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A case of primary synovial sarcoma of the soft palate is reported in a 19 year old man who was in good health and free of recurrence one year after operation. Radiation therapy was selected and a dose of 7600 rads was given. The presence of hyaluronic acid was investigated using the critical electrolyte concentration method. The tumor was considered histogenetically to be derived from undifferentiated mesenchymal tissue.
A case of granulocytic sarcoma of the hard palate in an elderly woman is presented. The diagnosis was suspected on the basis of histologic findings in routine tissue sections and confirmed by cytochemical and electron microscopic studies. No systemic evidence of myeloid leukemia or of any other myeloproliferative disorder was documented in the patient, who died of an unrelated cause shortly after diagnosis.
Selected papillary squamous tumors of the upper aerodigestive tract (UADT) mucosa in adult patients do not have well-defined histologic criteria and the clinical behavior is poorly understood. To better characterize this spectrum of neoplasms, UADT papillary neoplasms were evaluated by routine histology, determination of cellular DNA content using Feulgen-stained tissue sections, and the typing of human papillomavirus (HPV) by in situ hybridization. Solitary papillomas were studied in two patients; there was no recurrence in either case, both had normal DNA content, and one was typed as HPV-6 while the other was typed as HPV-11. Seven adult patients with recurrent papillomatosis and at least one biopsy with dysplasia/atypia were identified (mean age at diagnosis, 13.3 years; mean age at last contact, 42.7 years). Six of seven patients had abnormal DNA cellular content in foci of epithelial atypia. In all biopsies evaluated, the papillomas of the seven patients were consistently typed as either HPV-6 or HPV-11. Six patients with malignant papillary neoplasms also had abnormal DNA cellular content, but none revealed evidence of HPV type 6, 11, 16, or 18 by in situ hybridization of tissue sections. In many of the recurrent papillomas, the degree of epithelial atypia encountered was pronounced and was commonly misdiagnosed as carcinoma in situ or papillary carcinoma. The aneuploid DNA content of these foci of atypia reflected the abnormal cellular appearance and partially explained the overdiagnosis of malignancy. However, none of the seven patients were treated for malignant disease and none progressed to invasive carcinoma, with an average follow-up period of almost 30 years. We conclude that histologic and cytologic atypia in HPV-containing papillomatosis may be appreciable. The aneuploid DNA content may represent premalignant conditions and the patient may be at an increased risk for the subsequent development of squamous cancer. However, none of the seven patients with recurrent papillomatosis developed any evidence of malignancy. In addition, none of the patients with papillary carcinomas had previous recurrent papillomatosis.
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Four squamous cell carcinomas of the oral cavity were simultaneously analysed by DNA flow cytometry (FCM) and fluorescence in situ hybridization (FISH) with alpha-telomeric DNA probes specific for chromosomes 1, 2, 3, 6, 7, 8, 10, 12, 17, and X. Nuclei with 2 hybridization signals for most chromosomes were in agreement with flow cytometric DNA content in a diploid tumor, but a monosomy 8 for half of the cells indicated a tumor clone with an aberrant chromosome 8. Aberrations of virtually all chromosomes were found in 3 aneuploid tumors. Comparing the relative numbers of disomal and aneusomal nuclei with the corresponding proportions of DNA diploid and aneuploid sample cells provided evidence that the flow cytometrically diploid cell population of an aneuploid tumor consisted of both karyotypically normal and abnormal cells. Although there was a high degree of concordance between aberrant DNA content and magnitude of chromosomal aberration, discrepancies between both methods suggested a notable clonal heterogeneity in aneuploid tumor cell populations. These results demonstrate that a simultaneous application of DNA flow cytometry contributes to broaden the utility of interphase cytogenetics.
OBJECTIVE: To discuss the presentation and management of melanotic neuroectodermal tumor of infancy (MNTI) of the hard palate. METHOD: Case presentation and literature review. CASE: A 6-month-old girl presented with a slow growing, non-tender anterior oral hard palate mass. Radiologic imaging revealed a well-circumscribed cystic lesion containing teeth. After excision, histopathologic and electron microscopic evaluation revealed MNTI. No recurrence was seen at 12-month follow-up. CONCLUSIONS: This case and a review of the literature reveal MNTI to be a rare, benign hard palate tumor, which may present as a smooth, firm, painless, slow-growing anterior palatal lesion. Imaging reveals a well-circumscribed cystic lesion. Complete excision should be curative. Management requires attention to the potential need for palatal reconstruction, orthodontic care and correction of secondary nasal deformities.
