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Ultrasonic diagnosis of oral and neck malignant lymphoma.

A series of 14 patients with nodal and extranodal non-Hodgkin's lymphoma of the oral and neck region was analyzed by ultrasonogram evaluation. Eight nodal lymphomas and six extranodal lymphomas commonly exhibited almost completely similar ultrasonographic findings, specifically, clear delineation of the boundary echo and a homogeneous, weak internal echo, the so-called pseudo-liquid-like images. The results derived from our study suggest that ultrasonic diagnosis is also helpful in evaluating patients with lymphoma during the initial diagnosis and initial treatment like other diagnostic imaging modalities.

Adult↗

[Oral cancer. Retrospective analysis of 118 cases].

AIM: Oral carcinoma is a form of neoplasia with well-known clinical and morphologic features. This study presents the difference of incidence and behaviour in relation to the time of onset of oral carcinoma, and describes the experience made at the Department of Oral and Maxillofacial Surgery of the Second University of Naples. METHODS: In this study 118 patients are analysed. They are divided into 3 groups according to age: group A up to 40 years; group B, from 41 to 75 years; group C from 75 years onwards. RESULTS: No patient of group A showed a carcinoma of verrucous type. This histologic type was found in group B, (14 patients: 14,1%) and in group C (6 patients: 46,1%). CONCLUSIONS: The results of this study underline the importance of the time of onset in the behaviour of oral carcinoma and the age of patients.

Adult↗

[Metalloproteinase (MMP-1, 2 and 11), tissue inhibitor of metalloproteinase-1 (TIMP-1), and p53 expression in nasal-type angiocentric T/NK-cell lymphoma: an immunohistochemical study].

UNLABELLED: Twenty cases of extraganglionar Nasal-type T/NK-cell lymphomas were analyzed at the National Cancer Institute of Mexico. We studied immunophenotype of neoplastic cells, nuclear p53 expression, and enzymes as matrix metalloplroteinases participating in invasion, tissular destruction and metastases. MATERIAL AND METHODS: Paraffin blocks from all cases were retrieved and analyzed by hermatoxilin and eosin. Histopathological features included cellular size and cytologic characteristics. We performed immunohistochemistry to determine CD3, CD56, p53 cellular type and expression of (MMPs-1, 2, 11) matrix metalloproteinases and one tissue inhibitor of TIMP-1 metalloproteinase. Demographic variables included, age, sex, primaony location, clinical stage, treatment and follow-up. STATISTIC ALANALYSIS: The association of different matrix metalloproteinases in epthial and tumoral cells, stroma, necrosis and endothelial cells were found to be significant using Fisher's exact test. RESULTS: All studied cases were positive to cytoplasmic CD3, CD56 (NK cells), 19 of them were positive to p53, five of them with nuclear overexpression of p53 in more than 50% of neoplastic cells. There was significant expression of MMP-1 in tumoral cells; the epithelium displayed significant expression of TIMP-1 and MMP-11. Patients with p53 overexpression displayed a poorer prognosis. Three of them had undergone radiotherapy and died within the first month of treatment. DISCUSSION: This type of lymphoma is a common neoplasm in Asia, Latin America and Mexico. It is worth noting it has has been linked to Epstein-Barr virus with T/NK-cell phenotype, which often displays cellular atypia, an angiocentric growth pattern and necrosis. It is clinically expressed by progressive destruction of midline facial soft tissue and has a poor prognosis.

Adult↗

Smoking and chewing habits of oral cancer patients in the Solomon Islands.

A 5-year retrospective study (1994-97 and 1999) on the prevalence of oral cancer was conducted using patients' records at the Dental Department in the Solomon Islands, National Referral Hospital. The aim of the study was to investigate the relationship between smoking and betel nut chewing in patients with oral cancer. Relevant information regarding patient's smoking and betel nut chewing, site of oral cancer and personal history were extracted from patient's dental records and analyzed. There were 48 cases of oral cancer reported at the hospital over the 5-year period. Males aged 45 years and over were mostly affected with the distribution showing 31.5% of the cases from Malaita, 20.8% from Temotu and 14.6% from the Western Provinces. Ninety percent (90%) of the oral cancer patients practice both smoking and betel nut chewing, compared to those who only practice one habit and this was highly significant (p<0.001). Chewing of high levels of betel quid per day (>5) showed statistical significance (p<0.001) for oral cancer patients (83%) compared to those individuals (17%) who chewed lesser (<5) betel quid. About 62% of these patients smoked cigarette rolls and tobacco stick rolls. However, there was no significance in the relationship of oral cancer and those individuals who smoke (p > 0.05). Buccal mucosa (3 1 %) and buccal mucosa+adjacent comer of the mouth (25%) are the most common affected site in the oral cavity. This study has shown that the combinations of tobacco smoking and chewing of betel quid are the main risk factors for oral cancer. Therefore, these factors are to be emphasized in the public and preventive education of communities in the Solomon Islands.

