Upregulation of circGDI2 inhibits tumorigenesis by stabilizing the expression of RNA m6A demethylase FTO in oral squamous cell carcinoma.

Background: Oral squamous cell carcinoma (OSCC) is a malignant tumour that is difficult to identify and prone to metastasis and invasion. Circular RNAs (circRNAs) are important cancer regulators and can be used as potential biomarkers. However, OSCC-related circRNAs need to be further explored. We investigated the role of circGDI2 in OSCC and explored its downstream regulatory mechanisms. Methods: Quantitative real-time PCR was used to detect the expression levels of circGDI2 and fat mass and obesity-associated protein (FTO) in cells. Lentiviral transfection was used to construct stable circGDI2 overexpressing cells for subsequent cell function tests. RNA pull-down, RNA Immunoprecipitation (RIP), western blotting, and protein stability assays were conducted to detect circGDI2 binding proteins and their functions. CCK8, Transwell, and wound healing assays were used to verify cell functions after overexpressing circGDI2 or suppressing FTO expression. Animal experiments were performed to verify the results in vivo. Results: The expression of circGDI2 was markedly decreased in both OSCC cell lines and patient tissues. Overexpression of circGDI2 in OSCC cell lines led to decreased proliferation, migration, and invasion abilities. Knockdown of circGDI2 showed the opposite trend. CircGDI2 has been validated to interact with the FTO protein within cells, as evidenced by mass spectrometry and RIP assays. This interaction was found to prevent the degradation of the FTO protein. Dot blot analysis showed a reduction in N6-methyladenosine (m6A) modification after circGDI2 overexpression. Reduced FTO levels reversed the inhibitory effects of circGDI2 overexpression on cell proliferation, migration, and invasion in vitro and on tumorigenesis in vivo. Conclusions: CircGDI2 functions as a tumour suppressor by binding to the FTO protein to reduce RNA m6A modification levels and ultimately inhibit proliferation and migration in OSCC cells. This study indicates the potential use of circGDI2 as a new target for the prevention and treatment of OSCC.

Hepatic squamous cell carcinoma initially presenting as cholecystitis misdiagnosed as cholangiocarcinoma: A case report.

Primary squamous cell carcinoma of the liver (PSCCL) is a rare intrahepatic primary tumor. Due to a lack of distinctive clinical presentations and radiological features, early diagnosis is challenging. The present study, describes a patient who initially presented with symptoms indicative of cholecystitis but was misdiagnosed with cholangiocarcinoma. It is hypothesized that fluctuations in carcinoembryonic antigen levels during laboratory tests can significantly aid the diagnosis, treatment and prognosis of tumors. Furthermore, imaging studies are essential for the early diagnosis of PSCCL and the exclusion of metastatic squamous cell carcinoma.

Visibility of esophageal squamous cell carcinoma under iodine staining on texture and color enhancement imaging.

Objective: Iodine staining on white light imaging (WLI) is the gold standard for detecting and demarcating esophageal squamous cell carcinoma (ESCC). We examined the effects of texture and color enhancement imaging (TXI) on improving the endoscopic visibility of ESCC under iodine staining. Methods: Twenty ESCC lesions that underwent endoscopic submucosal dissection were retrospectively included. The color difference between ESCC and the surrounding mucosa (ΔEe) on WLI, TXI, and narrow-band imaging was assessed, and ΔEe under 1% iodine staining on WLI and TXI. Furthermore, the visibility grade determined by endoscopists was evaluated on each imaging. Result: The median ΔEe was greater on TXI than on WLI (14.53 vs. 10.71, respectively; p < 0.005). Moreover, the median ΔEe on TXI under iodine staining was greater than the median ΔEe on TXI and narrow-band imaging (39.20 vs. 14.53 vs. 16.42, respectively; p < 0.005 for both). A positive correlation in ΔEe under iodine staining was found between TXI and WLI (correlation coefficient = 0.61, p < 0.01). Moreover, ΔEe under iodine staining on TXI in each lesion was greater than the corresponding ΔEe on WLI. The visibility grade assessed by endoscopists on TXI was also significantly greater than that on WLI under iodine staining (p < 0.01). Conclusions: The visibility of ESCC after iodine staining was greater on TXI than on WLI.

