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Abramson Cancer CenterNCI CANCERLIT® Search: Mouth Cancer - May 2002
National Cancer Institute®
Last Modified: May 1, 2002
Table of Contents
1
UI - 11771021
AU - Kramer D; Durham JS; Jackson S; Brookes J
TI -
Management of the neck in N0 squamous cell carcinoma of the oral cavity.
SO - J Otolaryngol 2001 Oct;30(5):283-8
AD - Department of Surgery, University of British Columbia, Vancouver General
Hospital.
Mortality in treated squamous cell carcinoma of the oral cavity is most
often owing to locoregional failure. In an attempt to improve survival,
an aggressive approach to surgical management is often favoured.
Although it is generally accepted that the N0 neck should be treated if
the risk of micrometastatic disease exceeds 20%, there is little direct
support in the literature for this position. A retrospective review of
all patients presenting with T1-2, N0 squamous cell carcinoma of the
oral cavity treated at the Cancer Control Agency of British Columbia
from 1985 to 1994 was conducted. Patients were followed for a minimum of
5 years with documentation of patterns of recurrence and
disease-specific survival relative to initial management. The decision
regarding management of the neck was frequently made to accommodate
treatment of the primary site or reconstructive strategies. Thirteen
percent of patients with T1, N0 disease underwent prophylactic neck
dissection. No significant difference in outcome was noted in this
group. Thirty-three percent of patients with T2, N0 disease underwent
prophylactic neck dissection. There was a trend toward improved 5-year
survival and lower recurrence rates in the group whose necks were
treated, but the difference was not found to be statistically
significant. In conclusion, this review showed a trend toward increased
survival with prophylactic treatment of the neck in T2, N0 squamous cell
carcinoma of the oral cavity, but a larger study would be needed to show
a statistically significant benefit.
2
UI - 11846854
AU - Orsini G; Fioroni M; Rubini C; Piattelli A
TI -
Peripheral calcifying odontogenic cyst.
SO - J Clin Periodontol 2002 Jan;29(1):83-6
AD - Dental School, University of Chieti, Italy.
BACKGROUND: Calcifying odontogenic cyst (COC) is a rare lesion
representing about 1% of jaw cysts. It may occur in a central
(intraosseous) or peripheral (extraosseous) location. METHOD: A case of
peripheral COC located on the gingiva, appearing as a painless,
circumscribed, pink nodule has been reported. RESULTS: Peripheral, in
contrast to central, COC tends to affect older patients. Peripheral COC
is a less aggressive lesion than the central counterpart, and a simple
excision biopsy is curative. CONCLUSION: The histological finding of a
keratinized epithelium rich in ghost cells has helped in making the
diagnosis.
3
UI - 11929827
AU - Gasco M; Bell AK; Heath V; Sullivan A; Smith P; Hiller L; Yulug I;
TI -
Numico G; Merlano M; Farrell PJ; Tavassoli M; Gusterson B; Crook T
Epigenetic inactivation of 14-3-3 sigma in oral carcinoma: association
with p16(INK4a) silencing and human papillomavirus negativity.
SO - Cancer Res 2002 Apr 1;62(7):2072-6
AD - UO Oncologia Medica, Azienda Ospedaliera S Croce e Carle, 12100 Cuneo,
Italy.
In vitro studies have identified 14-3-3sigma as a regulator of
senescence in human keratinocytes. To assess its contribution to
squamous neoplasia, we have analyzed genetic and epigenetic changes in
this gene in squamous cell carcinomas (SCCs) and dysplastic lesions of
the oral cavity. No mutations were detected in the coding sequence of
14-3-3sigma in 20 oral carcinomas, and there was loss of heterozygosity
in only 7 of 40 informative cases. In contrast to the absence of genetic
change, aberrant methylation within 14-3-3sigma was detected in 32 of 92
squamous cell carcinomas and in 3 of 6 oral dysplasias and was
associated with reduced or absent expression at both mRNA and protein
levels. Methylation was not detected in matched, normal epithelial
tissue controls. Carcinomas in which 14-3-3sigma was methylated were
significantly more likely to lack DNA sequences from human
papillomavirus and to have coincident methylation of p16(INK4a) than
cases that expressed 14-3-3sigma. Methylation was detected in SCC, both
wild-type and mutant for p53, but was more commonly detected in cancers
with wild-type p53. These results implicate coincident epigenetic
abrogation of function in both sigma and p16(INK4a) in a subset of SCCs
of the oral cavity.
4
UI - 11944548
AU - Lipsker D; Chosidow O
TI -
[White lesions of the oral mucosa]
SO - Rev Prat 2002 Feb 15;52(4):389-93
AD - Clinique dermatologique, Hopitaux Universitaires de Strasbourg 67091
Strasbourg. dlipsker@noos.fr
In this review, the etiologies of white oral lesions will be discussed.
Thrush is the commonest form of oral candidiasis and it is the prototype
of pseudomembranous lesions. The latter are whitish lesions that can be
easily rubbed off. All patients with erosive or ulcerative lesions of
the oral mucosa, e.g. patients with immunobullous diseases, can present
with such lesions. Leucokeratosis refers to white, firmly adherent,
lesions. A great number of diseases can manifest with such lesions:
inflammatory diseases like lichen planus, infectious diseases like
chronic candidiasis or hereditary diseases like the white sponge nevus.
Leucoplakia refers to keratosic lesions tobacco-induced or that can not
be precisely classified clinically. Such lesions are considered
premalignant. When other clinical signs like erythema or ulceration are
associated, these lesions are often epidermoid carcinomas.
5
UI - 11987327
AU - Kashyap AS; Kashyap S
TI -
Head and neck cancer.
