Multi Centricity of Oral Verrucous Carcinoma: A Case Series of 22 Cases.

Verrucous carcinoma (VC) is an uncommon variant of squamous cell carcinoma characterized by proliferative outgrowing clinical appearance of the tumor, Incidence of VC is 2-12 % among oral cancers, the true incidence of VC can be accessed only from surgically treated cases since thorough processing of the entire tumor is necessary for accurate diagnosis, foci of invasive squamous cell carcinoma are found often in the substance of these tumors, thus, over reporting of this tumor is not uncommon. The retrospective data of a tertiary cancer hospital was analysed to understand the clinical challenges and outcome of patients with VC. The frequent association of VC with second primary oral cancer (22.7 %) observed in our series highlights the multi centricity of carcinogenesis in these patients.

HER2/neu negative salivary duct carcinoma of parotid: A case with forty months recurrence free follow up.

INTRODUCTION: Salivary duct carcinoma (SDC) is very rare, only 1-3% of all salivary gland tumors are reported as SDC. SDC predominantly occurs in elderly males, SCD is characterized by an aggressive clinical course of the disease with less than 60% five years survival from the day of initial diagnosis, lymph node metastasis and facial nerve involvement is common, the current literature lacks protocol regarding management of this entity and the advantage of adjuvant therapy has not been evaluated due to its rare occurrence. PRESENTATION OF CASE: We report patient with stage IV HER2/neu negative SDC successfully treated with surgery followed by adjuvant radiotherapy, patient is followed up for 40 months without evidence of recurrence or metastasis. DISCUSSION: SDC is reported to be similar to mammary duct carcinoma in clinical and immunohistologic typing, further it shows an association of expression of HER-2/neu and p53, with early local disease recurrence, distant metastasis and survival, however; current case was adequately followed up and reevaluated after 26 months, MRI did not show evidence of recurrence. CONCLUSION: SDC is a rare tumor and information on association of HER2/neu with survival is useful in further research on this tumor.

Close margins in oral cancers: implication of close margin status in recurrence and survival of pT1N0 and pT2N0 oral cancers.

INTRODUCTION: Among all prognostic factors, "margin status" is the only factor under clinician's control. Current guidelines describe histopathologic margin of >5 mm as "clear margin" and 1-5 mm as "close margin." Ambiguous description of positive margin in the published data resulted in comparison of microscopically "involved margin" and "close margin" together with "clear margin" in many publications. Authors attempted to compare the outcome of close and clear margins of stage I and stage II squamous cell carcinoma of oral cavity to investigate the efficacy of description of margin status. PATIENTS AND METHODS: Historical cohorts of patients treated between January 2010 and December 2011 at tertiary cancer hospital were investigated and filtered for stage I and stage II primary squamous cell carcinomas of oral cavity. Patients with margin status of tumor at margin or within 1mm from cut margin were excluded and analyzed in multivariate logistic regression model for locoregional recurrences and Cox regression for overall survival. RESULTS: A total of 104 patients fulfilled the abovementioned criteria, of whom 36 were "clear margin" and 68 were "close margin" with median period of follow-up of 39 months. There was no significant difference in locoregional recurrence (P value: 0.0.810) and survival (P value: 0.0.851) among "close margin" and "clear margin" patients.