Comparative analyses of short- and long-term outcomes between endoscopic submucosal dissection and endoscopic laryngo-pharyngeal surgery for superficial pharyngeal carcinomas.

Objectives: Endoscopic treatment of superficial pharyngeal carcinomas includes endoscopic submucosal dissection (ESD; usually performed by endoscopists), and endoscopic laryngo-pharyngeal surgery (ELPS; primarily performed by otolaryngologists). Few studies have compared the efficacy of the two techniques in treating superficial pharyngeal carcinomas. In this study, we compared the outcomes of these two techniques to determine the advantages. Methods: We retrospectively examined the short- and long-term outcomes of 93 consecutive patients with superficial pharyngeal carcinoma who either underwent an ESD or ELPS between August 2008 and December 2021. Results: There were 35 lesions among 29 patients and 93 lesions among 71 patients in the ESD and ELPS groups, respectively. The ELPS group had a significantly shorter procedure time (121.2 ± 97.4 min vs. 54.7 ± 40.2 min, p<0.01), greater procedure speed (0.10 ± 0.06 min/min vs. 0.30 ± 0.23 min/min, p<0.01), and less laryngeal edema than that of the ESD group. There were no significant differences in the 3-year overall, relapse-free, or disease-specific survival rates between the two groups. Intervention with ESD during ELPS was most commonly required when it was difficult to secure the visual field. Conclusions: There were no differences in batch resection rates or long-term prognoses between the two groups; nevertheless, the ELPS group had a shorter treatment time and less laryngeal edema than the ESD group. However, the treatment of narrow areas, such as the esophageal inlet patch, is a technical limitation of ELPS; thus, ELPS should be combined with ESD techniques.

Anterior lamellar corneoscleral keratoplasty for the management of corneal thinning following treatment with mitomycin-C and interferon to treat highly suspected ocular surface squamous neoplasia: a case report

ABSTRACT A patient presented with corneoscleral thinning five months after the treatment of suspected ocular squamous surface neoplasia with mitomycin-C and interferon. For tectonic and aesthetic purposes, we decided to perform lamellar corneoscleral transplantation. The approach used established new tectonic support and corneal homeostasis. This technique might be an option in similar cases.

Identification of novel genetic variants associated with oral squamous cell carcinoma (OSCC) in South-West coast of India using targeted exome sequencing.

Oral squamous cell carcinoma (OSCC) is a subset of head and neck squamous cell carcinoma (HNSCC). This study explores the genetic landscape of oral squamous cell carcinoma (OSCC) in a cohort of 33 patients from Southern India using targeted exome sequencing. Our analysis revealed a diverse range of mutations across the cohort, with missense mutations being the most prevalent. Pathogenic mutations, as classified by ClinVar, exhibited significant individual variation, highlighting the heterogeneity of OSCC. Seventy-five genes were identified to harbor pathogenic or potentially pathogenic mutations, with notable recurrence in genes such as TP53, PDGFRA, and RAD50 among others. Comparison with high-frequency mutation genes in HNSCC from TCGA database revealed significant overlap, emphasizing the relevance of these mutations across different populations. Additionally, several novel mutations were identified, including those in CHD8, ITPKB, and HNF1A, shedding light on potential genetic risk factors specific to this population. Functional annotation and pathway analysis underscored the involvement of these mutated genes in various cancer-related pathways. Despite limitations such as sample size and the need for further validation, this study contributes to a deeper understanding of OSCC pathogenesis and highlights potential genetic markers for prognosis and targeted interventions, especially in the Indian context.

