Sinonasal verrucous carcinoma with oral invasion.

Verrucous carcinoma is a rare warty variant of squamous cell carcinoma, most often seen in the oral cavity and larynx. Its occurrence in the sinonasal tract is rare. This tumor constitutes approximately 1% of all sinonasal neoplasms. The clinical presentation and the histopathological features of verrucous carcinoma are a subject of continuous discussion amongst diagnosticians and pathologists. A case with oral and nasal presentation of this tumor is reported here.     

An update on squamous carcinoma of the oral cavity, oropharynx, and maxillary sinus

There are more than 45,000 new cancer cases involving the head and neck diagnosed each year within the United States. Squamous cell carcinoma accounts for the majority of cases, often occurring within the oral cavity and oropharynx. This article reviews current literature and various controversial topics involving the diagnosis and treatment strategies for patients with oral cavity/oropharyngeal cancers. Although not considered cancer within the oral cavity, maxillary sinus squamous cell carcinoma is discussed.     

Large cell neuroendocrine carcinoma of the floor of mouth and retromolar trigone in association with basaloid squamous cell carcinoma

Large cell neuroendocrine carcinoma and basaloid squamous cell carcinoma are each rare but aggressive diseases of the head and neck. A case of large cell neuroendocrine carcinoma occurring simultaneously with a basaloid squamous cell carcinoma originating from the oral cavity is described in this report. The diagnosis of these pathologies can be challenging but is important, as staging and treatment recommendations differ from those for oral cavity squamous cell carcinoma.     

Adolescent gingival squamous cell carcinoma: Report of a case and review of the literature

In this article we describe a case of adolescent squamous cell carcinoma of the gingiva. The tumor presented as an ulcerative lesion of the gingiva that was originally thought to be pseudoepitheliomatous hyperplasia. The pathologic differentiation between squamous cell carcinoma and pseudoepitheliomatous hyperplasia is discussed and a review of the literature with respect to pediatric and adolescent oral squamous cell carcinoma is presented. The reported case illustrates the difficulties that may be encountered in attempting to histopathologically distinguish between pseudoepitheliomatous hyperplasia and well-differentiated squamous cell carcinoma of the oral cavity.     

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??Objective    To investigate the expression of p16 protein in the tissues of Maxillary Sinus Squamous Cell Carcinoma ??MSSCC?? and analyze its relationship with the clinical pathological characteristics. Methods    Immunohistochemistry ??IHC?? was used to detect the expression of p16 protein in 34 cases of maxillary sinus squamous cell carcinoma and 10 cases of normal nasal mucosa. Results    Positive expression rates of p16 protein in maxillary sinus squamous cell carcinoma and normal nasal mucosa tissue were 32.35% and 100.0%??which in the poor differentiation group was significantly lower than that in the good-differentiation group ??P < 0.05??. Conclusion    The expression of p16 protein is significantly lower in the maxillary sinus squamous cell carcinoma and correlates with the degree of differentiation. The higher the degree of malignancy??the lower the expression. The results suggest that p16 protein may play a role in the occurrence and development of maxillary sinus squamous cell carcinoma.     

上颌窦鳞状细胞癌中p16蛋白表达研究

目的    探讨p16蛋白在上颌窦鳞状细胞癌 （maxillary sinus squamous cell carcinoma,MSSCC） 组织中的表达,分析其与MSSCC临床病理特征的关系。方法    收集2010年10月至2015年6月于中国医科大学附属第一医院耳鼻咽喉科手术切除或活检并经病理证实的MSSCC蜡块标本34例（MSSCC组）,另取鼻中隔偏曲矫正术中正常下鼻甲黏膜组织10例（正常鼻黏膜组）,采用免疫组化SP法分别检测MSSCC和正常鼻黏膜组织中p16蛋白的表达情况。结果    MSSCC组和正常鼻黏膜组中的p16蛋白阳性表达率分别为32.35%（11/34）和100.0%（10/10）,差异有统计学意义（P < 0.05）,且低分化MSSCC组p16蛋白阳性表达率明显低于高中分化组（P < 0.05）。结论    p16蛋白在MSSCC组织中明显低表达,且表达与肿瘤的分化程度有关,恶性程度越高,其表达越低,提示p16蛋白可能与MSSCC的发生、发展有关。     

Vertebral metastases from oral squamous cell carcinoma.

