Clear cell variant of oral squamous cell carcinoma: case report and review

Abstract The clear cell variant of Oral Squamous Cell Carcinoma (OSCC) is an uncommon histological variant. Kuo first discovered it in the skin, and Frazier et al. found it in the oral cavity. We know of only nine cases of clear cell variant of OSCC reported in the literature till now. The present case is in a 60-year-old male patient with an ulcer on the left posterolateral border of the tongue. The patient had a history of chewing tobacco for 22 years. Clinical examination showed features of malignant ulcer associated with pain and discomfort. Histopathological examination revealed sheets and islands of atypical epithelial cells with clear cytoplasm, nuclear and cellular pleomorphism, and few keratin pearls in the connective tissue suggesting OSCC. Various special stains were performed to identify clear cells. Periodic Acid Schiff-Diastase (PAS-D) and Mucicarmine stains showed positive and negative reactions in clear cells, respectively. Immunohistochemical (IHC) analysis for cytokeratin (AE1/AE3) showed diffuse positivity in clear cells and other epithelial cells. Based on special stains and IHC markers, we confirmed the diagnosis as a clear cell variant of OSCC. This variant is rare and presents diagnostic challenges. It is said to be aggressive in nature. More such cases should be reported to understand its biological behavior and prognosis.

Rose Bengal staining - diagnostic aid for potentially malignant and malignant disorders: A pilot study.

Background: The word "Cancer" itself is sufficient to cause a fear in the minds of people. Early detection of oral potentially malignant and malignant disorders is still a diagnostic challenge for most of the clinicians. In the present study, we have evaluated the efficacy of Rose Bengal staining in the detection of oral premalignant and malignant lesions. Aim: The aim of the study was to evaluate the efficacy of the Rose Bengal staining for the identification of dysplastic areas clinically, and then correlating the findings with the histological grading of dysplasia. Methods and Materials: A total of 20 patients were selected for the study. Patients had been evaluated clinically and histopathologically along with the grading of dysplasia, and Rose Bengal stain was painted over the lesional mucosa with the patient's consent. Incisional biopsies were taken from the stained area of the Rose Bengal dye, and studied histopathologically. Grading of dysplasia and intensity of the Rose Bengal staining were found to be correlated. Chi square test was performed and a statistical significance of P<0.001 was observed. Statistical significance was defined as P<0.001. Results and Conclusion: Grading of dysplasia and the intensity of Rose Bengal staining were directly proportional to each other according to this study. P value was found to be significant. Thus Rose Bengal stain can be used as a diagnostic aid in the detection of oral potentially malignant and malignant disorders.

Down's syndrome patient with multiple sialoliths in Stenson's duct.

The presence of multiple sialoliths (calculi) in parotid duct is considered extremely rare. Parotid duct sialoliths are usually small and single. Multiple calculi formation, in any case, is an uncommon finding in the salivary glands. Salivary lithiasis is comparatively common in the Wharton's duct due to its tortuous ascending course and chemical composition of saliva of submandibular gland. The mechanism of sialolith formation in Down's syndrome patients is not completely known, and there are seldom cases reported in the literature available. The present case report is a very rare combination of a Down's syndrome with multiple sialoliths in Stenson's duct of left parotid gland in a 21year old male patient.

Histopathological study of apparently normal oral mucosa in lepromatous leprosy.

In lepromatous leprosy, it may be postulated that apparently normal areas of skin are the probable sites of future extension of the pathological process and the events taking place in these site might represent the earlier stages of such an extension. Thus the present study has been done to evaluate any such changes in the apparently normal oral mucous membrane of the lepromatous leprosy patients, since oral involvement is common in these patients. Twenty two cases of lepromatous leprosy were studied histologically to see changes in apparently normal oral mucosa. Out of the 22 patients, apparently normal skin biopsies were taken from 13 patients and 5 lesional biopsies were taken from the same patients. Apparently normal oral mucosal biopsies were done for all patients. Biopsies of 22 cases of apparently normal oral mucosa did not show granulation formation of acid-fast bacilli histologically. The only change present was mild inflammation.