Cases reported "Tongue Neoplasms"

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1/10. lung and aero-digestive cancers in young marijuana smokers.

    Marijuana has been shown to be one of the commonly abused substances in the world, especially among teenagers and young adults. Although its addictive potential and psychomotor side-effects have been widely publicized, the issue of possible carcinogenicity is not as well perceived. Marijuana smoke contains many of the same organic and inorganic compounds that are carcinogens, co-carcinogens, or tumor promoters found in tobacco smoke. We have encountered several young marijuana users with no history of tobacco smoking or other significant risk factors who were diagnosed to have lung or other aero-digestive cancers in our practice. Although there are several experimental and epidemiological studies suggesting an association of marijuana use as a possible cause of cancers, this issue remains controversial. It is hoped that our case presentation can help to stimulate further awareness and research into this issue.
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2/10. osteoradionecrosis of the mandible.

    osteoradionecrosis is a major complication of surgery or trauma in previously irradiated bone in the absence of tumor persistence. radiation-induced vascular insufficiency rather than infection causes bone death. It occurs most commonly in the mandible after head and neck irradiation. risk factors include the total radiation dose, modality of treatment, fraction size and dose rate, oral hygiene, timing of tooth extractions as well as the continued use of tobacco and alcohol. This condition is often painful, debilitating, and may result in significant bone loss. The recommended treatment guidelines are irrigation, antibiotics, hyperbaric oxygen therapy, and surgical techniques, including hemimandibulectomy and graft placements.
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3/10. Rapid development of esophageal squamous cell carcinoma after liver transplantation for alcohol-induced cirrhosis.

    Liver transplant recipients have an increased risk of developing de novo malignancies. It is generally accepted that chronic alcohol abuse is a contributive factor in the pathogenesis of several malignancies, in particular, of oropharyngeal squamous cell carcinoma (SCC). Thus, patients with end-stage alcohol-induced cirrhosis could be at risk of esophageal SCC following orthotopic liver transplantation (OLT). From January 1986 to December 1997 a total of 313 patients underwent OLT for various indications. Of these patients, 72 had alcohol-related cirrhosis. Oropharyngeal and esophageal malignancies after OLT were not observed in non-alcoholic patients. In contrast, these malignancies were diagnosed in three male patients who underwent transplantation for alcohol-induced cirrhosis (incidence 4.2%). Furthermore, all patients had a history of tobacco abuse. The tumors were located in the tongue of one patient and in the esophagus of two patients. While SCC of the tongue became apparent 5 years after OLT, esophageal SCC was detected 8 and 16 months after transplantation. Shortly before transplantation, endoscopy of the esophagus had not revealed evidence of pre-malignant dysplastic lesions in any of these patients. Thus, esophageal SCC may develop rapidly in patients undergoing transplantation for alcohol-related cirrhosis with a history of tobacco abuse before liver transplantation, which warrants careful post-transplant screening of these patients.
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4/10. Cancer of the oral cavity- a growing concern in the micronesia: a case report from the Marshall islands.

    Cancer of the oral cavity is of growing concern worldwide. In the micronesia, there has been a recent increase in use of betel nut and tobacco chewing in addition to already existing problem of smoking and alcohol drinking. These deleterious habits have further added the risk for development of oral cancers in the Marshall islands. The oral cancers have good prognosis, which is directly related to the early diagnosis and treatment. Advanced staged cancers need mutilating surgery in addition to radiotherapy and carry high mortality rate. The epidemiology, etiology and recent approaches in the management of oral cavity cancer has been discussed along with a case report of advanced cancer of the floor of the mouth from the Marshall islands.
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5/10. Detecting oral cancer: a new technique and case reports.

    The VELscope is an important aid in patient assessment, and when added to a well-thought out clinical assessment process that takes into consideration the age of the patient and risk factors that include tobacco, alcohol, and immunologic status, it increases the clinician's ability to detect oral changes that may represent premalignant or malignant cellular transformation. False positive findings are possible in the presence of highly inflamed lesions, and it is possible that use of the scope alone may result in failure to detect regions of dysplasia, but it has been our experience that use of the VELscope improves clinical decision making about the nature of oral lesions and aids in decisions to biopsy regions of concern. Where tissue changes are generalized or cover significant areas of the mouth, use of the scope has allowed us to identify the best region for biopsy. As with all clinical diagnostic activities, no single system or process is enough, and all clinicians are advised to use good clinical practice to assess patients and to recall and biopsy lesions that do not resolve within a predetermined time frame. Lesions that are VELscope-positive and absorb light need to be followed with particular caution, and if they do not resolve within a 2-week period, then further assessment and biopsy are generally advised. It is much better to occasionally sample tissue that turns out to be benign than to fail to diagnose dysplastic or malignant lesions. In our fight to protect patients from cancer, the VELscope improves our odds for early detection, hopefully resulting in fewer deaths from oral cancer.
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6/10. marijuana smoking and carcinoma of the tongue. Is there an association?

