ABSTRACT
BACKGROUND: Breast carcinoma is a common tumor in women, but it rarely metastasizes to the oral region. Furthermore, metastases to the oral region occur mainly to the maxillary and mandibular bone and rarely to soft tissue. CASE PRESENTATION: We describe a case of breast cancer metastasis to the buccal area. Examination of the right buccal mass of a 66-year-old Japanese woman was suggestive of breast cancer metastasis, and a breast lump was detected. Since receiving hormone-based treatment, the patient has survived more than 5 years and is now in remission. CONCLUSIONS: An oral metastatic lesion may be the first sign of breast carcinoma; oral surgeons should be aware of this possibility.
Subject(s)
Breast Neoplasms , Carcinoma , Melanoma , Skin Neoplasms , Aged , Breast Neoplasms/pathology , Cheek/pathology , Female , HumansABSTRACT
Lymph node metastasis (LNM) is associated with poor survival in patients with oral squamous cell carcinoma (OSCC). Vascular endothelial growth factor-C (VEGF-C) is thought to be responsible for increased lymphangiogenesis and LNM. Understanding of the mechanism by which VEGF-C expression is regulated in OSCC is thus important to design logic therapeutic interventions. We showed that inoculation of the SAS human OSCC cells expressing the venus GFP (V-SAS cells) into the tongue in nude mice developed LNM. V-SAS cells in LNM were isolated by FACS and re-inoculated into the tongue. This procedure was repeated eight times, establishing V-SAS-LM8 cells. Differential metastasis PCR array between the parental V-SAS and V-SAS-LM8 was performed to identify a molecule responsible for lymphangiogenesis and LNM. Fibronectin 1 (FN1) expression was elevated in V-SAS-LM8 cells compared to V-SAS-cells. V-SAS-LM8 tongue tumor showed increased expression of FN1 and VEGF-C, and promoted lymphangiogenesis and LNM compared with V-SAS tumor. Further, phosphorylation of focal adhesion kinase (FAK), a main downstream signaling molecule of FN1, was up-regulated, and epithelial-mesenchymal transition (EMT) was promoted in V-SAS-LM8 cells. Silencing of FN1 by shRNA in V-SAS-LM8 cells decreased FAK phosphorylation, VEGF-C expression and inhibited lymphangiogenesis and LNM. EMT was also reversed. The FAK phosphorylation inhibitor PF573228 also decreased VEGF-C expression and reversed EMT in V-SAS-LM8 cells. Finally, we detected intense FN1 expression in some clinical specimens obtained from OSCC patients with LNM. These results demonstrate that elevated expression of cellular FN1 and following activation of FAK lead to increased VEGF-C expression, lymphangiogenesis and LNM and promoted EMT in SAS human OSCC cells and suggest that FN1-phosphorylated FAK signaling cascade is a potential therapeutic target in the treatment of LNM in OSCC.
Subject(s)
Carcinoma, Squamous Cell/pathology , Fibronectins/metabolism , Head and Neck Neoplasms/pathology , Lymphatic Metastasis/pathology , Mouth Neoplasms/pathology , Vascular Endothelial Growth Factor C/biosynthesis , Animals , Blotting, Western , Cell Line, Tumor , Disease Models, Animal , Fluorescent Antibody Technique , Heterografts , Humans , Immunohistochemistry , Lymphangiogenesis/physiology , Mice , Mice, Nude , Real-Time Polymerase Chain Reaction , Squamous Cell Carcinoma of Head and NeckABSTRACT
OBJECTIVE: This study aimed to determine the relationship of cyclooxygenase-2 (COX-2) and vascular endothelial growth factor-c (VEGF-C) expression with lymphangiogenesis, lymph node metastasis (LNM), and other clinicopathologic features in human oral tongue cancers. STUDY DESIGN: Forty tongue cancer specimens were immunohistochemically examined for COX-2 and VEGF-C expression and for lymphatic vessel density (LVD). We analyzed the relationships between COX-2 and VEGF-C expression and the relationships of such expression with clinicopathologic findings and survival of patients. RESULTS: Eighteen tumors out of 40 (45%) showed COX-2 expression, and 18 tumors (45%) expressed VEGF-C. Twelve tumors (30%) coexpressed COX-2/VEGF-C. A significant correlation was found between COX-2 and VEGF-C expression (P < .01). Of note, COX-2/VEGF-C coexpression significantly correlated with lymphangiogenesis, LNM, TNM stage (P < .01), and LVD (P < .05). In Cox regression for survival, COX-2/VEGF-C coexpression was identified as an independent prognostic factor (P < .05). CONCLUSIONS: Our results suggest that examination of immunohistochemical expression of COX-2 and VEGF-C predicts LNM and survival in human oral tongue cancers.
Subject(s)
Carcinoma, Squamous Cell/metabolism , Carcinoma, Squamous Cell/pathology , Cyclooxygenase 2/metabolism , Tongue Neoplasms/metabolism , Tongue Neoplasms/pathology , Vascular Endothelial Growth Factor C/metabolism , Aged , Aged, 80 and over , Female , Humans , Immunoenzyme Techniques , Lymphangiogenesis/physiology , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Grading , Neoplasm Staging , Prognosis , Survival AnalysisABSTRACT
We report a very rare case of anomaly in the maxillofacial region. This case is a patient with a cleft palate who had Simpson-Golabi-Behmel syndrome. This X-linked symptom was first described by Simpson et al in 1975 and is characterized by prenatal and postnatal overgrowth, as well as visceral and skeletal anomalies. The syndrome consists of a distinctive facial appearance with wide nasal bridge, anteverted nostrils, wide-open mouth, enlarged tongue, and large protruding maxilla and jaw. The cleft palate was repaired surgically using the push-back method.
