Nevo azul na mucosa bucal: Relato de Casos

Gabriela Lopes dos Santos, Bruna Maria Rodrigues Vilardi, Taisa Maria Rodrigues Vilardi, Ana Lucia Conelian Gentili, Nancy Alfieri Nunes

Resumo


Objetivo: Este trabalho teve como objetivo avaliar a incidência, características clinicas e histopatológicas e possível malignidade de nevos azuis de cavidade bucal, e descrever dois casos clínicos no período de 25 anos. Relato de casos: Os pacientes, em idades diferentes apresentaram lesões enegrecidas azuladas na mucosa do lábio superior e rebordo alveolar inferior esquerdo, com diagnóstico inicial de nevo azul e melanoma, respectivamente. As lesões foram removidas cirurgicamente, porém a de rebordo se encontrava aderida ao periósteo. O resultado histopatológico de ambas foi de nevo azul de mucosa bucal. O nevo azul é diagnosticado histopatologicamente como um acúmulo de células melanódicas em profundidade ou no tecido conjuntivo sub-epitelial. O acompanhamento de tais casos foi de 22 anos e 8 meses, respectivamente, para avaliar possível malignização. Conclusão: O cirurgião-dentista deve estar apto para avaliar clinicamente as lesões melanóticas da mucosa bucal e conduzir seu diagnóstico, tratamento e acompanhamento posterior ante a possibilidade de ocorrência de malignidade mesmo anos após o diagnóstico da lesão benigna. Os exames imunoistoquímicos podem ser relevantes para diferenciação histopatológica dessas lesões.

 

PALAVRAS-CHAVE: Nevo azul. Mucosa bucal. Nevo pigmentar

Palavras-chave


Nevo azul; Mucosa bucal; Nevo pigmentar

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Referências


- Ferreira L, Jham B, Assi R, Readinger A, Kessler HP. Oral melanocytic nevi: a clinicopathologic study of 100 cases. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015; 120: 358–367. https://doi.org/10.1016/j.oooo.2015.05.008

- Meleti M, Vescovi P, Mooi WJ, Van der Waal I. Pigmented lesions of the oral mucosa and perioral tissues: a flow-chart for the diagnosis and some recommendations for the management. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 105: 606–616. https://doi.org/10.1016/j.tripleo.2007.07.047

- Hadziabdic N, Sulejmanagic H, Kurtovic-Kozaric A.. The role of general dental practitioners in the detection of early-stage oral malignancies–A review. J Oral Maxillofac Surg Med Pathol. 2017; 29: 363–376. https://doi.org/10.1016/J.AJOMS.2017.03.009

- Santos TS, Frota R, Martins-Filho PRS, Cavalcante JR, Raimundo R.C, Andrade ESS. Extenso nevo azul intraoral: relato de caso. An Bras Dermatol. 2011; 86: 61–65. https://doi.org/10.1590/S0365-05962011000700015

- Marangon Júnior H, Souza PEA, Soares R., de Andrade BAB, de Almeida OP, Horta MCR. Oral Congenital Melanocytic Nevus: A Rare Case Report and Review of the Literature. Head Neck Pathol. 2015; 9: 481–7. https://doi.org/10.1007/s12105-015-0639-8

- Barnhill RL, Argenyi Z, Berwick M, Duray PH, Erickson L, Guitart J et al. Atypical Cellular Blue Nevi (Cellular Blue Nevi With Atypical Features): Lack of Consensus for Diagnosis and Distinction From Cellular Blue Nevi and Malignant Melanoma (“Malignant Blue Nevus”). Am J Surg Pathol. 2008; 32: 36–44. https://doi.org/10.1097/PAS.0b013e3181573aaf

- Gombra V, Kaur M, Sircar K, Popli DB. Pigmented oral compound nevus of retromolar area – A rare case report. Singapore Dent J. 2016; 37: 33–35. https://doi.org/10.1016/j.sdj.2016.10.001

- Magro CM, Crowson AN, Desman G, Zippin JH. Soluble Adenylyl Cyclase Antibody Profile as a Diagnostic Adjunct in the Assessment of Pigmented Lesions. Arch Dermatol 2012: 148: 335. https://doi.org/10.1001/archdermatol.2011.338

- Teles JC, Cardoso AS, Gonçalves AR. Blue nevus of the oral mucosa. Review of the literature and report of two cases. Oral Surg Oral Med Oral Pathol.1974; 38: 905–10. https://www.sciencedirect.com/science/article/abs/pii/0030422074903430?via%3Dihub

