The objective of this study was to provide evidence that the magnitude of angiogenesis induced by... more The objective of this study was to provide evidence that the magnitude of angiogenesis induced by oral mucosa epithelium with potentially malignant lesions is related to the degree of epithelial aggressiveness. We evaluated 96 biopsies that included: (1) leukoplakia with and without dysplasia, (2) nontumoral borders adjacent to squamous cell carcinomas with and without dysplasia, and (3) normal oral mucosa. Number, size, and localization of vessels labeled immunohistochemically for the antigen CD34 were assessed by image analysis using a software developed "ad hoc." All vascular sections and those localized immediately below the epithelium (sub-basal vessels) were separately evaluated in areas 30-μm deep. Vascular endothelial growth factor (VEGF) expression was labeled immunohistochemically and evaluated semiquantitatively against a standard. Leukoplakia and nontumoral borders adjacent to carcinomas exhibited an increase in VEGF expression and in subepithelial vascularizat...
Oral manifestations of tuberculosis (TB) are exceedingly uncommon and are usually secondary to pu... more Oral manifestations of tuberculosis (TB) are exceedingly uncommon and are usually secondary to pulmonary TB. The development of extrapulmonary TB is mainly facilitated by immunosuppression. The oral manifestations of TB can be highly variable and non-specific therefore they can cause difficulties in diagnosis and delay in instituting the appropriate treatment. This article describes an infrequent case of secondary oral TB in an adult HIV-negative patient. The aim of this case report was to emphasize the importance of considering TB in the differential clinical diagnosis of ulcers affecting the oral mucosa.
Medicina oral, patología oral y cirugía bucal, 2008
Oral Squamous Cell Carcinoma has a low survival rate, 34 to 66% five-year survival after initial ... more Oral Squamous Cell Carcinoma has a low survival rate, 34 to 66% five-year survival after initial diagnosis, due to late diagnosis. The aim of the present study was to examine the clinical features and evolution of oral cancer in the University of Buenos Aires. 274 patients with primary oral carcinoma, over the 1992-2000 period were included in the study. The survival rate of this population was 80% at 12 months, 60% at 24 months, 46% at 36 months, 40% at 48 months, and 39% at 60 months (5 years). The tumor localizations with worse prognosis were floor of mouth and tongue, with survival rates of 19% and 27% respectively. Sixty-five percent of the oral carcinomas evaluated were diagnosed at advanced stages (III and IV). The patients under study exhibited the lowest survival rate described for oral cancer (34% five-year survival after initial diagnosis). The population included in this study can be considered representative of the Argentine population. This bad prognosis would be mainl...
To determine whether the Sjögren's syndrome B (SSB)-positive/Sjögren's syndrome A (SSA)-n... more To determine whether the Sjögren's syndrome B (SSB)-positive/Sjögren's syndrome A (SSA)-negative antibody profile is associated with key phenotypic features of SS. Among registrants in the Sjögren's International Collaborative Clinical Alliance (SICCA) with possible or established SS, we compared anti-SSA/anti-SSB reactivity profiles against concurrent phenotypic features. We fitted logistic regression models to explore the association between anti-SSA/anti-SSB reactivity profile and each key SS phenotypic feature, controlling for potential confounders. Among 3297 participants, 2061 (63%) had negative anti-SSA/anti-SSB, 1162 (35%) had anti-SSA with or without anti-SSB, and 74 (2%) anti-SSB alone. Key SS phenotypic features were more prevalent and had measures indicative of greater disease activity in those participants with anti-SSA, either alone or with anti-SSB, than in those with anti-SSB alone or negative SSA/SSB serology. These between-group differences were highly ...
