Oral Oncology Extra最新文献

The present case is a rare report of an adenomatoid odontogenic tumor (AOT) in the maxilla of a 12-year-old African-American male involving an impacted canine and bicuspid and its subsequent management.

PTCH gene is well-known to be responsible for the development of Gorlin syndrome. It is also believed that PTCH mutation is responsible for the developmental of odontogenic keratocysts both in the Gorlin syndrome related and the sporadic cases. There is a conflict opinion in the literature regarding its role in odontogenic cysts. Furthermore, it is not known whether PTCH expression has any relevant clinical role in the outcome of the odontogenic cysts. In this study 8 odontogenic keratocysts, 16 dentigerous cysts and 23 radicular cysts treated in the academic hospital of the Free University of Brussels were subjected to an immunohistochemistry study for their expression of PTCH. The data obtained were linked to the clinical behaviour of the cysts for a follow-up of up to 20 years. Eighty eight percent of the odontogenic keratocysts (OKC), 67% of dentigerous cysts, (DC) and only 25% of radicular cysts (RC) expressed PTCH. This difference was statistically significant. Seventeen patients could be called back for clinical evaluation, the follow-up ranged from 10 to 20 years. Four patients suffering from OKC had clinical complications, 3 in the DC group and 2 in the RC group. Complications ranged from (multiple) recurrence to one case of transformation into an ameloblastoma. Only one patient suffered from clinical complication of a RC without being PTCH positive. One patient who had a PTCH negative DC and seven patients with PTCH negative RC had no clinical complications. The results indicate that PTCH expression in odontogenic cysts is more likely to be the reason of clinical complication rather than a cause of pathogenesis.

Primary intraosseous squamous cell carcinoma (SCC) is a rare malignant tumor of the jaw. We report a case of intraosseous SCC involving the mandible of a 60-year-old male. The serum level of carcinoembryonic antigen (CEA) was exceedingly elevated. Immunohistochemical analysis showed that the tumor was strongly stained with anti-CEA antibody. The patients underwent wide surgical excision of the tumor, and serum CEA level gradually decreased and remained in the normal range. Serum CEA level increased 37 months after tumor resection, and radical neck dissection was performed because of lymphadenopathy. The serum level of CEA correlated well with the clinical course of present tumor and was useful in monitoring the treatment and relapse.

Distant metastasis to small bones from buccal mucosal cancer was extremely rare. We reported a rare case of buccal carcinoma with an unusual metastasis to the calcaneus. Subsequently, this metastatic lesion directly involved the left ankle joint. As a result, it initially presented with a monoarthritis mimicking refractory gouty arthritis. Moreover, it transformed to an acute toxic reaction mimicking infectious monoarthritis. This case confirmed our clinical experience that cancer patients presented with common symptoms and refractory to conventional management might have an underlying malignant disease in nature.

We describe herein an association of a nevoid basal cell carcinoma syndrome and an angiosarcoma arising in muscle of neck. This inextirpable tumour showed a rapid progression. The patient died 3 months after diagnosis despite two lines of chemotherapy. This association was not previously described.

The calcifying epithelial odontogenic tumor (CEOT) is a rare benign but locally aggressive odontogenic neoplasm first described as an entity by a Dutch pathologist Jens Jorgen Pindborg in 1955. It accounts for less than 1% of all odontogenic lesions. In 1976, a review of the world literature comprising 113 cases was published. Presently, there is still no documented case of a Filipino with this type of odontogenic tumor. Although Pindborg tumors have characteristic clinical and histopathologic features some variants can mimic malignant neoplasms. We report of a case of recurrent calcifying epithelial odontogenic tumor which showed cytologic features of malignancy. Definitive resection of the entire mass with tumor-free surgical margins and long-term follow up are recommended.

Hyalinizing clear cell carcinoma (HCCC) is a newly described entity with distinctive histological features. A 48-year-old woman with HCCC was described in minor salivary glands of right maxillary tuberosity with two years duration. Physical examination revealed a red-colored, firm mass measuring 2.0 cm × 1.8 cm with telangiectases in the overlying mucosal surface. Computed tomography scans demonstrated a bony destruction of buccal cortex of maxillary alveoli and right maxillary tuberosity. Resection biopsy, wide excision of the underlying alveoli including part of maxilla was performed. Pathological examination revealed typical clear cells arranged in anastomosing trabeculae, cords, nests, or solid sheets with a hyalinizing stroma. These clear cells were strongly positive for the periodic acid-Schiff (PAS) but were negative for the mucicarmine staining. Immunohistochemically, those neoplastic cells were immunoreactive to cytokeratin, but negative to smooth muscle actin and S-100 protein. Neither recurrence nor distant metastasis was found during the 12-month follow-up period.

Human papilloma virus (HPV) is the most common sexually transmitted viral disease responsible for mucosal warts and anogenital malignancies. HPV-associated oral lesions include condyloma, focal epithelial hyperplasia and some squamous cell carcinomas. Both oral and genital lesions caused by HPV are more commonly seen in those co-infected with HIV. While there is some degree of HPV genotypespecific clinical presentation, unusual manifestations of oral HPV disease in the HIV-positive patient frequently occur. Examinations of oral-wart biopsy specimens from HIV-positive individuals reveal a range of HPV genotypes, including cutaneous type 2; genital types 6, 11, 16 and 18; and oral type 13. However, the most common HPV genotypes identified in HIV-associated oral warts are oral specific HIV type 32 and the cutaneous HPV type 7. This paper presents two cases of HPV lesions associated with these types, which progressed into oral squamous cell carcinoma.

Sinonasal undifferentiated carcinomas (SNUC) are highly aggressive lesions arising in the superior nasal cavity and paranasal sinuses. The differential diagnosis may be wide since a range of similar lesions may present at this site. Recently the criteria for diagnosis of SNUC has been clarified. Histologically they show marked pleomorphism, mitotic activity and necrosis with no evidence of squamous or glandular differentiation or of rosettes. They express low molecular weight cytokeratins and are typically negative for S-100 and neuroendocrine markers. They do not express EBV.

Lymphangioma circumscriptum (LC) is an unusual but well recognized disease entity in dermatopathology. Although acquired LC can also arise in oral mucosa, there are no reported cases in the literature. Oral LC lesions are reactive in nature and can occur as a consequence of radiotherapy in patients treated for oral cancer. Similar lesions developing at denture-bearing sites can mimic leukoplakia clinically. The purpose of this article is to draw the attention of clinicians and pathologists to this entity in order to avoid possible confusion with malignant or premalignant lesions.