Abstract Objective: To describe the accuracy of HealthVCF, a software product that uses artificial intelligence, in the detection of incidental moderate-to-severe vertebral compression fractures (VCFs) on chest and abdominal computed tomography scans. Materials and Methods: We included a consecutive sample of 899 chest and abdominal computed tomography scans of patients 51–99 years of age. Scans were retrospectively evaluated by the software and by two specialists in musculoskeletal imaging for the presence of VCFs with vertebral body height loss > 25%. We compared the software analysis with that of a general radiologist, using the evaluation of the two specialists as the reference. Results: The software showed a diagnostic accuracy of 89.6% (95% CI: 87.4–91.5%) for moderate-to-severe VCFs, with a sensitivity of 73.8%, a specificity of 92.7%, and a negative predictive value of 94.8%. Among the 145 positive scans detected by the software, the general radiologist failed to report the fractures in 62 (42.8%), and the algorithm detected additional fractures in 38 of those scans. Conclusion: The software has good accuracy for the detection of moderate-to-severe VCFs, with high specificity, and can increase the opportunistic detection rate of VCFs by radiologists who do not specialize in musculoskeletal imaging. Objective HealthVCF intelligence moderatetosevere moderate severe (VCFs Methods 89 5199 51 99 51–9 age 25 25% reference Results 896 6 89.6 95% 95 (95 CI 87.4–91.5% 874915 87 4 91 5 738 73 8 73.8% 927 92 7 92.7% 948 94 94.8% 14 42.8%, 428 42.8% , 42 (42.8%) 3 Conclusion 519 9 51– 2 89. (9 87.4–91.5 87491 73.8 92.7 94.8 1 42.8 (42.8% ( 87.4–91. 8749 73. 92. 94. 42. (42.8 87.4–91 874 (42. 87.4–9 (42 87.4– (4 87.4 87.

Resumo Objetivo: Descrever a acurácia do software HealthVCF na detecção incidental de fraturas compressivas de corpos vertebrais moderadas a graves em exames de tomografia computadorizada do tórax e abdome. Materiais e Métodos: Foram incluídos 899 exames consecutivos de pacientes com idades entre 51 e 99 anos. As imagens foram retrospectivamente avaliadas pelo software e por dois radiologistas especializados em musculoesquelético que investigaram fraturas compressivas de corpos vertebrais com perda da altura somática > 25%. A análise comparativa foi realizada entre o software e um radiologista geral, usando a avaliação do especialista como referência. Resultados: O software apresentou uma acurácia de 89,6% (IC 95%: 87,4–91,5%) para fraturas compressivas moderadas a graves, com sensibilidade de 73,8%, especificidade de 92,7% e valor preditivo negativo de 94,8%. Entre as 145 tomografias positivas detectadas pelo software, o radiologista geral deixou de relatar as fraturas em 62 (42,8%) e o algoritmo detectou fraturas adicionais em 38 dessas tomografias. Conclusão: O software possui boa acurácia na detecção de fraturas compressivas moderadas a graves, com alta especificidade, podendo aumentar a taxa de detecção oportunística dessas fraturas por radiologistas não especializados em musculoesquelético. Objetivo abdome Métodos 89 5 9 anos 25 25% referência Resultados 896 6 89,6 IC 95% 95 87,4–91,5% 874915 87 4 91 738 73 8 73,8% 927 92 7 92,7 948 94 94,8% 14 42,8% 428 42 (42,8% 3 Conclusão 2 89, 87,4–91,5 87491 73,8 92, 94,8 1 42,8 (42,8 87,4–91, 8749 73, 94, 42, (42, 87,4–91 874 (42 87,4–9 (4 87,4– ( 87,4 87,

Resumo Objetivo: Descrever os achados de ressonância magnética (RM) mais prevalentes em pacientes com diagnóstico clínico de polimialgia reumática (PMR). Materiais e Métodos: Dezesseis pacientes com PMR não tratada, classificados pelos critérios do American College of Rheumatology, foram submetidos a RM do ombro e/ou quadril, segundo suas queixas clínicas. Seis pacientes também foram submetidos a RM da coluna. Resultados: Foram avaliados 24 ombros, identificando-se bursite subacromial-subdeltoide em 21 (87,5%), sinovite glenoumeral em 17 (70,8%) e distensão líquida da bainha do tendão da cabeça longa do bíceps em 15 (62,5%). Peritendinite e edema capsular foram observados em 21 (87,5%) e 17 (70,8%) ombros, respectivamente. Dezessete quadris foram analisados, identificando-se sinovite em 12 (70,6%), bursite trocantérica em 11 (64,7%), peritendinite em 17 (100%) e edema capsular em 14 (82,4%). Os seis pacientes que realizaram RM da coluna apresentavam bursite interespinhosa. Conclusão: Bursite subacromial-subdeltoide, sinovite glenoumeral e do quadril são achados de imagem prevalentes em pacientes com PMR. Além disso, achados como peritendinite e edema capsular tiveram alta prevalência nesses pacientes. Estudos de caso- controle devem ser realizados para validar esses dados e estabelecer o real impacto desses achados no diagnóstico de PMR.

