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Salivary Gland Cancer
Molecular Biology of Oral Cancers

Information Patients and the Public (11 links)


Information for Health Professionals / Researchers (13 links)

Latest Research Publications

This list of publications is regularly updated (Source: PubMed).

Khan AA, Garg A, Dhawan S, et al.
T cell non-Hodgkin's lymphoma with colesional mucormycosis presenting as palatal perforation: a case report.
J Indian Med Assoc. 2012; 110(7):499-500 [PubMed]
Non-Hodgkin's lymphoma (NHL) is predominantly a disease of lymph nodes, but extranodal involvement is not very uncommon. Palatal involvement by NHL is rare. Mucormycosis is a devastating fungal infection commonly seen in immunocompromised individuals, including those with NHL, but it is affecting the same region has been reported very rarely. Simultaneous infiltration of hard palate by NHL and mucormycosis is extremely unusual. Herein we describe a patient who presented with palatal hole with histopathological examination revealing presence of lymphoma with colesional mucormycosis. The identification of mucor was vital because chemotherapy alone in the absence of antifungals would have had devastating consequences as the mortality of untreated mucormycosis is high.


Nonaka CF, de Oliveira PT, de Medeiros AM, et al.
Peripheral ameloblastoma in the maxillary gingiva: a case report.
N Y State Dent J. 2013; 79(1):37-40 [PubMed]
Peripheral ameloblastoma is an uncommon, extraosseous counterpart of solid ameloblastoma, which occurs in the soft tissues overlying tooth-bearing areas or the alveolar mucosa of the mandible and maxilla. In this paper, the authors report a case of peripheral ameloblastoma located in the maxillary gingiva of a 54-year-old woman and review the literature regarding clinicopathological features, differential diagnosis and therapeutic management of peripheral ameloblastomas.


Asgary S, Aminzadeh N
Unilateral gingival enlargement in patient with neurofibromatosis type I.
N Y State Dent J. 2012; 78(6):50-3 [PubMed]
Neurofibromatosis (NF) is a benign peripheral nerve sheath tumor. It is a neurocutaneous disorder with two defined entities: (1) Peripheral type I (NF1), described by von Recklinghausen; and (2) central type II, affecting mainly the central nervous system. NF1, the more common type, is an autosomal dominant, inherited disease, characterized by neural and cutaneous manifestations, as well as skeletal, oral and jaw expressions. All oral tissues have been reported to be affected with this tumoral disorder. Gingival neurofibroma in NF1 is uncommon. Diagnosis of NF1 is based upon a series of clinical criteria. The purpose of this report is to present a case of NF1 with a unilateral gingival neurofibroma in the buccal attached gingiva of the lower left molars, along with a review of the literature. Because NF1 is among the most common genetic diseases and its oral manifestations are commonplace, dentists should be aware of its different characteristics.


Hertrampf K, Wiltfang J, Katalinic A, et al.
Recent trends in incidence and mortality of oral and pharyngeal cancer in Schleswig-Holstein in Northern Germany.
Community Dent Health. 2012; 29(4):268-73 [PubMed]
OBJECTIVE: Oral and pharyngeal cancer is still a serious public health problem with more than 10,000 new cases every year in Germany, more than 4,000 patients die of this tumour each year. Aim of the project was a detailed analysis on incidence and mortality rates by age, gender and tumour sites in Northern Germany.
METHODS: The data on incidence and mortality rates from the population-based Cancer Registry of Schleswig-Holstein in Northern Germany were evaluated by age, gender and tumour sites from 2000 to 2006.
RESULTS: Some 3,127 new cases of oral and pharyngeal cancer (72% men, 28% women) were registered. About half of all cases were aged 60-79 years. The incidence trends for 40-59 years described a slight decrease. Trends for pharyngeal cancer showed the highest incidence rates for both genders in those aged 60-79. This detailed analysis with subgroups showed interesting differences and revealed considerable variations, especially compared to the increasing trends in several European countries.
CONCLUSIONS: These population-based data of Schleswig-Holstein showed interesting differences in the trends for incidence and mortality rates for age groups and tumour sites within the state and compared to the national German data and revealed noticeable different trends compared to several European countries. This population-based information informs effective cancer control.


