Oral Oncology Extra最新文献

Granular cell odontogenic tumour (GCOT) is a rare benign odontogenic neoplasm composed of granular cells and ameloblastic epithelium. The GCOT tends to occur in the posterior region of the mandible, especially in 50-year-old women. We report a case of GCOT that occurred in the mandible of a 20-year-old woman. Immunohistochemically, while a low proliferating cell nuclear antigen (PCNA) staining was observed in the granular cells, the epithelium showed a significant PCNA labelling, which suggests that the odontogenic epithelium may have an important role on the GCOT tumorigenesis.

A case of odontogenic sarcoma with smooth muscle differentiation arising in a 70-year-old woman is described. The lesion grew out of an extraction socket and enlarged rapidly. Radiographically, a large radiolucent lesion with ill-defined margins was observed in the left posterior mandible. Histopathologically, islands of odontogenic epithelium with a surrounding malignant mesenchymal proliferation were noted. The latter exhibited hyperchromatic oval and spindle-shaped cells with 3–4 mitoses in some high-power fields and foci of necrosis. Lesional cells demonstrated immunoreactivity with vimentin and alpha smooth muscle actin, but were negative for antibodies directed against S100, CD34 and CD31. Cytokeratins highlighted the epithelial islands, but did not react with the mesenchymal proliferation. To date, fewer than 70 cases of odontogenic sarcoma have been described in the literature. To our knowledge, this is the first report of an odontogenic malignancy showing smooth muscle differentiation.

Ancient schwannoma rarely occurs in the oral cavity. Reviewing the literature, only six intra-oral cases of ancient schwannoma have been reported in the English-language medical literature. Here we present an intra-oral ancient schwannoma in a male patient with, to our knowledge, the longest reported duration: 18 years. In addition, a brief review of the pertinent literature is included.

Adenomatoid odontogenic tumor (AOT) is a benign (hamartomatous), non-invasive lesion with slow but progressive growth. There are three variants of AOT: follicular, extrafollicular, and peripheral. This report illustrates an unusual case of AOT, i.e., arising within the periodontal ligament. A boy was brought in by his parents for evaluation of a gingival swelling. Periapical radiograph revealed thickening of the periodontal ligament with foci of calcification. Clinical diagnosis was peripheral ossifying fibroma. Biopsy was performed and microscopic examination revealed the presence of an AOT. The patient has been followed-up for eleven months without recurrence.

Leiomyoma of the nasal cavity is an extremely rare tumor and a search of the literature revealed only 24 prior reports. We present two cases of leiomyomas arising from the wall of the nasal cavity with the symptom of nasal obstruction, which they were treated by complete surgical excision.

Melanomas are malignant tumors prone to develop in regional and distant metastatic foci. Desmoplastic melanoma is an uncommon melanoma variant that commonly affects the head and neck and can promote early regional metastasis through both lymphatic and neural routes. We report an uncommon case of metastatic desmoplastic melanoma from the scalp to submandibular and parotid lymph nodes in a 79-year-old male, diagnosed through fine-needle aspiration biopsy. This report reinforces the importance of considering melanoma metastasis on the differential diagnosis of asymptomatic salivary gland swellings and the utility of fine needle aspiration biopsy in their early diagnosis.

Primary leiomyosarcomas in the head and neck are rare tumors. We report a case of maxillary leiomyosarcoma in a 35-year-old male. The patient was referred to our hospital in October 2003, and diagnosed with leiomyosarcoma, originating around the left maxillary sinus. Superselective intra-arterial chemotherapy with docetaxel (DOC) and cisplatin (CDDP) via a superficial temporal artery was employed as preoperative therapy. The tumor decreased in size to less than 50% of its initial volume after this therapy. Total maxillectomy was performed, and 70–80% of tumor cells showed degeneration and necrosis. The patient has been free of disease for 2 years after operation. Chemotherapy is thought to have little effect in achieving local control of leiomyosarcomas, however, superselective intra-arterial chemotherapy was very beneficial in this patient.

A case of tongue cancer developing in a 33-year-old man 7 years and 7 months after allogenic bone mallow transplantation (BMT) for acute myeloid leukemia is presented. The patient received chemotherapy and total body irradiation of a total dose of 12 Gy in a conditioning regimen. He was affected with chronic graft-versus-host disease after BMT, but had not complained of symptom in the oral cavity. Oral examination showed an ulcerative mass with induration at the right lateral border of the tongue. The mass was diagnosed as a squamous cell carcinoma by biopsy. The tumour was surgically removed. There was no evidence of recurrence or metastasis 9 months after surgery. The necessity of long-term follow-up of the oral cavity in recipients undergoing BMT is emphasized.