Multiple oral radiopaque masses leading to Gardner's syndrome diagnosis.

Gardner's syndrome, an autosomal dominant syndrome, is linked to familial adenomatosis polyposis (FAP), which is known mainly as a colorectal disease. FAP also presents extracolonically as intestinal polyposis, multiple osteomas, cutaneous cysts, or fibromas. This article reports the case of a 66-year-old white woman who was referred to the Oral Medicine Clinic, School of Dentistry, Universidade Vale do Rio Verde, Brazil, for evaluation of multiple sclerotic, asymptomatic masses in the jaws that were observed in a routine periapical radiographic exam by a dentist. The patient presented with intestinal poliposis, periosteal osteoma in the face, and fibromas and multiple endosteal osteomas in the maxilla, which are indications of Gardner's syndrome. The clinical differential diagnosis included multiple buccal exostoses, idiopathic osteosclerosis, cemento-osseous dysplasias, multiple odontomas, osteomas, and Gardner's syndrome. Patients with a suspected diagnosis of Gardner's syndrome should be referred to a dermatologist, have a colonoscopy performed, and be followed up by a dentist.

CD44/CD24 immunophenotypes on clinicopathologic features of salivary glands malignant neoplasms.

BACKGROUND: Salivary glands malignant neoplasms (SGMNs) account for 3-6% of head and neck cancers and 0.3% of all cancers. Tumor cells that express CD44 and CD24 exhibit a stem-cell-like behavior. CD44 is the binding site for hyaluronic acid, and CD24 is a receptor that interacts with P-selectin to induce metastasis and tumor progression. The present study aims to evaluate the expression of CD44 and CD24 on SGMNs and correlated these data with several clinicopathologic features. METHODS: Immunohistochemical stains for CD44 and CD24 were performed on tissue microarrays containing SGMN samples from 69 patients. The CD44, CD24 and CD44/CD24 expression phenotypes were correlated to patient clinicopathologic features and outcome. RESULTS: CD44 expression was associated with the primary site of neoplasm (p = 0.046). CD24 was associated with clinical stage III/IV (p = 0.008), T stage (p = 0,27) and lymph node (p = 0,001). The CD44/CD24 profiles were associated with the primary site of injury (p = 0.005), lymph node (p = 0.011) and T stage (p = 0.023). Univariate analysis showed a significant relationship between clinical staging and disease- free survival (p = 0.009), and the overall survival presents relation with male gender (p = 0.011) and metastasis (p = 0.027). CONCLUSION: In summary, our investigation confirms that the clinical stage, in accordance with the literature, is the main prognostic factor for SGMN. Additionally, we have presented some evidence that the analysis of isolated CD44 and CD24 immunoexpression or the two combined markers could give prognostic information associated to clinicopathologic features in SGMN. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1284611098470676.

Prognostic impact of p53 and p63 immunoexpression in oral squamous cell carcinoma.

BACKGROUND: The role of p53 and p63 proteins in the prognosis of oral squamous cell carcinoma (OSCC) is still debatable. Our aim here was to investigate the relationship between the immunoexpression of these proteins with some clinicopathologic parameters of prognostic significance in OSCC. METHODS: Formalin-fixed paraffin-embedded sections from 106 patients were used for study together with the following data: primary site, histologic differentiation, recurrences, metastasis, disease-free survival and overall survival (OS). RESULTS: In OSCCs, the positive rate for p63 protein immunoexpression (87.8%) was higher than p53 (52.8%). p53 expression correlated with metastasis. Tumors negative for p53 and with strong intensity for p63 expression had a significantly higher OS. CONCLUSIONS: p53 overexpression is associated with a larger number of metastases and is correlated with a poor outcome as well as decreased intensity in p63 immunoexpression.