Abstract Objective: To describe the prevalence of magnetic resonance imaging (MRI) findings in patients with the clinical diagnosis of polymyalgia rheumatica (PMR). Materials and Methods: Sixteen consecutive patients with untreated PMR, meeting the American College of Rheumatology criteria, underwent MRI examinations of the shoulder(s), hip(s), or both, depending on clinical complaints. Six patients also underwent MRI of the spine. Results: We evaluated 24 shoulders, among which we identified subacromial-subdeltoid bursitis in 21 (87.5%), glenohumeral joint effusion in 17 (70.8%), and fluid distention of the long head of the biceps tendon sheath in 15 (62.5%). Peritendinitis and capsular edema were observed in 21 (87.5%) and 17 (70.8%) shoulders, respectively. We also evaluated 17 hips, identifying hip joint effusion in 12 (70.6%), trochanteric bursitis in 11 (64.7%), peritendinitis in 17 (100%), and capsular edema in 14 (82.4%). All six of the patients who underwent MRI of the spine were found to have interspinous bursitis. Conclusion: Subacromial-subdeltoid bursitis, glenohumeral joint effusion, and hip joint effusion are common findings in patients with PMR. In addition, such patients appear to be highly susceptible to peritendinitis and capsular edema. There is a need for case-control studies to validate our data and to determine the real impact that these findings have on the diagnosis of PMR by MRI.

RESUMO Objetivo Comparar a eficácia, a durabilidade e as intercorrências pós-operatórias da cirurgia de suspensão frontal com o uso de fáscia lata autóloga, faixa de silicone ou fio de polipropileno. Métodos Estudo descritivo analítico, observacional e retrospectivo de pacientes portadores de ptose grave submetidos à cirurgia de suspensão frontal durante o período de 2 anos. Os dados analisados foram a distância margem-reflexo comparativa, a fenda palpebral e as intercorrências. Resultados A fáscia lata foi o material que proporcionou os melhores resultados de distância margem reflexo e fenda palpebral na análise pós-operatória, após 1 ano de cirurgia. Além disso, apresentou a menor taxa de intercorrências (10%) e nenhum caso de infecção. Em seguida, os materiais que apresentaram melhor resultado pós-operatório foram a faixa de silicone (5% de infecção e 5% de reincidência), seguida pelo fio de polipropileno (15% de hipocorreção e 5% de reincidência). Conclusão A fáscia lata mostrou-se superior aos outros materiais em relação à durabilidade do efeito e à melhora da ptose, bem como menor taxa de intercorrências.

ABSTRACT Objective To compare efficacy, durability and postoperative complications of frontal suspension with the use of autologous fascia lata, silicone sling or polypropylene suture. Methods A descriptive, analytical, observational and retrospective study of patients with severe ptosis who underwent frontalis suspension, during a 2-year period. Data analyzed included comparative margin to reflex distance, palpebral fissure, and complications. Results Fascia lata was the material that provided the best results of margin to reflex distance and palpebral fissure in the postoperative analysis after one year. In addition, it had the lowest rate of complications (10%) and no cases of infection. Silicone sling ranked second in best results (5% of infection and 5% of recurrence), followed by polypropylene suture (15% of undercorrection and 5% of recurrence). Conclusion Fascia lata was shown to be superior to other materials regarding durability of the effect and improvement of ptosis, as well as lower rate of complications.

