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BACKGROUND: MicroRNAs (miRs) are small, non-coding mRNA molecules which regulate cellular processes in tumorigenesis. miRs were discovered in extracellular environment and biological fluids, carrying marks of head and neck squamous cell carcinoma (HNSCC). They were also identified in abundance in salivary exosomes, in which they are protected by exosome lipid barrier against enzymatic injuries and therefore, the accuracy of exosomal miR-based cancer detection increase. This systematic review aimed to reveal and inventorize the most reliable exosomal miRNAs in saliva samples which can be used as novel biomarkers for early detection of HNSCC. MATERIALS AND METHODS: A systematic literature search, according to PRISMA guideline, was performed on Pubmed and Google Academic libraries, based on specific keywords. Original articles published between 2010 and 2021 were selected. The quality of each paper was assessed using the Quality Evaluation Scoring Tool. RESULTS: At the end of selection process, five studies met the inclusion criteria. These studies analyzed twelve salivary exosomal miRs, presenting different methods of exosome and miR identification for HNSCC detection. A comprehensive explanation of the miR pathways of action was drawn and illustrated in this review. CONCLUSION: Exosomal miRs are promising biomarkers for oral cavity and oropharyngeal cancer detection. miR-10b-5p, miR-486-5p, miR-24-3p and miR-200a stand as the most useful ones in saliva sample examination.
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Peripheral T-cell lymphoma not otherwise specified (PTCL-NOS) is the rarest subtype of primary cutaneous lymphoma, accounting for approximately 2% of cutaneous lymphomas. The rarity of primary cutaneous PTCL-NOS means that there is a paucity of data regarding clinical and histopathological features and its clinical course. This malignancy is an aggressive and life-threatening hematological malignancy that often presents mimicking other less severe plaque-like skin conditions. Due to the nonspecific nature of these lesions, CD4-positive cutaneous T-cell lymphoma (CTCL) is often misdiagnosed as either mycosis fungoides or Sezary syndrome. We describe a patient who presented with a large tumoral mass in the right frontal area, with involvement of the right upper eyelid and the ocular globe, causing loss of vision greatly impacting the quality of life. Biopsy revealed primary cutaneous PTCL-NOS, treated successfully with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) plus etoposide combination chemotherapy. As elderly patients are indicated to receive attenuated doses of chemotherapy, CHOP-based regimens represent viable options.
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INTRODUCTION: The bisphosphonate-related osteonecrosis of the jaw was first referred to in 2003. Bisphosphonates action is focused on the osteoclasts. The drastic inhibition of the osteoclastic function is harmful for the jaws which are the only bones of the human skeleton in relative contact with the external environment. The adverse effects of the bisphosphonate-related therapy include the pathology for which they are prescribed, the atypical fractures in pathological bone. METHOD: The aim of this research was to analyze the risk factors and the treatment methods in case of osteonecrosis of the jaws. To achieve these goals, the author analyzed the observation sheets of the patients admitted to the Oral and Maxillofacial Surgery Clinic during the period 2010-2015. The inclusion criteria were as follows: treatment with bisphosphonates, current or previous; the lesions of the mucous gingiva of the maxillaries followed by exposed necrotic bone, older than 8 weeks, with no tendency of healing; specific radiological image showing extended osteolysis with diffuse outline or radiopacity surrounded by radio-transparence, representing the necrotic bone sequestered; no metastasis in the necrotic maxillary bone; patient with no medical background of cervical-facial radiations. The patients who met these criteria were admitted in the study after signing the informed consent. Afterwards, the information found in the notes of the observational sheet (anamnesis, general examination and the imagistic investigation, treatment, postoperative recovery, prescription, postoperative recommendations) were gathered and submitted for statistic analysis. RESULTS: Of the 20 patients in total, 13 were women and 7 men, of ages ranging from 43 to 83. The most numerous cases were registered in the seventh age decade. All patients included in the study had lesions of the gingival maxillary mucosal areas with exposure of the subjacent necrotic bone. 60% of them were under intravenous treatment with zoledronic acid (Zometa®). A single patient was under oral treatment with bisphosphonates. 19 of these 20 patients developed osteonecrosis following a dental extraction while one case was due to the instability of the mandibular mobile prosthesis. 61% of the patients included in the study developed a necrotic process in the mandibular bone, 80% of the localizations were in the posterior area. As first intention, the choice of treatment was represented by local lavages with antiseptic solutions, general antibiotics and sequestrectomy. Of these patients, a third had relapsed and needed radical surgery treatment. CONCLUSIONS: Prevention of the bisphosphonate-related osteonecrosis of the jaw represents the best method of treatment. The development of bone sequesters damages the volume of the maxillary bone as such, reducing the chances for prosthetic functional rehabilitation of the dento-maxillary system. An increase in the quality of life by oral restoration of these patients may represent a challenge.