Breast malignant phyllodes tumour metastasising to soft tissues of oral cavity.

Metastases from infraclavicular neoplasms to the oral cavity are rare, and the anatomical structures most frequently affected are the maxillae. The primary sites that develop metastases to head and neck include lung, breast, liver, thyroid gland, kidney and melanomas, among others. The breast is one of the usual primary regions that can present them. In the literature, most metastases to these regions correspond to squamous cell carcinomas and adenocarcinomas; few studies report other type of neoplasms such as phyllodes tumour (PT) that present this behaviour. The importance of identifying metastatic disease to the oral cavity, be it as the first manifestation of a neoplasm from unknown origin or as a development in the course of the disease, is that it allows determination of adequate treatment, which has an effect on the patient's prognosis. The usual behaviour of PT is frequent recurrence and, when metastases are present, these are to lungs and bone. Two cases of malignant PT metastasising to tongue and lip are presented, as well as a review of the literature.

Breast malignant phyllodes tumour metastasising to soft tissues of oral cavity

Metastases from infraclavicular neoplasms to the oral cavity are rare, and the anatomical structures most frequently affected are the maxillae. The primary sites that develop metastases to head and neck include lung, breast, liver, thyroid gland, kidney and melanomas, among others. The breast is one of the usual primary regions that can present them. In the literature, most metastases to these regions correspond to squamous cell carcinomas and adenocarcinomas; few studies report other type of neoplasms such as phyllodes tumour (PT) that present this behaviour. The importance of identifying metastatic disease to the oral cavity, be it as the first manifestation of a neoplasm from unknown origin or as a development in the course of the disease, is that it allows determination of adequate treatment, which has an effect on the patient's prognosis. The usual behaviour of PT is frequent recurrence and, when metastases are present, these are to lungs and bone. Two cases of malignant PT metastasising to tongue and lip are presented, as well as a review of the literature (AU)

Tumores odontogénicos malignos. Estudio retrospectivo y colaborativo de 7 casos / Malignant odontogenic tumors. A retrospective and collaborative study of seven cases

Se presenta la frecuencia, características clínico-patológicas y evolución de los tumores odontogénicos malignos diagnosticados en tres servicios de patología de la Ciudad de México, de acuerdo a los criterios vigentes de la O.M.S. En total, se encontraron siete casos (5 en varones y 2 en mujeres), lo que representa menos del 4 por ciento de todos los tumores odontogénicos diagnosticados. Hubo seis carcinomas (dos ameloblastomas malignos, dos carcinomas odontogénicos de células claras, un carcinoma primario intra-óseo y un carcinoma originado del revestimiento de quiste odontogénico) y un fibrosarcoma ameloblástico. El intervalo de edad fue de 25 a 72 años (media: 43.8). Los carcinomas odontogénicos de células claras se presentaron en la región caninopremolar en maxilar y en mandíbula (un hombre y una mujer), mientras que el resto de lesiones se localizaron en la zona posterior de la mandíbula, con predominio por el sexo masculino (4:1), lo que concuerda con lo reportado en la literatura. El tratamiento en todos los carcinomas consistió en la resección quirúrgica, mientras que el fibrosarcoma fue tratado con quimioterapia debido a su gran extensión, sin respuesta favorable. El paciente con carcinoma primario intraóseo presentó metástasis submaxilar y cervical y la neoplasia fue causa de fallecimiento. A pesar de su rareza, los tumores odontogénicos malignos constituyen una causa importante de intervenciones quirúrgicas extensas en la región maxilofacial. (AU)

p53, p21, Rb, and MDM2 proteins in tongue carcinoma from patients < 35 versus > 75 years.

Relatively rare squamous cell carcinomas of the tongue in young patients may be associated with different etiologic factors and pathogenetic mechanisms than carcinomas from the same site in older patients. Alterations in cell cycle proteins likely contribute to the biologic behavior of these neoplasms. The purpose of this investigation was to evaluate cell cycle proteins (p53, p21, Rb, MDM2) in lateral tongue cancers from patients at the two ends of the age spectrum. All available archived lateral tongue carcinomas from patients < 35 years (n = 36, 23 males and 13 females) were sectioned, immunohistochemically stained, and evaluated. Protein expression was scored as percent positive nuclei. An equal number of sequentially accessioned lateral tongue specimens from patients > 75 years (23 males and 13 females) were stained and compared. Positive p53 staining was seen in 18/36 of the < 35-year group versus 24/36 of the > 75-year group (p = 0.149). Increased p21 staining (both percent of positive cells and intensity) was evident in 25/32 of the < 35-year group versus 24/32 of the > 75-year group (p = 1.0). Increased p21 expression was seen in both p53-positive and -negative cases in both age groups. Rb protein was increased in 16/29 of the < 35-year group versus 17/26 of the > 75-year group (p = 0.58). Fourteen cases (4/35 vs 10/36, p = 0.135) showed positive MDM2 staining; MDM2-positive cases were also p53 positive in 4/4 younger and 8/10 older patients. We conclude that p53, p21, Rb, and MDM2 are over-expressed in lateral tongue cancers, and that immunohistochemical profiles are heterogeneous. A p53-independent pathway of p21 induction is supported by the results; p53 suppression may be associated with MDM2 protein expression in a subset of cancers. Significant differences in the expression of p53, p21, Rb, and MDM2 proteins are not evident in lateral tongue carcinomas from patients < 35 years as compared to patients > 75 years.

Angiocentric lymphomas of the palate: clinico-pathological considerations in 12 cases.

Angiocentric lymphomas (AL) involving the mid-face are infrequent lesions. Their incidence seems to be higher in certain Asian and Latin American countries, where most of the reported series reveal a predominance of T-cell lineage and a high frequency of EBV-positive cells. The clinical and pathological features of 12 AL that affected the palate are presented. Immunophenotypic studies were performed in nine of these cases. Seven (77%) demonstrated T-cell lineage, one was of B-cell origin and one could not be classified. The high incidence of T-cell lesions in this and other studies supports the existence of geographical and possibly of etiological differences in these neoplasms.

Odontogenic tumors in Mexico: a collaborative retrospective study of 349 cases.

Reports about the frequency of odontogenic tumors are scarce, and diagnostic criteria used in the reports are not uniform. This article presents the results of a retrospective study of odontogenic tumors recorded in four services of diagnostic pathology in Mexico City (two dental schools, one cancer hospital, and one private oral pathology service). The final diagnosis in each case was based on the 1992 histologic criteria of the World Health Organization. The frequency of odontogenic tumors, expressed as a percent of all oral and maxillofacial specimens, ranged from 0.8% in the cancer hospital (0.02% of all biopsies) to 3.7% in the private oral pathology service. The frequency was identical for the two dental schools (2.5%). We found a total of 349 odontogenic tumors; of these, 345 were benign (98.8%), and 4 (1.1%) were malignant (3 were primary intraosseous carcinomas and 1 was a malignant ameloblastoma). The most frequently occurring tumors were odontoma (34.6%), ameloblastoma (23.7%), myxoma (17.7%), adenomatoid odontogenic tumor (7.1%), and calcifying odontogenic cyst (6.8%). Although relatively rare, odontogenic tumors are still an important cause of extensive surgical procedures in Mexico.