Abstract Aims: The purpose of this study was to evaluate the acute effects of different resistance exercise (RE) volumes on postexercise cardiac autonomic modulation in men. Methods: Ten young men (25.5 ± 4.9 years, 24.8 ± 2.1 kg/m2) performed 3 trials of RE with 1, 2 or 3 sets (48-72 h between each trial) of 10-12 repetitions (70% of the one-maximum repetition) of bench press, leg press, and barbell row. Heart rate variability (HRV) was assessed at the 1st and 5th minutes of recovery (fast phase) and 3 consecutive 5-minute intervals from the 5th to 20th minute of recovery (slow phase). Parasympathetic and global modulations were assessed using the SD1 and SD2 indices of HRV, respectively. The comparison of the interventions was performed using the Friedman and Wilcoxon tests (p<0.05). Results: Lower parasympathetic modulation was identified after 2 and 3 sets compared to 1 set in both the fast and slow recovery phases (p= 0.004-0.05). Lower global modulation was identified after 3 sets compared to 1 set in both fast and slow recovery phases (p= 0.005-0.01). No differences in post-exercise parasympathetic and global modulation were observed between 2 and 3 sets. Conclusion: We concluded that 2 and 3 sets of RE compared to 1 set promoted higher autonomic reduction on the post-exercise phase, which should be considered by coaches when prescribing an RE program for untrained participants or intend to manipulate the postexercise organic recovery.

RESUMO Pacientes com Transtorno Bipolar (TB) costumam apresentardéficits cognitivosao envelhecer. No entanto, a correlação com síndromes demenciais é inconclusiva, apesar da similaridade com a variante comportamental da demência frontotemporal (bvFTD). Nósrelatamos uma paciente de 78 anos de idade com TB tipo 1 desde a adolescência. Seus sintomas variavam de apatia a mania psicótica. A paciente passou por 3 internações, sendo a última há 10 anos, seguida de estabilização clínica. No entanto, nos últimos 2 anos, ela apresentou sintomas diferentes, como irritabilidade expressada por agressões verbal e física, comprometimento cognitivo, padrão repetitivo de comportamento, perambulação, delírios persecutórios, desorientação e hiporexia. O tratamento com anticolinesterásicos ou estabilizadores de humor não revelou melhora. Apresentou 17/30 pontos no miniexame do estado mental, a avaliação neuropsicológica sugeriu déficit de função executiva, atenção e memória. Os exames de neuroimagem demonstraram atrofia e hipoperfusão fronto-temporal. Abordagens diagnósticas e terapêuticas para este tipo de paciente representam um desafio significativo para os clínicos.

ABSTRACT Patients with Bipolar Disorder (BD) usually display cognitive deficits with aging. However, the correlation between BD and dementia syndromes is inconclusive, despite the similarity with behavioral variant frontotemporal dementia. We report a 78-year-old female patient who had bipolar type 1 disorder since adolescence. Her symptoms ranged from apathy to psychotic mania. She had had three hospitalizations, and since her last stay 10 years ago, her symptoms had remained stable. However, in the past 2 years, she displayed different symptoms, such as irritability manifested as verbal and physical aggression, cognitive impairment, repetitive pattern of behavior, perambulation, persecutory delusions, disorientation, and hyporexia. Treatment with anticholinesterases or mood stabilizers promoted no improvement. She scored 17/30 points on the Mini-Mental State Examination. Neuropsychological assessment suggested deficits in executive function, attention, and memory. Neuroimaging tests revealed frontotemporal degeneration and hypoperfusion. Diagnostic and therapeutic approaches for this type of patient represent a significant challenge for clinicians.

Abstract Halitosis is defined as a foul odor emanated from the oral cavity, with great impact in quality of life and social restraints. Recently, the use of Breath Alert™ in research increased significantly. Halimeter™, another portable device, is often used in clinical practice. Nevertheless, not many studies have verified the accuracy and compared the results of both devices simultaneously. Objective: To verify the accuracy of Breath Alert™ and Halimeter™ in patients without chief complaint of halitosis, using the organoleptic test (OT) as "gold standard." The second aim was to verify whether their concomitant use could enhance the diagnostic accuracy of halitosis. Material and Methods: A cross-sectional analytical study was performed. The quality of expired air of 34 subjects without chief complaint of halitosis was assessed. Two experienced examiners carried out the OT. Afterward, a third blinded examiner performed Halimeter™ (HT) and Breath Alert™ (BA) tests. Results: The OT identified halitosis in 21 subjects (62%). The area under the ROC curve (95% confidence interval) was 0.67 (0.48-0.85) and 0.54 (0.34-0.75) for HT and BA, respectively. The accuracy for HT and BA was 59% and 47%, respectively. The combined usage of HT and BA provided 11 positive results, being 9 subjects (43%) out of the total of 21 positive cases. Conclusions: Halimeter™ and Breath Alert™ were not able to diagnose halitosis in non-complainer subjects at the same level as the organoleptic examination, since their accuracy were low. Our results suggest that such portable devices are not reliable tools to assess halitosis and may neglect or misdiagnose a considerable number of patients in clinical practice.