Geißler C, Tahtali A, Diensthuber M, et al.
The role of p16 expression as a predictive marker in HPV-positive oral SCCHN--a retrospective single-center study.
Anticancer Res. 2013; 33(3):913-6 [PubMed]
UNLABELLED: Squamous cell carcinoma of the head and neck (SCCHN) is the sixth most common type of cancer worldwide; 600,000 new cases are diagnosed every year. Infected with high-risk human papilloma virus (HPV) types are particularly linked to oropharyngeal cancer. Among over 100 different HPV types, HPV-16 and HPV-18 are detected in the majority of HPV-positive SCCHNs. The p16 gene is often mutated in SCCHN, its overexpression is caused by the viral E7 protein. Consequently, p16 is assumed to be an indirect marker of HPV-induced SCCHN. The aim of the present study was to determine the role of p16 expression as a predictive marker of HPV infection in SCCHN tumors in a retrospective single-center study.
MATERIALS AND METHODS: Oropharyngeal tumor samples from 45 patients (34 males, 11 females) were analyzed. Tumor samples were examined for HPV infection using a two-step PCR. p16 staining by immunohistochemistry was then performed.
RESULTS: Samples with strong p16 signal were typed HPV-16-positive. Out of 14 tumor samples with HPV-positive PCR results, 13 samples contained the high risk variant HPV-16. In one sample, HPV-6 DNA was detected. All HPV-16-positive tumors overexpressed p16 (p16(+++)), whereas the HPV-6 sample was p16-negative.
CONCLUSION: p16 is not a surrogate marker for replacing PCR testing, but both methods in combination, PCR and immunohistochemistry, could lead to a higher diagnostic validation.


Roman E, Lunde ML, Miron T, et al.
Analysis of protein expression profile of oral squamous cell carcinoma by MALDI-TOF-MS.
Anticancer Res. 2013; 33(3):837-45 [PubMed]
In this study, two-dimensional gel electrophoresis (2-DE) and matrix-assisted laser desorption/ionisation-time of flight mass spectrometry (MALDI-TOF-MS) technology was used to examine differentially expressed proteins in oral squamous cell carcinoma (OSCC) tissues from Norway (n=15) and the UK (n=45). Twenty-nine proteins were found to be significantly overexpressed in the OSCCs examined compared to the normal controls. Identified proteins included, family of annexin proteins that play important roles in signal transduction pathways and regulation of cellular growth, keratin-1, heat-shock proteins (HSP), squamous cell carcinoma antigen (SCC-Ag), cytoskeleton proteins, and proteins involved in mitochondrial and intracellular signalling pathways. The expression of four selected proteins (annexin II and V, HSP-27, and SCC-Ag) was verified using western blot analysis of 76 fresh tissue biopsy specimens in total, from Norway (n=53) and the UK (n=23). Proteomic analysis of OSCCs examined here demonstrated involvement of several proteins that might function as potential biomarkers and molecular targets for early cancer diagnostics, and may contribute to a novel approach to therapeutics and for predicting prognosis of OSCC.


Stassen L, Khosa AD, Israr M
The value of the 'buccal pad of fat' in the reconstruction of oral defects following removal of intraoral tumours--a clinical assessment.
Ir Med J. 2013; 106(1):13-5 [PubMed]
The buccal pad of fat (BPF) is an important structure found in the orofacial region of humans. It is larger in infants and gradually becomes smaller in adults. We present twenty seven (27) cases with an average age of 60 years, with a variety of pathological lesions in which we have used the BPF to reconstruct the defects following resection of tumours. Twenty (74%) patients were diagnosed with Squamous Cell Carcinma. The commonest surgical sites were the soft palate and maxilla (46%). A clinical analysis of the value of BPF in reconstruction was made by using assessment criteria, mouth opening, cosmesis, fistula formation, approved by the ethical committee of the Hospital. Our findings show that the BPF is an excellent pedicled graft for the reconstruction of defects up to 10x5.5x1.1 cm in size. The donor site had no morbidity in terms of fuctions including, mouth opening (normal), masticatory movement, deglution, motor / sensory loss and patients were unaffected cosmetically (no temporal hollwing). There was no abnormal finding e.g. fistula, Frey's syndrome, speech and movement of the soft palate was unaffected. Salivary function was not affected (parotid duct). Speech outcomes were normal. We used a pre-surgery constructed blow--down soft or a preformed acrylic plate to support the fat pad in 13 (50%) patients, secured with mini screws. The use of a splint to support and protect the flap allowed early feeding.


