PARECE, MAS NÃO É: PARACOCCIDIOIDOMICOSE ORAL COMO DIAGNÓSTICO DIFERENCIAL DO CÂNCER ORAL

Katilene Aparecida dos Santos Leite; Renata Tucci; Rebeca de Souza Azevedo; Juliana de Souza  Do Nascimento

doi:10.69909/

Authors

Katilene Aparecida dos Santos Leite Graduanda em Odontologia, Faculdade Independente do Nordeste (FAINOR), Vitória da Conquista, BA, Brasil
Renata Tucci Professora de Patologia Bucal, Instituto de Saúde de Nova Friburgo da Universidade Federal Fluminense (ISNF/UFF), Nova Friburgo, RJ, Brasil
Rebeca de Souza Azevedo Professora de Patologia Bucal, Instituto de Saúde de Nova Friburgo da Universidade Federal Fluminense (ISNF/UFF), Nova Friburgo, RJ, Brasil
Juliana de Souza Do Nascimento Professora de Odontologia, Faculdade Independente do Nordeste (FAINOR), Vitória da Conquista, BA, Brasil

DOI:

https://doi.org/10.69909/

Keywords:

Paracoccidioidomycosis, Blastomycosis, Squamous cell carcinoma, Oral cancer, Differential diagnosis, Microscopy

Abstract

South American blastomycosis, also known as paracoccidioidomycosis, is a systemic mycosis caused by the fungus Paracoccidioides brasiliensis that grows in the soil feeding on decomposing organic matter and it is considered the most important fungal infection in Latin America, with Brazil being an endemic center. The infection initially involves the lungs through inhalation of the fungal spores with possible spread to other regions of the body, including the mouth. In the oral cavity, lesions usually manifest with a granular, erythematous, and ulcerated appearance. Other diseases can have similar characteristics, such as squamous cell carcinoma. The objective of this study is to report a clinical case of a patient with paracoccidioidomycosis that mimicked the clinical features of squamous cell carcinoma. A 57-year-old male patient presented with a lesion in the lower labial mucosa region extending to the gingiva and floor of the mouth. The lesion exhibited a moriform, ulcerated appearance with ill-defined borders. The diagnostic hypotheses were paracoccidioidomycosis and squamous cell carcinoma. Histopathological examination showed pseudoepitheliomatous hyperplasia and multinucleated giant cells with Paracoccidioides brasiliensis yeasts inside, which is consistent with the definitive diagnosis of paracoccidioidomycosis. It is concluded that paracoccidioidomycosis and squamous cell carcinoma have similar clinical and microscopic characteristics, which may lead to a mistaken clinical diagnosis. Thus, the definitive diagnosis can only be established after confirmation of the presence of the fungus.

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