Polymorphous low-grade adenocarcinoma of maxillary alveolus metastasising to the abdomen: the role of immunomarkers in diagnosis.

Polymorphous low-grade adenocarcinoma (PLGA) originating mostly in the minor salivary glands of the posterior hard and soft palate is characterised by its indolent growth and a slower rate of metastasis. Seldom does the PLGA present an aggressive behaviour and demonstrate distant metastasis, as in the present case where a 73-year-old female patient with a swelling in the maxillary alveolus was diagnosed as PLGA exhibiting high-grade transformation, subsequently metastasizing to the abdomen and lungs. The importance of immunomarkers, c-kit and ki-67 in deciphering the clinical behaviour of this PLGA is highlighted. Distant metastasis to the abdomen has not yet been reported; hence, this case of PLGA emphasises the importance of immunohistochemistry in assessing its aggressiveness and understanding a novel aspect of its pathogenesis.

Gene polymorphism of interleukin-1 alpha and beta in keratocystic odontogenic tumors.

AIM AND BACKGROUND: Odontogenic keratocysts have a different growth mechanism and biologic behavior in comparison with more common dentigerous and radicular cysts. It was reclassified as keratocystic odontogenic tumor (KCOT). The proliferative activity of the epithelial cells of KCOT has a close relationship with tissue levels of interleukin-1 (IL-1). Moreover, IL-1 increases the expression of several matrix metalloproteinases in the fibroblasts of adjacent stroma and activates the osteoclastogenesis process. So it plays an important role in the activity, spread, and local aggressiveness of this tumor. Therefore, it seems that the gene polymorphism of the cytokines of the IL-1 family is influential in the pathogenesis of KCOT and the patients' susceptibility to disease. METHOD: A total of 38 blood samples of patients suffering from KCOT and 150 blood samples of healthy patients were assessed using PCR-SSP. The blood samples were assessed for the following polymorphisms: interleukin-1 alpha (-889) and interleukin-1 beta (-511). Following up the patients, we found six recurrent and one syndromic cases. FINDINGS: By comparing the case and control groups, we observed the significant dominance of allele T over C, and genotype TT over CC and CT in IL-1α, although no significant difference was seen in the allele frequency and genotypes regarding IL-1ß. CONCLUSION: The function of IL-1α has a significant relationship with KCOT. Its effective genotype associated with pathogenesis, growth, local invasion, and recurrence is TT.

[Maxilla-mandibular brown tumors as a first sign of parathyroid adenoma]. / Tumeurs brunes maxillomandibulaires révélant un adénome parathyroïdien.

OBJECTIVES: Through a novel observation of parathyroid adenoma revealed by brown tumors of the jaws and a review of the literature, the authors describe this rare mode of primary hyperparathyroidism discovery. MATERIAL AND METHODS: The patient was a 23-year-old woman who consulted for a recurrent tumefaction of the maxillary; histology showed reparative giant cell granuloma. RESULTS: The clinical examination found an osseous tumefaction in continuity with the zygomatic bone and a gingival tumefaction on the mandible symphysis. The radiological findings showed two osteophytic lesions: mandibular and maxillary. The phosphocalcic metabolism was disturbed and the parathormone rate was high. The etiologic search consisted of a MRI of the neck, which showed a mass behind the thyroid gland, suggesting a parathyroid adenoma. The diagnosis was confirmed at surgical exploration. After removal of this tumor, the blood calcium rate dropped sharply and the bone tumefaction progressively regressed. CONCLUSION: Brown tumors are a rare mode of parathyroid adenoma discovery, and the jaw location is exceptional. The diagnosis is based on the parathormone rate, and radiological exams generally find the etiology. Treatment is based on surgery of the parathyroid adenoma.

[Influence of chemotherapy regimen on antioxidant level in patients with locally-advanced tumors of the maxilla, nasal and paranasal sinuses].

