Appearances can be deceptive - Innocuous swelling on the gingiva masking an aggressive lesion within the maxilla.

The central giant cell granuloma displays a varied biologic behaviour ranging from simple reactive lesions to aggressive neoplasms. The pathogenicity still remains enigmatic and needs to be differentiated from other giant cell containing lesions. Both maxilla and mandible are affected and 80% involve the region anterior to the first premolar region. CGCL arises centrally within bone, whereas PGCG is a gingival soft tissue lesion. Clinical and radiographic correlation is required to rule out a peripheral giant cell granuloma. The case described here was a rare presentation of a large epulis clinically with involvement of maxilla radiographically and was histologically diagnosed as a central giant cell lesion.

Comparative evaluation of quality of life in oral cancer patients undergoing 3-dimensional conformal radiation therapy with or without concomitant chemotherapy - A longitudinal study.

OBJECTIVES: To assess and compare the quality of life (QOL) in Oral Cancer patients undergoing 3-DCRT with or without concomitant Chemotherapy at three different time intervals. MATERIALS AND METHODS: This unicentric longitudinal study included 50 patients of oral cancer undergoing 3-DCRT with or without concomitant chemotherapy. QOL was recorded using the EORTC H and N 35 Questionnaire at baseline, end of treatment (EOT), and 3 months after treatment. RESULTS: Maximum deterioration of most QOL domains were noted at End of treatment (EOT) in all the patients. A highly statistically significant difference was noted between different time intervals with the highest scores noted at the EOT ( P < 0.01). There was a statistically significant difference in patients undergoing 3DCRT with chemotherapy when compared to those with 3DCRT without chemotherapy ( P < 0.05). CONCLUSION: There is substantial deterioration in QOL at the EOT after head-neck irradiation by 3-DCRT with or without concomitant Chemotherapy although it gradually improves over time. However, 3DCRT results in clinically meaningful and statistically better QOL scores at 3 months after treatment compared to baseline and EOT.

Basal cell adenoma of the floor of the mouth masquerading as ranula- A rare case in an unusual location.

A 65-year-old female patient with a history of wearing a denture for 15 years reported with a complaint of pain in the floor of the mouth. On examination, a swelling measuring about 2.2 X1.2 cms was noted in the floor of the mouth on the left side. The lesion was excised under local anesthesia. Histopathology revealed a cystic lesion with basaloid cells arranged in tubules, nests and cribriform pattern. A diagnosis of basal cell adenoma was made and confirmed by immunohistochemistry. We report a rare case of Basal Cell Adenoma of the floor of the mouth which mimicked a ranula. The predominantly cystic nature of this basaloid tumor posed a diagnostic challenge. Histopathological and immunohistochemical analysis to arrive at a definitive diagnosis aid in treatment planning and prognostication.

Oral pulse granuloma associated with ameloblastoma: Report of a case and review of literature.

Oral pulse granuloma (PG) is a rare lesion that presents as a foreign body granulomatous reaction to implanted food particles of plant or vegetable origin. It is classified as a central or a peripheral lesion depending on the location. Rarely, a central oral PG may be associated with a cyst or tumor, thus leading to a deceptive histopathological picture. This is exemplified in the present case of 27-year-old female patient who reported with a swelling on the left posterior region of mandible which was diagnosed as ameloblastoma. The excisional specimen depicted a varied histopathological picture showing follicular ameloblastoma and foreign body granulomas associated with hyaline rings. Based on histopathological, histochemical and polarized microscopy findings; these hyaline rings were diagnosed to be remnants of a plant cell/legume. The aim of this article was to present a case of PG associated with ameloblastoma and discuss its histochemical and polarizing microscopic features.

Estimation of salivary sialic acid in oral premalignancy and oral squamous cell carcinoma.