SO - N Engl J Med 2002 May 2;346(18):1416-7
6
UI - 11805779
AU - Abdelsayed RA; Sumner T; Allen CM; Treadway A; Ness GM; Penza SL
TI -
Oral precancerous and malignant lesions associated with
graft-versus-host disease: report of 2 cases.
SO - Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002 Jan;93(1):75-80
AD - Oral Biology and Maxillofacial Pathology, School of Dentistry, Medical
College of Georgia, Augusta 30912, USA. rabdelsa@mail.mcg.edu
The development of secondary malignancies has been recognized as a
potential iatrogenic complication in patients who have graft-versus-host
disease secondary to bone marrow transplantation. Lymphohematopoietic
cancer is most frequent, although solid malignancies have also been
reported. We describe 2 patients with graft-versus-host disease who
developed oral precancerous and malignant lesions. The first patient, a
24-year-old white man, had erythroplakia of the buccal mucosa that
proved to be carcinoma in situ histopathologically. The second patient,
a 14-year-old Hispanic boy, developed synchronous cutaneous and lingual
squamous cell carcinomas. The current cases and similar sporadic case
reports found in the literature highlight the susceptibility of patients
with graft-versus-host disease to the development of oral cancer.
Therefore, it is recommended that thorough evaluation of the oral mucosa
and close follow-up be offered to all patients treated with bone marrow
transplantation and particularly to those who develop graft-versus-host
disease.
7
UI - 11829232
AU - Kubler AC; de Carpentier J; Hopper C; Leonard AG; Putnam G
TI -
Treatment of squamous cell carcinoma of the lip using Foscan-mediated
photodynamic therapy.
SO - Int J Oral Maxillofac Surg 2001 Dec;30(6):504-9
AD - Department of Oral and Maxillofacial Surgery, University of Cologne,
Koln, Germany. A.Kuebler@uni-koeln.de
Carcinoma of the lip is a common cancer of the head and neck area; its
incidence is approximately one-quarter that for oral cavity cancers. It
occurs most frequently on the lower lip of elderly males. This
non-randomized Phase II study aimed to estimate the complete response
(CR) rate to Foscan-mediated photodynamic therapy (Foscan-PDT) in
patients with primary cancer of the lip, duration of CR, and the
tolerability and safety of Foscan-PDT. Twenty-five patients with
squamous cell carcinoma (SCC) of the lip (Tis, T1, T2/N0/M0) and
Karnofsky status > or = 70 received 0.15 mg/kg Foscan intravenously,
followed 4 days later by a single non-thermal illumination of the tumour
(light dose 20 J/cm2, irradiance 100 mW/cm2, lambda=652 nm). Response
was determined after 12 weeks and mean follow up is 424 days so far.
After 12 weeks, 96% of cases (24/25) showed CR, and all CRs were
confirmed by biopsy. The most common adverse event was swelling and
local pain at the treatment site. Tumour recurrence was observed in two
patients 4 and 18 months after PDT. One patient developed a single lymph
node metastasis 7 months after therapy. Photosensitivity reactions
occurred in five patients. The functional results were excellent in all
patients without any signs of limited mouth opening or impaired lip
closure. The cosmetic outcome was better than after surgical therapy.
Foscan-PDT is an effective treatment modality for small primary tumours
of the lips. Foscan-PDT yields complete response rates comparable to
those published for surgery or radiotherapy without causing major
toxicity. It allows preservation of form and function and does not
compromise future treatment options for recurrent, residual or second
primary disease.
8
UI - 11937964
AU - Lombardi T; Samson J; Kuffer R
TI -
[Solitary circumscribed neuroma (palisaded encapsulated neuroma) of the
oral mucosa]
SO - Ann Dermatol Venereol 2002 Feb;129(2):229-32
AD - Division de Stomatologie, Faculte de Medecine de Geneve, Suisse, France.
tommaso.lombardi@medecine.unige.ch
BACKGROUND: The solitary circumscribed neuroma or "Palisaded
Encapsulated Neuroma" is an infrequent benign tumor of the skin of
adults, often localised on the face, around the orifices. The
involvement of the oral mucosa or of the vermilion border of the lips is
rare.CASE REPORTS: In our 5 cases, a small painless and more or less
protruding nodule had been present for years on the mucosa of the hard
palate (50 year-old man, 43 year-old woman), the soft palate (63
year-old woman), the vermilion border of the lower lip (48 year-old
woman), and the gingiva (26 year-old man). The non specific clinical
aspect did not permit a correct diagnosis.DISCUSSION: Histologically,
the solitary circumscribed neuroma is formed by a proliferation of
Schwann cells arranged in interlacing bundles, featuring one or several
well-limited nodules, sometimes surrounded by a thin capsule. At first
sight, this aspect might sometimes mimic schwannoma or neurofibroma. The
lesion is interspersed with a variable amount of axons. An association
with neurofibromatosis or MEN syndrome type IIb has never been found.
Even after incomplete excision the solitary circumscribed neuroma does
not recur, a fact supporting a reactive rather than a neoplastic origin.
9
UI - 11955736
AU - Bhattathiri VN
TI -
Cumulative interfraction interval analysis of influence of time and
interruptions on radiotherapy results in oral cancers.
