Comparative histological and immunohistochemical study of ameloblastomas and ameloblastic carcinomas.

BACKGROUND: This study aimed to compare the histological and immunohistochemical characteristics of ameloblastomas (AM) and ameloblastic carcinomas (AC). MATERIAL AND METHODS: Fifteen cases of AM and 9 AC were submitted to hematoxilin and eosin (H&E) and immunohistochemical analysis with the following antibodies: cytokeratins 5,7,8,14 and 19, Ki-67, p53, p63 and the cellular adhesion molecules CD138 (Syndecan-1), E-cadherin and ß-catenin. The mean score of the expression of Ki-67 and p53 labelling index (LIs) were compared between the groups using the t test. A value of p<0.05 was considered to be statistically significant. RESULTS: All cases were positive for CKs 5, 14 and 19, but negative for CKs 7 and 8. CKs 5 and 19 were positive mainly in the central regions of the ameloblastic islands, while the expression in AC was variable in intensity and localization. CK14 was also variably expressed in both AM and AC. Ki-67 (P=.001) and p53 (P=.004) immunoexpression was higher in AC. All cases were positive for p63, but values were higher in AC. CD138 was mainly expressed in peripheral cells of AM, with a weak positivity in the central areas, while it was positive in most areas of ACs, except in less differentiated regions, where expression was decreased or lost. E-cadherin and ß-catenin were weakly positive in both AM and AC. CONCLUSIONS: These results shows that Ki-67, p53 and p63 expression was higher in AC as compared to AM, suggesting that these markers can be useful when considering diagnosis of malignancy, and perhaps could play a role in malignant transformation of AM. Pattern of expression of CKs 5 and 19 in AC were different to those found in AM, suggesting genetic alterations of these proteins in malignant cells. It was confirmed that CK19 is a good marker for benign odontogenic tumors, such as AM, but it is variably expressed in malignant cases.

Osteoma gigante en mandíbula. Reporte de Caso / Giant osteoma in Jaw. Case Report

El osteoma es una neoplasia benigna poco común, que se caracteriza por presentar un crecimiento óseo progresivo, el cual está  compuesto por la proliferación bien diferenciada de hueso compacto y/o esponjoso. En el área maxilofacial se presenta con mayor frecuencia en la cara lingual posterior de la mandíbula. Se caracteriza por crecimiento lento y asintomático. El caso describe una paciente de 45 ños con un osteoma gigante mandibular de 4 años de evolución tratado quirúrgicamente.

Osteomas are considered a rare benign neoplasm, characterized by a progressive bone growth, which is composed of a proliferation well differentiated of compact or cancellous bone. In the maxillofacial area when present, commonly found in the posterior lingual surface of the mandible. It is characterized by slow growth and asymptomatic. The case describes a mandibular giant osteoma of 4 year of evolution treated with surgical treatment.

Carcinoma de células escamosas de cavidad bucal en un centro de tercer nivel de atención social en la ciudad de México. Experiencia de cinco años / Oral cavity squamous cells carcinoma, 5 years experience in a third

El carcinoma epidermoide o de células escamosas, es una neoplasia maligna que se origina de las células escamosas del epitelio que recubre la mucosa, es la más frecuente de la cavidad bucal. Objetivo: determinar si la supervivencia y muerte de los pacientes con carcinoma epidermoide de cavidad bucal, asociada a la edad, género, factores de riesgo, grado histológico y tratamiento recibido. Método: Se revisaron los archivos del servicio de Anatomía Patológica del Centro Médico Nacional "20 de Noviembre" de 1997 al 2001 (49.615 registros histopatológicos). Sólo 149 con diagnóstico de carcinoma epidermoide en cavidad bucal, y presentaban las variables: edad, género, alcoholismo, tabaquismo, enfermedades de transmisión sexual, ocupación, enfermedades sistémicas, uso de prótesis dental, antecedentes familiares oncológicos, liquen plano bucal; grado de diferenciación histológica, localización, tratamiento, recurrencia, metástasis, supervivencia y muerte; se analizaron los resultados con la prueba de Fisher. Resultados: De los 149 sólo 49 casos contaban con todos los datos, de éstos, la relación hombre-mujer 2:1, localización más frecuente la lengua, grado de diferenciación: 35 casos bien diferenciados (71,4%), 9 moderadamente diferenciados (18,4%) y 5 poco diferenciados (10,2%). Los factores de riesgo, uso de tabaco (65,3%) y alcohol (63,3%); ambas en 55,1%; hipertensión arterial 10,2% y Diabetes Mellitus 26,5%. antecedentes heredofamiliares oncológicos 22,45%. El tratamiento fue la combinación de quimioterapia, cirugía y radioterapia (59,2%). El seguimiento de los pacientes desde un mes hasta 120 meses con una media de 34,85 meses. La recurrencia se presentó en 23 de 49 casos (46,9%). presentaron metástasis 16 pacientes (32,2%). 11 de los 49 murieron (22,45%). Discusión: Las asociaciones más importantes fueron las siguientes: entre la muerte y los antecedentes heredofamiliares oncológicos (p = 0,094) y entre el grado de diferenciación y la recidiva (p = 0,034) con la prueba de Fisher (AU)

Squamous cell carcinoma is the most frequent malignant neoplasm in the oral cavity. Squamous epithelial cells surrounding the oral mucosa are the source of this neoplasm. Objective: To determine if survival and death of patients with oral squamous cell carcinoma are associated with age, gender, risk factors, histological grade and treatment received. Method: Files (49,615) dated from 1997 to 2001 from the Pathology Service in Centro Medico Nacional "20 de Noviembre" were studied. One hundred and forty nine histopathological files out of 49,615 were of oral squamous cell carcinoma. These variables were registered: age, gender, alcoholism, tabaco, sexually transmitted diseases, occupation, systemic diseases, dental prothesis usage, oncological family history, lichen planus, histological differentiation grade, localization, treatment, recurrence, methastasis, survival and death. Results were analyzed with Fisher test. Results: There were 49 cases with complete data, ratio 2:1 men-women, the most frequent localization was tongue. The histological differentiation grade was: 35 well differentiated cases (71.4%), 9 of moderate differentiation (18.4%) and 5 low differentiated (10.2%). Risk factors were tobacco (65.3%), alcohol (63.3%); both tobacco and alcohol (55.1%); high blood pressure (10.2%), Diabetes Mellitus (26.5%) and oncological family history (22.45%). The treatment was the combination of surgery, radiotherapy and chemotherapy (59.2%). Patients’ follow-up was from one month to 120 with an average of 34.85 months. Twenty three out of 49 cases (46.9%) showed recurrence. Sixteen patients (32.2%) showed methastasis. Eleven out of 49 died (22.45%). Discussion: The most important associations were: between death and oncological family history (p = 0.094), as well as between histological grade and recurrence (p = 0.034) (AU)