Unusual Presentation of Adenoid Cystic Carcinoma of the Tongue: A Case Report and Review of the Literature.

Adenoid cystic carcinoma (ACC) is a rare malignant tumor that affects the salivary glands. Its notable characteristics include aggressive local growth, infiltration of nerves (perineural invasion), a propensity to disseminate to other parts of the body (metastasize), and a high likelihood of recurrence. Here, we present the case of a 71-year-old male patient who presented with swelling on the posterior left side of his tongue, which had been causing him difficulty in chewing for the past six months. The parotid gland is frequently impacted in the head and neck area, with the tongue being comparatively uncommon. While distant metastasis is frequent, metastasis to nearby lymph nodes is not as common. However, if it does occur, it is associated with a poor prognosis and reduces the average survival age of the patient. The preferred treatment for ACC is surgical removal with wide resected margins. If it metastasizes to lymph nodes, then adjunct therapy is the treatment modality for the lesion. ACC exhibits three histopathological patterns: solid, tubular, and cribriform. The solid type is associated with a poorer prognosis compared to cribriform type, which typically has a better prognosis. This case, occurring on the tongue, is rare.

Peripheral Odontogenic Fibroma: A Report of a Rare Case and Review of Literature.

Peripheral odontogenic fibroma (POF) is described as a relatively rare, benign, extraosseous odontogenic tumor derived from odontogenic ectomesenchyme. It is characterized by a mature fibrous stroma with embedded inactive resting islands of odontogenic epithelium. In the category of peripheral/extraosseous neoplasms, odontogenic fibroma (OF) is one of the most prevalent tumors. The radiographic examination shows minimum bone loss in the alveolar crest area. It poses a diagnostic challenge for clinicians and pathologists because its clinical and radiological aspects are similar to other peripheral odontogenic as well as non-odontogenic tumors, and the differential diagnosis is predicated on histological assessment. Histopathological examination is the key to a final confirmed diagnosis. This article presents a case report of a 53-year-old male who reported a painless, pale pink mass in the maxillary anterior region. We emphasize the clinicopathological, radiographical, and histopathological aspects of the rare entity of POF.

A Dermoid Cyst of the Head, Neck, and Face Region: A Case Report.

Dermoid cyst (DC), a rare benign tumor of developmental origin that develops from mesoderm and ectoderm, is frequently identified in children. DC refers to three cysts that are histologically related, namely, DC, epidermoid cyst, and teratoma. About 70% of DCs are discovered in children aged five years or younger, with the majority being congenital. DC of the head and neck are rare, accounting for only 7% of all such cysts. DC, or benign cutaneous tumors, tend to grow and persist. The presence of epithelial cells along the lines of embryonic closure results in a DC. It is always difficult to properly diagnose these lesions using clinical tests and conventional radiography. Histologically, a DC must have two germ cell layers, and the diagnosis can only be made with pathologic confirmation. Specialized imaging tests including CT, MRI, ultrasonography, and histological examinations should be performed to make a diagnosis and choose the best course of action for surgery.

Correlation of Pattern of Invasion, Stromal Inflammation and Lymphovascular Invasion With Histopathological Grading in Oral Squamous Cell Carcinoma: A Retrospective Study.

INTRODUCTION: Despite the progress in diagnostics and treatment modalities, the survival rate of oral squamous cell carcinoma (OSCC) patients has remained unchanged. Early diagnosis of the disease helps in better treatment and prognosis. Identifying clinicopathological and histopathological parameters that help predict disease progression is crucial. OBJECTIVES: To assess the significance of various clinical and histopathological factors in OSCC and to correlate the patterns of invasion of tumour (POI), stromal inflammation, and lymphovascular invasion with the histopathological grading of OSCC. MATERIALS AND METHODS: This study included 30 oral squamous cell carcinoma cases from 2015 to 2021. The surgically operated cases of OSCC were obtained from the archives of the Oral Pathology Department. The subjects were categorized according to the degree of differentiation of OSCC. The parameters like the pattern of invasion of tumour (POI), stromal inflammation, and lymphovascular invasion were assessed and correlated with the different histopathological grades of OSCC. RESULTS: We observed a statistically significant correlation between the pattern of invasion and stromal inflammation with histopathological grades of OSCC. There was no significant association between lympho-vascular invasion and histopathological grades of OSCC. CONCLUSION: We conclude that histopathological parameters like the pattern of invasion and stromal inflammation significantly impact different grades of OSCC. These parameters should be included in routine histo-pathological reports for predicting clinical outcomes and management of the disease.

