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At least 253 records · Page 14Linked to original sources

Oral carcinoma in situ.

Oral carcinoma in situ (CIS) as a histopathologic entity was studied in seventy-seven patients to determine the clinical and histologic parameters of the disease. There were forty-nine male and twenty-eight female patients, with 45.1 per cent of the lesions being described clinically as white, 15.9 per cent as red, and 8.5 per cent as a combination of the two. The high-risk sites for CIS were floor of the mouth (23.2 per cent of all lesions), tongue (22.0 per cent), and lips (in males only, 19.5 per cent). Histologically, there was a considerable range of variation in surface keratinization, thickness of epithelium, and certain cytologic alterations. The most consistent of all cytologic changes was loss of orientation of cells. There is no information available concerning possible regression of oral CIS, as is known for CIS of uterine cervix. Furthermore, there is no information concerning the frequency of or the period of transition from oral CIS to invasive carcinoma or whether all oral carcinoma is preceded by CIS. Further studies on this disease are essential.

Adult↗

NECROTIZING SIALOMETAPLASIA.

Nonhealing palatal ulcerations in two white male patients, one 50 and another 58 years of age, were clinically suspected of being malignant, even after the initial biopsies were negative. Second biopsies in each case confirmed the original opinions, but the lesions were diagnosed specifically as "necrotizing sialometaplasia". This is an interesting condition of uncertain etiology that can mimic cancer, both clinically and microscopically. The condition heals spontaneously. It should be considered in a differential diagnosis of suspicious lesions of the palate.

Biopsy↗

Association of oral pemphigus with chronic lymphocytic leukemia.

Pemphigus is a bullous autoimmune disease of the skin and mucosae. Recently pemphigus has been associated with malignant disorders originating from several tissues. Two cases of oral pemphigus associated with chronic lymphocytic leukemia are reported. Direct immunofluorescence studies of oral biopsy material showed a pattern consistent with pemphigus in both cases. The nature of the anti-ICS antibodies was IgG. However, in one case anti-ICS antibodies were detected in the serum while in the other anti-striated-muscle autoantibodies were present. The clinical course and interrelationship of the two disorders are discussed.

Aged↗

Follicular lymphoid hyperplasia of the hard palate: a benign lymphoproliferative process.

Follicular lymphoid hyperplasia of the hard palate is a reactive lymphoid proliferation which closely simulates the palatal lymphomas, both clinically and histologically. It is therefore imperative that the pathologist be familiar with the features that separate these two conditions. In equivocal cases like the present one, immunologic analysis would seem to be indicated to determine whether the lesion is monoclonal (neoplastic) or polyclonal (reactive).

Aged↗

Epipalatus: a rare intraoral teratoma.

A wide range of discrete head and neck tumors are developmental, including those termed choristoma, hamartoma, dermoid cysts, teratoid tumors, and true teratomas. In classifying various teratomas, consideration is given to the embryonal layers represented within the substance of the tumor and to their level of organizational complexity. By definition, a hamartoma is a tissue mass, present at or near the time of birth, that is benign and native to the site of origin. Growth capacity of a hamartomatous process parallels that of the host organism. A choristoma, on the other hand, is a mass of tissue that is foreign to the site of discovery and is thought to result from growth to displaced primordial tissue that is histologically normal for that tissue.

Bone and Bones↗

HIV infection: clinical features and treatment of thirty-three homosexual men with Kaposi's sarcoma.

The clinical findings of patients with oral Kaposi's sarcoma are reviewed. These oral findings commonly included candidiasis, hairy leukoplakia, gingivitis associated with human immunodeficiency virus (HIV), periodontitis, and other symptoms, including xerostomia. The other common symptoms of HIV disease that may be of importance in leading to a diagnosis are reviewed in this patient group. Treatment by local radiotherapy or by intralesional vinblastine of these oral Kaposi's sarcomas resulted in successful palliation, with more than 50% regression of the lesions in 80% of the patients treated.

Adult↗

Oral malignant melanoma in Japan.

Clinical examination was performed on 20 cases of malignant melanoma in the oral region encountered at the First Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tokyo Medical and Dental University, during the 22-year period from 1970 to 1991. In addition, we reviewed 140 cases reported in the Japanese literature since the last major review in 1974. The results of our study revealed that the clinical course of malignant melanoma in the oral region is worse than oral squamous cell carcinoma and that treatment by radiotherapy is effective in prolonging the life of these patients. Clinically, the tumors were classified into five types: (1) pigmented nodular type; (2) nonpigmented nodular type; (3) pigmented macular type; (4) pigmented mixed type; and (5) nonpigmented mixed type. We suggest that oral malignant melanoma might be different from cutaneous malignant melanoma and that new criteria for diagnosis and therapy for oral disease should be considered.

Adult↗

Results of irradiation in squamous cell carcinoma of the soft palate and uvula.

Out of a series of 235 patients presenting with tumours of the soft palate at the Institut Curie, between 1958 and 1980, 146 cases were analysed to evaluate the results of radical radiation therapy. Seventy patients (48%) had advanced T3-T4 disease and 40 patients (27%) had clinically involved metastatic nodes. All patients had a minimum follow-up of 5 years. In 103 cases, megavoltage X-ray therapy was employed. For 43 patients, presenting with small or moderately advanced tumours, a combination of megavoltage and intra-oral orthovoltage X-rays was used. The local control rate at 3 years was 92% for T1, 70% for T2, 58% for T3 and 49% for T4 lesions. Nodal failure was seen in 19 patients. In 9 of these, it was not associated with failure at the primary site, 7 out of 9 occurring marginally or outside the treatment portals. Complications were observed in 16 patients, 7 requiring surgery. The crude 3 and 5 year survival rate was 52 and 40%, respectively, and the disease-free survival 59 and 53%.

Carcinoma, Squamous Cell↗

Malignant melanoma of the oral cavity--an increasing clinical diagnosis?

Oral malignant melanoma is fortunately a rare lesion. However the actual incidence in the population at present is unknown but may be increasing. The overall prognosis remains poor despite more radical surgery with adjuvant radiotherapy, chemotherapy and immunotherapy. The clinical presentation of oral malignant melanoma can vary widely from a typically pigmented macular or proliferative lesion to a non-pigmented soft vascular tumour; single or multiple, primary or metastatic. Our experience of five patients with malignant melanoma of the oral cavity is presented and the management of such lesions discussed.

Aged↗