Systemic therapies for salivary gland carcinomas: an overview of published clinical trials

Background: There is no consensus about effective systemic therapy for salivary gland carcinomas (sgcs). Our aim was summarized the clinical trials assessing the systemic therapies (ST) on sgcs.Material and Methods: Electronic searches were carried out through MEDLINE/pubmed, EMBASE, Scopus, Web of Science, and the Cochrane Library databases, and gray literature. Results: Seventeen different drugs were evaluated, and the most frequent histological subtype was adenoid cysticcarcinoma (n=195, 45.5%). Stable disease, observed in 11 ST, achieved the highest rate in adenoid cystic carcinoma treated with sunitinib. The highest complete (11.1%) and partial response (30.5%) rates were seen in androgen receptor-positive tumors treated with leuprorelin acetate. Conclusions: Despite all the advances in this field, there is yet no effective evidence-based regimen of ST, with all the clinical trials identified showing low rates of complete and partial responses. Further, translational studies are urgently required to characterize molecular targets and effective ST. (AU)

What is the frequency of floor of the mouth lesions? A descritive study of 4016 cases / ¿Cuál es la frecuencia de las lesiones del suelo de la boca? Un estudio descriptivo de 4016 casos

Background: The aim of this study was to investigate the frequency of oral lesions in the floor of the mouth fromrepresentative oral pathology centres in Latin America.Material and Methods: This study was conducted on biopsies obtained from January of 1978 to December of 2018at nine Latin America oral and maxillofacial pathology centres. Gender, age and histopathological diagnosis wereevaluated. Data were analysed using descriptive methods. Chi-square test was used for pairwise comparisons.Results: From 114,893 samples, 4,016 lesions (3.49%) occurred in the floor of the mouth. Brazil showed 3,777 cases(94%), Mexico 182 cases (4.5%) and Argentina 57 cases (1.4%). Benign lesions represented 65.1% (2,617 cases),followed by 34.9% (1,404 cases) of malignant disorders. Lesions of epithelial origin were more frequent (1,964) cases; 48.9%), followed by salivary glands (1,245 cases; 31%) and soft tissue lesions (475 cases; 11.7%). The mostcommon histological subtypes were oral squamous cell carcinoma (1,347 cases; 33.5%), ranula (724 cases; 18%), oralleukoplakia (476 cases; 11.8%) and inflammatory fibrous hyperplasia (239 cases; 5.9%). The lesion affected males in2,129 cases and females in 1,897 cases.Conclusions: In the current study, lesions in the floor of the mouth represented 3.49% of biopsies submitted to oralpathology services and oral squamous cell carcinoma, ranula and leukoplakia were the most common lesions.(AU)

Oral Kaposi sarcoma development is associated with HIV viral load, CD4+ count and CD4+/CD8+ ratio / El desarrollo del sarcoma de Kaposi oral está asociado con carga viral de VIH, recuento de CD4+ y relación CD4+/CD8+

Background: Kaposi’s sarcoma (KS) is an uncommon, multifocal and angioproliferative lesion, which demon-strates a poor prognosis. The aim of the present research was to explore the association of HIV viral load, CD4+and CD8+ counts and the CD4+/CD8+ ratio on the risk of oral Kaposi’s sarcoma (KS) development.Material and Methods: A total of 62 patients were retrieved from March 2008 to October 2020 from the files oftwo oral pathology centres. Clinical, laboratory and follow-up data were retrieved from their medical files. Poissonregression was used to explore the role of history of immunosuppression and its association with oral KS develop-ment. A P-value <0.05 was considered significant.Results: Sixty-two patients were included in the present study (32 with oral KS and 30 with no presentation oflesions anywhere on the body). Patients with oral KS presented a mean age of 32.6 years, and male patients weremore affected. The hard palate (15 cases; 46.8%) was the main anatomical site affected. The lesions were mostlypresented as swellings (13 cases; 40.6%) and nodules (12 cases; 37.5%). Systemic manifestations were also ob-served, including candidiasis (4 cases; 12.5%), bacterial infection (3 cases; 9.3%), tuberculosis (3 cases; 9.3%),herpes simplex (3 cases; 9.3%) and pneumonia (3 cases; 9.3%). A significant correlation was observed betweenHIV viral load, CD4+ count and the CD4+/CD8+ ratio with oral KS development.Conclusions: HIV viral load, CD4+ count and the CD4+/CD8+ ratio are associated with oral KS development.(AU)

Benign oral vascular lesions treated by sclerotherapy with ethanolamine oleate: A retrospective study of 43 patients

Background: Although sclerotherapy is a common treatment for benign oral vascular lesions, there is no well standardized protocol for this purpose. The aim of the present study was to describe the clinical characteristics of patients treated by sclerotherapy with ethanolamine oleate (EO), in order to contribute to a better understanding of this technique. Material and Methods: Medical records and images of 90 patients treated by the same sclerotherapy protocol were retrieved and analysed. Thus, 43 cases with complete information were selected and described. Results: The most affected age group was 41-70 years, with a female predominance and 86% of patients being Caucasian. Lips were the most affect site (70%) followed by the tongue (16%). Regarding clinical appearance, approximately 90% of lesions were classified as nodules, and 90% of patients reported no pain. Approximately 40% of lesions were 0.5-1.0 cm in size. In 58% of the patients, only one application of ethanolamine oleate was necessary. The application doses varied according to the lesion size and number of applications. Complete clinical regression occurred in 91% of cases, whereas 9% showed partial regression. Conclusions: Sclerotherapy with EO is an acceptable, effective and affordable treatment for benign oral vascular lesions (AU)