Cardiofaciocutaneous syndrome (CFCS) is an extremely rare genetic disorder that belongs to the gr... more Cardiofaciocutaneous syndrome (CFCS) is an extremely rare genetic disorder that belongs to the group of syndromes known as RASopathies. The craniofacial and ectodermal manifestations of this syndrome are distinctive and play an important role in the diagnosis of this entity. Nevertheless, there is no scientific evidence to date of the presence of CFCS-related lesions in the oral mucosa. The present study is the first to report the presence of oral lichen planus (OLP) in a patient with CFCS. This finding should be taken into account in the assessment and diagnosis of CFCS in order to establish whether it is an un-related lesion or is associated with the syndrome.
Metastases derived from primary tumours distant to the oral and maxillofacial region account for ... more Metastases derived from primary tumours distant to the oral and maxillofacial region account for only 1% of all malignancies at that location, usually with a poor prognosis. In women, the primary tumours that most frequently metastasise to the oral cavity are breast adenocarcinomas affecting the jawbones and soft tissues (41% and 24%, respectively), followed by adrenal glands and female genital organs to the jawbones (8%), and female genital organs to the soft tissues (15%). Metastatic tumours of the mouth are a challenging diagnosis because of their exceptional occurrence. We report on the case of an 83-year-old woman who consulted for a bleeding ulcerated tumour on the floor of the mouth. A biopsy-confirmed metastasis of an adenocarcinoma of Müllerian origin. The oral lesion was the first sign of undetected cancer. The patient agreed to surgical resection and was further referred to palliative care for her symptoms.
Tumor hypoxia is an important indicator of cancer prognosis. Among the different genes that are u... more Tumor hypoxia is an important indicator of cancer prognosis. Among the different genes that are upregulated by hypoxia is carbonic anhydrase IX, which combines carbon dioxide and water to form bicarbonate and hydrogen. Although expression of this enzyme is very low in normal tissues, carbonic anhydrase IX is overexpressed in several types of cancer. The aim of the present work was to analyze carbonic anhydrase IX expression in the two most frequent potentially malignant oral disorders: oral lichen planus and oral leukoplakia. Immunohistochemical analysis of oral lichen planus and oral leukoplakia biopsies was performed using anticarbonic anhydrase IX antibody. Samples of normal mucosa served as controls. Statistical analysis was performed by Fischer's exact test. The enzyme was detected in the epithelium of both lesions. The staining was more intense in the basal layer and decreased towards the surface in oral lichen planus. Conversely, the most intense reaction was observed in ...
Objective: To compare the clinical features, histopathological diagnosis, localization, clinical ... more Objective: To compare the clinical features, histopathological diagnosis, localization, clinical stage and survival of oral carcinoma (OC) in two periods: 1992-2000 and 2001-2009. Method: The study comprised 507 patients diagnosed with OC who attended the Oral Medicine Department, Faculty of Dentistry, UBA. Tumor location, clinical and histopathological diagnosis, clinical staging and patient follow-up were recorded on a digital database. Statistical analysis was performed using the comparison test of proportions and prognostic assessment of survival was performed employing Kaplan Meier’s test. Result: Tongue localization corresponding to the 1992-2000 period was 30.29% and in the 2001-2009 period was 39% (p<0.05). Analysis of tumor staging (S) corresponding to the 1990-2000 period 16.83% were SI, 13.07% were SII (sum of SI-SII 30%), 44.75% were SIII and 25.35% were SIV (sum of SIII-SIV 70%) whereas in the 2001-2009 period showed 33.9 % were SI, 34.5% were S II (EI-EII 68.4%), 17...
Oral Lichen Planus and Leukoplakia are two precancerous lesions of great relevance in oral pathol... more Oral Lichen Planus and Leukoplakia are two precancerous lesions of great relevance in oral pathology. A total of 4183 patients from the National University of Córdoba (UNC) and 4838 patients from the University of Buenos Aires (UBA) who had been admitted to the corresponding Oral Pathology Departments were analyzed. Of the total number of patients, 476 corresponded to Lichen Planus cases and 418 to Leukoplakia cases. Of the 476 Lichen Planus cases, 330 came from UBA and 146 from UNC, whereas of the 418 cases of Leukoplakia, 284 came from UNC and 134 from UBA. These differences were statistically significant (p < 0.02). Distribution according to sex and age was similar for Lichen Planus and Leukoplakia patients from both Oral Pathology Departments. The association between diabetes and Lichen Planus was similar for both centers, 11.5% for UNC and 14% for UBA. Similarly, no differences were found in terms of the association with tobacco consumption and dental microtrauma. Twenty-two...
