Metastatic Sarcomatoid Renal Cell Carcinoma: A Journey From the Kidney to the Gingiva.

Oral metastatic lesions are very rare and are often diagnosed at a later stage, complicating treatment. Renal cell carcinoma (RCC) is the third most frequent neoplasm to metastasize to the oral cavity, following breast and lung cancers. These metastatic lesions are usually asynchronous and develop after the initial diagnosis, affecting the overall survival rate. This report describes a known case of RCC with a growth in the mandibular gingiva. Multiple pulmonary and femoral metastases appeared five years after the initial renal lesion. The gingival growth was excised and referred for histopathological examination, which revealed a pleomorphic sarcomatoid cellular morphology. Immunohistochemistry with an array of markers led to the diagnosis of sarcomatoid RCC, a rare high-grade tumor. This case underscores the importance of detailed history-taking, interpretation of clinical findings, and emphasis on histopathological examination to arrive at a conclusive diagnosis.

Unravelling the Significance of NLRP3 and IL-ß1 in Oral Squamous Cell Carcinoma and Potentially Malignant Oral Disorders: A Diagnostic and Prognostic Exploration.

BACKGROUND: Nucleotide-binding domain-like receptor protein 3 (NLRP3), an inflammasome, is reported to be dysregulated or aberrantly expressed in chronic inflammation, leading to a myriad of inflammatory disorders, autoimmune diseases, and cancer. This study aimed to explore the expression and role of NLRP3 protein and the secreted cytokine IL-ß1 in oral squamous cell carcinoma (OSCC) and potentially malignant oral disorders (PMOD). MATERIAL & METHODS: Tissue NLRP3 expression was quantified using sandwich ELISA in 30 cases each of OSCC, PMOD, and normal oral mucosa. Serum IL-ß1 level was also measured by ELISA to determine their correlation. In surgically treated OSCC cases, pathological parameters such as tumor size, depth of invasion (DOI), pTNM stage, and perineural & lymphovascular invasion were assessed and correlated with NLRP3 & IL-ß1 levels to investigate their roles in tumor progression, invasion, and metastasis. RESULTS: Tissue NLRP3 expression was markedly elevated in OSCC, with significant IL-ß1 levels observed in the serum of both OSCC and PMOD cases. Both markers showed a pronounced increase with the severity of dysplasia, indicating a strong association (p = 0.003%). The expression levels of tissue NLRP3 and serum IL-ß1 were positively correlated with DOI and tumor size. Furthermore, their elevated levels, alongside higher histological grades, indicate roles in the dedifferentiation and progression of tumor cells. CONCLUSION: The findings indicated that increased expression of NLRP3 and IL-ß1 in PMOD correlates with higher transformation rates, along with tumor progression and dedifferentiation in OSCC. Consequently, these markers hold promise as valuable targets for prognostic assessment, diagnostics, and therapeutic strategies in OSCC.

Potential role of mast cells and eosinophils in establishing the clinical severity of oral lichen planus.

BACKGROUND: Oral lichen planus (OLP) can be broadly classified clinically as an erosive (e) and non-erosive (ne) form. Mast cells (MCs) are granules containing cells that play an important role in the etiopathogenesis of OLP and have bidirectional interaction with eosinophil. In the present study, MCs and eosinophil densities were studied to find out if they could aid in the clinical severity of eOLP and neOLP. METHODS: The study group included 20 cases of eOLP and 30 cases of neOLP. All the sections were stained with special stains, toluidine blue (TB) for MCs and Congo red (CR) for eosinophils. Histopathological analysis was done by using Nikon NIS Elements Version 5.30 software (Nikon, Tokyo, Japan) by applying 100×100 µm grids to standardize the field of evaluation. Three subepithelial zones were demarcated as follows: 1) zone I was up to a subepithelial depth of 100 µm from the basement membrane; 2) zone II was beneath zone I from 100 µm to 200 µm; and 3) zone III was beneath zone II from 200 µm to 300 µm. In each of these zones, five high power fields with high cellular density were chosen to count MCs and eosinophils. RESULTS: The results of the study showed a significant increase in the number of MCs (intact and degranulated) in zone II and III compared to zone I in both eOLP and neOLP. Eosinophil density was significantly higher in zone II of both eOLP and neOLP when compared to zone I and III. We also observed a significantly higher number of both MCs and eosinophils in eOLP compared to neOLP. This difference was most prominent between zone II of eOLP and neOLP. No significant difference between granulated and degranulated MCs was found between the three zones. CONCLUSIONS: Increased MC and eosinophil densities, as well as their interactions in eOLP, suggest that they play a significant role in etiopathogenesis and in establishing the clinical severity of the disease.

Lifting the lid over the pearl: A histological insight.

Epithelial pearls and Keratin pearls are pathognomonic of squamous cell carcinoma. However, their histogenesis is not well understood. Only a handful of studies have been conducted in the past in this regard. This brief communication aims to understand the formation of these pearls with a few of our own experiences.