Induction Chemotherapy for Sinonasal Tumors in Patients Presenting with Brain Invasion and/or Neurological Deficits.

Objective The aim of this study was to investigate the safety of induction chemotherapy (IC) for patients with sinonasal malignancies with brain invasion or a neurological deficit. Methods We conducted a retrospective analysis of patients who underwent IC for sinonasal malignancies with intracranial invasion or a neurological deficit at a single tertiary cancer center from 1992 to 2020. Results In total, 460 patients with sinonasal malignancies were included in the study. Of the patients reviewed, 341 underwent IC and within this group 40 had brain invasion (BI) and 31 had a neurological deficit (ND) at presentation. The most prevalent malignancy was sinonasal undifferentiated carcinoma (BI 40%, ND 41.9%), followed by esthesioneuroblastoma (BI 27.5%, ND 9.7%). All tumors were stage T4 with the majority lacking nodal metastases (BI N0: 72.5%, ND N0: 77.5%). All patients completed at least two cycles of IC. Partial or complete response to IC was seen in 80% of BI and 71% of ND patients. No patients had cessation of treatment due to neurologic decline and none required urgent surgery. Five patients (12.5%) with BI and 2 (6.5%) with ND had interruption of IC for reasons other than neurological decline. In patients with ND, IC led to improvement of 54.5% NDs. Conclusion In patients with sinonasal malignancies with BI or ND who underwent IC, no patients had cessation of treatment due to neurologic decline. In contrast, most patients had improvement of neurologic symptoms with IC. IC was safely administered without interruption due to neurological decline or symptom progression.

Label-based comparative proteomics of oral mucosal tissue to understand progression of precancerous lesions to oral squamous cell carcinoma.

Introduction: Oral squamous cell carcinomas typically arise from precancerous lesions such as leukoplakia and erythroplakia. These lesions exhibit a range of histological changes from hyperplasia to dysplasia and carcinoma in situ, during their transformation to malignancy. The molecular mechanisms driving this multistage transition remain incompletely understood. To bridge this knowledge gap, our current study utilizes label based comparative proteomics to compare protein expression profiles across different histopathological grades of leukoplakia, erythroplakia, and oral squamous cell carcinoma samples, aiming to elucidate the molecular changes underlying lesion evolution. Methodology: An 8-plex iTRAQ proteomics of 4 biological replicates from 8 clinical phenotypes of leukoplakia and erythroplakia, with hyperplasia, mild dysplasia, moderate dysplasia; along with phenotypes of well differentiated squamous cell carcinoma and moderately differentiated squamous cell carcinoma was carried out using the Orbitrap Fusion Lumos mass spectrometer. Raw files were processed with Maxquant, and statistical analysis across groups was conducted using MetaboAnalyst. Statistical tools such as ANOVA, PLS-DA VIP scoring, and correlation analysis were employed to identify differentially expressed proteins that had a linear expression variation across phenotypes of hyperplasia to cancer. Validation was done using Bioinformatic tools such as ClueGO + Cluepedia plugin in Cytoscape to extract functional annotations from gene ontology and pathway databases. Results and discussion: A total of 2685 protein groups and 12,397 unique peptides were identified, and 61 proteins consistently exhibited valid reporter ion corrected intensities across all samples. Of these, 6 proteins showed linear varying expression across the analysed sample phenotypes. Collagen type VI alpha 2 chain (COL6A2), Fibrinogen ß chain (FGB), and Vimentin (VIM) were found to have increased linear expression across pre-cancer phenotypes of leukoplakia to cancer, while Annexin A7 (ANXA7) was seen to be having a linear decreasing expression. Collagen type VI alpha 2 chain (COL6A2) and Annexin A2 (ANXA2) had increased linear expression across precancer phenotypes of erythroplakia to cancer. The mass spectrometry proteomics data have been deposited to the ProteomeXchanger Consortium via the PRIDE partner repository with the data set identifier PXD054190. These differentially expressed proteins mediate cancer progression mainly through extracellular exosome; collagen-containing extracellular matrix, hemostasis, platelet aggregation, and cell adhesion molecule binding. Conclusion: Label-based proteomics is an ideal platform to study oral cancer progression. The differentially expressed proteins provide insights into the molecular mechanisms underlying the progression of oral premalignant lesions to malignant phenotypes. The study has translational value for early detection, risk stratification, and potential therapeutic targeting of oral premalignant lesions and in its prevention to malignant forms.