The study dealt with effect of chemoradiotherapy on the oxidant/antioxidant system in 57 patients with locally-advanced tumors (stage III-IV) of the maxilla, nasal and paranasal sinuses. Therapy modalities ranged from systemic chemoradiotherapy (22), intraarterial chemoradiotherapy + UHF-hyperthermia (20) and intraarterial chemotherapy + radiotherapy (15). The most frequent regimen of chemotherapy involved cisplatin 15 mg/ m2, total dose of 100 mg; fluorouracil 600 mg/m2, total dose of 2,000-3,000 mg, and doxorubicin 15 mg/m2, total dose of 40-60 mg. As far as telegammatherapy is concerned, all patients received STD of 3 Gy and TTD of 40-60 Gy. Unlike systemic chemoradiotherapy, continuous intraarterial chemoradiotherapy with UHF-hyperthermia or without it was followed by lower incidence of enhanced oxidative reaction response and tumor-related endotoxicosis.

Clearance of ascorbic acid in plasma in patients before major maxillofacial surgery compared with that in volunteers.

Reduced concentration of ascorbic acid (AA) in plasma is often observed in tumor patients. Besides malnutrition, an increased AA consumption in tumor patients is discussed as a main reason for reduced AA concentration in plasma. A reduced AA concentration caused by malnutrition would not influence the total clearance (Cltot) of AA in plasma; however, a change in AA consumption would alter the Cltot. To investigate this further, a study was carried out on 20 patients hospitalized for major maxillofacial surgery and 20 volunteers. The Cltot of AA in plasma after bolus injection of AA (4 mg/kg body wt) in tumor patients was compared with that in volunteers. AA concentration in plasma (P < 0.05) was significantly lower in tumor patients (median and 25th and 75th percentiles: 23.7, 14.6, and 32.7 mumol/l) than in volunteers (median and 25th and 75th percentiles: 66.5, 59.6, and 78.6 mumol/l). No significant change in Cltot was observed for tumor patients (median and 25th and 75th percentiles: 11.5, 8.0, and 14.0 l/h) compared with volunteers (median and 25th and 75th percentiles: 11.3, 9.9, and 13.2 l/h). No indication of an increased consumption of AA in tumor patients could be detected. The lowered concentration of AA in plasma observed in our patients might be the result of a reduced AA intake.

[Burkitt lymphoma in Cameroon children: descriptive and clinico-anatomical aspects]. / Lymphome de Burkitt chez l'enfant au Cameroun: aspects descriptifs et anatomocliniques.

This retrospective study is armed to indicate the descriptive and pathological aspects of children Burkitt lymphoma in Cameroon. It was performed on a 4 year period between July 1988 and July 1992. Children from 0 to 15-year-old who were hospitalized and who had histologically provern Burkitt lymphoma were included. There were 39 patients, that is 27% of all malignant tumors in children during this period. Twenty-four were boys and 15 were girls; the median age was 90 months (+/-46) (range from 3 to 180 months). All children had Plasmodium falciparum infection. EBV serology was positive in 18 patients out of 25 (72%), 14 (36%) had a good nutritional status, the 25 other patients suffered malnutrition. Tumor localizations were: maxillary in 29 (74%) patients, abdominal in 7 (18%), other in 3 patients. Clinical stages according to Murphy classification were: stage I in 6 (15%) patients, II in 3 (8%), III in 20 (51%) and IV in 10 (26%). It is concluded from this series that clinical aspects and histological pattern in children Burkitt lymphoma in Cameroon are not different from what is observed in other endemic areas.

[The concentration of ferritin in blood serum of patients with neoplasms of the larynx and the maxillary-ethmoidal complex]. / Stezenie ferrytyny w surowicy krwi u chorych na nowotwory zlosliwe krtani lub masywu szczekowo-sitowego.

