Primary Oral Mucosal Melanomas - Two Case Reports and Comprehensive Literature Review.

Oral melanoma (OM) occurs from activated or genetically altered epidermal melanocytes. There is no scientific evidence that OM can be linked to physical, chemical and thermal irritation, or to other risk factors of the oral cavity. According to fi gures from various countries, OM accounts for 0.2% to 7.5% ( Japan) of all cases of melanoma of the skin and mucous membrane. The male to female ratio of OM is 2:1. About 80% of OMs are located in the mucosa of the palate and maxillary gingiva. This paper presents two cases of oral mucosal melanoma of the upper and lower lips in women aged 62 and 59 years. Diagnosis, differential diagnosis and therapy are reported.

Reconstruction of total and subtotal nose defects.

INTRODUCTION: Reconstruction of nose defects after tumor resection, trauma or infection disease is imperative for full patient rehabilitation. For satisfying esthetic and functional results achievement, it is necessary to use surrounding skin with similar semblance, which precisely restores and imitates missing part with its outlines. MATERIAL AND METHODS: This paper represents management of the patients with subtotal and total nose defects using forehead and nasolabial flaps. During a period from 2007 to 2010, 20 patients with total or subtotal nasal defects were observed. Among them, 6 defects had traumatic etiology and 14 of them resulted after tumor resection. All of them were full thickness defects overtaking the nasal mucosa, skin of the nasal antechamber, cartilage frame and external nasal skin. In all cases there was indication for local flap reconstruction. Median forehead flap has been used in 12 cases and nasolabial flap in 6 cases. Combination of these two flaps has been used in 2 cases. RESULTS: Good and satisfying results were achieved in all of 20 cases, except for one speech dysfunction. Nose function was maintained with proper porosity of the nostril. Three-dimensional appearance of the nose was reconstructed with achievement of acceptable esthetics results. DISCUSSION AND CONCLUSION: Because of its good vascularisation, adaptability, color and outlining without hair, nasolabial and median forehead flap, as well as surrounding area flaps are the most frequent used flaps in nose defect reconstruction.

A giant cutaneous horn.

A cutaneous horn is a uncommon and rare lesion. It is a conical projection of hyperkeratotic epidermis. Vary from a few milimeters to a several centimeters in length. The cutaneous horn is a clinical diagnosis and different histologic lesions have been documented at the base of the keratin mound. We presented a 77 years old female with a large "horn" of 3 years duration, arising from her forehead. Excision was performed and defect was covered by split thickness skin graft. Hystopathology reported keratoacanthoma at the base of the horn. By reviewing cutaneous horns presented in literature we can declare that this is one of the biggest cutaneous horn recorded cases. Also it is important to mention that horn itself is not the most important issue, but rather the underlying condition, which may be malignant.

Transmandibular approach to the malignant neoplasms of the mouth base, tongue root and oropharynx.

Tumors of the mouth basis, tongue root and oropharynx present a challenge for surgical treatment. High recurrence rates, poor survival, and significant postoperative alterations in speech and swallowing function are common experiences for patients with malignancies in these anatomic sites. This paper reviews the evaluation of displayed patients: pathologic features, surgical approaches and postoperative complications reported in recent managing patients with these neoplasms. A modification of usual surgical techniques has been used by the author to treat 30 tumors in this region and it is presented in this paper. Out of the 30 tumors, 4 were benign lesions and 26 were malignant neoplasms. Transmandibular approach was the method of choice. The wide field of access offers a lot of advantages: wide direct and indirect visualization, better manipulation, and good control of bleeding and light insertion of free and related composites used in primary reconstruction of postoperative defects.