• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제29권2호
• /
• pp.116-122
• /
• 2003

Pleomorphic adenoma is the most common salivary neoplasm mainly occurring in the major salivary glands - especially in parotid gland, which is characterized by variable histopathologic appearances and high recurrence rate with malignant transformation according to surgical situations. And this benign mixed tumor occurring in minor salivary glands is believed to shows same clinicopathologic appearances and relatively low recurrent rate compared with the case in major salivary glands. But there are few comparative studies of large series of pleomorphic adenoma occurring in minor salivary glands which includes different histopathologic appearance, clinical characteristics, treatment methods, recurrence rate, and malignant transformation. We retrospectively studied the 54 patients who were pathologically confirmed with pleomorphic adenoma occurring in minor salivary glands, and analyzed the clinico-histopathological appearance, surgical methods, recurrent cases. The results obtained are as follows. 1. The incidence of the tumor was most frequent in 4th & 5th decade, and in female. 2. Palate(90%) including hard & soft palate was the most frequent site for pleomorphic adenoma in minor salivary glands. 3. The exact duration could not be known due to asymptomatic slow growth patterns of the tumor. 4. The mean tumor size was 2.3cm. 5. 28 (52%) pleomorphic adenomas were classified as Cellular type (cell-rich), 17 (31%) specimen as Intermediate type(equal cell to stroma ratio), and 9 (17%) as Myxoid type(stroma-rich). 6. Surgically 51 cases (94%) were showed well-encapsulated tumors, but histopathologically only 34 specimen (63%) were wellencapsulated. Therefore pleomorphic adenomas in minor salivary glands also have to be excised more widely, not enucleated. And in case of suspicious malignancy or large tumor, preoperative incisional biopsy can be applied in the center of the tumor for prevention of rupture of tumor cell, and total excision with use of frozen biopsy for detection of malignancy and confirming the excision margin, and closed follow-up according to final histopathologic results is recommended.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제30권2호
• /
• pp.165-169
• /
• 2004

본 증례는 우측 이하선에 종물을 가진 50세 여자 환자에서 술전에 시행한 세침흡인검사와 전산화단층촬영 소견 및 술중에 시행한 동결생검에서 괴사소견으로 인해 점액표피양암종으로 진단되어 우측 이하선 전적출술과 경부청소술 등을 시행하였으나 수술 후 조직병리학적 검사에서 괴사를 동반한 다형성 선종으로 최종 진단되었다. 괴사를 동반한 다형성 선종에서 보이는 편평 상피세포는 점액표피양암종에서 나타나는 편평세포의 특징으로 오진할 수 있으므로 주의해야 한다. 본 증례는 악성종양으로 잘못 진단할 수 있는 다형성 선종의 괴사와 조직병리학적 특징들을 이해함으로써 임상의사들의 오진 가능성을 예방하고 다형성 선종의 진단과 치료에 주의해야 함을 시사한다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제29권6호
• /
• pp.538-542
• /
• 2007

Sweet syndrome is characterized by acute onset of fever. neutrophilic leukocytosis, painful erythematous plaque on the face and extremities, infiltration of mature neutrophils in the dermis. Cutaneous lesion and clinical symptoms rapidly improve after treatment with systemic corticosteroids. The cause of sweet syndrome is unknown but the associations with hypersensitivity to bacteria, virus, or tumor antigen have been reported. Sweet syndrome itself can be a premonitory manifestation of malignancy, so diagnostic work up for other internal malignancy is recommended. Because of fever and leukocytosis, cutaneous infections are important differentials. Sweet syndrome can be divided into 4 categories according to associated disease and symptom. (Idiopathic Sweet syndrome, Parainflammatory Sweet syndrome, Paraneoplastic Sweet syndrome, Pregnacy associated Sweet syndrome.) Sweet syndrome is relatively rare disease and the association with myelodisplastic syndrome has been reported. We report a case of Sweet syndrome associated with myelodisplastic syndrome which has initial manifestation of odontogenic buccal cellulites.

• Journal of Oral Medicine and Pain
• /
• 제3권1호
• /
• pp.3-10
• /
• 1977

Few changes were found in the mouths of 52 smokers were examined as a part of program to evaluate the oral health of Korean smokers. 52 smokers and 30 non-smokers were performed careful oral examination. In many of smokers, heavy, black deposits are found on the buccal and lingual surfaces of the teeth and leukoplakia were obsreved in 2 subjects and varied merely in the severity of the involvement. Cytologic studies were carried out on 60 oral smears from the hard palate, buccal mucosa, and gingiva. Smears were taken wit a wood spatula scraped over the mucosal surface. After fixation the slides were stained using the papanicolau cells without nuclei. The cornified cells were smaller than the noncornified cells and stained a deep brown or orange as compared with the blue or red of the large, round or polygonal cells in nonkeratinized regions of oral mucosa. Abnormal cell forms, suggestive of malignancy were not found in smears from the mucosa of smokers. Cells with large hyperchromatic nuclei and elongated, spindle-type cells with large nuclei were not observed.

