National Cancer Institute®
Last Modified: May 1, 2002
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.
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.
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.
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. firstname.lastname@example.org
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.
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. email@example.com
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.
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.
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. firstname.lastname@example.org
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.
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. email@example.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.
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. firstname.lastname@example.org
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.
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.
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 -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.
-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 -paradol and other structurally related derivatives, -paradol, -dehydroparadol, -dehydroparadol, and -dehydroparadol, with the exception of -paradol induce apoptosis in an oral squamous carcinoma cell line, KB, in a dose-dependent manner. -paradol and -dehydroparadol exhibited a similar extent of cytotoxicity to that of -paradol. -Dehydroparadol and -dehydroparadol appeared to be more potent, with an IC50 less than 40 microM. Treatment of KB cells with an apoptosis-inducing concentration of -dehydroparadol caused induction of proteolytic cleavage of pro-caspase-3. These results suggest that -paradol and structurally related derivatives induce apoptosis through a caspase-3-dependent mechanism.
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.
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.
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. email@example.com
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.
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.
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. firstname.lastname@example.org
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.
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. email@example.com
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.
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.
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. firstname.lastname@example.org
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
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. email@example.com
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.
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.
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.
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. firstname.lastname@example.org
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.
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.
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.
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.
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.
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. email@example.com
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.
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.
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. firstname.lastname@example.org
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.
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.
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