Evaluation of the Ki-67 and MCM3 Expression in Cytologic Smear of Oral Squamous Cell Carcinoma

Statement of the Problem: Squamous cell carcinoma (SCC) is the most frequent oral cancer whose 5-year survival rate is 80% for early-detected lesions and nearly 30-50% for advanced lesions. Early detection of oral cancers and precancerous lesions can improve the patient’s survival and decrease the morbidity. Purpose: This study aimed to evaluate and compare the Ki-67 and MCM3 expression in cytologic smear of oral SCC (OSCC). Materials and Method: We examined 48 oral brush biopsies including 28 OSCC and 20 healthy non-smoking samples. Immunocytochemistry staining was performed for Ki-67 and MCM3 by using an EnVision-labeled peroxidase system, and labeling index (LI) was calculated. Results: Out of 28 OSCC cases, 27(96.4%) cases contained MCM3 positive cells and 22(78%) cases contained Ki-67 positive cells. All normal mucosa were Ki-67 and MCM3 negative. MCM3 and Ki-67 LI were significantly higher in OSCC than normal mucosa (p< 0.001). MCM3 LI was significantly higher than Ki-67 LI in OSCC group (p< 0.001). Conclusion: Immunocytologic evaluation of Ki-67 and MCM3 can be used for early detection of OSCC. Furthermore, MCM3 may be a more sensitive cytologic biomarker than Ki-67 in SCC patients

D-1 Gene Polymorphism in Salivary Gland Tumors

Objectives This study aimed to assess PD-1gene polymorphism in salivary gland tumors in patients referred to Khalili Hospital in Shiraz. Methods This case-control study evaluated 48 patients with salivary gland tumors and 100 age- and sex-matched healthy controls. First, 5cc blood samples were obtained from patients and transferred to vials containing anti-coagulated EDTA. DNA was extracted, and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was performed on the samples. The PD-1 gene genotype was determined using the Fermentas kit. After 24 hours of incubation, all the samples were electrophoresed. The genotypes were reported based on the size of bands, and the chi-square test was applied. To compare the alleles, the Fisher’s Exact test was applied. The Yates correction was used to compare the genotype and genotypic alleles based on the tumor grade. Results The mean age was 44.81±15.69 years in patients and 46.54± 13.86 years in controls. Statistical analysis did not show any significant difference in PD1 gene polymorphism between the two groups (P=0.098). No significant correlation was found between the genotype frequency and lymph node involvement (P=0.06), tumor genotype (P=0.12), side (right or left) (P=0.22), tumor location (P=0.27), and size or invasion of the tumor to the surrounding tissue (P=0.14). PD1.3 genotype frequency did not differ significantly between malignant and benign tumors (P=0.6). Conclusion This study did not reveal any significant difference in genotype frequency of PD1.3 in the patient and control groups; however, further studies are needed with a larger sample size to obtain more accurate results

Salivary Gland Tumors in Maxillofacial Region: A Retrospective Study of 130 Cases in a Southern Iranian Population

Tumors of the salivary glands are uncommon head and neck neoplasia. We conducted a retrospective study of 392 cases over the last 6 years in Shiraz, south of Iran, to investigate the clinicopathological features of these tumors in Iranian population. The age of the patients ranged from 8 to 85 years, with the mean age 44.57 ± 14.65 years and male-to-female (M : F) ratio was 1.02 : 1. For benign tumors, there was a propensity towards females, whereas the malignant tumor was more common in males. The ratio of benign tumors to malignancies was 2.19 : 1. Pleomorphic adenoma (PA) was the most common tumor and accounted for 85% of all benign tumors, followed by Warthin's tumor (8.6%). Of the 125 malignancies, adenoid cystic carcinoma (40%), mucoepidermoid carcinoma (24%) and invasive squamous cell carcinoma (16%) were the most common histological types. Most of the salivary gland tumors (75%) originated from major salivary glands and the remained (25%) originated from minor glands. The parotid gland was the most common site both in benign and malignant tumors. Most of our findings were similar to those in the literature, with some variations. The salivary tumors slightly predominated in males. Adenoid cystic carcinoma and mucoepidermoid carcinoma constituted the most common malignancies

