Lymphovascular invasion as a prognostic tool for oral squamous cell carcinoma: a comprehensive review.

Oral cancer is the most common malignancy of the head and neck region, characterized by a poor prognosis. Novel prognostic markers are needed to better stratify these patients. Lymphovascular invasion (LVI) has been included in the eighth edition of the AJCC Cancer Staging Manual as an additional prognostic factor, but its influence on the recurrence risk and lymph node metastasis is relatively understudied. This is a comprehensive review of the literature on the clinical and prognostic role of LVI in oral cancer. A relevant search of the PubMed, Scopus, and Web of Science databases yielded 29 articles that satisfied the inclusion criteria. Findings indicated that LVI is an independent negative prognostic factor in oral cancer patients and appears to be associated with cervical lymph node metastasis and loco-regional recurrence. Notably, in oral tongue cancer, survival outcomes progressively worsen when LVI is associated with other adverse pathological features, especially in the early stages. Therefore, these patients could benefit from elective neck dissection and/or adjuvant therapy. The high variability of LVI prevalence hinders the comparison of literature results. Several methodological limitations were found to be present in the collected articles, including the lack of a rigorous definition for LVI, the difficult detection in routine histological section, the presence of potential confounders, the retrospective nature, and an inadequate sample size in most studies. Therefore, it is necessary to conduct prognostic studies using standardized methods to define and quantify LVI.

Non-neoplastic jaw cysts: a 30-year epidemiological study of 2150 cases in the Italian population.

Non-neoplastic jaw cyst (NJC) is one of the most common lesions in oral cavity, but there are only few detailed and extended epidemiological data based on the 2017 WHO classification. The aim of this study was to perform an epidemiological analysis of all NJCs treated from 1990 to 2019 at the Marche Polytechnic University, and to compare these data with those published in the literature. This retrospective study considered 2060 patients treated from 1990 to 2019. The NJCs were classified according to the 2017 WHO classification, and the main clinicopathological variables were analysed (sex, age, diagnosis, site of onset, size, and recurrences). Of 2150 total lesions, there were 2095 primary cysts and 55 recurrences; men are more frequently affected than women (M/F ratio of 1.73:1). The mean age of occurrence was 46.6 years, with a peak of frequency in the fifth decade. The mandible was more frequently involved than the maxilla, with a mean size of 1.9cm. Radicular cyst was the most frequently diagnosed cyst (56.6%), followed by dentigerous cyst (23.4%) and odontogenic keratocyst (12.9%). This is the first epidemiological study on NJCs in the Italian population according to 2017 WHO classification.

Analysis of oral mucosa erosive-ulcerative lesions by reflectance confocal microscopy.

In vivo Reflectance Confocal Microscopy (RCM) allows to optically biopsy vital tissues, non-invasively and in real time. It results in horizontal virtual slices at a microscopic resolution and correlating with conventional histopathology. The aim of the present work is to describe RCM cellular and architectural findings in oral mucosae affected by erosive-ulcerative diseases, thus highlighting in vivo the wellknown histological peculiarities. A series of conventionally diagnosed Recurrent Aphthous stomatitis (RAS) and Pemphigus Vulgaris (PV) erosive and/or ulcerative oral lesions underwent RCM imaging to establish the application of RCM imaging to this kind of inflammatory non-tumoral lesions. A total of 12 RAS-related lesions and 8 PV-related lesions were considered. RCM imaging was capable to visualize their microscopic peculiarities, mainly inflammatory infiltrate, vessel dilation (RAS) and acantholytic cells, intraepithelial clefts and inflammatory cell carpets (PV). Despite RCM may result unnecessary to diagnose oral lesions referred to RAS and PV, its capability to highlight their main microscopic features could be advantageously used to monitor the healing or worsening of the clinical situation as well as the responsiveness/refractoriness to therapy.

Large cell neuroendocrine carcinoma of the submandibular gland: a case report and literature review.

Neuroendocrine tumors (NET) are a heterogeneous group of malignancies with a broad spectrum of histomorphologies, tissue origins, and clinical outcomes, which arise from neural crest cells with neuroendocrine differentiation. Salivary gland tumors account for 3-6% of all head and neck neoplasms, while large cell neuroendocrine carcinomas (LCNEC) of the salivary gland are extremely rare, with few cases reported in literature, and only 5 cases involving submandibular gland. The rarity of these tumors in salivary glands is probably related to the scarcity of neuroendocrine cells in this tissue, whose presence is still a matter of debate. Regardless of their low frequency, it is imperative to differentiate these tumors from the much more common squamous cell carcinomas and metastatic NETs, due to different therapeutic approach and prognosis. In this paper, we report the case of a 21-year-old man, with a LCNEC involving a submandibular gland followed by several recurrences over the years. In addition, we include a comprehensive review of the available literature on this topic.

