Oral carcinoma after hematopoietic stem cell transplantation – a new classification based on a literature review over 30 years

BACKGROUND: Patients undergoing hematopoietic stem cell transplantation (HSCT) have a higher risk of developing secondary solid tumors, in particular squamous cell carcinoma, because of several risk factors, including full-body irradiation (TBI), chemotherapy, and chronic graft versus host disease (GVHD). Based on the review presented here, a classification of oral changes is suggested in order to provide a tool to detect high-risk patients. Methods and Results The literature over the last 30 years was reviewed for development of malignoma of the oral cavity after HSCT. Overall, 64 cases were found. In 16 out of 30 cases, the tongue was the primary location, followed by the salivary gland (10 out of 30); 56.4% appeared in a latency time of 5 to 9 years after HSCT. In 76.6%, GVHD was noticed before the occurrence of oral malignancy. Premalignant changes of the oral mucosa were mucositis, xerostomia, and lichenoid changes, developing into erosive form. CONCLUSION: All physicians involved in the treatment of post-HSCT patients should be aware of the increased risk, even after 5 years from the development of oral malignancy, in particular when oral graft versus host changes are visible. In order to develop evidence management and to detect and offer adequate therapy as early as possible in this patient group, multicenter studies, involving oncologists and head and neck surgeons, should be established

Oligonucleotide microarray analysis of ameloblastoma compared with dentigerous cyst.

Background: Ameloblastoma is a benign, but locally invasive tumor known for its high rate of recurrence. However, few comprehensive genetic studies have been conducted about its tumorigenesis. Our aim was to identify possible genes involved in the development and progression of ameloblastoma, using microarray analysis with dentigerous cyst as a control. Methods: Total RNA was extracted from two fresh dentigerous cysts and ameloblastoma specimens. Following microarray analysis, semiquantitative reverse transcription–polymerase chain reaction (RT–PCR) and immunohistochemistry were performed on selected genes. Results: Seventy-three genes were overexpressed and 49 were underexpressed. These genes were divided into categories according to function. The microarray results for 13 selected genes were verified with semiquantitative RT–PCR. Conclusions: We identified important genes related to the development and progression of ameloblastoma through a large-scale gene expression analysis. This study will stimulate further investigations on genes significant for early diagnosis and prognosis of ameloblastoma