Malignant potential of oral lichen planus; a follow-up study of 326 patients.

326 patients with oral lichen planus were followed for periods ranging from 6 months to 10 years (mean 4.8 years), in an attempt to clarify the malignant potential of this disease which is still controversial. Malignant transformation occurred in 4 patients (1.3%) in a mean time of 6.5 years after the onset of lichen planus. Before cancer development, 3 of these patients manifested the erosive form of oral lichen planus, while the others, a combination of the papular/atrophic form. Malignant transformation in our patients could not be associated with any evident factors, such as family history, local irritation, alcohol consumption, nutritional disturbances or other systemic diseases.

Granulomatous cheilitis: a study of six cases.

OBJECTIVE: Granulomatous cheilitis (GC) is a very rare disorder of unknown etiology. Clinically, GC is characterised by recurrent swelling of the labial tissues, which may be followed by a permanent enlargement. Histologically, the typical form of GC is characterised by the formation of scattered aggregates of non-caseating granulomas. GC is the most frequent sign of orofacial granulomatosis, a disorder under which also encompasses sarcoidosis, Crohn's disease, atypical tuberculosis, Anderson-Fabry disease, possibly some allergic reactions, and Melkersson-Rosenthal syndrome (MRS). Some consider GC as an oligosymptomatic or monosymptomatic form of MRS. SUBJECTS AND METHODS: In this study we examined the clinical records of six patients presenting with GC which were examined and treated in the Department of Oral Medicine and Pathology of the Dental School of Aristotle University of Thessaloniki (Greece) during a 16-year period. In five of six patients a persistent swelling of the lower lip was recorded, one of whom also developed swelling in the upper lip. In one case the swelling was present in both lips and in another the GC was the only clinical finding, while in the other five cases it was accompanied by at least one other feature of MRS. In five cases, the histological picture revealed non-caseating granulomas. RESULTS: The treatment with the intralesional infusion of corticosteroids in three cases and the oral administration of corticosteroids in two cases was successful. One of the patients refused to be treated. This patient also presented later with permanent swelling of the upper lip.

Desquamative gingivitis: a clinical, histopathologic, and immunologic study.

Desquamative gingivitis is believed to be a clinical sign of certain mucocutaneous diseases rather than a distinct pathologic entity. The prevalence of desquamative gingivitis was studied in a group of patients with the most common mucocutaneous diseases. Of 414 patients with pemphigus vulgaris, mucous membrane pemphigoid, or oral lichen planus, 49 (11.8%) exhibited gingival lesions in the form of desquamative gingivitis. Desquamative gingivitis was most prevalent in the patients with mucous membrane pemphigoid (41.6%) followed by those with pemphigus vulgaris (9.1%). Other clinical characteristics, as well as histopathologic and immunohistochemical findings, that aid in early diagnosis are presented.

Oral tuberculosis.

A case with oral tuberculosis and unaware of systemic tuberculosis is reported. The oral lesions clinically manifested as two painless ulcerations in the hard palate. Pulmonary tuberculosis was diagnosed following the histopathologic and bacteriologic examination of the oral lesions.

Squamous cell carcinoma of the lips in a northern Greek population. Evaluation of prognostic factors on 5-year survival rate--I.

The purpose of this study was to determine the clinical features of squamous cell carcinoma (SCC) of the lips, along with its prognostic factors, in order to extend and update the information related to lip cancer in northern Greece and to provide a basis for international comparison. Records of 1510 patients with SCC of the oral cavity presented at the Theagenion Anticancer Institute of Thessaloniki, Greece from 1979 and 1989 were reviewed. The most common site for oral squamous cell carcinoma (OSCC) was found to be the lips (59.4%) as compared to 40.5% of intra-oral SCC. Males were affected more frequently, presenting a ratio of 9.2:1. The peak age of incidence was found to be the 6th decade for men and the 8th for women. Rural residents and outdoor workers were affected more than urban residents (79.9% versus 28.1%). Most of the patients were diagnosed in early categories and early clinical stages of the disease. Almost all (98.5%) were classified into T1 and T2 categories, and 92.9% into stages I and II. A total of 7.59% of patients presented with clinically-positive lymph-node involvement. Most of them were classified as an advanced stage of the disease. Primary surgical excision was performed on 60.14%, radiotherapy on 35.14%, a combination of these on 2.47%, and chemotherapy alone or in combination with the above regimens in 2.22% of the cases. The outcome was adequate for surgery, radiotherapy, and the combination of the two, since 91.3, 74, and 90%, respectively, survived for more than 5 years. An overall 5-year survival rate of 83.3% was found. Our findings showed that the survival rate was significantly influenced by the main prognostic factors, such as the size of the tumour, the lymph-node involvement, the clinical stage of the disease and the histologic differentiation. SCC of the lips continues to be the most common site of oral cancer development amongst the Greek population. The aetiologic significance of actinic radiation for SCC of the lips is confirmed by our findings. The main prognostic factors proved to significantly influence the survival of our patients. Our results support the fundamental principal of head and neck cancer, i.e. that early detection of the primary tumour is the best prognostic factor for increasing survival rates. Therefore, public awareness concerning the disease, and better education for health care workers which will provide a thorough knowledge for the prognosis of oral cancer and the factors influencing it, is necessary.

