A report on 222 cases of oral squamous cell carcinoma.

Cancer is the second leading cause of death in the United States after cardiovascular diseases. Cancer of the oral cavity and pharynx accounts for approximately 2.5% of all cancer cases. This study attempts to highlight some of the risk factors and the clinical signs associated with oral cancer. Data over a 13-year period were collected from the Case Western Reserve University Oral Pathology Laboratory. There were 222 cases of squamous cell carcinoma. The results indicated that the typical male patient was 7 years younger than the typical female patient. Apart from the use of alcohol and tobacco, the wearing of removable prostheses was associated with an increased rate of malignancy. The risks of malignancy were associated with the site and color of the lesions. In addition, we found that the suspicion of cancer among clinicians tend to be higher when the lesions were larger, ulcerated, painful, and hemorrhagic.

Mohs fixed-tissue excision of dentoalveolar bone in canines: a histologic evaluation.

Mohs surgery is a well-established surgical technique that involves conservative, microscopically guided excision of malignant lesions, thereby sparing the maximum amount of normal surrounding tissue. Current surgical therapy for oral cancer frequently involves resection with wide margins, resulting in significant cosmetic and functional deficits. This pilot study used the Mohs technique for in situ fixation and excision of maxillary and mandibular bone in mongrel dogs. Histologic examination of the excisional sites was carried out at 8 weeks to examine changes in the surrounding bone, periodontal ligament, and dental pulp of adjacent teeth. The findings suggest that zinc chloride fixative paste does not result in destruction of the dental pulp or surrounding dentoalveolar bone of teeth in the vicinity of a fixed-tissue excision. The Mohs fixed-tissue technique may allow preservation of oral structures that would otherwise be sacrificed in the presence of bony tumor involvement.

Granular cell ameloblastoma: electron microscopic observations.

A case of granular cell ameloblastoma was studied by light and electron microscopy. Histologically, the lesion resembled simple ameloblastoma, but differed from the latter in that it contained many cells with granular eosinophilic cytoplasm. Ultrastructurally, the cytoplasmic granules were identified as lysosomes. These organelles were particularly abundant in cells situated in the center of islands and clusters of neoplastic cells. Since no cytoplasmic components could be identified in any of these lysosomes, it was concluded that they are not engaged in autophagy or in remodeling of the neoplastic cells.

A survey of 4,793 oral lesions with emphasis on neoplasia and premalignancy.

A survey was taken of a selected group of 4,793 oral lesions submitted to the oral pathology biopsy service between 1950 and 1970. About two thirds of all the specimens examined microscopically were classified as inflammatory, infectious, or reactive hyperplasia. Of the 12.6% of the sample classified as neoplasms, one of every five was malignant. Three of every four of the malignant neoplasms were microscopically diagnosed as squamous cell carcinomas. Benign neoplasms were most common in ages 40 to 60, whereas premalignancies and malignancies were most commonly discovered in the slightly older age group of 50 to 70. Although malignant neoplasms were found more often in men than women, there was a striking increase in the incidence of malignancies in women in the second ten-year period of the study. There were unexplainably few malignant neoplasms found in blacks. Patients should be taught to recognize the early signs of oral premalignancy and malignancy through the use of a simple method of self-examination at home. They should be discouraged from the frequent use of tobacco and alcohol, which have long been known to be predisposing factors in the production of oral squamous cell carcinomas.