AIMS: Oral cancer is the most life-threatening disease of oral tissues. In societies where the incidence of oral cancer is high, clinically recognizable premalignant lesions are particularly common. Diagnosing oral cancers at an early stage is critical in improving the survival rate and reducing the morbidity associated with the disease. Alterations in the sialic acid levels in cancer patients have stimulated interest in this sugar residue as a possible tumor marker. SETTINGS AND DESIGN: The purpose of this study was to estimate the salivary sialic acid levels in patients with oral premalignancy and squamous cell carcinoma and to correlate it with their grades to develop a cost-effective and noninvasive diagnostic parameter. MATERIALS AND METHODS: Unstimulated whole saliva was collected from the groups under study and subjected to biochemical analysis for determination of sialic acid levels. STATISTICAL ANALYSIS USED: The salivary sialic acid levels were correlated with the clinical stage and histological grade by one-way ANOVA (SPSS software version 15). RESULTS: Salivary sialic acid was elevated in oral squamous cell carcinoma (OSCC) compared to oral premalignancy and control group. A statistically significant correlation was observed between the grades of squamous cell carcinoma, grades of dysplasia in premalignancy, and sialic acid level. CONCLUSION AND CLINICAL SIGNIFICANCE: Evaluation of salivary sialic acid levels in premalignant and malignant lesions can serve as a screening tool. The mortality and morbidity of OSCC can be reduced if the lesions are diagnosed in early precancerous states using such noninvasive diagnostic methods for screening and monitoring of the population.

Plexiform unicystic ameloblastoma: a rare variant of ameloblastoma.

The term plexiform unicystic ameloblastoma refers to a pattern of epithelial proliferation that has been described in cystic cavity. Because of unilocular presentation, it is commonly misdiagnosed as an odontogenic cyst. However, they may often behave clinically as biologically aggressive tumors. These tumors show high incidence of cortical perforation, tooth resorption and a high rate of recurrence after simple enucleation. This paper aims to provide an insight into this biologically distinct entity. A literature review on the topic has been added along with a case report highlighting the approach of diagnosis and management of such ameloblastomas.

Sediment cytology in diagnostic evaluation of oral neoplasms.

AIM: To evaluate the role of sediment cytology of biopsy specimen fixatives in early diagnosis of oral neoplasms. MATERIALS AND METHODS: Cytological smears were prepared by centrifuging the fixatives in which the biopsy specimens were received. The smears were analyzed and the cytological results were compared with histological diagnosis. RESULTS: Of 20 lesions studied by sediment cytology, 8 were labeled as benign, 9 as malignant and 3 cases as inconclusive. Final histopathological diagnosis labeled 12 lesions as malignant and 8 lesions as benign. Comparing the cytological diagnosis with histological sections, 17 out of 20 cases were concordant. The overall diagnostic accuracy of 85% was achieved. CONCLUSION: Biopsy sediment cytology is a good complimentary method to histopathology in the study of oral biopsy material.

Chondrosarcoma of the maxilla: A case report and review of literature.

We report a case of recurrent chondrosarcoma of the maxilla in a 29 yr old male patient. The lesion presented as a small diffuse swelling on the left maxillary anterior region which had progressed over a period of one year. On aspiration, a chondromyxoid matrix was noted with cells arranged singly or in groups. Bi and tri-nucleation was noted with a moderate degree of nuclear pleomorphism. A diagnosis of well differentiated chondrosarcoma was made which was confirmed on histopathology. The clinicopathological findings of this case and a review of chondrosarcoma is presented and discussed.

The role of stroma in the expansion of odontogenic cysts and adenomatoid odontogenic tumor: A polarized microscopy study.

OBJECTIVES: To compare the polarization colors of collagen fibers of odontogenic keratocyst (OKC), radicular cyst, dentigerous cyst, and adenomatoid odontogenic tumor (AOT) with reference to their biological behavior. STUDY DESIGN: Twenty cases each of OKC, radicular cyst, dentigerous cyst, and AOT were stained with picrosirius red stain and studied under polarized light. RESULTS: A predominance of green to greenish yellow thick fibers was noted in OKC and AOT as compared to dentigerous cyst and radicular cyst. There was no significant difference between the polarization colors of the thin fibers in all the three groups. CONCLUSION: The stroma of OKC and AOT consists of poorly packed or pathologic collagen and plays a role in its neoplastic behavior.