Queratocisto odontogênico agressivo: relato de caso

Introdução: O queratocisto odontogênico compreende uma lesão cística benigna, de origem dos restos da lamina dentaria ou células epiteliais adjacentes, com altas taxas de recorrência, crescimento rápido no sentido antero-posterior no interior do tecido ósseo medular. Objetivo: Este trabalho tem como objetivo descrever relato de caso de um queratocisto atípico. Relato de Caso: Paciente leucoderma, 17 anos, encaminhando ao serviço de Cirurgia e Traumatologia Bucomaxilofacial devido queixa de aumento de volume, dor, dormência do lábio inferior, mobilidade dentaria. Foi solicitado exame de imagem, uma tomografia de face, onde se evidenciou uma imagem hipodensa, osteolítica, envolvendo região mandibular. O paciente foi diagnostico com queratocisto odontogênico, sendo submetido a tratamento conservador da lesão. Conclusão: O tratamento escolhido foi individualizado e escolhido conforme o embasamento teórico encontrado, levando em consideração todas as complicações. O tratamento proposto foi efetivo até atual momento, e o paciente permanece em acompanhamento clinico e radiográfico, entretanto não indica cura da doença. Descritores: Cistos Ósseos; Patologia Bucal; Mandíbula. Referências Neville BW, Damm DD, Alen CM, Bouquot JE. Patologia oral e maxilofacial. 4.ed. Rio de Janeiro: Elsevier; 2016. Tenorio J, Arias P, Martínez-Glez V, Santos F, García-Miñaur S, Nevado J, Lapunzina P. Simpson-Golabi-Behmel syndrome types I and II. Orphanet J Rare Dis. 2014;9:138. Sánchez-Burgos R, González-Martín-Moro J, Pérez-Fernández E, Burgueño-García M. Clinical, radiological and therapeutic features of keratocystic odontogenic tumours: a study over a decade. J Clin Exp Dent. 2014;6(3):e259-64. de Castro MS, Caixeta CA, de Carli ML, Ribeiro Júnior NV, Miyazawa M, Pereira AAC, Sperandio FF, Hanemann JAC. Conservative surgical treatments for nonsyndromic odontogenic keratocysts: a systematic review and meta-analysis. Clin Oral Investig. 2018;22(5):2089-2101. Fidele NB, Yueyu Z, Zhao Y, Tianfu W, Liu J, Sun Y, Liu B. Recurrence of odontogenic keratocysts and possible prognostic factors: Review of 455 patients. Med Oral Patol Oral Cir Bucal. 2019;24(4):e491-e501. Chrcanovic BR, Gomez RS. Recurrence probability for keratocystic odontogenic tumors: An analysis of 6427 cases. J Craniomaxillofac Surg. 2017 Feb;45(2):244-51. Jalali E, Ferneini EM, Rengasamy K, Tadinada A. Squamous cell carcinoma arising within a maxillary odontogenic keratocyst: A rare occurrence. Imaging Sci Dent. 2017;47(2):135-40.

Comparison of osteoclastogenesis and local invasiveness of ameloblastoma and keratocystic odontogenic tumor

Objectives The aim of this study was to compare the expression of receptor-activated nuclear factor kappa B (RANK) with its ligand (RANKL) and matrix metalloproteinase-2 (MMP2) in solid/multicystic ameloblastomas (ABs) and keratocystic odontogenic tumors (KOTs). Materials and Methods: The expression of MMP2, RANK, and RANKL molecules was evaluated in 13 ABs and 14 KOTs by immunohistochemistry. The expressions were calculated in the odontogenic epithelial cells as well as the stromal cells. Results: Odontogenic epithelia of AB expressed MMP2, RANK, and RANKL significantly higher than that of KOTs (P < 0.05). The expression of MMP2, RANK, and RANKL was highest in plexiform subtype (79.9%, 81.08%, and 65.1%, respectively). KOTs without daughter epithelia nests expressed both MMP2 and RANK the least (56.06% and 47.5%, respectively). Stromal cells, on the other hand, expressed similar MMP2 pattern in odontogenic epithelia of both AB and KOT. RANKL was expressed weaker in the stromal cells of both lesions. Conclusion: Invasive biological and osteolytic behaviors of both lesions were evaluated in this study. It was found to be more in AB than keratocystic odontogenic. A significant expression of MMP2, RANK, and RANKL in both KOTs associated with microcyst and plexiform type AB as well.