Immunoproteomics reveals that cancer of the tongue and the gingivobuccal complex exhibit differential autoantibody response.

Autoantibody response to tumor antigens has been widely used to identify novel tumor markers for different cancers, including that of the head and neck. The oral cavity, which is in the head and neck region, comprises of many sub sites with distinct biologies and incidence of cancer of each sub site of the oral cavity is different. It is anticipated therefore that each sub site of the oral cavity may elicit a differential autoantibody response. This report evaluates the autoantibody response in 15 patients with cancer of gingivo-buccal complex and in 15 patients with cancer of tongue using Immunoproteomics, and shows that the autoantibody response to alpha-enolase, HSP 70, peroxiredoxin-VI, annexin II, pyruvate kinase, alpha-tubulin, beta-tubulin, ATP synthase, triose phosphate isomerase and aldose reductase seen in patients with cancer of gingivo-buccal complex is absent in patients with cancer of tongue. This suggests that cancer of these sub sites should be studied separately because of their different biology and emerging site specific molecular signatures including autoantibody responses to ensure unambiguous clinical interpretations.

Spontaneous regression of non-Hodgkin's lymphoma in the oral cavity after incisional biopsy.

We report a case of gingival T cell non-Hodgkin's lymphoma that responded initially to chemotherapy, recurred at another site a year later, but regressed spontaneously after incisional biopsy. We are not aware of any other reports about spontaneous regression of T cell lymphomas in the oral cavity.

Epstein-Barr virus and human immunodeficiency virus-negative oral plasmablastic lymphoma.

Plasmablastic lymphoma (PBL) is an unusual subtype of human immunodeficiency virus (HIV)-related diffuse large B-cell lymphoma that was first described in the oral cavity. HIV-related lymphomas are frequently associated with Epstein-Barr virus (EBV). Recently, dual infection with EBV and human herpesvirus 8 (HHV8) has been demonstrated in PBL. So far, a few cases of PBL occurring in an HIV-negative patient have been documented and all of them were associated with immunosuppression status and/or EBV infection. Here we report a EBV and HHV8-negative oral PBL occurring in an immunocompetent HIV-negative male, which would be the first case.

The influence of blood arterial oxygen condition on the tumor response to preoperative radiation therapy in oral cancer patients.

The relationship between clinicopathological factors and response of radiation therapy in oral squamous cell carcinoma has been studied. It has been suggested that factors such as tumor site, extent and tumor differentiation determine the response to radiation therapy. It is known that oxygenation is related to the therapeutic effects of radiation therapy. However, there are few reports on the relationship between oxygen condition and the response to radiation therapy. The present study was carried out to assess whether any clinicopathological factors, including an evaluation of the oxygen condition can be used to predict the effects of preoperative radiation therapy in oral squamous cell carcinomas. Forty-seven patients with oral cancer treated with external radiation therapy preoperatively were evaluated. There were no significant differences in response to the radiation with respect to age, sex, tumor site, stage, macroscopic shape of tumors, and the histological factors. The hemoglobin (Hb) and arterial oxygen content (CaO(2)) levels of favorable cases (Hb: 14.4 g/dl, CaO(2) 19.1 ml/dl) were significantly higher than those of unfavorable cases (Hb: 11.0 g/dl, CaO(2): 16.1 ml/dl). These findings suggest that oxygen conditions of oral cancer patients predict tumor response to preoperative radiation therapy.

[Hypophosphatemic oncogenic osteomalacia]. / Hypophosphataemiával járó onkogén osteomalacia.

The first case of oncogen osteomalacia in Hungary is reported, to draw the attention of the medical profession to it and to present the new data about its pathomechanism. Pathological hip fracture caused by hypophosphataemic osteomalacia due to isolated renal phosphate wasting was found in a previously healthy 19 years old sportsman. In spite of daily 1.5 micrograms calcitriol treatment and phosphate supplementation, hypophosphataemia persisted for 13 years and he needed regular indometacin medication for his bone pain. During that time an 1.5 cm gingival tumour was found and radically removed. The serum phosphate level returned to normal in a few hours after the operation (preoperative 0.51, after 2, 4 and 8 hours 0.61, 0.68 and 0.79 mmol/l respectively), and remained normal without calcitriol. The histological examination showed epulis with fibroblast and vascular cell proliferation, which has never been previously reported in connection with oncogenic osteomalacia. The pain resolved after 3 months and the bone density became normal in one year. Oncogenic osteomalacia must be considered in every case presenting with atypical hypophosphataemic osteomalacia. Careful dental examination is needed also in the course of search for the underlying tumour. Every tumour-like growth, even the common epulis, has to be operated radically and serum phosphate monitored in the postoperative period in all such cases.

Endodermal sinus (yolk sac) tumor of oral cavity originating from gingiva.

Endodermal sinus tumor is a malignant germ cell tumor which usually arises in gonads. Extragonadal endodermal sinus tumors in the head and neck are very rare. Here a gingival endodermal sinus tumor is reported. The lesion demonstrated typical microscopic features of the endodermal sinus tumors of gonads. The tumor cells showed alpha-fetoprotein immunoreactivity in immunohistochemical evaluation. The serum alpha-fetoprotein level was high. This is the first gingival case in the related literature.

A case of IgD myeloma with extraosseous spread to the gingiva.

A case of IgD myeloma at first diagnosed as Bence Jones type is reported. Multiple myeloma was diagnosed in the patient, a 39-year-old man with a tumor of the gingiva, because of the presence of multiple bone lesions with plasma cell proliferation and profuse urinary excretion of Bence Jones protein (lambda-type). An increase of serum IgD level (770 mg/dL) and a decrease in other classes of immunoglobulins were indicated by quantitative analysis; however, no apparent M-component was indicated by conventional electrophoresis on a cellulose acetate membrane. Microscopic examination of the specimen showed numerous atypical plasma cells. The disease profile of IgD myeloma, as well as the reasons IgD myeloma may be easily mistaken for Bence Jones type myeloma, is discussed.

Melanotic neuroectodermal tumor of infancy with high serum levels of alpha-fetoprotein. Ultrastructural study and immunological evidence of glial fibrillary protein and alpha-fetoprotein.

We report an infant melanotic neuroectodermal tumor in the anterior part of the upper gingiva, which was associated with high urinary excretion of vanilmandelic acid. Serum levels of alpha-fetoprotein were abnormally high (200 ng/ml). They returned to normal after removal of the tumor (10 ng/ml). The tumor was characterized histologically and ultrastructurally by the presence of melanocytic and astrocytic cells containing glial fibrillary protein. Intracellular alpha-fetoprotein was demonstrated by the immunoperoxidase method (PAP) in scattered foci of interstitial cells.