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Objective: The aim of this study was to analyse quality of life (QoL) pretreatment and up to 24 months post radiation therapy (RT) in patients with head and neck (H&N) cancer. Methods: Twenty‐nine patients (19 men and 10 women) with a mean age of 59 ± 8 years were included. The stimulated salivary secretion was measured and the patients completed the European Organisation for Research and Treatment of Cancer Quality of Life questionnaires (EORTC QLQ‐C30 and H&N35) and the Hospital Anxiety and Depression scale (HADS) pretreatment and at 6, 12 and 24 months post RT. Results: At all time‐points after RT (6, 12, and 24 months), patients with hyposalivation (stimulated secretion rate ≤0.7 mL/min) reported clinically significant differences (> 10 points) regarding insomnia, swallowing, social eating, dry mouth, and sticky saliva. Statistically significant differences were found for emotional functioning and insomnia at 12 months (P < 0.05 for both) and for sticky saliva at both 12 and 24 months (P < 0.05 and P < 0.01). The number of clinically significant differences increased from 10 at both 6 and 12 months post‐RT to 14 functioning/symptom scales and single items at the 24 months follow‐up. At 24 months post RT, 21% of patients with hyposalivation had HADS scores suggesting anxiety problems compared to 7% for those with stimulated salivary secretion rates >0.7 mL/min. Conclusion: Patients with hyposalivation showed deterioration in health related quality of life (QoL) at 24 months compared with 12 months post RT. Most pronounced were problems with insomnia, swallowing, social eating, dry mouth, and sticky saliva. [ABSTRACT FROM AUTHOR]

Abstract Objective The objective is to investigate the topographical distribution of sentinel nodes (SNs) and lymph node metastases in T1-2cN0 oral squamous cell carcinomas (OSCCs). Methods The study entailed a prospective enrolment of 220 patients with clinical T1-2N0 OSCCs who underwent preoperative lymphoscintigraphy (LSG) followed by gamma probe–guided sentinel lymph node biopsy (SLNB). Patients with positive SNs were treated with completion neck dissection. Excised lymph nodes were grouped into the neck level according to the international guidelines. Results The SN detection rate by LSG was 99.1%. Patients with midline tumours had bilateral lymphatic drainage on LSG in 15/21 (71.5%). There were 45/199 (22.6%) patients with lateralised tumours that had unexpected bilateral or contralateral drainage patterns on LSG. Fifty-five patients (25.0%) were SLNB positive, and metastases were found in 72/781 (9.2%) of the excised SNs. Metastatic involvement of neck level IV was rare and only observed in patients with anterior tongue cancer. No patients had level V involvement. Eleven patients developed isolated cervical recurrences, with no new primary tumour as origin. The SLNB procedure ensured an overall sensitivity of 83.3% and a negative predictive value of 93.3%. Conclusion Completion neck dissection of level I–III in SLNB-positive patients might be sufficient in most patients with OSCC except patients with anterior tongue cancer, but further studies are needed to support this potential therapeutic algorithm. Our study showed that SLNB was helpful in clarifying unexpected bilateral or contralateral metastatic drainage patterns. In our cohort, 8/55 patients with occult metastasis would have been missed by elective neck dissection of the ipsilateral neck. Highlights • Sentinel lymph node biopsy procedure can assess the individual drainage pattern. • Most occult metastases are located in neck level I–III. • The sentinel node biopsy approach is promising for individual surgical planning. • The regional recurrence rate in our sentinel node-negative patients is equal to the rate after elective neck dissection reported previously. • 8/55 (14.5%) patients with occult metastasis would have been missed by conservative elective neck dissection treatment of the ipsilateral neck. [ABSTRACT FROM AUTHOR]