Abstract Purpose: To identify the most relevant flaws in standardization in husbandry practices and lack of transparency to report them. This review proposes some measures in order to improve transparency, reproducibility and eventually external validity in experimental surgery experiments with rat model. Methods: We performed a search of scientific articles in PUBMED data base. The survey was conducted from august 2016 to January 2017. The keywords used were "reproducibility", "external validity", "rat model", "rat husbandry", "rat housing", and the time frame was up to January 2017. Articles discarded were the ones which the abstract or the key words did not imply that the authors would discuss any relationship of husbandry and housing with the reproducibility and transparency of reporting animal experiment. Reviews and papers that discussed specifically reproducibility and data reporting transparency were laboriously explored, including references for other articles that could fulfil the inclusion criteria. A total of 246 articles were initially found but only 44 were selected. Results: Lack of transparency is the rule and not the exception when reporting results with rat model. This results in poor reproducibility and low external validity with the consequence of considerable loss of time and financial resources. There are still much to be done to improve compliance and adherence of researchers, editors and reviewers to adopt guidelines to mitigate some of the challenges that can impair reproducibility and external validity. Conclusions: Authors and reviewers should avoid pitfalls of absent, insufficient or inaccurate description of relevant information the rat model used. This information should be correctly published or reported on another source easily available for readers. Environmental conditions are well known by laboratory animal personnel and are well controlled in housing facilities, but usually neglected in experimental laboratories when the rat model is a novelty for the researcher.

ABSTRACT The human skin aging process is a complex mechanism that can be induced both by intrinsic and extrinsic factors. Observations include a decrease in the biosynthetic and proliferative capacity of cells, increased expression of matrix metalloproteinases, reduction in collagen type I expression, and the progressive disappearance of elastic tissue in the papillary dermis. L-arginine, the substrate of nitric oxide synthesis, is involved in angiogenesis and cell proliferation, as well as an indirect precursor of collagen synthesis via the proline pathway. The aim of this study was to examine the tensile strength, histology, and immunohistochemistry of female and male mice skin receiving different concentrations of topically applied L-arginine, in order to evaluate the possibility of using L-arginine as an active cosmetic ingredient in antiaging products. The results suggest that the application of L-arginine improves the mechanical resistance of skin from older female mice (20 weeks old) and promotes the formation of a larger amount of collagen and elastic fibers in the skin when applied at a concentration of 15%.

RESUMO Manifestações orofaciais ocorrem com frequência nas doenças reumáticas e, comumente, representam sinais iniciais ou de atividade da doença que ainda são negligenciados na prática clínica. Entre as doenças reumáticas autoimunes com possíveis manifestações orais, incluem-se a artrite reumatoide (AR), miopatias inflamatórias (MI), esclerose sistêmica (ES), lúpus eritematoso sistêmico (LES), policondrite recidivante (PR) e síndrome de Sjögren (SS). Sinais e sintomas orofaciais como hipossalivação, xerostomia, disfunções temporomandibulares, lesões na mucosa bucal, doença periodontal, disfagia e disfonia podem ser a primeira expressão dessas doenças reumáticas. Esse artigo revisa as principais manifestações orofaciais das doenças reumáticas que podem ser de interesse do reumatologista, para diagnóstico e acompanhamento das doenças reumáticas autoimunes.

ABSTRACT Orofacial manifestations occur frequently in rheumatic diseases and usually represent early signs of disease or of its activity that are still neglected in clinical practice. Among the autoimmune rheumatic diseases with potential for oral manifestations, rheumatoid arthritis (RA), inflammatory myopathies (IM), systemic sclerosis (SSc), systemic lupus erythematosus (SLE), relapsing polychondritis (RP) and Sjögren's syndrome (SS) can be cited. Signs and symptoms such as oral hyposalivation, xerostomia, temporomandibular joint disorders, lesions of the oral mucosa, periodontal disease, dysphagia, and dysphonia may be the first expression of these rheumatic diseases. This article reviews the main orofacial manifestations of rheumatic diseases that may be of interest to the rheumatologist for diagnosis and monitoring of autoimmune rheumatic diseases.