    There is considerable theoretical evidence that marijuana should be carcinogenic. However, most reviews have found no direct evidence of chronic marijuana smoking causing lung cancer. Some recent reports implicate marijuana smoking as a cause of cancer of the upper aerodigestive tract, though most of the subjects were exposed to other, possibly confounding, etiologic factors, namely tobacco and alcohol. We report two cases of squamous cell carcinoma of the tongue in men who chronically smoked marijuana but had no other risk factors. The totality of cases may point to a predilection of marijuana smoke for carcinogenesis in the upper aerodigestive tract. This correlates with nonmalignant effects and may be related to a different method of smoking marijuana compared with tobacco.
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7/10. A rare human model for oncogenesis.

    A rare female human model of oral carcinoma (OC) who refrained from any type of tobacco and/or betel nut habits, belonged to an younger age group, had no pre-existing precancerous lesions in the oral cavity and who was exposed chronically to cashew nut oil, is presented. The role of genetic inherited influences, occupational and endocrine disturbances with racial factors in the causation of oral carcinoma is discussed. The significance of further studies at the genetic level, to rule out protooncogenic activation in the causation of oral cancer is summed up. The literature on the concept of oncogenesis is reviewed briefly.
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8/10. Four primary malignant neoplasms in a single patient.

    A 60-year-old Caucasian male, with a previous history of a 10-year occupational exposure to ionizing radiation, chemical carcinogens, and a long history of tobacco and alcohol abuse, developed synchronous squamous cell carcinoma of the floor of the mouth and adenocarcinoma of the lung. Four years later, squamous cell carcinoma of the larynx followed by squamous cell carcinoma of the tongue were diagnosed. In this case report, we suggest that increased exposure to multiple carcinogenic factors may result in an increased incidence of both synchronous and metachronous primary malignant neoplasms.
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9/10. Oral verrucous carcinoma: report of two cases and review of literature.

    Verrucous carcinoma is a rare and distinct pathological and clinical variant of well-differentiated squamous cell carcinoma. Two case reports of histologically proven oral verrucous carcinoma are presented. One case presented with a history of tobacco chewing, snuff taking and miraa chewing. While the relationship between tobacco chewing or snuff dipping and verrucous carcinoma has been investigated and described, the role played by miraa chewing is still unknown and thus requires further study. Both cases were successfully managed by only conservative surgical excision. No radiotherapy was used. Clinical and histo-pathological examination of verrucous carcinoma is therefore very important in its diagnosis and treatment planning.
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10/10. Carcinoma of the oral cavity in a young woman.

    Although tobacco and alcohol abuse are known factors in the genesis of many head and neck cancers, none of the consultants believe that the cause and effect is established in younger patients. No one is willing to make a connection between her carcinoma and her connective tissue disease. With regard to panendoscopy, the consultants would perform a rigid bronchoscopy and an esophagoscopy (Dr. Donald), laryngoscopy and esophagoscopy (Dr. Eibling), and esophagoscopy (Dr. DeSanto). (Editor's note: bronchoscopy and/or esophagoscopy have been considered standard in the evaluation of patients with head and neck malignancies, but the editor believes there is little or no justification for endoscopy in nonsmoking young adults.) There is consensus as to how to treat this woman. The consultants concur that excision followed by radiotherapy offers the best chance for cure. On expert (Dr. Eibling) suggests that postoperative chemotherapy should also be given. radiotherapy or chemotherapy alone are not options that anyone believes in as curative. Cure rate estimates center around 40% to 50% five-year survival (Dr. Donald) or 30% to 50% (Dr. Eibling). One physician believes it is useless to estimate the patient's odds (Dr. DeSanto). When this patient refuses surgery and stops her radiotherapy, one expert suggests waiting until the mucositis resides and proceeding with a resection (Dr. Donald). Another encourages completing the course (Dr. Eibling) and another believes there are no guidelines in such an ad-hoc program (Dr. DeSanto).(ABSTRACT TRUNCATED AT 250 WORDS)
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