Most neoplasm of the floor of the mouth are squamous cell carcinoma. They originate from anterior midline floor of the mouth and penetrate into the sublingual gland. Invasion of the mandible is a late manifestation. Lymphatic spread is the submaxillary and subdigastric nodes and advanced lesions of them produce severe pain, The initial step in managing patients with cancer pain is the oncology therapy in the form of radiotherapy, surgery, or chemotherapy, alone or combined. When oncologic therapy is ineffective, the pain must be treated by systemic analgesic, psychologic, neurostimulating, regional analgesic,and meuroablative techniques. We successfully treated with gasserian ganglion block on the left side and mandibular nerve block on the right side with pure alcohol in the patient having severe submandibular, lower lip and tongue pain.
Cho Moon-June;Kim Ki-Hwan;Kim Byung-Kook;Song Chang-Joon;Kim Jun-Sang;Kim Jae-Sung;Jang Ji-Young
Korean Journal of Head & Neck Oncology
/
v.17
no.1
/
pp.59-62
/
2001
Objectives: We report an interim result of conformal radiotherapy in a patient with early stage cancer at the base of the tongue, which developed in a previously irradiated area. Materials and Methods: A 64-year-old male patient was diagnosed with T4N0M0 supraglottic cancer. He received 72Gy of radiation therapy from 21 November 1988 to 24 February 1989. He had local failure and underwent a salvage total laryngectomy on 28 August 1989. Subsequently, he did well. In early 1999, he suffered from throat pain. He had a 2.5cm ulcerative mass at the base of his tongue, in the area that had been irradiated previously. Biopsy showed squamous cell carcinoma. After workup, he was diagnosed with base of tongue cancer with T2N0M0. Surgery was not feasible because the morbidity was not acceptable. Since it was difficult to re-irradiate the area with a curable dose using conventional 2D radiation therapy with an acceptable morbidity, we decided to try conformal radiotherapy. We used 7 static beam ports with field sizes from $7x6.4\;to\;8x8cm^2$, using 6 and 10MV photons. The fractionation regimen was 1.8Gy, 5 times per week. He received 64.8Gy in 36 fractions from 9 April 1999 to 1 June 1999. Results: In the 21 months since radiotherapy, the patient has not experienced any acute or chronic complications, such as xerostomia. He experienced relief of pain shortly after the start of radiotherapy, showed a complete response, and is still doing well. Conclusion: Conformal radiotherapy can be used to treat cancer that develops within a previously irradiated field, with curative intent.
Maleki, Davood;Ghojazadeh, Morteza;Mahmoudi, Seyed-Sajjad;Mahmoudi, Seed-Mostafa;Pournaghi-Azar, Fatemeh;Torab, Ali;Piri, Reza;Azami-Aghdash, Saber;Naghavi-Behzad, Mohammad
Asian Pacific Journal of Cancer Prevention
/
v.16
no.13
/
pp.5427-5432
/
2015
Background: Oral cancer stands among the 10 top causes of cancer death in the world. Considering the role of epidemiologic information on planning and effective interventions, the present study aimed to investigate the epidemiology of oral cancer in Iran. Materials and Methods: The required information for this systematic review study was obtained from PubMed, Google Scholar, CINAHL,SID, Medlib, Magiran and Iranmedex databases, using key words "cancer", "oral cancer", "squamous cell carcinoma", "oral cavity carcinoma" and their Persian equivalents in combination with keywords of epidemiology, prevalence, etiology, frequency, and Iran from 1990 to 2014. From 1,065 related studies found, finally 25 were included to the study. Results: The mean age of 8,248 patients in 25 studies was $54.0{\pm}15.1years$. The male/female ratio for oral cancer was 1.91. Tongue with average percentage of 29.9 was the most involved site. Regarding microscopic grade, 65.7% of cases were grade 1. SCCs, accounting for an average of 70.0%, was the most common among all types of oral cancer. In the majority of studies, smoking including cigarette, hookah, and tobacco consumption was found to be a risk factor. Conclusions: The epidemiological pattern of oral cancer in Iran is somewhat similar to that of other countries. Yet the information on hand in this field is limited and considering the role of epidemiological data we suggest conducting more accurate studies to catch data that is required for effective programs and interventions.