PURPOSE: The purpose of this study was to review the incidence and clinical presentation of vertebral metastases related to squamous cell carcinoma of the oral cavity. PATIENTS AND METHODS: We conducted a retrospective review of our clinical experience with 597 cases of squamous cell carcinoma of the oral cavity. RESULTS: Four patients with vertebral metastases were identified, accounting for 0.7% of the series. Thirteen vertebrae were involved in these 4 patients. All patients showed advanced cervical metastases as evidenced by several histologically positive nodes with extracapsular invasion when the ablative tumor specimen was examined. All patients displayed symptoms of their vertebral metastases, including severe pain, hypercalcemic somnolence, and flaccid paralysis of the lower extremities as part of the cauda equina syndrome. CONCLUSIONS: Vertebral metastases are rare forms of distant metastasis related to squamous cell carcinoma of the oral cavity. Bone pain is a symptom that should result in expedient radiographic examination in such patients, particularly when advanced cervical metastases are identified during the primary tumor surgery, which places the patient at risk for distant metastatic disease.     

An electron and optical microscopic study of juxtaposed odontogenic keratocyst and carcinoma

Odontogenic keratocyst and squamous cell carcinoma commonly occur within the oral cavity; however, the juxtaposition of these lesions is rare. The light microscopic and ultrastructural features of such an event are reported. Although some morphologic similarities between the cyst and tumor were observed, definitive evidence of a common origin was not obtained.     

口腔基底样鳞状细胞癌的临床病理及免疫组织化学特点

目的研究口腔基底样鳞状细胞癌的临床病理学特点。方法用ＨＥ染色、病理学观察及免疫组织化学染色法对１４例基底样鳞状细胞癌进行了分析。结果口腔基底样鳞状细胞癌占口腔鳞状细胞癌的１％，男性多于女性，可发生在口腔粘膜任何部位，临床表现主要为肿物和溃疡。肿瘤由基底样细胞和鳞状细胞构成，以基底样细胞为主，常形成粉刺样坏死，核分裂较多，邻近上皮常有异常增生。肿瘤细胞角蛋白ＡＥ１／３、ＣＫ１３阳性，Ｓ１００阴性，增殖细胞核抗原（ｐｒｏｌｉｆｅｒａｔｉｎｇｃｅｌｎｕｃｌｅａｒａｎｔｉｇｅｎ，ＰＣＮＡ）阳性细胞多，ｐ５３阳性率为５０％。３５．７％的病例初次手术时已有淋巴结转移。结论口腔基底样鳞状细胞癌较普通鳞状细胞癌恶性程度高，具有独特的组织学特点，临床及病理上应予重视。     

Pseudo bilateral tonsilloliths: a case report and review of the literature

Tonsilloliths are very rare concretions found in the tonsillar crypt. They are usually single and unilateral, but occasionally may be multiple or bilateral. Small concretions in the tonsils are common, but well formed giant unilateral or bilateral tonsilloliths are extremely uncommon. Only two cases of bilateral tonsilloliths have so far been reported in the literature. A case of unilateral tonsillolith, mimicking bilateral tonsilloliths taken with the orthopantogram (OPT) in a 57-year-old Malaysian Indian female with squamous cell carcinoma of the oral cavity is described. Although the OPT is a reliable and standard panoramic X-ray unit used in dentistry, superimposition of a lesion involving one side of the jaw creates a pseudo or ghost image on the contralateral side leading to a misdiagnosis of bilateral lesions. This report highlights that tonsilloliths, though rare, should be considered in the differential diagnosis of radiopaque masses involving the mandibular ramus, and that investigations such as CT scan or MRI may be required to differentiate pseudo or ghost images from true bilateral pathologies.     