AbstractOral lichen planus (OLP) represents a common mucocutaneous disease. Various authors have suggested that OLP has malignant potential; however, the mechanisms involved in malignant transformation have not yet been elucidated. A 79-year-old man presented a white lesion for five months in the buccal mucosa diagnosed as OLP. After two months using 0.05% clobetasol ointment for treatment, the lesion became ulcerated. A new biopsy of the same lesion was performed, and histological analysis showed an in situ oral carcinoma (ISOC). An immunohistochemistry panel was performed, and p16 expression was negative in OLP, however, it showed weak cytoplasmic staining in ISOC. There was strong nuclear BUB3 staining in both OLP and ISOC areas. p53 showed less intense nuclear staining in both regions. Ki67 was negative in OLP area, but showed nuclear staining in the ISOC. SOX4 was negative in both studied areas. BUB3 expression, first reported in this case, and the p16 expression may suggest some influence of these genes on pathogenesis or malignant potential of OLP.

PURPOSE: To evaluate the effect of simvastatin on relapse of tooth movement in rats using microtomography (micro CT), as well as the correlation of bone density with the orthodontic relapse.METHODS: Twenty-five adult male Wistar rats, divided into two groups, had stainless steel springs installed on left maxillary first molar. The molars were moved for 18 days, and after removing the springs, were applied by oral gavage, 5mg/kg of simvastatin in the experimental group for 20 days. Tooth relapse was assessed with a micro CT scanner, and the images chosen through the Data Viewer software 1.5.0.0 had their measurement guides made and checked by the software Image ProR plus 5.1, and compared by Mann-Whitney test. After rats were sacrificed, bone mineral density was evaluated by micro CT through the software CT Analyzer 1.13 and compared by independent T-test, as well as by Spearman correlation test.RESULTS: Relapse and bone mineral density (BMD) was lower in the experimental group than in the control group, however without a statistically significant difference.CONCLUSION: Simvastatin did not inhibit the relapse of tooth movement in rats, and there was no correlation between bone density and orthodontic relapse.

A síndrome de Williams-Beuren (WBS) é uma doença genética rara, acometendo, aproximadamente, de 1:20.000 a 1:50.000 crianças nascidas. As crianças com WBS têm deformidades esqueléticas específicas, má formações dentárias e, algumas vezes, disfunção muscular da língua. As necessidades ortodônticas e ortognáticas têm sido consideradas um verdadeiro desafio clínico, até mesmo para aqueles profissionais com vasta experiência, uma vez que requerem um plano de tratamento individualizado e complexo. Esse relato de caso aborda uma expansão ortopédica da maxila, em que foi utilizada uma máscara facial modificada para protração do complexo maxilar, acompanhada de uma rotação horária da maxila. Além disso, considerações especiais sobre o tempo de tratamento e resultados ortopédicos são discutidas.

Williams-Beuren syndrome (WBS) is a rare genetic condition that affects approximately 1 in every 20,000 - 50,000 live births. WBS children have specific skeletal deformities, dental malformations and rare lingual muscle dysfunction. The need for orthodontic and orthognathic therapy has arisen and has been considered a real clinical challenge even for experienced professionals, once it requires a complex and individualized treatment plan. This study reports a case of orthopedic expansion of the maxilla, in which a modified facial mask was used for protraction of the maxillary complex associated with clockwise rotation of the maxilla. In addition, special considerations about treatment time and orthopedic outcomes are discussed.

Estudou-se o efeito de quatro condições de manejo sobre a aceitação de banana 'Pacovan'. Os frutos foram colhidos no ponto de maturação fisiológica ideal para o armazenamento, em quatro propriedades rurais do município de Bananeiras - PB, seguindo-se delineamento inteiramente casualizado. Os tratamentos foram identificados como: P1: irrigação+adubação química e orgânica +controle químico de plantas invasoras; P2: controle manual de plantas invasoras; P3: irrigação+adubação química+controle manual de plantas invasoras; P4: controle manual e químico de plantas invasoras. Em cada propriedade, foram colhidos cinco cachos de banana que foram submetidos à climatização com carbureto de cálcio por 12 horas para uniformização da maturação. Após esse período, foram mantidos à temperatura ambiente até sua completa maturação. O painel sensorial foi composto por 62 julgadores não treinados, com idade média de 18 anos. Os atributos aroma, sabor, textura e cor da polpa foram avaliados por meio de teste de aceitação, utilizando-se de escala hedônica estruturada de 9 pontos. Para o teste de intenção de compra, foi utilizada escala estruturada de 5 pontos. As amostras foram apresentadas aos julgadores na forma de rodelas, com espessura aproximada de 1,5 cm. Os resultados foram submetidos à análise de variância (ANOVA), e as médias, comparadas pelo teste de Tukey, ao nível de 5% de probabilidade. Para todos os atributos avaliados,os valores situaram-se entre 7,34 e 7,68, posicionando-se na escala hedônica entre os termos 'gostei moderadamente' e 'gostei muito'. Para intenção de compra, o percentual de aceitação foi de 74,19; 72,58; 72,58 e 70,97%, respectivamente, para as amostras P1, P2, P3 e P4. O tipo de manejo não influenciou na aceitação da banana 'Pacovan', sendo os frutos considerados pelos julgadores como produto de boa aceitação.