Park Young Hwan;Park Woo Yoon;Cho Chul Koo;Koh Kyung Hwan;Yoo Seong Yul;Shim Yoon Sang;Oh Kyoung Kyun;Lee Yong Sik
Radiation Oncology Journal
/
v.8
no.2
/
pp.189-198
/
1990
Sixty-six patients with squamous cell carcinoma of the oropharynx were treated with radiation therapy and retrospectively analyzed to evaluate the treatment result in the Department of Therapeutic Radiology, Korea Cancer Center Hospital between January 1980 and December 1986. There were 42 patients with carcinoma of the tonsil including the fossa and pillar, 9 patients with carcinoma of the base of tongue,12 patients with carcinoma of the soft palate, and 3 patients with carcinoma of the posterior and lateral pharyngeal walls. Considering all oropharyngeal sites of involvement together, response rates for T1, T2, T3, and T4 were 80%, 77%, and 40%, respectively, with a overall response rate of 70%. The response rate for N1, N2, and N3 were 69%, 63%, and 40%, respectively, with the overall regional response rate of 70%. In lower T status, undifferentiated carcinoma and primary tumor arising from the soft palate, higher response rates were obtained. The S year overall and disease-free survival rate were 56%, 55%, respectively. A better prognosis was obtained in early T stage (T1+T2) (p<0.01) and in patients without tumor extension into adjacent structures in carcinomas arising from tonsillar area (p<0.01). Through this study we suggest that, in terms of anatomical and functional preservation, radiation therapy seems to be an effective method for the primary treatment of patients with oropharyngeal carcinoma.
Oral lichen planus (OLP) is a chronic inflammatory disease observed in approximately 0.5-2.2% of the population, and it is recognized as a premalignant lesion that can progress into oral squamous cell carcinoma (OSCC). The rate of malignant transformation is approximately 1.09-2.3%, and the risk factors for malignant transformation are age, female, erosive type, and tongue site location. Malignant transformation of OLP is likely related to the low frequency of apoptotic phenomena. Therefore, apoptosis-related genetic factors, like p53, BCL-2, and BAX are reviewed. Increased p53 expression and altered expression of BCL-2 and BAX were observed in OLP patients, and the malignant transformation rate in these patients was relatively higher. The involvement of microRNA (miRNA) in the malignant transformation of OLP is also reviewed. Because autophagy is involved in cell survival and death through the regulation of various cellular processes, autophagy-related genetic factors may function as factors for malignant transformation. In OLP, decreased levels of ATG9B mRNA and a higher expression of IGF1 were observed, suggesting a reduction in cell death and autophagic response. Activated IGF1-PI3K/AKT/mTor cascade may play an important role in a signaling pathway related to the malignant transformation of OLP to OSCC. Recent research has shown that miRNAs, such as miR-199 and miR-122, activate the cascade, increasing the prosurvival and proproliferative signals.
Angiogenesis is important for the growth and metastasis of solid tumors. Some growth factors, inflammatory cytokines, and angiogenin are known to promote tumor angiogenesis. Among them, Vascular endothelial growth factor (VEGF) is the most intriguing factor in regard to tumor angiogenesis. Inhibition of VEGF activity by neutralizing antibodies or by the introduction of dominant negative VEGF receptors into endothelial cells of tumor-associated blood vessels resulted in the inhibition of tumor growth and in tumor regression, indicating that VEGF is a major initiator of tumor angiogenesis. VEGF promotes angiogenesis through their receptors, Flt-1 and Flk-1/KDR. on vascular endothelial cells. These two receptors were usually believed to be expressed specifically on vascular endothelial cell. Several reports have now shown that VEGF is not only significantly associated with microvessel density but also has prognostic value in both node-negative and node-positive oral squamous cell carcinoma. For many years several histologic features of the neoplasms are being considered when assessing the influence of malignancy grading on recurrence and prognosis. Among the characteristics investigated, degree of keratinization, nuclear pleomorphism, mode of invasion, microscopic depth of invasion, intravascular invasion, lymphocyte infiltration, and number of mitoses have been considered as important prognostic factors. So, this study was conducted to evaluate the correlation of vascular endothelial growth factor expression with malignancy in paraffin-embedded biopsy specimens from 11 patients with tongue cancers. Our results showed that high immunoreactivity specimens of VEGF expression were significantly lower keratinization degree and more pronounced nuclear pleomorphism than in low immunoreactivity specimens. Thus, VEGF expression could be used as a prognostic marker in tongue cancer.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.34
no.2
/
pp.141-150
/
2008
We studied 1809 oral cancer patients who visited and were treated in 2002 at the 148 institutions certified as training facilities by the Japanese Society of Oral and Maxillofacial Surgeons, which is composed of 39 dental university hospitals, 44 medical university hospitals, 64 general hospitals, and 1 unknown institution. The patients consisted of 1071 (59.2%) males and 738 (40.8%) females (male:female ratio, 1.45:1), who had a mean age of 65.2 years old. The tongue (40.2%) was the most common site affected, followed by the gingiva (32.7%), buccal mucosa (10.1%), and oral floor (9.0%). There were 6 cases of intraoral multiple cancer. In histopathological examinations, squamous cell carcinoma (88.7%) was the most common type found, followed by adenoid cystic carcinoma (2.1%), and mucoepidermoid carcinoma (1.7%). In addition, non-epithelial tumors comprised 1.8%, among which malignant melanoma was the most common type. Cases classified as T2N0 were the most common (32.1%), followed by T1N0 (21.4%), T4N0 (8.0%), and T2N1 (7.6%). Distant metastasis occurred in 17 patients (1.0%). The sizes of the non-epithelial malignant tumors ranged from 1.0 to 7.0 cm, with a mean size of 3.7 cm.
