A rare case report of acanthomatous ameloblastoma based on aspiration cytology with histopathological confirmation.

Ameloblastoma is a benign progressively growing intraosseous epithelial odontogenic tumor. It is characterized by expansion and a tendency for a local recurrence if inadequately removed. Since it has an aggressive clinical course, surgical removal and histopathological examination should be done for appropriate management. In this case study, a 52-year-old female patient came to our institute with a complaint of swelling in the lower midline of gum. The patient has a history of bleeding gum and swelling 25 years back, for that she underwent tooth extraction in a private clinic. The patient again developed gum swelling year back, for that she underwent tooth extraction in a private clinic. However, this time her symptoms persisted, and for this reason, the patient visited our institute. On palpation, the lesion was firm and non-tender, appeared to arise from mandibular bone. Magnetic resonance imaging (multiplanar and multisequence) was done and it was reported as expansile multiseptate mandibular symphysis mass, possibly ameloblastoma. FNAC was done from the right lower alveolus in a private pathology laboratory, which was reported as pleomorphic adenoma with focal squamous metaplasia. These slides were reviewed in our institute and we reported it as suggestive of odontogenic tumor, favoring ameloblastoma. Biopsy and histopathological examination was advised for confirmation. Tumor was surgically enucleated along with curettage of the site and excised specimen was sent for histopathological examination to the pathology department of our institute. Based on the clinical, radiological, cytological, and histopathological examination, a final diagnosis of acanthomatous ameloblastoma was made. To the best of our knowledge, very few cases of acanthomatous type of ameloblastomas have been diagnosed on aspiration cytology followed by excision and histopathological confirmation. In this case study, we tried to highlight the importance of early diagnosis by cytology which helps in early treatment by surgical excision of this locally aggressive tumor.

High-Risk Human Papillomavirus Infection in Squamous Cell Carcinoma of the Larynx: A Study From a Tertiary Care Center in North India.

Background Human papillomavirus (HPV) 16/18 infection has been considered as an important etiological factor for laryngeal carcinoma. Considering its impact on prognosis, it is important to understand the true prevalence of HPV-associated laryngeal squamous cell carcinoma (LSCC) in the northeast region of India. Materials and methods A prospective observational study was conducted among patients with laryngeal squamous cell carcinoma in the department of otolaryngology of King George's Medical University (KGMU), Lucknow. Results In this study, the total number of cases was 62. HPV 16/18 positivity was higher (p=0.02) among the age group 31-40 years (40%) as compared to above 50 years (3.3%). HPV positivity was higher among females (50%) as compared to males (12.5%). Out of 34 tobacco smokers, HPV positivity was seen in 20.6% as compared to no positivity among patients without any history of addiction. HPV positivity was found in 19.6% of supraglottic cancer and no positivity among glottic cancer. HPV positivity was higher among the T1 stage of supraglottic carcinoma (40%) as compared to T3 (17.4%). In glottic cases, HPV positivity was nil in all T stages. Conclusion The association of tumor HPV status with laryngeal squamous cell carcinoma in females and young patients (<50 years) observed in our study is consistent with prior studies, and this reflects that HPV status should be considered in the design or analysis for the treatment of laryngeal cancer. We tried to highlight the importance of diagnosing HPV-positive laryngeal squamous cell carcinoma at early stages of the disease and also added information about the prevalence of HPV-positive LSCC in this zone of the country. We have observed that laryngeal carcinoma from tobacco smokers contains transcriptionally active HPV and hence may act as a risk factor or act synergistically with HPV infection. Further studies with larger sample size are needed to clearly establish the association of HPV in laryngeal squamous cell carcinoma and its impact on disease prognosis.

Metastasis of mucinous breast carcinoma to the lower alveolus as initial presentation: a diagnostic dilemma.

Metastases in the oral cavity are rare and comprise approximately 1% of all oral malignancies. They usually involve the jaws but may also be found in the soft tissues and salivary glands. Women's most common metastatic malignancies are from primary breast cancers. However, metastasis of mucinous breast carcinoma to the lower alveolus mimicking an aggressive primary malignancy as the initial presentation is exceptionally uncommon. We describe the case of a 66-year-old lady with an ulceroproliferative growth in the right lower alveolus. The lesion eroded the mandible and involved the adjacent soft tissues with no prior history of lesion anywhere else. The lesion clinically mimicked a squamous cell carcinoma and masqueraded as a salivary gland mucinous adenocarcinoma on histopathology. The possibility of a metastatic lesion from the breast rather than a primary of the alveolus was also entertained, aided by the immunohistochemical findings of positivity of the tumor cells for GATA3. A positron emission tomography (PET) scan was undertaken to ascertain the primary site. It detected a hypermetabolic lesion in the left breast, which biopsy revealed mucinous breast carcinoma on histopathological evaluation. Metastasis of breast mucinous carcinoma by the hematogenous route is extremely rare; very few cases have been reported. This case illustrates the diagnostic challenges such a lesion can pose to the surgeon and the pathologist. In the advent of such lesions being the initial clinical presentation, a vigilant clinicopathological and radiological assessment is essential to detect the primary.

Metastasis of mucinous breast carcinoma to the lower alveolus as initial presentation: a diagnostic dilemma

ABSTRACT Metastases in the oral cavity are rare and comprise approximately 1% of all oral malignancies. They usually involve the jaws but may also be found in the soft tissues and salivary glands. Women's most common metastatic malignancies are from primary breast cancers. However, metastasis of mucinous breast carcinoma to the lower alveolus mimicking an aggressive primary malignancy as the initial presentation is exceptionally uncommon. We describe the case of a 66-year-old lady with an ulceroproliferative growth in the right lower alveolus. The lesion eroded the mandible and involved the adjacent soft tissues with no prior history of lesion anywhere else. The lesion clinically mimicked a squamous cell carcinoma and masqueraded as a salivary gland mucinous adenocarcinoma on histopathology. The possibility of a metastatic lesion from the breast rather than a primary of the alveolus was also entertained, aided by the immunohistochemical findings of positivity of the tumor cells for GATA3. A positron emission tomography (PET) scan was undertaken to ascertain the primary site. It detected a hypermetabolic lesion in the left breast, which biopsy revealed mucinous breast carcinoma on histopathological evaluation. Metastasis of breast mucinous carcinoma by the hematogenous route is extremely rare; very few cases have been reported. This case illustrates the diagnostic challenges such a lesion can pose to the surgeon and the pathologist. In the advent of such lesions being the initial clinical presentation, a vigilant clinicopathological and radiological assessment is essential to detect the primary.