Background: Long-term smoking and drinking are known to contribute to the onset of tongue cancer (TC). However, the increasing incidence of TC in younger adults has been suggested to be associated with other factors. Objectives: The present study investigated the relationship between TC and human papillomavirus (HPV) infection. Material and methods: Clinical records and surgically resected specimens from 86 patients (<40-years-old, n = 12; ≥40-years-old, n = 74) with TC were analyzed. Strong nuclear and cytoplasmic p16 staining was considered positive. HPV DNA (high-risk subtypes: 16, 18, 31, 33, 35, 52b, and 58; low-risk subtypes: 6 and 11) was detected using consensus primer-mediated polymerase chain reaction. Results: Strong p16 expression was observed in 10 (11.6%) patients. HPV DNA was detected in 9 (10.5%) patients (high-risk subtypes, n = 2; low-risk subtypes, n = 7). Strong p16 expression was observed more frequently among younger adults than among older adults (33.3% vs. 8.1%; p = .045). p16 staining did not correlate with the detection of HPV DNA (correlation coefficient, 0.113; p = .300). Conclusions and significance: In TC, p16 expression was not associated with HPV infection, suggesting that it may be caused by a different mechanism. [ABSTRACT FROM AUTHOR]

Introduction: Patients are characterized by locally advanced tumours in 70-80% of cases at presentation. Thus, the possibilities for curing and surgical treatment are limited. Total glossectomy, which involves tongue base resection, is associated with severe and permanent disabilities. Total glossectomy leads to severe dysphagia, alalia and social maladjustment. A number of issues motivated us to develop a new method of surgical treatment of locally advanced base of tongue cancer. Objective: To introduce new opportunities for surgical treatment of locally advanced cancer of the tongue base. Materials and Methods: Glossectomy was accomplished in five patients suffering from tongue cancer and admitted to N.N. Blokhin National Medical and Research Center of Oncology. Swallowing and speech were preserved in all 5 cases. Results: We developed a new technique of surgical treatment of locally advanced cancer of the tongue base. Conclusion: The developed surgical technique allows early rehabilitation. Patients are able to breath effortlessly, swallow and speak. Permanent tracheostomy and PEG tubes are not necessary. All patients remained socially active. [ABSTRACT FROM AUTHOR]

Background: Long-term smoking and drinking are known to contribute to the onset of tongue cancer (TC). However, the increasing incidence of TC in younger adults has been suggested to be associated with other factors. Objectives: The present study investigated the relationship between TC and human papillomavirus (HPV) infection. Material and methods: Clinical records and surgically resected specimens from 86 patients (<40- years-old, n ¼ 12; 40-years-old, n ¼ 74) with TC were analyzed. Strong nuclear and cytoplasmic p16 staining was considered positive. HPV DNA (high-risk subtypes: 16, 18, 31, 33, 35, 52b, and 58; low-risk subtypes: 6 and 11) was detected using consensus primer-mediated polymerase chain reaction. Results: Strong p16 expression was observed in 10 (11.6%) patients. HPV DNA was detected in 9 (10.5%) patients (high-risk subtypes, n ¼ 2; low-risk subtypes, n ¼ 7). Strong p16 expression was observed more frequently among younger adults than among older adults (33.3% vs. 8.1%; p ¼ .045). p16 staining did not correlate with the detection of HPV DNA (correlation coefficient, 0.113; p ¼ .300). Conclusions and significance: In TC, p16 expression was not associated with HPV infection, suggesting that it may be caused by a different mechanism. [ABSTRACT FROM AUTHOR]