Hynes S, Narasimhan K, Courtemanche DJ, Arneja JS
Complicated infantile hemangioma of the lip: outcomes of early versus late resection.
Plast Reconstr Surg. 2013; 131(3):373e-9e [PubMed]
BACKGROUND: Lip hemangiomas have traditionally been approached with expectant management. However, intervention is warranted for associated complications, including facial disfigurement, feeding difficulties, speech impairment, and psychosocial manifestations. The authors evaluated outcomes of complicated lip hemangiomas resected during the proliferative as compared with the involutional phase.
METHODS: A retrospective review of patients with complicated lip hemangiomas managed with resection in the proliferative or involutional phase from 2005 to 2011 was performed. A transverse elliptical vermilion-mucosal resection technique was used. Review parameters included demographics, lesion size and location, growth phase, hemangioma-related complications, and preoperative management (corticosteroid or pulsed dye laser). Evaluated outcomes included surgical complications, recurrence, and patient- and surgeon-reported aesthetics.
RESULTS: Twenty-one patients underwent surgical resection of a lip hemangioma (10 proliferative and 11 involutional), with a mean follow-up of 21.4 and 23.3 months, respectively. The two groups were comparable with respect to lesion size and location. Patients in the involutional group experienced higher rates of hemangioma-related complications (bleeding, 45 percent versus 10 percent; speech impairment, 82 percent versus 0 percent; feeding difficulties, 82 percent versus 20 percent; and psychosocial issues, 100 percent versus 80 percent). There were no postoperative aesthetic concerns. One recurrence in the proliferative group was treated with reresection. Speech therapy was required for 82 percent of patients in the involutional group.
CONCLUSIONS: Surgical resection is efficacious treatment for hemangiomas of the lip and yields acceptable aesthetic results during both the proliferative and involutional phases. Resection in the proliferative phase should be considered to prevent complications associated with delayed treatment.


Shah AA, LeGallo RD, van Zante A, et al.
EWSR1 genetic rearrangements in salivary gland tumors: a specific and very common feature of hyalinizing clear cell carcinoma.
Am J Surg Pathol. 2013; 37(4):571-8 [PubMed]
The Ewing sarcoma breakpoint region 1 (EWSR1) is translocated in many sarcomas. Recently, its rearrangement has been described in salivary gland hyalinizing clear cell carcinomas (HCCCs) and in a subset of soft tissue myoepitheliomas. This study examines the presence of the EWSR1 rearrangement in a variety of salivary gland lesions including classic myoepitheliomas and HCCCs. Using a tissue microarray and whole-mount sections, fluorescence in situ hybridization (FISH) was performed on a variety of salivary gland lesions including HCCCs. The EWSR1 rearrangement was detected in 87% of HCCCs (13 of 15); all other salivary gland lesions including classic myoepitheliomas had intact EWSR1. Patients with HCCCs with rearranged EWSR1 included 1 man, 10 women, and 2 of unknown sex. Ages ranged from 35 to 83 years; the tumor size ranged from 0.8 to 5.5 cm, and the involved locations included: palate (2), base of the tongue (2), mandible (2), submandibular gland (2), lip (1), floor of the mouth (1), sublingual gland (1), inner cheek (1), and nasopharynx (1). All HCCCs were composed of sheets and nests of monotonous cells with clear cytoplasm within a hyalinized stroma. All tested cases were immunoreactive with antibodies to p63 and were nonreactive with antibodies to more conventional myoepithelial antigens (e.g., smooth muscle actin and S100 protein). These findings show that the EWSR1 rearrangement is almost a defining feature of HCCCs and also confirm that classic salivary gland myoepitheliomas are distinct from these tumors and do not share a pathogenetic relationship with their soft tissue counterparts.


Gabali A, Ross CW, Edwards PC, et al.
Pediatric extranodal marginal zone B-cell lymphoma presenting as amyloidosis in minor salivary glands: a case report and review of the literature.
J Pediatr Hematol Oncol. 2013; 35(3):e130-3 [PubMed]
We report an unusual case of an extranodal marginal zone B-cell lymphoma (EMZL) arising in the labial minor salivary gland in an immunocompetent 11-year-old boy. The initial histopathologic review favored localized amyloidosis. However, further evaluation supported the diagnosis of low-grade B-cell lymphoma with plasmacytic differentiation, surrounded by deposits of AL κ-type amyloid. Clinical management consisted of excision with no recurrence at 1-year follow-up. This case demonstrates that a diagnosis of lymphoma must be considered in cases of amyloidosis associated with minor salivary gland involvement, even in children. In addition, we provide a literature review of extranodal marginal zone B-cell lymphoma arising in salivary glands.


Wu G, Sun X, Yuan H, Hu M
Ezrin gene expression and protein production in the CD44(+) subpopulation of SCC-9 cells in a malignant oral cancer cell line in vitro.
J Oral Maxillofac Surg. 2013; 71(3):e151-7 [PubMed]
PURPOSE: The primary objective of this study was to examine ezrin in the CD44(+) subpopulation of SCC-9 cells in a malignant oral cancer cell line.
MATERIALS AND METHODS: The CD44(+) subpopulation of SCC-9 cells was sorted using CD44 fluorescence-activated cell sorting flow cytometry. Expressions of the ABCG2, CD133, Oct-4, BMI-1, an ezrin genes and proteins were detected by immunofluorescence and real-time polymerase chain reaction, and their differential expressions in the CD44(+) and CD44(-) cell populations and embryonic stem cells were compared. The location of the ezrin protein expressed in SCC-9 cells was determined using laser scanning confocal microscopy.
RESULTS: The expression of ezrin in the CD44(+) subpopulation was 38 times higher than in the CD44(-) subpopulation based on real-time polymerase chain reaction, and levels of ABCG2, CD133, Oct-4, and BMI-1 in the CD44(+) subpopulation were higher than those in the CD44(-) subpopulation (P < .05).
CONCLUSION: The overexpression of ezrin in the CD44(+) subpopulation of SCC-9 cells might affect the functions of CD44(+) tumor cells, which contribute to the metastatic behavior of malignant oral squamous cell carcinoma.


