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PubMed1995

Computed tomographic evaluation of lymph node metastasis in head and neck carcinomas.

A retrospective study of 53 patients was undertaken to evaluate the efficacy of computer tomography (CT) in the detection of nodal metastases from carcinomas of the head and neck. The CT findings of 53 patients with head and neck carcinomas who underwent a total of 57 neck dissections were compared with the findings of physical examination (PE) and histopathological examination. Using node size larger than 10 mm in the short-axis diameter or the presence of central lucency as the criteria of nodal metastasis CT scanning staged correctly 52 of 57 necks, providing an accuracy of 91%, a sensitivity of 86% and a specificity of 100% in the detection of nodal metastases. There was agreement of PE findings with histology in 43 (74%) of 57 necks, with a sensitivity of 97% and a specificity of 38%, respectively. Because CT scanning was superior to PE in the pre-operative staging of head and neck carcinomas, it should be used for pre-operative evaluation of metastatic neck disease.

Carcinoma, Squamous Cell↗
PubMed1993

Leiomyosarcomas of the oral cavity. Report of four cases and review of the literature.

Leiomyosarcomas (LMS) make up 7% of all soft tissue sarcomas. In the oral cavity, the LMS is rare due to the paucity of smooth muscle in that region. Four cases of intraoral LMS are reported, plus 34 cases found in the literature reviewed. There were 24 males and 14 females. The age range at presentation was 10 months to 88 years with no predilection for any particular age group. The commonest presenting symptom was a mass. The intraoral LMS occurred most commonly in the jaws (59% of cases). The mass was painful in 61% of cases. Follow-up of the case reports was assessed. Recurrence occurred in 36% of cases. Distant metastases occurred in 39% of cases, most commonly to the lungs. Cervical nodal metastasis was reported in 15% of cases. The 5-year survival rate determined on cases with adequate follow-up (n = 13) was 23% free of disease, 8% alive with disease and 69% who died of disease. In comparison with stage I and stage II tongue squamous cell carcinomas, the intraoral LMS is very aggressive. It is best treated surgically, early and aggressively.

Adult↗
PubMed1989

Odontogenic carcinoma with sarcomatous proliferation. A case report.

An unusual case of odontogenic carcinoma of the mandible showing a sarcomatous proliferation is described. The tumour had caused invasive bone destruction with extension into the soft tissues of the cheek. It was successfully treated by resection of the mandible and radical neck dissection. Although ameloblastomatous features were observed in an infrabony area, the majority of the intrabony lesion consisted of a proliferation of epithelial cells arranged in fine strands or networks which were randomly scattered in a collagenous stroma in the periphery. The tumour cells assumed a fibroblastic appearance and were intermingled with stroma cells in the extrabony lesion. The lesion could not be placed in any of the three entities of odontogenic carcinoma in the WHO classification.

Aged↗
PubMed2004

Current treatment options in squamous cell carcinoma of the oral cavity.

Oral cavity SCC remains a significant health problem and requires a multidisciplinary approach. Treatment with surgery alone or in combination with adjuvant radiotherapy for more advanced lesions is the standard of care. Major advances have been made in surgical approaches,reconstructive options, and the rehabilitation of patients who have oral cavity SCC. These advances have significantly improved disease-specific outcome and quality of life. The future may lie in the development of treatment regimes that combine early detection with organ preservation and result in improved cure rates and quality of life.

Brachytherapy↗
PubMed1995

Rhabdomyosarcoma of the oral cavity. Report of four cases.

Clinical and pathologic findings of four cases of rhabdomyosarcoma of the oral soft tissues are described that include findings from immunohistochemistry and electron microscopy. Three cases occurred in children under 16 years of age and one in a 22-year-old. Included is a brief discussion on reported gene abnormalities that may contribute to neoplastic development.

Adolescent↗
PubMed1996

Clear-cell ameloblastoma (clear-cell odontogenic carcinoma): report of a case.

