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Medpor porous polyethylene implants are commonly used for facial skeletal reconstruction due to reported biocompatibility, fibrovascularization, and durability. While uncommon, late implant infections are an important consideration. We report delayed infections in 2 patients after unilateral total oncologic maxillectomy and reconstruction using Medpor implants for an ossifying fibroma and squamous cell carcinoma, respectively. In the first patient, annual interval computed tomography (CT) scans showed no recurrence of tumor or inflammatory changes. The second was lost to follow-up after adjuvant chemoradiation 1 year after resection. Patients both presented with swelling, drainage, and erythema around the implant at a mean of 4.5 years following maxillectomy. Both failed several attempts at conservative treatment. Cultures of implants removed at a mean of 2.5 months after infection grew α-hemolytic Streptococcus in the first and multiple organisms in the second, showing that the potential for delayed infection should be considered years after reconstruction.

We conducted a retrospective analysis of 28 patients—15 men and 13 women, aged 17 to 71 years (mean: 41.6)—who had undergone surgery for the treatment of a benign tumor of the hard or soft palate. The most common chief complaint was a palatal mass, which was reported by 14 patients (50.0%). Tumors were more common in the hard palate than in the soft palate by a margin of 23 to 5 (82.1 to 17.9%; p = 0.001). The most common histopathologic diagnosis was pleomorphic adenoma, which occurred in 9 cases (32.1%). Most patients were treated with local excision with clear margins, which was sufficient in almost all cases, as there were only 2 recurrences, both of which occurred in men with a hard-palate pleomorphic adenoma. For these 2 patients, a wider excision and repair with palatal islet flaps was performed, and no further recurrence or malignant transformation was observed during follow-up. Two patients with a soft-palate hemangioma were treated with an intralesional steroid injection and radiofrequency ablation, which reduced the size of their lesion considerably.

A case report of a central giant cell granuloma in the palate, which arose after orthodontic treatment, is presented with a review of relevant literature. Treatment options and clinical implications are also discussed.

Acute development of cardiomyopathy and occlusive thromboembolic events following cisplatin and 5-fluorouracil (5-FU) is rare but frequently lethal. The authors report the successful management of such an event in a 52-year-old man with squamous cell carcinoma of the soft palate. The possible pathophysiological mechanisms are discussed.

Background: Although all epidemiologic subsets of Kaposi's sarcoma (KS) (i.e., sporadic, endemic, epidemic, and iatrogenic) have an association with human herpes virus 8 (HHV8), these subsets occur in patient populations with distinctive clinical features. To a variable degree men outnumber women in all subsets. Objective: A retrospective study of women with histologically proven cutaneous KS was undertaken to determine the clinical and histopathologic features, as well as any associations. Methods: Two hundred and fifty cases of cutaneous KS in women from 1975 to 1993 were reviewed. Results: Of the patients, 80% were more than 60 years of age, and of the patients less than 60 years old, 28 were from areas of the world with endemic KS. All HTV+ patients but one were from areas of endemic KS. Two patients were renal transplant patients. Sixty-four percent of the patients had single lesions and 21% recurrent lesions. Twelve patients had, or were known to develop, internal involvement, and in six patients the cause of death was KS. All but four cases histologically showed areas of solid proliferations of tumour cells consistent with plaque or tumour stage. An angiosarcoma-like histologic pattern appeared to be associated with more aggressive epidemiologic subsets. High mitotic rates were rarely seen and did not correlate with aggressive epidemiologic subsets. Conclusion: Kaposi's sarcoma in women is diagnosed almost exclusively in plaque or tumour stage. The majority of women within our study fit within the epidemiologic subset of sporadic KS.

Objective Prosthetic treatment for speech disorders attributable to surgically acquired soft palate defects are introduced. Case A patient who underwent soft palate resection for cancer is presented. The resected portion of the soft palate was confined to the posterior segments. A prosthesis with a speech bulb was adapted to the patient. Conclusion Excellent restoration of speech and improvement of velopharyngeal function was achieved following placement of the special prosthesis.

Objective Congenital tumors of the oral cavity are extremely uncommon. The teratoid tumors (epiganthi, dermoid, and hairy polyps) account for almost all of the reported cases and are not infrequently associated with cleft of the soft palate. Of the remaining tumors in the pediatric cleft palate population, infantile lipoma of the oral cavity is exceedingly rare. A case of a congenital lipoma associated with a cleft of the soft palate is presented. The review of the literature, the description of the lesion, the diagnosis, and the management of this finding are outlined.

We report the case of an adult who developed an isolated-solitary papilloma on the margin of the soft palate 1 month after he had undergone a uvulopalatopharyngoplasty. We describe the clinical and cellular characteristics of this common lesion.

