Brown tumor of hyperparathyroidism with multiple lesions.

Brown tumors are rare focal giant-cell lesions that arise as a direct result of the effect of parathyroid hormone (PTH) on bone tissue in some patients with hyperparathyroidism. Browns tumor is a syndrome associated with an increase in PTH levels by parathyroid glands resulting in hypercalcemia. In the present case report, a 44-year-old female patient presented with a rare case of brown tumor with multiple lesions in the head-and-neck region. The recent advance in various diagnostic and biochemical tests helps in early diagnosis of hyperparathyroidism cases. The dentist should be aware of oral manifestations associated with this type of systemic disease.

Evaluation of immunomorphological patterns of cervical lymph nodes in oral squamous cell carcinoma.

BACKGROUND: The Immunomorphological patterns of Lymph Nodes indirectly assess the host immune response facing a malignant tumor. These patterns also help us predict the susceptibility of the patient to Lymph Node Metastasis. AIMS AND OBJECTIVES: To evaluate the Immunomorphological patterns of Lymph Nodes in Oral Squamous Cell Carcinoma and to correlate them with the histopathological subtype of Oral Squamous Cell Carcinoma, TNM staging and the degree of tumor involvement within the Lymph Nodes. METHODOLOGY: A total of 40 subjects were taken for the study. Individuals who were clinically and histopathologically diagnosed as cases of Squamous Cell Carcinoma, who had undergone Radical or Elective Neck dissection were considered. The excised Lymph Nodes along with the primary tumor were collected stained with Hematoxylin and Eosin. The Lymph Nodes were assessed for Metastasis and Immunomorphological patterns. Statistical Correlation was done between the Immunomorphological pattern of Lymph Nodes and (a) Size of the tumor, (b) TNM stage of the tumor, (c) Histopathological Grade of the primary tumor, (d) Metastasis of the Lymph Node and (e) Grade of the Metastasis of Lymph Node. Statistical Correlation was done between the Metastasis of the Lymph Node and (a) Size of the tumor and (b) TNM stage of the tumor. RESULTS AND CONCLUSION: Statistically, a significant association was observed between TNM staging and Immunomorphological patterns of Lymph Node (P < 0.01). The relationship between histopathological grade of primary tumor of Squamous Cell Carcinoma and the Immunomorphological patterns was statistically significant (P < 0.01). Statistically, a significant association was observed between Sinus Histiocytosis pattern and decreased occurrence of nodal metastasis (P < 0.01).

Evaluation of genotoxicity by micronucleus assay in oral leukoplakia and oral squamous cell carcinoma with deleterious habits.

BACKGROUND: Oral cancer is the 12th most common cancer in women and the 6th in men. Of all oral malignancies, more than 92-95% is Oral Squamous Cell Carcinoma (OSCC). The high risk was due to Lifestyle-related habits such as smoking, alcohol consumption, chewing of areca nut related products which are considered as the major risk factors in OSCC. The exogenous carcinogens from tobacco smoke may induce a defective DNA damage response, which may alter the expression of genes that protect us against cancer that may result in genomic instability and this DNA damage can be assessed by studying the chromosomal aberrations, sister chromatid exchanges and the varied forms of the micronucleus. AIMS AND OBJECTIVES: The aim of this study was to evaluate the risk of development of oral leukoplakia (OLP) and OSCC due to DNA damage by studying micronuclei count in the east coast of Andhra Pradesh population with tobacco consumption habit and habit-free controls using Fluorescent microscopy. MATERIALS AND METHODS: A total of 60 subjects, 20 normal controls, 20 oral leukoplakia and 20 OSCC patients were selected from the outpatient patients of GITAM Dental College and Hospital, Rushikonda, Visakhapatnam and peripheral cancer hospitals in and around Visakhapatnam. Exfoliated cells were collected by giving 5-6 gentle strokes with spatula in a continuous unidirectional movement and then were uniformly spread on the previously cleaned microscopic slide. Fluorescent stain 4', 6'-diamidino-2 phenylindole (DAPI) was used for MN analysis. RESULTS: Mean of cells with MN in controls, leukoplakia and OSCC cases was observed to be 1, 5.1,10.1 (F = 112.396, P < 0.001) respectively. Mean of the cells with MN in different grades of leukoplakia. (F = 35.594, P < 0.001) Mean of the cells with MN in different grades of OSCC. (F = 39.752, P < 0.001). CONCLUSION: The present study revealed an increase in mean frequency of cells with micronucleus from healthy individuals however similar studies in larger sample has to be done. This study concludes that MN index can be used as a screening test among high risk groups.

Lymphoma in an extraction socket.

Non-Hodgkin's lymphoma (NHL) is a lymphoproliferative malignancy that can involve both lymph node and lymphoid organs as well as extranodal organs and tissues. The aim of presenting this case of NHL is to highlight the suspicion of its occurrence in the region of unhealed extraction sockets and the significance of its awareness. NHL can be presented in various forms; therefore, a thorough knowledge regarding this malignancy is essential for arriving at the earliest possible diagnosis and therapy for the patient.

Expression of Heat Shock Protein 70 in Oral Epithelial Dysplasia and Oral Squamous Cell Carcinoma: An Immunohistochemical Study.

