Association of lymph vessel density with occult lymph node metastasis and prognosis in oral squamous cell carcinoma.

BACKGROUND: The aims of this study were to determine intra (ILVD) and peritumoral (PLVD) lymphatic vessel density (LVD), and to investigate the relationship of LVD with occult metastasis and prognosis. METHODS: Eighty-seven oral squamous cell carcinomas, in clinical stages I or II, arising in the tongue or floor of the mouth were stained with podoplanin. Lymphatic vessels were quantified in intra and peritumoral areas by sequential analysis and hot spot evaluation. Associations of the ILVD and PLVD with clinicopathologic parameters were determined by Chi-square or Fisher's exact test. The 5 and 10-year survival rates were calculated by the Kaplan-Meier and compared using the log-rank test. RESULTS: No significant association was observed between ILVD or PLDV and clinicopathologic variables including occult lymph node metastasis, or clinical follow-up. However, ILVD showed a significant association with regional recurrence (p = 0.040). The perineural invasion was associated with PLVD (p = 0.041). Disease-specific (p = 0.044) and disease-free survivals (p = 0.016) had significant association with PLVD. CONCLUSIONS: The intra or peritumoral lymphatic vessel density had no predictive value for occult lymph node metastasis in the early stages of oral cancer arising in the tongue or floor of mouth.

Palisaded encapsulated neuroma in tongue - A commonly misdiagnosed peripheral nerve sheath tumor.

Palisaded encapsulated (solitary circumscribed) neuromas are benign neural tumors, rarely found in oral mucosa. This case reports a 24-year-old man that presented a unique soft nodule at the left side of the tongue. An excisional biopsy was performed under local anesthesia and histopathological examination of the surgical specimen revealed a well circumscribed mass composed of spindled Schwann cells, often aligned and fasciculated, forming occasional nodules embedded in a fibrous stroma. Histopathological analysis showed the presence of positive cells for S-100, EMA, CD57, and collagen IV. Based on clinical and microscopical features, the diagnosis established was of palisaded encapsulated neuroma. This case report aims to discuss the differential diagnosis among palisaded encapsulated neuroma and the other neural tumors that affect the oral mucosa.

Palisaded encapsulated neuroma in tongue: a commonly misdiagnosed peripheral nerve sheath tumor

Palisaded encapsulated (solitary circumscribed) neuromas are benign neural tumors, rarely found in oral mucosa. This case reports a 24-year-old man that presented a unique soft nodule at the left side of the tongue. An excisional biopsy was performed under local anesthesia and histopathological examination of the surgical specimen revealed a well circumscribed mass composed of spindled Schwann cells, often aligned and fasciculated, forming occasional nodules embedded in a fibrous stroma. Histopathological analysis showed the presence of positive cells for S-100, EMA, CD57, and collagen IV. Based on clinical and microscopical features, the diagnosis established was of palisaded encapsulated neuroma. This case report aims to discuss the differential diagnosis among palisaded encapsulated neuroma and the other neural tumors that affect the oral mucosa(AU).

Peripheral compound odontoma erupting in the gingiva.

BACKGROUND: Peripheral odontoma arising in the extraosseous soft tissues is rare and if not removed early, may enlarge over time and eventually erupt in the oral cavity. CASE PRESENTATION: A 15-year-old girl presented with "denticles on the gingiva". During the intraoral examination, seven small tooth-like structures were found. These were exposed in the anterior left gingiva between the permanent maxillary lateral incisor and canine teeth, and the left first premolar was absent. Radiographic examination revealed irregular tooth-like structures without evidence of bone involvement. CONCLUSION: The lesion was surgically removed, and the specimens were analyzed histopathologically. The diagnosis of compound odontoma was established. CLINICAL SIGNIFICANCE: This is the twelfth reported case of peripheral odontoma in the gingiva and the first one that erupted in the oral cavity.

The 434(G>C) polymorphism in the eosinophil cationic protein gene and its association with tissue eosinophilia in oral squamous cell carcinomas.

OBJECTIVE: The aim of this study was to investigate the prevalence of the Eosinophil cationic protein (ECP)-gene polymorphism 434(G>C) in oral squamous cell carcinoma (OSCC) patients and its association with tumor-associated tissue eosinophilia (TATE), demographic, clinical, and microscopic variables. METHODS: The ECP genotypes of 165 healthy individuals and 157 OSCC patients were detected by PCR-RFLP analysis after cleavage of the amplified DNA sequence with enzyme PstI. TATE was obtained by morphometric analysis. Chi-square test or Fisher's exact test was used to analyze the association of ECP-gene polymorphism 434(G>C) with TATE, demographic, clinical, and microscopic variables in OSCC patients. Disease-free survival and overall survival were calculated by the Kaplan-Meier product-limit actuarial method and the comparison of the survival curves were performed using log rank test. RESULTS: Most of healthy individuals (53.33%) and OSCC patients (57.97%) were heterozygous for the ECP 434(G>C) polymorphism. Based on numerical differences, our results showed that OSCC patients with intense TATE and at least one C allele had a higher frequency of bilateral neck dissection, local recurrence, vascular embolization, involved resection margins, and postoperative radiotherapy. No statistically significant differences on survival rates were found in OSCC patients presenting different ECP 434(G>C) genotypes. CONCLUSIONS: These results suggest a tendency towards a poor clinical outcome in OSCC patients with intense TATE and 434GC/CC genotypes, probably due to an ECP genetic variant with altered cytotoxic activity.

Oral plexiform neurofibroma not associated with neurofibromatosis type I: case report.

An unusual case of isolated plexiform neurofibroma arising in the oral cavity without other clinical manifestations or family history of neuro-fibromatosis-1 (NF-1) is described. The tumor was histopathologically analyzed and an immunohistochemical panel comprising S-100 protein, epithelial membrane antigen (EMA), collagen IV, and CD34 was performed. Typical features of plexiform neurofibroma characterized by enlarged nerve fascicles composed of elongated nuclei and scant cytoplasm cells were identified. Subjacent to the oral epithelium, tactile-like bodies were also detected. On the basis of this report, we would like to emphasize that plexiform neurofibroma can occur in the oral cavity as a benign isolated tumor in patients without other stigmata of NF-1.

Expression of PCNA, p53, Bax, and Bcl-X in oral poorly differentiated and basaloid squamous cell carcinoma: relationships with prognosis.

BACKGROUND: The aim of this study was to compare the clinical features and proliferating cell nuclear antigen (PCNA), p53, Bcl-X, and Bax expression in primary oral basaloid squamous cell carcinoma (BSCC) and poorly differentiated squamous cell carcinoma (PDSCC) matched by stage and site and to assess the possible prognostic significance of these variables. METHODS: Seventeen cases of oral BSCC were compared with 27 PDSCCs matched by stage and tumor site. In addition, PCNA, p53, Bax, and Bcl-X expression in both carcinomas were evaluated in relation to their clinicopathologic features and prognostic values using the Kaplan-Meier method and Cox regression models. RESULTS: No statistically significant differences were found between the groups (BSCC and PDSCC) in regard to clinical features and immunohistochemical reactivity for antibodies PCNA, p53, and Bcl-X. In comparison with PDSCC, the BSCC group exhibited a higher Bax score (p = .031). The 5-year and 10-year overall survival, cancer-specific survival, and disease-free survival rates demonstrated no significant differences between the BSCC and PDSCC groups, and the PCNA, p53, Bax, and Bcl-X also showed no prognostic value. CONCLUSIONS: These results suggest that the clinical and biologic course of BSCC is similar to PDSCC in the oral cavity when clinical stage and site are matched.