• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.3
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• pp.191-196
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• 2017

Squamous cell carcinoma of the buccal mucosa has an aggressive nature, as it grows rapidly and penetrates well with a high recurrence rate. If cancers originating from the buccal mucosa invade adjacent anatomical structures, surgical tumor resection becomes more challenging, thus raising specific considerations for reconstruction relative to the extent of resection. The present case describes the surgical management of a 58-year-old man who presented with persistent ulceration of the mucosal membrane and a mouth-opening limitation of 11 mm. Diagnostic imaging revealed a buccal mucosa tumor that had invaded the retroantral space upward with involvement of the anterior border of the masseter muscle by the lateral part of the tumor. In this report, we present the surgical approach we used to access the masticator space behind the maxillary sinus and discuss how to manage possible damage to Stensen's duct during resection of buccal mucosa tumors.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.1
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• pp.1-8
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• 2010

Background and Purpose: Vascular endothelial growth factor (VEGF)-C and VEGF receptor (VEGFR)-3 are involved in tumor lymphangiogenesis. Oral mucosal squamous cell carcinoma (OMSCC) preferentially metastasizes to cervical lymph nodes, so we investigated the expression and distribution of VEGFR-3 signaling proteins in OMSCC. Materials and Methods: Tissue samples of 18 OMSCC, 10 oral mucosal leukoplakia, and 3 normal oral mucosa were evaluated for expression of VEGF-C, VEGF-D, and VEGFR-3 by immunohistochemical staining. The presence of lymphatic vessels was determined using D2-40 staining, by which we also measured lymphatic vessel density (LVD). Results: 72% (13/18) and 56% (10/18) of tissue samples showed VEGF-C and VEGF-D immunopositivity in tumor cells and tumor-associated endothelial cells. VEGFR-3 was also expressed in most of OMSCC, which was up-regulated when compared with normal mucosa or with leukoplakia. Furthermore, LVD was higher in OMSCC than in leukoplakia. Conclusion: Taken together, our results suggest that autocrine activation of lymphatic endothelial cell via VEGFR-3 by VEGF-C and/or VEGF-D could be involved in progression of OMSCC. Therefore, VEGF-C/VEGFR-3 signaling pathway can be a molecular target for anti-metastatic therapy in OMSCC.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.1
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• pp.45-48
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• 2009

Verrucous carcinoma is a distinctive form of low-grade squamous cell carcinoma. The tumor has an exophytic, cauliflower-like appearance, and usually occurs in males and tends to affect individuals over 60 years of age. It typically involves the oral cavity, larynx, esophagus and skin. Most intraoral cases involve the mandibular vestibule, the buccal mucosa and the hard palate. The cause is unknown, but most verrucous carcinomas arise from the oral mucosa in people who chronically use chewing tobacco or snuff. The treatment of oral verrucous carcinoma remains controversial. Whenever possible, surgically total excision and skin or mucosal grafting is recommended. After total excision of huge verrucous carcinoma,instead of dermal or mucosal grafting, we used artificial dermis silicone membrane. We had a good result without recurrence and present this case.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.6
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• pp.529-539
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• 2008

Background and Purpose : Oral squamous cell carcinoma (OSCC) is one of the most aggressive tumors of the head and neck area. OSCC is known to preferentially metastasize via lymphatic system, and resulting cervical lymph node metastasis is the most reliable of treatment failure. But the biological mechanism of the regional nodal metastasis is not clear. So, we determined metastasis-related factors in orthotopic nude mouse models of OSCC. Experimental Design : Two cell lines-KB and YD-10B cells, established from human oral mucosal squamous cell carcinoma, were xenografted into the tissue space of athymic murine mouth floor. The mice were followed for tumor development and growth, the murine tumors were examined histopathologically for local invasion or regional or distant metastasis. Finally, we performed immunohistochemical assays with antiepithelial growth factor (EGF), EGF receptor (EGFR), phosphorylated EGFR (pEGFR), and anti-vascular endothelial growth factor (VEGF), VEGF receptor (VEGFR)-2, phosphorylated VEGFR-2/3 (pVEGFR-2/3) antibodies. We also determined the microvessel density. Results : Transplantation of human OSCC tumor cells into the mouth floor successfully resulted in the formation of orthotopic tumors. KB cell line showed significantly higher tumor proliferation and higher nodal metastatic potential than YD-10B cell line. Furthermore, immunohistochemical staining demonstrated higher expression of EGFR/pEGFR, VEGF, and pVEGFR-2/3 as well as higher microvessel density in KB murine tumors than in YD-10B murine tumors. Conclusion : An orthotopic model of OSCC in athymic mice was established which copies the cervical lymph nodal metastasis of human OSCC. Our mouth floor model should facillitate the understanding of the molecular pathogenesis of cervical nodal metastasis of OSCC.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.11.1-11.5
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• 2018

