Atypical intraosseous mucoepidermoid carcinoma with two years of evolution and cutaneous infiltration

The intraosseous mucoepidermoid carcinoma is a rare lesion that frequently affects the posterior region of the mandible. This case reports a multilocular osteolytic radiolucency with two years of evolution, that expanded and perforated the cortical bone, with irregular and indefinite margins, that extended from the mandibular angle to the ascendant ramus, with cutaneous ulceration, detected in a 51 years-old male. An incisional biopsy was performed and confirmed the diagnosis of low-grade intraosseous mucoepidermoid carcinoma. The patient was submitted to partial mandibulectomy, neck dissection and post-operative radiotherapy. In three years of follow-up, there was no evidence of tumor recurrence. This case report reinforces that even a low-grade intraosseous mandibular mucoepidermoid carcinoma tends to expand and to perforate the bone cortical, infiltrating to adjacent soft tissues, in long time of evolution

The relationship between ezrin and podoplanin expressions in keratocystic odontogenic tumors

Background\ud The aims of this study were to investigate the immunolocalization of ezrin and its relationship with the podoplanin expression in keratocystic odontogenic tumors.\ud \ud \ud Material and Methods\ud The immunohistochemical expressions of ezrin and podoplanin by odontogenic epithelium were evaluated in keratocystic odontogenic tumors using monoclonal antibodies.\ud \ud \ud Results\ud Our results showed strong cytoplasmic ezrin and membranous podoplanin expressions in basal epithelial layer of all keratocystic odontogenic tumors. The cytoplasmic and membranous ezrin expressions were also detected in suprabasal epithelial layers of tumors. Statistically significant difference between cellular immunolocalization of ezrin and podoplanin odontogenic epithelium were found by Wilcoxon’s test (p < 0.05). No correlation between both proteins in keratocystic odontogenic tumors was detected by Spearman test.\ud \ud \ud Conclusions\ud These results suggest that ezrin and podoplanin may contribute to the expansive growth and local invasiveness of keratocystic odontogenic tumors. Additionally, as both proteins were overexpressed by odontogenic epithelium, their possible roles need to be further explored in benign odontogenic tumors.Fundação de Amparo à Pesquisa do Estado de São Paulo [2012/13411-6; 2013/16999-7]Conselho Nacional de Desenvolvimento Científico e Tecnológic

MicroRNA expression in oral potentially malignant disorders and in lower lip cancer

