Evidence of field cancerization of oral squamous cell carcinoma: a case report

Objectives. From 1953 (1) the term “field cancerization” has been used to describe an “increased risk of cancer de- velopment in the entire upper aerodigestive tract due to multiple genetic abnormalities in the whole region after pro- longed exposure to carcinogen” (2). This phenomenon implies the occurrence of multiple primary tumors/potentially malignant disorders as results of cell-molecular aberrations in different independent sites (polyclonal theory) or from the same site through widespread expansion or later spread across the mucosa (monoclonal theory). Case report. A 63-year-old female patient referred in June of 2014 for exophytic/ulcerative lesion in the hard palate. At the same time, several teeth (1.5, 1.6 and 3.6) with poor prognosis and an incisional biopsy were per- formed. The histological examination reported a diagnosis of oral squamous cell carcinoma (G1) and the manage- ment (imaging and TNM staging) was scheduled. Unfortunately, 30 days after exodontia, one of alveolar sites (3.6) showed proliferative tissue and not healing. A new biopsy was carried out, revealing an histological diagnosis of “epithelium with marked parakeratosis, acanthosis and papillomatosis associated with areas of moderate dys- plasia (IIC: PanCK)”. Conclusions. The features described in different areas of the oral cavity led us to make a diagnosis of oral field can- cerization. This condition still must be analyzed in order to clarify the onset and development but, most importantly, a protocol for manage these patients have to be developed. Chemoprevention and cessation of smoking and alcohol may impact new tumors. Amelioration of surgery, radiotherapy, chemotherapy and gene therapy may influence the morbidity and mortality of oral cancer patients, even if a short follow up and the secondary prevention may warrant a life-long surveillance

The surgical treatment of mandibular peripheral calcifying epithelial odontogenic tumour (pindborg tumor) with Er,Cr:YSGG laser: a case report.\u201d

The aim of this case report was to propose a new treatment modality of peripheral calcifying epithelial odontogenic tumour (CEOT) using Er, Cr: YSGG laser

PRIMARY ORAL MUCOSA MELANOMA: A REPORT OF AN UNUSUAL CLINICOPATHOLOGICAL CASE

Primary oral melanoma is a rare malignancy with an aggressive behaviour. Up to date, the wide clinicalhistological variability of this oncological entity does not clarify the etiopathogenetic characteristics of these cancers and limit the therapeutic strategies. We report a case of a 64-year-old white female referred to the Dept. of Surgical, Oncological and Oral Sciences for a pigmented lesion of the mandibular gingiva, already arising 20 years ago but dimensionally increased in the last three months. Clinically, a black plaque-like pigmentation of the vestibular alveolar mucosa of the mandible (from 3.6 to 3.3) was observed. This lesions was still painless. CT dentalscan and ecography of the head and neck lymph nodes have showed no signs of bone and lymph nodes involvement. An incisional biopsy of the lesion was performed under local anaesthesia. Histopathologic examination showed a nodular proliferation of atypical melanocytic elements with epithelioid aspect and nuclear alterations; numerous abnormal mitotic figures were evident and the malignant melanocytes were characterized by marked intra/extracellular pigmentation. Immunohistochemical staining showed strong and diffuse positivity for Melan A and HMB45, 40% positive for Ki67 and positive/negative result for p16. These histopathologic features were suggestive for animal-type invasive melanoma. After diagnosis, the patient was referred to the Dept. of Head and Neck Surgery for staging and chirurgical approach of the lesion. At the best of our knowledge, only a very small number of animal-type melanomas have been reported in the oral cavity and usually with a more indolent behavior than conventional melanoma and a better prognosis. However, future reports are necessary to characterize the features of this cancer and to determine any factors that may correlate with outcome

Temporomandibular disorders and oral features in idiopathic inflammatory myopathies (Iims) patients: An observational study