SO - Int J Radiat Oncol Biol Phys 2002 Apr 1;52(5):1251-6
AD - Department of Radiotherapy and Clinical Radiobiology Section, Regional
Cancer Centre, Medical College PO, Trivandrum, India. vnbtvm@vsnl.com
PURPOSE: To present a new approach to analyze the influence of time and
interruptions in fractionated radiotherapy, in terms of cumulative
interfraction intervals (CIFIs), that is, the interval between
nonsuccessive fractions of radiotherapy. METHODS AND MATERIALS: The
subjects were 142 patients with epidermoid cancer of the buccal
mucosa-gingiva-palate region treated by 60 Gy in 25 fractions during 5
weeks. The influence of CIFI between the first and sixth, eleventh,
sixteenth, and twenty-first fractions (CIFI(1-6), CIFI(1-11),
CIFI(1-16), and CIFI(1-21), respectively), as well as overall treatment
time on local control, was analyzed by Kaplan-Meier calculation of the
primary relapse-free survival and Mann-Whitney U testing of the
difference in various CIFIs between the tumors that recurred (recurred
group) and those that did not (controlled group). RESULTS: Only
CIFI(1-11) influenced local control significantly, with the 5-year
primary relapse-free survival rate being 67.9%, 48.4%, and 32.6% in
those with CIFI(1-11) of <14, 14, and >14 days (p = 0.0181). The median
CIFI(1-11) in the controlled group was significantly lower than that in
the recurred group (14 days vs. 15 days; p = 0.0037). CONCLUSION:
Interruptions during the first 11 fractions, including planned weekend
gaps, decrease the effect of radiotherapy, possibly because of
successful tumor cell repopulation during the protracted interfraction
intervals. The analysis of time in terms of CIFI rather than overall
treatment time appears to be a promising area for research.
10
UI - 11955737
AU - Marsiglia H; Haie-Meder C; Sasso G; Mamelle G; Gerbaulet A
TI -
Brachytherapy for T1-T2 floor-of-the-mouth cancers: the Gustave-Roussy
Institute experience.
SO - Int J Radiat Oncol Biol Phys 2002 Apr 1;52(5):1257-63
AD - Brachytherapy Unit, Radiation Oncology Department, European Institute of
Oncology, Milan, Italy. hrmars@ieo.it
PURPOSE: In a retrospective analysis, we evaluated the Gustave-Roussy
Institute's experience of locoregional control, survival, and
complications of low-dose rate brachytherapy for carcinoma of the floor
of the mouth. METHODS AND MATERIALS: Between 1970 and 1985, 160 patients
with previously untreated carcinoma of the floor of the mouth received
interstitial brachytherapy as definitive treatment. Of the 160 patients,
79 (49%) had T1 and 81 (51%) had T2 lesions, and 127 (79%) had N0 and 33
(21%) had N1; 84% of tumors arose from the anterior floor of the mouth.
Brachytherapy was performed with 192Ir wires, according to the Paris
system rules, followed by neck dissection (T2 or N1) or follow-up
(T1N0). RESULTS: With a follow-up period of 9-19 years, the observed
survival rates were 89% at 2 years and 76% at 5 years, and the local
control rates were 93% in T1 and 88% in T2 tumors. A low rate of distant
metastases was noticed (5%); 31% of patients developed a second primary
cancer. Severe mucosal necrosis was observed in <10% of patients. Any
grade of bone necrosis was seen in 18% of cases (only 2.5% had G3
necrosis). This complication occurred more frequently in patients with
poor dental status and in those treated without dental protection during
implantation (p <0.001). CONCLUSION: Radical brachytherapy offers
excellent local control (89%) and an acceptable rate of complications
(<10% severe necrosis) that may be significantly decreased with dental
care and the use of protective devices. The high incidence of second
malignancies remains a major concern in these patients.
11
UI - 11957138
AU - Solomides CC; Miller AS; Christman RA; Talwar J; Simpkins H
TI -
Lymphomas of the oral cavity: histology, immunologic type, and incidence
of Epstein-Barr virus infection.
SO - Hum Pathol 2002 Feb;33(2):153-7
AD - Department of Pathology and Laboratory Medicine, Temple University
School of Medicine, Philadelphia, PA 19140, USA.
The purpose of this study was to determine the histologic class and
immunologic phenotype of lymphomas presenting initially in the oral
cavity and whether this correlated to a high incidence of Epstein-Barr
virus (EBV) infection as has been reported with lymphomas in the nasal
cavity. Seventy-one cases of oral lymphomas from the oral pathology
referral service were analyzed retrospectively. They were classified
according to the Revised European American Lymphoma (REAL)
classification system using routine immunohistochemistry. EBV infection
was determined by detection of early viral RNA sequences (EBER) and
latent membrane protein (LMP-1) expression. Only non-Hodgkin's lymphomas
were observed, with a female predominance of 2:1. They were primarily of
B-cell origin and histologically classified mainly as large B-cell type
(68%); T-cell lymphomas were rare (8%). EBV infection was observed in
14% of the B-cell lymphomas, an incidence rate higher than that reported
in studies of B-cell lymphomas not located in the oral cavity but not as
high as that observed in pleomorphic T-cell lymphomas (all sites, 36%)
or nasal cavity T-cell lymphomas (nearly 100%). Interestingly, EBV
proliferation did not correlate with expression of either Bcl-2 or p53.
Copyright 2002, Elsevier Science (USA). All rights reserved.
12
UI - 11809529
AU - Keum YS; Kim J; Lee KH; Park KK; Surh YJ; Lee JM; Lee SS; Yoon JH; Joo
TI -
SY; Cha IH; Yook JI
Induction of apoptosis and caspase-3 activation by chemopreventive
[6]-paradol and structurally related compounds in KB cells.
SO - Cancer Lett 2002 Mar 8;177(1):41-7
AD - Oral Cancer Research Institute, Department of Oral Pathology and Oral
Biology, College of Dentistry, Yonsei University, Seoul 120-752, South
Korea.
