Oral and Sinonasal Tumors.

This article reviews the different types of equine non-neoplastic and neoplastic oral and sinonasal tumors and describes their known prevalence and general characteristics. The clinical and ancillary diagnostic findings (primarily radiography and endoscopy, and increasingly computed tomography) for each type of growth that can aid diagnosis are described. Most lesions require a histopathological confirmation of the diagnosed growth. The possible treatments and prognosis for these growths are briefly described.

Congenital granular cell epulis of newborn: importance of prenatal diagnosis.

Congenital granular cell epulis is a rare benign lesion usually arising as single mass from the alveolar ridge of maxillary bone of female newborns, composed of polygonal granular cells that typically stain negative for S-100, in contrast to the adult counterpart. Larger lesions can disturb breathing and breast-feeding, requiring surgery. Prenatal diagnosis is achieved in few cases, even if this would be important for best management of delivery and therapy. Here we present a case of multiple CGCE in a female newborn discovered at birth, together with a brief review of pathogenesis, differential diagnoses and treatment implications of early diagnosis.

Multi-omics analysis profile oral tumor module clusters to reveal the potential pathogenic mechanism.

Oral tumors are malignant cancers caused by abnormal proliferation or pathological changes of soft or hard tissues in the oral cavity. Serious cases may pose a threat to life. However, its precancerous lesions remain unclear. This study is based on a comprehensive strategy to explore a multi-factor-driven oral cancer barrier module, which is an attempt to describe the pathogenesis of the disease and potential regulatory drugs from a global perspective. Functional disease modules were identified by constructing a protein-specific interaction network in patients' oral tissues. Then, comprehensive pathogenesis was explored through combination with analysis of functional and signaling pathway enrichment, prediction of key regulatory factors. It was found that these specifically expressed proteins and their interactions often play a pivotal part in oral tumors. This is reflected in the results of functional and pathway enrichment of modulating genes, which show that they are mainly involved in various immune responses, inflammatory reactions, oral plaque, and oral ulcer-related regulatory processes. This may represent the potential pathogenesis of oral tumors. On the predictive analysis of regulators, a series of ncRNAs (including miR-590, CRNDE and miR-340) and transcription factors (including E2F1, MYC and TP53) were identified that have potential important regulatory effects on oral tumors. These key regulators may manipulate a crucial part of the module sub-network and then work together to mediate the occurrence of oral tumors. On the comprehensive Multi-omics module analysis, the specific proteins and their interactions in patients' oral tissues were identified, while the prominent pivotal regulators were involved in the different pathogenic functions of oral tumors.

In-gel digestion coupled with mass spectrometry (GeLC-MS/MS)-based salivary proteomic profiling of canine oral tumors.

BACKGROUND: Various types of oral tumors, either benign or malignant, are commonly found in dogs. Since saliva directly contacts the tumors and saliva collection is non-invasive, easily accessible and cost effective, salivary biomarkers are practical to be used for the diagnosis and/or prognosis of these diseases. However, there is limited knowledge of protein expression in saliva for canine oral tumors. The present study aimed to investigate novel biomarkers from the salivary proteome of dogs with early- and late-stage oral melanoma (EOM and LOM, respectively), oral squamous cell carcinoma (OSCC), benign oral tumors (BN), and periodontitis and healthy controls (CP), using an in-gel digestion coupled with mass spectrometry (GeLC-MS/MS). The relationships between protein candidates and chemotherapy drugs were explored and the expression of potential biomarkers in saliva and tissues was verified by western blot analysis. RESULTS: For saliva samples, increased expression of protein tyrosine phosphatase non-receptor type 5 (PTPN5) was shown in all tumor groups compared with the CP group. Marked expression of PTPN5 was also observed in LOM and OSCC compared with that in BN and EOM. In addition, tumor protein p53 (p53), which appeared in the PTPN5-drug interactions, was exhibited to be expressed in all tumor groups compared with that in the CP group. For tissue samples, increased expression of p53 was shown in LOM compared with the control group. CONCLUSION: PTPN5 and p53 were proposed to be potential salivary biomarkers of canine oral tumors.

Oral tumors in children: Diagnosis and management.

