Oral melanoacanthoma. Review of the literature and report of ten cases.

Melanoacanthoma is a simultaneous benign proliferation of two cell types--the keratinocyte and the melanocyte. It is a rare lesion; only twenty cases have been reported on skin and three cases intraorally. This article reports a series of ten cases of intraoral melanoacanthoma. Significant clinical differences exist between skin and mucosal lesions. Whereas the skin lesions occur almost exclusively in white persons and in an older population, the mucosal melanoacanthoma occurs in a much younger population, is seen almost exclusively among blacks, and is frequently associated with a history of trauma or irritation which precedes the rapid development of the lesion. Several cases have resolved with incomplete removal. It is conjectured that this lesion may represent a reactive phenomenon on oral mucosa rather than neoplasia.

Tangier disease with oral abnormalities.

A patient with Tangier disease, pulpal calcifications, and bilateral mandibular intrabony lesions (unusual odontomas) is presented. A relationship between Tangier disease and the oral manifestations found in this patient has not been established. Of the 27 known patients with Tangier disease, only 2 have been examined.

Gingival granula cell tumors of the newborn (congenital "epulis"): a clinical and pathologic study of 21 patients.

The clinical and pathologic features of 24 gingival granular cell tumors in newborns are reviewed. These tumors occurred exclusively in females and were localized on the anterior alveolar ridge (maxilla: 14; mandible: 9); the gingiva overlying future canine and lateral incisor teeth was most frequently involved. Follow-up data for 15 patients (average duration 15 years) indicated a lack of tumor recurrence despite incomplete resection in 11 instances. Tumors resected early in the newborn period were larger (maximum diameter 2.0 cm) and showed confluent to nodular submucosal growth with relatively less collagen. Some showed features suggesting involution. The histology in most cases supported a mesenchymal origin rather than one from odontogenic epithelium. Immunohistochemical staining for selected oncofetal and other antigens was negative. Electron microscopy did not entirely resolve the controversy regarding histogenesis.

Granular cell tumor: a clinicopathologic study of 110 patients.

The clinicopathologic features of 118 granular cell tumors (GCT) encountered at two affiliated hospitals were reviewed. A total of 110 patients were affected over this 32-year period of study (71 men, 39 women), and in 5% GCT were multiple. Patients ranged in age from 16 to 58 years (average 32 years) and were symptomatic for an average duration of 11 months prior to diagnosis. There was a greater than expected frequency of GCT among black patients (29%). Although tongue was the single most common anatomic site involved, relatively more GCT (44%) occurred in skin or subcutaneous tissue. Less common locations were breast parenchyma (10 cases), rectal mucosa and anus (6), vulva (4), esophagus and larynx (2 cases each). The correct preoperative diagnosis of this protean tumor was made in only three patients. GCT were surgically treated with the average diameter of resected tumor being 1.2 cm (range 0.2--3.5 cm). Pseudoepitheliomatous hyperplasia was noted in 11 tumors and in one vulvar GCT there was overlying in situ squamous cell carcinoma. Tumors were incompletely excised in 24 of 56 patients having adequate followup; only five of these 24 patients experienced a local recurrence of tumor. Malignant behavior was not observed. Results of histochemical and ultrastructural study are briefly discussed. The precise histogenesis of GCT is uncertain but Schwann cell origin is favored in most cases.