Huang MW, Zhang JG, Zhang J, et al.
Oncocytic carcinoma of the parotid gland.
Laryngoscope. 2013; 123(2):381-5 [PubMed]
OBJECTIVES/HYPOTHESIS: The incidence of oncocytic carcinoma of the parotid gland is low, so a systematic evaluation of treatment strategies is lacking. We aimed to describe our experiences in treating this malignancy.
STUDY DESIGN: Retrospective study.
METHODS: We reviewed the files for 18 patients (14 males) of oncocytic carcinoma of the parotid gland in our institution from 1991 to 2011. Four patients underwent surgery alone, four surgery and postoperative radiotherapy, nine surgery and postoperative brachytherapy, and one radiotherapy alone. Median follow-up was 36 months (range 2-108 months).
RESULTS: The 5-year local control rate was 66.9%, overall survival 68.6%, disease progression-free survival 46.2%, and 5-year freedom from distant metastasis 61.0%. Clinical N category, local recurrence, and distant metastasis significantly influenced overall survival.
CONCLUSIONS: Conservative parotidectomy is not radical enough to treat oncocytic carcinoma of the parotid gland. Elective neck dissection is recommended for patients with cancer stage T2 to 4. Surgery with postoperative (125) I brachytherapy leads to good local control for patients with advanced disease or with positive or close resection margins.


Candrlić B, Pusić M, Kukuljan M, et al.
Patient with lingual thyroid and squamous cell carcinoma of the tongue base--case report.
Coll Antropol. 2012; 36 Suppl 2:227-9 [PubMed]
We demonstrate a rare case of lingual thyroid together with squamous cell carcinoma of the base of tongue. 54-year-old patient presented with left sided lymph node enlargement in regions II, III and IV without any clinical symptoms. Physical examination revealed semicircular bulge at the base of tongue measuring 30 x 20 mm and tumorous lesion was suspected. Neck ultrasound showed pathological enlargement of lymph nodes and FNA of lymph node revealed squamous carcinoma cells in the smear. Further investigation included CT and MRI of the neck depicted ectopic thyroid tissue in base of tongue and enlarged and necrotic lymph nodes in regions II and III. Primary carcinoma could not be depicted. Biopsy of the lingual mass was performed and histology confirmed ectopic thyroid tissue. Physical examination of the oral cavity was repeated and suspicious area on the left side of the tongue base near ectopic thyroidal tissue was identified. Histology after biopsy confirmed squamous cell carcinoma with superficial growth. This case emphasizes the important role that collaboration of radiologist and otorhinolaryngologyst has in correctly diagnosing oropharyngeal pathology. Also, we underline the importance of careful oropharyngeal region screening in case of unknown pathologic lymphadenopathy, when the possibility of oropharyngeal cancer has to be considered.


Brusić SK, Pusić M, Cvjetković N, et al.
Osteosarcoma of the mastoid process following radiation therapy of mucoepidermoid carcinoma of the parotid gland--a case report.
Coll Antropol. 2012; 36 Suppl 2:223-5 [PubMed]
Radiation therapy is frequently used method in treatment of the head and neck malignancies. Osteosarcoma is a rare complication of radiation therapy and usually occurs after a long latent period. We report the case of 75-year-old female with osteosarcoma of the mastoid process. Twelve years before presentation she received radiation therapy after total parotidectomy and radical neck dissection in treatment of mucoepidermoid carcinoma of the parotid gland. Diagnostic procedures included contrast-enhanced CT and MRI of the head and neck and HRCT of the temporal bone. The final diagnosis of the low grade osteosarcoma was confirmed by biopsy. Diagnostic criteria were fulfilled and the lesion was classified as a radiation induced osteosarcoma.


Bernić A, Novosel I, Krizanac S
An unusual mole: an adult case of Dabska tumour.
Coll Antropol. 2012; 36 Suppl 2:171-2 [PubMed]
In 1969 Dabska and her colleagues described for the first time this rare malignant tumour, also later known as a malignant endovascular papillary angioendothelioma of childhood. Overall, depending amongst other factors on its location, it is thought to have a generally favourable prognosis and a wide local excision seems to be the treatment of choice. We here present a very rare and unusual case of a 63 year old woman with a 20 year history of slow-growing right buccal dermatological lesion which resembled a common mole. The histopathological diagnosis of Dabska Tumour was made following the hematoxylin and eosin (H&E) biopsy. The analysis revealed multiple delicate interconnecting vascular channels with papillary plugs, some of which containing hyalinized core, projecting into the lumen lined by atypical plumped endothelial cells.