Noma: a reappraisal in Western countries - are HIV-negative immunocompetent adult patients safe?

Noma is an ancient Greek term referring to a gangrenous disease that destroys soft and hard tissues of oral and perioral structures. This disease has been known since ancient times and persisted in Europe until World War 2, while in the present day it is almost exclusively found in sub-Saharan Africa.

Spider Zygoma: a new implant rehabilitation technique for atrophic maxilla.

OAtrophic maxilla is a challenge in dental implant surgery, and new strategies are needed. We present a new minimally-invasive approach, called "Spider Zygoma", consisting of implant-supported prosthesis with the addition of customized maxillofacial plates and screws on surface of zygomatic bone. A 3D-model of the edentulous upper jaw was used as preoperative model. Two customized bone plates were created and used as guide for placement of implants and zygomatic screws. Although this is only a pilot study, this new surgical technique seems to be safe and accurate, confirmed by the maintenance of good aesthetic and functional results after 5-year follow-up.

Odontogenic tumors: a retrospective clinicopathological study from two Italian centers.

OBJECTIVE: The aim of this retrospective study was to perform an epidemiological analysis of all odontogenic tumors treated in the University Hospitals "Ospedali Riuniti" in Ancona and "Policlinico" in Bari, from 1990 to 2015. MATERIALS AND METHODS: A retrospective survey of 277 patients treated for odontogenic tumors from 1990 to 2015 was performed. Data were retrieved from the archives of the above quoted Sections of Pathology. The lesions were classified according to 2005 WHO histological classification, and the following variables were analyzed: age, sex, histopathological diagnosis, site distribution, tumor size, and relapses. Peripheral odontogenic tumors were analyzed considering these lesions separately from their central counterparts. RESULTS: In a total of 344 surgical specimens, there were 277 primary tumors and 67 recurrences. As regards primary lesions, there were 185 odontogenic keratocysts (keratocystic odontogenic tumors) (66.8%), 49 ameloblastomas (17.7%), and 40 other benign odontogenic tumors (14.4%). As to malignant tumors, only 3 ameloblastic carcinomas were found (1.1%). The mean age was 46.7 years, with a M:F ratio of 1.8:1. The mandible was the most common site of localization, with 211 cases (76.2%). Also, 21 cases of peripheral odontogenic tumors were found, ameloblastomas being the most common (8 cases, 38.1%). CONCLUSIONS: There is a wide variety of cysts, some of which are subject to variations according to sex, localization, and age. Odontogenic tumors are rare neoplasms and appear to show variations according to sex, localization, and age, and may be useful to the clinicians who need to make clinical judgments before biopsy about the most probable diagnosis.

Oral ulcer by Sphingomonas paucimobilis: first report.

The first case of an oral infection caused by Sphingomonas paucimobilis is reported. A 73-year-old man presented with a gingival ulcer with bone exposure affecting the attached gingiva in the anterior maxillary region. He reported pain during chewing and the presence of fever. Since the first case of S. paucimobilis infection was reported in 1977, involving a leg ulcer, the number of reports related to this organism has been increasing, indicating that the bacterium should be considered an emerging pathogen. It is possible that other non-classical pathogens of the oral cavity may be responsible for infectious lesions, which represents a diagnostic and therapeutic challenge.

Trail overexpression inversely correlates with histological differentiation in intestinal-type sinonasal adenocarcinoma.

INTRODUCTION: Despite their histological resemblance to colorectal adenocarcinoma, there is some information about the molecular events involved in the pathogenesis of intestinal-type sinonasal adenocarcinomas (ITACs). To evaluate the possible role of TNF-related apoptosis-inducing ligand (TRAIL) gene defects in ITAC, by investigating the immunohistochemical expression of TRAIL gene product in a group of ethmoidal ITACs associated with occupational exposure. MATERIAL AND METHODS: Retrospective study on 23 patients with pathological diagnosis of primary ethmoidal ITAC. Representative formalin-fixed, paraffin-embedded block from each case was selected for immunohistochemical studies using the antibody against TRAIL. Clinicopathological data were also correlated with the staining results. RESULTS: The immunohistochemical examination demonstrated that poorly differentiated cases showed a higher percentage of TRAIL expressing cells compared to well-differentiated cases. No correlation was found with other clinicopathological parameters, including T, stage and relapses. CONCLUSION: The relationship between upregulation of TRAIL and poorly differentiated ethmoidal adenocarcinomas suggests that the mutation of this gene, in combination with additional genetic events, could play a role in the pathogenesis of ITAC.