Oral surgery, oral medicine, oral pathology and oral radiology, 2013
Mucosa-associated lymphoid tissue (MALT) lymphomas are known to occur in Sjögren syndrome (SS) pa... more Mucosa-associated lymphoid tissue (MALT) lymphomas are known to occur in Sjögren syndrome (SS) patients, but reported cases in labial salivary glands (LSG) are rare. We report a case of 60-year-old female patient with SS who developed MALT lymphoma in the labial salivary glands during a 2-year time interval when she was participating in the Sjögren's International Clinical Collaborative Alliance, an ongoing longitudinal multisite observational study funded by the National Institutes of Health of the United States. At follow-up exam, LSG biopsy showed atypical diffuse infiltration by mononuclear cells of variable size and atypical nuclei affecting the whole specimen with destruction of glandular architecture, leading to a diagnosis of B-cell MALT lymphoma. Computerized tomography and bone marrow biopsy failed to show additional evidence of disease. Clinical, serologic, ocular, histologic and immunohistochemical findings are presented. A "watch and wait" policy was adopt...
BACKGROUND: Dermoscopy is a non-invasive in vivo method rarely used for the diagnosis of oral pig... more BACKGROUND: Dermoscopy is a non-invasive in vivo method rarely used for the diagnosis of oral pigmented lesions. OBJECTIVE: To analyze clinical, dermoscopic, and histologic features of Oral Melanotic Macules (OMMs), and to evaluate the usefulness of dermoscopy in the diagnosis of OMMs. METHODS: Fifty patients presenting solitary or multiple circumscribed pigmented lesions in the oral mucosa were included. RESULTS: OMMs were diagnosed in 19 patients (84% women and 16 % men); 52 % of patients had multiple lesions, 48% had one lesion. Lesion sites in decreasing order of frequency were the labial mucosa (63 %), gingiva (31.57 %), cheek mucosa (26.31%), labial semimucosa (21%), palate (10.52 %), alveolar ridge (5.26 %) and tongue (5.26 %). The dermoscopic pattern of OMMs was linear in 89 % of cases (47% parallel line, 35% fish scale-like, and 17% hyphal patterns). Histological analysis showed increased melanin in the basal cell layer in all cases with a linear dermoscopic pattern, slight...
Cardiofaciocutaneous syndrome (CFCS) is an extremely rare genetic disorder that belongs to the gr... more Cardiofaciocutaneous syndrome (CFCS) is an extremely rare genetic disorder that belongs to the group of syndromes known as RASopathies. The craniofacial and ectodermal manifestations of this syndrome are distinctive and play an important role in the diagnosis of this entity. Nevertheless, there is no scientific evidence to date of the presence of CFCS-related lesions in the oral mucosa. The present study is the first to report the presence of oral lichen planus (OLP) in a patient with CFCS. This finding should be taken into account in the assessment and diagnosis of CFCS in order to establish whether it is an unrelated lesion or is associated with the syndrome.
Oral manifestations of tuberculosis (TB) are exceedingly uncommon and are usually secondary to pu... more Oral manifestations of tuberculosis (TB) are exceedingly uncommon and are usually secondary to pulmonary TB. The development of extrapulmonary TB is mainly facilitated by immunosuppression. The oral manifestations of TB can be highly variable and non-specific therefore they can cause difficulties in diagnosis and delay in instituting the appropriate treatment. This article describes an infrequent case of secondary oral TB in an adult HIV-negative patient. The aim of this case report was to emphasize the importance of considering TB in the differential clinical diagnosis of ulcers affecting the oral mucosa.