Oral tumors are one of important tumors which could be associated with serious problems in infant and children. It has been showed that a variety of cellular and molecular pathways including genetics and epigenetics mechanisms (eg, chromosomal alterations, and microRNA) involved in pathogenesis events present in oral tumors. Identification of these pathways could contribute to better treatment of oral tumor patients. Early detection is one of key steps in management of oral tumors which could contribute to improve clinical outcomes and better treatment of infant with oral tumors. Despite of easy accession of the oral cavity, oral tumors (malign/benign) are diagnosed in advance stages. Therefore, these tumors indicate a poor survival rate. It has been showed that various approaches including imaging techniques, chemical, genetics, and epigenetic biomarkers could have critical roles in early detection of oral tumors. Treatment of oral tumors is associated with employing of various therapeutic approaches including surgery, chemotherapy, and radiation. Data on effective diagnostic platforms and therapeutic approaches for oral tumors in children and infant are rare. We offer that a variety of biomarkers such as microRNAs which could be used for oral tumors in adults may be good candidates for early detection of oral tumors in children. Here, we summarized various aspects of oral tumors in children such as molecular pathways, diagnosis, and management of them.

Solid type primary intraosseous squamous cell carcinoma in a cat.

BACKGROUND: Squamous cell carcinoma (SCC) is the most common nonodontogenic oral tumor in cats. In the jaw, it usually presents as an ulceroproliferative lesion associated with enlargement of the affected bone. CASE PRESENTATION: This report describes the case of a cat in which clinical and radiographic findings of a mandibular swelling were suggestive of an aggressive process, but the oral mucosa was unaffected. The results of histopathological and immunohistochemical examination of the samples obtained from the intraosseous lesion were consistent with SCC. The animal was euthanized 5 months after initial presentation as a result of the severe progression of the disease, and no other primary tumors were identified at necropsy. CONCLUSIONS: Based on the clinicopathological, microscopic, and immunohistochemical staining features, as well as the absence of a primary tumor at a distant site, we propose that the term, solid type primary intraosseous SCC (PIOSCC), be used to describe this neoplasia, as it shares similar features with human PIOSCC.

Histopathologic Diagnoses From Biopsies of the Oral Cavity in 403 Dogs and 73 Cats.

This retrospective study documents the prevalence of various histopathological diagnoses within a practice specializing in veterinary dentistry and oral surgery. Histopathology results obtained from biopsies of oral lesions from 403 dogs and 73 cats were sorted and categorized. Lesions of inflammatory origin represented the most common histopathology result in cats (n = 37; 51%), followed by squamous cell carcinoma (n = 27; 37%). The most common histopathological diagnoses in dogs were malignant neoplasms (n = 151; 37%), followed by tumors of odontogenic origin (n = 138, 34%) and lesions of inflammatory origin (n = 114; 28%). The results of this study are representative of a private referral dentistry practice and are compared to other studies that assessed common oral neoplasia diagnoses in dogs and cats. Treatment options and prognoses of the most common canine and feline neoplasms are discussed.

CEACAM1 is overexpressed in oral tumors and related to tumorigenesis.

Carcinoembryonic antigen-related adhesion molecule 1 (CEACAM1) is a type 1 transmembrane glycoprotein belonging to the CEA family, which has been known to exist as either soluble forms in body fluids or membrane-bound forms on the cell surface. Aberrant CEACAM1 expression is associated with tumorigenesis and has been reported in a variety of human tumors, especially malignancies. The aim of this study is to determine the expression of CEACAM1 in oral tumors, trying to study CEACAM1 different expressions as a function of histotype. CEACAM1 expression was observed by immunohistochemistry (IHC) with mouse anti-human antibody for CEACAM1. IHC was performed using avidin-biotin-diaminobenzidine staining. The results were expressed as average score ± SD (0 = negative/8 = highest) for each histotype. Oral tumors expressed more CEACAM1 than normal tissues including squamous and salivary epithelia (P < 0.05). In malignancies, the squamous cell carcinoma overexpressed CEACAM1, compared to well-differentiated squamous cell with more membranous expression; the intermediately and poorly differentiated squamous cell carcinoma showed more cytoplasmic expression (P < 0.05). In addition, the salivary tumors significantly expressed more CEACAM1 than squamous cell carcinoma (P < 0.05). So, we thought oral tumors overexpressed CEACAM1 and the cytoplasmic CEACAM1 might be involved in tumorigenesis, and also CEACAM1 might be regarded as a marker of salivary glandular tumors.

Sevoflurane-Based General Anesthesia Induction via Nasopharyngeal Endotracheal Tube Prior to Definitive Airway Control in Pediatric Oral Tumors.

