Quantitative assessment of tumor-associated tissue eosinophilia and mast cells in tumor proper and lymph nodes of oral squamous cell carcinoma.

Background: Oral squamous cell carcinoma (OSCC) is the most common cancer of the oral cavity. Tumor stage, thickness, lymph node metastasis (LNM), extranodal spread, perineural invasion, tumor differentiation, mutations, human papillomavirus infection and tumor microenvironment are independent prognostic indicators of OSCC. However, clinically, among all factors, LNM is considered an important prognostic factor in OSCC as it not only determines the stage of disease but also the strongest independent factor which predicts recurrence of disease. Further research proves that there are several biologically important factors in tumor tissue and LNs which promote or defend LNM. While it is proposed that tumor-associated tissue eosinophils (TATE) and mast cells (MCs) have "immuno-protective" effect, this remains unproven and various researchers have conflicting opinion. Aim: The aim is to determine the presence of TATE and MCs in OSCC and to evaluate if any association exists between them and LNM. Study Design: It is a comparative retrospective study between two groups including 35 OSCC cases positive and 35 negative for LNM. Materials and Methodology: Quantification of cells was done by counting total number of cells in 10 high-power fields under ×40 objective lens using "zigzag" method and dividing it by total number of fields. Eosinophils stained bright red with carbol chromotrope and MCs purple-violet with toluidine blue. Statistics: Independent t-test and Pearson's correlation were done using STATA IC 0.2 software. The level of significance was at 5%. Comparison of eosinophil and MC infiltration was done based on gender, metastatic, nonmetastatic LN and in tumor proper. Results and Conclusion: Our study showed weak positive correlation between mean eosinophils count in tumor and LNs which implies a definite association between the microenvironment of tumor, its progression and LNM. There was a significant association between MC density and decreased LNM also. We conclude that an increased number of immunological cells (TATE and MCs) are a favorable prognostic indicator in OSCC. There is evidence of reduction in LNM with increasing density of these immunological cells. Recognition of TATE and MCs as integral to tumor biology opens an avenue for novel approaches to cancer therapies.

Oral fibrolipoma: A report of two cases and review of literature.

Fibrolipoma is a benign tumor which is classified as a histological variant of conventional lipoma. It rarely occurs in oral and maxillofacial region. When present, it occurs as a soft, smooth surfaced nodular mass that can be pedunculated or sessile. Most of the lesions are less than 3 cm in size, although it may vary. Fibrolipomas mostly affect buccal mucosa and buccal vestibule and cause functional and cosmetic disabilities. Herniation of buccal pad of fat caused by trauma may also mimic lipoma. Hence, accurate histopathological examination of lipomas is important for a correct treatment plan. Here, we present 2 cases of oral fibrolipoma that presented on the retromolar triangle area and alveolar ridge in relation to missing maxillary right first molar.

Quantitative assessment of tumor-associated tissue eosinophilia and mast cells in tumor proper and lymph nodes of oral squamous cell carcinoma.

BACKGROUND: Oral squamous cell carcinoma (OSCC) is the most common cancer of oral cavity. Tumor stage, thickness, lymph node metastasis (LNM), extranodal spread, perineural invasion, tumor differentiation, mutations, human papillomavirus infection, and tumor microenvironment are independent prognostic indicators of OSCC. However, clinically, among all factors, LNM is considered an important prognostic factor in OSCC as it not only determines the stage of disease but also the strongest independent factor which predicts recurrence of disease. Further research proves that there are several biologically important factors in tumor tissue and LNs which promote or defend LNM. While it is proposed that tumor-associated tissue eosinophils (TATE) and mast cells (MCs) have "immuno-protective" effect, this remains unproven and various researchers have conflicting opinion. AIM: The aim is to determine the presence of TATE and MCs in OSCC and to evaluate if any association exists between them and LNM. STUDY DESIGN: It is a comparative-retrospective study between 2 groups including 35 OSCC cases positive and 35 negative for LNM. MATERIALS AND METHODOLOGY: Quantification of cells was done by counting total number of cells in 10 high-power fields under ×40 objective lens using "zigzag" method and dividing it by total number of fields. Eosinophils stained bright red with carbol chromotrope and MCs purple-violet with toluidine blue. STATISTICS: Independent t-test and Pearson's correlation were done using STATA IC 0.2 software. Level of significance was at 5%. Comparison of eosinophil and MC infiltration was done based on gender, metastatic, nonmetastatic LN, and in tumor proper. RESULTS AND CONCLUSION: This study showed weak positive correlation between mean eosinophils count in tumor and LNs. Recognition of TATE and MCs as integral to tumor biology opens an avenue for novel approaches to cancer therapies. We conclude that an increased number of immunological cells are a favorable prognostic indicator in OSCC.