Background: The incidence of squamous cell carcinoma of the oral tongue (SCCOT) is increasing in people under age 40. There is an urgent need to identify prognostic markers that help identify young SCCOT patients with poor prognosis in order to select these for individualized treatment.Materials and Methods: To identify genetic markers that can serve as prognostic markers for young SCCOT patients, we first investigated four young (≤40 years) and five elderly patients (≥50 years) using global RNA sequencing and whole-exome sequencing. Next, we combined our data with data on SCCOT from the cancer genome atlas (TCGA), giving a total of 16 young and 104 elderly, to explore the correlations between genomic variations and clinical outcomes.Results: In agreement with previous studies, we found that SCCOT from young and elderly patients was transcriptomically and also genomically similar with no significant differences regarding cancer driver genes, germline predisposition genes, or the burden of somatic single nucleotide variations (SNVs). However, a disparate copy number variation (CNV) was found in young patients with distinct clinical outcome. Combined with data from TCGA, we found that the overall survival was significantly better in young patients with low-CNV (n = 5) compared to high-CNV (n = 11) burden (P = 0.044).Conclusions: Copy number variation burden is a useful single prognostic marker for SCCOT from young, but not elderly, patients. CNV burden thus holds promise to form an important contribution when selecting suitable treatment protocols for young patients with SCCOT. [ABSTRACT FROM AUTHOR]

Objective: To determine if there is a critical depth of invasion that predicts micrometastasis in early oral tongue cancer.Methods: Retrospective series identifying patients undergoing primary surgical resection of T1 or T2 oral tongue cancer who elected against neck treatment between 2000 and 2015. Cox proportional-hazard model compared the relative hazard and cumulative incidence of recurrence to depth of invasion. The model used a 2 parameter quadratic effect for depth that was chosen based on Akaike's information criterion.Results: Ninety-three patients were identified with T1 or T2 oral tongue squamous cell carcinoma and clinically N0 neck undergoing glossectomy without elective neck treatment. 61% were male and median age was 60 years. Median follow up was 45 months, and 76 patients had at least two years of follow up. Thirty-six of 76 patients recurred (47.4%), with 15 recurring in the oral cavity (19.7%) and 21 developing nodal metastasis (27.6%). Cox proportional-hazards quadratic polynomial showed increasing hazard of recurrence with depth of invasion and the cumulative incidence increased sharply within the range of data from 2 to 6 mm depth of invasion.Conclusions: Depth of invasion is significantly associated with nodal metastasis and has been added to the 8th AJCC staging guidelines. Variable depths of invasion have been associated with regional metastasis; however, there is likely not a critical depth that predicts neck recurrence due to progressive hazards and cumulative risk of occult metastasis. The risk of regional metastasis is likely much greater than previously believed and increases progressively with increasing depth. [ABSTRACT FROM AUTHOR]

Background: The aim of the study was to present dosimetric comparison of image guided high-dose-rate brachytherapy (IGBT) with volumetric modulated arc therapy (VMAT) for head and neck cancer regarding conformity of dose distribution to planning target volume (PTV) and doses to organs at risk (OARs). Patients and methods: Thirty-eight consecutive patients with T1-4 mobile tongue, floor of mouth and base of tongue cancer treated with IGBT were selected. For these patients additional VMAT treatment plans were also prepared using identical computed tomography data. OARs and PTV related parameters (e.g. V98, D0.1cm3, Dmean, etc.) were compared. Results: Mean V98 of the PTV was 90.2% vs. 90.4% (p > 0.05) for IGBT and VMAT, respectively. Mean D0.1cm3 to the mandible was 77.0% vs. 85.4% (p < 0.05). Dmean to ipsilateral and contralateral parotid glands was 4.6% vs. 4.6% and 3.0% vs. 3.9% (p > 0.05). Dmean to ipsilateral and contralateral submandibular glands was 16.4% vs. 21.9% (p > 0.05) and 8.2% vs. 16.9% (p < 0.05), respectively. Conclusions: Both techniques showed excellent target coverage. With IGBT dose to normal tissues was lower than with VMAT. The results prove the superiority of IGBT in the protection of OARs and the important role of this invasive method in the era of new external beam techniques. [ABSTRACT FROM AUTHOR]

