Immunohistochemical expression of CD34 and basic fibroblast growth factor (bFGF) in oral submucous fibrosis.

BACKGROUND: Oral submucous fibrosis (OSMF) is an insidious chronic fibrotic condition that involves the oral mucosa and occasionally the pharynx and esophagus. Vascularity in OSMF has always been a matter of debate. The prevailing concept is that epithelial atrophy occurs due to lack of perfusion but the recent data challenges this concept. Therefore, the present study was conducted to evaluate the immunoreactivity of CD34 and basic fibroblast growth factor (bFGF) in different histological grades of OSMF. This might further shed light to the role of microvasculature in OSMF, so that the epithelial atrophy and resultant malignant transformation seen in the advanced stages might be elucidated. MATERIALS AND METHODS: A total of 30 cases of OSMF were included in the study and mean vascular density (MVD) was calculated using CD34 and bFGF. Five cases of OSMF with dysplasia and 2 cases of OSMF turning malignant were added during the course of the study. RESULTS: Mean vascular density was found to decrease significantly as the diseases advanced. Furthermore, vascularity increased significantly in cases of OSMF turning towards malignancy. CONCLUSION: Our study supports the concept of epithelial atrophy aftermath of lack of perfusion. There is reduced vascularity as the disease advances and this denies the systemic absorption of carcinogens, which affects the already compromised epithelium. Consequently, liberation of angiogenic factors occurs because of malignant transformation, which explains the neoangiogenesis and increased vascularity in OSMF turning towards malignancy. Further studies are required to identify the mechanism leading to carcinogenesis in the atrophied epithelium aftermath of fibrosis and decreased vascularity.

Intraosseous lipoma of mandible presenting as a swelling.

Lipomas are the most common form of benign mesenchymal tumors and are composed of mature adipocytes. They can occur anywhere in the body where fat is found and thus, called as the 'universal tumor' or the 'ubiquitous tumor'. Intraosseous lipomas (IOL) are among the rarest (0.1%) of primary bone tumors and are very rarely seen in head and neck bones. They have been subdivided based on the site of origin within bone, into intramedullary and intracortical. Of the two, few cases of intramedullary lipoma have been reported intraorally and none of the latter. Intraosseous lipomas are usually asymptomatic and are detected incidentally on radiographs taken for other complaints. Here, we report a case of intraosseous lipoma in the mandible presenting as a large swelling.

Disseminated histoplasmosis with oral and cutaneous manifestations.

Histoplasmosis is a systemic mycotic infection caused by the dimorphic fungus, Histoplasma capsulatum. Systemic histoplasmosis has emerged as an important opportunistic infection in human immunodeficiency virus (HIV) patients and those in endemic areas. Reported cases of histoplasmosis have been low in India with less than 50 cases being reported. We are reporting a case of disseminated histoplasmosis with oral and cutaneous involvement in an HIV seronegative patient.

Plasma cell myeloma infiltrating the dental pulp: An interesting finding.

Plasma cell myeloma (PCM) is a clonal neoplastic proliferation of terminally differentiated B lymphocytes (plasma cells/myeloma cells) that involves the skeletal system in a multifocal fashion. Even though jaw involvement has been reported in as many as 30% of cases, myeloma cells infiltrating into the pulpal tissue is extremely rare. Here, we present a case of PCM in which myeloma cells are seen infiltrating into the pulpal tissue of 46.

Clear cell variant of intraosseous mucoepidermoid carcinoma: Report of a rare entity.

Intraosseous mucoepidermoid carcinoma of jaw bones is a rare lesion. Abundance of clear cells in an intraosseous mucoepidermoid carcinoma may complicate its histopathologic diagnosis. It becomes extremely important to distinguish this lesion from other clear cell lesions of jaw region. Here, we report a case of clear cell variant of intraosseous mucoepidermoid carcinoma in the mandible.

Necrotizing sialometaplasia of tongue.

Necrotizing sialometaplasia, is a benign inflammatory lesion primarily involving the minor salivary glands of the hard palate. The lesion often presents itself as a deep-seated palatal ulcer with clinical and histological features similar to those of a malignant neoplasm. Here we report a case of necrotizing sialometaplasia in a 40-year-old female, present on the lateral border of the tongue, mimicking squamous cell carcinoma, clinically. A correct diagnosis to avoid mutilant surgical treatments is essential, considering that it is a self-limiting disease.

Changing trends in oral cancer.

CONTEXT: No study highlighting the incidence of oral squamous cell carcinoma (OSCC) in young adults has been reported from North Kerala until now. AIMS: To study the cases of OSCC reported at our institution, with emphasis on the clinicopathologic variables in young adults. SETTINGS AND DESIGN: This was a retrospective study of OSCC cases reported from 2002 to 2007. MATERIALS AND METHODS: Data of oral cancer cases reported between 2002 and 2007 were retrieved from the records. The cases in patients below 40 years of age formed a separate study group. The data obtained was tabulated and comparisons drawn on the observed variables between the two groups. RESULTS: Results showed a high incidence of OSCC among young adults. The demographic and anatomic location of these cases showed significant variations from cases of oral cancer in older patients. In addition, a significant number of these cases failed to show any relation with the commonly implicated etiologic agents of oral cancer. CONCLUSION: The findings of our study indicate a high incidence of oral cancer among young adults in our region. The tongue is the most common site in these cases with a significant number showing no possible etiological factors.

Squamous cell carcinoma of tongue in a 19-year-old female.

Squamous cell carcinoma is the most common malignant neoplasm of the Oral Cavity, usually affecting individuals over 50 years of age. It rarely occurs in patients who are less than 40 years old (0.4-5.5%). However, since it is so rare, when cases occur they are often misdiagnosed and inappropriately treated leading to delay in definitive treatment. This report describes a case of squamous cell carcinoma, involving the posterolateral border of the tongue of a 19-year-old female patient, with no deleterious habits usually associated with oral cancer. This report focuses on the etiological factors and prognosis related to the case. Additionally, a brief literature review regarding squamous cell carcinoma in young patients is also included.