The objective of this study was to provide evidence that the magnitude of angiogenesis induced by... more The objective of this study was to provide evidence that the magnitude of angiogenesis induced by oral mucosa epithelium with potentially malignant lesions is related to the degree of epithelial aggressiveness. We evaluated 96 biopsies that included: (1) leukoplakia with and without dysplasia, (2) nontumoral borders adjacent to squamous cell carcinomas with and without dysplasia, and (3) normal oral mucosa. Number, size, and localization of vessels labeled immunohistochemically for the antigen CD34 were assessed by image analysis using a software developed "ad hoc." All vascular sections and those localized immediately below the epithelium (sub-basal vessels) were separately evaluated in areas 30-μm deep. Vascular endothelial growth factor (VEGF) expression was labeled immunohistochemically and evaluated semiquantitatively against a standard. Leukoplakia and nontumoral borders adjacent to carcinomas exhibited an increase in VEGF expression and in subepithelial vascularizat...
Oral manifestations of tuberculosis (TB) are exceedingly uncommon and are usually secondary to pu... more Oral manifestations of tuberculosis (TB) are exceedingly uncommon and are usually secondary to pulmonary TB. The development of extrapulmonary TB is mainly facilitated by immunosuppression. The oral manifestations of TB can be highly variable and non-specific therefore they can cause difficulties in diagnosis and delay in instituting the appropriate treatment. This article describes an infrequent case of secondary oral TB in an adult HIV-negative patient. The aim of this case report was to emphasize the importance of considering TB in the differential clinical diagnosis of ulcers affecting the oral mucosa.
Medicina oral, patología oral y cirugía bucal, 2008
Oral Squamous Cell Carcinoma has a low survival rate, 34 to 66% five-year survival after initial ... more Oral Squamous Cell Carcinoma has a low survival rate, 34 to 66% five-year survival after initial diagnosis, due to late diagnosis. The aim of the present study was to examine the clinical features and evolution of oral cancer in the University of Buenos Aires. 274 patients with primary oral carcinoma, over the 1992-2000 period were included in the study. The survival rate of this population was 80% at 12 months, 60% at 24 months, 46% at 36 months, 40% at 48 months, and 39% at 60 months (5 years). The tumor localizations with worse prognosis were floor of mouth and tongue, with survival rates of 19% and 27% respectively. Sixty-five percent of the oral carcinomas evaluated were diagnosed at advanced stages (III and IV). The patients under study exhibited the lowest survival rate described for oral cancer (34% five-year survival after initial diagnosis). The population included in this study can be considered representative of the Argentine population. This bad prognosis would be mainl...
To determine whether the Sjögren's syndrome B (SSB)-positive/Sjögren's syndrome A (SSA)-n... more To determine whether the Sjögren's syndrome B (SSB)-positive/Sjögren's syndrome A (SSA)-negative antibody profile is associated with key phenotypic features of SS. Among registrants in the Sjögren's International Collaborative Clinical Alliance (SICCA) with possible or established SS, we compared anti-SSA/anti-SSB reactivity profiles against concurrent phenotypic features. We fitted logistic regression models to explore the association between anti-SSA/anti-SSB reactivity profile and each key SS phenotypic feature, controlling for potential confounders. Among 3297 participants, 2061 (63%) had negative anti-SSA/anti-SSB, 1162 (35%) had anti-SSA with or without anti-SSB, and 74 (2%) anti-SSB alone. Key SS phenotypic features were more prevalent and had measures indicative of greater disease activity in those participants with anti-SSA, either alone or with anti-SSB, than in those with anti-SSB alone or negative SSA/SSB serology. These between-group differences were highly ...