Danić D, Hadzibegović AD, Stojadinović T, et al.
Harmonic scalpel surgical treatment of the tongue angioleomyoma--case report and review of the literature.
Coll Antropol. 2012; 36 Suppl 2:167-70 [PubMed]
Angioleiomyoma is benign soft tissue tumor composed of smooth muscle cells and vascular endothelium, characterized with slow growth, unspecific symptoms and rare malignant transformation. It is very rare in the head and neck region and complete surgical excision is the gold standard for diagnosis and treatment. We present a very rare case of angoleomyoma of the tounge base treated with partial glosectomy with harmonic scalpel which shortened surgical procedure, reduced bleeding and postoperative complications.


Ostović KT, Luksić I, Virag M, et al.
The importance of team work of cytologist and surgeon in preoperative diagnosis of intraoral minor salivary gland tumours.
Coll Antropol. 2012; 36 Suppl 2:151-7 [PubMed]
Tumours arising from oral minor salivary glands may exhibit an overlap of clinical and morphological features that may produce diagnostic and therapeutic dilemmas. The aim of this study is to asses the value of fine needle aspiration cytology (FNAC) in differentiation of benign and malignant tumours and to render a specific diagnosis. We evaluated the team work of surgeon and cytologist to improve diagnostic accuracy. Two steps are important for accuracy: sampling aspirate that should be done together by surgeon and cytologist and cytological microscopic analysis of the smears that should be performed by an experienced cytologist. The study included 132 patients with intraoral minor salivary gland tumours between 2002 and 2011. Adequate material was obtained from 121 (91.7%) patients. FNAC was usually performed by cytologist in a team with maxillofacial surgeon at cytology department that is more convenient for preparing the samples and especially for ROSE procedure (rapid-on site evaluation) of smears. In such a way the cytologist checked the adequacy of samples and decided whether some ancillary techniques should be used and therefore repeat FNAC. A total of 82 patients underwent surgery, 40 with malignant and 42 with benign tumours. Preoperative cytological diagnoses were compared with histopathological ones using histopathology as a gold standard. The most common benign tumour was pleomorphic adenoma and among malignant tumours adenoid cystic carcinoma. The most commonly affected site was the palate. The team work of surgeon and cytologist achieved specificity of 95.1%, sensitivity of 97.6% and diagnostic accuracy of 96.3%. We can conclude that although subclassification of some tumour types of salivary glands remains poor, FNAC is invaluable in patient triage and therefore should be considered in the first line investigations of these lesions by the cytologist and surgeon.


Luksić I, Suton P, Manojlović S, et al.
Pleomorphic adenoma in ectopic salivary gland tissue in the neck.
Coll Antropol. 2012; 36 Suppl 2:133-6 [PubMed]
A case of pleomorphic adenoma originating from ectopic salivary gland tissue (ESGT) of the upper neck is reported. A 34-year-old male patient was referred to our Department for a painless swelling in the right submandibular region. Preoperative evaluation (clinical examination, fine-needle aspiration cytology (FNAC) and imaging studies) was performed and the finding was that of pleomorphic adenoma in ESGT A modified "S" incision with extension to the submandibular region was performed and the tumour was extirpated. The histopathological report confirmed our initial diagnosis. No recurrence was obtained during a four-year follow-up period. Isolated neck mass may be overlooked as ectopic salivary gland tissue neoplasm (ESGTN). Proper preoperative assessment and optimal surgical treatment are the keys for successful management of these rare tumours. The distinction between metastatic lesion from a head and neck tumour and ESGTN may present considerable diagnostic problem. A review of the literature on ESGT and associated tumours with emphasis on clinical features, diagnosis and treatment is also presented.


Foco F, Bilalović N, Vranić S, et al.
Peritumoral p53 expression in oral carcinoma.
Coll Antropol. 2012; 36 Suppl 2:129-32 [PubMed]
p53 is one of the most frequently mutated genes in human tumors including head and neck tumors like oral squamous cell carcinoma. It might be responsible for more than 50% of all relapses in patients with surgically treated oral carcinoma and clean margins. The aim of the present study was to explore p53 protein expression in peritumoral tissue and correlate it with relapse of the disease. The study included 25 patients (17 males and 8 females) with oral squamous cell carcinoma in the period August 2006 till August 2008. For immunohistochemical assay, a monoclonal antibody against p53 protein was applied (clone DO-7, DAKO Glostrup, Denmark). Peritumoral expression of p53 was as follows: 10 out of 25 cases (40%) were negative, 2 cases (8%) showed weak, 5 cases (20%) moderate and 8 cases (32%) strong p53 positivity. No significant correlation between peritumoral expression of p53 protein and patient's relapse was found. In contrast, we found a trend toward association between intratumoral p53 expression and patient's relapse (p = 0.07). There was also trend toward higher peritumoral p53 expression in females comparing with p53 expression in males (52.9% of males did not have p53 expression while 87.5% females had mild, moderate or high p53 expression, p = 0.088). Peritumoral expression of p53 protein is frequently seen in oral squamous cell carcinoma and merits further research.


