epigenetic modifications in oral squamous cell carcinoma

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Evaluation of specific modified histones in lip carcinogenesis

OBJECTIVE

Histones regulate chromatin density and therefore influence gene expression and cellular proliferation. These properties are modified by methylation, acetylation and phosphorylation of histones. The aim of this study was to investigate the variation of specific modified histones in actinic cheilitis (AC) and squamous cell carcinoma of the lip (SCCL).

METHODS

Samples of non-neoplastic tissue of the lip (NNTL, n = 9), AC (n = 33), and SCCL (n = 27) were submitted to immunohistochemistry to detect the modified histones H3K36me3, H3K9ac, H4K12ac, and H3S10 ph.

RESULTS

Reactivity for all of the modified histones was significantly decreased from NNTL to AC, but not from AC to SCCL. Dysplasia in AC or histological grade in SCCL were not related to the reactivity of any modified histones.

CONCLUSIONS

Histone modifications are related to initial actinic damage, but not to malignant transformation in the lip.