The increased level of ferritin is known as a nonspecific marker of inflammatory processes and neoplasms. A purpose of the article was to indicate concentration of ferritin in blood serum before treatment of 33 patients with cancer of larynx and 16 patients with malignant neoplasms of maxillo-ethmoid complex. The patients with cancer of larynx were characterized by significantly high level of ferritin in comparison to patients with malignant neoplasms of maxillo-ethmoid complex (p < 0.05) and to healthy people (p < 0.05) (respectively 241.9 +/- 154.9; 106.9 +/- 45.4 and 125.0 +/- 30.4 ng/ml). Contrary to patients with cancer of larynx patients with malignant neoplasms of maxillo-ethmoid complex did not differ in significant level of ferritin from healthy people. The concentration of hemoglobin in blood in both groups of patients was similar and was characteristically lower than values obtained in healthy people. The results achieved suggest that indicating of ferritin can be helpful while making a differentiation between cancer of larynx and malignant neoplasms of maxillo-ethmoid complex.

Neutralizing antibodies to human interleukin 6 reverse hypercalcemia associated with a human squamous carcinoma.

Bone resorbing cytokines may be associated with abnormalities in bone cell function and calcium homeostasis in a number of pathological conditions. One of these cytokines is interleukin 6 (IL-6), which is a multifunctional cytokine which has been shown to be associated with increased formation of bone resorbing osteoclasts in vitro. In this report, we demonstrate that neutralizing antibodies to human IL-6 lower the blood calcium in nude mice carrying a human tumor associated with increased IL-6 production. There was no effect on blood calcium in hypercalcemic nude mice carrying tumors not associated with increased IL-6 production and normocalcemic tumor-bearing nude mice. These results suggest that increased production of IL-6 may contribute to disturbances in calcium homeostasis in some malignancies, and suggest that neutralization of IL-6 effects can lower the serum calcium in these tumors.

Serum sialic acid levels in patients with oral and maxillofacial malignancy.

Serum sialic acid levels were measured using the thiobarbituric acid method in 80 healthy subjects and in 40 patients with benign and 61 with malignant tumors in the oral and maxillofacial region. It was shown that the cancer group had statistically higher sialic acid levels than control group and the group with benign disease (P less than .05), but no significant difference was noted between the normal control group and the patients with benign tumor (P greater than .05). Serum sialic acid levels were significantly higher in the patients with stages III and IV cancer than in those individuals with stage I and II cancer, but no differences were seen between stages I and II, and between stages III and IV cancer patients (P greater than .05). There was also no difference when considering the anatomic site of the malignant lesion. Furthermore, during the serial sialic acid determination in cancer patients before and following treatment, the sialic acid levels usually declined with remission of the disease and increased with recurrence, metastasis, or a poor prognosis. We conclude from this study that the sequential measurement of sialic acid level is particularly useful in monitoring patients with oral cancer, and sialic acid may prove to be a valuable tumor marker in oral and maxillofacial malignancy.

[Role of the tumor marker TAG-72 in head and neck neoplasms]. / Zur Rolle des Tumormarkers TAG-72 in den Neoplasien des Kopf-Hals-Bereiches.

The serum glycoprotein TAG-72 level was determined in 34 patients with chronic laryngitis or ENT malignancy. This marker is in widespread use in cases of gynaecological and gastrointestinal malignancy. TAG-72 levels did not differ significantly either from the levels of healthy subjects or in the post-operative follow-up, so that this indicator appears to be of no clinical value in head and neck oncology.

[State of the hemostasis system in patients with malignant III-stage neoplasms of the maxilla and larynx]. / Sostoianie sistemy gemostaza u bol'nykh so zlokachestvennymi novoobrazovaniiami verkhnei cheliusti i gortani III stadii.