Subcutaneous Chest Wall Metastasis From Bladder Carcinoma Over the Totally Implantable Venous Access Port: A Rare Complication.

A totally implantable venous access port (TIVAP) plays a main role in delivering chemotherapy to patients with cancer. A 70-year-old woman with bladder carcinoma presented with a mass over a port chamber of a TIVAP site. CT studies showed a mass surrounding the catheter near the port reservoir attached to the chest wall. The port was removed and the mass was biopsied. The pathology from the biopsy showed squamous cell carcinoma (SCC) from bladder carcinoma. We present a rare occurrence of chest wall metastasis at the site of a venous access port from primary bladder carcinoma.

Primary Urachal Squamous Cell Carcinoma: A Case Report.

The urachus is a tubular vestigial remnant extending from the anterior dome of the bladder to the umbilicus. Carcinoma arising from it is uncommon but aggressive. Primary urachal carcinoma, an epithelial neoplasm, is one such abnormality which is rare and aggressive accounting for a very small portion of all bladder cancers. We herein present a case of a 48-year-old woman admitted with complaints of abdominal pain and abdominal mass. The mass was fixed to the anterior abdominal wall. A radiological investigation revealed a mass involving the midline of the anterior abdominal wall in the infraumbilical region with irregular margins along the course of the urachal ligament with surrounding fat stranding, suggesting a possibility of urachal malignancy with local extension. An ultrasound-guided core needle biopsy showed squamous cell carcinoma. The tumor was removed surgically. Further histological examination showed primary moderately differentiated squamous cell carcinoma of the urachus with metastasis to regional lymph nodes, extending into anterior abdominal muscles and up to the mucosa of the ileum. These findings correspond to the stage IVA of the Sheldon staging system for urachal carcinoma. Due to the rarity of urachal squamous cell carcinoma and limited research, definitive treatment guidelines are lacking. Current recommendations are based on small case series and lack a standardized staging system. Surgical intervention remains the cornerstone of treatment, often encompassing complete resection of the urachus, umbilicus, adjacent involved tissue with free margins, and potentially the bladder or regional lymph nodes to mitigate the risk of metastasis and local recurrence.

Metallophosphoesterase-Domain-Containing Protein 2 (MPPED2) Expression in High-Risk Human Papilloma Virus-Induced Cervical Carcinoma and Its Correlation With p16INK4A Protein.

Introduction Recently, the expression of metallophosphoesterase-domain-containing protein 2 (MPPED2) was identified in cervical cancer. However, its precise role and correlation with other tumor suppressor proteins, such as p16INK4A, is not well studied in high-risk human papillomavirus (HPV) integrated human cervical carcinoma. Hence, in the present study, we try to see the expression of MPPED2 in human cervical carcinoma and its correlation with age and p16INK4A protein expression level. Methods The prospective study consists of 200 samples of 150 known cervical carcinoma and 50 controls. Histopathological evaluation, immunohistochemical staining, and semi-quantitative scoring of the intensity of proteins were performed. Statistical analysis was performed with the Shapiro-Wilk test, Spearman's rho correlation sig. (two-tailed), and Student's t-test. Results The data show that among the 150 cases, 136 (68.0%) cervical carcinoma tissues express the presence of high-risk HPV viral genome integration in the host cell. The expression of p16INK4A protein is higher in those tissues identified with high-risk HPV viral genomes. In contrast, the expression of MPPED2 protein is lesser or absent in those cervical tissues that have the higher expression of p16INK4A protein and vice versa. There is a significant correlation (p=0.000) between age and p16INK4A protein expression but not with MPPED2. A significant linear correlation (p=0.000) is found between the p16INK4A and MPPED2 proteins. Conclusion It may support the therapeutic application of MPPED2 protein to prevent cervical carcinoma progression in the near future.