Salimi M, Esfahani M, Habibzadeh N, et al.
Change in nicotine-induced VEGF, PGE2 AND COX-2 expression following COX inhibition in human oral squamous cancer.
J Environ Pathol Toxicol Oncol. 2012; 31(4):349-56 [PubMed]
Cigarette smoke has been documented to be related to the development of cancer. However, the exact mechanism for the carcinogenic action of cigarette smoke is still unknown. Nicotine is recognized to be the major compound in cigarette smoke and has been suggested to play a role in oral cancer via a cyclooxygenase (COX)/ prostaglandin-dependent pathway. This study was designed to evaluate the action of nicotine in the oral cancer cell and to further examine whether COX-2 is responsible for expression of tumor-associated angiogenic vascular endothelial growth factor (VEGF) in vitro. Viability of human oral squamous cancer cells (BHY) was measured using MTT assay. Protein expression was determined by Western blot and immunoassay kits. We found that exposure of BHY cells to nicotine (200 µg/mL for 6 hours) resulted in 2.9-fold induction of COX-2 expression as well as a 4-fold increase in VEGF levels compared with a control group. Pretreatment with celecoxib inhibited nicotine-induced change in the expression of VEGF and COX-2. The results suggest that stimulation of COX-2 and VEGF expression can contribute as important factors in the tumorigenic action of nicotine in oral cancer progression. This effect can be blocked by celecoxib, suggesting an interaction of nicotine and COX-2 pathways.


Powell DK, Nwoke F, Urken ML, et al.
Scapular free flap harvest site: recognising the spectrum of radiographic post-operative appearance.
Br J Radiol. 2013; 86(1023):20120574 [PubMed] Article available free on PMC after 01/03/2014
OBJECTIVE: Scapular free flap harvesting for oral cavity cancer reconstruction is an increasingly used and versatile option. We aim to describe the appearance of the scapula harvest site on chest radiograph and CT.
METHODS: We retrospectively reviewed a surgical database of 82 patients who underwent scapular osteocutaneous flap harvesting for oral cavity cancer reconstruction and had imaging performed at our institution. We searched the picture archiving and communications system for all associated imaging.
RESULTS: Characteristic radiographic appearance in the immediate post-operative period as well as in the remote post-operative period is described, including an upside-down V-shaped paraglenoid notch, rectangular (or triangular) lateral border defects and a sharply pointed inferior scapular body. Additionally, common CT appearances are discussed, including an abrupt gleno-scapular interval, an absent axillary rim bulge and a Z-shaped scapula.
CONCLUSION: The altered appearance of the scapular defect following surgical harvest is easily recognised. Although the description of this defect may not alter management and may reasonably be omitted, a radiologist's comfort with these appearances may potentially enhance the understanding of patient management and recognition of superimposed complications, such as infection. ADVANCES IN KNOWLEDGE: Scapular osteocutaneous free flap reconstruction is an increasingly used technique after oral cavity surgery. Very few radiologists reported in our review the surgical scapular defects, and there is apparent ignorance of their appearance. We described characteristic radiographic and CT signs of scapular free flap harvesting to increase radiologists' familiarity with these defects, which may provide clinical information and possibly contribute to detection of complications.


Yang F, Liu R, Kramer R, et al.
Discovery of specific ligands for oral squamous carcinoma to develop anti-cancer drug loaded precise targeting nanotherapeutics.
J Calif Dent Assoc. 2012; 40(12):939-43 [PubMed]
Oral squamous cell carcinoma has a low five-year survival rate, which may be due to late detection and a lack of effective tumor-specific therapies. Using a high throughput drug discovery strategy termed one-bead one-compound combinatorial library, the authors identified six compounds with high binding affinity to different human oral squamous cell carcinoma cell lines but not to normal cells. Current work is under way to develop these ligands to oral squamous cell carcinoma specific imaging probes or therapeutic agents.


