1/11. Verruciform xanthoma associated with squamous cell carcinoma.Verruciform xanthoma (VX) is a rare lesion of unknown etiology that is typically solitary and predominantly located within the oral cavity. Less commonly, they arise on the skin, with the majority of cases occurring in anogenital sites. They can be confused clinically with verruca vulgaris, condyloma, leukoplakia, verrucous carcinoma, and squamous cell carcinoma. Histologic features include acanthosis with uniform elongation of the rete ridges and xanthomatous cells that lie in and are typically confined to the papillary dermis. Although epidermal atypia is not a characteristic finding, we describe an unusual case of VX that has features of both VX and squamous cell carcinoma. In addition, there was a VX with typical histologic characteristics located at a separate site in the same patient. This case is also the first to our knowledge to be reported on the neck and axilla and is the third case associated with cutaneous graft versus host disease secondary to bone marrow transplant for acute lymphoblastic leukemia.- - - - - - - - - - ranking = 1keywords = oral cavity, cavity (Clic here for more details about this article) |
2/11. Unusual gingival presentation of post-transplantation lymphoproliferative disorder: a case report and review of the literature.Post-transplantation lymphoproliferative disorder is a well-documented complication of solid organ or bone marrow transplantation. Histologically, it is characterized by an abnormal proliferation of lymphocytes, which can range from benign B-cell hyperplasia to malignant lymphoma. Non-Hodgkin's lymphoma (NHL) is associated with several risk factors, such as congenital or acquired immunodeficiency states, autoimmune disorders, and infectious agents (eg, Epstein-Barr virus). Primary sites of presentation in the head and neck are Waldeyer's ring, paranasal sinuses, salivary glands, the oral cavity, and the larynx. Clinical appearance of gingival NHL varies but is usually found to be an asymptomatic gingival enlargement or mass resembling a pyogenic granuloma. We present a patient with a gingival ulceration that was subsequently diagnosed as Epstein-Barr virus malignant lymphoma resulting from the immunosuppression needed to prevent graft-versus-host disease after bone marrow transplantation.- - - - - - - - - - ranking = 1keywords = oral cavity, cavity (Clic here for more details about this article) |
3/11. Severe oral manifestations of chronic graft-vs.-host disease.BACKGROUND: Graft-vs.-host-disease, or GVHD, is the main cause of morbidity in patients who have received bone marrow transplants. Chronic GVHD, or cGVHD, occurs 100 days or more after the transplant procedure and may take the form of various oral manifestations. CASE DESCRIPTION: A 23-year-old woman received an allogeneic bone marrow transplant. Although prophylactic therapy was provided, the patient developed cGVHD. Appropriate therapy was initiated, and it received a good clinical response at all sites affected by cGVHD, except in the oral cavity. The patient received complete symptomatic relief through revised systemic therapy, improved oral hygiene, use of topical medications and a monitored diet. CLINICAL IMPLICATIONS: Effective intervention by dentists is an important part of increasing treatment effectiveness and improving quality of life in patients who received bone marrow transplants.- - - - - - - - - - ranking = 1keywords = oral cavity, cavity (Clic here for more details about this article) |
4/11. Localized lymphoid relapse in the pancreas following allogeneic hematopoietic stem cell transplant for chronic myelogenous leukemia.The incidence of isolated extramedullary disease (EMD) following allogeneic hematopoietic stem cell transplant (allo-HSCT) for chronic myelogenous leukemia (CML) is not fully known. One review found the incidence of isolated myeloid EMD, or granulocytic sarcoma (GS), in an allo-HSCT treated CML/myelodysplastic subgroup to be just 0.22%. The incidence of lymphoid EMD in similar patients is extremely rare with only two cases reported in the literature. While the etiology of EMD in the post-transplant setting is not entirely clear, there may be inefficacy of immune surveillance function outside of the bone marrow cavity. Isolated CML GS following allo-HSCT carries a median interval to bone marrow relapse between 7 and 10 months and a median survival of 12 months. Less is known about lymphoid EMD. The treatment in these cases is ill defined with modalities ranging from involved field radiation to second allo-HSCT. We present a case of isolated pancreatic lymphoid EMD diagnosed 15 months after allo-HSCT for CML. Our patient was also treated with withdrawal of his immunosuppressive regimen. Unfortunately, at just over 4 months following pancreatic resection, he developed systemic relapse and died. While EMD can occur anywhere in the body, CML associated pancreatic EMD is not previously reported.- - - - - - - - - - ranking = 0.018990186873214keywords = cavity (Clic here for more details about this article) |
5/11. Squamous cell carcinoma of the oral cavity associated with graft versus host disease: report of a case and review of the literature.Allogenic peripheral stem cell transplantation (HSCT), a procedure that is widely used in the treatment of a large number of malignant and nonmalignant hematological diseases, is still associated with a wide range of complications, one of the most important of which is graft-versus-host disease (GVHD). The patients undergoing allogeneic HSCT are at high risk of developing secondary neoplasms, particularly leukemias and lymphomas. Solid tumors are less frequent, but their incidence seems to be higher in the patients who develop GVHD; the most frequent solid tumors are squamous cell carcinomas. We here describe the clinical course and histopathologic aspects of a squamous cell carcinoma arising on GVHD-induced oral lesions in a 53-year-old woman with non-Hodgkin's lymphoma undergoing allogeneic HSCT. Immediately after the transplantation, the patient developed GVHD involving the gastroenteric tract, skin, joints, and oral cavity, which was treated with cyclosporin, prednisone, azathioprine, colchicine, and photophereses. In addition to the sporadic reports of similar pictures published in the literature (16 cases of squamous cell carcinoma owing to oral GVHD in patients undergoing allogeneic HSCT), our case underlines the susceptibility of HSCT patients with oral GVHD to carcinoma of the oral cavity. All patients treated with allogeneic HSCT (particularly those who have developed GVHD) should therefore undergo a careful examination of the oral mucosa and be closely followed up over the long term with the aim of identifying the onset of secondary tumors as early as possible.- - - - - - - - - - ranking = 6keywords = oral cavity, cavity (Clic here for more details about this article) |
