Prostate Metastasis in Oral Malignant Melanoma - A Case Report.

ABSTRACT: Melanoma is the ninth most prevalent and the second most lethal tumour. The aetiology and pathogenesis remain uncertain. It occurs in elderly people, over the fifth decade, and is predominant in males. Clinically, they present as an asymptomatic macular or nodular growth. The prognosis is impacted by the size of the tumour and distant metastases. Patients with distant metastases have a 5-year survival rate of less than 30%, constituting metastasis as the major cause of melanoma-related fatality. Currently, the mainstay of treatment for metastatic melanoma is immunotherapy due to the inoperable state, radioresistant nature of the tumour and high chances of cytotoxicity in chemotherapy. A senile male patient, who was diagnosed with oral malignant melanoma of the maxillary buccopalatal gingiva with distant metastasis to the liver and the prostate, is reported here. Although metastasis to the liver is common among malignant melanomas, in this case metastasis to the prostate gland highlights the rarity.

Asymptomatic palatal mass: A case report.

Accidental detection of asymptomatic clinically suspicious lesions is a common occurrence in routine clinical examination of the oral cavity. In certain cases, these lesions may mimic benign lesions further adding to confusion. In this case report, we have discussed the case of a 51-year-old male patient with an asymptomatic palatal mass which was detected during a routine dental check-up and subsequently confirmed to be an adenoid cystic carcinoma (ACC) arising from the minor salivary glands. The patient underwent right partial maxillectomy followed by radiation therapy and has been disease-free for 6 years and is on follow-up. ACC is a malignant tumour of the salivary glands commonly occurring in the palate, characterized by a slow indolent growth phase, with a high predilection for late recurrences which can be local or systemic. This article describes the importance of recognizing this clinical entity as a differential diagnosis in the evaluation of asymptomatic palatal lesions to enable early diagnosis and institution of appropriate treatment to successfully treat the disease.

Association of Human Papilloma Virus in Oral Squamous Cell Carcinoma: An Alarming Need for Human Papillomavirus 16 Screening in Cancer Patients.

BACKGROUND: The percentage of cancers of the tongue and palatine tonsils has continued to increase by 2%-4% among younger men. This increased prevalence of a subsection of oropharyngeal carcinoma can be associated with human papillomavirus (HPV). Among the head-and-neck cancers, a strong association with HPV infection is evident with oropharyngeal cancers, particularly tonsillar and basal tongue cancers. OBJECTIVES: Oral carcinoma, with an overall incidence of 16.1 adults per 100,000, is one of the leading malignancies worldwide, presenting a noticeable geographic variation in its distribution. Squamous cell carcinoma (SCC) being the most common of all oral malignancies, the objective of the study is to detect the HPV antigen p16 over-expression in patients with oral SCC using immunohistochemistry (IHC). MATERIALS AND METHODS: Oral SCC (OSCC) diagnosed formalin-fixed-paraffin embedded blocks were processed for IHC. RESULTS: Out of 50 cases, 3 were deferred due to insufficient tumor sample and 2/47 cases were p16 positive and the site was the lateral border of the tongue. CONCLUSION: The HPV antigen overexpression in patients with OSCC was investigated to detect the incidence of HPV in SCC of oral cavity. P16 was used as a marker for the detection of OSCC using IHC in HPV-induced OSCC. Positives were detected thus concluding the significance of studying HPV expression during diagnosis.

Intraoperative Management of Recurrent Leukoplakia at Red Zone.

Oral leukoplakia (OL) is a potentially malignant oral disorder (PMOD) that sometimes trans-form into oral squamous cell carcinoma (OSCC). OL is one of the most frequent PMODs seen in the oral cavity. The global prevalence of OL is approximately 2.6%, with its worst prognosis of undergoing a malignant transformation. Leukoplakia is clinically divided into red zones (tongue and floor of mouth) and nonred zones (buccal mucosa, palate, and soft palate) areas. The red zone areas have more potency of transforming into malignancy. Hence, patients with red zone areas need to be followed up more frequently and treated appropriately. This case report signifies the importance of treating one such case of leukoplakia at red zone area.

Pleomorphic Sarcoma of the Oral Cavity: A Rare Case Entity.

Pleomorphic sarcomas are extremely rare in the oral cavity, representing only 5% of all soft tissue sarcomas in the extremities of adults. They form a group of highly undifferentiated pleomorphic malignant tumors. A 36-year-old male reported to the OP with a chief complaint of a tooth ache in the right lower quadrant for the past 6 months. The patient gave a history of extraction of a mobile tooth in that region. A radiograph of the region was advised. An incisional biopsy was also done and sent for histopathological examination. The microscopy revealed the presence of spindle-shaped cells showing dysplastic features. A panel of immunohistochemical markers were performed to identify the tissue of origin of the lesion. The article details the clinical, radiographic, and microscopic features of a pleomorphic soft tissue lesion along with the array of immunohistochemical markers, leading to the final diagnosis of such enigmatic lesions.

Disto-angular transmigrated impacted mandibular molar with enostosis: A rare intraoral lesion.

A 29-year-old male patient reported for replacement of missing teeth. The patient gave history of unerupted right lower posterior teeth and the orthopantomogram revealed transmigrated mandibular second molar to the inferior border of mandible just below the root apices of second premolar associated with enostosis distally toward the ramus of mandible with size of about 21 mm Χ 20 mm. This rare interosseous defect plays a vital role in deciding prosthetic treatment options for missing teeth and utmost care should be taken to preserve the health of the patient during such procedures.