- Buchner A, Merrell PW, Carpenter WM. Relative frequency of solitary melanocytic lesions of the oral mucosa. J Oral Pathol Med Oral Pathol. 2004; 33:550–557. https://doi.org/10.1111/j.1600-0714.2004.00238.x

- Cerroni L, Borroni RG, Massone C, Kerl H. “Ancient” Blue Nevi (Cellular Blue Nevi With Degenerative Stromal Changes). Am J Dermatopathol. 2008; 30: 1–5. https://doi.org/10.1097/DAD.0b013e31815b7530

- Takata M, SaidaT. Genetic alterations in melanocytic tumors. J Dermatol Sci. 2006; 43: 1–10. https://doi.org/10.1016/j.jdermsci.2006.05.002

- de Andrade BAB, León JE, Carlos R, Delgado-Azañero W, Mosqueda-Taylor A, de Almeida OP. Immunohistochemical expression of p16, p21, p27 and cyclin D1 in oral nevi and melanoma. Head Neck Pathol. 2012; 6: 297–304. https://doi.org/10.1007/s12105-012-0334-y

- Pilloni L, Bianco P, DiFelice E, Cabras S, Castellanos ME, Atzori L, Ferreli C, Mulas P, Nemolato S, Faa G. The usefulness of c-Kit in the immunohistochemical assessment of melanocytic lesions. Eur J Histochem. 2011; 55: 20. https://doi.org/10.4081/ejh.2011.e20

- Gilbert ML, Hanna W, Ghazarian D, Dover D, Klieb HBE. Congenital melanocytic nevus of the oral mucosa: report of a rare pigmented lesion and review of the literature. Clin Pract 2011; 1: 17. https://doi.org/10.4081/cp.2011.e17

- Agarwal P, Saxena S, Kumar S, Gupta R. Melanotic neuroectodermal tumor of infancy: Presentation of a case affecting the maxilla. J Oral Maxillofac Pathol. 2010; 14:29–32. https://doi.org/10.4103/0973-029X.64309

- Jain A, Shetty DC, Singh Rathore A, Kumar K, Juneja S. Non-pigmented intramucosal nevi in a young female patient: A rare case report. J Med Radiol. Pathol Surg 2015; 13: 18–21. https://doi.org/10.15713/ins.jmrps.1

- Freitas DA, Bonan PR, Sousa AA, Pereira MM, Oliveira SM, Jones KM. Intramucosal nevus in the oral cavity. J Contemp Dent Pract. 2015; 16, 74–6. https://www.ncbi.nlm.nih.gov/pubmed/25876954

- Dutta D, Kamath V, Rajkumar K, 2015. Oral melanocytic nevi: Report of two cases with immunohistochemical elaboration of their probable origin and maturation. Indian J. Dermatopathol Diag Dermatol. 2015; 2: 29. https://doi.org/10.4103/2349-6029.173413

- Heenan PJ. Histological Diagnosis of Nevi and Melanoma. Am J Dermatopathol. 2005; 27: 275–276. https://doi.org/10.1097/01.dad.0000160983.75176.25

- Buchner A, Hansen LS. Pigmented Nevi of the Oral Mucosa: A Clinicopathologic Study of 36 New Cases and Review of 155 Cases From the Literature. Part II: Analysis of 191 Cases. Oral Surg Oral Med Oral Pathol. 1987; 63 (6): 676-82. https://doi.org/10.1016/0030-4220(87)90370-7

- Hasse CD, Zoutendam GL, Gombas OF. Intraoral blue (Jadassohn-Tieche) nevus. Oral Surg Oral Med Oral Pathol. 1978; 45, 755–61. https://doi.org/10.1016/0030-4220(78)90151-2

- Aloi F, Pich A, Pippione M. Malignant Cellular Blue Nevus. Dermatol. 1996; 192: 36–40. https://doi.org/10.1159/000246311

- Hanna A, Rawal SY, Anderson KM, Rawal YB. The epithelioid blue nevus: A rare intraoral nevomelanocytic tumor. J. Oral Maxillofac. Pathol. 2011;15: 88–90. https://doi.org/10.4103/0973-029X.80018

- Rodriguez HA, Ackerman LV. 1968. Cellular blue nevus. Clinicopathologic study of forty-five cases. Cancer 1968; 21: 393–405. https://doi.org/ 10.1002/1097-0142(196803)21:3<393::aid-cncr2820210309>3.0.co;2-k