[6]-paradol, a pungent phenolic substance found in ginger and other
Zingiberaceae plants, has been demonstrated to be an effective inhibitor
of tumor promotion in mouse skin carcinogenesis. In the present study,
we found that [6]-paradol and other structurally related derivatives,
[10]-paradol, [3]-dehydroparadol, [6]-dehydroparadol, and
[10]-dehydroparadol, with the exception of [3]-paradol induce apoptosis
in an oral squamous carcinoma cell line, KB, in a dose-dependent manner.
[10]-paradol and [10]-dehydroparadol exhibited a similar extent of
cytotoxicity to that of [6]-paradol. [6]-Dehydroparadol and
[3]-dehydroparadol appeared to be more potent, with an IC50 less than 40
microM. Treatment of KB cells with an apoptosis-inducing concentration
of [6]-dehydroparadol caused induction of proteolytic cleavage of
pro-caspase-3. These results suggest that [6]-paradol and structurally
related derivatives induce apoptosis through a caspase-3-dependent
mechanism.
13
UI - 11955367
AU - Guan W; Yu S; Gao Y
TI -
[Expression of apoptosis-related protein in epithelial dysplasia and
squamous cell carcinoma]
SO - Zhonghua Kou Qiang Yi Xue Za Zhi 2002 Jan;37(1):65-8
AD - Department of Stomatology, Union Hospital, Fujian Medical University,
Fuzhou 350001, China.
OBJECTIVE: To study the expression and significance of apoptosis-related
protein p53, Bcl-2, and Bax during the development of oral squamous cell
carcinoma (SCC). METHODS: The expression was observed in 10 normal oral
epithelia, 48 dysplasia epithelia and 42 SCC by immunohistochemical
evaluation. RESULTS: In normal mucosa, the positive rate of p53, Bcl-2
and Bax were 0%, 20% and 60%. In dysplasia epithelia, the positive rate
of p53 is increased (P < 0.05), the positive rate of Bcl-2 and Bax
remained no significant change (P > 0.05), but the positive intensity in
severe dysplasia was higher than in mild group. In SCC, the positive
rate of Bcl-2 increased significantly (compared with dysplasia, P <
0.05), while the expression of Bax was decreased with the increase of
SCC histological grade. Further analysis showed the correlation was
evident in p53 and Bax in dysplasia, and in p53 and Bcl-2 in SCC.
CONCLUSIONS: In dysplasia, p53 gene mutation results in accumulation of
dysplasia cells. In SCC, the cooperation of p53, Bcl-2 and Bax results
in the progression of SCC. Apoptosis genes could work either
independently or cooperatively.
14
UI - 11836590
AU - Leonardi R; Pannone G; Magro G; Kudo Y; Takata T; Lo Muzio L
TI -
Differential expression of heat shock protein 27 in normal oral mucosa,
oral epithelial dysplasia and squamous cell carcinoma.
SO - Oncol Rep 2002 Mar-Apr;9(2):261-6
AD - Department of Medical and Surgical Sciences, II Dental Unit, University
of Catania, Catania, Italy.
The aim of this study was to evaluate HSP27 expression in fetal, normal
and inflamed oral mucosal epithelium and in oral premalignant epithelial
lesions and in their ensuing invasive cancers. In developing human oral
epithelia, immunoreactions for HSP27 were moderately observed in
suprabasal keratinocytes of palate and tongue. Normal oral epithelium
had an intense suprabasal positivity. In inflamed oral mucosa, HSP27
staining was stronger in basal and suprabasal keratinocytes than in
normal epithelium. Most oral premalignant lesions showed no (5 cases,
29%) or low (8 cases, 46.4%) staining. In OSCC both low and high HSP27
levels of expression were observed. HSP27 immunolabelling was
down-regulated in poorly differentiated areas and up-regulated in highly
differentiated ones. These findings indicated that HSP27 expression
seems to protect cells from apoptosis during inflammation, while the
down-regulation in dysplasia could impair the protective mechanism
against mutagenesis induced by environmental factors and thus enhancing
the transformation of oral epithelial dysplasia into OSCCs.
15
UI - 11836604
AU - Mese H; Sasaki A; Nakayama S; Yoshioka N; Yoshihama Y; Kishimoto K;
TI -
Matsumura T
Prognostic significance of heat shock protein 27 (HSP27) in patients
with oral squamous cell carcinoma.
SO - Oncol Rep 2002 Mar-Apr;9(2):341-4
AD - Department of Oral and Maxillofacial Surgery and Biopathology, Graduate
School of Medicine and Dentistry, Okayama University Graduate Schools,
Okayama 700-8525, Japan. hmese@md.okayama-u.ac.jp
Heat shock proteins (HSPs) have been defined as proteins induced by heat
shock and other environmental and pathophysiologic stress. Heat shock
protein 27 (HSP27) is one of the small heat shock proteins. HSP27 is
implicated in protein-protein interactions such as folding,
translocation, and prevention of inappropriate protein aggregation. Many
of their functions suggest that they play important roles in cancers.
Archival tissues from 40 patients with oral squamous cell carcinoma who
received primary surgical resection were examined for HSP27 by
immunohistochemistry and correlated with clinical stage, lymph node
metastasis, histological grade and survival period. HSP27 expression was
positive staining (+) in 20 (50%), weak or negative staining (-) in 20
(50%) of total 40 cases. There was no correlation between HSP27
expression and clinical stage, lymph node metastasis and histological
grade. However, when compared with clinicopathological features, the
expression of HSP27 correlated inversely with survival period. This
study suggests that the expression of HSP27 is frequently promoted in
patients with oral squamous cell carcinoma and should be considered an
independent prognostic factor of oral squamous cell carcinoma patients.
16
UI - 11884802
AU - Gath HJ; Hell B; Zarrinbal R; Bier J; Raguse JD
TI -
Regeneration of intraoral defects after tumor resection with a
bioengineered human dermal replacement (Dermagraft).