Development of diffuse cutaneous squamous cell carcinoma in situ after chemotherapy for ovarian carcinoma and remission with PD1-inhibitor.

This is a 74-year-old female, initially presenting with malignant pleural effusion, and evaluation revealed programmed cell death ligand 1 (PDL1)-positive stage IV high grade serous ovarian cancer. Following initiation of standard chemotherapy agents, carboplatin and paclitaxel, the patient developed a diffuse, itchy rash over her abdomen, back, and bilateral upper and lower extremities. Biopsy of the rash revealed a diffuse non-resectable cutaneous squamous cell skin carcinoma (cSCC) in situ. Consequently, a PD1-inhibitor was added to her neoadjuvant chemotherapy regimen, which resulted in complete response to both metastatic ovarian and diffuse cSCC in situ at time of surgery.

Global research trends in the treatment of squamous cell carcinoma over the past decade: A bibliometric analysis.

Objective: This study aims to identify research trends and hot spots in the treatment of Squamous Cell Carcinoma (SCC) over the past decade using bibliometric analysis. Methods: Data were extracted from the Web of Science Core Collection, including Science Citation Index Expanded (SCI-Expanded), Social Sciences Citation Index (SSCI), and Emerging Sources Citation Index (ESCI). The data underwent manual cleaning to remove inaccuracies and irrelevancies, followed by transformation into an analyzable format via the VOSviewer software. This tool facilitated the visualization of co-occurrence networks and keyword maps, highlighting the relationships and the prominence of research themes. Results: A total of 46448 authors from 7374 institutions across 108 countries contributed to the literature, reflecting a broad international effort. The study documented a consistent increase in SCC-related publications up to 2020, with some variability in subsequent years. Notably, the United States, Germany, China, the United Kingdom, and France were predominant in this research area. The University of Texas MD Anderson Cancer Center and the University of Pittsburgh were leading contributors in terms of publication volume and citation impact. Key journals included 'Oral Oncology' and 'Clinical Cancer Research', which were central to the dissemination of high-impact research. Our keyword analysis identified three major research clusters focused on molecular mechanisms, clinical treatment strategies, and emerging interests in immunotherapeutic approaches. Conclusions: The extensive collaboration and the increasing publication trend underscore the growing global commitment to advancing SCC treatment. The high level of engagement from top institutions and the concentration of research in influential journals reflect the field's dynamic evolution towards innovative and effective treatment modalities. This study provides a valuable overview for researchers, guiding future studies towards areas of high impact and emerging trends in SCC treatment. The findings advocate for enhanced focus on personalized medicine and combination therapies, which are poised to improve outcomes for SCC patients.

Margin-to-depth ratio as an independent prognostic factor in resected oral cavity squamous cell carcinoma: A nationwide cohort study.