Os miRNAs são pequenas moléculas não codificantes de RNA, cuja expressão desregulada vem sendo associada à progressão das lesões potencialmente malignas para o câncer de boca. O objetivo deste trabalho foi analisar a expressão dos miRNA-181b, miRNA-21, miRNA-31, e miRNA-345 nas queilites actínicas e nos carcinomas espinocelulares de lábio inferior, verificando se estes miRNAs podem ajudar a identificar o risco de transformação maligna e a evolução para o câncer. Foram selecionados, a partir de material emblocado em parafina, 19 queilites actínicas sem displasia epitelial, 32 queilites actínicas com displasia epitelial, 42 carcinomas espinocelulares de lábio inferior e 10 amostras de mucosa bucal com padrão de normalidade, provenientes da Faculdade de Medicina de Botucatu, UNESP e da Faculdade de Odontologia de Bauru, USP. A quantificação dos miRNAs nas amostras foi realizada por meio da reação de polimerase em cadeia, em tempo real (RT-PCR). A partir da diferença da expressão relativa de cada miRNA em relação ao epitélio labial normal, a expressão dos miRNAs foi classificada em aumentada, equivalente ou diminuída. A comparação quantitativa das expressões dos miRNAs analisados nas queilites actínicas com e sem displasia epitelial e nos carcinomas espinocelulares de lábio inferior, foi realizada pelo teste de Kruskal-Wallis, com nível de significância de 5%. Os resultados mostraram diferentes níveis de expressão dos miRNA-181b, miRNA-21, miRNA-31, e miRNA-345 no epitélio bucal das lesões investigadas. Houve uma expressão aumentada dos miRNA-181b, miRNA-31 e miRNA-345 na maioria das queilites actínicas sem displasia epitelial. Entretanto, nas queilites actínicas com displasia epitelial e nos CEC de lábio inferior, a expressão dos miRNA-181b, miRNA-31 e miRNA-345, foi equivalente àquela da mucosa bucal com padrão de normalidade. O aumento da expressão do miRNA-21 nos CEC de lábio inferior foi estatisticamente significativo (p=0,022) quando comparado às queilites actínicas com displasia epitelial. A partir desses resultados, conclui-se que os miRNA- 181b, miRNA-21, miRNA-31 e miRNA-345 são expressos no epitélio bucal da região de lábio e o aumento da expressão do miRNA-21 pode ajudar a identificar as queilites actínicas com displasia epitelial que apresentam um risco de evolução para o carcinoma espinocelular de lábio.Micro-RNAs (miRNAs) are small non-coding RNAs, which expression has been associated with the progression of oral potentially malignant disorders to oral cancer. The aim of this study was to analyze the expression of miR-181b, miR-21, miR-31 and miR-345 in actinic cheilitis and lower lip squamous cell carcinomas, and to verify if these miRNAs can be helpful to determine the risk of malignant progression to oral cancer. The sample was selected from formalin-fixed paraffin embedded tissues of 19 actinic cheilitis without epithelial dysplasia, 32 actinic cheilitis with epithelial dysplasia, 42 lower lip squamous cell carcinomas and 10 normal oral mucosa, from the Bauru School of Dentistry (USP) and from the Botucatu School of Medicine (UNESP). Micro-RNA expression was quantified by real time polymerase chain reaction (RT-PCR). The differences between the relative miRNA expression in the sample and in the normal lip epithelium were obtained and classified according to these values in up-regulated, equivalent or down-regulated. The expression of the selected miRNAs in actinic cheilitis, with and without epithelial dysplasia, and in lower lip squamous cell carcinomas was statistically compared by Kruskal-Wallis test and p values lower than 0.05 were considered statistically significant. The results showed that different levels of miR-181b, miR-21, miR-31, e miR-345 were detected in the oral epithelium of actinic cheilitis and lower lip squamous cell carcinomas. The miR-181b, miR-31 and miR-345 were upregulated in most of the actinic cheilitis without epithelial dysplasia. However, the expression of miR-181b, miR-31 and miR-345 in actinic cheilitis with epithelial dysplasia and in lower lip cancer was equivalent to the normal oral mucosa. Additionally, the increased expression of miR-21 in lower lip squamous cell carcinomas was statistically significant (p=0.022) when compared to actinic cheilitis with epithelial dysplasia. Based on our results, we concluded that miR-181b, miR-21, miR-31 and miR-345 are expressed in oral epithelium of the lip region and that the up-regulation of miR-21 can be helpful to identify patients with actinic cheilitis presenting epithelial dysplasia and higher risk of progression to lip cancer

A Rare Case of Intraductal Papilloma Arising from Minor Salivary Gland in the Floor of the Mouth

A 77-year-old woman with a rare oral intraductal papilloma arising from the minor salivary gland located on the floor of the mouth and causing the mucus retention is reported. Microscopically, the lesion was characterized by unicystic cavity exhibiting the lumen partially filled by papillary projections of the ductal epithelium with varying degree of oncocytic metaplasia. Based on the histopathological analysis, the differential diagnosis of oral intraductal papillomas and other ductal neoplasms of salivary origin are discussed

Tissue Eosinophilia and Its Association With Tumoral Invasion of Oral Cancer

This study investigated if tumor-associated tissue eosinophilia (TATE) could be associated with the process of tissue invasion in oral squamous cell carcinomas (OSCCs) and its influence on patient`s prognosis. Forty-three patients treated for OSCCs with or without lymph nodes involvement, at A. C. Camargo Cancer Hospital, Brazil, were selected for TATE analysis. Two degrees of tissue eosinophilia were established in OSCC: absent/mild and intense. The TATE was evaluated in relation to the clinicopathological features and prognostic value using chi(2) test and the Kaplan-Meier method. Most of the patients with OSCC in advanced clinical stage presented Muscular infiltration and significantly intense TATE whereas those with tumors in early stage frequently showed absent/mild eosinophilia (P = .009). The TATE showed no prognostic value for 5-year and 10-year survival rates of the OSCC. These findings suggest that intense TATE seems to reflect the stromal invasion of the OSCCs that occur in advanced clinical stage.FAPESP[2006/02532-6]CNPq (Conselho Nacional de Desenvolvimento Cientffico e Tecnologico, Brazil