Extremely rare maxillary unicystic ameloblastoma causing double vision: First case report in the Middle East.

INTRODUCTION AND IMPORTANCE: Unicystic ameloblastomas are less aggressive than solid (multicystic) variant, unfortunately this subtypes mimics clinically and radiographically more gentle lesions: like odontogenic cysts, so are misdiagnosed unless a histological study is carried out. Moreover, it is clinically silent and normally discovered accidentally. CASE PRESENTATION: 60-year-old male patient, suffering from a pain and swelling located in the left maxillary region; the patient came with double vision and that was the main compliment. Radiographs showed uniocular radiolucent lesion in the left sinus that contained an impacted third molar. Patient asked for minimal aggressive surgical intervention, and a curettage was preformed along with third impacted molar extraction. Final diagnosis was obtained from histological study, the result was intraluminal unicystic ameloblastoma plexiform subtype. Healing went eventually, patient recovered double vision in one month period and six years follow up showed no recurrence. CLINICAL DISCUSSION: Unicystic ameloblastoma is a rare odontogenic lesion, with clinical, radiographic and gross features of jaw cysts. The lesion histologically shows typical ameloblastomatous epithelium lining part of the cyst cavity with or without and/or mural tumor growth. Unicystic ameloblastoma usually presents in posterior mandibular ramus region, while it is rare and atypical in posterior maxillary region. Unicystic ameloblastomas with orbital invasion cases are 4 worldwide and this case reports represents the first case in the Middle East. CONCLUSION: Thorough examination is recommended when unilocular radiolucency of the jaw is detected. Likewise, orbital surgeons are highly advised to take into account the biological behaviors of maxillary odontogenic tumors.

Overexpression of heat shock protein 27 (HSP-27) is associated with bad prognosis in oral squamous cell carcinoma.

BACKGROUND: Heat shock protein 27 (HSP­27) is a member of the small-molecular-weight HSP family, the expression of which is increased when cells are exposed to elevated temperatures or any other kinds of stress; it seems that the cellular protective properties this protein demonstrates might also help cancer cells stay immortal. Family members of HSPs are either expressed continuously or controlled inductively, and are present in different subcellular structures. OBJECTIVES: The aim of this study was to investigate the prognostic value of HSP­27 expression in the histological grades of oral squamous cell carcinoma (OSCC). MATERIAL AND METHODS: In the present study, HSP­27 expression was compared immunohistochemically among 30 cases with OSCC (15 men and 15 women), ranging between 22 and 74 years of age (mean age: 48 years). The cases were divided into 3 groups (n = 10) according to the histological grade. RESULTS: While all grades expressed HSP­27 in the cancerous epithelial cells, the intensity of expression rose gradually from grade 1 to grade 3 tumors (grade 1 < grade 2 < grade 3). The statistical analysis indicated significant differences between the 3 groups (p = 0.000). CONCLUSIONS: This study has found that HSP­27 may be used as a marker for the histological grades of OSCC and that its expression may be an indicator of the biological behavior of the tumor.