Metastatic hepatocellular carcinoma of the oral cavity - A report of two cases.

Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide that is etiologically linked to a previous hepatitis B infection. We describe two cases of HCC metastasis to the oral cavity in 60- and 67-year-old male patients. The first case was a diffuse, hard swelling in the left body of the mandible. Histopathologic and immunohistochemical analysis was done, and a positive for CK7, CK19, HEPPAR and TTF and a negative for NAPSIN were found to be diagnostic of metastatic HCC. Subsequent examination of the serum alfa- fetoprotein (AFP) level showed a high value of 450 ng/ml, confirmatory of HCC. The second case was a pedunculated, reddish, mobile soft tissue growth on the retromolar region. Its macroscopic and histopathologic features themselves were confirmatory of HCC, and the elicited history was corroborant of metastasis.

Primary Reconstruction in Segmental Resection of Mandible-An Outcome Analysis of Different Reconstructive Techniques.

Functional and cosmetic defects in the maxillofacial region may result from trauma, inflammatory disease, benign or malignant tumors. There are several well established reconstructive options for restoring mandibular continuity and function. Traditionally, surgeons have used their past experience to determine the best way to perform the osteotomy, graft harvesting, and graft shaping procedures for mandibular reconstruction. Focus has now shifted to optimize functional and aesthetic outcomes in mandible reconstruction. Refinements in surgical techniques continue to improve patient's quality of life. The purpose of this study was to evaluate the outcome of a range of reconstructive techniques in 20 patients who underwent segmental resection of mandible during the period 2004-2017.

Analysis of lip print and fingerprint patterns in patients with type II diabetes mellitus.

BACKGROUND AND OBJECTIVES: Globally, the prevalence of diabetes is soaring high in the recent times. There is an ardent search in the scientific community for a reliable and cheap early predictor which can serve the purpose of mass screening of a genetically vulnerable population. Hence, the present study was conducted to assess the predictive role of cheiloscopy on type II diabetes mellitus (T2DM). Several studies have established the association of dermatoglyphics with diabetes. However, results are still far from satisfaction. Thus, we also evaluated fingerprint analysis along with cheiloscopy. MATERIALS AND METHODS: The study was conducted on 100 uncontrolled T2DM patients and 50 healthy controls. Lip prints were obtained using lipstick and cellophane paper analyzed and classified using Suzuki and Tsuchihashi's classification. Fingerprints were obtained using kajal stick, analyzed and classified using Henry's system of classification. RESULTS: Type IV pattern of lip prints was found significantly more in the diabetic patients. Howbeit, fingerprint analysis did not reveal any significant association with diabetes. CONCLUSION: The present study showed a ray of hope for application of cheiloscopy as a potential biomarker in the early diagnosis of T2DM which can be used in mass screening. Further studies are warranted to confirm the findings.

Expression of survivin and p53 in oral lichen planus, lichenoid reaction and lichenoid dysplasia: An immunohistochemical study.

CONTEXT: The malignant transformation potential of oral lichen planus (OLP) and related lesions is a subject of great controversy. AIM: The aim of this study was to compare the expression of proteins related to apoptosis and tumour suppressor gene processes in OLP, oral lichenoid reaction (OLR) and oral lichenoid dysplasia (OLD). MATERIALS AND METHODS: The immunohistochemical study was carried out to investigate the expressions of survivin and p53 in a total of 30 lesional biopsy specimens - 10 cases each of OLP, OLR and OLD. The expression rates were further compared with 10 control specimens of normal oral mucosa (NORM). RESULTS: Immunoreactivity for p53 was seen in 7 cases (70%) of OLD, 4 cases (40%) of OLP and 2 cases (20%) of OLR and none of NORM. We obtained a significant difference (P = 0.01) in mean p53 expression between the different entities. The positive staining rate of survivin was found to be significantly different between OLD (50%), OLP (10%), OLR (0%), and normal mucosa (0%) (P = 0.004). There was a positive correlation between p53 and survivin expression in OLP and OLD using Pearson's correlation coefficient. CONCLUSION: Lichenoid dysplasia has shown p53 and survivin expression in the range of not OLP, but leukoplakia. On the other hand, OLR seems to be an innocuous lesion. The study results with OLP are inconclusive but points toward a small but important malignant potential in OLP. This kind of comparative study highlights the importance of biopsying OLP and related lesions for proper diagnosis and appropriate management.

Benign Fibrous Histiocytoma of Mandible: A Case Report and Updated Review.

Benign Fibrous Histiocytoma (BFH) is a well recognised tumour of the soft tissue, developing entirely within the subcutaneous tissue, the deep soft tissues or in the parenchymal organs. However, BFH of bones is poorly defined. It has been rarely reported in the bones with femur, tibia and pelvic bone being the most commonly affected bones. Involvement of the jawbones is rare. Their clinical and radiographic features often simulate the common odontogenic and non-odontogenic lesions of the jaws. Hence, it is imperative for a dentist to have proper knowledge of various conditions affecting the jaws. Here we report a case of BFH which presented as an indolent swelling of the right mandibular posterior region for 15 years. The case emphasizes the need for considering BFH in the differential diagnosis of swellings of the jaws.

Reactive hyperplasic lesions of the oral cavity: A survey of 295 cases at a Tertiary Health Institution in Kerala.

BACKGROUND: The aim of this study was to review the clinicopathologic features of reactive hyperplastic lesions (RHLs) of the oral cavity at a Tertiary Health Institution in Kerala and compare these data with those of previously reported studies. MATERIALS AND METHODS: The patient case files from the Department of Oral and Maxillofacial Pathology during the period between January 2007 and December 2011 were reviewed for cases of RHLs of the oral cavity. Both clinical and histopathological diagnoses of reactive lesions were selected for the study. Data including the type of the lesion, age, gender and the site involved were collected. RESULTS: From a total of 2753 cases reviewed, 295 histologically diagnosed cases of RHLs were obtained with a prevalence of 10.7%. The data consist of 85 (28.8%) males and 210 (71.2%) females. The most common lesion clinically was traumatic fibroma (69.3%) and histologically fibrous hyperplasia (51.9%). The reactive lesions clinically presented as either sessile (54.9%) or pedunculated (45.1%) lesions. CONCLUSION: The clinical features of reactive hyperplasia among our patients were similar to those reported previously with divergence in some analyzed data. The novelty in our study was the correlation between histopathology and clinical features which were not reported in literature until date.

Orbital trauma: keep an eye for the details!

Orbital injuries are often missed out when they occur concomitantly with other facial bone fractures. Clinical examination and plain radiographic findings alone may prove inadequate in the detection of orbital floor fractures. Refined imaging techniques like CT scans and MRI are immensely helpful in the diagnosis of orbital blowout fractures. A case of 'impure' orbital blowout fracture which went undetected at the time of initial examination and its secondary surgical reconstruction is reported here. This case report emphasizes the importance of careful clinical and radiologic evaluation in orbital injuries.

Clear cell variant of intraosseous mucoepidermoid carcinoma: Report of a rare entity.

Intraosseous mucoepidermoid carcinoma of jaw bones is a rare lesion. Abundance of clear cells in an intraosseous mucoepidermoid carcinoma may complicate its histopathologic diagnosis. It becomes extremely important to distinguish this lesion from other clear cell lesions of jaw region. Here, we report a case of clear cell variant of intraosseous mucoepidermoid carcinoma in the mandible.