• Imaging Science in Dentistry
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• v.36 no.3
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• pp.169-175
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• 2006

The Inflammatory myofibroblastic tumor (inflammatory pseudotumor) is a rarely occurring soft tissue lesion of unknown etiology. It can be of any location, but commonly it is found in lungs. It has been considered as a nonneoplastic reactive inflammatory lesion, but nowadays, confusion and dispute about its character is increasing due to its high recurrence rate and metastasis. We present a patient who had been diagnosed with an inflammatory pseudotumor in the right maxilla area, 1 year before visiting our hospital. After that, her pain and swelling did not resolved and she visit our hospital. On radiographic examination, aggressively infiltrative growth of the lesion with destruction of adjacent bony structure was noted. We found unusual aggressiveness of the inflammatory myofibroblastic tumor of the head and neck region. Because the typical behavior of the inflammatory myofibroblastic tumor is not defined yet, we recommend the surgical excision of the lesion and close follow-up.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.1
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• pp.18-26
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• 2009

Purpose: Recently, the role of serum tumor marker has been studied for an important issue on diagnosing and treating tumors in the head and neck region because tests using tumor markers need relatively simple procedures and are acceptable to patients, compared with other test methods. Tumor marker tests were performed on patients with squamous cell carcinoma, which were known to have the highest prevalence among tumors in the head and neck region. Association between each tumor marker, and diagnosis and prognosis of tumors was assessed. Materials and methods: Tumor marker tests were carried out on 31 patients who visited Oral and Maxillofacial Surgery Department in Dankook University Dental Hospital between January 2003 and August 2008 and who were diagnosed as primary oral squamous cell carcinoma through out histopathologic diagnosis. Blood sample from these patients was performed to measure tumor markers using nuclear medicine diagnostic equipment. Measured entries were as follows: PSA(prostate-specific antibody), SCCAg( Squamous Cell Carcinoma Related Antigen), CA 19-9(Cancer Antigen 19-9), Ferritin, $\alpha$- FP(Alpha-Fetoprotein), Cyfra 21-1, CA125 (Cancer Antigen 125) and p53. Results: Analyses on each tumor marker indicated that squamous cell carcinoma in the head and neck region had statistically significant correlation with p53, SCC-Ag(TA-4), Cyfra 21-1 and Ferritin. p53 demonstrated the highest sensitivity. Especially, 4 cases among 18 cases which Ferritin was measured exhibited metastasis. In all those 4 cases, Ferritin values were higher than the standards (15 - 332ng/ml). Therefore, Ferritin is considered to have a close relation with metastasis of squamous cell carcinoma. Conclusion: This study shows that tumor marker tests are more useful in evaluating progression and prognosis of tumors rather than in diagnosing them. Particularly, serum Ferritin is considered to be beneficial in assessing metastasis of squamous cell carcinoma in the head and neck region and in developing treatment plans based on the assessment.

• Imaging Science in Dentistry
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• v.39 no.2
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• pp.99-102
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• 2009

Adenomatoid odontogenic tumor (AOT) is a tumor of odontogenic epithelium with varying degrees of inductive changes in the connective tissue. The common radiographic appearance of AOT is a unilocular radiolucency associated with an unerupted tooth. Detectable radiopacities have been reported in many cases. We present a case of AOT in a 9-year old-female patient. Cystic lesion with numerous, punctuate radiopaque foci was observed on the anterior region of the mandible. These radiopacities were situated mostly on the buccal side of impacted tooth on the multi-planar images of cone beam computed tomograph. Characteristic duct like structures and amyloid like material were observed on histopathologic finding. (Korean J Oral Maxillofac Radiol2009; 39 : 99-102)

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.2
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• pp.66-73
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• 2009