The effect of four management conditions on the acceptance of 'Pacovan'banana was assessed. The fruits were harvested at ideal physiological maturity for storage in four farms in the municipality of Bananeiras - PB, according to a fully randomized design. Treatments were identified as P1: Irrigation + chemical and organic fertilization + chemical control of weeds; P2: manual control of weeds; P3: irrigation + chemical fertilization + manual control of weeds; P4: manual and chemical control of weeds. Five bunches of bananas were harvested in each farm and submitted to cooling with calcium carbide for 12 hours for uniform ripening. After this period, fruits were kept at room temperature until full maturation. The sensory panel was composed of 62 untrained judges, with mean age of 18 years. Attributes of aroma, flavor, texture and pulp color were assessed through acceptance test using a 9-point hedonic scale. The purchase intention test used a 5-point structured scale. The samples were presented to panelists in the form of slices with thickness of approximately 1.5 cm. Results were submitted to analysis of variance (ANOVA) and means were compared by the Tukey test at 5% probability. For all attributes, values ranged from 7.34 to 7.68, in the hedonic scale between terms 'liked moderately'and 'liked very much'. As for the purchase intention, acceptance percentages were 74.19, 72.58, 72.58 and 70.97% respectively for P1, P2, P3 and P4. The management condition did not influence the acceptance of 'Pacovan' banana, and the fruits were considered by the judges as a product of good acceptance.

O xantoma verruciforme é uma lesão rara de etiologia não determinada, que acomete, principalmente, a mucosa oral. Na maioria das vezes é assintomática, caracterizando-se por uma elevação bem-delimitada, de superfície rugosa ou papilar, e sua principal localização na boca é a gengiva. Com relação ao tamanho, a maioria das lesões não ultrapassa 2 cm no seu maior diâmetro. O objetivo do presente trabalho é relatar um caso raro de extenso xantoma verruciforme em paciente do gênero masculino, de 55 anos, apresentando lesão localizada no palato duro e na gengiva palatina. Clinicamente, a lesão possuía bordas bem-destacadas, de superfície levemente granular e coloração avermelhada, com consistência elástica, medindo aproximadamente 2,8 X 1,5cm. O exame histopatológico demonstrou a presença de proliferação do epitélio de revestimento, exibindo papilomatose, paraceratose e alongamento das cristas epiteliais. Na lâmina própria, células xantomatosas com citoplasma claro e vacuolado puderam ser observadas. O paciente encontra-se livre de recidivas após 18 meses de acompanhamento clínico. De acordo com extensa pesquisa em bases de dados (pubmed, medline, lilacs), o presente caso representa uma das maiores lesões do tipo xantoma verruciforme já relatadas na literatura.

Verruciform xanthoma represents a rare disease of unknown etiology that typically affects the oral mucosa. In most cases, it is asymptomatic and characterized by a well demarcated elevation with irregular or papillary surface. The gums are the most affected oral site, and the lesion is usually less than 2 cm in diameter. The aim of this study is to report a rare case of an extensive verruciform xanthoma in the hard palate and gums of a 55-year-old male. Clinically, the well delimitated, reddish, elastic lesion measuring approximately 2.8 X 1.5 cm had a slightly granular surface. Histopathological analysis found proliferative epithelial activity with evident papillomatosis, parakeratosis, and large epithelial ridges. Xanthomatous cells with clear, vacuolated cytoplasm were detected in the lamina propria. The patient has been disease free for 18 months. According to an extensive research in the PubMed, MEDLINE, and Lilacs databases, this paper describes one of the most extensive cases of verruciform xanthoma reported in the literature.