Kim, Myoung-Yun;Kim, Chin-Soo;Lee, Sang-Han;Kim, Jin-Wook;Jang, Hyun-Jung
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.33
no.6
/
pp.660-668
/
2007
We investigated 248 patients who were diagnosed as malignant tumor in the department of Oral and maxillofacial Surgery of Kyungpook National University from 1999 to 2006, and following results were obtained. 1. Among 248 patients who have malignant tumor, 164 were men and 84 were women, which made the ratio of male to female 1.95:1. 2. The average age of oral cancer patients was 58.3. 3. As of the primary origin site, lower alveolus and gingiva were the greatest with 70 cases(28.2%), followed by tongue(l6.9%), upper alveolus and gingiva(14.9%), palate(13.7%), mouth floor(9.7%), buccal mucosa(4.8%), retromolar trigone(4.4%), Mx. & Mn. bone(3.2%) and lip(2.8%). 4. As of histologic distribution, squamous cell carcinoma was the greatest with 170 cases(68.6%), followed by sarcoma with 17 cases(6.9%), adenoid cystic carcinoma with 17 cases(6.9%), malignant lymphoma with 15 cases(6.0%), mucoepidermoid carcinoma with 13 cases(5.2%), metastatic carcinoma with 6 cases(2.4%) and malignant melanoma with 4 cases(1.6%). 5. Period between recognition of the symptom and the first visit to hospital was less than 3 months for 58.9% of the patients, and more than 3 months for 41% of the patients. 6. Investigation of whether the patients drink or smoke revealed that the number of non-smoking and non-drinking patients was 63 among 170 patients(37.0%) that were able to investigate. The number of patients who smoke only was 29(17.1%) and both drinking and smoking patients were 78(45.9%). 7. In clinical stage order, Stage IV(61.7%) was found th be the largest, followed by stage I(17.2%), stage II(13%) and stage III(7.8%). 8. The 5-year survival rate of the entire oral cancer patients appeared to be 57.7%. The survival rate was higher in younger group and women had higher survival rate but there was no statistical significance to this. In the aspect of stage, the survival rate was Stage I, Stage II, Stage IV and Stage III in decreasing order. The order according to T classification was the same. In N classification, patients with N0 had the highest survival rate and the survival rate decreased in the order of N1 and N2. Survival rate was especially low in patients with N2.
Background: Oral cancer presents with high mortality rates, and the likelihood of survival is remarkably superior when detected early. Health care providers, particularly dentists, play a critical role in early detection of oral cancers and should be knowledgeable and skillful in oral cancer diagnosis. Purpose: The aim of the present study was to assess the current knowledge of future Yemeni dentists and their opinions on oral cancer. Materials and Methods: A pretested self-administered questionnaire was distributed to fourth and fifth year dental students. Questions relating to knowledge of oral cancer, risk factors, and opinions on oral cancer prevention and practices were posed. Results: The response rate was 80%. The vast majority of students identified smoking and smokeless tobacco as the major risk factors for oral cancer. Most of the students (92.6%) knew that squamous cell carcinoma is the most common form of oral cancer, and 85.3% were aware that tongue and floor of the mouth are the most likely sites. While the majority showed willingness to advise their patients on risk factors, only 40% felt adequately trained to provide such advice. More than 85% of students admitted that they need further information regarding oral cancer. As expected, students of the final year appeared slightly more knowledgeable regarding risk factors and clinical features of the disease. Conclusions: The findings of the present study suggest that here is a need to reinforce the undergraduate dental curriculum with regards to oral cancer education, particularly in its prevention and early detection.
The State of Punjab has been in focus because of aperceived increasing rate of cancer. Both print and electronic media have created an impression that Punjab, especially the cotton belt of Malwa Region, has become a high incidence cancer region. Actually the increased number of cancer patients might be at least partly because of increasing population and heightened health awareness and reporting. The purpose of this study is to find out the pattern of cancer amongst patients registered in Mukh Mantri Punjab Cancer Rahat Kosh Scheme (MMPCRKS), under cancer registry at Rajindra Hospital Patiala from the various districts of Punjab. The study covers 500 cancer patients registered under MMPCRKS at Rajindra Hospital Patiala, for free cancer treatment. Information regarding age, gender, religion, method of diagnosis and affected sites was obtained. Results were analyzed statistically. Of the 500 patients, 65% were females and 35% were males. The most affected female age groups were 50-54 and 60-64; while males in the age groups of 65-69 and 60-64 had the highest risk. The leading cancers in females were breast followed by cervix and ovary where as in males they were were colon followed by esophagus and tongue. The commonest histological type was adenocarcinoma followed by squamous cell carcinoma. The increasing trend of cancer in Punjab is alarming. Since this study is a preliminary investigation, it could provide a leading role in prevention, treatment and future planning regarding cancer in Punjab.
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