Solitary Osseous Plasmacytoma of the Head and Neck

Purpose: This study aimed to report the characteristics and treatment outcome of 8 patients with solitary osseous plasmacytoma of the head and neck with special focus on mandibular plasmacytoma.Materials and Methods: The study was conducted on 8 patients with solitary osseous plasmacytoma of the head and neck who were treated at two academic tertiary referral hospitals between 1999 and 2010. All the patients were treated with curative intent. Four patients (50%) were primarily treated with radiotherapy alone at initial diagnosis, one patient (12.5%) underwent surgery alone, and 3 patients (37.5%) were treated with gross tumor resection followed by radiotherapy. The median total radiation dose was 46 (range 30-50) GY.Results: There were 4 women and 4 men aging from 37 to 73 years, with a median and mean age of 52 years at diagnosis. Pain (in 7 cases) and swelling (in 5 cases) were the most common presentations. Mandible (in 4 cases) was the most frequent primary site. The median tumor size was 4.8 (range 3.5-6) cm. After a median follow-up of 44 months (range 27-79 months), 5 patients are alive and without disease, one is alive with multiple myeloma, and two died of multiple myeloma.Conclusion: Solitary osseous plasmacytomas of the head and neck have a propensity to involve the mandibular bones and response well to effective local treatments of radiotherapy and/or surgery. These Patients tend to progress to multiple myeloma even years after the initial treatment

T-helper Type 1 and 2 Cytokine Levels in Patients with Benign and Malignant Salivary Gland Tumors

ABSTRACT Background: Salivary gland tumors are among malignancies that have high recurrence rate. Immune responses in salivary gland tumors have not been well elucidated. T helper type 1 (Th1) and Th2 cytokines have been reported to play a role in the outcome of head and neck cancers. Objective: To evaluate the serum levels of interferon gamma (IFN-γ), as the hallmark of Th1 cytokines, and interleukin-4 (IL-4), as the hallmark of Th2 cytokines, in patients with benign and malignant salivary gland tumors in comparison with healthy controls. Methods: Fifty patients with benign and 14 patients with malignant salivary gland tumors, as well as 23 healthy individuals were recruited. Serum levels of IFN-γ and IL-4 were measured using ELISA method. Nonparametric tests were used for data analysis. Results: Serum levels of IFN-γ and IL-4 were found not to be significantly different in patients compared to the control group (0.68 ± 0.29 vs. 1.03 ± 0.57 pg/ml, p=0.58 for IFN-γ, 4.57 ± 1.57 vs. 4.41 ± 1.31 pg/ml, p=0.28 for IL-4). IFN-γ and IL-4 serum levels were also not significantly different between patients with benign and malignant salivary gland tumors (p=0.54 and p=0.86, respectively). Conclusion: The systemic levels of IL-4 and IFN-γ seem not to be associated with salivary gland tumor in our study. Investigation of other cytokines produced by Th1 and Th2 cells are warranted

Diagnosis of pleomorphic adenoma in a heterotopic salivary gland: a case report

Background: The histologic diversity encountered in pleomorphic adenoma may cause diagnostic difficulty in fine needle aspiration cytology (FNA) due to limited and selective sampling. Case A 40-year-old woman presented with a mass in the anterior aspect of the neck along the sternocleidomastoid muscle. FNA revealed a cellular tumor with a chondrimyxoid background and epithelial cells intermingled with a few mesenchymal cells. The diagnosis of pleomorphic adenoma was confirmed on histopathology. Conclusion: Primary ectopic pleomorphic adenoma can confidently be diagnosed by FNA. This technique is a useful tool in the initial assessment of the tumor

Osteopetrosis Complicated by Maxillary Osteomyelitis: A Case Report

Introduction: Maxillary osteomyelitis is a rare phenomenon. If it occurs, evaluation for underlying disease especially osteopetrosis must be considered. Osteomyelitis occurs as a complication in 10% of the cases of osteopetrosis. Case report: This is a case report of maxillary osteomyelitis presented in a 15-year old boy with osteopetrosis.  In this case, the disease represented mainly with facial pain and swelling and also drainage from facial skin fistulas in bilateraral infraorbital area and lower eyelids. Diagnosis was confirmed by clinical and radiological findings. Treatment consisted of surgical debridment and intravenous antibiotic therapy which led to partial response. Conclusion: Maxillary osteomyelitis is a rare phenomenon. If it occurs, evaluation for underlying disease especially osteopetrosis must be considered

Non-Hodgkin's Lymphoma of the Tongue Presenting as an Ulcerative Lesion

Malignant lymphoma may occur in the oral cavity and oropharynx, but is most commonly located in Waldeyer's ring, particularly in the palatine and lingual tonsil. The occurrence of malignant lymphoma in the tongue is very rare. Clinical features are nonspecific ulcerative lesions that do not heal. In the literature, the majority of casesare non-Hodgkin’s lymphoma, diffuse large B cell type; however T-cell phenotype also may occur. We describe a 60-year-old man who presented with an ulcerative mass in the left lateral aspect of his tongue, unresponsive to medical therapy. After tissue biopsy, histopathological and immunohistochemical analyses confirmed a diagnosis of non-Hodgkin’s lymphoma, diffuse large B cell type