SO - Plast Reconstr Surg 2002 Mar;109(3):889-93; discussion 894-5
AD - Charite, Campus Virchow-Klinikum, Medizinische Fakultat der
Humboldt-Universitat zu Berlin, Klinik fur Mund-, Kiefer-, und
Gesichtschirurgie, Augustenburger Platz 1, 13353 Berlin, Germany.
The experiences of seven patients with squamous cell carcinomas of the
oral cavity who underwent reconstruction with a bioengineered human
dermal replacement (Dermagraft) are examined. The human dermal
replacement consists of fibroblasts seeded onto a three-dimensional
polymer scaffold to create a living dermal structure. In this setting,
the fibroblasts secrete a mixture of growth factors and matrix proteins
in physiological concentration that is essential for wound healing and
epithelization. The fibroblast tissue remains metabolically active after
cryopreservation and can be used as an off-the-shelf tissue to cover
medium-sized defects and avoid donor-site morbidity. In the first series
of patients treated with this tissue, defect closure was achieved
without functional problems, allowing optimal postoperative monitoring
for tumor recurrence.
17
UI - 11985196
AU - Delbem AC; Correia MG; Pugliesi DM; Crivelini MM
TI -
Palatal lymphangioma: a case report.
SO - ASDC J Dent Child 2001 Sep-Dec;68(5-6):344-6, 300
AD - Department of Pediatric Dentistry, School of Dentistry, Paulista State
University-UNESP, Rua Jose Bonifacio, 1193, CEP:16015-050, Aracatuba,
Sao Paulo, Brazil. adelbem@foa.unesp.br
Lymphangioma is a rare, congenital benign tumor involving vascular
malformation, with a great potential for recurrence. It appears during
the early years of life and therefore is highly common among children.
We report here a five-year-old patient with a simple lymphngioma. The
mother of the child reported she had noted the lesion in the palate
after an injury in the area with a pen. The recommended treatment was
surgical excision since this was a small and well-delimited lesion.
Periodic clinical controls for 18 months showed that mucosa presented
normal characteristics, with no signs of recurrence.
18
UI - 11887537
AU - Bathi RJ; Kumar YP; Natarajan K
TI -
Cowden's syndrome: a case report.
SO - Quintessence Int 2002 Jan;33(1):75-80
AD - Department of Oral Medicine and Radiology, Shri Dharmasthala
Manjunatheshwara College of Dental Sciences, Dharwad, Karnataka 580009,
India. sdmtl@bgl.vsnl.net.in
Cowden's syndrome, a rare genodermatosis of autosomal-dominant
inheritance with variable expressivity, is characterized by a
combination of ectodermal, mesodermal, and endodermal hamartomas that
may involve the skin, mucous membranes, breasts, gastrointestinal tract,
and thyroid. A 26-year-old woman who presented for replacement of her
teeth, all of which had been extracted because of rapidly progressive
periodontitis. She was diagnosed with Cowden's syndrome based on
mucocutaneous abnormalities, thyroid involvement, and abnormalities of
the skeletal and genitourinary systems. The clinical significance and
differential diagnosis of this disease are highlighted.
19
UI - 11911069
AU - Svirsky JA; Burns JC; Page DG; Abbey LM
TI -
Computer-assisted analysis of the oral brush biopsy.
SO - Compend Contin Educ Dent 2001 Feb;22(2):99-102, 104, 106; quiz 108
AD - Virginia Commonwealth University, Richmond, Virginia, USA.
Computer-assisted analysis of the oral brush biopsy is a recently
introduced tool that determines the significance of an oral lesion. The
oral brush biopsy is minimally invasive, requires no anesthesia, and
definitively distinguishes benign from precancerous and cancerous
lesions. Oral brush biopsy specimens are analyzed with the aid of a
highly specialized neural network-based computer system specifically
designed to detect oral epithelial precancerous and cancerous cells.
20
UI - 11988932
AU - Piattelli A; Rubini C; Fioroni M; Iezzi G; Santinelli A
TI -
Prevalence of p53, bcl-2, and Ki-67 immunoreactivity and of apoptosis in
normal oral epithelium and in premalignant and malignant lesions of the
oral cavity.
SO - J Oral Maxillofac Surg 2002 May;60(5):532-40
AD - Oral Medicine and Pathology, Dental School, University of Chieti,
Chieti, Italy. apiattelli@unich.it
PURPOSE: Loss of normal p53 is correlated to the progression of several
preneoplastic lesions to neoplasms, and overexpression of bcl-2
determines an alteration of programmed cell death. There is an increased
awareness of the importance of apoptosis in cancerogenesis, and a strong
correlation of Ki-67 with high tumor grade has been reported. MATERIALS
AND METHODS: The aim of our study was to investigate
immunohistochemically the expression and relationship of p53, bcl-2,
MIB-1, and the apoptotic index (AI) in normal oral epithelium,
leukoplakia, dysplasia, and oral squamous cell carcinoma. RESULTS: A
strong correlation was found between p53 overexpression and cell
proliferation (MIB-1) and the AI. An inverse relationship was found
between bcl-2 expression and MIB-1 and AI. A significant inverse
relationship was found between p53 and bcl-2. A good positive
correlation was present between AI and MIB-1 expression. CONCLUSIONS:
Apoptosis could be important to help to understand oral carcinogenesis.
Copyright 2002 American Association of Oral and Maxillofacial Surgeons
21
UI - 11988945
AU - Bourgeois SL Jr; Alvarez CM
TI -
Use of vinyl polysiloxane impression material as an extraoral obturator
for orocutaneous fistulas.