Clear-cell ameloblastoma (clear-cell odontogenic carcinoma) is an uncommon odontogenic epithelial neoplasm. We report a case of a well-circumscribed 2 cm radiolucent lesion of the anterior mandible in a 30-year-old woman; this tumor was curetted. The first recurrence (at 5-year follow-up) was treated by aggressive curettage, and in the second recurrence a block resection was performed. However, 2 years after the resection was performed, the tumor recurred for a third time as an extraosseous gingival tumor, and 6 months later a recurrence was noted involving only alveolar mucosa.

Adult↗
PubMed1996

Nerve sheath myxoma of the oral cavity: case report and review.

Nerve sheath myxoma is a benign peripheral nerve sheath tumor that rarely occurs in the oral cavity; approximately 12 cases have been reported to date. On histologic evaluation the lesions consist of closely aggregated fascicles that vary considerably in cellularity. Some of the lesions are predominantly myxoid with widely spaced, stellate-shaped cells. Other lesions consist of closely aggregated spindle cells in a matrix that appears fibrous yet stains strongly for acid mucopolysaccharides (extracellular mucin). Small numbers of mitotic figures may be observed. Because of their rarity and unusual histologic appearance, it is advisable that the pathologist be familiar with these lesions; they may be mistaken for other myxoid lesions of the oral mucosa. We describe a single case of nerve sheath myxoma that arose in the buccal mucosa in a woman.

Aged↗
PubMed1998

Cytokeratin expression in squamous cell carcinoma of the lung and oral cavity: an immunohistochemical study with possible clinical relevance.

OBJECTIVE: Serologic identification of the fragment of cytokeratin 19 known as CYFRA 21-1 has been used for early detection of squamous cell carcinoma of the lung. The sensitivity of the CYFRA 21-1 assay in detecting oral cancers is lower than that in detecting lung cancers. To clarify the reason for this, we compared the cytokeratin expression in these cancers, with special reference to cytokeratin 19. STUDY DESIGN: Oral squamous cell carcinomas and lung squamous cell carcinomas were immunostained with cytokeratin 19, cytokeratin 10, and cytokeratin 13 antibodies. Staining intensity was scored on a graduated scale from 0 to 4. RESULTS: With respect to cytokeratin 19, the stainings of all lung cancers were scored as 4, which indicates a greater expression of cytokeratin 19 than is seen in oral cancers (p < 0.01). With an average cytokeratin 19 staining score of 1.67, oral cancers ranked lowest among the antibodies. Squamous cell carcinomas of the maxillary sinus arising from pseudostratified ciliated epithelium were highly expressive of cytokeratin 19. A marker for keratinizing cells (cytokeratin 10) and a marker for squamous cells (cytokeratin 13) were expressed more frequently and intensely in oral cancers (p < 0.01) than in lung cancers (p = 0.019). CONCLUSIONS: From the viewpoint of immunohistochemistry, cytokeratin 19 was found to be a tumor marker with low specificity and sensitivity in oral cancers. The staining results suggested that poor expression of cytokeratin 19 by oral squamous cell carcinoma may result in a low serum value of CYFRA 21-1 in patients with this condition.

Antibodies↗
PubMed1998

Principles of oncologic orofacial surgery.

The most common orofacial tumors of dogs are malignant melanoma, squamous cell carcinoma, fibrosarcoma, osteosarcoma, and acanthomatous epulis. These tumors vary significantly in their metastatic potential, but are consistently locally invasive. Bone involvement is common, and complete excision often requires partial mandibulectomy or partial maxillectomy. Survival times after surgery are most strongly influenced by tumor type (or metastatic rate) and tumor location. Recent large retrospective studies have reported median survival times ranging from 4.6 to 26 months. The most common oral tumor of cats is squamous cell carcinoma. This is a highly invasive tumor that occasionally can be effectively treated with surgery alone, but that often requires a combination of surgery and radiation therapy.