BACKGROUND: The prognostic significance of margin-to-depth ratio (MDR) in oral cavity squamous cell carcinoma (OCSCC) remains unclear, particularly in comparison to traditional margin status. We aimed to examine the association between MDR and clinical outcomes in a large Taiwanese cohort. METHODS: A total of 18,324 patients with first primary OCSCC were categorized by margin status: positive (1013), <5 mm (8371), and ≥ 5 mm (8940). Disease-specific survival (DSS) and overall survival (OS) served as the main outcome measures. RESULTS: After excluding patients with positive margins (MDR = 0), the optimal MDR cutoff value for DSS and OS was 0.6. Patients with MDR > 0.6 showed significantly better 5-year DSS and OS rates (87 %, 81 %) compared to those with MDR ≤ 0.6 (71 %, 63 %) and MDR = 0 (53 %, 43 %). Multivariable analysis identified MDR ≤ 0.6 as independently associated with both DSS and OS in the entire cohort (hazard ratio [HR] = 1.34/1.32). This finding was consistent in the subgroups with surgical margins < 5 mm (HR = 1.39 for DSS and 1.38 for OS) and margins ≥ 5 mm (HR = 1.21 for both DSS and OS). In subgroups with surgical margins < 5 mm and ≥ 5 mm, an MDR > 0.6 was associated with better survival outcomes. CONCLUSIONS: An MDR (cutoff: 0.6) is independently associated with prognosis in OCSCC, offering improved risk stratification compared to margin status alone. While MDR may guide surgical margin modification, further research is needed to determine whether MDR could serve as a postoperative indicator for adjuvant therapy in patients with close or clear margins.

Exploring patient stratification in head and neck squamous cell carcinoma using machine learning techniques: Preliminary results.

BACKGROUND: Head and Neck Squamous Cell Carcinoma (HNSCC) presents a significant challenge in oncology due to its inherent heterogeneity. Traditional staging systems, such as TNM (Tumor, Node, Metastasis), provide limited information regarding patient outcomes and treatment responses. There is a need for a more robust system to improve patient stratification. METHOD: In this study, we utilized advanced statistical techniques to explore patient stratification beyond the limitations of TNM staging. A comprehensive dataset, including clinical, radiomic, genomic, and pathological data, was analyzed. The methodology involved correlation analysis of variable pairs and triples, followed by clustering techniques. RESULTS: The analysis revealed that HNSCC subpopulations exhibit distinct characteristics, which challenge the conventional one-size-fits-all approach. CONCLUSION: This study underscores the potential for personalized treatment strategies based on comprehensive patient profiling, offering a pathway towards more individualized therapeutic interventions.

Telaglenastat as an alternative to cisplatin as a radiosensitizer in the treatment of head and neck squamous cell carcinoma.

The efficacy of radiation treatment (RT) of head and neck squamous cell carcinoma (HNSCC) is limited by radioresistance and the toxicity of FDA approved radiosensitizers. In extension to our previous research where we demonstrated that telaglenastat (CB839) increased efficacy of RT in in vitro and in vivo HNSCC models, here, we examine the radiosensitizing effects of telaglenastat in comparison to cisplatin's, as cisplatin is currently the standard of care for concurrent therapy. Combination of telaglenastat with RT reduced tumor volume in a HNSCC patient derived xenograft mouse model. The efficacy of telaglenastat with RT in reducing cell survival and increasing apoptosis was similar if not greater than that of cisplatin with RT in Cal27 and HN5 HNSCC cells. The addition of telaglenastat increased reactive oxygen species and reduced the antioxidant glutathione in both Cal27 and HN5 cells. Reverse Phase Protein Array analyses revealed alterations in cell death and DNA damage response proteins. This study provides the scientific underpinnings for the use of telaglenastat as a radiosensitizer in the treatment of HNSCC either as an alternative to cisplatin or in cisplatin-ineligible patients.

WNT7B promotes cancer progression via WNT/ß-catenin signaling pathway and predicts a poor prognosis in oral squamous cell carcinoma.