SO - J Oral Maxillofac Surg 2002 May;60(5):597-9
AD - Department of Oral and Maxillofacial Surgery, University of Texas Health
Sciences Center at San Antonio, San Antonio, TX 78284-7908, USA.
s2bourgie@msn.com
22
UI - 11994586
AU - Celik N; Wei FC; Chen HC; Cheng MH; Huang WC; Tsai FC; Chen YC
TI -
Osteoradionecrosis of the mandible after oromandibular cancer surgery.
SO - Plast Reconstr Surg 2002 May;109(6):1875-81
AD - Department of Plastic and Reconstructive Surgery, Chang Gung Memorial
Hospital, Medical College, Chang Gung University, Taipei, Taiwan.
Although postoperative radiotherapy has proved effective in improving
local control and survival in patients with head and neck cancers, its
complications, especially mandibular osteoradionecrosis, reduce the
quality of life. Mandibular surgery before the radiotherapy adds an
additional risk factor for osteoradionecrosis. This study reviews
patients in Chang Gung Memorial Hospital, Taipei, Taiwan, over a 10-year
period, who underwent intraoral cancer resection followed by
postoperative radiotherapy and thereafter developed osteoradionecrosis
of the mandible. A total of 24 men and three women with a mean age of
49.9 years were identified and included in the study. In 10 cases, tumor
resection was performed with a marginal mandibulectomy; in eight cases,
tumor resection was performed after mandibular osteotomy; and in three
cases, a segmental mandibulectomy was performed, and the defect was
reconstructed with a fibula osteoseptocutaneous flap. In six cases,
tumor excisions were performed without interfering with the mandibular
continuity. Patients received postoperative external beam radiotherapy
into the primary site and the neck, with a mean dose (+/-SD) of 5900 +/-
1300 cGy in an average of 35 fractions during an average of 6.5 weeks.
The average elapsed time between the end of radiation therapy and
clinical diagnosis of osteoradionecrosis of the mandible was 11.2 months
(range, 2 to 36 months). The time elapse between the end of the
radiation therapy and the diagnosis of osteoradionecrosis was influenced
by initial treatment (Kruskal-Wallis test: n = 27, chi-square = 12.884,
p < 0.005), and this period was shorter if the mandibular osteotomy or
marginal mandibulectomy was performed (the two lowest mean ranks in the
test). However, if the initial surgery resulted in a segmental
mandibulectomy reconstructed with a fibula osteoseptocutaneous flap,
onset of the osteoradionecrosis was relatively late (Kruskal-Wallis
test: n = 21, chi-square = 7.731, p = 0.052). After resection of
osteoradionecrotic bone and surrounding soft tissue, 22 patients
underwent reconstructive procedures with a fibula osteoseptocutaneous
flap, and five patients underwent reconstructive procedures with an
inferior genicular artery osteoperiosteal cutaneous flap. One fibula
osteoseptocutaneous flap showed total failure and another showed a 25
percent skin loss; both were revised with pedicled flaps. The skin
paddle of an inferior genicular artery flap was replaced with an
anterolateral thigh flap because of anatomic variation of the skin
vessel. Once the diagnosis of osteoradionecrosis is established,
replacement of the dead bone and surrounding tissue with a vascularized
free bone flap is inevitable, and a composite osteocutaneous free flap
is a good option.
23
UI - 11859625
AU - Calvo Boizas E; Diego Perez CI; Sancipriano Hernandez JA; Hermosa
TI -
Finamor P; Ahmad IS; Gomez Toranzo F
[Granular cell tumor. A lingual case report]
SO - An Otorrinolaringol Ibero Am 2001;28(6):621-9
AD - Servicio ORL y Patologia Cervico-Facial, Hospital Virgen de la Vega,
Salamanca.
Although the origin of granular cell tumor (GCT) is no totally
clarified, a neurogenic source is generally accepted. Some think its
forerunners are the Schwann cells. Despite the tongue's localisation is
frequently seen, few are the papers dealing with this topic. We report
the case of a patient suffering a granular cell tumor of the tongue and
profit the opportunity to reconsider the followings items: clinical
findings, examination, diagnosis, histology and management and course of
these growths. Literature's review of the theme.
24
UI - 11865791
AU - Alessandrini M; Lanciani R; D'Erme G; Nucci R; Bruno E
TI -
[Dermoid cysts of the floor of the mouth: case report]
SO - Acta Otorhinolaryngol Ital 2001 Oct;21(5):316-9
AD - Clinica Otorinolaringoiatrica, Universita di Roma Tor Vergata.
Dermoid cysts are for the most part benign neoformations most likely
deriving from ectodermic differentiation of totipotent cells. Although
localization on the floor of the mouth has been described for more than
a century it is still reported as rare and can give rise to problems in
differential diagnosis. This work presents a case of dermoid cyst of the
floor of the mouth in a 16-year-old patient and provides considerations
on clinical approach, diagnosis and therapy for this type of lesion.
25
UI - 11330465
AU - Tavani A; Gallus S; La Vecchia C; Talamini R; Barbone F; Herrero R;
TI -
Franceschi S
Diet and risk of oral and pharyngeal cancer. An Italian case-control
study.
SO - Eur J Cancer Prev 2001 Apr;10(2):191-5
AD - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
tavani@marionegri.it
The relation between diet and risk of oral and pharyngeal cancer was
analysed in a case-control study conducted in North-East Italy between
1996 and 1999. Cases were 132 patients (including 33 women), with
incident, histologically confirmed cancer of the oral cavity or pharynx,
and controls were 148 subjects (including 45 women) admitted to
hospitals for acute conditions unrelated to smoking or alcohol drinking.
