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We encountered and reported a case of congenital tongue mass that developed on the dorsum of the tongue in a boy aged 1 and a half months. Histologically, it was a tissue malformation involving tissues such as smooth muscle, striated muscle, lymphatic vessels, blood vessels and salivary glands. So, diagnosis of heterotopic tissue was made. Congenital tongue mass has been reported as tongue anomaly, hamartoma, leiomyoma or benign mesenchymoma in literature, there being no unity in terminology. Many of the cases reported concern small pedunculated masses that developed on the dorsum of the tongue, and cases diagnosed as having hamartoma predominated. These tongue masses are diagnosed as tissue malformation histologically and somewhat different from true tumors in many cases. Hamartoma has a character intermediate between true tumors and malformations. Primarily it shows the structure deemed as overgrowth of tissue elements at the site of development, being applied to a relatively wide range of lesions. Accordingly, the term hamartoma is not appropriate for diagnosis of small masses of the tongue having heterotopic tissue. Benign mesenchymoma may fall under the category of hamartoma. However, it is one that stresses the concept of tumor and moreover, it is aimed at lesions which lack epithelial elements and in which several kinds mesenchymal elements are admixed. In contrast, congenital tongue masses contained epithelial elements such as salivary glands in many reported cases. Therefore, the term benign mesenchymoma is not preferable in the diagnosis of congenital tague mass. Leiomyoma is also tumor, and encapsulation is noted in many of the cases reported. However, the presence of capsules is not observed at all in the reported cases of congenital tongue mass, so far as the cases mentioned are concerned. So, dealing with congenital tongue mass regarded as tissue malformation as tumor is open to question. At present, there is no evidence that tissue malformation is of one stage of differentiation of tumor. So, tissue malformation needs to be strictly differentiated from tumor.As to a mass that is histologically regarded as tissue malformation, therefore, it would be preferable to refrain from using such a term that may be confuses with “tumor”.

We made a clinico-statistical observation of 100 cases of benign tumor patients who had been examined during the 11 years from April, 1978 to December, 1988 at the Department of Dentistry and Oral Surgery, Nagoya National Hospital.1) The ratio of odontogenic tumors to non-odontogenic tumors to salivary gland tumors was 1: 10. 3: 1. 3, indicating that the majority were non-odontogenic tumors. The ratio of male to female was 1: 1. 8, indicating female was higher than male.2) By histological classification there were 5 cases of ameloblastoma, 2 of cementoma and 1 of odontogenic myxoma in odontogenic tumors, 52 of fibroma, 14 of hemangioma, 6 of papilloma, 6 of lymphagioma and 4 of steatoma in non-odontogenic tumors, and 10 of plemorphia adenoma in salivary gland tumors.3) By the presumptive age group at the primary manifestation, the majority were in the 30 s and 40 s, and the average age was 35. 9 years. In odontogenic tumors there were patients in the teens and the 30 s, and the average age was 29. 8 years. In non-odontogenic tumors there were more patients in the 30 s and 50 s, and the average age was 38. 7 years. In salivary gland tumors there were more patients in the teens and 40 s the average age being 39. 3 years.4) By the age group at the primary examination there were more patients in the 60 s, 50 s, and 30 s, the average age being 39. 8 years. In odontogenic tumors, the majority were in the 30 s and the average age was 37. 8 years. In non-odontogenic tumors, there were more patients in the 60 s, 50 s, and 30 s, the average age being 42. 5 years. In salivary gland tumors, the majority were in the 40 s, the average age being 43. 1 years.5) The affected period ranged from 1 month to 3 months in most cases. The affected period was from 1 year to 3 years in non-odontogenic tumors, and it was from 1-3 months in the majority of salivary gland tumors.6) Chief complaints were swelling and oncogenesis, accounting for 85 cases (84.2%), followed by 7 cases (6.9%) of incongruity feeling and 6 cases (5.9%) of pain in this order.7) By manifestation site the tongue was most frequently was affected accounting for 26.0%, followed by gum in 18.0%, palate in 14.0%, and lips in 14.0%. With regard to the odontogenic tumors, they appeared only in the maxilla and the mandible. The salivary gland tumors mostly appeared in the palate and parotid gland regions.8) By dimensions, 33 cases were from 5 to less than 10mm (33.0%), followed by 28 cases from 10 to less than 20mm (28.0%) and 16 cases from 20 to less than 40mm (16.0%).9) For therapy all were treated by excision or extraction except in 2 adamantinoma cases in which excision of the maxillary bone was conducted.