Carcinoma of unknown primary (CUP) comprises approximately 1%-5% of all head and neck malignancies. Primary site detection rates for metastatic cervical squamous cell carcinoma (SCC) remain variable, with current diagnostic imaging unable to identify all tumours. Prevailing evidence suggests that most head and neck CUP are located in the oropharynx. Diagnostic surgical efforts have been directed at sampling the entire oropharynx. Present techniques that make this possible include transoral robotic surgery (TORS). TORS Lingual tonsillectomy or tongue base mucosectomy performed in the setting of head and neck CUP increases the detection rate of occult tumour. The indication, surgical technique, evidence base, and controversies of performing TORS in the context of the unknown primary are presented. [ABSTRACT FROM AUTHOR]

Background: To identify the difference of surgical margin and recurrence status of early stage tongue carcinoma via wide excision in a single institution with and without free flap reconstruction. Objective: Survey whether the reconstruction methods for early tongue cancer affects disease control, survival outcomes. Methods: This was a retrospective study and patients with early tongue cancer underwent surgery via tumor ablation with (group 1 = 56) or without free flap reconstruction (group 2 = 291). Results: The percentage of patients with free margin less than 5 mm was higher in the group 2 than in group 1 (49.48% vs. 19.64%, p < .001), as the mean free margin was significantly larger in group 1 than in group 2 (7.88 mm vs. 5.68 mm; p < .001). Despite higher number of T2 stage patients in group 1 (89.29%), the group 1 resulted in a significant lower recurrence rate (p = .024). Conclusions: The utilization of free flap reconstruction for early stage tongue cancer achieved a large pathologic free margin and had relative lower recurrence and good survival rates. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Depth of invasion was added to the eighth edition American Joint Committee on Cancer guidelines for T staging of HPV‐negative oral cavity squamous cell carcinoma. Our aim was to determine the impact of depth of invasion on pathological variables and outcomes in low‐stage tongue cancer patients. We also examine the impact of tumor thickness and tumor clinical staging for comparison. Subjects and Methods: All clinical T1/T2 N0 HPV‐negative tongue squamous cell carcinoma patients who received elective neck dissections at our institution between 2000 and 2015 were included. Logistic regression models and Cox proportional hazard models were used to examine pathological variables, recurrence, and 3‐year disease‐free survival. Results: Sixty‐seven patients met criteria; the mean age was 52.0 (SD: 17.7). Depth of invasion was a significant predictor of occult metastasis (OR: 2.0, p = 0.05) and lymphovascular invasion (OR: 4.1, p = 0.02), and tumor thickness was a significant predictor of lymphovascular invasion (OR: 3.3, p = 0.04). None of the variables were predictive of recurrence or disease‐free survival. Conclusion: Depth of invasion at biopsy may be a potential useful metric to inform on regional management selection in this radiographic node‐negative population. [ABSTRACT FROM AUTHOR]

Background: To identify the difference of surgical margin and recurrence status of early stage tongue carcinoma via wide excision in a single institution with and without free flap reconstruction. Objective: Survey whether the reconstruction methods for early tongue cancer affects disease control, survival outcomes. Methods: This was a retrospective study and patients with early tongue cancer underwent surgery via tumor ablation with (group 1=56) or without free flap reconstruction (group 2=291). Results: The percentage of patients with free margin less than 5mm was higher in the group 2 than in group 1 (49.48% vs. 19.64%, p<.001), as the mean free margin was significantly larger in group 1 than in group 2 (7.88mm vs. 5.68 mm; p<.001). Despite higher number of T2 stage patients in group 1 (89.29%), the group 1 resulted in a significant lower recurrence rate (p=.024). Conclusions: The utilization of free flap reconstruction for early stage tongue cancer achieved a large pathologic free margin and had relative lower recurrence and good survival rates. [ABSTRACT FROM AUTHOR]

We report a case of a 63-year-old male who presented with synchronous pT1N1 p16-positive squamous cell carcinoma (SCC) of the left tonsil and pT4N0 p16-negative SCC of the left tongue. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 81-year-old woman with pain on the left border of the tongue having xerostomia. Topics include affected by rheumatoid arthritis and on therapy with prednisone with no recent blood tests available, no cervical lymphadenopathy, or extraoral swelling being detectable; and firm consistency seemed to originate from submucosal layer.