Foreign bodies of the hard palate are rare occurrences with only 11 reported cases in the literature. These patients can present to the Otolaryngologist in a variety of ways and often with confusing histories. We present seven cases of foreign bodies adherent to the hard palate. The age range was three to eighteen months and the most common referring diagnosis was a suspected tumor (five patients). The most common object removed was a nut shell. In six of the seven cases the foreign body could be removed in the ambulatory clinic without the need for sedation or anesthesia. The clinical presentation, incidence and management is reported and discussed with reference to the literature.
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OBJECTIVE: A variety of surgical procedures can be used to treat malignancies of the hard palate and inferior maxilla. This study was designed to evaluate the efficacy of alveolectomy, palatectomy, and infrastructure maxillectomy in the treatment of cancers in these areas. METHODS AND MATERIAL: A retrospective review of 50 patients who underwent alveolectomy, palatectomy, or infrastructure maxillectomy from 1971 to 1997 was performed. The pathology of these lesions included squamous cell carcinoma (25), adenoid cystic carcinoma (11), adenocarcinoma (6), and others (8). RESULTS: The 5-year survival rate by Kaplan-Meier analysis for all lesions was 85%. The 5-year survival rate for squamous cell carcinoma was 76%, and that for adenoid cystic carcinoma was 90%. The 10-year survival rate for adenoid cystic carcinoma was 75%. There was minimal morbidity associated with these procedures. DISCUSSION: Alveolectomy, palatectomy, and infrastructure maxillectomy are the procedures of choice for lesions in the region of the hard palate. The differences between these surgical techniques are presented, and indications, contraindications, and results for each technique are discussed.
Hairy polyps (dermoids or oronasopharyngeal teratomas) are a type of congenital tumour that contain elements of bigerminal origin (ectoderm and mesoderm). We describe a baby who presented with a hairy polyp of the hard palate protruding from the mouth. This was not causing respiratory distress but she had feeding difficulties. She was successfully operated on the age of 5 days, the defect was reconstructed with hairless skin of the mass and she was able to suck after a month.
A 53-year-old white woman presented with a 5-month history of throat pain. The soft palate was biopsied and histological examination confirmed the diagnosis of infiltrating squamous cell carcinoma. She refused surgery and radiotherapy and was therefore offered photodynamic therapy which she accepted. She was treated with 20 J/cm2 at 100 m W/cm2 over a 3 cm area. She was discharged three days later having made an uncomplicated recovery, though substantial analgesia was required. Healing was complete after 2 months, with no loss of palatal function and at most recent follow-up (16 months) there was no sign of residual disease and she remained well.
A new bilayer membrane proved effective as a mucosal substitute. The membrane is composed of an outer layer of silicone and an inner layer of dehydrothermally cross linked composites of fibrillar and denatured collagen sponge. The membrane was placed on oral mucosal defects of five patients after operations for cancer. Ten to 14 days after application the outer silicone sheet was removed, leaving only the inner collagen sponge layer into which cellular tufts of fibroblasts and capillaries had infiltrated. The infiltrated collagen matrix became a new connective tissue that epithelialised rapidly by migration of peripheral epithelium 4-5 weeks after application. In all cases the postoperative course was unremarkable and the repair was effective.
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PURPOSE: This report evaluates the use of the buccal fat pad in reconstruction of defects of the hard and soft palate. PATIENTS AND METHODS: Twenty-nine patients with different indications (oroantral fistula, tumor of the hard and soft palate, posterior fistula in cleft patients, covering of bone transplants in augmentation procedure) were treated with a pedicled buccal fat pad without lining. The maximum reconstructed defect was 5.5 x 4 cm. RESULTS: All inserted fat grafts healed well without any aesthetic disturbances. The surface of the fat converted to normal mucosa. CONCLUSIONS: Use of the buccal fat pad is a safe and easy method to reconstruct defects in the posterior maxilla and soft palate. Good vascularization, ease of access, and minimal donor site morbidity make it a reliable soft tissue graft.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.