Impact of depth of invasion on local recurrence in R0 resected node-negative oral tongue squamous cell carcinoma.

BACKGROUND: This study evaluates the impact of depth of invasion (DOI) on local recurrence (LR) in node-negative oral tongue squamous cell carcinoma (SCC). METHODS: Fifty-one patients were retrospectively reviewed from an institutional database. Patients were evaluated for local control (LC). Cox-proportional hazards modeling was used to calculate hazard ratios. RESULTS: There were 84.3% T1/2 and 15.7% T3/4 classification tumors. The 3-year overall survival rate was 97.9%. Local failure rate was 5.7% with a 3-year LC of 93.6%. On Univariate analysis, increased hazard of LR was noted with each unit increase in DOI (HR 1.40, 95% CI 1.07-1.83, p = 0.014). Age, sex, T classification, margins ≥5 mm, lymphovascular invasion (LVI) and perineural invasion (PNI), and adjuvant treatment were not associated with LR. On Multivariate analysis, adjusting for age and adjuvant treatment, results for DOI remained significant (aHR 1.46, 95% CI 1.08-1.98, p = 0.013). CONCLUSION: On evaluation of our institutional dataset increasing DOI was associated with increased hazard of local recurrence with oral tongue SCC.

Idiopathic gingival papillokeratosis with crypt formation, a report of 7 cases of a previously undescribed entity: possible unusual oral epithelial nevus?

We report 7 cases of hitherto undescribed keratotic papillary plaques of uncertain etiology involving the gingiva. All 7 cases presented on the anterior maxillary attached gingiva of patients in the second decade. The lesions were asymptomatic and 86% (6 of 7 cases) presented in a bilateral symmetric distribution. Microscopically, the lesions exhibited parakeratosis and papillary acanthosis with parakeratin-filled crypts. No specific etiology such as a factitial habit or a common exogenous agent has been identified. The possibility of a developmental etiology such as an oral epithelial nevus cannot be entirely excluded. We propose the descriptive term idiopathic gingival papillokeratosis with crypt formation (IGPC) for this condition.

Intraoral Spitz nevus: case report and literature review.

Spitz nevi account for approximately 1% of all melanocytic nevi of the skin in children. Although Spitz nevi often develop in the skin of the head and neck, intraoral Spitz nevi are rare. These nevi contain epithelioid and spindle cells and exhibit cytologic and architectural atypia when compared with routine melanocytic nevi, and may be mistaken for atypical Spitz tumor, Spitzoid melanoma, or conventional melanoma. Here, we report a Spitz nevus on the buccal mucosa of an 11-year-old boy. The tumor was composed of a proliferation of mostly epithelioid melanocytes with a smaller spindle cell component. The melanocytes were positive for S100, MART-1, and p16 proteins, with HMB-45-positive cells located only in the basal cell layer and superficial lamina propria. Less than 5% of the nuclei were positive for MIB-1, and there were no mitotic figures. We review the literature on 7 previously reported cases of Spitz nevi.

Extraneural sclerosing perineurioma of the buccal mucosa: a case report and clinicopathologic review.

The perineurioma is an infrequently encountered benign peripheral nerve sheath tumor composed of a clonal proliferation of perineurial cells. Rare cases of perineurioma have been reported in the oral cavity. An extraneural sclerosing perineurioma arising in the buccal mucosa of a 17-year-old male is presented. Histopathologically, the tumor is composed of a well circumscribed nodular proliferation of spindle cells arranged in a storiform growth pattern, in some areas subtly arranged around vascular channels. The tumor cells reveal positive immunostaining for epithelial membrane antigen (EMA), collagen type IV and vimentin, and negative immunostaining for S-100 protein, consistent with a perineurial origin. To the best of our knowledge, this case represents the first report of an extraneural sclerosing perineurioma involving the oral cavity.

Sclerosing polycystic adenosis of minor salivary glands: report of three cases and review of the literature.

Sclerosing polycystic adenosis (SPCA) of the salivary gland is a rarely encountered lesion of uncertain pathogenesis that shares histologic features with sclerosing adenosis and fibrocystic disease of the mammary gland. To date, fewer than 40 cases of SPCA have been reported in the literature; all but one have arisen in the major salivary glands. We report 3 cases of SPCA involving minor salivary glands and discuss the characteristic histopathologic features of SPCA , which include a combination of fibrosis, tubuloacinar proliferation, and cystic change with retention of a somewhat lobular architecture. We also provide a review of contemporary relevant literature. Given that SPCA has been mistaken for malignant salivary gland neoplasia, a familiarity with the entity is critical. Three new cases of SPCA involving minor glands are added to 1 existing case in the literature to raise awareness of the lesion and to reduce the likelihood of misdiagnosis.

Diagnosis and management of suspicious lesions of the oral cavity.

Oral lesions associated with premalignant changes and malignancy present in diverse ways. This article discusses the clinical characteristics of such lesions enabling clinicians to identify classical features.Additionally, an effort is made to familiarize clinicians with the significance of red and white lesions, especially those having a high index of suspicion for oral cancer, and to alert clinicians when a biopsy is mandatory.