Actinomycosis is a subacute or chronic suppurative infection caused by Actinomyces species, which are anaerobic Gram-positive bacteria that normally colonize the human mouth and digestive and urogenital tracts. Cervicofacial actinomycosis is the most frequent clinical form of actinomycosis, and is associated with odontogenic infection. Characterized by an abscess and mandibular involvement with or without fistula, but the cervicofacial form of actinomycosis is often misdiagnosed because the presentation is not specific and because it can mimic numerous infectious and non-infectious diseases, including malignant tumors. We report a rare case of actinomycosis infection with coexisting submandibular sialolithiasis. The patient presented with a $1{\times}1cm$ abscess-like lesion below the lower lip. Punch biopsy of the lesion revealed atypical squamous cell proliferation with infiltrative growth, suggestive of squamous cell carcinoma. The patient underwent wide excision of this lesion, where the lesion was found to be an abscess formation with multiple submandibular sialolithiases. The surgical specimen was found to contain Actinomyces without any evidence of a malignant process. We assumed that associated predisposing factors such as poor oral hygiene may have caused a dehydrated condition of the oral cavity, leading to coexistence of actinomycosis and sialolithiasis.
Hemophilia A is a hemorrhagic disease caused by coagulation factor VIII deficiency. In head and neck cancer surgery, especially during a reconstructive one, complications can occur. These include hematomas due to bleeding which can then lead to flap ischemia, necrosis, and impaired wound healing. There are fewer cases of reconstructive surgery in patients with hemophilia A. Here in we report, a reconstructive surgery that involved mass resection, partial glossectomy (right), selective neck dissection (right, Levels I, II, III, IV), and reconstruction at the lateral arm free flap (left) in a 25-year-old man with hemophilia A. The surgery was successfully performed without any complications after pretreatment with Factor VIII concentrate, which has not been reported earlier.
Factors such as location, volume, and the type of neoplasm complicate achieving tumor control. Electrochemotherapy (ECT) is a supplementary treatment for inoperable neoplasms in veterinary patients. Three dogs were diagnosed with a tumor. Two were squamous cell carcinoma (SCC), and the other was liposarcoma, each with a single tumor with the size range of 1 to 5 cm. The tumor locations were the cervical, oral, and abdominal cavity. ECT was selected as a treatment. Bleomycin was injected intratumorally at the dose of 0.5 to 1.0 mg/㎤. Five minutes after the injection, electric pulses applied in a sequence of eight pulses lasting 100 μsec each, were delivered in 1,000 V/cm. An evaluation was performed after 1 week, and the next session was administered 2 weeks later. In a patient with oral SCC, the tumor was in partial remission after two sessions of ECT. Another patient with SCC on her neck was showed complete remission after 2 weeks of ECT administration. A third patient showed stable disease for 8 weeks. Complications were mild and transient and included skin necrosis, edema, local pain, and gait disturbance. ECT is a valid adjuvant, especially for inoperable, cutaneous, or accessible intra-abdominal tumors.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.38
no.4
/
pp.212-220
/
2012
Objectives: Fluorine-18 fluorodeoxyglucose positron emission tomography ($^{18}F$-FDG PET) is a non-invasive diagnostic tool for many human cancers wherein glucose uptake transporter-1 (GLUT-1) acts as a main transporter in the uptake of $^{18}F$-FDG in cancer cells. Increased expression of glucose transporter-1 has been reported in many human cancers. In this study, we investigated the correlation between $^{18}F$-FDG accumulation and expression of GLUT-1 in oral cancer. Materials and Methods: We evaluated 42 patients diagnosed with oral squamous cell carcinoma (OSCC) and malignant salivary gland tumor as confirmed by histology. 42 patients underwent pre-operative $^{18}F$-FDG PET, with the maximum standardized uptake value ($SUV_{max}$) measured in each case. Immunohistochemical staining was done for each histological specimen, and results were evaluated post-operatively according to the percentage (%) of positive area, intensity, and staining score. Results: For OSCC, $SUV_{max}$ significantly increased as T stage of tumor classification increased. For malignant salivary gland tumor, $SUV_{max}$ significantly increased as T stage of tumor classification increased. For OSCC, GLUT-1 was expressed in all 36 cases. GLUT-1 staining score (GSS) increased as T stage of tumor classification increased, with the difference statistically significant. For malignant salivary gland tumor, GLUT-1 expression was observed in all 6 cases; average GSS was significantly higher in patients with cervical lymph node metastasis than that in patients without cervical lymph node metastasis. Average GSS was higher in OSCC ($11.11{\pm}1.75$) than in malignant salivary gland tumor ($5.33{\pm}3.50$). No statistically significant correlation between GSS and $SUV_{max}$ was observed in OSCC or in malignant salivary gland tumor. Conclusion: We found no statistically significant correlation between GSS and $SUV_{max}$ in OSCC or in malignant salivary gland tumor. Studies on the various uses of GLUT during $^{18}F$-FDG uptake and SUV and GLUT as tumor prognosis factor need to be conducted through further investigation with large samples.