Benatar MJ, Dassonville O, Chamorey E, et al.
Impact of preoperative radiotherapy on head and neck free flap reconstruction: a report on 429 cases.
J Plast Reconstr Aesthet Surg. 2013; 66(4):478-82 [PubMed]
BACKGROUND: The primary objective of this study was to evaluate the impact of preoperative radiotherapy on the outcomes of head and neck microvascular reconstruction. The secondary objective was to assess the specific effects of irradiation doses (IDs) ≥60 Gy on the outcomes of head and neck microvascular reconstruction.
METHODS: All patients who underwent head and neck free-flap reconstruction in our institution between 2000 and 2010 were included in this retrospective study. A total of 429 patients were enrolled including 136 patients previously irradiated on the head and neck. The impact of preoperative radiotherapy on free-flap success, local and general complications, postoperative mortality, time of decannulation, duration of enteral nutrition and length of stay was assessed in univariate and multivariate analyses.
RESULTS: In multivariate analysis, preoperative radiotherapy (irrespective of ID) was a significant risk factor for fistula formation (p = 0.003) and wound infection (p = 0.005). Previous neck irradiation at doses ≥60 Gy was associated with an increased risk of free-flap failure (p = 0.04), overall local complications (p = 0.05), haematoma (p = 0.04) and longer duration of enteral nutrition (p = 0.006) and hospital stay (p = 0.004).
CONCLUSIONS: Preoperative radiotherapy, particularly for ID ≥ 60 Gy, is one of the main determinants of the outcomes of head and neck microvascular reconstruction.


Frölich K, Alzoubi A, Müller J, Kleinsasser N
Bone marrow carcinosis in head and neck carcinoma in a young adult.
J Oral Maxillofac Surg. 2013; 71(4):e198-202 [PubMed]
Bone marrow carcinosis has been reported as a consequence of several solid tumors. However, in relation to head and neck squamous cell carcinoma, it is an indication of the rarity of the disease that only 2 reported cases exist in the literature. A 36-year-old male patient was admitted with the diagnosis of squamous cell carcinoma on the floor of the mouth. After the exclusion of distant metastatic disease, tumor surgery was performed. After a regular postoperative course over 3 days, the patient complained of progressive pain in the lower back. Extensive workup included position-emission tomography, which detected an enhancement of the bone marrow. Bone marrow biopsy elucidated advanced bone marrow carcinosis. Palliative chemotherapy was recommended, but the patient deteriorated rapidly and died from septic multiorgan failure within 6 weeks after surgery. Thus, bone marrow carcinosis must be considered in patients with head and neck tumor and osseous pain.


Southorn B, Manor E, Bodner L, et al.
Metachronous pleomorphic adenomas occurring in the parotid and a minor salivary gland with genetic changes detected by comparative genomic hybridization.
J Oral Maxillofac Surg. 2013; 71(4):805-8 [PubMed]
A 32-year-old female underwent an extracapsular dissection for a pleomorphic adenoma (PA) of the parotid gland. Six months later, she presented with an increasing lump on the upper lip that, following excision, was confirmed to be a second PA. Formalin-fixed paraffin embedded tissues were analyzed for chromosomal aberrations. Comparative genomic hybridization analysis showed multiple chromosomal aberrations in the parotid PA. In comparison, no chromosomal aberrations were found in the lip PA. To our knowledge, metachronous benign pleomorphic adenomas occurring in both a major and minor salivary gland is unreported, and furthermore, there are no comparative genomic hybridization reports of this rare occurrence. We discuss the clinicopathological implications.


Tasić D, Pavlović M, Stanković D, et al.
Ossifying chondrolipoma of the tongue.
Vojnosanit Pregl. 2012; 69(11):1009-12 [PubMed]
INTRODUCTION: Chondrolipomas and osteolipomas are uncommon variants of lipomatous tumors.
CASE REPORT: We presented a 60-year-old woman with ossifying chondrolipoma of the tongue. Clinical examination revealed a firm nodular mass, located in the midline of the posterior region on the dorsal surface of the tongue. Histologically, the lesion was well-delimited showing areas of mature adipocytes arranged in lobules and separated by fibrous connective tissue septa, islands of mature cartilaginous tissue and osseous metaplasia. Trabeculae of lamellar bone within a fibro-fatty background were visible throughout the tumor. The cartilaginous areas merging centrally with bone formation and fatty marrow tissue were present, as well as the hematopoietic elements in the fatty marrow. The bone forming was found to be through both membranous and enchondral mechanisms.
CONCLUSION: Ossifying chrondrolipoma with hematopoietic elements is extremely unusual lesion. This interesting entity should be kept in mind in the differential diagnosis of lingual lesions.


Anjani Kumar JH, Madhumathi S, Anjan Kumar S, Pavan Kumar VV
Cavernous lymphangioma of the lower lip--a rare case report.
Niger J Med. 2012 Oct-Dec; 21(4):455-7 [PubMed]
Lymphangioma are rare, benign, and hamartomatous tumors of the lymphatic vessels, that show a marked predilection for the head and neck region. Very few cases of Cavernous lymphangioma have been reported to occur in the lower lip. We report a rare case of Cavernous Lymphangioma of the lower lip in a 13 years old child who was treated surgically by excision and primary closure. Postoperative wound healing was satisfactory and there was no recurrence found till the last follow up.


