Oral Risk Factors in Patients with Cancer Undergoing Chemotherapy - A Pilot Study.

BACKGROUND: Treatment modalities for cancer including surgery, radiotherapy and chemotherapy, have some complications even in the oral cavity. The literature describes oral lesions that may arise as a result of chemotherapy. However, information regarding oral symptoms in advanced cancer patients is poor. OBJECTIVE: To identify the oral manifestations like oral mucositis, dry mouth and loss of taste in patients undergoing chemotherapy treatment. METHODS: We evaluated 60 patients affected by malignancy undergoing chemotherapy treatment. The clinical and pathological data such as age, gender, diagnosis of malignancy and types of treatments with anticancer chemotherapeutic drug treatment, were obtained. Patients were routinely evaluated for the presence of oral mucositis based on the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 scale for adverse effects and graded. Other findings like dry mouth and loss of taste were recorded. RESULTS: Of the 60 patients, 40 (66.6%) were male, and 20 (33.3%) females with a mean age of 53.7 years. Most patients about 63% and 83% were diagnosed with dry mouth and loss of taste, respectively and 71% of patients had mucositis. Chemotherapy drugs like Cyclophosphamide, carboplatin, nanoxel, paclitaxel, oxaliplatin, docetaxel and doxorubicin, were directly associated with oral mucositis. CONCLUSION: Patients treated with chemotherapy for cancer most often suffer from a multitude of intense and debilitating oral dysfunctions. Oral lesions found in patients undergoing chemotherapy were mucositis, dry mouth and loss of taste. These adverse effects and an appropriate symptomatic therapy need to be discussed with the patients. Chemotherapy has a significant but transient effect on the oral symptoms.

Unusual presentation of primary central xanthoma of the maxilla associated with impacted canine: An update on immunohistochemistry in the diagnosis.

A xanthoma is an extremely rare condition that affects the soft tissues and bones and is characterized by a predominance of lipid-rich foamy histiocytes. The onset of xanthomas is frequently accompanied by primary or secondary hyperlipidemia. Primary bone xanthomas are very uncommon benign bone lesions that are not linked to hyperlipidemia. Histopathologically, they are distinguished by histiocytes, an abundance of foam cells or xanthoma cells that contain lipids, and a paucity of multinucleated giant cells. There have only been four reports of primary maxillary xanthoma in the medical literature. We present a rare primary intrabony xanthoma of the anterior maxilla in a 23-year-old normolipidemic female patient with solitary radiolucency. Using CD68, S-100, and CD1a immunohistochemical staining, it is possible to distinguish between macrophage/non-Langerhans histiocytes and Langerhans histiocytes. Therefore, a diagnosis of a central xanthoma of the jaws must be made.

Exploring the Changing Diagnostic Criteria of Gorlin-Goltz Syndrome: A Case Report.

Gorlin-Goltz syndrome, also known as Gorlin syndrome, basal cell nevus syndrome, and nevoid basal cell carcinoma syndrome, is an autosomal dominant genetic disorder. Its hallmark is an early onset of basal cell carcinoma. Additionally, the syndrome is characterized by a spectrum of distinct clinical attributes encompassing oral, skeletal, ophthalmic, neurological, and developmental aberrations. This condition arises due to anomalies in the Hedgehog signaling pathway, leading to constant pathway activity and uncontrolled growth of tumor cells. Early identification of the disorder through available diagnostic methods and clinical and radiological findings is crucial for accurate diagnosis, which subsequently leads to the formulation of an effective treatment regimen. The purpose of this case report is to discuss the role of a dentist in early detection based on various author-prescribed criteria and the need for a multidisciplinary approach to the treatment of patients with this syndrome.

Unusual case presentation associated with impacted mandibular molars: Clinicopathological correlation and immunohistochemical analysis.

ABSTRACT: Ewing's sarcoma of bone is a rare malignant round cell tumor of the head and neck. The jaw, particularly the mandible, accounts for 3% of occurrences in the head and neck area. These tumors have been reported more frequently in men than in women, and they are usually between 5- and 20-year-old. It is difficult for clinicians and pathologists to make a diagnosis based solely on clinical and microscopic findings. Immunohistochemistry presents a plausible tool that can help the pathologist to arrive at a confirmatory diagnosis. This jaw tumor has the best prognosis when detected and treated early in the disease course, so the importance of timely, and accurate diagnosis cannot be overemphasized. The highlighting feature of this case report of an 18-year-old male that was primary detected by immunohistochemically as Ewing's sarcoma and is localized to the impacted left mandibular molars.