Adult↗

[Provisional silicone obturator for closure of hard and soft palatal defects].

Treatment of intraoral squamous cell carcinomas is guided by the clinical stage of the disease and includes surgical resection. The resulting defect may be closed surgically or prosthodontically. This article describes a technique for provisional closure of a surgical defect. The interim obturator permits normal oral functioning until permanent rehabilitation is performed.

Carcinoma, Squamous Cell↗

Follicular dendritic cell sarcoma of the soft palate.

Follicular dendritic cell (FDC) sarcomas are extremely rare, with only 2 reported cases involving the palate. These tumors have typical oval to spindle cells with fine chromatin, obvious nucleoli and indistinct cell borders. They are usually arranged as sheets, whorls, or in a storiform pattern. Although FDC sarcoma has a characteristic morphologic picture, due to its rarity it may be mistaken for other types of sarcoma, carcinoma or melanoma. Immunohistochemical and ultrastructural studies are useful for confirmation of the diagnosis. We report a case of FDC sarcoma developing in the soft palate. The patient suffered from an oral cavity mass with dysphagia in the previous 2 months as well as body weight loss of 8 kg during the previous 6 months. He was well previously and denied any other systemic problems. Wide excision of the tumor was performed and no recurrence or metastasis was noted for 5 years. The success of the procedure may have been due to a well-defined tumor margin and less aggressive histological features. The ability to recognize and differentiate extranodal FDC tumors based on knowledge of their full morphologic spectrum is important as they have an intermediate malignant potential.

Dendritic Cells, Follicular↗

[Treatment of tumors of the oral cavity. Long-term follow up of 1223 cases. Clinico-experimental computerized processing using BMDP program].

The study assesses a series of 1223 patients treated for oral cavity neoplasm at the Institute of Oncology of Turin. It confirms the proportional deterioration of the survival rate in correlation with the advanced stage of the carcinoma. It shows the influence of the different types of treatment on survival, particularly referring to tumor site and stage at the time of first treatment.

Adult↗

[Necrotizing sialometaplasia of the palate. Literature report of 3 new cases].

In this study 3 cases diagnosed as necrotizing sialometaplasia (NS) of the palate are described and discussed together with 106 other cases cited in the literature. A benign, self-limiting, inflammatory lesion NS is reviewed focusing on age, sex, race, clinical and symptomatic features, etiology, and therapy. Clinically and histologically NS mimics malignancy. Male (mean age 49.8 yrs) to female (mean age 36.3 yrs) ratio is 1.95:1. The etiology of NS remains unknown, but it may be associated with local trauma, use of a denture, arteriosclerosis or allergy. Most investigators seem to favor an ischemic cause of NS. Lesions heal spontaneously without treatment within 1-3 months; the only invasive procedure required is a biopsy.

Adult↗

[The primary reconstruction of soft palate by intraoral buccal transposition flap].

A method for the primary reconstruction of soft palate after radical tumor excision is described. By combination of a cranial pedicled pharynx flaps and a cranial pedicled intraoral buccal transposition flap is it possible to close the resulting defect in a double layer. In additional resection of the combination of the method with a M. masseter-transposition flap is possible. By the method it is possible to have a satisfactory reconstruction of swallowing and speech functions with only small operative troubles.

Carcinoma, Squamous Cell↗

[Contribution of superselective arteriography and embolization in maxillofacial surgery. Apropos of 2 cases].

After describing the technique of embolisation and its therapeutic indications,the authors present two cases of different indications:--embolisation as the sole treatment,--pre-operative embolisation of a haemorrhagec tumour. These two cases illustrate two applications of the technique of embolisation:--Medical therapeutic value: making possible the reduction or stabilisation of the size of a vascular tumour difficult to excise surgically, in addition to eliminating the complications (haemorrhage, local trophic disturbance, pain);--Surgical interest: elective lesional embolisation such as is carried out at present greatly facilitates the surgical procedure in operations which may be associated with severe bleeding. Problems of healing are avoided. The procedure is carried out at the same time as selective arteriography. When in the hands of a skilled team, scarcely any risk is involved.

Aged↗