Airway-related tumors in pediatrics are always challenging for anesthesiologists. We present 2 cases of friable, bleeding large tumors in the oral cavity where conventional methods of securing the airway were not possible. Induction of general anesthesia could potentially lead to complete airway collapse and catastrophic obstruction in such cases. Awake fibrotic intubation is limited in pediatric patients. We describe the innovative use of an endotracheal tube inserted blindly as a nasopharyngeal airway guided by end-tidal carbon dioxide trace. This allowed us to bypass the anatomical obstruction and induce anesthesia using sevoflurane in high-flow oxygen. By the described technique, we were able to maintain and assist the spontaneous breathing of the child as well. We also highlight limitations of the use of a conventional nasopharyngeal airway in such situations.

Prevalence of Premalignant Conditions and Their Transformation Into Oral Cancers: A Clinical Study.

Objectives: The purpose of this study is to look at how often premalignant oral diseases are among patients who visit a tertiary care center, as well as how often these problems progress to become mouth malignancies. Methods: Between 2017 and 2022, 200 patients at a tertiary care facility who were identified with premalignant oral lesions had their medical records retrospectively examined. Information on lesion features, histological results, and demographics was gathered. Statistical analysis was used to determine the prevalence of premalignant oral lesions and the rate at which these lesions turned into oral malignancies, with a significance threshold of P < 0.05. Findings: The research population's mean age was 55 years (SD ± 10), with a 65% male preponderance. The most prevalent premalignant lesions were leukoplakia (45%), erythroplakia (30%), and oral submucous fibrosis (25%). Remarkably, during follow-up, 40% of patients showed development of premalignant lesions into mouth malignancies. Based on statistical analysis, there were significant correlations (P < 0.05) between dysplastic alterations, age, tobacco use, and the development of oral malignancies from premalignant lesions. Conclusion: In conclusion, this study highlights the need of early diagnosis and focused therapies in tertiary care settings by offering important insights into the occurrence and evolution of premalignant oral lesions. The results provide important information that may be used to create screening programs and preventive measures that will lessen the incidence of oral cancer.

Factors Related to Masticatory Rhythm in Patients with Oral Tumors.

Background: Older adults who have undergone surgery for oral tumors are at increased risk of impaired masticatory rhythm. This study investigated the correlations between masticatory rhythm, objective masticatory performance, and subjective masticatory performance as well as factors related to masticatory rhythm. Methods: The participants were 44 adults (24 men, 20 women; age range 42~90 years old) who had undergone maxillectomy, mandibulectomy, or glossectomy and were rehabilitated with a maxillofacial prosthesis. The number of functional contact teeth pairs was confirmed by intraoral examination. Chewing rate, cycle duration, coefficient of variation (CV) for cycle duration (reflecting the stability of masticatory rhythm), and mixing ability were measured simultaneously using a mastication movement rhythm tracking device during gum chewing. Maximum occlusal force was measured using the dental prescale system. Patients' perception of chewing ability was rated using a questionnaire. Results: The Spearman's rank correlation test revealed that mixing ability, patient-rated masticatory scores, cycle duration, CV for cycle duration, and maximum occlusal force showed significant correlations with chewing rate. Multiple linear regression analysis identified mixing ability and the CV for cycle duration as significant predictors of masticatory rhythm. Conclusions: Factors associated with a faster chewing rate were higher mixing ability and masticatory scores, greater maximum occlusal force, shorter cycle duration, and smaller CV for cycle duration. Stable masticatory rhythm and mixing ability are significant predictors of chewing rate. Poor masticatory performance and unstable masticatory rhythm can result in slower chewing and thus a higher risk of inadequate dietary intake.

Diagnostic accuracy of intraoperative frozen section for margin evaluation of oral cavity squamous cell carcinoma.

OBJECTIVES: Intraoperative frozen-section evaluation is a valuable technique for detecting positive margins intraoperatively for oral squamous cell carcinoma. We conducted this study to determine the diagnostic accuracy of frozen section in detecting margin status and the effect of tumor grade and stage on diagnostic accuracy. RESULTS: A total of 251 biopsy-proven cases of oral squamous cell carcinoma were included in this study. The tissue specimen resected during surgery was sent to the laboratory for frozen section evaluation. The frozen section results were then compared with the permanent section results to determine the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy. The mean age of the patients included in the study was 51.65 ± 10.03 years, with male predominance (55.4%). The overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of frozen section were 88.81%, 94.84%, 95.20%, 88.10%, and 91.63%, respectively. We conclude that frozen section is a useful technique in determining the margin status intraoperatively in oral cancers, with high diagnostic accuracy. Moreover, certain clinical parameters such as age, gender, disease duration, and tumor stage and grade appear to affect the diagnostic accuracy of frozen section.

