Incipient ameloblastoma or odontogenic hamartomatous proliferation: is BRAFV600E mutation helpful to distinguish them?

Lucas Lacerda de Souza; Ana Luiza Oliveira Corrêa Roza; André Luiz de Araújo Neri; Ciro Dantas Soares; John M. Wright; Pablo Agustin Vargas

doi:10.5327/2525-5711.249

Autores

Lucas Lacerda de Souza University of Campinas, Oral Diagnosis – Piracicaba (SP), Brazil. https://orcid.org/0000-0002-9481-7796
Ana Luiza Oliveira Corrêa Roza University of Campinas, Oral Diagnosis – Piracicaba (SP), Brazil. https://orcid.org/0000-0002-4463-9602
André Luiz de Araújo Neri University of Campinas, Oral Diagnosis – Piracicaba (SP), Brazil.
Ciro Dantas Soares University of Campinas, Oral Diagnosis – Piracicaba (SP), Brazil. https://orcid.org/0000-0002-6861-6640
John M. Wright Texas A&M University, Sciences – Dallas, TX, United States of America.Diagnostic https://orcid.org/0000-0003-3924-0602
Pablo Agustin Vargas University of Campinas, Oral Diagnosis – Piracicaba (SP), Brazil. https://orcid.org/0000-0003-1840-4911

DOI:

https://doi.org/10.5327/2525-5711.249

Palavras-chave:

Odontogênico, ameloblastoma, mandíbula, terceiro molar

Resumo

A distinção entre proliferação hamartomatosa odontogênica e outros cistos e tumores odontogênicos representa um desafio diagnóstico. Este relato apresenta um caso único de um paciente do sexo masculino de 18 anos que se queixou de dor e secreção de pus na parte posterior direita da mandíbula por três semanas. No exame intraoral, o paciente apresentou eritema e secreção purulenta na mandíbula posterior, inicialmente diagnosticados como pericoronarite. A tomografia computadorizada revelou uma lesão bem definida, hipodensa e unilocular, aderida à junção cemento-esmalte do terceiro molar inferior direito. O exame histopatológico da amostra cirurgicamente excisada indicou a presença de uma lesão cística revestida por um epitélio reduzido do esmalte, junto com ilhas de células tumorais palisadas hipercromáticas com disposição semelhante ao retículo estrelado dispersas em um estroma fibroso na porção profunda da mucosa oral. O diagnóstico inicial foi um hamartoma odontogênico, mas uma análise posterior utilizando imunohistoquímica para BRAF V600E e PCR para analisar a mutação no códon 600 do BRAF confirmou o diagnóstico de ameloblastoma incipiente. O paciente está sob observação há um ano e quatro meses sem sinais de recorrência.

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Incipient ameloblastoma or odontogenic hamartomatous proliferation: is BRAFV600E mutation helpful to distinguish them?

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