Unicystic Ameloblastoma (UA): A Case Series.

Ameloblastomas are true benign tumors of odontogenic epithelial origin mostly seen in the mandible. After odontoma, it is the second most commonly seen odontogenic neoplasm. Ameloblastomas comprise several clinical, radiological, and histological varieties, making them the most significant odontogenic neoplasm. Unicystic ameloblastomas (UAs) refer to those cystic lesions that show clinical, radiographic, or gross features of jaw cysts but on histologic examination, they show a typical ameloblastomatous epithelium lining the cysts' cavities, with or without luminal and/or mural tumor proliferation. UAs are a less encountered variant of ameloblastomas and are believed to be less aggressive. As this tumor shows considerable similarities with dentigerous cysts, both clinically and radiographically the biological behavior of this tumor group was reviewed.

Aneurysmal Bone Cyst Plus Lesions: A Case Report and a Literature Review.

The intraosseous osteolytic lesions mainly involving the metaphyseal region of vertebrae and long bones were diagnosed as aneurysmal bone cysts (ABCs). Further, an ABC was known as an ossifying hematoma. It is considered an expanding osteolytic lesion consisting of blood-filled spaces of variable sizes separated by connective tissue septa containing trabeculae of osteoid tissue and osteoclast giant cells. It is frequently reported to involve long bones; however, only 1.9% prevalence is seen in jaw bones. It represents a very small percentage of all non-odontogenic tumors. ABC shows variations in age prevalence and its clinical presentation may be challenging to the surgeon. In addition, ABC may occur in association with other primary bone pathologies like ossifying fibroma, fibrous dysplasia, and giant cell tumor; such entities are known as ABC plus lesions. Here we present a classic case of ABC plus lesion.

Significance of HIF-1α and CD105 in establishing oral squamous cell carcinoma associated with oral submucous fibrosis a distinct clinicopathological entity.

Context: Oral squamous cell carcinoma associated with oral submucous fibrosis (OSCC with OSMF) is clinicopathologically a distinct entity. However, scientific proof in view of assessment of biomarkers of hypoxia and neoangiogenesis to differentiate them are lacking. The expression of hypoxia-inducible factor 1-α (HIF-1α) and CD105 in OSCC with and without OSMF possibly will be explicated along these lines. Aim: This study aims to evaluate the molecular basis of hypoxia and neoangiogenesis in terms of immunohistochemical expression of HIF-1α and CD105 in OSCC with and without OSMF cases. Settings and Design: A retrospective cohort. Subjects and Methods: The study comprise of 203 histopathologically diagnosed surgically operated cases of OSCC retrieved from the departmental archives. The OSCC cases were subgrouped into two, OSCC with OSMF (Group I) and OSCC without OSMF (Group II). The evaluation of hypoxia and angiogenesis was carried out by immunohistochemical markers, HIF-1α and CD105. MVD is the parameter of angiogenesis expressed by CD105. Statistical Analysis Used: Differences in CD105, and HIF-1α immunoreactivity between study groups were done using descriptive statistics using "Kruskal-Wallis test," "Mann-Whitney test." Statistical significance was set at P < 0.05. Results: On comparison of MVD in Group I and II, statistically significant difference was found in MVD (8.88 ± 3.41, 16.13 ± 5.86, P = 0.0001). The HIF1-α expression was less in Group I (6.85 ± 2.62) as compare to Group II (7.22 ± 3.08) but the difference was statistically nonsignificant (P = 0.35). Conclusions: The OSCC with OSMF is not only clinicopathologically distinct entity of OSCC but also diverse in its molecular pathogenesis as explicited by distinct expression of HIF-1 α and CD105.