After allowance for tobacco, alcohol and several other potential
confounding factors, significant inverse association with the risk of
oral and pharyngeal cancer was found for consumption of total green
vegetables (OR 0.37) and total fruit (OR 0.34) with significant trends
in risk Compared with alcohol drinkers of < 20 drinks/week and eating >
13 portions/week of total green vegetables, the OR for drinkers of > or
= 20 drinks/week and eating < 7 portions/week of green vegetables was
15.44. Our study provides further support to the beneficial effect of
high intake of vegetables and fruit, particularly in heavy smokers and
alcohol drinkers.
26
UI - 11839675
AU - Khan AJ; King BL; Smith BD; Smith GL; DiGiovanna MP; Carter D; Haffty BG
TI -
Characterization of the HER-2/neu oncogene by immunohistochemical and
fluorescence in situ hybridization analysis in oral and oropharyngeal
squamous cell carcinoma.
SO - Clin Cancer Res 2002 Feb;8(2):540-8
AD - Department of Therapeutic Radiology, Yale University School of Medicine,
New Haven, Connecticut 06520-8040, USA.
PURPOSE: The role of HER-2/neu in squamous cell carcinoma (SCC) of the
head and neck is not well defined. The purpose of the current study is
to measure the frequency of HER-2/neu expression, to demonstrate
HER-2/neu gene amplification in the cases found to be positive for
protein overexpression, and to investigate the prognostic significance
of overexpression and/or amplification in SCC of the head and neck.
EXPERIMENTAL DESIGN: A cohort of 77 patients with SCC of the oral cavity
or oropharynx, with stage III or IV disease and uniformly treated with
surgical resection and postoperative radiation, served as the primary
patient population for the study. Of these, 56 patients had adequate
follow-up and paraffin-embedded specimens available for analysis. Median
follow-up was 6.1 years. Each of the paraffin-embedded specimens were
immunohistochemically stained for HER-2/neu expression and graded for
intensity of staining by a pathologist. All cases that demonstrated
positive staining by immunohistochemistry were analyzed by fluorescence
in situ hybridization (FISH) to assess HER-2/neu amplification status.
RESULTS: Five-year survival for the 56 evaluable patients was 40%, with
25% experiencing local relapse, 18% regional relapse, and 25% distant
relapse. The percentage of tumors staining positive for HER-2/neu by
immunohistochemistry was 17%. There was no statistically significant
correlation between HER-2/neu and T stage, N stage, tumor grade,
survival, or disease-free survival. HER-2/neu expression did correlate
with vascular endothelial growth factor expression. FISH analysis
revealed four cases that were amplified for HER-2/neu. Of note, of the 4
amplified cases, 2 suffered regional relapse, 1 suffered distant
metastasis, and all 4 expired by 5 years of follow-up. CONCLUSIONS: This
is the first demonstration of HER-2/neu gene amplification by FISH in
SCC of the head and neck. FISH validates a previously contested
controversial role for HER-2/neu gene overexpression in SCC of the head
and neck. The prognostic significance and clinical implications of
HER-2/neu expression and amplification in head and neck cancer will
require additional studies.
27
UI - 11956537
AU - Chandy B; Abreo F; Nassar R; Stucker FJ; Nathan CA
TI -
Expression of the proto-oncogene eIF4E in inflammation of the oral
cavity.
SO - Otolaryngol Head Neck Surg 2002 Mar;126(3):290-5
AD - Department of Otolaryngology-Head and Neck Surgery, Louisiana State
University Health Science Center and Veterans Administration Shreveport,
71130, USA.
OBJECTIVE: eIF4E (4E) is elevated in 100% of head and neck squamous cell
carcinoma (HNSCC) and in premalignant lesions of the larynx. However, it
is not elevated in normal mucosa. In this study, we hypothesize that 4E
is not significantly elevated in inflammation unlike its expression in
premalignant lesions of the oral cavity. STUDY DESIGN: Biopsies from the
oral cavity were divided into 5 groups: (1) normal mucosa, (2) chronic
inflammation, (3) mild dysplasia from leukoplakic lesions, (4) mild
dysplasia in surgical margins of patients with HNSCC, and (5) HNSCC.
Immunohistochemical qualitative analysis was then performed. RESULTS:
None of the 15 specimens in group 1 and 100% of the 15 specimens in
group 5 expressed 4E. Of the 29 specimens in group 2 only 4/29 (13%)
overexpressed 4E compared with 10/31 (32%) in group 3 and 9/21 (42%) in
group 4. There was a significant difference between groups 2 and 3 and
groups 2 and 4 (P < 0.0001 and P < 0.003 respectively) but no
significant difference between groups 1 and 2 (P = 0.13) and between
groups 3 and 4 (P = 0.30). CONCLUSION: 4E is not significantly elevated
in inflammation of the oral cavity thus fulfilling one of the criteria
that biomarkers require to be useful in a clinical setting.
28
UI - 10789776
AU - Moritz JD; Ludwig A; Oestmann JW
TI -
Contrast-enhanced color Doppler sonography for evaluation of enlarged
cervical lymph nodes in head and neck tumors.
SO - AJR Am J Roentgenol 2000 May;174(5):1279-84
AD - Department of Pediatric Radiology, University Hospital of Giessen,
Abteilung Kinderradiologie, Justus-Liebig-Universitat Giessen, Germany.