Background: Squamous cell carcinoma (SCC) is the most commonly occurring malignant tumor in the oral cavity. In South Korea, it occurs most frequently in the mandible, tongue, maxilla, buccal mucosa, other areas of the oral cavity, and lips. Radial forearm free flap (RFFF) is the most widely used reconstruction method for the buccal mucosal defect. The scar of the forearm donor, however, is highly visible and unsightly, and a secondary surgical site is needed when such technique is applied. For these reasons, buccal fat pad (BFP) flap has been commonly used for closing post-surgical excision sites since the recent decades because of its reliability, ease of harvest, and low complication rate. Case presentation: In the case reported herein, BFP flap was used to reconstruct a cheek mucosal defect after excision. The defect was completely covered by the BFP flap, without any complications. Conclusion: Discussed herein is the usefulness of BFP flap for the repair of the cheek mucosal defect. Also, further studies are needed to determine the possibility of using BFP flap when the defect is deep, and the maximum volume that can be harvested considering the changes in volume with age.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.6
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• pp.453-460
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• 2009

Background and Purpose: Vascular endothelial growth factor (VEGF)-C, VEGF-D and their tyrosine kinase receptor, VEGF receptor (VEGFR)-3 are recently known to have lymphangiogenic activities in various tumor types. Oral mucosal squamous cell carcinoma (OMSCC) easily metastasizes to cervical lymph nodes, so we determined the expression levels of VEGF-C, VEGF-D and VEGFR-3 in oral squamous cell carcinoma. Materials and Methods: We performed Western blot analyses with 4 OMSCC cultured tumor cell lines (SCC9, KB, YD-10B, YD-38), and with 7 surgical specimens of OMSCC for the detection of VEGF-C, VEGF-D and VEGFR-3 proteins. Expression of VEGF-C mRNA as well as mRNA for VEGFR-3 in 4 OMSCC cell lines (KB, SCC-4, SCC-9, YD-10B) was investigated by RT-PCR. We also measured VEGFC/VEGF-D protein concentrations in the media and protein concentration of VEGFR-3 in cell lysates of 4 OMSCC cell lines (SCC9, KB, YD-10B, YD-38) using commerical ELISA kits. Finally, we performed immunoprecipitation for the detection of VEGF-C in cell lysates of 4 OMSCC cells (KB, SCC-4, SCC-9, YD-10B) and real-time RT-PCR for the quantification of VEGF-C mRNA. Results: In the result of Western blotting with cell lysates of 4 OMSCC cells, we could not detect the protein expression of VEGF-C, VEGF-D, and VEGFR-3. But, all tumor tissues demonstrated VEGF-C and VEGFR-3. VEGF-C mRNA was detected at various levels in 4 OMSCC cell lines. Moreover, OMSCC cells secreted VEGF-C, not VEGF-D and VEGFR-3 was also detected in cell lysates of OMSCC by ELISA. Immunoprecipitation and real-time RT-PCR revealed VEGF-C was also expressed in 4 OMSCC cell lines. Conclusion: Taken together, tumor cells of OMSCC secrete VEGF-C, not VEGF-D. And VEGFR-3 is expressed tumor cells as well as OMSCC tumor tissues, needs further study.