Down syndrome (DS), a genetic disorder caused by chromosome 21 trisomy, is characterized by intellectual disability, congenital malformations, craniofacial alterations, and dentofacial anomalies. Although some oral lesions have been reported in patients with DS, this is the first reported case of a pyogenic granuloma affecting the tongue of a patient with DS. A 20-year-old man presented with a well-demarcated nodular lesion on the right lateral border of the tongue. The 2-cm lesion had a pedunculated base, flaccid consistency, and a superficial ulceration covered by a serofibrinous pseudomembrane. The patient's mother reported that the patient had a recurring habit of traumatizing the lateral border of the tongue. A similar lesion had been surgically removed from the site 1 month earlier, but the excised tissue had not been sent for pathologic analysis. Surgical excision of the new lesion was performed under local anesthesia, and microscopic analysis confirmed the diagnostic hypothesis of pyogenic granuloma, a nonneoplastic vascular hyperplasia of a reactive nature. There was another recurrence at the same site 2 months after the second surgical excision. The patient was given a mandibular silicone mouthguard for 1 month of nightly use to prevent further trauma to the site. Complete healing of the site was observed at the 18-month follow-up examination. and there was no sign of recurrence. Considering the high prevalence of oral alterations in patients with DS, dentists should be able to recognize, diagnose, and correctly manage oral pyogenic granuloma. [ABSTRACT FROM AUTHOR]

The lingual cyst lined by respiratory epithelium is a rare pathology. It probably appears from the default of undifferentiated cells of the foregut during embryonic growth. This pathology is seen more often in males and children; however, only 5 patients younger than 4 years old have been reported. The pathophysiology and the management of this cyst were described in a 4-year-old girl. She presented with a soft mass on the dorsum of the tongue covered by normal mucosa, which existed since her birth, causing difficulty in eating, breathing, and talking. The magnetic resonance described a hyperintense image with an anteroposterior diameter of 27 mm, craniocaudal of 19 mm, and transversal of 26 mm in the midline groove of the tongue; the scintigraphy showed normality. The enucleation of the lesion was performed, eradicating the capsule of the cyst and obtaining a complete cleavage. The histopathologic examination defined a cyst lined predominantly by respiratory epithelium. Unlike in other cases, in this case their cystic lining and capsular constituents were contemplated considering the current histological recommendations. It is relevant to differentiate this pathology from other cysts with similar histological findings. [ABSTRACT FROM AUTHOR]

The presence of multiple primary oral squamous cell carcinomas (SCCs) in a single patient is rare in dental practice. A 63-year-old man was referred for evaluation of a single tongue lesion. No lymphadenopathy was detected on extraoral examination. However, multiple asymptomatic ulcerated and crusted lesions were observed on the vermilion border of the lower lip. The intraoral examination revealed an extensive, painful endophytic ulcer of 3 months' duration on the right lateral border of the tongue. No additional findings were observed. Incisional biopsies were performed, and the histopathologic analysis confirmed the diagnosis of SCCs. The patient was referred for oncologic therapy. Surgery was the treatment of choice for both the extraoral and intraoral lesions. No disease was found after 5 months of follow-up. Although uncommon, multiple oral SCCs can appear to be clinically similar to deep infectious disease. Metachronous tumors were diagnosed in this patient in light of the probable course of onset of the lesions. A rigorous clinical examination that includes the lips is essential to make an accurate diagnosis and refer the patient for appropriate treatment. [ABSTRACT FROM AUTHOR]