Rhabdomyosarcoma is a rare soft tissue tumor that was found incidentally in a repaired cleft palate oronasal fistula of a 3-year-old boy. This situation has yet to be reported in the literature. During this fistula repair, a small piece of tissue was sent for routine pathology, which showed embryonal rhabdomyosarcoma. A literature review as well as diagnostic and treatment algorithms are discussed concerning management of this rare malignancy. Also, routine pathology should be reviewed carefully because unsuspected tissues may have pathologic findings that dramatically affect patient diagnosis and management.

Eight spontaneous highly invasive oral and nasopharyngeal squamous cell carcinomas were observed over an 18- month period in a breeding colony of the common marmoset (Callithrix jacchus). Affected marmosets were predominantly males over four years of age. The incidence of this tumor in the four-year-plus age group was 4.9%. The tumors were locally invasive through the palate to the nasal cavity, retrobulbar space and cranial cavity in some marmosets with lung metastases present in three cases. The incidence of neoplasia in nonhuman primates generally has been considered to be low and induction of tumors with chemical carcinogens rarely has yielded malignant neoplasms.9* 12* 14* I' Since primate manage- ment has improved and permits a longer life span, various tumor types in many primate species have accumulated. There are few reports of spontaneous neoplasms of squamous epithelium, and those are principally in the skin. Squamous papillomas have been reported in the chimpanzee'' and Colobus m~nkey.~ Basal cell carci- nomas occurred in DeBrazza' and rhesus" monkeys while basal cell carcinomas of the skin of irradiated rhesus monkeys also have been reported.I2 One squa- mous cell carcinoma of the skin of a rhesus monkey was reported from a series of 678 necropsies12 and another case also has been de~cribed.'~ Reviews of oral diseases and tumors of primates5-" covered early cases of oral squamous papillomas and carcinomas, including cases in the rhesus and squirrel monkey.' I Highly invasive squamous cell carcinomas of the mandible of a rhesus monkeyi6 and a baboonI8 with metastases to lymph node have been described. Squamous cell carcinoma of the head, extending to the nasopharynx, has been reported in the African green monkey.6 No oral squamous cell carcinomas have been reported previously in the marmoset, Callithrix jac- chus, nor in the related tamarins.

Melanomas diagnosed in 29 cats over an 11 year period included 19 ocular (16 intraocular, three palpebral), five oral, and five dermal melanomas. Intraocular melanomas involved the ciliary body and iris in 12; the whole eye was involved in four. The average age of cats with intraocular melanomas was 11 years; the female:male ratio was 9:7. Histologically, eight intraocular tumors were mixed, six were epithelioid, and two were spindle cell. Ten of 16 cats (62.5%) with intraocular melanomas were killed because of the tumor at a mean of 156 days; four arc living with no evidence of disease (average, 255 days). The mean time of death in cats with palpebral melanoma was 409 days. Metastasis occurred in 63% of cats with intraocular melanoma and all cats with palpebral melanoma. Four cats with oral melanoma were killed at a mean of 61 days; all had metastasis. Of five cats with cutaneous melanoma, one was killed with metastasis at 90 days; three cats were alive without evidence of recurrence or metastasis >365 days after surgery. Results of this study indicate that in the cat, ocular melanomas are more common than oral and dermal melanomas, and ocular and oral melanomas arc more malignant than dermal melanomas, with higher rates of mortality and metastasis.

The results from radiographic and scintigraphic examination of 28 patients with malignant tumors of the nasal, paranasal and palate regions, 23 patients with purulent maxillary sinuitis, and 15 control cases were compared. A combination of radiography and scintigraphy yielded the best information on the differentiation between an inflammatory condition and malignant tumor and the extent of malignant growth in adjacent bone.

The review of 21 cases of mixed tumor of the palate showed that the prognosis, after surgical treatment, is much better than in mixed tumors of the parotid gland. No recurrence was seen in 20 cases, although histologically they often showed great cellularity and pseudo-cylindromatous or muco-epidermoid areas. In the only case which evolved unfavourably, invasive tendency toward the mucous membrane and cylindromatous areas were found.

SUMMARY A case of metastatic carcinoma of the hand is reported. This has been the only case in the records at the Saint Savvas Special Hospital for the treatment of cancer. The primary was from the hard palate. The patient underwent an amputation and the follow-up one and a half years later showed no further metastases. A review of the literature confirms the rarity of hand malignancies either primary or metastatic.

Infantile vomiting can occur from many causes. A mass in the nasopharynx is an obscure reason for emesis. Maternal detection of an intermittently visible mass secured a diagnosis that had eluded observation, even after the patient had been hospitalized. "Hairy polyp" has received almost no attention in the Pediatrics literature.1,2This report is both for information about the unusual tumor and for reaffirmation of the value of parental observation.