Atypical Tongue Abscesses Mimicking Submucosal Malignancies: A Review of the Literature Focusing on Diagnostic Challenges.

Tongue abscesses are rare conditions that usually follow mucosal disruption due to mechanical trauma or foreign body impaction. They typically manifest abruptly as a rapidly growing, hard mass or swelling in the context of tongue muscles; the patient frequently complains of pain, difficulties in swallowing or speaking, and fever. Nonetheless, the features of its presentation, together with accurate clinical evaluation, blood tests, and appropriate imaging tests, are usually sufficient to easily discern a tongue abscess from a malignancy. However, in rare cases, they may occur with slowly progressing and subtle symptoms, nuanced objective and laboratory findings, and inconclusive radiological evidence, leading to difficult differential diagnosis with submucosal malignancy. Herein, we review the literature, available on Pubmed, Embase, and Scopus, on publications reporting tongue abscesses, with atypical presentation suggesting an oral tumor. Our review confirms that tongue abscesses may manifest as a slowly growing and moderately painful swelling without purulent discharge and minimal mucosal inflammation; in this case, they may constitute an actual diagnostic challenge with potentially severe impact on correct management. Atypical tongue abscesses must therefore be considered in the differential diagnosis of tongue malignancy with submucosal extension, even when other diagnostic elements suggest a neoplasia; in this case, a deep biopsy under general anesthesia is essential for differential diagnosis, and simultaneous drainage of the necrotic and abscessual material may resolve the condition.

Implant Survival Rate in Mandible Reconstructed with Free Fibula Flaps After Oral Tumors: A Systematic Review and Meta-Analysis.

PURPOSE: To assess the implant survival rate in mandibles reconstructed with free fibula flap after oral tumor resection after 1 year of prosthetic loading. A secondary objective was to compare immediate or delayed implant placement protocols in this population. MATERIALS AND METHODS: Electronic and manual searches were performed on different databases for controlled and prospective trials that indicated implant survival rate. This systematic review followed PRISMA guidelines. Risk of bias was evaluated using Cochrane Collaboration tools. Meta-analyses heterogeneity source assessment and GRADE evaluation were performed among studies with identical follow-ups. RESULTS: Among 305 primarily selected articles, 109 were eligible after reading the title and abstract, and 8 were included after full-text reading: 2 randomized controlled trials and 6 prospective studies comprising 140 patients and 507 implants. Meta-analyses estimated an overall survival rate of 97% (95% CI: 94% to 99%) after 1 year of prosthetic loading. The survival rate was 98% (95% CI: 94% to 100%) with immediate implantation and 97% (95% CI: 90% to 99%) with delayed implantation. Only 3 studies reported radiotherapy treatment, with no real impact on implant survival rate. Overall, 69% of tumors were benign. CONCLUSIONS: Implant placement in vascularized fibula flaps in the mandible is recommended for patients undergoing segmental mandibular reconstruction after tumor resection. Within the limitations of this study, no significant difference in survival rates was found between immediate and delayed implant placement.

Characteristics of canine oral tumors: Insights into prevalence, types, and lesion distribution.

Objective: The escalating prevalence of canine oral tumors has emerged as a considerable health concern. This study examined the prevalence, types, and distributions of lesions linked to canine oral tumors. Material and Methods: The medical records of 526 dogs diagnosed with oral tumors were analyzed to determine the prevalence, types, and distributions. Tumor stages were classified into four categories using the tumor node metastasis system. Results: Among the 526 dogs, there were 118 cases of benign tumors and 408 cases of malignant tumors. Acanthomatous ameloblastoma was the most common benign tumor (43.22%), while melanoma was the most common malignant tumor (51.23%). The gingiva was the most common site for both benign and malignant lesions, accounting for 89.83% and 63.73% of cases, respectively. Melanoma, squamous cell carcinoma, and fibrosarcoma were primarily located in the gingiva, whereas osteosarcoma was commonly found in the mandible. Most tumors were classified as stage III (ranging from 46.84% to 74.58%). Of the reported cases, 56.08% were males and 43.92% were females, and the most common breed was mixed at 30.41%, followed by Poodle at 14.25% and Shih Tzu at 11.40%. Moreover, patients with malignant oral tumors (11.6 ± 3.1 years) were significantly older than those with benign tumors (8.9 ± 3.4 years, p < 0.0001). Conclusion: Gingiva was the primary site for oral tumors, and mainly classified as stage III. These findings emphasize the increasing occurrence of oral tumors in senior and geriatric dogs and provide insights into the prevalent types and distribution.