Low‑grade myofibroblastic sarcoma (LGMS) is a rare intermediate tumor, which rarely metastasizes and has myofibroblastic differentiation in various sites. It is particularly associated with the tongue in the head and neck region. The lack of any pathological features means it is difficult to make a conclusive diagnosis of LGMS. The immunohistochemical features and genomic rearrangements, including SS18‑SSXs and MYH9‑USP6s and the genetic mutations of cancer‑associated genes, including APC, CTNNB1, EGFR, KRAS, PIK3CA and p53 were examined in a case of LGMS arising in the tip of the tongue. Immunohistochemically, the tumor cells were positive for alpha‑smooth muscle actin and vimentin, as in previous reports. They demonstrated neither genomic rearrangements nor point mutations of cancer‑associated genes. Although several tumor cells demonstrated intravascular invasion, the MIB‑l labeling index of the cells was the same as the original lesion. To the best of our knowledge, this is the first case report of LGMS arising in the tip of the tongue with intravascular invasion. [ABSTRACT FROM AUTHOR]

Background: Certain periodontopathogenic bacteria have been linked to cancers. Treponema denticola (Td) is associated with severe periodontitis. Chymotrypsin-like proteinase (CTLP), a major virulence factor of Td, can degrade various host proteins and peptides, and modulate inflammatory responses. However, the role of Td in the tongue carcinogenesis remains unknown. This study aimed to investigate the presence of Td-CTLP in early-stage mobile tongue squamous cell carcinoma (MTSCC) and its relation to clinical and pathological characteristics.Methods: The immunopositivity of Td-CTLP was assessed in samples obtained from 60 patients with MTSCC and associated with their clinicopathological data. Additionally, Td-CTLP expression was compared with immunoexpression of matrix metalloproteinases (MMP-8 and MMP-9), toll-like receptors (TLR-2, TLR-4, TLR-7 and TLR-9), c-Myc, Ki-67, Bmi-1 and Snail.Results: Treponema denticola-chymotrypsin-like proteinase was present in 95% of MTSCC tumours of which many (40.4%) showed high immunopositivity. Td-CTLP positivity was significantly associated with invasion depth, tumour diameter and the expression of TLR-7, TLR-9 and c-Myc. High Td-CTLP immunopositivity in younger patients (≤ 60 years old) predicted early relapse.Conclusion: Our data indicate that Td and its CTLP are present in early-stage MTSCC carcinoma and may contribute to carcinogenesis, and therefore provide novel perspectives into intervention and therapeutic measures of MTSCC. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the capability of indirect computed tomography and magnetic resonance lymphography (CT/MR-LG) with gadolinium-loaded, polyethylenimine-entrapped gold nanoprobes (Gd-Au PENPs) for assessing lingual sentinel lymph node (SLN) metastasis in a tongue VX2 carcinoma model. Materials and methods: Seventeen rabbits were used to establish a metastatic cervical lymph node model by implanting VX2 carcinoma suspension into the ventral tongue muscle. CT and MR images were acquired one hour after Gd-Au PENPs injection into the tongue submucosa bilaterally, on 1w (n = 4), 2w (n = 6) and 3w (n = 7) tumour-bearing rabbits after carcinoma transplantation. Then, the filling defects and enhancement features of the lingual SLN on indirect CT/MR-LG were assessed. Results: The enhanced lingual SLNs were observed bilaterally in all rabbits using indirect CT/MR-LG. In total, 15 enhanced SLNs displayed oval or round shape with uniform density and no filling defects or only local small filling defects, and all nodes were metastasis-negative, while 19 enhanced SLNs demonstrated irregular morphologies with filling defects, non-uniform densities and unclear borders, of which 14 nodes were metastatic. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value when using SLN enhancement with irregular morphology, filling defects, non-uniform density and unclear border as diagnostic criteria for metastasis were 100%, 75.0%, 85.3%, 73.7% and 100%, respectively. Conclusions: Indirect CT/MR-LG with Gd-Au PENPs can be used for the metastatic diagnosis of lingual SLN in tongue cancer. [ABSTRACT FROM AUTHOR]