Hemostasis of patients with III stage malignant neoplasms of the maxilla and larynx was investigated. We examined 40 patients, 8 of which had maxillary tumor and 32 had laryngeal tumor. The age of the patients varied from 44 to 68 years. It was found that the patients with malignant neoplasms of the maxilla and larynx had hemostatic disorders which formed the thrombohemorrhagic syndrome. During the surgical intervention they displayed the hypocoagulation phase of the syndrome, which indicated the most dangerous prethrombotic state of the blood system.

[Biosynthesis and significance of acute phase proteins].

Acute phase proteins (APP) increase by the chemical receptors of macrophage via stimulations of either Fc or complement or other chemical receptors. No differences of APP pattern were observed by the different stimulants, because the effects of stimulation are changed by many processing steps in the macrophage as well as in the liver cell thereafter. Whether the APP increase results in good prognosis for original sickness or not are examined by multiple regression analysis in 38 cases of maxillary and 51 cases of laryngeal cancer with the observation for over five years. Alpha 1X contributes positively with length of their life, whereas alpha 1AG and ceruloplasmin contribute negatively. We could say that not all components of APP increase are advantageous for the diseases.

The investigation of serum and salivary, immunoglobulin levels in patients with head and neck region cancer.

Tumor immunology has been studied in animal experiments. The studies of Prehn and Main in the year 1957, have been pioneer studies. The early diagnosis of cancer, the prognosis, proflaksia and treatment has been studied in several immunological experiments and is still being studied. In the investigations being made before the Second World War mostly the Conditions after the immunological answer has been studied from the beginning where the antigen enters the body and which organs and tissues the antigen enters, which cells do recognise and how the immunological answers is formed. By solving the secrets of the immunological system, oto-immunological, allergic diseases and cancer would be able to be treated easier it is possible that much more better results will be able to be reached with organ transformation.

Squamous cell carcinoma antigen in the serum of oromaxillary cancer.

Squamous cell carcinoma (SCC) antigen levels in sera and several tissues were estimated in patients with oral and maxillary cancer. The normal value of serum SCC antigen level was 1.7 ng/ml in this experiment, and 43.3% of squamous cell carcinoma was positively higher than 1.7 ng/ml as a whole, including cases of carcinoma in situ and of recurrence and metastasis in the oral region. In relation to the clinical staging of tumors, 20.0% in stage I, 14.3% in stage II, 42.9% in stage III, and 77.8% in stage IV were positive for SCC antigen. In the group with definite regional lymph node metastases, 80% of patients revealed a higher value than the normal cut-off value. Patients with recurrent SCC demonstrated elevated SCC antigen values in sera except 1 case with an early condition of recurrence. Serum SCC antigen also presented good responses to various cancer treatments. The measurement of SCC antigen does not appear to be useful for the detection of early stage oral and maxillary SCC; however, for detection of recurrence and for lymphatic and/or remote metastases in the follow-up period, it would appear that SCC antigen level would be some value.

Increased plasma-6-oxo-PGF1-alpha but normal PGI2 half-life in patients with maxillo-facial tumors.

In 56 patients with histologically verified maxillo-facial cancer the plasma 6-oxo-PGF1-alpha was determined prior surgery using a specific RIA and the double antibody technique. Furthermore, the half-life of synthetic PGI2 has been assessed via the disappearance curve of biological activity on platelet aggregation inhibition. Part of the patients has been monitored by the same test different time intervals after radical surgery. Normal values of 6-oxo-PGF1-alpha amount below 1 pg/ml. - normal half-life of PGI2 in plasma in-vitro about 10 minutes. Prior surgery a significantly increased 6-oxo-PGF1-alpha can be seen, whereas the PGI2 half-life is unaffected. In patients without local or general recurrence normal 6-oxo-PGF1-alpha levels are monitored. No change occurred in the half-life of PGI2. These findings underline the additive value of 6-oxo-PGF1-alpha as a tumor marker. The data do not support the view presented earlier, that a change in plasmatic PGI2 half-life might favour the onset and the extent of recurrence at least in patients suffering on maxillo-facial cancer.