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Panoramic and skull imaging may aid in the identification of multiple myeloma lesions

Background: The purpose of this study was to investigate the presence of punched-out lesions in craniofacial bones using three different radiographic protocols in a large cohort of patients. Material and Methods: One hundred fifty-five MM patients were evaluated using panoramic and skull (frontal and lateral) radiographs, which were performed in all patients at the time of MM diagnosis. The diagnostic potential for detecting punched-out lesions was compared among the radiographic techniques. Results: MM punched-out lesions were identified in 135 (87%) panoramic radiographs, 141 (91%) frontal and 144 (93%) lateral skull radiographs. Punched out-lesions were synchronously present in skull and jawbones in 129 (83.23 %) cases. The lesions were detected exclusively in skull in 18 (11.61%) cases and exclusively in jawbones in 6 (3.87%) cases. Punched out-lesion mainly affected the skull and the jawbones in a synchronous way (p<0.001) rather than separately Conclusions: All investigated radiographic techniques (panoramic, frontal and lateral skull approaches) demonstrated high detection rates for MM punched-out lesions in craniofacial bones. Panoramic radiography may aid to the radiographic protocols to identify multiple myeloma bone lesions (AU)

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Orbital apex syndrome affecting head and neck cancer patients: A case series

BACKGROUND: Orbital apex syndrome (OAS) is a complex and uncommon disorder that typically damages multiple cranial nerves in association with optic nerve dysfunction. OAS is associated with several different pathologies, however; only a few cases have been reported in association with head and neck cancer (HNC) so far. MATERIAL AND METHODS: A case series of HNC patients diagnosed with OAS is described including clinicopathological data, image findings, and disease outcome. RESULTS: Ptosis and diplopia were diagnosed in four male patients with mean age of 61.2 years who were undergoing treatment for late-stage carcinomas of the tongue, larynx, and nasopharynx, eventually leading to the diagnosis of OAS. The mean overall survival rate after the diagnosis of OAS was 9.5 months. CONCLUSIONS: The current study reinforces evidence that OAS indicates poor prognosis and highlights the importance of early diagnosis

Development of proliferative verrucous leukoplakia (PVL) in oral lichen planus: Is it not a clinical spectrum of PVL?

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Calcified carotid artery atheromas on panoramic radiographs of head and neck cancer patients before and after radiotherapy

BACKGROUND: The aims of this study were to verify if head and neck radiotherapy (RT) is able to induce calcified carotid artery atheroma (CCAA) in a large head and neck cancer (HNC) population and also to compare the sociodemographic and clinical findings of patients with and without CCAA detected on panoramic radiographs. MATERIAL AND METHODS: Panoramic radiographs taken before and after head and neck radiotherapy (RT) of 180 HNC patients were selected and analyzed in order to identify the presence of CCAA. In addition, CCAA presence or absence on panoramic radiographs were compared and correlated with clinicopathological findings. RESULTS: A high overall prevalence of CCAA was found on panoramic radiographs (63 out of 180 = 35%) of HNC patients. No significant difference of CCAA before and after RT was observed. There were also no differences between groups (with and without CCAA) regarding age, gender, tobacco and alcohol use, arterial hypertension, diabetes mellitus, acute myocardial infarction, hypercholesterolemia, tumor location, clinical stage of disease and RT dose. However, there was a greater prevalence of strokes in patients with CCAA (p < 0.05). CONCLUSIONS: Although CCAA were frequently found in panoramic radiographs of patients with HNC, RT seems not to alter the prevalence of these calcifications

Facial pigmentation associated with amiodarone.

Amiodarone is one of the most commonly used drugs for treatment of cardiac arrhythmia. Several undesirable effects are associated with its long-term use. This report describes the case of a 71-year-old female patient, with a diagnosis of cardiac arrhythmia, who presented with a stigmatizing blue-gray facial pigmentation and altered serum values of thyroid hormones associated with the intake of amiodarone. The patient was referred to her cardiologist. The aim of this report is to increase clinicians' awareness about the potential adverse effects of this drug.

Clinical and histopathological analysis of oral squamous cell carcinoma in young people: a descriptive study in Brazilians.

We retrospectively analysed the clinical and histological characteristics of oral squamous cell carcinoma (SCC) in a sample of Brazilian patients 45 years of age or less. Files from a single oral histopathological service were studied during the period 1990 to 2005 and the clinical data collected. The histological sections of the invasive part of each tumour were analysed and classified using the criteria of Bryne et al. A total of 46 patients were selected, 36 (78%) of whom were white; 38 (83%) were male; and the most common site was the floor of the mouth (n=14, 30%) followed by the tongue (n=13, 28%). Most selected patients used tobacco and alcohol, and 43 were diagnosed as having clinical stages III and IV disease. Nine of the tumours (20%) were well differentiated, 23 were moderately differentiated, and the rest (n=14) were poorly differentiated. The characteristics of this group suggest that oral SCC in young patients does not behave differently from the oral SCC found in the overall population.