title: Oral cavity eumycetoma.
abstract: Mycetoma is a pathological process in which eumycotic (fungal) or actinomycotic causative agents from exogenous source produce grains. It is a localized chronic and deforming infectious disease of subcutaneous tissue, skin and bones. We report the first case of eumycetoma of the oral cavity in world literature.
  
  
  METHODS
  A 43-year-old male patient, complaining of swelling and fistula in the hard palate. On examination, swelling of the anterior and middle hard palate, with fistula draining a dark liquid was observed. The panoramic radiograph showed extensive radiolucent area involving the region of teeth 21-26 and the computerized tomography showed communication with the nasal cavity, suggesting the diagnosis of periapical cyst. Surgery was performed to remove the lesion. Histopathological examination revealed purulent material with characteristic grain. Gram staining for bacteria was negative and Grocott-Gomori staining for the detection of fungi was positive, concluding the diagnosis of eumycetoma. The patient was treated with ketoconazole for nine months, and was considered cured at the end of treatment.
  
  
  CONCLUSIONS
  Histopathological examination, using histochemical staining, and direct microscopic grains examination can provide the distinction between eumycetoma and actinomycetoma accurately.
authors.affiliation: Department of Pathology, University of Western São Paulo, Presidente Prudente, SP, Brazil. patologia@unoeste.br
authors.forename: Gisele Alborghetti
authors.initials: GA
authors.lastname: Nai
authors.forename: Maria Luiza de Toledo
authors.initials: ML
authors.lastname: Stuani
authors.forename: Luís Antonio Sasso
authors.initials: LA
authors.lastname: Stuani
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D006801:Humans; D007654:Ketoconazole / Q000627:therapeutic use; D008297:Male; D009059:Mouth Diseases / Q000188:drug therapy / Q000382:microbiology*; D008271:Mycetoma / Q000188:drug therapy / Q000382:microbiology*; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D007654:Ketoconazole