Tumor angiogenesis is a process leading to formation of blood vessels within tumors and is crucial for maintaining a supply of oxygen and nutrients to support tumor growth and metastasis. Vascular endothelial growth factor(VEGF) plays a key role in tumor angiogenesis including induction of endothelial cell proliferation, migration, survival and capillary tube formation. VEGF binds to two distinct receptors on endothelial cells. VEGFR-2 is considered to be the dominant signaling receptor for endothelial cell permeability, proliferation, and differentiation. Bevacizumab(Avastin, Genetech, USA) is a monoclonal antibody against vascular endothelial growth factor. It is used in the treatment of cancer, where it inhibits tumor growth by blocking the formation of new blood vessels. The goal of this study is to identify the anti-tumor effect of Bevacizumab(Avastin) for oral squamous cell carcinoma cell lines. Human squamous cell carcinoma cell line(HN4) was used in this study. We examined the sensitivity of HN4 cell line to Bevacizumab(Avastin) by using in vitro proliferation assays. The results were as follows. 1. In the result of MTT assay according to concentration of Bevacizumab(Avastin), antiproliferative effect for oral squamous cell carcinoma cell lines was observed. 2. The growth curve of cell line showed the gradual growth inhibition of oral squamous cell carcinoma cell lines after exposure of Bevacizumab(Avastin). 3. In the apoptotic index, groups inoculated Bevacizumab(Avastin) were higher than control groups. 4. In condition of serum starvation, VEGFR-2 did not show any detectable autophosphorylation, whereas the addition of VEGF activated the receptor. Suppression of phosphorylated VEGFR-2 and phosphorylated MAPK was observed following treatment with Bevacizumab(Avastin) in a dose-dependent manner. 5. In TEM view, dispersed nuclear membrane, scattered many cytoplasmic vacuoles and localized chromosomal margination after Bevacizumab(Avastin) treatment were observed. These findings suggest that Bevacizumab(Avastin) has the potential to inhibit MAPK pathway in proliferation of oral squamous cell carcinoma cell lines via inhibition of VEGF-dependent tumor growth.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.2
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• pp.136-142
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• 2004

Malignant fibrous histiocytoma(MFH) is the malignant part of mesenchymal cell-originated tumor, which is supposed that the tumor is presented various histologic features consisted of fibrosarcomatic and histiocytic portions. When the tumor is arisen in the head and neck region, the most affected sites are the nasal cavity and paranasal sinuses, and secondly the maxillary alveolar bone is occasionally influenced. Therefore, MFH can readily involve the adjacent alveolar bone. The treatment of MFH in the head and neck is various, that is, the involved sites and the differentiation of tumor must be considered when the tumor is treated. The treatment protocols are subjected to general ones of soft tissue sarcoma, and simple or combination therapy is used in the surgery, chemotherapy and radiation therapy. So, we report a clinical case of chemotherapy involving intraarterial chemotherapy, and surgery of malignant fibrous histiocytoma(MFH) in the maxilla, with review of the literature.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.4
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• pp.1599-1603
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• 2015

Background: Epigenetic silencing of tumor suppressor genes due to promoter hypermethylation is one of the frequent mechanisms observed in cancers. Hypermethylation of several tumor suppressor genes involved in cell cycle regulation has been reported in many types of tumors including oral squamous cell carcinomas. LATS1 (Large Tumor Suppressor, isoform 1) is a novel tumor suppressor gene that regulates cell cycle progression by forming complexes with the cyclin dependent kinase, CDK1. Promoter hypermethylation of the LATS1 gene has been observed in several carcinomas and also has been linked with prognosis. However, the methylation status of LATS1 in oral squamous cell carcinomas is not known. As oral cancer is one of the most prevalent forms of cancer in India, the present study was designed to investigate the methylation status of LATS1 promoter and associate it with histopathological findings in order to determine any associations of the genetic status with stage of differentiation. Materials and Methods: Tumor chromosomal DNA isolated from biopsy tissues of thirteen oral squamous cell carcinoma biopsy tissues were subjected to digestion with methylation sensitive HpaII enzyme followed by amplification with primers flanking CCGG motifs in promoter region of LATS1 gene. The PCR amplicons were subsequently subjected to agarose gel electrophoresis along with undigested amplification control. Results: HpaII enzyme based methylation sensitive PCR identified LATS1 promoter hypermethylation in seven out of thirteen oral squamous cell carcinoma samples. Conclusions: The identification of LATS1 promoter hypermethylation in seven oral squamous cell carcinoma samples (54%), which included one sample with epithelial dysplasia, two early invasive and one moderately differentiated lesions indicates that the hypermethylation of this gene may be one of the early event during carcinogenesis. To the best of our knowledge, this is the first study to have explored and identified positive association between LATS1 promoter hypermethylation with histopathological features in oral squamous cell carcinomas.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.1
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• pp.11-19
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• 2007