Histopathologic risk factors in oral and oropharyngeal squamous cell carcinoma variants: An update with special reference to HPV-related carcinomas

Accurate identification of the microscopic risk factors of oral and oropharyngeal (OP) squamous cell carcinomas (SCC) and their morphologic variants is of at most importance, as these generally determine treatment modalities, prognosis and overall patient outcome. The great majority of oral and oropharyngeal squamous cell carcinomas are microscopically described as kerartinizing squamous cell carcinoma (KSCC). They bear certain resemblance to keratinizing stratified squamous epithelium. Tobacco habits and excessive consumption of alcoholic beverages have been considered to be the main etiologic agents in these carcinomas. The tumors occurred in older patients more commonly affected the oral tongue and floor of the mouth with well established morphologic risk factors including tumor grade, pattern of invasion and perineural involvement. Within the last 30 years however, the advent and expanding prevalence of high risk human papillomavirus (HPV) as an important etiologic agent for head and neck squamous cell carcinoma, particularly in the OP, has resulted in a significant change in the established morphologic criteria for risk assessment. The majority of HPV relate carcinomas of the OP are nonkeratinizing squamous cell carcinoma (NKSCC). These tumors are found to be more responsive to treatment with a favorable patient outcome and good prognosis. Consequently, alterations in treatment protocols aimed at de-escalation are currently being evaluated. More recently, other morphologic variants that are HPV positive are reported with increasing frequency in the OP and other head and neck sites. As a result, several clinical and pathologic questions have emerged. Importantly, whether the virus is biologically active in these tumors and involved in their pathogenesis, and second, what are the clinical implications with regard to patient management and outcome in the HPV-related variants. Examples of HPV-related squamous cell carcinoma variants that will be addressed here are: basaloid squamous cell carcinoma (BSCC), undifferentiated carcinoma (UCa), papillary squamous carcinoma (PSCC) and small cell carcinoma. Some studies have suggested favorable prognosis in some variants, analogous to that of the (NKSCC), while others showed poorer outcome. So far the number of studies on this subject is limited and the number of cases evaluated in each investigation is few. Because of that, it is prudent at this stage, not to alter management protocols as a result of identification of HPV in these variants and to await additional information Key words:Histopathologic risk-factors, oral cavity, oropharynx, squamous cell carcinoma variants, keratinizing squamous cell carcinoma, nonkeratinizing squamous cell carcinoma, HPV, basaloid squamous cell carcinoma, undifferentiated carcinoma, papillary squamous cell carcinoma, small cell carcinoma.     

Squamous cell carcinoma antigen in oral squamous cell carcinomas

Squamous cell carcinoma (SCC) antigen is a tumor-associated antigen isolated from the squamous cell carcinoma of the uterine cervix. In order to estimate the usefulness of the SCC antigen in monitoring the clinical behaviors of oral squamous cell carcinomas, we analyzed clinicopathologically and immunohistochemically 54 cases of squamous cell carcinoma of the oral cavity. Elevated serum SCC antigen levels were detected in 23 (42.6%) out of 54 oral squamous cell carcinomas. The positive rate of serum SCC antigen levels was significantly higher in the patients with advanced clinical stages and poorly differentiated carcinoma. The serum levels declined rapidly after the surgical operation. It is considered that the serum SCC antigen levels could be useful in monitoring the extension, effectiveness of therapy, recurrence and metastases of the oral squamous cell carcinomas. Immunohistochemically, strong staining was seen in the cytoplasm of the well-differentiated carcinoma cells.     

Inverted papilloma of paranasal sinuses.

INTRODUCTION: Inverted papilloma (Schneiderian papilloma) is a primarily benign lesion that occurs in the nasal cavity and paranasal sinuses. Clinical problems include a tendency towards local destruction, recurrence and malignant transformation into squamous cell carcinoma. Hence, complete surgical removal is the therapy of choice and a meticulous follow-up is mandatory. STUDY DESIGN: This is a review including a short introduction to the different histological types of nasal papilloma, their pathogenesis and the clinical and histopathological diagnosis. Staging systems, therapeutic approaches, and surgical concepts are discussed. RESULT: The detection and definition of factors that allow a prognosis of recurrence or malignant transformation of inverted papilloma is an active field of research. The results of studies dealing with the definition of prognostic factors, that investigated immunohistochemical methods, virus detection, molecular genetics, and histomorphological studies are discussed including our own results on the prognostic value of histology. A concept for the diagnosis, management, therapy and follow-up of inverted papilloma is proposed.     