6/11. Cicatricial pemphigoid of the oropharynx after allogeneic stem cell transplantation for relapsed follicular lymphoma.A 44-year-old woman with refractory follicular lymphoma underwent allogeneic stem cell transplantation (SCT) and achieved complete remission. Grade III acute graft-versus-host disease (GVHD) developed on day 23, but no chronic GVHD occurred. The patient developed severe erosion with bullous lesions in the oral cavity 18 months after SCT. At that time, the lymphoma remained in complete remission, and she had no clinical or laboratory findings suggesting chronic GVHD. A biopsy of the oral mucosa showed moderate lymphoplasmacytic infiltration and subepidermal bullae, and direct immunofluorescence staining demonstrated linear deposition of C3 at the dermo-epidermal junction. An immunoblotting assay using human epidermal extracts confirmed the presence in her serum of an antibody against the 230-kd bullous pemphigoid antigen 1 (BPAG1). A diagnosis of cicatricial pemphigoid (CP) was made, and complete resolution of the CP was achieved with prednisolone therapy. The occurrence of autoimmune blistering diseases is rare after allogeneic SCT.- - - - - - - - - - ranking = 1keywords = oral cavity, cavity (Clic here for more details about this article) |
7/11. Graft-versus-host disease, an eight case report and literature review.Graft versus host disease (GVHD) is a common complication in bone marrow transplant (BMT) patients. It is characterized by systemic and oral cavity alterations. Depending on the timing of lesions, GVHD is classified as acute or chronic. Alterations in the oral cavity are lichenoid reticular lesions, erythema, ulcerations, and xerostomia. Sporadically, mucocele and pyogenic granulomas can be present. Aim: To describe GVHD oral manifestations in eight allogenic BMT patients, and discuss GVHD and drug-immunosuppresion associated lesions diagnosis and treatment. Study design: For a year, we examined the oral mucosa of eight consecutive allogenic BMT patients attending the dermatology out-patient clinic at the Instituto Nacional de Cancerologia (National Institute of Oncology) in mexico City, looking for oral mucosa lesions. Results: patients were five men and three women, ages 24.8 -/ 9.7 years. Four had a BMT because of chronic granulocytic, two for acute myeloblastic, one for acute lymphoblastic leukemia, and one for aplastic anemia. Three patients developed acute GVHD, with reticular oral mucosa lesions, erythema and mucositis; and all eight developed chronic GVHD, with reticular oral lesions, erythema, and ulcerations. A Patient had tongue and cheek pyogenic granulomas. Six reported xerostomia. Other oral lesions, associated to drug-immunosuppression, were candidiasis and herpes simplex. Conclusions: patients with GVHD frequently develop oral lesions, some of which interfere with normal feeding; timely diagnosis and treatment are therefore essential to improve the quality of life of affected patients. We propose an alternative treatment for pyogenic granulomas.- - - - - - - - - - ranking = 2keywords = oral cavity, cavity (Clic here for more details about this article) |
8/11. An unusual presentation of chronic graft-versus-host disease in an unrelated bone marrow transplantation.The case described is that of an unrelated bone marrow transplantation in a 43-year-old man. Although the major histocompatibility complex met the criteria for a perfect genotypic match, de novo graft-versus-host disease developed with unusual manifestations involving structures of the oral cavity and associated areas. The loss of taste and smell, as well as profound xerostomia, was treated by stimulating salivary flow. Synergistic sialagogues were used with the hope that an increase in salivary production would mediate an improvement in taste and smell.- - - - - - - - - - ranking = 1keywords = oral cavity, cavity (Clic here for more details about this article) |
9/11. head and neck manifestations of the chronic graft vs. host disease.Bone marrow transplantations are being used with increasing frequency in the treatment of patients with leukemia and aplastic anemia. The graft-vs.-host disease (GVHD) is a serious complication that affects long-term survivors following bone marrow transplantation. It is the result of an immunologic reaction mounted by the grafted reticuloendothelial cells against the tissues of the recipient, and it affects multiple organ systems. Involvement of the skin and mucosal surfaces of the head and neck region, in particular the oral cavity, occurs in a large number of patients with GVHD. In this report we present four patients with GVHD in whom mucosal lesions and infections of the head and neck region were prominent features. Our observations indicate that the clinical and histological characteristics of these lesions vary according to the time elapsed from the onset of the disease. Therefore, clinical examination of the head and neck region and biopsy of the oral mucosa are important not only in the diagnosis of the GVHD, but also in the evaluation of its progress and response to treatment.- - - - - - - - - - ranking = 1keywords = oral cavity, cavity (Clic here for more details about this article) |
10/11. Intracytoplasmic lumina in squamous epithelial lesions of the oral cavity.Intracytoplasmic lumina are considered a diagnostic feature of adenocarcinomas and have not been reported in squamous cell carcinomas. We are documenting intracytoplasmic lumina in a case of primary squamous cell carcinoma of the oral mucosa and in the oral squamous mucosa in two cases of graft versus host disease, confirming that intracytoplasmic lumina are also present in squamous epithelia and their tumors. Likely explanations for the presence of intracytoplasmic lumina in non-neoplastic and malignant squamous cells of the oral cavity include multiple differentiation, phagocytosis and immune attack on desmosomes.- - - - - - - - - - ranking = 5keywords = oral cavity, cavity (Clic here for more details about this article) |
| | Next -> |