Soluble HER-2 in Patients with Head and Neck Squamous Cell Carcinoma

Introduction: The presence of HER-2 has been shown to be a prognostic factor in many kinds of cancers, but its role in head and neck squamous cell carcinoma (HNSCC) is not still defined. The purpose of the current study is to investigate the role of HER-2 in HNSCC and its correlation with various clinicopathologic parameters.   Materials and Methods: Peripheral blood samples were obtained from 17 healthy volunteers and 69 patients with HNSCC before curative surgery. The HER-2 level was determined in each sample by sandwich ELISA. Statistical analysis was performed using an independent t-test, one-way ANOVA, and Mann-Whitney Test.   Results: Mean HER-2 serum levels in patients with HNSCC compared with healthy controls was not statistically significant (3.85ng/ml vs. 3.75ng/ml; P>0.05). The mean serum level of HER-2 was higher in patients with lymph node involvement, metastasis, invasion, tumor size ≥2 cm, and stage>1, although the differences were not statistically significant (P>0.05).   Discussion: Mean HER-2 serum levels in patients with tumor size T3 and higher were greater than those from patients in stage T1 and T2, a finding which may be translated into disease progression, growth and invasiveness.  Conclusion: In this study the mean HER-2 serum level in patients with HNSCC was found statistically insignificant compared with the healthy control group. The role of soluble HER-2 as a tumor marker is still controversial and needs further studies to clarify its clinical  relevance for early detection or screening for HNSCC

Melanoma primário de mucosa do trato nasossinusal: relato de 18 pacientes e análise de 1077 pacientes na literatura Primary mucosal melanoma of the sinonasal tract: report of 18 patients and analysis of 1077 patients in the literature

O presente estudo tem por objetivo relatar as características, fatores prognósticos e desfecho de tratamento de 18 casos de melanoma da mucosa nasossinusal e conduzir uma revisão da literatura. MÉTODO: Entre 1995 e 2005, 18 pacientes consecutivos diagnosticados com melanoma da mucosa do trato nasossinusal e tratados em nossa instituição. Para encontrar as principais casuísticas de estudos relacionados, conduzimos uma revisão da literatura em PubMed e Scopus. No total, encontramos 35 casuísticas, incluindo 1.077 pacientes com melanoma da mucosa nasossinusal. RESULTADOS: Encontramos 16 homens e 2 mulheres. A idade de apresentação foi 51-80 anos (mediana de 58 anos). Todos os pacientes sofreram excisão cirúrgica seguida de radioterapia com ou sem quimioterapia. A mediana de sobrevida foi de 15 meses e a sobrevida geral de 5 anos foi de 23%. Sob análise univariada, estadiamento e remissão completa após tratamento inicial foram importantes fatores prognósticos. Entretanto, sob análise multivariada, somente estágio da doença teve significância estatística. CONCLUSÃO: Melanoma nasossinusal é um tumor raro e agressivo com alto fracasso locorregional e distante e pobre desfecho de tratamento. Entretanto, em uma revisão da literatura, encontramos significativa melhora em termos de sobrevida de 5 anos para casuísticas recentes comparadas com casuísticas previamente relatadas.The present study aimed at reporting on the characteristics, prognostic factors and treatment outcomes of 18 cases of nasosinusal mucosa melanoma, and do a literature review on the subject. METHODS: between 1995 and 2005, 18 patients consecutively diagnosed with nasosinusal mucosa melanoma were managed in our institution. We reviewed the literature in PubMed and Scopus in order to find the main series from studies associated with this topic. We found a total of 35 series, involving 1,077 patients with nasosinusal mucosa melanoma. RESULTS: we found 16 men and 2 women, with age at presentation between 51 and 80 years (median of 58 years). All these patients were submitted to surgical excision followed by radiotherapy with or without chemotherapy. The survival median was 15 months, and the 5-year general survival had a percentage value of 23%. Considering our univariate analysis: tumor staging and complete remission after initial treatment were deemed relevant prognostic factors. Nonetheless, considering the multivariate analysis, only disease stage was statistically significant. CONCLUSION: nasosinusal melanoma is a rare and aggressive tumor, with high loco-regional and distant failure rates, and poor treatment outcomes. Notwithstanding, in a literature review we found significant improvements considering the 5-year survival for recent series when compared to previously reported ones