Lugol's iodine identifies synchronous invasive carcinoma—time for a clinical trial

Lugol's iodine is currently under investigation as a technique to detect dysplasia, carcinoma in situ and invasive carcinoma at resection margins, plus further afield.Lugol's iodine is inexpensive and easy to use. We present two cases where the technique revealed abnormal mucosa (one carcinoma, one squamous cell carcinoma in situ) at distant sites from the tumour being treated within oral cavity and oropharynx.     

口腔鳞癌患者血清催乳素的变化对预后的影响

目的 研究血清催乳素(PRL)水平的变化对口腔鳞癌患者预后的影响。方法 采用放射免疫分析(RIA)检测68例口腔鳞癌患者手术前后血清PRL水平的改变。结果 26例口腔鳞癌患者术前血清PRL水平升高(P<0.01);30例术后血清PRL值>17.1μg/L的患者中有28例术后发生复发或转移(P<0.01)。结论 血清PRL升高提示可能与口腔鳞癌的发生发展有关。     

Monoclonal antibodies against squamous cell carcinoma

We report on a monoclonal antibody reactive with squamous carcinoma cell lines and with frozen sections from squamous cell carcinomas of the oral cavity but not with frozen sections of normal squamous epithelium of the oral cavity, esophagus, and skin. In addition, we identified other monoclonal antibodies with restricted specificity as reflected by their binding to a panel of established tumor cell lines. Subsequent testing of these monoclonal antibodies against a panel of normal and tumor tissue sections revealed two types of reactivity patterns: binding to normal tissue and binding to normal and tumor tissue.     

血清SCC-Ag的变化对口腔鳞状细胞癌患者预后的影响

目的 研究血清鳞状细胞癌抗原(SCC-Ag)水平的变化对口腔鳞癌患者预后的影响。方法 采用ELISA检测了58例口腔鳞状细胞癌（鳞癌）患者手术前后血清SCC-Ag水平的改变。结果 术前及术后血清SCC-Ag值<1.5 μg/L的口腔鳞癌患者术后发生复发或转移发生率为15.6%和3.1%;术前和术后血清SCC-Ag水平>1.5 μg/L的口腔鳞癌患者术后发生复发或转移发生率为83.3%和95.5%;术前血清SCC-Ag水平>1.5 μg/L的口腔鳞癌患者术后血清SCC-Ag水平下降且SCC-Ag值<1.5 μg/L,其术后复发或转移发生率为25%。结论 血清SCC-Ag可能与口腔鳞癌的发生发展有关,其结果可作为判断患者病情的进展及肿瘤是否复发或转移。     

Prosthetic rehabilitation of a total rhinectomy patient resulting from squamous cell carcinoma of the nasal septum: a clinical report

The clinical characteristics and prosthetic rehabilitation of a patient with squamous cell carcinoma of the nasal septum after combined radiation therapy and a total rhinectomy is presented.     

Cardiac metastasis after squamous cell carcinoma of the oral cavity: case report

A 58-year-old woman presented with respiratory problems 6 months after she had had a squamous cell carcinoma in the oral cavity resected. We found on computed tomography a large lesion in the cardiac muscle. There were no abnormalities in the electrocardiogram. The patient died 7 days later and necropsy confirmed a solitary metastasis in the myocardium that originated from a squamous cell carcinoma of the mouth.     

Prosthetic rehabilitation of a patient after partial rhinectomy: a clinical report

Carcinoma of the nasal vestibule often requires radical surgical excision, which results in total or partial loss of the nose followed by radiation therapy. A noninvasive, cost-effective technique for rehabilitation of a patient with squamous cell carcinoma of the nasal vestibule following partial rhinectomy and radiation therapy using heat-polymerizing clear acrylic resin is presented.