Oral Microflora in the Background of Oral Cancer: A Review.

Oral cancer exhibits a multifactorial etiology. Microorganisms residing within the oral cavity as normal commensals have long been studied in terms of their role in the process of carcinogenesis. Other factors such as tobacco and alcohol consumption have also been implicated in carcinogenesis as the primary risk factors. Poor oral hygiene, dietary abnormalities, and betel nut chewing can also act as contributory factors in the process of carcinogenesis. Multiple research works have been carried out in the past to shed some light on the role of exogenous bacterial species in the development of cancers. Studies conducted were to assess changes in the oral microflora in patients suffering from oral carcinoma and to evaluate and compare pre-operative and post-operative changes in oral microbiota. For this review, multiple articles were studied and evaluated. Appropriate conclusions were drawn and are presented in the review. A definitive link between cancer and microflora is yet to be established. In the present article, a review of the studies done on the contribution of microbial flora present within the oral cavity and their role in oral cancer is done and its nature and extent are evaluated. A variety of microbiological agents can contribute to the progression of carcinogenesis in the presence of definitive risk factors such as alcoholism and smoking.

Oral submucous fibrosis: An enigmatic morpho-insight.

Oral submucous fibrosis (OSMF) is a chronic progressive, scarring disease affecting oral, oropharyngeal, and sometimes the esophageal mucosa. It is characterized by the progressive fibrosis of the submucosal tissue. The pathogenesis of OSMF has been directly related to the habit of chewing areca nut and its commercial preparation, which is widespread in Indian subcontinent and Southeast Asia. The areca nut has been classified as a "group one human carcinogen." Oral squamous cell carcinoma in the background of OSMF is one of the most common malignancies in South and Southeast Asian countries. Malignant transformation has been reported in 7%-12% cases of OSMF. Histopathological spectrum of OSMF includes the apparent alterations observed in the epithelium and connective tissue. Epithelial atrophy and sometimes epithelial hyperplasia with or without dysplasia are the peculiar alterations seen in the epithelium. In the connective tissue, there is extracellular matrix remodeling which results in excessive collagenization. Further cross-linking of collagen leads to hyalinization which makes the collagen resistant to proteolysis. Owing to fibrosis in the connective tissue, there is narrowing of blood vessels which further results in compromised blood supply to the local tissue milieu, that is, hypoxia. This tissue hypoxia elicits angiogenesis which may result in the malignant transformation of OSMF. Perpetual irritation of areca nut and its constituents to the oral mucosa leads to upregulation of pro-inflammatory cytokines and further juxtaepithelial inflammation. Thus, these coordinated reactions in epithelium and connective tissue leads the OSMF toward malignant transformation.

Impact of virtual microscopy with conventional microscopy on student learning in dental histology.

BACKGROUND: In dental histology, the assimilation of histological features of different dental hard and soft tissues is done by conventional microscopy. This traditional method of learning prevents the students from screening the entire slide and change of magnification. To address these drawbacks, modification in conventional microscopy has evolved and become motivation for changing the learning tool. Virtual microscopy is the technique in which there is complete digitization of the microscopic glass slide, which can be analyzed on a computer. This research is designed to evaluate the effectiveness of virtual microscopy with conventional microscopy on student learning in dental histology. MATERIALS AND METHODS: A cohort of 105 students were included and randomized into three groups: A, B, and C. Group A students studied the microscopic features of oral histologic lesions by conventional microscopy, Group B by virtual microscopy, and Group C by both conventional and virtual microscopy. The students' understanding of the subject was evaluated by a prepared questionnaire. RESULTS: The effectiveness of the study designs on knowledge gains and satisfaction levels was assessed by statistical assessment of differences in mean test scores. The difference in score between Groups A, B, and C at pre- and post-test was highly significant. This enhanced understanding of the subject may be due to benefits of using virtual microscopy in teaching histology. CONCLUSION: The augmentation of conventional microscopy with virtual microscopy shows enhancement of the understanding of the subject as compared to the use of conventional microscopy and virtual microscopy alone.