RESUMO O sarcoma de Ewing é um tumor maligno que surge principalmente de tecido ósseo, pelo qual sua apresentação extra-óssea não é muito comum, sendo ainda mais raro seu aparecimento em tecidos moles da cavidade bucal. O objetivo deste caso foi descrever as características clínicas de um Sarcoma de Ewing extra-ósseo em língua em paciente pediátrico. Refere-se a paciente escolar masculino de 11 anos de idade, quem acudiu a consulta de Medicina Bucal referindo um aumento de volume em língua. Intraoralmente observou-se lesão tumoral em borda lateral esquerda de língua, indurada, da mesma cor da mucosa com áreas ulceradas e bordas bem definidas, de aproximadamente 2,5cm. Foi indicada uma ressonância magnética cervical e maxilofacial, observando-se uma lesão hiperintensa, parcialmente delimitada e não infiltrante na zona descrita. Realizou-se biópsia incisional com diagnóstico histopatológico de Neoplasia maligna de células redondas azuis, o marcador de imunohistoquímica CD99, encontrado positivo neste caso foi chave para o diagnóstico definitivo. Uma tomografia abdominotorácico-pélvico foi requerida pelo serviço de Oncologia Pediátrica, além de aspirado e biópsia de medula óssea, nos quais não se evidenciaram infiltrações neoplásicas. Após quatro ciclos de quimioterapia, realizou-se a cisão da lesão e consecutivo estudo da peça cirurgica, indicando bordas livres de lesão. O sarcoma de Ewing é um tumor de comportamento agressivo, pelo qual este caso representa um achado de relevância clínica e epidemiológica, tanto por sua aparição extra-óssea quanto por seu comportamento inusual.

ABSTRACT Ewing’s sarcoma is a malignant tumor that arises mainly from bone tissue, so that its extra-osseous presentation is not very common and even more unusual, in the soft tissues of the oral cavity. The objective of this case was to describe the clinical characteristics of an extra-osseous Ewing’s Sarcoma of the tongue in a pediatric patient. An 11-year-old male school patient, who attended an oral medicine consultation referring a volume increase in the tongue. Intraorally, a tumoral lesion was observed on the left lateral edge of the tongue, indurated, with the same color of the mucosa with ulcerated areas, well defined edges and symptomatic on palpation, with an approximate size of 2.5 cm. A cervical and maxillofacial MRI was indicated, observing a partially delimited hyperintense and non-infiltrating lesion in the described area. An incisional biopsy was performed with histopathological diagnosis of malignant neoplasm of blue round cells, theCD99 marker was found to be positive in the immunohistochemical study and was key to the definitive diagnosis of this tumor. A thoraco-abdomino-pelvic tomography was requested by the Pediatric Oncology service, as well as biopsy and aspiration of bone marrow, in which no neoplastic infiltrations were evidenced. After four cycles of chemotherapy, total removal of the lesion was performed with a consecutive histopathological study of the surgical piece, indicating free edges of the lesion. Ewing’s sarcoma is a tumor with aggressive behavior, so this case represents a finding of clinical and epidemiological relevance, both due to its extra-osseous appearance and its unusual behavior.

Resumen: El objetivo de esta investigación fue caracterizar las manifestaciones bucales y maxilofaciales presentes en pacientes adictos a las drogas. Se realizó una investigación descriptiva, de campo. Se seleccionaron 32 individuos recluidos en un centro de rehabilitación localizado en el estado Zulia, Venezuela. Se realizó una encuesta y un examen clínico para determinar las manifestaciones bucales y maxilofaciales. El promedio de edad de los sujetos fue de 37,7 años, siendo la mayoría del género masculino. Las drogas consumidas con mayor frecuencia fueron el crack, seguido de cocaína y marihuana. Con respecto a las manifestaciones bucales se observó el predominio de caries (87,5%), seguida de la presencia de signos de enfermedad periodontal. Los hallazgos reportados revelan el escaso cuidado bucal por parte de los sujetos narcodependientes, lo que aumenta el riesgo a procesos infecciosos, pérdida de órganos dentales, disminución de todas las funciones y por ende el deterioro de su calidad de vida.

Abstract: The aim of this research was to characterize oral and maxillofacial manifestations in patients addicted to drugs. A descriptive field study was conducted. Thirty-two individuals attending voluntarily a rehabilitation center located in Zulia State, Venezuela, were selected. A survey and a clinical examination were conducted to determine the oral and maxillofacial manifestations. The average age of the subjects was 37.7, most of them being male. The most commonly used drugs were crack, followed by cocaine and marijuana. Regarding oral manifestations, the predominance of caries (87.5%) was observed, followed by the presence of signs of periodontal disease. These findings point to the poor oral care of the drug-dependent subjects, which increases the risk of infectious processes, loss of dental organs, decrease of all functions and therefore leads to the deterioration in quality of life.