Cutaneous horn: A mask to underlying malignancy.

Cutaneous horns (cornu cutaneum) are uncommon lesions consisting of keratotic material resembling that of an animal horn. It is a conical- or cylindrical-shaped excessive hyperkeratosis of variable size ranging from few millimeters to several centimeters with a variable in size and shape, such as cylindrical, conical, pointed, transversely or longitudinally corrugated, or curved like a ram's horn. The lesions typically occur in sun-exposed areas, particularly the face, ear, nose, forearms and dorsum of hands. Even though 60% of the cutaneous horns are benign in nature, the possibility of skin cancer should always be kept in mind. The clinical diagnosis includes various benign and malignant lesions at its base. Lesions associated with cutaneous horn are keratosis, sebaceous molluscum, verruca, trichilemmal, Bowen's disease, epidermoid carcinoma, malignant melanoma and basal cell carcinoma. Herewith, we report a case of cutaneous horn on the upper lip vermillion masking the underlying malignancy at its base.

Evaluation of occlusal groove patterns of mandibular first and second molars in an Indian population: A forensic anthropological study.

BACKGROUND: The study of dental morphological characteristics is important in anthropological research as it can provide information on the phylogenetic relationship between species, as well as variations and diversities within a population. AIMS AND OBJECTIVES: To determine the prevalence of six types of mandibular second molars in Gujarat state and the results can be used in both forensic anthropological researches and clinical aspects of dental sciences. MATERIALS AND METHODS: This descriptive investigation was undertaken among 1000 students (13-25 years old) in high schools and dental institutes of Gujarat state. The students were selected by cluster sampling method and screened for the number of cusps and groove patterns of mandibular first and second molars. Gender and religion of the students were recorded on prepared forms. STATISTICAL ANALYSIS: It was done with the help of STATAIC-13 software. Descriptive statistics were used to summarize the data and Pearson's Chi-square test was used to check association between variables. Throughout the discussion, level of significance was set at 5%. RESULTS AND CONCLUSION: The high percentage of "+-"shaped groove pattern and low percentage of primitive "y-"shaped pattern in our study shows a tremendous evolutionary trend persisting in this population. The analysis of dental morphological traits is crucial in anthropological research as it can provide data on the phylogenetic relationship between species, as well as variations and diversities within a population.

A Rare and Extensive Case of Oral Malignant Melanoma involving Mandibular Gingiva.

Oral malignant melanoma is an infrequent but an aggressive neoplasm of unknown etiology, seen most commonly in middle age male patients and is more frequently seen at the hard palate and gingiva. The tumor tends to metastasize or locally invade tissue more readily than other malignant tumors in the oral region. In this article, we report a rare case of extensive oral melanoma in a 55-year-old male patient, with a chief complaint of painless growth in mandibular anterior gingiva measuring about 2.6 X 1.7 X 0.8 cm and extending bilaterally till posterior mandibular gingiva and unilaterally to right buccal mucosa. The most common site being hard palate and maxillary gingiva, it is extremely rare in mandibular gingiva (less than 7%) and hence, this rare occurrence in mandibular gingiva is reported, the diagnosis of which was confirmed by histopathology and immunohistochemistry.