- Hatch CL. Pigmented lesions of the oral cavity. Dent Clin North Am. 2005; 49:185–201, ix–x. https://doi.org/10.1016/j.cden.2004.07.013

- Alawi F. Pigmented lesions of the oral cavity: an update. Dent Clin North Am. 2013; 57: 699–710. https://doi.org/10.1016/j.cden.2013.07.006

- Pinto A, Raghavendra S, Lee R, DeRossi S, Alawi F. Epithelioid blue nevus of the oral mucosa: a rare histologic variant. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 96:429–436. https://doi.org/10.1016/s1079-2104(03)00319-6

- Barker GR., Sloan P. An intraoral combined blue naevus. Br. J. Oral Maxillofac. Surg. 1988; 6:165–168. https://doi.org/10.1016/0266-4356(88)90014-9

- Magliocca RK, Hand, MK, Su LD, Helman JI. Melanoma-in-situ of the orall cavity. Oral Oncol Extra 2006; 42: 46-48. https://doi.org/10.1016/j.ooe.2005.08.009

- Mahmoud MM, Madi M, Gamal R. Uncommon clinical presentation of oral malignant melanoma. Ben- Suef Univ J Basic Appl.Sci. 2018; 7: 220-222.https://doi.org/10.1016/j.bjbas.2017.11.003e.

- De-Andrade BB, León JE, Carlos R, Delgado-Azañero W, Mosqueda-Taylor A, Edgard Graner E, Almeida OP. Expression of fatty acid synthase (FASN) in oral nevi and melanoma. Oral Diseases 2011 Nov;17(8):808- 12. https://doi.org/10.1111/j.1601-0825.2011.01841.x

- Toeda Y, Uzawa K, Yamano Y, Hiroshima K, Irié T, Kaneku K., Nakashima D, Higo M, Kasamatsu A, Sakamoto Y, Ito H, Tanzawa H. Blue nevus of the hard palate: A case report. J Oral Maxillofac Surg.Med Pathol. 2016; 28, 406- 409. https://doi.org/10.1016/j.ajoms.2016.03.001

- Mellouli N, Sioud S, Garma M, Chokri A, Hamdi H, Selmi J. Oral malignant melanoma: History of malignant degeneration of a pigmented lesion. J Oral Med Oral Surg. 2019;25:19-26.

https://doi.org/10.1051/mbcb/2019003

- Chaudhry AP, Hampel A, Gorlin RJ. Primary malignant melanoma of the oral cavity: A review of 105 cases. Cancer 1958; 11:923– 928. https://doi.org/10.1002/1097-0142(195809/10)11:5<923::aid-cncr2820110507>3.0.co;2-1

- Mohan M, Sukhadia VY, Pai D, Bhat S. Oral malignant melanoma: Systematic review of literature and report of two cases. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;116:e247–254. https://doi.org/10.1016/j.oooo.2011.11.034

- Patel PB, Wright JM, Kang DR, Cheng YL. Longitudinal clinicopathologic data of the progression of oral mucosal melanoma – Report of 2 cases and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;126(1):e21–e30. https//doi.org/ 10.1016/j.oooo.2017.12.015

- Williams MD. Update from the 4th Edition of the World Health Organization Classification of Head and Neck Tumours: Mucosal Melanomas. Head Neck Pathol. 2017;11:110–117. https://doi.org/10.1007/s12105-017-0789-y

- Taylor CO, Lewis JS. Histologically documented transformation of benign oral melanosis into malignant melanoma: A case report. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg. 1990; 48:732–734. 14. https://doi.org/ 10.1016/0278-2391(90)90060-f

- Umeda M, Komatsubara H, Shibuya Y, Yokoo S, Komori T. Premalignant melanocytic dysplasia and malignant melanoma of the oral mucosa. Oral Oncol. 2002; 38:714–722. https://www.sciencedirect.com/science/article/abs/pii/S1368837502000088?via%3Dihub




DOI: https://doi.org/10.15600/2238-1236/fol.v30n1p69-76

 A Revista da Faculdade de Odontologia de Lins e sua Comissão Editorial tem como alvo alterar sua periodicidade para quadrimenstral, para isso conta com a comunidade de pesquisadores para submissão de artigos científicos, revisões estruturadas, casos clínicos e resenhas.

ISSN Eletrônico: 2238-1236