Cases reported "Mouth Neoplasms"

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1/73. Intraoral tumor of Chievitz in a child.

    Juxtaoral organs known as organs of Chievitz are intramuscular embryonic structures found close to the angle of the mandible near the insertion of the pterygomandibular raphae. They are considered of neuroepithelial origin with no known function. We describe the first tumor of the organ of Chievitz which presented intraorally in a child. Immunohistochemically, the Chievitz nests showed positive reaction for vimentin, cytokeratins, and epithelial membrane antigen and ultrastructurally demonstrated cytoplasmic processes and intermediate filament bundles. These observations, together with light microscopic features, suggest that the epithelial nests of the organ of Chievitz are meningothelial rather than neuroepithelial.
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2/73. Proliferative verrucous leukoplakia: report of two cases and a discussion of clinicopathology.

    Proliferative verrucous leukoplakia (PVL) is a recently delineated but poorly recognized form of multifocal leukoplakia that is premalignant and of unproven origin. PVL generally presents as a simple benign form of hyperkeratosis that tends to spread and become diffuse. Although slow-growing, the disease is persistent and irreversible. Clinically, PVL often presents as an exophytic wart-like form of leukoplakia that appears to be resistant to nearly all forms of therapy. PVL of the oral cavity is best-defined as a continuum of oral epithelial disease with hyperkeratosis at one end of a clinical and microscopic spectrum and verrucous carcinoma or squamous cell carcinoma at the other. The microscopic findings associated with PVL are dependent on the stage of the disease and the adequacy of the biopsy. Microscopic findings can be markedly variable. PVL is a clinicopathologic disorder that includes the microscopic entity known as verrucous hyperplasia as a component of its histopathologic progression. This article reports on two cases of PVL, describes the clinicopathology of the disease process, and presents therapeutic and etiologic considerations.
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3/73. Spontaneously relapsing clonal, mucosal cytotoxic T-cell lymphoproliferative disorder: case report and review of the literature.

    Primary T-cell lymphoma of the gastrointestinal tract is a rare and usually aggressive disorder that may be associated with celiac disease. The authors describe a unique case of a clonal proliferation of CD8 T cells involving the oral mucosa, ileum, and colon of a 35-year-old man that has regressed spontaneously and recurred numerous times over a 9-year period without treatment. The patient's symptoms were limited to occasional rectal bleeding and recurring painful oral ulcers. Within the intestine, these collections of small T cells induced minimal architectural distortions and did not show extensive epitheliotrophism. polymerase chain reaction and sequencing analyses revealed that the identical T-cell clone has been present for more than 9 years and in different mucosal locations in this patient. This may represent a unique T-cell lymphoproliferative process akin to a mucosal counterpart of lymphomatoid papulosis of the skin.
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4/73. Acquired tufted angioma: a unique vascular lesion not previously reported in the oral mucosa.

    We describe two patients with acquired tufted angioma, a unique vascular lesion not previously reported in the oral mucosa. In one patient, the lesion manifested as a purple-red papule and, in the other, as a blue submucosal swelling. Both lesions were non-painful and neither was associated with a history of trauma. The histopathological features consisted of scattered, irregularly shaped tufts, primarily composed of poorly formed capillary spaces and slit-like vascular channels. Capillary spaces were often closely packed, producing solid areas which stained for smooth muscle actin. Staining for factor viii-related antigen was positive only within endothelial cells lining well-formed vascular channels. Both lesions were treated by excision; short-term follow-up of one patient revealed no evidence of recurrence. Similarities between this and other vascular processes may have resulted in misdiagnosis of this lesion in the past. The clinical significance of acquired tufted angioma in the oral mucosa is not known.
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5/73. Pigmented lesion of the oral cavity with eight years follow-up.

    A 27 year old white female with a pigmented lesion on the anterior portion of the mandibular gingival is described. A prophylactic excisional biopsy was performed in conjunction with a gingival graft. A gingival graft was performed to accelerate the healing process and reduce post operative discomfort. An intradermal nevus was diagnosed. The number of documented oral nevi in the literature now exceeds 200 and approximately half of them are histologically of the intradermal type. If early detection of thin oral melanomas is to be achieved, all pigmented oral cavity lesions should be viewed with suspicion.
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6/73. Alveolar soft-part sarcoma of the cheek: report of a case with a review of the literature.

    An alveolar soft-part sarcoma (ASPS) occurring in the cheek is described, with a review of the literature. The subject was a 25-year-old woman who presented with a large swelling in the left cheek. The lesion, initially diagnosed as a benign tumor on radiographic and computed tomographic examinations, was surgically excised. Histopathological examination of the mass revealed a nest-like or organoid cellular arrangement as confirmed by three-dimensional computer graphic reconstruction. The cytoplasm of the large polygonal tumor cells contained abundant diastase-resistant, PAS-positive inclusions, ultrastructurally confirmed to be crystalloid materials. The tumor cells were immunoreactive for anti-myoglobin, sarcomeric actin, and neuron-specific enolase antibodies, suggesting a myogenic origin.
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ranking = 102.44624609864
keywords = alveolar
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7/73. An unusual association between oral sarcoma and bulbar palsy.