Many myocutaneous flaps have been used for the reconstruction of intraoral defects caused by the excision of oral cancer. Among these myocutaneous flaps, cervical island flap has been introduced by Farr et al. Although different in detail, this flap was designed as the platysma myocutaneous flap by Futrell et al in the supraclavicular site. Since many authors applied this flap to cover intraoral defect, they discussed deeply the blood supply of this flap. To improve further flap survival, it was modified by Tashiro et al. This flap makes its vascularity highly reliable. The amount of tissue needed for reconstruction can be accurately planned. The surgical and reconstruction procedure can be performed simply, rapidly, and effectively. Oral functions including deglutition, speech, and denture fitting are not compromised. With it's minimal deformity, new donor fields is not necessory. Of course, we keep in mind that this flap has limitations in patients where much bulk of tissue defects is needed and more than 3000 rad radiation due to the metastasis of neck lymph node is exposed. In three patients with intraoral squamous cell carcinoma($T_{1-3}N_0M_0$), we performed induction chemotherapy with FP regimen including pepleomycin. Thereafter, we ablated oral cancer and peformed reconstruction of intraoral defects with cervical island flap designed by Tashiro et al. Due to these significant benefits and minimal limitations, we have found that this flap is adequate for reconstruction of most intraoral defects following cancer ablation.
Purpose: Tumor associated angiogenesis and/or lymphangiogenesis are known to be linked by VEGFR signaling pathways. These processes are regulated by several growth factors including VEGFR-2, VEGFR-3. E7080 is an orally active inhibitor of multiple tyrosine kinases including VEGFR-2, 3. Therefore, it was proposed that E7080 may inhibit angiogenesis and lymphangiogenesis. The aim of this study was to determine the effect of E7080 in a nude mouse model of OSCC. Methods: KB cells were xenografted into the submucosal tissue of the mouth floor of athymic mice. Seven days after the xenograft, the mice were randomized into 2 groups. E7080 were administered orally to the experimental group once per day. The mice were sacrificed 3 weeks after the treatment. The tumors were examined histopathologically. Immunohistochemical assays with anti- VEGF-C, VEGFR-2, VEGFR-3, phosphorylated VEGFR-2/3 (pVEGFR-2/3), and D2-40 antibodies were then performed. Results: The transplantation of human OSCC tumor cells into the mouth floor resulted in the formation of orthotopic tumors. The experimental (E7080 treatment) group showed a slowly increased tumor volume. Moreover, immunohistochemical staining demonstrated higher levels of VEGF-C, VEGFR-2, VEGFR-3, pVEGFR-2/3 and D2-40 expression in the control group than in the experimental group. Conclusion: These results suggest that E7080 may provide therapeutic benefits in OSCC.
Fluorination of drinking water has been used world widely to reduce the incidence of caries. Recently, contradictory results on the cytotoxicity of fluoride compounds are reported. In addition, there are attempts to use fluorosilicate for fluorination of drinking water in Korea, therefore, we tried to analyze the cytotoxicity of fluoride compounds on oral epidermoid carcinoma (KB and A253) and osteosarcoma (HOS and MG-63) cells in this study. We treated cells with 0, 10, 50 and 250 ppm of fluorosilicic acid (domestic or from Fluka, F$\_$6/H$_2$Si), sodium fluorosilicate (F$\_$6/Na$_2$Si), sodium fluoroacetate (FCH$_2$CO$_2$Na), sodium fluoride (NaF) or potassium fluoride(KF) and measured the relative cell survival by MTT assay. At the concentration of < 10ppm, no significant cytotoxicity was observed. At 50 ppm, each cells revealed different response to fluoride treatment. Among cells used in this study, MG-63 was the most resistant to fluoride treatment. Comparable toxicity data from domestic and imported fluorosilicic acids were obtained. When we compared the relative cytotoxicity of fluoride compounds against their fluoride contents, the differences in relative cell survival were smaller. Most of cells showed < 20% of survival at 250 ppm. In order to analyze the pH dependence of the cytotoxicity of fluorosilicates, the pH of cell culture media containing fluorosilicate was adjusted to 7.4 or 6.5 and the relative cytotoxicity was measured. At lower pH, about 10% higher cytotoxicity was obtained. Thus, our data suggested that the toxicity of domestic fluorosilicic acid was similar to that of fluorosilicic acid from Fluka, and the cytotoxicity of fluoride compounds was dependent on the relative content of fluoride and pH.