BACKGROUND: WNT7B is a glycoprotein that plays a crucial role in tumorigenesis. This study aimed to investigate the role of WNT7B in oral squamous cell carcinoma (OSCC). METHODS: Bioinformatic databases, immunohistochemistry, a real-time polymerase chain reaction, western blot, and enzyme-linked immunosorbent assay were used to detect WNT7B expression in OSCC. The clinical and prognostic importance of WNT7B expression was evaluated. WNT7B expression was examined in oral leukoplakia and carcinoma induced by 4-nitroquinoline 1-oxide in mice. Loss- and gain-of-function analyses were performed to elucidate the role of WNT7B in OSCC cells. Subcutaneous tumor model was established to observe the effects of WNT7B on tumor growth. Co-Immunoprecipitation was used to explore the Frizzled receptors that WNT7B may bind to. RESULTS: WNT7B upregulated in OSCC and associated with lymph node metastasis, perineural invasion, and an unfavorable prognosis in patients with OSCC. A gradual increased in WNT7B expression during the malignant progression of OSCC. WNT7B promoted cell proliferation, migration, invasion, while silencing WNT7B abolished these effects. Knocking down the expression of WNT7B inhibits tumor growth in vivo. WNT7B functions by binding to the Frizzled 7 receptor and facilitates the nuclear translocation of ß-catenin. CONCLUSIONS: WNT7B contributes to the progression of OSCC by modulating the WNT/ß-catenin signaling pathway. These findings highlight the potential of WNT7B as a novel prognostic biomarker and promising therapeutic target for OSCC.

Artificial intelligence enhances the management of esophageal squamous cell carcinoma in the precision oncology era.

Esophageal squamous cell carcinoma (ESCC) is the most common histological type of esophageal cancer with a poor prognosis. Early diagnosis and prognosis assessment are crucial for improving the survival rate of ESCC patients. With the advancement of artificial intelligence (AI) technology and the proliferation of medical digital information, AI has demonstrated promising sensitivity and accuracy in assisting precise detection, treatment decision-making, and prognosis assessment of ESCC. It has become a unique opportunity to enhance comprehensive clinical management of ESCC in the era of precision oncology. This review examines how AI is applied to the diagnosis, treatment, and prognosis assessment of ESCC in the era of precision oncology, and analyzes the challenges and potential opportunities that AI faces in clinical translation. Through insights into future prospects, it is hoped that this review will contribute to the real-world application of AI in future clinical settings, ultimately alleviating the disease burden caused by ESCC.

Frederic Mohs: A Trailblazer in Dermatologic Surgery.

Frederic Mohs was an American physician and surgeon who revolutionized the treatment of skin cancer through the development of the Mohs micrographic surgery technique. Born in 1910, Mohs devised this innovative procedure while still a medical student, seeking a more effective method for removing skin cancers with minimal damage to surrounding healthy tissue. The technique, which involves the precise removal of cancerous tissue, layer by layer, while examining each under a microscope, allows for the highest possible cure rates and the preservation of as much healthy tissue as possible. Mohs' method has since become the gold standard in dermatologic surgery for certain types of skin cancer, significantly improving patient outcomes. His contributions have had a lasting impact on both the medical field and the lives of countless patients.

Poorly Differentiated Squamous Cell Carcinoma With Jaw Bone Osteomyelitis and Skin Perforation: A Report of a Rare Clinical Case.

Oral squamous cell carcinoma is a perpetual challenge for current clinicians and oral pathologists. In this case report, we present an unusual case of oral squamous cell carcinoma involving the left buccal mucosa with extensive bone exposure and skin perforation. It showed features of ulceration, necrosis, and maggot infestation. On histological examination, the malignant epithelial cells in the dense fibrous connective tissue stroma were keratinized, highly pleomorphic, had a high nucleo-cytoplasmic ratio, and were organized in sheets, cords, and nests. Decalcified tissue sections revealed the presence of necrotic bone. Immunohistochemistry indicated diffuse PanCK (cytokeratin) positivity confirming the epithelial origin of the malignant tumor cells. A final diagnosis of poorly differentiated squamous cell carcinoma (Bryne score 13/16) with chronic osteomyelitis and skin involvement was confirmed. Palliative care with supportive therapy was recommended. Hence, this case report emphasizes how critical it is to receive an early diagnosis and treatment to stop the disease progression, prevent the host's immune suppression, and improve the overall quality of life of the patient.