OBJECTIVE: We determined whether contrast-enhanced color Doppler
sonography can differentiate benign from malignant enlarged cervical
lymph nodes in head and neck tumors. SUBJECTS AND METHODS: Ninety-four
enlarged lymph nodes in 39 adult patients (32 men and seven women; age
range, 30-81 years) were examined with B-mode sonography and with
unenhanced and contrast-enhanced color Doppler sonography. All patients
had carcinoma of the oral cavity. Histologically, lymphadenitis was
found in 57 nodes and metastases in 37 nodes. Geometric dimension,
texture, and margin of the node and detection and location of vessels
were noted. Histology and imaging findings were correlated. RESULTS: The
transverse-to-longitudinal diameter ratio in combination with texture
and margin analysis resulted in a correct diagnosis in only
approximately 79% of the nodes. With contrast-enhanced color Doppler
sonography, 86% of nodes showed vessels, and 28% of nodes showed vessels
with this technique exclusively. Characteristic configurations were
identified: hilar vessels with branching indicated lymphadenitis
(sensitivity, 98%; specificity, 100%), and predominantly peripheral
vessels indicated metastases (100%, 98%). These findings changed the
diagnosis in 13 nodes, changed the therapy in four patients, and led to
an incorrect diagnosis in one patient. CONCLUSION: Enlarged lymph nodes
can be characterized as metastatic or inflammatory with high diagnostic
accuracy on the basis of their vascular architecture as seen on
contrast-enhanced color Doppler sonography.
29
UI - 11913253
AU - Perkins TM; Perkins I
TI -
Chronic alcoholism: a common risk factor in oral cancer and alcoholic
cirrhosis.
SO - Compend Contin Educ Dent 2001 Jul;22(3):49-51
AD - Department of Pediatric Dentistry, Louisiana State University, School of
Dentistry, New Orleans, Louisiana, USA.
Oral cancer and alcoholic cirrhosis are relatively common diseases
encountered in medical and dental practices. This article reviews the
clinical, pathophysiological, and epidemiological characteristics of
these two conditions. A major risk factor common to both oral cancer and
alcoholic cirrhosis is the excessive use of alcohol. A challenge for
practitioners and researchers is to become mindful of the connection
between oral cancer and alcoholic cirrhosis. Earlier studies exploring
these relationships and potential mechanisms are discussed.
30
UI - 11905777
AU - Sharma D C
TI -
Indian group develops tools for oral cancer diagnosis.
SO - Lancet Oncol 2001 May;2(5):258
31
UI - 11905796
AU - Dimitrov B D
TI -
Uncommon cancers are also important.
SO - Lancet Oncol 2001 Feb;2(2):71-2
32
UI - 11996421
AU - Weinberg MA; Estefan DJ
TI -
Assessing oral malignancies.
SO - Am Fam Physician 2002 Apr 1;65(7):1379-84
AD - New York University College of Dentistry, Department of Periodontics,
New York 10010, USA. mea.weinberg@nyu.edu
Oral cancers account for approximately 3 percent of all cases of cancer
in the United States. An estimated 30,000 people will be diagnosed with
oral cancer this year, and about one half of them will eventually die of
the disease. The most common type of oral cancer is squamous cell
carcinoma. Sixty percent of oral cancers are well advanced by the time
they are detected, even though physicians and dentists frequently
examine the oral cavity. The two most important risk factors for oral
cancer are tobacco use and heavy alcohol consumption. The keys to
reducing mortality are prevention and control. The earlier any intraoral
or extraoral abnormalities or lesions are detected and biopsied, the
more lives can be saved. Controversy exists whether screening programs
effectively reduce the mortality rate. Specific step-by-step guidelines
should be followed to perform an adequate examination of the head and
neck.
33
UI - 12004653
AU - Silverman S Jr
TI -
Pathways to saving lives.
SO - Gen Dent 2000 Nov-Dec;48(6):626, 628
34
UI - 12004660
AU - Drinnan AJ
TI -
Screening for oral cancer and precancer--a valuable new technique.
SO - Gen Dent 2000 Nov-Dec;48(6):656-60
AD - State University of New York at Buffalo, Department of Oral Diagnostic
Sciences, Squire Hall, Room 355, 3435 Main Street, Buffalo, NY
14214-3008, USA.
Many precancerous or cancerous oral lesions may resemble benign lesions
and a definitive diagnosis on clinical grounds alone may be difficult,
if not impossible, to make. The introduction of OralCDx, an oral brush
biopsy procedure, permits the dental practitioner to determine which
lesions contain atypical or dysplastic epithelial cells and require that
a conventional scalpel biopsy be performed. This article reviews the
features of the test, explains the clinical situations for which its use
is recommended, and discusses the interpretation and significance of the
biopsy reports.
35
UI - 12004667
AU - Lopes MA; Pazoki AE; Ord RA
TI -
Proliferative verrucous leukoplakia: a case report.
SO - Gen Dent 2000 Nov-Dec;48(6):708-10
AD - Department of Oral Diagnosis, Faculty of Odontology-UNICAMP, Sao Paulo,
Brazil. mal001@dental.umaryland.edu
Proliferative verrucous leukoplakia (PVL) is a particularly aggressive
form of oral leukoplakia that is resistant to treatment and presents a
high risk of recurrence and malignant transformation. This article
describes the microscopic and clinical characteristics of one case of
PVL, which initially presented as hyperkeratosis with mild dysplasia and
posteriorly developed multifocal areas and verrucous carcinoma despite
treatment.
36
UI - 12004673
AU - Fantasia JE; Damm DD
TI -
Mucosal pigmentation. Nevus.
SO - Gen Dent 2001 Jan-Feb;49(1):36, 100
AD - Department of Dental Medicine, Long Island Jewish Medical Center, New
Hyde Park, NY, USA.
37
UI - 12004680
AU - Casiglia J; Woo SB
TI -
A comprehensive review of oral cancer.
SO - Gen Dent 2001 Jan-Feb;49(1):72-82
AD - Division of Oral Medicine, Department of Oral Medicine, Diagnostic
Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA.
Oral squamous cell carcinomas comprise 2-3% of all new malignancies
diagnosed in the United States, making it the 10th most common
malignancy. However, for the last few decades, t
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