Intraoral salivary duct carcinoma: a clinicopathological study of four cases and review of the literature.

Salivary duct carcinoma (SDC) is a distinctive entity of highly malignant salivary gland tumors. We present the clinical features and outcomes of four cases in minor salivary glands and of 69 additional cases previously reported in the literature. The tumor occurs most frequently in the sixth and seventh decades of life with a 3.8:1 male preponderance. The prognosis is dismal. Sixty-one percent of patients were dead within 5 months to 10 years (mean 25 months) and the rate of lymph node metastasis was 60%. Twenty-eight percent of patients were without evidence of the disease for 13 months to 9 years (mean 33 months). The histologic features, differential diagnosis, and origin of SDC are discussed.

Kaposi's sarcoma of the oral cavity: case reports.

Classic Kaposi's sarcoma is a rare malignant neoplasm of endothelial cell origin. Oral manifestation of Kaposi's sarcoma is even more uncommon. The purpose of this article is to describe two cases of classic Kaposi's sarcoma and to discuss the current knowledge regarding its pathogenesis, epidemiology, clinical characteristics, and therapy.

The role of the time of application of the promoter in two-stage chemically induced carcinogenesis in the oral mucosa: experimental study in the rat.

The purpose of this study is to determine the role of the time of application of the promoter (in this case, mechanical irritation) in two-stage chemically induced oral carcinogenesis. One hundred fifty-five male rats were divided into seven groups. Group 1, 2 and 3 each received two intraperitoneal injections of the carcinogen N-nitroso-N-methylurea (NMU): 50 mg/Kg BW. Mechanical irritation was applied on the left buccal mucosa, 7 days before the first injection of NMU (group 1), 16 days (group 2), and 80 days (group 3) after the carcinogenic administration. Animals of groups 4, 5, 6 and 7 served as controls. Only group 1 and 2 animals developed tumors in the irritated buccal mucosa. From the results of this study we conclude that the delay of the application of the promoter does not lead to tumor formation. This could be explained by the repair of the carcinogenic lesion at the cellular level.

Salivary gland tumors studied by means of the AgNOR technique.

Silver-binding nucleolar organizer regions (AgNORs) were counted in sections from formalin-fixed, paraffin-embedded tissue blocks of 14 benign and 17 malignant tumors of minor salivary glands. The difference in the mean number of AgNORs count per nucleus between benign and malignant tumors was found to be statistically significant (p < 0.001). A positive correlation between the AgNORs count and the degree of malignancy of the malignant salivary gland tumors was generally observed. The AgNORs technique can be used as a diagnostic aid in differentiating between benign and malignant salivary gland tumors, and possibly the salivary duct carcinoma from the acinic cell carcinoma and poorly differentiated mucoepidermoid carcinoma.

Eosinophils in oral and cutaneous lesions of erythema multiforme.

The purpose of this retrospective clinicopathologic study was to investigate the presence of eosinophils in oral and skin lesions of erythema multiforme. Seventeen cases were selected which fulfilled clinical and histopathologic criteria for the disease. Twelve out of 13 sections taken from skin biopsies and 4 out of 5 sections taken from oral lesions contained eosinophils in varying densities. The occurrence of eosinophils in the lesions of erythema multiforme is parallelized and discussed with the existence of certain clinical and histopathologic aspects. Therefore, we suggest that eosinophils occur in cutaneous and oral lesions of erythema multiforme and are occasionally numerous.

Reticulohistiocytic granuloma of the tongue: a case report.

Reticulohistiocytic granuloma is a type of reticulohistiocytosis that is manifested without systemic disturbances. A rare case of reticulohistiocytic granuloma presenting as a solitary nodule on the tongue is reported and discussed.

Primary tuberculosis of the oral cavity.

Two cases of primary tuberculosis of the mouth are reported. Painless ulceration of long duration and enlargement of the regional lymph nodes that did not respond to conservative and antibiotic therapy were the main manifestations of the disease in both cases. In the first case the tubercle ulcer was located in the lower buccogingival sulcus of a 17-year-old girl. In the second case the lesion occurred as a chronic periodontal inflammation around the gingiva of the left lower second molar tooth. When the tooth was extracted, a painless ulceration appeared around the socket, which was filled by granulation tissue. Histopathologic examination; bacteriologic, serologic, and blood tests; and chest x-ray film confirmed the diagnosis. Predisposing factors that might favor primary inoculation of tubercle bacilli into oral mucosa are also discussed. Finally we emphasize that in such cases it is essential to attempt to locate a possible primary site elsewhere in the body before oral tuberculosis is considered the primary disease.

Extensive aneurysmal bone cyst of the mandible: surgical resection and immediate reconstruction. A case report.