Cardiofaciocutaneous syndrome (CFCS) is an extremely rare genetic disorder that belongs to the gr... more Cardiofaciocutaneous syndrome (CFCS) is an extremely rare genetic disorder that belongs to the group of syndromes known as RASopathies. The craniofacial and ectodermal manifestations of this syndrome are distinctive and play an important role in the diagnosis of this entity. Nevertheless, there is no scientific evidence to date of the presence of CFCS-related lesions in the oral mucosa. The present study is the first to report the presence of oral lichen planus (OLP) in a patient with CFCS. This finding should be taken into account in the assessment and diagnosis of CFCS in order to establish whether it is an un-related lesion or is associated with the syndrome.
Metastases derived from primary tumours distant to the oral and maxillofacial region account for ... more Metastases derived from primary tumours distant to the oral and maxillofacial region account for only 1% of all malignancies at that location, usually with a poor prognosis. In women, the primary tumours that most frequently metastasise to the oral cavity are breast adenocarcinomas affecting the jawbones and soft tissues (41% and 24%, respectively), followed by adrenal glands and female genital organs to the jawbones (8%), and female genital organs to the soft tissues (15%). Metastatic tumours of the mouth are a challenging diagnosis because of their exceptional occurrence. We report on the case of an 83-year-old woman who consulted for a bleeding ulcerated tumour on the floor of the mouth. A biopsy-confirmed metastasis of an adenocarcinoma of Müllerian origin. The oral lesion was the first sign of undetected cancer. The patient agreed to surgical resection and was further referred to palliative care for her symptoms.
Tumor hypoxia is an important indicator of cancer prognosis. Among the different genes that are u... more Tumor hypoxia is an important indicator of cancer prognosis. Among the different genes that are upregulated by hypoxia is carbonic anhydrase IX, which combines carbon dioxide and water to form bicarbonate and hydrogen. Although expression of this enzyme is very low in normal tissues, carbonic anhydrase IX is overexpressed in several types of cancer. The aim of the present work was to analyze carbonic anhydrase IX expression in the two most frequent potentially malignant oral disorders: oral lichen planus and oral leukoplakia. Immunohistochemical analysis of oral lichen planus and oral leukoplakia biopsies was performed using anticarbonic anhydrase IX antibody. Samples of normal mucosa served as controls. Statistical analysis was performed by Fischer's exact test. The enzyme was detected in the epithelium of both lesions. The staining was more intense in the basal layer and decreased towards the surface in oral lichen planus. Conversely, the most intense reaction was observed in ...
Objective: To compare the clinical features, histopathological diagnosis, localization, clinical ... more Objective: To compare the clinical features, histopathological diagnosis, localization, clinical stage and survival of oral carcinoma (OC) in two periods: 1992-2000 and 2001-2009. Method: The study comprised 507 patients diagnosed with OC who attended the Oral Medicine Department, Faculty of Dentistry, UBA. Tumor location, clinical and histopathological diagnosis, clinical staging and patient follow-up were recorded on a digital database. Statistical analysis was performed using the comparison test of proportions and prognostic assessment of survival was performed employing Kaplan Meier’s test. Result: Tongue localization corresponding to the 1992-2000 period was 30.29% and in the 2001-2009 period was 39% (p<0.05). Analysis of tumor staging (S) corresponding to the 1990-2000 period 16.83% were SI, 13.07% were SII (sum of SI-SII 30%), 44.75% were SIII and 25.35% were SIV (sum of SIII-SIV 70%) whereas in the 2001-2009 period showed 33.9 % were SI, 34.5% were S II (EI-EII 68.4%), 17...
Oral Lichen Planus and Leukoplakia are two precancerous lesions of great relevance in oral pathol... more Oral Lichen Planus and Leukoplakia are two precancerous lesions of great relevance in oral pathology. A total of 4183 patients from the National University of Córdoba (UNC) and 4838 patients from the University of Buenos Aires (UBA) who had been admitted to the corresponding Oral Pathology Departments were analyzed. Of the total number of patients, 476 corresponded to Lichen Planus cases and 418 to Leukoplakia cases. Of the 476 Lichen Planus cases, 330 came from UBA and 146 from UNC, whereas of the 418 cases of Leukoplakia, 284 came from UNC and 134 from UBA. These differences were statistically significant (p < 0.02). Distribution according to sex and age was similar for Lichen Planus and Leukoplakia patients from both Oral Pathology Departments. The association between diabetes and Lichen Planus was similar for both centers, 11.5% for UNC and 14% for UBA. Similarly, no differences were found in terms of the association with tobacco consumption and dental microtrauma. Twenty-two...
