Abstract This communication reports the second known case of oral phaeohyphomycosis in a patient with squamocellular carcinoma of the lip. The patient, an 82-year-old black woman, a former smoker (for more than 30 years), suffering from an ulcerous vegetative lesion in the middle third of the lower lip for approximately 12 months. The result of the histopathological analysis indicated carcinoma, with well-differentiated keratinized squamous cells and the presence of septate mycelial filaments. In the direct mycological examination, thick and dematiaceous septate mycelial filaments were observed. After the resection surgery, the patient did not need to use an antifungal drug to treat the phaeohyphomycosis, and no follow-up radiotherapy was needed to treat the squamocellular carcinoma. We stress that the presence of the squamocellular lesion of the lip was a possible contributing factor to the infection.

INTRODUÇÃO: O aumento do interesse pelas variações histológicas do fibroadenoma deve-se às dificuldades diagnósticas em pequenas biópsias, bem como ao discreto aumento de risco para carcinoma do fibroadenoma complexo. OBJETIVOS: Determinar e comparar a distribuição das alterações epiteliais e estromais intratumorais em mulheres jovens e mais velhas. MÉTODO: Revisão da macro e da microscopia de 316 casos de fibroadenomas diagnosticados no Departamento de Patologia do Hospital de Câncer de Pernambuco no período de 1997 a 2000 (163 mulheres com 15 a 39 anos e 153 com 40 a 79). RESULTADOS Prevaleceram nas jovens padrão pericanalicular, epitélio normotrófico, adenose comum, metaplasia apócrina, hiperplasia típica, estroma normo e hipercelular. Nas mais velhas predominaram padrão intracanalicular, atrofia epitelial, calcificação intraductal, hialinização, calcificação estromal. No grupo jovem houve associação do padrão intracanalicular com o estroma mixóide. As maiores lesões foram encontradas entre as mais jovens e nas com padrão pericanalicular. Todas essas diferenças foram estatisticamente significantes. Não houve desigualdade na incidência de fibroadenomas complexos, nem relação deste tipo de tumor com hiperplasia epitelial. DISCUSSÃO: Os dados mostram que elementos morfológicos indicativos de atividade do tumor são mais freqüentes na faixa etária mais baixa e os involutivos, na mais avançada. CONCLUSÃO: Confirma-se a ocorrência de um continuum de alterações regressivas nos fibroadenomas, acarretando diminuição do diâmetro, atrofia epitelial, estroma hialinizado e calcificado. Sugere-se progressão do padrão pericanalicular para o intracanalicular ao longo do tempo, e um maior potencial de crescimento daqueles com estroma mixóide, que já crescem em padrão intracanalicular mesmo nas mais jovens.

BACKGROUND: The increased interest in histological variations of fibroadenomas is due to the diagnostic difficulties found in small biopsies, as well as the slightly increased risk for carcinoma in cases of complex fibroadenoma. GOAL: Determine and compare the distribution of intratumoral epithelial and stromal alterations in young and older women. METHOD: Revision of gross and microscopy of 316 cases of fibroadenomas diagnosed in Department of Pathology at Hospital de Cancer de Pernambuco, from 1997 to 2000 (163 women with 15 to 39 years and 153 with 40 to 79 years). RESULTS: Pericanalicular pattern, normotrophic epithelium, adenosis, apocrine hyperplasia, typical hyperplasia, normo and hypercelular stroma prevailed in the younger group. Intracanalicular pattern, epithelial atrophy, intraductal calcification, stromal hyalinization and calcification were predominant in the older group. There was an association between intracanalicular pattern and myxoid stroma. The larger lesions were more commonly found in younger group as well as in cases showing pericanalicular pattern. These findings were statistically significant. There was no difference in incidence of complex fibroadenomas. DISCUSSION: Morphological elements that indicate lesion activity were more common in younger women, whereas involutive findings were more frequent in older group. CONCLUSION: The occurrence of a continuum of regressive alterations in fibroadenomas is confirmed by decrease in diameter, epithelial atrophy, stromal hyalinization and calcification. The study also suggests there is a progression from pericanalicular to intracanalicular pattern along the years, as well as a larger growth potential for those showing myxoid stroma, which is associated with intracanalicular pattern even in younger women.