Animals↗
PubMed2002

A conjugate of doxorubicin and an analog of Luteinizing Hormone-Releasing Hormone shows increased efficacy against oral and laryngeal cancers.

A doxorubicin and [D-Lys(6)]Luteinizing Hormone-Releasing Hormone (LH-RH) conjugate, AN-152, was designed to target LH-RH receptor positive cells. AN-152 is more potent against a specific group of cancers than doxorubicin and has less peripheral toxicity. This therapy is potentially efficacious against many other types of malignancies. Here, AN-152 was tested on oral (KB) and laryngeal (HEp-2) carcinoma cells. LH-RH receptor presence was demonstrated by displacement binding assays. Cells were treated with 10 nM EGF or left untreated, then exposed to 0-10 microM AN-152. Cytotoxicity was assessed by MTT assay to determine ED(50) values. AN-152 association with the cells was monitored using two-photon laser scanning microscopy. AN-152 was more potent than doxorubicin in both KB and HEp-2 cell lines (P<0.05). Up-regulation of LH-RH receptors by epidermal growth factor (EGF) increased the entry and potency of AN-152 in KB cells, but not in HEp-2 cells. This novel approach may be effective against a variety of cancers.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1998

Dental factors in the genesis of squamous cell carcinoma of the oral cavity.

This study investigated the role of dental factors in the genesis of squamous cell carcinomas of the oral cavity. 99 newly diagnosed patients with advanced head and neck cancer were evaluated for potential demographic, dental and prosthetic risk factors. Patients with extra-oral malignancies were used as controls in the analysis of dental factors in patients with intra-oral cancers. We performed multiple comparisons of these factors against the primary tumour sites. An analysis of dental and prosthetic factors and patients with intra-oral versus extra-oral tumours revealed no significant differences. However, all 28 intra-oral malignancies arose in areas in contact with teeth and/or appliances. For example, all 10 oral tongue lesions arose on the lateral borders and all six floor of (drop) mouth primary tumours developed at the flange extension of a lower denture. Patients with partial or full dentures had significantly lower node (N) scores than patients without a prosthesis. Although this paper suggests a relationship between dental factors and the genesis of oral squamous cell malignancies, a larger prospective study would be required to achieve definitive data. Patients at risk should be followed carefully for the development of chronic irritation from teeth and appliances.

Adolescent↗
PubMed1998

Trinucleotide repeat length variation in the human ribosomal protein L14 gene (RPL14): localization to 3p21.3 and loss of heterozygosity in lung and oral cancers.

Chromosome 3p is consistently deleted in lung cancer, oral squamous cell carcinoma, and renal cell carcinoma, and is believed to contain several tumor suppressor genes. We have shown a role for chromosome 3 in tumor suppression by microcell-mediated chromosome transfer experiments. We have isolated a gene that is located at 3p21.3 within the smallest region of deletion overlap in lung tumors and is the human homolog of the ribosomal protein L14 gene (RPL14). The RPL14 sequence contains a highly polymorphic trinucleotide repeat array which encodes a variable-length polyalanine tract. Genotype analysis of RPL14 shows that this locus is 68% heterozygous in the normal population, compared with 25% in non-small cell lung cancer (NSCLC) cell lines (p = 0.008). Cell cultures derived from normal bronchial epithelium show a 65% level of heterozygosity, reflecting that of the normal population. Squamous cell carcinoma of the head and neck (SCCHN), which has the same risk factors as lung cancer and is hypothesized to have a similar etiology, demonstrates 54% loss of heterozygosity at the RNA level, suggesting that transcriptional loss may be a primary mechanism of RPL14 alteration in SCCHN. In addition, RPL14 shows significant differences in allele frequency distribution in ethnically-defined populations, making this sequence a useful marker for the study of ethnicity-adjusted lung cancer risk.

Biopsy↗