Oral surgery, oral medicine, oral pathology and oral radiology, 2013
Mucosa-associated lymphoid tissue (MALT) lymphomas are known to occur in Sjögren syndrome (SS) pa... more Mucosa-associated lymphoid tissue (MALT) lymphomas are known to occur in Sjögren syndrome (SS) patients, but reported cases in labial salivary glands (LSG) are rare. We report a case of 60-year-old female patient with SS who developed MALT lymphoma in the labial salivary glands during a 2-year time interval when she was participating in the Sjögren's International Clinical Collaborative Alliance, an ongoing longitudinal multisite observational study funded by the National Institutes of Health of the United States. At follow-up exam, LSG biopsy showed atypical diffuse infiltration by mononuclear cells of variable size and atypical nuclei affecting the whole specimen with destruction of glandular architecture, leading to a diagnosis of B-cell MALT lymphoma. Computerized tomography and bone marrow biopsy failed to show additional evidence of disease. Clinical, serologic, ocular, histologic and immunohistochemical findings are presented. A "watch and wait" policy was adopt...
BACKGROUND: Dermoscopy is a non-invasive in vivo method rarely used for the diagnosis of oral pig... more BACKGROUND: Dermoscopy is a non-invasive in vivo method rarely used for the diagnosis of oral pigmented lesions. OBJECTIVE: To analyze clinical, dermoscopic, and histologic features of Oral Melanotic Macules (OMMs), and to evaluate the usefulness of dermoscopy in the diagnosis of OMMs. METHODS: Fifty patients presenting solitary or multiple circumscribed pigmented lesions in the oral mucosa were included. RESULTS: OMMs were diagnosed in 19 patients (84% women and 16 % men); 52 % of patients had multiple lesions, 48% had one lesion. Lesion sites in decreasing order of frequency were the labial mucosa (63 %), gingiva (31.57 %), cheek mucosa (26.31%), labial semimucosa (21%), palate (10.52 %), alveolar ridge (5.26 %) and tongue (5.26 %). The dermoscopic pattern of OMMs was linear in 89 % of cases (47% parallel line, 35% fish scale-like, and 17% hyphal patterns). Histological analysis showed increased melanin in the basal cell layer in all cases with a linear dermoscopic pattern, slight...
Cardiofaciocutaneous syndrome (CFCS) is an extremely rare genetic disorder that belongs to the gr... more Cardiofaciocutaneous syndrome (CFCS) is an extremely rare genetic disorder that belongs to the group of syndromes known as RASopathies. The craniofacial and ectodermal manifestations of this syndrome are distinctive and play an important role in the diagnosis of this entity. Nevertheless, there is no scientific evidence to date of the presence of CFCS-related lesions in the oral mucosa. The present study is the first to report the presence of oral lichen planus (OLP) in a patient with CFCS. This finding should be taken into account in the assessment and diagnosis of CFCS in order to establish whether it is an unrelated lesion or is associated with the syndrome.
Oral manifestations of tuberculosis (TB) are exceedingly uncommon and are usually secondary to pu... more Oral manifestations of tuberculosis (TB) are exceedingly uncommon and are usually secondary to pulmonary TB. The development of extrapulmonary TB is mainly facilitated by immunosuppression. The oral manifestations of TB can be highly variable and non-specific therefore they can cause difficulties in diagnosis and delay in instituting the appropriate treatment. This article describes an infrequent case of secondary oral TB in an adult HIV-negative patient. The aim of this case report was to emphasize the importance of considering TB in the differential clinical diagnosis of ulcers affecting the oral mucosa.
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Papers by Mariana Gandolfo