A case of extensive aneurysmal bone cyst of the mandible is described. The surgical defect was reconstructed immediately with two autogenous ribs and corallin porous hydroxyapatite. The postoperative results were good. There was no recurrence after 2 years of follow-up. The patient does not have any functional or esthetic problems.

Congenital lipoma of the tongue. Report of a case.

A case of a congenital lipoma of the tongue in a 20-day old female infant is reported. The tumor was completely removed and follow-up showed excellent healing without recurrence.

[The effect of the chronic irritation and pregnancy in the development of the pregnancy tumor. Experimental study in rats]. / E epidrase tou Chroniou epethismou kai tes kyeses ste demiourgia antidrastikes hyperplasias (ogkou kyeses). Peiramatike melete se epimyes.

This study was undertaken in purpose to estimate the chronic irritation as an aetiological factor in the development of pregnancy tumor. Wire was attached around the first upper molar of 40 female rats, so that its free ends would irritate the mucosa of the cheek. The rats were divided in groups A, B and C. Group A contained 15 rats which were placed for fertilization 7 days after the irritation started. Group B contained 15 rats which were placed for fertilization immediately after the irritation started. Group C contained 10 rats which remained with the irritation. All rats were sacrificed 50 days after the experiment started and the irritated mucosa of the cheek was removed, fixed in formaline and examined histologically. In 11 rats of group A and in 7 of group B a small size tumor appeared in the irritated region. In the remaining rats, ulceration was present. The histological findings of the tumors were compatible with pregnancy tumors. Our results support that the hormonal changes during the pregnancy consist the primary aetiological factor in the development of pregnancy tumors and that the local chronic irritation acts as a secondary auxiliary factor.

[Ultrastructural and histochemical study of a pleomorphic adenoma of the palate]. / Hypermikroskopike kai histochemike melete polymorphou adenomatos tes hyperoas.

Histochemical and ultrastructural study of the epithelial regions forming lumina in one case of pleomorphic adenoma of the palate was undertaken. The ultrastructural findings suggest that these epithelial regions are derived from the intercalated ducts. The presence in the cytoplasm of periluminal cells of pinocytotic vesicles and vacuoles containing material similar in appearance of that seen in the luminal supports a reabsorptive activity of these cells. The microcalculi of calcium phosphate occasionally seen in the cytoplasm of these cells may be formed by the phagocytosis of the endocytotic material from the lumina.

[Chondrosarcoma: review of the literature and report of a case located in the maxilla]. / Chondrosarkoma. Anaskopise tes bibliographias kai anaphora se mia dike mas periptose me entopise sten ano gnatho.

Chondrosarcomas of the jaws and facial region are very rare tumors when compared with other bony tumors. It may show growth for several months or it may present as a rapidly growing tumor causing facial deformity, nasal obstruction, epistaxis, visual disturbances and teeth dislocation. Tumor radiologic evaluation must be done very carefully with conventional techniques, CT or M.R. Treatment must be surgical with wide an block excision. Treated patients should have a long-term follow up, because may recur, even after years.

[Lithiasis in small salivary ducts. Report of 3 cases]. / Lithiasis der kleinen Speicheldrüsen. Bericht über drei Fälle.

Three cases with sialolithiasis of minor salivary gland are presented. The sialoliths were found on the left side of the upper lip (two patients) with local infection and on the right side of buccal mucosa (one patient) without any symptom. The histologic findings resulted from our own cases and the etiology are discussed extensively and a literature review is made as well.

Submucous dirofilariasis involving the cheek. Report of a case.

Dirofilariasis is characterized by the presence of numerous filarial worms in the subcutaneous tissues, and by the formation of subcutaneous nodules. The clinical symptoms and histologic features of the disease are discussed, together with a case report from Greece.

[Clinical study of sialolithiasis. Findings from 100 cases]. / Klinike melete tes sialolithiases. Euremata apo 100 periptoseis.

The present work is based on a study of 100 cases of sialolithiasis referred to the Department of Oral Medicine, Dental School, University of Thessaloniki during the period 1963-1986. Among 100 cases sialolithiasis was distributed as following: Submandibular glands 89 cases, parotids 8 cases and minor salivary glands 3 cases. Sialolithiasis of sublingual glands were not found. In most of the cases the calculus was single while on 16 cases calculi were double or even more. Among the cases of sialolithiasis of minor salivary glands we found single in two cases while in the remaining one the calculi were double. There was a slight but not significant prevalence in the male sex (52 male/48 female) and their age varied from 6 to 70 years. In 72% of the cases the patient's age was under 40 with the most common (34%) in the 3rd decade. Inflammatory swelling of the sublingual plica and wharton's duct appeared in 46.4%. Complication of acute sialadenitis was observed in 23.7% of the cases. The first symptom was swelling of the gland during the meals (88.7%) while pain in the gland was followed after different period of time. The duration of symptoms was ranged between 1 to 30 years in 3% of the cases, and in the remaining 61% it ranged from 1 day to 1 year. The calculi were removed surgically in 40 cases and conservatively in 8 cases. All three cases of minor salivary gland sialolithiasis were treated surgically. The remaining 49 patients didn't return for complete treatment.