A Comparison of the Oral Microbiota in Healthy Dogs and Dogs with Oral Tumors.

The aim of this study was to further describe the oral microbiota of healthy dogs by DNA shotgun sequencing and compare those to dogs with oral tumors. Oral swabs (representative of all niches of the oral cavity) were collected from healthy dogs (n = 24) and from dogs with different oral tumors (n = 7). DNA was extracted from the swabs and shotgun metagenomic sequencing was performed. Only minor differences in microbiota composition were observed between the two groups. At the phylum level, the Bacteroidota, Proteobacteria, Actinobacteriota, Desulfobacterota and Firmicutes were most abundant in both groups. Observed Operational Taxonomic Units-OTUs (species richness) was significantly higher in the healthy patients, but there was no significant difference in the Shannon diversity index between the groups. No significant difference was found in beta diversity between the groups. The core oral microbiota consisted of 67 bacterial species that were identified in all 24 healthy dogs. Our study provides further insight into the composition of the oral microbiota of healthy dogs and in dogs with oral tumors.

Case report: Abrikossoff's tumor of the facial skin.

Abrikossoff tumors, also known as granular cell tumors (GCT), originate from Schwann cells. The most common location is in the oral cavity, followed by the skin, but they can also be found in the breast, digestive tract, tracheobronchial tree, or central nervous system. They can affect both sexes at any age, with a higher incidence between 30 and 50 years and a slight predisposition for female sex. They are usually solitary tumors but may also be multifocal. Most of the time, they are benign, with malignancy being exceptional in <2% of cases. Clinically, they appear as solid, well-defined, painless tumors, located subcutaneously with dimensions that can reach up to 10 cm. The definitive diagnosis is based on the immunohistochemical examination, and the treatment for benign tumors consists of surgical excision. Chemotherapy or radiotherapy may be required for malignant lesions, but the treatment regimens and their benefits remain unclear. This manuscript presents the case of a 12-year-old girl with a benign GCT, located in the skin on the mandibular line.

Metronomic Chemotherapy for Palliative Treatment of Malignant Oral Tumors in Dogs.

The aim of this study was to evaluate the efficacy of metronomic chemotherapy in the palliative treatment of various malignant oral tumors in dogs. Our focus was to determine the effect of treatment on local disease control and to assess the tolerability and safety of the treatment in dogs with various oral malignancies. Metronomic chemotherapy with cyclophosphamide was used to treat 12 dogs and was combined with non-steroidal anti-inflammatory drugs in 6/12 (50%) of dogs. A clinical benefit was observed in 6/12 (50%) patients 1 month and in 4/12 (33%) 3 months after treatment initiation. The median survival time of the dogs was 155 days (range 21-529 days). At the end of the observation period, the disease had progressed in 10/12 (83.3%) of the patients. Sterile hemorrhagic cystitis was the most commonly reported side effect of treatment, occurring in 4/12 (33.3%) dogs. The results of our study suggest that metronomic chemotherapy with cyclophosphamide can be, in a subset of dogs, beneficial in the palliation of malignant oral tumors.

Intraoral Lipoma of the Cheek - A Case Report With a One-Year Follow-up and Review of Literature.

Lipomas are mesenchymal adipose tumors that are most common in the human body. However, they are rare in the oral cavity at an occurrence rate of 1% to 4% with male gender predilection. The case presented is of a 37-year-old male who presented with a large painless swelling on the right cheek region. The swelling was present for the past year and had aggravated in the previous one month, causing discomfort during mastication and speech. On clinical examination, a solitary non-fluctuating circumferential swelling on the right cheek was observed. A provisional diagnosis of lipoma was made based on the history and clinical examination, and it was decided to treat by surgical excision. A final diagnosis of lipoma was made based on histopathological analysis of the excised specimen. The patient at a one-week follow-up had recovered from his speech and chewing problems, and no recurrence was reported at a one-year follow-up.