Ciclosporine-induced fibrovascular polyps in the tongue
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Tipo de produção
conferenceObject
Data de publicação
2012
Título da Revista
ISSN da Revista
Título do Volume
Editora
WILEY-BLACKWELL
Autores
TORRES-PEREIRA, C.
ROCHA, A. C.
ROCHA, G. B. L.
BONFIM, C. S.
Citação
ORAL DISEASES, v.18, suppl.1, Special Issue, p.40-41, 2012
Resumo
Introduction: Cyclosporine (CsA) is used for chronic graft-versus-host disease (cGVHD) treatment and can lead to increased or synthesis of collagen and fibrous eposition. Gingival overgrowth is a common adverse effect of CsA, however it is rarely seen in patients using CsA for treatment of cGVHD. The development of CsA- associated nongingival growth is rare and represents polyps of granulation/fibrous tissue. These lesions have been referred as oral inflammatory polyps that may be aggravated in the presence of cGVHD. Case details: A 6 year old male with Fanconi Anemia underwent an unrelated hematopoietic stem-cell transplantation (HSCT) in March/2007. cGVHD was diagnosed in skin and oral mucosa and was treated with cyclosporine and corticosteroids. In August 2008 the patient was referred to the Oral Medicine Service for evaluation of a 3 cm growing polyps in the border of the tongue. Incisional biopsy was performed and revealed fibrous-vascular hyperplasia. While the patient waited for an excisional biopsy, the polyps increased in size to 10 cm. This biopsy revealed the same histopathological characteristic. In May 2011 the patient presented with other polyps of the middle side of tongue associated with other small nodules. These lesions were completely removed and again the diagnosis of fibrous-vascular hyperplasia was given immunohistochemistry examination revealed negativity to anti-cytomegalovirus (CMV)/anti-herpesvirus (HSV) and Ki-67 expression showed moderate to strong staining. No atypical cells were observed. Conclusions: Although it is an unusual reported lesion, fibrous-vascular polyps are a recent described pathological entity associated with the use of CsA. These lesions should be considered as a differential diagnosis of oral masses in post HSCT Fanconi Anemia patients, particularly to exclude malignancies in this high risk group of individuals. Relevance: Fanconi anaemia patients need to be closely monitored due to a high prevalence of secondary malignancies.