The Usefulness of Saturated Salt Solution Embalming Method for Oral Surgical Skills Training: A New Cadaveric Training Model for Bone Harvesting.

The purpose of this study was to assess the usefulness of saturated salt solution-embalmed cadavers for oral surgical skills training related to bone graft harvesting. Two half-day surgical skills training workshops were held at the Tokyo Medical University utilizing eight cadavers embalmed with the saturated salt solution. A total of 22 participants including oral surgeons, residents, and dentists attended the workshop. Surgical training consisted of six procedures related to intraoral and extraoral bone harvesting. The participants were surveyed to assess self-confidence levels for each surgical procedure before and after completion of each workshop. The Wilcoxon signed-rank test was used to compare the differences between each median score before and after the workshop. There were statistically significant increases in the self-assessed confidence scores in bone harvesting procedures for the zygomatic bone (P = 0.003), maxillary tuberosity (P = 0.002), and other sites (P < 0.001). The anatomical features of saturated salt solution-embalmed cadavers were also examined. The textures of the oral mucosa and skin were similar to those of living individuals. The structure of bone tissues was well-preserved and the hardness was realistic. Consequently, all procedures were performed with sufficient realism. The saturated salt solution method has a relatively low cost of preparation and storage, and almost no odor. The authors suggest that saturated salt solution-embalmed cadavers could provide a new model for oral surgical skills training in bone harvesting.

Follicular lymphoid hyperplasia of the posterior maxillary site presenting as uncommon entity: a case report and review of the literature.

BACKGROUND: Follicular lymphoid hyperplasia (FLH) is characterized by an increased number and size of lymphoid follicles. In some cases, the etiology of FLH is unclear. FLH in the oral and maxillofacial region is an uncommon benign entity which may resemble malignant lymphoma clinically and histologically. CASE PRESENTATION: We report the case of a 51-year-old woman who presented with an asymptomatic firm mass in the left posterior maxillary site. Computed tomography scan of her head and neck showed a clear circumscribed solid mass measuring 28 × 23 mm in size. There was no evidence of bone involvement. Incisional biopsy demonstrated benign lymphoid tissue. The patient underwent complete surgical resection. Histologically, the resected specimen showed scattered lymphoid follicles with germinal centers and predominant small lymphocytes in the interfollicular areas. Immunohistochemically, the lymphoid follicles were positive for CD20, CD79a, CD10, CD21, and Bcl6. The germinal centers were negative for Bcl2. Based on these findings, a diagnosis of benign FLH was made. There was no recurrence at 1 year postoperatively. CONCLUSIONS: We diagnosed an extremely rare case of FLH arising from an unusual site and whose onset of entity is unknown. Careful clinical and histopathological evaluations are essential in making a differential diagnosis from a neoplastic lymphoid proliferation with a nodular growth pattern.

Adenosquamous carcinoma of the tongue: clinicopathologic study and review of the literature.

Adenosquamous carcinoma (ASC) of the tongue is an uncommon malignant oral neoplasm with mixed glandular and squamous differentiation and a propensity for aggressive clinical behavior. Here, we report a rare case of ASC of the lateral border of the tongue in a 65-year-old Japanese man. The patient was treated by radical operation and remained well for 6 months before developing metastasis of the hilar and pretracheal lymph nodes. Subsequently, the patient was treated with combined chemotherapy (nedaplatin plus docetaxel and S-1 for two cycles, intravenously) and radiotherapy. Radiation therapy of metastatic lymph nodes was performed at a total dose of 60 Gy and was delivered in 2 Gy fractions 5 days/week. The patient is currently tumor free and is being followed up carefully. This article describes a rare case of ASC of the tongue and its conventional histologic, immunohistochemical, and electron microscopic findings, together with a review of the literature. The findings provide important information to better understand the possible clinical and therapeutic approaches for this uncommon tumor of the tongue.

Exceptionally large solitary fibrous tumor arising from the cheek: an immunohistochemical and ultrastructural study with a review of the literature.

Solitary fibrous tumor (SFT) is a rare mass-forming soft tissue tumor that occurs most commonly in the pleura, but has been described in various extrathoracic sites. Extrapleural manifestation of SFT, particularly in the head and neck region, is rare. The most common extrapleural site is the oral cavity; these tumors have also been described in the orbit, nasopharynx, paranasal sinuses, salivary glands, and larynx. We report an extremely rare case of a SFT in the subcutaneous region of the cheek. This tumor in the left cheek was a large firm mass, approximately 8.5 cm × 6 cm in size and was successfully treated by surgical resection. Immunohistochemistry revealed reactivity for vimentin, CD34, and bcl-2, but no staining for cytokeratin, epithelial membrane antigen, S-100, desmin, caldesmon, actin, α-smooth muscle actin, CD117, and CD99. Immunohistochemical study is the key to establish a definitive diagnosis of SFT, and ultrastructural study is also useful for making an accurate diagnosis. The patient recovered uneventfully without evidence of tumor recurrence 2 years after surgery.

Solitary myofibroma of the mandible: an immunohistochemical and ultrastructural study with a review of the literature.

A solitary myofibroma (MF) is an unusual spindle cell neoplasm that usually arises in the soft tissue, skin, or bone of the head and neck region in infancy. We report an extremely rare case of MF of the mandible in an 18-year-old Japanese woman together with the conventional histologic, immunohistochemical, and electron microscopic findings. The tumor was well circumscribed and composed of fibroblast-like or myofibroblast-like spindle cells. On immunohistochemical evaluation the tumor cells were positive for vimentin, α-smooth muscle actin, HHF-35, and calponin, but negative for neurogenic antigens and markers for vascular endothelial cells. The Ki-67 labeling index was 10 % and the p53 labeling index was 10 %. Ultrastructural examination revealed smooth muscle cell differentiation. The patient was treated by surgical resection and underwent follow-up without any signs of recurrence. MF presents a wide range of differential diagnosis, including benign and malignant neoplasms. Therefore, accurate diagnosis may avoid an unnecessarily aggressive therapy.