RECURRENT PARACOCCIDIOIDOMYCOSIS: A CASE REPORT

RECURRENT PARACOCCIDIOIDOMYCOSIS: A CASE REPORT

ORAL AND MAXILLOFACIAL PATHOLOGY e118 Abstracts a secondary side effect of the therapy. A 2-year-old female patient diagnosed with ALL B-lineage was s...

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ORAL AND MAXILLOFACIAL PATHOLOGY e118 Abstracts a secondary side effect of the therapy. A 2-year-old female patient diagnosed with ALL B-lineage was sent to a reference center for treatment. She started chemotherapy through GBTLIALL-2009 protocol and underwent 2 cycles of MADIT. During therapy, presented severe ulcerated lesion of mucositis characterized by painful sores on the lips and gum region that caused dysphagia. Ulcerative lesions were diagnosed as grade III mucositis, according to WHO classification. Topical corticosteroid triamcinolone-acetonide was used for treating the injuries. The cleaning mucosa was performed using chlorhexidine gluconate plus orientation about oral hygiene. Quantification of HSV-1 was also performed and the viral load was high, with 718978 copies. In the following weeks, the patient developed worsening of clinical symptoms and died 4 weeks after the start of chemotherapy because of exacerbation of the underlying disease.

CPP327 - NODULE CYSTIC BASAL CELL CARCINOMA IN NASOLABIAL GROOVE: A CASE REPORT. LUCAS COSTA ZARANZA, RENATA GUALBERTO DA CUNHA, DÉBORAH LÚCIA LIMA DA COSTA, TATIANA NAYARA LIBORIO-KIMURA, RICARDO ALEXANDRE GUIMARAES, MICHELLE MARTINS, SILVANA DE ALBUQUERQUE SILVA DAMASCENO. A 79-year-old male patient was referred to the Department of Dermatology from an Institution, presenting lesion in nasolabial groove region. Physical examination revealed a hardened plate with pigmented pearly edges measuring 1.5 cm x 1.5 cm. The patient reported previous surgery in the area 9 years ago. Excisional biopsy with the hypothesis of recurrent basal cell carcinoma was performed. Histopathologic examination revealed epithelium containing ulceration and hyperkeratotic areas. On the dermis, it was observed a tumor characterized by proliferation of basaloid cells arranged in palisade, with some cell masses presenting central degeneration. Deposits of homogenized collagen bundles, fibroblast proliferation, inflammatory infiltrate focus containing lymphocytes, plasma cells, histiocytes, eosinophils and neutrophils were also observed, as well as tumor cells permeating nerve fillets and blood vessels and presence of amyloid material with areas of calcification, melanin pigment and mucin. The histopathologic diagnosis of nodule-cystic basal cell carcinoma was established. Patient is under clinical follow-up for 10 months.

CPP328 - AMELOBLASTIC CARCINOMA INTRAOSSEOUS SECONDARY TYPE OF THE MAXILLA. HUGO COSTA-NETO, ANDRÉIA FERREIRA DO CARMO, LUIZ ARTHUR BARBOSA DA SILVA, MARIA LUIZA DINIZ DE SOUSA LOPES, LÉLIA BATISTA DE SOUZA, ROSEANA DE ALMEIDA FREITAS, HÉBEL CAVALCANTI GALVÃO. Ameloblastic carcinoma (secondary type) is an extremely rare occurrence that represents malignant transformation of a preexisting well-differentiated benign ameloblastoma. Multiple local recurrences will precede this transformation. Herein we report a case of ameloblastic carcinoma, secondary type, arising at the posterior maxilla in a 42-year-old female patient submitted to ameloblastoma resection, which came after 3 recurrences of benign ameloblastoma in a period of 4 years. Image exams showed radiopaque mass with cortical bone disruption and maxillary sinus invasion. Histologic analysis demonstrated

OOOO August 2017 features of nests and islands of epithelium malignant transformation, atypia, pleomorphic cell, nuclear hyperchromatism, cystic degeneration, comedonecrosis and desmoplasia. Ameloblastic carcinoma, secondary type, represents a rare and challenging histologic diagnosis. Surgical access with adequate hard and soft tissue margins is essential for the patient’s survival.

CPP329 RECURRENT PARACOCCIDIOIDOMYCOSIS: A CASE REPORT. MÁRCIO CAMPOS OLIVEIRA, MARIA EMÍLIA SANTOS PEREIRA RAMOS, MICHELLE MIRANDA LOPES FALCÃO, VALÉRIA SOUZA FREITAS, JENER GONÇALVES DE FARIAS, ANA PAULA EUFRÁZIO DO NASCIMENTO ANDRADE, TARSILA DE CARVALHO FREITAS RAMOS. The paracoccidioidomycosis is the most important systemic mycosis in Brazil, with morbidity related to disease activity and possible sequels. A male patient, 46 years old, farmer, attended the oral medicine service with lesions in the lower lip and floor of the mouth, with painful symptoms of 4 months of evolution. On clinical examination, there was large granulomatous ulcers. The clinical diagnosis was paracoccidioidomycosis, which after incisional biopsy was confirmed by the histopathologic examination followed by special staining. The patient was referred for treatment with pulmonologist, which prescribed ketoconazole. Three years after, the patient returned with extensive damage on the floor of the mouth with the same clinical aspect and admitted not having completed the initial treatment. A new biopsy was performed and the diagnosis was again confirmed. The patient was referred to the pulmonologist again and is under strict monitoring and injury free for 6 months.

CPP330 - SIALOLITHIASIS: CLINICAL AND RADIOGRAPHIC APPROACH. FERNANDA MOMBRINI PIGATTI, ZILDA FAGUNDES OLIVEIRA, LIGIA BULLOTO SCHMITD, FABIANA DE FREITAS BOMBARDA-NUNES. The sialolithiasis is characterized by the formation of a calcified structure within the salivary gland or its ductal system. In general, the submandibular gland is the most prevalent, being most common in adults over 40 years. Clinical tests and imaging studies are essential to confirm the diagnosis. A 41-year-old female patient attended the Regional Health Unit of the Municipality of Serra, complaining of difficulty feeding, swallowing and phonation for over 3 months, with a significant worsening in the previous 3 days. Clinically, it was observed unilateral left cervical lymphadenopathy and a hardened nodule was pointed out in the floor of the mouth region. The occlusal radiographic examination revealed the presence of a radiopaque mass. Based on clinical and radiographic observations, the diagnostic sialolithiasis was confirmed. Postoperative follow-up was proven to normal salivary flow and also the anatomic aspects of oral floor after surgical treatment.

CPP331 - DESMOPLASTIC FIBROMA OF THE MANDIBLE: A CASE REPORT. MÁRCIO CAMPOS OLIVEIRA, TARSILA DE CARVALHO FREITAS RAMOS, MICHELLE MIRANDA LOPES FALCÃO, JOANA DOURADO MARTINS, ANA PAULA EUFRÁZIO DO NASCIMENTO ANDRADE, ANTÔNIO VARELLA CANCIO, JENER GONÇALVES DE FARIAS.