    A 90 year old male presented with symptoms and signs of right lower cranial nerves palsy. A small mass was found on the right side at the back of his mouth. light microscopy and histoimmunochemical studies of the biopsy of the mass showed an alveolar soft part sarcoma arising from the right myohyoid muscle. The unusual location and presentation of this rare tumor is discussed.
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keywords = alveolar
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8/73. Primary malignant melanoma of the oral cavity: case report.

    An 80-year-old-female patient had a pigmented lesion on: the hard palate, the soft palate, the alveolar mucosa and the vestibular mucosa of the maxillary gingiva. Pigmented macules and patches had been persistent and asymptomatic for many years (Fig. 1). The lesion exhibited irregularities of pigmentation, border and surface contour. About 1 year later the patient had noticed an extension of the pigmented macules and plaques; there was also the appearance of nodules of the maxillary gingiva accompanied by swelling. Loosening of teeth as a result of extensive destruction of bone was further noted (Fig. 2). The histological examination showed a downward streaming in the dermis of the tumor cells and a disintegration and ulceration of the epidermis (Fig. 3). An increased number of large round or polygonal cells resembling atypical epithelioid cells were found on the submucosa. The atypical cells had enlarged, pleomorphic nuclei with prominent and sometimes multiple nucleoli. Mitoses were observed at various tissue levels (Fig. 4). Abundant pigmented melanin was present in the tumor cells (Fig. 5). Many cells had fine, dusty melanin particles. The tumor cells showed great variations in size. Immunohistochemical staining, with S100 protein and HMB45 antibodies, stained many of the spindleshaped cells, indicating that they were melanocytic cells. An inflammatory infiltrate of lymphocytes was seen in a band beneath the invading tumor cells.
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ranking = 102.44624609864
keywords = alveolar
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9/73. Orofacial rhabdomyosarcoma in neonates and young children: a review of literature and management of four cases.

    rhabdomyosarcoma (RMS) is an aggressive malignant skeletal muscle neoplasm arising from embryonal mesenchyme. It accounts for over 50% of all pediatric soft tissue sarcomas. The head and neck region is the most common site for this tumor in children. Neonatal presentation of this tumor is rare. We present the management of one neonatal case and three additional cases of orofacial RMS in children under the age of 7 years. All four patients were seen in the department of oral and maxillofacial surgery at Children's Hospital and Regional Medical Center (CHRMC) in Seattle between 1992-2000. Three of the four cases were alveolar RMS and one was botryoid sub-type of embryonal RMS. Three patients were treated with a combination of surgery, chemotherapy and radiation, while the patient with botryoid RMS was treated with surgery and chemotherapy only. The patient with congenital RMS died at 2.5 years of age due to recurrent metastatic disease. The other three patients are alive without evidence of recurrent with a mean follow up was 5.5 years (range 2.5-8.5 years). We discuss the current management, diagnosis, biological behavior, histopathology, prognosis and survival of head and neck RMS in neonates and young children.
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ranking = 102.44624609864
keywords = alveolar
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10/73. radiotherapy prostheses.

    The orofacial region performs the essential functions of mastication and speech, as well as that of appearance, which for better or worse evokes an instant and instinctive response in other people. In this region, tissue loss caused by surgical resection of a malignant tumor has a tremendous negative impact on the patient's quality of life, with deep mental and psychological repercussions. Therefore, from the standpoint of preserving form and function, radiotherapy has a major role to play in the treatment of malignant tumors in the orofacial region. That said, important organs, such as sensory organs, are present in close proximity to each other in this small region. During the irradiation process, therefore, it is important to ensure that the lesion is sufficiently irradiated while simultaneously protecting the surrounding normal tissue. In certain cases of radiotherapy of malignant tumors of the orofacial region, the use of radiotherapy prostheses can help to satisfy a basic principle of radiotherapy: that of delivering a lethal dose to the tumor while minimizing irradiation to normal tissue. In recent years, medical and dental experts have taken a team approach to creating and employing a variety of radiotherapy prostheses, working towards improving the treatment record for malignant tumors as well as reducing complications in surrounding normal tissue. As a result, patients treated with radiotherapy prostheses are now able to receive post-radiotherapy prosthodontic treatment in a dramatically safer and more rapid manner. It is clear that radiotherapy prostheses contribute significantly to the improvement of these patients' quality of life.
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