Background: Thymol is a transient receptor potential ankyrin subtype 1 channel, (TRPA1) agonist found in thyme and oregano. Thymol has antioxidant, anti-inflammatory, and antimicrobial properties; thus, thymol is added to many commercially available products including Listerine mouthwash. Thymol is also cytotoxic to HL-60 (acute promyelocytic leukemia) cells in vitro. Therefore, we evaluated the effects of thymol against oral squamous cell carcinoma (OSCC) and its anticancer mechanism-of-action.Methods: The antiproliferative effects of thymol in OSCC Cal27 cells were determined by MTS assays. Antitumor effects were evaluated in Cal27- and HeLa-derived mouse xenografts. Calcium imaging, mitochondrial transmembrane potential (ΔΨm) studies, and Western blot analysis of cleaved PARP (c-PARP) evaluated thymol's mechanism-of-action.Results: Thymol had significant, long-lasting antiproliferative effects in vitro. In vivo, thymol displayed significant antitumor effects in Cal27-derived tumors. Thymol's anticancer effects were confirmed in HeLa-derived xenografts demonstrating that thymol effects are not tumor-type specific. Calcium imaging verified calcium influx in Cal27 cells that were reversed with the TRPA1 antagonist, HC030031. However, no calcium influx was seen in HeLa cells indicating that TRP channels do not regulate thymol cytotoxicity. This was confirmed using cell viability assays in which pre-treatment with HC030031 had no effect on thymol cytotoxicity. Instead, ΔΨm studies revealed that thymol induces significant ΔΨm depolarization and apoptosis.Conclusion: Our findings provide the first evidence of thymol's novel antitumor effects against OSCC in vivo, which do not rely on TRPA1 activity. Instead, we show that thymol induces mitochondrial dysfunction and apoptosis and may be efficacious against multiple cancers. [ABSTRACT FROM AUTHOR]

This study investigated a case of spindle cell carcinoma (SpCC) in tongue pathological lesions. The patient experienced a local recurrence and distant metastasis after surgical intervention. Although standard chemotherapy was administered, a granulomatous mass continued to develop. This aggressive growth led to survival of the tumor. Secondary debulking surgery was performed to improve the patient's quality of life at the request of the patient. Using a tissue sample derived from the secondary debulking surgery, we performed an analysis of the tumor's cell surface antigens, differentiation potential, metastatic ability, and inhibition potential by anticancer reagents. In vitro analysis revealed that the cell population grown under adherent culture conditions expressed the mesenchymal stem cell (MSC) markers CD73, CD90, and CD105. The cell line established from this SpCC contained colony-forming unit fibroblasts (CFU-Fs) and exhibited multipotent differentiation into several mesenchymal lineages, including bone, cartilage, and fat. The SpCC cells also displayed vigorous mobilization. These characteristics suggested that they had the differentiation potential of mesenchymal cells, especially MSCs, rather than that of epithelial cells. The surgical specimen analyzed in this study resisted the molecular target reagent cetuximab, which is an epidermal growth factor receptor inhibitor. This clinical insight revealed that chemotherapy-resistant SpCC cells have different characteristics compared to most other cancer cells, which are sensitive to cetuximab. Our cell death assay revealed that SpCC cell death was induced by the anticancer drug imatinib, which is known to inhibit protein tyrosine kinase activity of ABL, platelet-derived growth factor receptor α (PDGFRα), and KIT. Here, we report recurrent SpCC with characteristics of MSCs and potential for treatment with imatinib. [ABSTRACT FROM AUTHOR]

Carcinoma cuniculatum (CC) is a rare variant of squamous cell carcinoma (SCC). Only 27 cases have been published in English. A 50-year-old male, who presented a white nodule with erythematous areas, localized in the lateral border of the tongue with 2 months of duration. The patient presents oral lichen planus lesions on the tongue, commissure, and buccal mucosa. The microscopy evaluation of the nodular lesion of the tongue revealed a malignant epithelial neoplasia characterized by cuniculatum architecture, similar in appearance to "rabbit burrows" and the final diagnosis was of CC. The management of CC needs cooperation between surgeons and pathologists to establish a correct diagnosis and treatment. CC is a rare entity and must be recognized by oral pathologist so that it is not misdiagnosed as verrucous carcinoma or oral SCC (OSCC). Regarding prognosis, CC must be evaluated and distinguished from other variants of OSCC. [ABSTRACT FROM AUTHOR]