This study was to evaluate the expression of vascular endothelial growth factor receptors (VEGFRs) in tumor and stromal cells of tougue squamous cell carcinoma (SCC). We also wanted to characterize the differences, from the angiogenic aspect, between cancer-associated stromal cells and non-malignant stromal cells. Paraffin-embedded tumor specimens from eleven patients with tongue SCCs were studied. Immunohistochemical staining for VEGFR-1,-2, and -3 was performed on the tumor cells, stromal fibroblasts and tumor-associated macrophages of the specimens. The expression of all 3 receptors was detected in the tumor cells themselves of the biopsy specimens. All 3 receptors were also expressed on stromal cells, except that VEGFR-2 was not expressed in stromal fibroblasts. In radical excision specimens, the staining intensity for VEGFR-1, -2 in the tumor cells and VEGFR-1,-3 in the tumor-associated macrophages was significantly lower than that in the biopsy specimens (P < 0.05). By using the general marker of fibroblast and macrophage, 5B5 and CD68, respectively, we performed double immunofluorescence staining for 5B5 and each VEGFR in the stromal fibroblasts and for CD68 and each VEGFR in the tumor-associated macrophages of the radical excision specimens. We used 4 cases of fibroma and 4 cases of chronic inflammation tissue as the controls. It was found that only each marker was expressed in the control group, however, 5B5/VEGFR-1 and 5B5/VEGFR-3 in the stromal fibroblasts, and CD68/VEGFR-1 and CD68/VEGFR-3 in the tumor-associated macrophages were double stained in the radical excision specimens. Although our study used small number of specimens, the results of our study showed that in tongue SCC, in association with the angiogenesis, the stromal cells showed the activated phenotype and this was different from the nonmalignant stromal cells.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.1785-1787
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• 2016

Granular cell tumor (GCT) of the oral cavity is a benign lesion. Half of oral GCTs demonstrate pseudocarcinomatous hyperplasia (PCH) of the mucosa which can mimic invasive islands of oral squamous cell carcinoma (SCC). Such similarity can be confusing when diagnosing or evaluating the two conditions, potentially leading to misdiagnosis or misclassification. Indeed, several misdiagnosed cases of oral GCT have been reported in the literature as OSCC or malignant oral GCT that resulted in unnecessary aggressive treatment for the affected patients. The aim of this study was to investigate if the cytokeratin pattern of the PCH can help in differentiating GCT from oral SCC. To distinguish between these two entities, we examined 12 patient specimens of oral GCT-PCH and oral SCC histologically and via immunohistochemistry (IHC) for CK13, CK17 and P75. The results suggest that the cytokeratin profile of PCH is similar to that of oral SCC. Therefore, consideration of IHC findings for epithelial markers alone may lead to erroneous diagnosis; thus, the presence of the granular tumor underneath the PCH and its immunopositivity for P75 or other neural definition markers can be essential to identify the underlying tumor and exclude oral SCC. Finally we recommend more studies on the molecular biology of PCH to understand how it can mimic oral SCC histologically without harboring its malignant phenotype clinically, which could have significant translational potential for understanding invasive oral SCC.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.4
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• pp.221-226
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• 2016

Spindle cell carcinoma (SpCC) is referred to as a variant of oral squamous cell carcinoma. It is also known as "sarcomatoid squamous cell carcinoma" because it consists of normal squamous carcinoma cells with spindle-shaped cells that appear similar to a sarcoma. The term, "second primary tumor" (SPT) or "double primary tumor", is proposed for a second tumor that develops independently from the first. SPTs can present as either synchronous or metachronous lesions. Synchronous SPTs are defined as tumors occurring simultaneously or within 6 months after the first tumor. The patient in this case, whose primary tumor was in the tongue, was diagnosed with SpCC with metastases to both neck lymph nodes. This case also exhibited a second primary cancer as a synchronous lesion in the thyroid gland, which is uncommon. All carcinomas, both in the tongue and thyroid gland, were removed surgically, and especially in the tongue, an anterolateral thigh free flap was performed successfully to replace the defect.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.4
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• pp.374-379
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• 2006

Central granular cell odontogenic tumor(CGCOT) is a very rare lesion that consists of densely packed granular cells with numerous scattered strands of odontogenic epithelium interspersed throughout the tissue. CGCOT was initially reported in 1962 by Cough et al as central granular cell ameloblastic fibroma. But, recently, this term is inappropriate because of histologic and chronologic differences. CGCOT is usually present as painless swellings. Radiographs show a well-demarcated radiolucent or mixed radiopaque-radiolucent lesion. The average age on presentation of CGCOT is 47.3 and women are 75% more likely to develop this lesion than men. The tumor only occur in tooth bearing areas of the jaw with 88% of cases occurring in the mandible and 12% involving the maxilla, usually in an equal distribution between the caninepremolar-molar areas. This tumor is benign, and care is effected by localized surgical excision. We report an additional case of CGCOT that occurred in the Rt. Maxillar premolar/molar region of a 32-year old man with literature review.