Infected lingual osseous choristoma : report of a case and review of the literature

Osseous choristoma is a rare, benign lesion of the oral cavity occurring usually in the tongue. It appears as a tumorous mass of normal bony structure with mature cells in an ectopic position. The case of a 72 years Caucasian male is presented and analyzed along with 52 similar cases reported in the English literature between 1967 and 2007. Lingual choristoma shows a female predilection, whereas the commonest anatomic location is the posterior third of the tongue, occurring at or close to the foramen caecum and the circumvallate papillae. Histologically the lesions show signs of a well-circumscribed mass of vital bone located under the surface oral epithelium. Some lesions represent developmental malformations, whereas others may be reactive lesions after trauma or chronic irritation. Treatment of lingual osseous choristoma consists of simple excision

Proliferation Index: A Continuous Model to Predict Prognosis in Patients with Tumours of the Ewing's Sarcoma Family

The prognostic value of proliferation index (PI) and apoptotic index (AI), caspase-8, -9 and -10 expression have been investigated in primary Ewing's sarcoma family of tumours (ESFT). Proliferating cells, detected by immunohistochemistry for Ki-67, were identified in 91% (91/100) of tumours with a median PI of 14 (range 0–87). Apoptotic cells, identified using the TUNEL assay, were detected in 96% (76/79) of ESFT; the median AI was 3 (range 0–33). Caspase-8 protein expression was negative (0) in 14% (11/79), low (1) in 33% (26/79), medium (2) in 38% (30/79) and high (3) in 15% (12/79) of tumours, caspase-9 expression was low (1) in 66% (39/59) and high (3) in 34% (20/59), and caspase-10 protein was low (1) in 37% (23/62) and negative (0) in 63% (39/62) of primary ESFT. There was no apparent relationship between caspase-8, -9 and -10 expression, PI and AI. PI was predictive of relapse-free survival (RFS; p = 0.011) and overall survival (OS; p = <0.001) in a continuous model, whereas AI did not predict outcome. Patients with tumours expressing low levels of caspase-9 protein had a trend towards a worse RFS than patients with tumours expressing higher levels of caspase-9 protein (p = 0.054, log rank test), although expression of caspases-8, -9 and/or -10 did not significantly predict RFS or OS. In a multivariate analysis model that included tumour site, tumour volume, the presence of metastatic disease at diagnosis, PI and AI, PI independently predicts OS (p = 0.003). Consistent with previous publications, patients with pelvic tumours had a significantly worse OS than patients with tumours at other sites (p = 0.028); patients with a pelvic tumour and a PI≥20 had a 6 fold-increased risk of death. These studies advocate the evaluation of PI in a risk model of outcome for patients with ESFT

Tumours of the head and neck in the elderly: analysis of 190 patients

Tumours of the head and neck represent approximately 5% of human neoplasms. More than 50% of the patients are above 65 years of age. During the years 1991-1996, 190 patients aged 65 or more and suffering from ore-facial neoplasms were treated in our department. They represent 48.6% of the total number of hospitalized tumour patients. One hundred and ten,were male and 80 female. Benign tumours were found in 42 patients whereas 148 patients presented with malignant tumours. Of the malignant tumours, squamous cell carcinoma occurred in 103 patients and salivary gland tumours were the most frequently encountered benign tumours (12 patients). All patients with benign tumours were treated surgically Of the 148 patients with malignant neoplasms, 116 were treated by surgery alone or in combination with radiotherapy and/or chemotherapy, and the remaining 32 with radiotherapy. Mortality from cancer was 28.1% and mortality from other causes was 5.8%. Postoperative morbidity in the benign tumour group of patients was minimal. In the malignant tumour group of patients, where the magnitude of surgical treatment was greater, there were no intraoperative or immediate postoperative deaths. Five patients died postoperatively whilst in hospital. Deaths were attributed to pre-existing medical problems. It is concluded that the age of the patient is not an important factor in determining the extent of surgical treatment in patients with tumours of the head and neck

Evaluation of caspase-3 and caspase-8 deregulation in tongue squamous cell carcinoma, based on immunohistochemistry and computerised image analysis

Aims: To investigate the potential role of caspase-3 and caspase-8 protein expression in the biological behaviour of tongue squamous cell carcinoma. Materials and methods: We conducted immunohistochemical analyses of 87 specimens of primary tongue squamous cell carcinoma, using monoclonal anti-caspase-3 and anti-caspase-8 antibodies. A digital image analysis assay was also performed in order to evaluate the results. Results: Reduced expression of caspase-8 and -3 proteins was observed in 30/87 (34.5 per cent) and 79/87 (90.5 per cent) cases, respectively. Cox regression analysis showed no prognostic significance for the association between overall protein expression of either marker and survival probability (p = 0.174 for caspase-3; p = 0.608 for caspase-8). Interestingly, the size of the examined tumours was strongly correlated with survival status (p = 0.024). Conclusions: Simultaneous deregulation of caspase-8 and -3 is a frequent event in tongue squamous cell carcinoma. Activation of caspase-3, which is predominantly down-regulated, may be a crucial process for induction of apoptosis and response to therapeutic strategies. © 2008 JLO (1984) Limited