• Radiation Oncology Journal
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• v.16 no.1
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• pp.87-90
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• 1998

Malignant melanoma of the oral cavity is rare, accounting for 1 to $8\%$ of all malignant melanomas. The overall prognosis remains poor despite the available treatments such as radical surgery, adjuvant radiotherapy, chemotherapy and immunotherapy due to failure in early detection and tendency in early metastasis. The etiology of mucosal malignant melanoma remains unkown. However, there are few cases of malignant melanoma of the oral cavity reported in the literature, which might be related to preexisting melanosis and radiation treatment. A case with malignant melanoma developed on the same site after 6 years following irradiation for squamous cell carcinoma of the oral cavity is reported in this article.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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• pp.2187-2191
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• 2015

Background: Protrusive structures formed by migrating and invading cells are termed lamellipodia, filopodia, invadopodia and podosomes. Lamellipodia and filopodia appear on the leading edges of migrating cells and function to command the direction of the migrating cells. Invadopodia and podosomes are special F-actin-rich matrix-degrading structures that arise on the ventral surface of the cell membrane. Invadopodia are found in a variety of carcinomatous cells including squamous cell carcinoma of head and neck region whereas podosomes are found in normal highly motile cells of mesenchymal and myelomonocytic lineage. Invadopodia-associated protein markers consisted of 129 proteins belonging to different functional classes including WASP, NWASP, cortactin, Src kinase, Arp 2/3 complex, MT1-MMP and F-actin. To date, our current understanding on the role(s) of these regulators of actin dynamics in tumors of the orofacial region indicates that upregulation of these proteins promotes invasion and metastasis in oral squamous cell carcinoma, is associated with poor/worst prognostic outcome in laryngeal cancers, contributes to the persistent growth and metastasis characteristics of salivary gland adenoid cystic carcinoma, is a significant predictor of increased cancer risk in oral mucosal premalignant lesions and enhances local invasiveness in jawbone ameloblastomas.

• Korean Journal of Head & Neck Oncology
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• v.39 no.2
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• pp.23-26
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• 2023

Lower lip reconstruction in cases with a full-thickness defect over one-third of the vermilion is challenging. Numerous conventional techniques have been applied with unsatisfactory surgical outcomes because of microstomia and oral commissure blunting due to shortened horizontal lip length. Herein, we present a case in which a full-thickness lower lip defect of more than one-third of the horizontal lip length was covered with a novel mucosal roofing flap reconstruction to minimize the loss of horizontal lip length and to preserve mouth opening. No recurrences or metastases were observed during 3 years and 6 months of follow-up, with horizontal lower lip length maintained and mouth opening of 2.5 finger breadths.

• Korean Journal of Head & Neck Oncology
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• v.34 no.2
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• pp.29-34
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• 2018

Background/Objectives: The aim of this study was to investigate the diagnostic value of i-scan in the differential diagnosis of oral cavity leukoplakia based on visualization of abnormal vascular features. Materials & Methods: Thirty- one patients with oral cavity leukoplakia were enrolled in the study. Images of their oral cavity obtained using conventional white light endoscopy and an i-scan-enhanced endoscopy (Pentax DEFINA EPK-3000 Video Processors, with Pentax VNLJ10) were reviewed. The microvascular features of the lesions and vascular changes were analyzed and the results were compared with the histopathologic diagnosis. Results: Among the 31 oral cavity leukoplakia patients, 8 (25.8%) patients revealed hyperkeratosis, 10 (31.2%) low-grade dysplasia, 5 (16.2%) high-grade dysplasia and 8 (25.8%) invasive squamous cell carcinoma on histopathologic examination. Using i-scan-enhanced endoscopy, we could found abnormal vascular change with neoplastic neoangiogenesis in most high-grade dysplasia or invasive cancer in oral cavity. (high-grade dysplasia: 4/5 [80.0%], and invasive squamous cell carcinoma: 7/8 [87.5%]). Conclusion: i-scan-enhanced endoscopy could be a useful optical technique for the diagnosis of oral cavity leukoplakia. Our results suggest that i-scan may be a promising diagnostic tool in the early detection of suspected oral mucosal lesion.