Dental caries: Impact of tobacco product among tobacco chewers and tobacco smokers.

Objective: Tobacco is the most significant social burden and the leading cause of death. Tobacco is derived from "Nicotiana tabacum" which has nicotine as the main component. There are various disadvantages from tobacco on health which are reported in the medical literature. But the risk of caries among these tobacco users, such as chewers and smokers, is still debatable. Hence, the present study aims to determine the prevalence of dental caries among tobacco chewers and smokers. Materials and methods: In this study, 389 individuals were included. Out of 389 individuals, 304 were men and 85 were women aged between 18 and 60 years. They were classified into two groups. Group A had 207 individuals with habitual tobacco chewing, and Group B had 182 individuals with habitual tobacco smoking and provided a 6 months history. The DMFT index (Decayed, Missing, and filled teeth index-WHO modification 1997) was used to assess caries. Results: The study revealed a higher prevalence of dental caries among tobacco chewers compared to tobacco smokers. The DMFT scores were higher among gutka chewers compared to other types of tobacco use. The lower posterior tooth region showed higher dental caries in tobacco chewers compared to smokers. Conclusion: The higher presence of caries in the tobacco chewing group is due to the presence of sweeteners, which act as cariogenic agents. Similarly, smokers have a thiocyanate component that acts as an anticariogenic agent; therefore, the prevalence of caries was lower in tobacco smokers.

A new technique to resolve Nasal Rhinosporidiosis: A case report with review of literature.

INTRODUCTION AND IMPORTANCE: Rhinosporidiosis is a chronic, localized granulomatous infectious disease caused by Rhinosporidium seeberi that predominantly affects the mucosal membranes of the nose and nasopharynx, conjunctiva, and urethra. Rhinosporidium seeberi is a eukaryotic pathogen that spreads in certain geographical areas, particularly in tropical and subtropical areas, through aquatic exposure. CASE PRESENTATION: We present the case of a young man who had been suffering from a right nasal mass for four months, and whose diagnosis was confirmed after surgical excision and histopathological examination, which revealed distinct pathognomonic findings. Laser-assisted endoscopic excision, in combination with Dapsone, is recommended as a more effective treatment to prevent a recurrence. CLINICAL DISCUSSION: For clinicians, it has been advised to obtain a detailed case history of exposure in patients diagnosed with Rhinosporidiosis. Rhinosporidiosis can be diagnosed with a simple examination of H&E-stained histopathological sections. Because chemotherapy has not been proven to be effective, Laser-assisted endoscopic excision, in combination with Dapsone is the recommended treatment for Rhinosporidiosis. CONCLUSION: One of the differential diagnoses for Rhinosporidiosis in the nasal cavity is masses or abnormal growths without bleeding, which should be kept in mind by clinicians and pathologists.

Classification staging systems on clinical and radiographic features of inverted sinonasal papilloma: A case report.

Inverted sinonasal papilloma is an infrequent tumor that mostly affects the elder group of 40-50 yr. This tumor is distinguished from other sinonasal tumors by three characteristics: a high rate of recurrence, carcinomatous changes, and a high potential for local destruction. In 40% of cases of inverted sinonasal papilloma showed an association with the human papillomavirus and considered as the main etiological agent. Here, we present a case of a 36-year-old male presented with pus discharge from the right upper back teeth region in the past 1 year. Correlating with clinical, radiographical features, a diagnosis of the Inverted sinonasal papilloma.

Unusual case presentation of an aneurysmal bone cyst of maxilla in geriatric patient: A diagnostic challenge.

An aneurysmal bone cyst (ABC) is a non-neoplastic, rapidly expanding pathologic bone lesion that mostly affects the mandible and is most commonly found in the first to third decade of life. The most of the ABC cases are locally aggressive osteolytic lesion with a high recurrence rate. As a result, we present a swelling with pus discharge at the maxillary alveolus in a 68-year-old female who was diagnosed with ABC after a computed tomography scan and histological analysis. The conservative surgical excision was performed without considerable bleeding, and no recurrence was observed even after a five-year follow-up period.

Verruciform xanthoma: A view on the concepts of its etiopathogenesis.

Verruciform xanthoma is a very uncommon papillary growth seen chiefly in the oral mucosa. The presence of foam cells in the connective tissue papillae between the epithelial rete ridges forms the hallmark in its diagnosis. There has been wide speculation and various hypotheses put forth in explaining the etiopathogenesis of verruciform xanthoma and the origin of foam cells. This article aims to update the different hypotheses in understanding the pathogenesis of the lesion.