High prevalence of expression of p53 oncoprotein in oral carcinomas from India associated with betel and tobacco chewing.

A recent study reported a low prevalence of p53 expression (11%) in oral squamous cell carcinomas (SCCs) from South Asia, in contrast to a high prevalence (averaging 52%) in other studies. It was proposed that the different aetiologies for oral SCCs in the South Asia population, i.e. betel and tobacco chewing in combination with smoking and alcohol consumption as compared to smoking and alcohol consumption alone in other populations, may account for the low prevalence of p53 expression. To confirm this hypothesis, we examined p53 expression immunohistochemically in 23 cases of oral SCC from patients in Southern India. Thirteen of the 23 SCCs (56.5%) demonstrated nuclear p53 staining. The expression of p53 was strongly correlated with the number of tobacco-containing quids chewed per day (r = 0.8). These data support the hypothesis that carcinogens derived from tobacco and betel chewing may induce p53 mutations, which in turn are involved in the development of oral cancer.

Inflammatory hyperplasias of the oral mucosa.

Reactive inflammatory hyperplastic lesions of the oral mucous membranes comprise one of the most common pathological conditions seen in the oral cavity. Over the years, these "lumps and bumps" have been given a wide variety of names and have engendered a spectrum of theories regarding pathogenesis. This article presents a brief overview of these conditions from the perspective of those lesions that are "common" and those that are "not so common." Clinical examples are featured and, while their pathogenesis receives some comment, no attempt has been made to present either an in-depth discussion or a detailed histomorphological description of the various entities. The accompanying bibliography provides sufficient reference material for those wishing more detail regarding reactive hyperplasias of the oral mucosa.

Oral inverted ductal papilloma.

A case of oral inverted ductal papilloma that appeared on the lower lip of a 44-year-old man is described. A literature review and discussion of the histopathologic features and histogenesis of this uncommon lesion of minor salivary gland origin are also presented.

Familial renal hypophosphatemia, minor facial anomalies, intracerebral calcifications, and non-rachitic bone changes: apparently new syndrome?

We report on two brothers with renal hypophosphatemia, intracerebral calcifications, minor facial anomalies, and short distal phalanges. The children presented with recurrent dental abscesses; one had premature closure of the anterior fontanelle. Biochemical findings included hypophosphatemia and elevated serum alkaline phosphatase with normocalcemia. Blood levels of parathyroid hormone, 1,25(OH)2 and 25(OH) vitamin D levels were normal; TRP (the fractional tubular reabsorption of PO4) and TmP/GFR (the tubular maximum rate of PO4 reabsorption in relation to GFR) were low. Both parents had a normal serum phosphate and brain CT scan without evidence of calcifications. This apparently new syndrome of renal hypophosphatemia associated with intracerebral calcifications appears to be inherited as either an autosomal recessive or an X-linked trait.

ORPAMS: a data-management system for oral pathology.

Oral pathology diagnostic services accumulate considerable clinicopathologic information on oral diseases/conditions. The authors describe an Oral Pathology Data-Management System (ORPAMS) designed for an oral tissue diagnostic program. Various features of data entry, manipulation, retrieval, and storage are outlined, and the research potential of the system is discussed.

Oral manifestations in myelodysplastic syndrome. Review of the literature and report of a case.

Gingival hyperplasia in a patient with myelodysplastic syndrome is described. Gingival infiltration was the first sign of acceleration of a stable disease process and was followed by development of a more aggressive phase of chronic myelomonocytic leukemia that was not responsive to therapy. Oral and dental assessment of patients with the myelodysplastic syndromes should be a part of routine management.

The so-called eruption sequestrum.

The literature relating to so-called eruption sequestra is reviewed. Two cases in which there were calcified fragments adjacent to the crowns of all four first molars are described. Histologic evidence suggests that these calcified fragments consist of a cementum-like substance formed within the follicle, and not sequestrated bone.

Clinicopathological conference. Case 29, part 2. Follicular thyroid carcinoma metastatic to the mandible.

A case of follicular carcinoma of the thyroid metastatic to the mandible is reported and the literature is reviewed. Present conventional methods for determining the presence of secondary deposits, both in living patients and in cadavers, may account, in part, for the small number of cases reported in the literature involving metastases to the jaws. Careful attention to the medical history, clinical examination, scintigraphy, and results of the biopsy will help to establish early diagnosis of which definitive treatment can be based.