Jithesh PV, Risk JM, Schache AG, et al.
The epigenetic landscape of oral squamous cell carcinoma.
Br J Cancer. 2013; 108(2):370-9 [PubMed] Article available free on PMC after 05/02/2014
BACKGROUND: There is relatively little methylation array data available specifically for oral squamous cell carcinoma (OSCC). This study aims to compare the DNA methylome across a large cohort of tumour/normal pairs.
METHODS: DNA was extracted from 44 OSCCs and paired normal mucosa. DNA methylation analysis employed the Illumina GoldenGate high-throughput array comprising 1505 CpG loci selected from 807 epigenetically regulated genes. This data was correlated with extracapsular spread (ECS), human papilloma virus (HPV) status, recurrence and 5-year survival.
RESULTS: Differential methylation levels of a number of genes distinguished the tumour tissue sample from the matched normal. Putative methylation signatures for ECS and recurrence were identified. The concept of concordant methylation or CpG island methylator phenotype (CIMP) in OSCC is supported by our data, with an association between 'CIMP-high' and worse prognosis. Epigenetic deregulation of NOTCH4 signalling in OSCC was also observed, as part of a possible methylation signature for recurrence, with parallels to recently discovered NOTCH mutations in HNSCC. Differences in methylation in HPV-driven cases were seen, but are less significant than that has been recently proposed in other series.
CONCLUSION: Although OSCC seems as much an 'epigenetic' as a genetic disease, the translational potential of cancer epigenetics has yet to be fully exploited. This data points to the application of epigenetic biomarkers and targets available to further the development of therapy in OSCC.


Kauppila JH, Mattila AE, Karttunen TJ, Salo T
Toll-like receptor 5 (TLR5) expression is a novel predictive marker for recurrence and survival in squamous cell carcinoma of the tongue.
Br J Cancer. 2013; 108(3):638-43 [PubMed] Article available free on PMC after 19/02/2014
BACKGROUND: Toll-like receptor 5 (TLR5) is an immune receptor recognising bacterial flagellin. Activation of TLR5 results in cancer invasion and cytokine release. As certain bacteria have been linked to oral cancer, we wanted to study TLR5 expression in oral tongue squamous cell carcinoma (OTSCC).
METHODS: Samples from 119 patients with OTSCC were obtained, including 101 samples of adjacent normal lingual mucosa. The TLR5 histoscore (0-300) was assessed semiquantitatively by immunohistochemistry in a blinded manner.
RESULTS: Toll-like receptor 5 was expressed in 84 normal epithelia and 118 cancer samples. Expression of TLR5 was increased in cancer when compared with normal lingual epithelium (median histoscore 15 vs 135). In cancer, higher TLR5 was associated with age of >70 years at the time of diagnosis, female gender and disease recurrence. No association between TLR5 expression and tumour grade, stage or treatment was found. In multivariate analysis, TLR5 was an independent predictor of cancer mortality (hazard ratio (HR) 3.587, 95% confidence interval (CI) (1.632-7.882)) and disease recurrence (HR 4.455, 95% CI (2.168-9.158)).
CONCLUSION: Toll-like receptor 5 has a previously undescribed role in the pathophysiology of OTSCC and might represent a link between bacteria and cancer. It could be a useful marker for predicting recurrence or survival of OTSCC patients.


Steger S, Wesarg S
Automated skeleton based multi-modal deformable registration of head&neck datasets.
Med Image Comput Comput Assist Interv. 2012; 15(Pt 2):66-73 [PubMed]
This paper presents a novel skeleton based method for the registration of head&neck datasets. Unlike existing approaches it is fully automated, spatial relation of the bones is considered during their registration and only one of the images must be a CT scan. An articulated atlas is used to jointly obtain a segmentation of the skull, the mandible and the vertebrae C1-Th2 from the CT image. These bones are then successively rigidly registered with the moving image, beginning at the skull, resulting in a rigid transformation for each of the bones. Linear combinations of those transformations describe the deformation in the soft tissue. The weights for the transformations are given by the solution of the Laplace equation. Optionally, the skin surface can be incorporated. The approach is evaluated on 20 CT/MRI pairs of head&neck datasets acquired in clinical routine. Visual inspection shows that the segmentation of the bones was successful in all cases and their successive alignment was successful in 19 cases. Based on manual segmentations of lymph nodes in both modalities, the registration accuracy in the soft tissue was assessed. The mean target registration error of the lymph node centroids was 5.33 +/- 2.44 mm when the registration was solely based on the deformation of the skeleton and 5.00 +/- 2.38 mm when the skin surface was additionally considered. The method's capture range is sufficient to cope with strongly deformed images and it can be modified to support other parts of the body. The overall registration process typically takes less than 2 minutes.


This page last updated: 22nd May 2013
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