Aim: Inflammatory idiopathic myopathies (IIMs) are inflammatory processes affecting skeletal musculature and extramuscular organs. Temporomandibular disorders (TMD) involve jaw muscles and temporomandibular joint. The aim of this observational study was to investigate the prevalence of the main TMD symptoms and signs as well as oral implications in IIM patients. Methods: The study group included 54 patients (42 women and 12 men), 22 of whom affected by dermatomyositis (DM), 29 by polymyositis (PM) and 3 by inclusion body myositis (IBM). A group of 54 patients not affected by this disease, served as CG. Oral and TMD signs and symptoms were evaluated by means of a questionnaire and through clinical examination. Results: About oral symptoms, the study group complained more frequently dysgeusia, with loss of taste or unpleasant taste (p<0.0001) and feeling of burning mouth (9.4% versus 0 controls). Xerostomia was more prevalent in the study group respect to the CG (p<0.0001). Dysphagia was reported by 48.1% of IIM patients while was absent in CG (p<0.0001). About oral signs, cheilitis (p<0.05) and oral ulcers (p<0.05) were significantly more frequent in CG. As regard to TMD symptoms, arthralgia and tinnitus didn’t showed significant differences between the two groups, while neck/shoulders and masticatory muscle pain was significantly more referred in IIM patients than in the CG (p<0.05). About TMJ signs, sounds were overlapping in the two groups: click=11.1% in both IIM patients and CG (p<0.05), crepitation in 11.1% of IIM and 9.3% of controls (p>0.05). No significant difference was detected about deflection (9.3%, p>0.05), while deviation was wider in CG (p>0.05). Active opening and lateralities showed no significant differences, while endfeel was significantly increased in IIM group for a higher presence of muscular contracture. Bruxism was present only in CG. Conclusion: The data collected from this observational study seem to support the existence of a relationship between the prevalence of TMD symptoms and signs as well as oral features in patients with myositis. A remarkable reduction of salivary flow and dysphagia were more frequent and severe in IIM patients, as well as muscle contracture and myofacial pain evoked by palpation, this result being highly significant

The Role of Spatial Exploration and Territoriality in Establishing Gilthead Seabream (Sparus aurata) Hierarchies, and Their Effects upon Underlying Stress Physiology

Territoriality, spatial exploration and social hierarchy are strictly related behaviors in gregarious fishes, and are often under-appreciated in farms where the individuals are confined within crowded spaces. In this study, we investigated the role of spatial exploration, elucidating the importance of time upon forming the social organization, and the role of the territoriality in gilthead seabream (Sparus aurata), using two experimental approaches. In the first approach, three fish were placed sequentially in the aquarium with an interval of two days (sequential model), while in the second (simultaneous model), two fish were simultaneously placed in an aquarium divided by a barrier which was removed after a certain period of time. To study the effect of social stress and spatial perception in the two models, we monitored behavior (aggressive acts and feeding priority), integrated with the evaluation of physiological and cellular stress parameters, such as phagocytosis, cortisol, glucose, and blood osmolarity levels. After the establishment of the social hierarchy in the "sequential model", we observed that the levels of cortisol and an immunological cell-mediated marker were higher in subordinate individuals than in the dominant ones. We observed a different modulation of phagocytic activity in peritoneal cavity cells between dominant and subordinates, demonstrating that social stress acts upon immune response. Differently from the first model, no behavioral, physiological, or phagocytic differences were found between the two fish involved in the simultaneous model, where both fish acted as co-dominants, defending their territory. The study achieved a deeper understanding of the role of spatial exploration, territorial dominance and intraspecific interaction in gilthead seabream, and elucidated the link between them and physiological stress indicators. The results highlight aspects of interest to the aquaculture industry, showing the importance of a greater focus on rearing conditions, finding solutions to mitigate crowding effects and promoting the quality of aquacultural products

Drag forces at the ice-sheet bed and resistance of hard-rock obstacles:The physics of glacial ripping

Glacial ripping involves glaciotectonic disintegration of rock hills and extensive removal of rock at the ice-sheet bed, triggered by hydraulic jacking caused by fluctuating water pressures. Evidence from eastern Sweden shows that glacial ripping caused significant subglacial erosion during the final deglaciation of the Fennoscandian ice sheet, distinct from abrasion and plucking (quarrying). Here we analyse the ice drag forces exerted onto rock obstacles at the base of an ice sheet, and the resisting forces of such rock obstacles: glaciotectonic disintegration requires that ice drag forces exceed the resisting forces of the rock obstacle. We consider rock obstacles of different sizes, shapes and fracture patterns, informed by natural examples from eastern Sweden. Our analysis shows that limited overpressure events, unfavourable fracture patterns, low-Transmissivity fractures, slow ice and streamlined rock hamper rock hill disintegration. Conversely, under fast ice flow and fluctuating water pressures, disintegration is possible if the rock hill contains subhorizontal, transmissive fractures. Rock steps on previously smooth, abraded surfaces, caused by hydraulic jacking, also enhance drag forces and can cause disintegration of a rock hill. Glacial ripping is a physically plausible erosion mechanism, under realistic glaciological conditions prevalent near ice margins.</p