INTRODUCTION: Heat shock proteins are biomarkers regulating the degree of differention and aggressiveness in oral carcinogenesis. The study was carried out to evaluate the expression of HSP 70 in histological grades of epithelial dysplasia and oral squamous cell carcinoma using immunohistochemistry. METHODOLOGY: A sample of 40, which included 10 (Normal), 15 (epithelial dysplasia) and 15 (oral squamous cell carcinoma) were selected. The biopsy samples were stained using H and E staining and HSP 70 IHC. RESULTS: There was a statistical significant difference in expression of HSP 70 between normal oral mucosal tissue, leukoplakia and OSCC. DISCUSSION AND CONCLUSION: This study concludes the critical role of HSP70 as an oncogene in the development of oral cancer. HSP70 inhibition is, therefore a promising therapeutic approach for cancer treatment.

The "TROJAN HORSE" of a Dental Visit - Synovial Sarcoma.

The term "synovial sarcoma (SS)" is a histological error, a misnomer as it neither arises from nor differentiates toward synovium. Head and neck region is the most commonly affected region after extremities, representing 5% of all cases. This case report focuses to discuss a case of a SS that was diagnosed after an inadvertent root canal therapy. A 46-year-old male came to the outpatient department with a chief complaint of pain and swelling in his upper right back tooth region since 15 days. An ulceroproliferative mass of was observed protruding from the gingivobuccal sulcus from 11 to 15 tooth region obliterating the vestibule.

Evaluation of Genetic Polymorphisms in Glutathione S-Transferase Theta1, Glutathione S-Transferase Mu1, and Glutathione S-Transferase Mu3 in Oral Leukoplakia and Oral Squamous Cell Carcinoma with Deleterious Habits using Polymerase Chain Reaction.

CONTEXT: Oral squamous cell carcinoma (OSCC) is the sixth most common cancer in the world. As per previous studies, most patients who develop oral cancer are elderly males who are heavy users of tobacco and alcohol; however, the incidence is increasing in younger individuals and in those who neither smoke nor drink. Many of the genes that code for the detoxification enzymes are polymorphic with abnormal activity profiles. AIMS AND OBJECTIVES: The aim of this study was to evaluate the risk of development of oral leukoplakia (OLP) and OSCC in glutathione S-transferase polymorphisms genes in the east coast of Andhra Pradesh population with tobacco consumption habit and habit-free controls using polymerase chain reaction (PCR-restriction fragment length polymorphism). MATERIALS AND METHODS: This study included 15 patients each with histologically proven epithelial dysplasia and OSCC and compared with age- and gender-related controls with no tobacco habits in any form. A volume of 2 ml of blood sample was collected into presterilized vials containing ethylenediaminetetracetic acid from each individual under aseptic conditions. DNA extraction was done from whole blood, and PCR was performed. Statistical analysis was performed using Chi-square test and odds ratio (OR) and 95% confidence intervals (CIs). RESULTS: The results are suggestive that glutathione S-transferase mu1 (GSTM1) null was associated with increased risk of OLP (OR = 5.5, 95% CI = 1.14-26.41, P = 0.021) and OSCC (OR = 11, 95% CI = 1.99-60.5, P = 0.021). Glutathione S-transferase theta1 (GSTT1) null genotype was associated with increased risk of OLP (OR = 2.154, 95% CI = 0.74-26.672, P > 0.99) and OSCC (OR = 2.154, 95% CI = 0.74-26.672, P > 0.99). The glutathione S-transferase mu3 (GSTM3) AB + BB genotypes appear to be risk factors for OSCC (OR = 1.31, 95% CI = 0.31-5.58, P = 0.7) although statistically insignificant. CONCLUSION: Hence to conclude, because of small sample size in the present study, statistically insignificant results were found and this study failed to observe the relationship between GSTM3 and GSTT1 polymorphism and risk of developing OSCC and positive relationship was observed with GSTM1 polymorphism and risk of developing OSCC.

Malignant Peripheral Nerve Sheath Tumor -A Rare Malignancy in Mandible.

Malignant Peripheral Nerve Sheath Tumor (MPNST) is biologically an aggressive tumor that is usually found in the extremities, trunk and infrequently found in the head and neck area particularly in the jaws, arising from the cells allied with nerve sheath. Mandibular MPNST may either arise from a preexisting neurofibroma or develop de novo. Because of the greater variability from case to case in overall appearance both clinically and histologically, a case of MPNST of the mandible in a 25-year-old female patient is reported. The lesion was excised and immunohistological studies (S-100 & Neuron specific enolase) were conducted to confirm the neural origin.

Desmoplastic ameloblastoma.

Desmoplastic ameloblastoma is a relatively rare variety of ameloblastoma and only very few cases have been reported so far. The present case is an elderly man who had reported with a swelling in the anterior mandible which turned up to be desmoplastic ameloblastoma. Proper diagnosis is necessary to report such a case, so that the actual incidence can be noted.

Photodynamic therapy: the imminent milieu for treating oral lesions.

Photodynamic therapy (PDT) is used in curative and palliative treatment of head and neck squamous cell carcinoma (HNSCC) and other oral lesions. Oral infections (such as mucosal and endodontic infections, periodontal diseases, caries, and peri-implantitis) are among the specific targets where PDT can be applied Photodynamic therapy (PDT) efficacy depends on the local dose deposited in the lesion as well as oxygen availability in the lesion. Further long-term clinical studies are necessary in establishing a more specific place of the technique in the field of dentistry.