Risks with GSTM1 genotypes and potential roles of smoking in the susceptibility to oral squamous cell carcinoma (OSCC) were studied in Northeastern Thailand. Study subjects were 79 histologically-confirmed OSCC cases (31 men, 48 women) and 79 age- and sex-matched healthy controls ranging in age from 25 to 84 years. GSTM1 genotyping was achieved by two independent PCR assays. The GSTM1 null allele and the homozygous genotype did not increase risk of OSCC vs the wild type allele and the remaining genotypes. When the focus was on the smoking habit, male subjects who smoked ${\geq}10$ or ${\geq}35$ years were at significantly increased risk for OSCC with adjusted ORs of 4.88 [95%CI, 1.41-16.87, p=0.012] or 4.94 [95%CI, 1.62-15.12, p=0.005], respectively. A higher risk for OSCC was found for smoking amount; those who smoked >5 or >10 pack-years were at a higher risk with adjusted OR of 4.46 [95%CI; 1.45-13.74, p=0.009] or 3.89 [95%CI; 1.34-11.28, p=0.012], respectively. There are certain smoking patterns that give greater risks and thus both smoking duration and pack-years should be taken into consideration in tobacco related cancer prevention.
Background: Head and neck cancer (HNC) is the ninth most common cancer worldwide, and has a poor 5-year survival rate averaging 50%, which has not changed for decades. A high prevalence of HNC has been reported in the southwestern region of Saudi Arabia, as compared to other areas of the country. However, data in regards to HNC are scattered and not well documented. Thus, the aim of this systematic review was to gather all available and updated important information regarding HNC in Saudi Arabia, and highlight the gaps of knowledge in our country with regard to this disease. In addition, suggestions of solutions to overcome the current status and improve our future standard of care to fight HNC are also highlighted. Materials and Methods: The electronic databases PubMed and Google Scholar using English-language literature were used for this systematic review, using specific inclusion and exclusion criteria and keywords. The search was performed in April 2016 and updated in June 2016. Results: Our search revealed twenty-one studies that fulfilled our inclusion and exclusion criteria and that were conducted in Saudi Arabia. These studies investigated different aspects of HNC, including prevalence, risk factors, biomarkers, and assessed knowledge and awareness of both public and practitioners with regard to HNC. Conclusions: This review uncovered a big gap in our epidemiological data in cancer information in general, and head and neck cancer in particular. In addition, a lack of knowledge and awareness of both the public and health care practitioners hinders the early diagnosis of disease and negatively impact the prognosis, treatment and outcome. The Ministry of Health in Saudi Arabia should develop a more systematic way and adapt policies to gather cancer information in general, and head and neck cancer in particular, from all governmental and private sectors from all over the kingdom, and develop educational programs to raise the knowledge and awareness of HNC in the country.
Objectives: The development of thyroid tumor has a relationship with carcinogen, oncogene and tumor suppressor gene. With aminotriazole, radioactive iodine and nitrosomethylurea as carcinogens in rat, authors investigate the incidence in type of the thyroid tumors, p21 and p53 protein expression pattern by immunohistochemical stain and the relationship between the tumors and p21-p53 protein expressions. Materials and Methods: 80 experimental animals were divided into four groups; group 1(control, no carcinogen, n=20), group 2(oral administration of aminotriazole for 36 weeks, n=20), group 3(intraperitoneal injection of 131I for one time and oral administration of aminotriazole for 36 weeks, n=20), group 4(oral administration of nitrosomethylurea for 3 days and aminotriazole for 36 weeks, n=20). After 40 weeks they were sacrificed with pathologic examination and we performed immunohistochemical staining with pan-ras monoclonal antibody for p21 protein and CMI polyclonal antibody for p53 protein with paraffin-embedded specimens. Results: 1) No tumors were observed in group I, but 38.3% of nodular goiters, 11.7% of adenomas and 50.0% of carcinomas were observed in carcinogen treated groups(group 2, 3, 4). 2) The incidence of nodular goiter, adenoma and carcinoma were 70%, 20% and 10% in group 2, 40%, 15% and 45% in group 3 and 5%, 0% and 95% in group 4. 3) p21 protein was not expressed in normal thyroid tissues but was expressed in 26.1% of nodular goiters, 42.9% of adenomas and 6.7% of carcinomas. On the other hands, p53 protein was not expressed in normal thyroid tissues, nodular goiters, adenomas and in well differentiated thyroid carcinomas by immunohistochemical stain. Conclusion: The authors suggest that aminotrizole, 131I, nitrosomethylurea can be etiologic agents in the development of thyroid tumor and the p21 protein can be expressed in the early stage and in benign condition of thyroid tumor but p53 protein is not expressed in all conditions of development in rats.
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