A novel histological grading system for minor salivary gland involvement in oral submucous fibrosis patients with clinico-pathological validation.

BACKGROUND: The involvement of minor salivary glands (MSGs) with fibrosis in oral submucous fibrosis (OSMF) pathology is a quite conceivable fact. However, very little attention has been given to the status of MSGs in OSMF. METHODOLOGY: Total 53 cases of OSMF were recruited and demographic details, mouth opening, clinical oral dryness score (CODS), and buccal mucosal MSG flow rate were determined. The fibrosis around MSGs is categorized into three grades and compared with relevant clinicopathological parameters. RESULTS: Out of total 53 OSMF patients, there were 15 patients in grade I MSG involvement with fibrosis followed by 24 and 14 patients in grade II and grade III, respectively. Grade I MSG involvement showed maximum mouth opening (32 ± 3.87 mm) followed by Grade II (19.85 ± 4.31mm) and Grade III (11.42 ± 5.21mm) and the differences between them were statistically significant. The CODS score was more in grade III (5.5 ± 1.09 mm) as compared to Grade II (4.04 ± 0.62 mm) and Grade I (2.46 ± 0.74 mm) involvement of MSG. The flow rate was more in grade I (8.02 ± 2.99 mm) as compared to Grade II (3.97 ± 1.09 mm) and Grade III (3.4 ± 0.87 mm) involvement of MSG. CONCLUSION: The fibrosis associated with OSMF can affect the MSGs located at mucosal and sub-mucosal levels. The clinical determinants such as mouth opening, salivary flow rate, and CODS corroborate with the grading of the degree of MSG involvement with fibrosis.

Elevated tissue nitric oxide in oral squamous cell carcinoma.

CONTEXT: Nitric oxide (NO) is a diatomic molecule that has been implicated in tumor progression of oral squamous cell carcinoma (OSCC). However, the mechanism of NO affecting tumor growth and progression remains unknown. Tumor progression has been recently received considerable attention, and there is increasing evidence of correlation of tumor biology and behavior. AIMS: We aim to evaluate tissue NO of OSCC patients and correlate these findings with grade and stage of the OSCC patients. MATERIALS AND METHODS: To count tissue nitric oxide in normal and OSCC cases. To compare the findings of tissue nitric oxide between normal and OSCC cases. SUBJECTS AND METHODS: Forty-two fresh tissue specimens from the excisional biopsy of OSCC patients and 42 tissue samples of normal healthy mucosa using ultraviolet visible spectrophotometer. STATISTICAL ANALYSIS USED: Statistical analysis was done using Student's unpaired t-test and Tukey's post hoc analysis. RESULTS: Tissue NO level was higher in OSCC compared with control group (P < 0.01). There was an increase in NO levels with advanced clinical staging and with decreased differentiation of tumor. CONCLUSIONS: Increased tissue NO levels in OSCC patients along with an increase in the clinical stage of the tumor and decreased differentiation of tumor indicates the association of NO with tumor growth and with staging and grading of is well recognized.

Solitary Non Syndromic Oral Plexiform Neurofibroma: a Case Report and Review of Literature.

In oral cavity neurogenic tumors are rare, especially if they are malignant. Neurofibromas are the benign tumors of nerve sheath origin involving multiple nerve fascicles of the smaller branches of peripheral nerves. They may present as solitary lesions or as a part of generalized syndrome of neurofibromatosis also known as von Recklinghausen's disease (VRD) or very rarely as multiple neurofibromas without VRD. Oral solitary neurofibromas are not uncommon, but histologically plexiform variant is a rare form. This article describes a case of oral solitary plexiform neurofibroma with a review of literature.

Myoepithelial cell carcinoma of the oral cavity: A case report and review of literature.

Myoepithelial carcinoma (MC) is a malignant salivary gland neoplasm whose tumor cells demonstrate cytologic differentiation toward myoepithelial cells and lack ductal or acinar differentiation. It is a relatively rare tumor and many a times remains undiagnosed because of histopathological heterogeneity. It represents about 0.4-0.6% of all salivary gland tumors and 1.2-1.5% of carcinomas. It occurs predominantly in the parotid gland with a mean age of presentation being 55 years (range 14-86) with no sex predilection. MC appears to be a low grade malignancy when arising in a pleomorphic adenoma, but tends to be more aggressive and has a higher metastatic potential when arising de novo. The clinical behavior of MC is variable and there are no pathologic features that correlate with patients' outcome. Most tumors that display marked cytologic atypia, high mitotic activity and necrosis tend to behave aggressively. The current case is of a 42-year-old male with recurrent tumor mass in the mandibular right posterior region. The purpose of this article was to describe the clinicopathological and immunohistochemical features of intraoral MC and to discuss review of literature of this rare tumor.

Orthokeratinizing odontogenic cyst of maxilla with complex odontoma.

The orthokeratinized odontogenic cyst (OOC) and odontoma are the odontogenic cyst and tumor respectively that are minimally invasive neoplasms of head and neck region. OOC is a rare variant of odontogenic cyst characterized by the presence of excessive orthokeratin covering the cystic lining. Odontoma is a benign neoplasm/hamartoma often discovered accidently on panoramic radiographs. We came across a case of a 26-year-old male with swelling on his face along with difficulty in breathing. On the basis of radiographic and histopathological findings the final diagnosis of OOC associated with odontoma was given. However, there is no report in the English literature of the simultaneous occurrence of these two lesions and hence this case is very rare. It is unclear whether the two lesions were just coincidental or were actually related to each other.