Aggressive osteoblastoma of the mandible.

We report a case of aggressive osteoblastoma of the mandible, an extremely rare primary bone tumor of the maxillofacial skeleton. Although osteoblastomas are benign tumors requiring only curettage for cure, there is a small subset of tumors that exhibit locally aggressive behavior and have atypical histopathologic features. Differentiation from low-grade osteosarcoma is often difficult. There is some disagreement as to the proper classification of these tumors. The correct diagnosis must be based on clinical, radiographic and pathologic features. Surgical resection and reconstruction is the recommended treatment for these invasive lesions.

Benign epithelial odontogenic tumors.

Teeth are formed from a complex interaction of primitive ectoderm and ectomesenchymal tissues. Because humans develop 2 sets of teeth (deciduous and permanent), odontogenesis is a prolonged biologic process. Residues of odontogenic tissues are present in most humans- both during and after odontogenesis. These elements may be found in either bone or soft tissue of the jaws and may contribute to the formation of odontogenic tumors in these sites. Further, the mixture of epithelium and mesenchyme necessary for tooth formation allows for the development of tumors composed of either element or for mixed neoplasms. This article discusses 4 of the 5 benign odontogenic neoplasms that are of epithelial origin and offers an agreed on classification scheme, which includes important clinicopathological subtypes. Specifically discussed are ameloblastoma, calcifying epithelial odontogenic tumor (Pindborg tumor), adenomatoid odontogenic tumor, and squamous odontogenic tumor. A brief history of each tumor is given along with a discussion of demographic data, clinical findings, radiographic features, and gross features where useful. A thorough discussion is presented of diagnostic histopathology including histologic variants. Generally accepted modes of therapy and follow-up recommendations are discussed.

Oral mucosal melanomas: the WESTOP Banff workshop proceedings. Western Society of Teachers of Oral Pathology.

A workshop to discuss primary oral melanomas was convened at the annual Western Society of Teachers of Oral Pathology meeting in Bannf, Alberta, Canada. Fifty oral melanomas, identified from the files of the participants, were reviewed in order to better understand the clinical features, histologic spectrum, and natural history of these perplexing lesions. Results confirmed that oral melanomas occur in adults almost three times more frequently in men than women and have a decided predilection for the palate and gingiva. Some lesions exhibit a clinically detectable and prolonged in situ growth phase, whereas others seem to lack this property and exhibit only or predominantly invasive characteristics. Recurrences, metastases, and death from tumor were characteristic of the follow-up of a limited number of patients. Until definitive prospective data are collected that elucidate natural history, oral mucosal melanomas should be tracked separately from cutaneous lesions. All oral pigmented lesions that are not clinically diagnostic should be biopsied. Lesions with equivocal histopathologic features might be referred to as "atypical melanocytic proliferation" and should be excised. Recognition of lesions in an early in situ phase and aggressive treatment should have a favorable effect on prognosis. To enhance future or prospective study of these rare neoplasms, guidelines for reporting oral melanomas are suggested.

Education in early detection of oral squamous cell carcinoma: a community outreach program.

An educational program consisting of a slide presentation and lecture, a demonstration of how to examine the oral soft tissues, and handout materials was presented to practitioners, hygienists, assistants, and other personnel in their office. A pretest, a critique by the participants, and a follow-up questionnaire were used to determine the value of the program.

Premalignant oral mucosal diseases.

A premalignant phase in the development of oral cancer is predicted by the classic model of experimental epithelial carcinogenesis. Virtually all oral squamous cell carcinomas arise from a premalignant precursor, but it is difficult to specifically define the term premalignant. Oral pathologists use the term epithelial dysplasia to indicate microscopic features in a biopsy specimen that are associated with a risk of malignant change and then assign a grade of severity. There is good correlation between higher grades of dysplasia and increasing risk of cancer but less so with the lower grades. The clinical appearances manifested by oral epithelial dysplasia and early oral cancer include leukoplakia, erythroplakia, and speckled leukoplakia. This paper discusses and illustrates these clinical lesions, their associated risk factors, their relationship to epithelial dysplasia, and the associated risk of evolution into oral cancer.

Oral cancer: a self-assessment quiz.

This article consists of a quiz on oral cancer knowledge. The goals of the quiz are to reinforce known cancer information and present new information. Photographs are used to bring a sense of the practical problems that clinical pathology presents. Also, a number of real-life case situations are presented with their corresponding illustrations so that the readers may use their clinical judgment and experience in choosing an answer.