A unique case of infraorbital myxoid liposarcoma.

Liposarcomas of the head and neck are rare, owing to the paucity of adipose tissue in this region. We present what we believe is a unique case of a myxoid liposarcoma in the infraorbital region, which arose in a 38-year-old man. The patient had presented with a slowly growing mass under his left eye that had been present for about 3 months. A wide local excision was performed, and the tumor was removed in its entirety. The final pathology report identified the mass as a well-differentiated myxoid liposarcoma. The patient's postoperative course was uneventful, and at the 12-month follow-up, he exhibited no evidence of disease.

Endothelin receptor type B gene promoter hypermethylation in salivary rinses is independently associated with risk of oral cavity cancer and premalignancy.

Endothelin receptor type B (EDNRB) and kinesin family member 1A (KIF1A) are candidate tumor suppressor genes that are inactivated in cancers. In this study, we evaluated the promoter hypermethylation of EDNRB and KIF1A and their potential use for risk classification in prospectively collected salivary rinses from patients with premalignant/malignant oral cavity lesions. Quantitative methylation-specific PCR was performed to analyze the methylation status of EDNRB and KIF1A in salivary rinses of 191 patients. We proceeded to determine the association of methylation status with histologic diagnosis and estimate classification accuracy. On univariate analysis, diagnosis of dysplasia/cancer was associated with age and KIF1A or EDNRB methylation. Methylation of EDNRB highly correlated with that of KIF1A (P < 0.0001). On multivariable modeling, histologic diagnosis was independently associated with EDNRB (P = 0.0003) or KIF1A (P = 0.027) methylation. A subset of patients analyzed (n = 161) without prior biopsy-proven malignancy received clinical risk classification based on examination. On univariate analysis, EDNRB and risk classification were associated with diagnosis of dysplasia/cancer and remained significant on multivariate analysis (EDNRB: P = 0.047, risk classification: P = 0.008). Clinical risk classification identified dysplasia/cancer with a sensitivity of 71% and a specificity of 58%. The sensitivity of clinical risk classification combined with EDNRB methylation improved to 75%. EDNRB methylation in salivary rinses was independently associated with histologic diagnosis of premalignancy and malignancy and may have potential in classifying patients at risk for oral premalignant and malignant lesions in settings without access to a skilled dental practitioner. This may also potentially identify patients with premalignant and malignant lesions that do not meet the criteria for high clinical risk based on skilled dental examination.

A unique case of a sublingual-space schwannoma arising from the mylohyoid nerve.

We describe a unique case of a sublingual-space schwannoma presenting as a painless, 3 x 2-cm enlarging mass in the oral cavity of a 63-year-old man. Computed tomography demonstrated a distinct, well-encapsulated mass in the right side of the floor of the mouth. Findings on fine-needle aspiration cytology were consistent with a pleomorphic adenoma. Transoral excision was performed. Intraoperatively, the mass appeared to involve the nerve to the mylohyoid muscle. Upon removal, the gross tumor measured 4.4 x 3.5 x 2.5 cm. On microscopic examination, the spindle-cell neoplasm was found to be consistent with a schwannoma. Schwannomas of the sublingual space are exceedingly rare. Moreover, to the best of our knowledge, this case represents the first published occurrence of a schwannoma that arose from the mylohyoid nerve.