ORAL AND MAXILLOFACIAL PATHOLOGY OOOO

e128 Abstracts February 2014

GERALDO NASCIMENTO, GRAZIELLA CHAGASJAGUAR, JOSÉ DIVALDO PRADO, FÁBIO DE ABREUALVES. HOSPITAL AC CAMARGO.

Girl, 2, was referred for evaluation of a facial deformityconsisting of asymptomatic swelling of both the maxilla andmandible bilaterally. The first signs were noted 1 year previously.Imaging showed expansive osteogenic lesions with areas ofcalcification as well as thinning and rupture of the cortical bone ofthe primary teeth. Frozen biopsy was done, then, under generalanesthesia, tumor resection was performed in two different surgicalprocedures. Microscopic analysis of surgical specimens revealedhomogenous epithelial proliferation with irregularly formeddystrophic calcifications and dentin-like hard tissue resembling anadenomatoid odontogenic tumor (AOT). Remarkably, epithelialsheets formed of cuboidal cells produced areas with a glandularappearance and scant evidence of the tubular arrangement typicalof classical AOT. This less complex cellular organizationcompared to classical AOT may represent a hitherto less well-defined odontogenic tumor entity. The patient has been followedup for 3 years with no signs of local recurrence.

AO-39 - NEURILEMMOMAOFTHEHARDPALATE INAN18-YEAR-OLD WOMAN: CASE REPORT. GABRIELFUKUNAGA KATO, ANA MARIA HOYOS CADAVID, ANNATORREZANI, FABIANA MARTINS E MARTINS, MARILIATRIERVEILER MARTINS, FABIO DAUMAS NUNES,SUZANA CANTANHEDE ORSINI MACHADO DE SOUZA.FACULDADE DE ODONTOLOGIA DA UNIVERSIDADE DESÃO PAULO.

Woman, 18, was referred for assessment of an asymptomaticnodule in the hard palate. At the School of Dentistry of USP, thelesion was described as a 3-cm solid nodule exhibiting telangi-ectasia. According to the patient, the lesion had been growing for2 years. An incisional biopsy was immediately performed, withfindings suggesting mucoepidermoid carcinoma. Histopatholog-ical analysis with eosin-hematoxylin staining and immunohisto-chemical reaction showed proliferating Schwann cells, sometimesarranged in palisades around acellular zones (Verocay bodies).The Schwann cells were positive for S100 protein. These featureswere compatible with the diagnosis of neurilemmoma, so thepatient was referred to an oral and maxillofacial surgery servicefor appropriate surgical treatment.

AO-40 - 9-YEAR FOLLOW-UP OF POSTOPERATIVEAMELOBLASTIC FIBROMA: CASE REPORT. JOÃONUNES NOGUEIRA NETO, JEAN NUNES DOS SANTOS,ARLEI CERQUEIRA, SANDRA DE CÁSSIA SANTANASARDINHA. UNIVERSIDADE FEDERAL DA BAHIA.

Ameloblastic fibroma is an unusual odontogenic tumor foundpredominantly in young patients, with no gender predilection.The posterior jaw is affected most often and lesions are associatedwith impacted teeth. Usually asymptomatic, larger lesions withcortical extension may be painful. Characteristics include a softtissue mass with a smooth surface with or without a well-definedcapsule. Radiographs reveal a unilocular or multilocular radiolu-cent area with well-defined borders. Histopathologically there maybe odontogenic cubic or columnar epithelial cells and ovoid andstellate mesenchymal cells. Boy, 6, had painful swelling in theposterior area of the jaw diagnosed as ameloblastic fibroma.Assessing an ameloblastic fibroma can be difficult at first becauseof its nonspecific features. Conservative treatment can be sufficientfor early tumors; extensive excisions are required for large or

relapsing lesions. Patients should be followed up long-termbecauseof the possibility of relapse and malignant transformation.

AO-41 - NON-EXPOSED BISPHOSPHONATE OSTEO-NECROSIS OF THE MANDIBLE: A CRITICAL OVERVIEWOFDEFINITION, STAGING,ANDTREATMENT. MARCOSMARTINS CURI, DANIEL HENRIQUE KOGA, CAMILALOPES CARDOSO, CRISTINA ZARDETTO, SÉRGIOROCHA ARAÚJO. HOSPITAL SANTA CATARINA, SÃOPAULO.

Non-exposed bisphosphonate-related osteonecrosis of thejaws is a newly reported complication arising from bisphospho-nate therapy characterized by atypical symptoms and no apparentmucosal fenestration or exposure of necrotic bone. We present acase that could not be classified into any proposed stage becauseit had findings associated with stages 0 and 3. Woman, 66, had ahistory of intravenous bisphosphonate therapy over the past 6months and implant surgery 2 months previously. She developednon-exposed osteonecrosis of the mandible. Clinical examinationrevealed an intact oral mucosa around the implants with signs offistulae or bone exposure. Computed tomography scans showedpathologic fracture of the mandible involving one of the implants.Treatment consisted of bone resection and fixation with themandibular reconstruction plate with platelet-rich plasma. Thepatient’s bone/mucosal healing allowed her to resume wearing theimplant-supported prostheses 4 months after surgery.

AO-42 - ORAL AND MAXILLOFACIAL CONSIDER-ATIONS IN GARDNER’S SYNDROME: REPORTOF TWOCASES. PAULO ANDRÉ GONÇALVES DE CARVALHO,DEBORA LIMA PEREIRA, DANIEL CAMPANHÃ, RODRIGONASCIMENTO LOPES, FABIO DE ABREU ALVES, ANDRÉCAROLI ROCHA. A C CAMARGO CANCER CENTER.

Gardner syndrome (GS) is an autosomal dominant geneticdisorder characterized by intestinal polyps, multiple osteomas, andsoft tissue tumors. Dental abnormalities such as impacted orunerupted teeth, congenitally missing teeth, supernumerary teeth,hypercementosis, and compound odontomas are present in 30% to75%, and osteomas in 68% to 82% of GS patients. This studydescribed the stomatological manifestation of GS in two patients.In addition, the important role of the dentist in its diagnosis isemphasized. The first patient, a woman, 49, had supernumeraryteeth in both of jaws and osteomas on the right side of the mandibleand right condyle. The second patient, a woman, 20, had multipleosteomas on the right side of the mandible and was later diagnosedwith GS. Surgical excision of the osteomas on the right side of themandible was performed. In conclusion, the ability to diagnose thisdisease in its early stage allows an excellent prognosis and avoidsthe malignant transformation of colonic polyposis.

AO-43 - ORAL HERPES SIMPLEX VIRUS INFECTION INHEMATOLOGY PATIENT. GRAZIELLA CHAGASJAGUAR, ANA CLÁUDIA LUIZ, ADRIELE FERREIRAGOUVEA VASCONCELLOS, ARISTILIA KEMP, MARCELOBELLESSO, THAIS BIANCA BRANDÃO. INSTITUTO DOCÂNCER DO ESTADO DE SÃO PAULOeICESP.

Oral herpes simplex virus (HSV) infection is a commoncomplication in patients with hematological malignancies whoare undergoing chemotherapy. Although frequent, HSV in thesepatients often has atypical characteristics and can remain unrec-ognized or be misdiagnosed. The authors report an atypical caseof HSV with a complicated diagnosis and management. Woman,