• Journal of Oral Medicine and Pain
• /
• 제39권2호
• /
• pp.78-81
• /
• 2014

Verrucous carcinoma is a relatively rare variant of well differentiated squamous cell carcinoma first described by Ackerman in 1948. It is distinct in its slow progression, exophytic cauliflower like growth, low grade malignancy and low incidence of metastasis. The oral cavity is one of the predilection sites for verrucous carcinoma. In the oral cavity, the gingiva and buccal mucosa are the common site. Verrucous carcinoma of the lip is clinically quite rare and only several cases of that were reported in the world. The aim of this study is to report an unusual case of verrucous carcinoma of the lower lip.

• 대한치과의사협회지
• /
• 제50권12호
• /
• pp.732-742
• /
• 2012

White lesions of the oral mucosa are a common clinical finding that often present first to general dentist. Some white lesion may have possibility of malignancy. Leukoplakia is the most common "potentially malignant disorder" of the oral mucosa. Leukoplakia is at present defined as "A white plaque of questionable risk having excluded (other) known disease or disorders that carry no increased risk for cancer.". Therefore, it is important for general dentist to be familiar to clinical differential diagnosis of leukoplakia from the known white lesions such as candidiasis, lichen planus, leukoedema, frictional keratosis, and so on. It is also important to decide whether such lesions require further investigation through the biopsy. As a result of biopsy, the presence of epithelial dysplasia in the leukoplakia is still the strongest predictor of future malignant transformation. In this article, oral white lesions that must be differentiated from potentially malignant disorders or early invasive squamous cell carcinoma will be reviewed together with presenting clinical cases.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제28권3호
• /
• pp.226-230
• /
• 2002

Carcinomas derived from ameloblastomas have been designated by a variety of terms, including malignant ameloblastoma, ameloblastic carcinoma, metastatic ameloblastoma, and primary intra-alveolar epidermoid carcinoma. The term of ameloblastic carcinoma is differentiated from the term of malignant amelblastoma and is defined as an ameloblastoma in which there is histologic evidence of malignancy in the primary tumor or the recurrent tumor(or metastasis), regardless of whether it has metastasized. The well-documented and adequately followed cases are currently lacking and this report described an instance of ameloblastic carcinoma with good result after treatment and review of literature.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제27권6호
• /
• pp.528-534
• /
• 2005

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
• /
• 제36권3호
• /
• pp.228-230
• /
• 2010

Sarcomatoid carcinoma is a rare and occurs mainly in the upper aerodigestive tract such as the oral cavity, esophagus and vocal cords. It is a unique variant of squamous cell carcinoma. We report the case of a patient with spindle cell squamous cell carcinoma involving the mandible. At initial examination, overlying mucosa of that lesion was normal appearance. One week later, that lesion showed ulcerative and bloody change and rapid growth in size. This case showed unpredictable rapid growth although rapid growth in size was suspected of undergoing malignancy.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제32권1호
• /
• pp.57-61
• /
• 2010

Objective: Second primary malignancy (SPM) that occur in various period and region are important factors that deteriorate long-term survival rate in patients who recovered from oral cancer. Researches such as chemoprevention are being tried to reduce occurrence of SPMs. Only if analysis of clinical features of patients who develop SPM such as period, region and factors precedes, adequate prevention and treatment of SPM is possible. But, there are few researches about clinical features of SPMs that have primary lesion in oral cavity. In this study, we analysis that occurrence rates, regions that happen, risk factors and effect to survival rates of 2nd primary malignancies in oral cancer patients. From this survey, we willing to collect basic data for prevention and early diagnosis of SPMs. Methods: The medical records of 139 patients of oral oncology clinic of National Cancer Center who had up to 2-years follow up records after surgical or radiological treatment due to squamus cell carcinoma of oral cavity were reviewed. In these patients, survey of occurrence rate of SPMs, duration, survival rate and risk factors about occurrence of SPMs such as history of smoking, body mass index, age, sex, stage of primary lesion and history of radiologic treatment were achieved. Results: There are 15 patients who developed SPM in 139 cases. The actual occurrence rate of SPM was 10.79% and SPM were more likely to occur in male patients with 11 male Vs 4 female patients. Median age of these patient is 61.47 within 32 to 74 range. The regions that develop SPM are oral cavities (2 cases), stomach (4 cases), esophagus (2 cases), lung (2 cases) and others (1 case each breast, larynx, cervix, liver and kidney). In addition, metachronous cancers were 11 cases which happened more common than 4cases of synchronous cancers. Surveys of risk factors that relate to development of SPMs, such as sex, age, history of radiologic treatment, body mass index, history of smoking and stage of primary disease were done. Among them, factor of sex is only appear statistically significant (P=0.001), but rest are not significant in statistically. Conclusion: Occurrence rates of SPMs were reported from 10% to 20% by precede study. In this study, occurrence rate of SPMs is 10.79% that is similar to results of precede research. In comparison of 5-yr survival rates of groups that develop SPMs or not, there is statistically significance between two groups. Present treatment modalities of SPMs are surgical operation, radiotherapy, chemotherapy and combination of these modalities. In choosing the treatment modality, we must consider the first treatment modality, region of primary disease, region of SPMs and general conditions of patient. Because development of SPMs have big effect on prognosis, prevention of SPMs must regard to important objective of treatments in patients of SCCa in oral cavity.