We encountered and reported a case of squamous odontogenic tumor that developed in the gingiva of the lower third molar of a 51-ear old woman. This case may be the first of this kind of tumor ever reported in Japan. The chief complaints were gingival bleeding and painless swelling. The tumor was nodular, firm and located distal to the gingiva of the lower third molar. It was a tumor in size of the tip of the small finger, presenting the color of healthy gingiva. Radiographically, a horizontal type bone absorption was noted around the molar. As for the treatment, extraction of the molar and local excision of the tumor were performed. Histologically, numerous islands large and small consisting of well differentiated squamous epithelium were observed. The stroma was composed of mature fibrous collagenous connective tissue. The periphery of the islands was flattened or cuboidal but mostly flattened and showed no epithelial columnar cells. The presence of vacuolization and/or microcyst formation was observed in the islands and acidophilic substances were found in the microcyst formation. Prognostic observations were made for two years and six months during which no recurrence was noted. As to the development of this tumor, a theory that it is derived from Malassez epithelial remnant is widely accepted. However, we have presented a view againt this theory. In our view, it is possible that a weak dental lamina of the permanent teeth or the lateral enamel strand prior to formation of ameloblast remains in the jaw bone and/or paradentium and later developes into a tumor.

We present here some views obtained through clinical research and pathologic histological research on 84 cases diagnosed as mucocele at the department of dentistry and oral surgery, Nagoya National Hospital during 10 years and 9 months from April, 1978 to December, 1988.The mucocele we investigated were 63 cases of the mucocele which was derived from the minor salivary gland, 16 ranula cases, and 5 cases of Blandin-Nuhn gland cyst (total 84 cases).With regard to the manifestation frequency by age group, the mucocele derived from the minor salivary gland occurred numerously in those under 30 years old, and it occurred particularly numerously in those from 0 to 9 years old totaling as many as 15 cases.The ranula numerously occurred also in those under 30 years old, and the Blandin-Nuhn gland cyst in large numbers in those under 10 years old.With regard to the manifestation frequency by sex distinction, the ratio of the mucocele, derived from the minor salivary gland, of male to female was 1: 1.3, indicating higher femaletendency.With regard to size, most were under 6 to 10mm, accounting for 41 cases (48. 8%), followed by 26 cases (31. 6%) of under 5mm, and 5 cases (6. 0%) of over 21mm in the order mentioned.As a trend, those in the regions of labia, forelingual gland, and buccal mucosa were small, and those in the oral floor region (sublingual type) were large.With regard to the number of clays from recognizing symptoms to visiting our hospital, the majority was from 1 to under 3 months in 34 cases (40. 5%), followed by from 3 to under 6 months in 15 cases (17. 9%) in the order mentioned. The shortest period was one day, and the longest was 20 years.There were 7 cases of frequent manifestation (8. 3%). The ratio of male to female was 1: 2. 5, indicating it occurred more in female, and further there were 18 cases of anamonesis (21. 4%) such as trauma or pernicious habit.

The teeth taken from ovarian teratoma (dermoid cyst) were studied histopathologically, microradiographically and X-ray diffractively. The teeth had almost normal structure although they had neither cementum nor supporting bone. However, they showed hypocalcified area and Astraea-like pattern which was very similar to a crystal of Octa Calcium Phosphate, known as a precursor of hydroxyapatite, in enamel and dentine histopathologically and microradiographically. X-ray diffractive study of the Astraea-like area showed the same crystal pattern as that of hydroxyapatite.

Clinical and statistical observations were made of the first ten years' operations of the ward medical service started at the Department of the Dentistry and Oral Surgery in the National Nagoya Hospital.The total number of patients was 519, 247 and 272 females. Male to female ratio was 47.6% to 52.4%. (1) Patient numbers catagorized by disease are as follows: inflammatory cases 196 (34.3%), cystic cases 96 (16.7%), neoplasms 60 (10.4%), trauma 59 (10.2%), malposition of the tooth socket 49 (8.5%), salivary gland cases 43 (7.5%), deformities 18 (3.1%), tooth extraction 13 (2.3)%, neural disease 5 (0.9%), and others 37 (6.4%). (2) Concerning age/disease distribution, approximately 34% of those under ten years old were deformity case. Older patients suffered predominately neoplastic disease. (3) Concerning age distribution the majority were in their twenties (16.8%), and then in decreasing order as follows: forties, thirties, fifties, sixties, 10-20's, and under tens. (4) Concerning distribution by regions, 96.3% of cases were from Aichi Prefecture; Nagoya City accourting for 66.3% of that figure. Accordingly, our institute has therefore fully served its designed function as a medical service institute of quality in the dental and oral surgical fields for the City of Nagoya.

We experienced. case of tooth extraction with high-dose intravenous methyl prednisolone (m-PLS) pulse therapy in a 9-year-old female with clonic idiopathic thrombocytopenic purpura. With this treatment we obtained good results. M-PLS pulse therapy was continued for 3 days before operation.The dose of m-PLS diluted with 5% glucose solution (250ml) was 30mg/kg a day. Intravenous drop was given for about 2 hours.Sustained elevation of platelet counts was obtained during 3 days (1×104/mm3→10.6×104/mm3) and the operation was done. Prognosis was favorable, and she was discharged after one week.