The role of autophagy in tongue squamous cell carcinoma (TSCC) cisplatin resistance is unclear. We aimed to identify a possible synergistic effect of autophagy inhibitors and cisplatin in TSCC cells and explore the underlying mechanism. Our results indicate that autophagic flux was high in TSCC cells; Autophagy inhibitor bafilomycin A1 increased cisplatin cytotoxicity in TSCC cells by inhibiting lysosomal uptake of platinum and enhancing intracellular platinum ion binding to DNA; Autophagy gene (Atg5) knockout in TSCC cells did not duplicate the above-mentioned sensitization of bafilomycin A1. Furthermore, we found that cisplatin resistance of TSCC cells was related to cisplatin inducing lysosome biogenesis in a TFEB-dependent manner, which was regulated by c-Abl. In summary, this is the first study to show that Bafilomycin A1 increases the sensitivity of TSCC cells to cisplatin by inhibiting lysosomal function but not autophagy. Lysosomes may be a potential target to increase cisplatin cytotoxicity toward TSCC cells. [ABSTRACT FROM AUTHOR]

Ectomesenchymal chondromyxoid tumor (ECT) is a rare benign neoplasm, often affecting the anterior dorsum of the tongue. To date, approximately 74 cases of lingual ECT have been published. This report describes, for the first time, the morphological and immunohistochemical features of a unique ECT case, which revealed diffuse infiltration by immune cells with a dendritic-like appearance inside the tumor proliferation. The significance of these findings and discussion about the tumor cell-immune cell interactions are presented. [ABSTRACT FROM AUTHOR]

Background: Osteonecrosis of the jaw (ONJ) is a serious complication of both radiation and antiresorptive therapies. This study aimed to determine how many patients have been treated for medication-related osteonecrosis of the jaws (MRONJ) and osteoradionecrosis (ORN), and whether the number of diagnoses has decreased over time with improved awareness and preventative measures.Methods: Medical records at the Royal Brisbane and Women's Hospital, Gold Coast University Hospital and Robina Hospital were reviewed to identify patients diagnosed with MRONJ and ORN between January 2003 and May 2017. Data on patient demographics, year of admission and primary disease were analysed.Results: Two hundred and thirty-eight patients were diagnosed with ONJ, of which 74.4% were ORN and 25.6% were MRONJ. Tongue (24.6%), floor of mouth (17.3%) and tonsillar (15.1%) squamous cell carcinomas were the most common primary diseases associated with ORN, with a strong male predominance (80%). Of patients diagnosed with MRONJ, 52.5% were taking low-dose antiresorptives for osteoporosis (44.2%), rheumatoid arthritis (4.6%) or Paget's disease (3.3%), while 47.5% were oncology patients receiving high-dose antiresorptives.Conclusions: The number of patients diagnosed with MRONJ and ORN has trended upwards since 2003. ORN affected three times more patients than MRONJ, and patients on low-dose antiresorptives accounted for over half of the MRONJ cases. [ABSTRACT FROM AUTHOR]

Bazex syndrome (acrokeratosis paraneoplastica) is an uncommon dermatologic condition associated with an underlying malignancy, most commonly squamous cell carcinomas of the head and neck. This article describes Bazex syndrome in a 56-year-old woman who presented with bilateral cervical lymphadenopathy and a mass at the base of her tongue. [ABSTRACT FROM AUTHOR]

Background: Aimed at underlying the molecular regulatory mechanism and overall biological functions of LINC00511 in tongue squamous cell carcinoma (TSCC).Methods: The expression level of LINC00511 was examined by QRT-PCR. In particular, Tca-8113 cell line was selected for subsequent experiments, in which the expression level of LINC00511 was the most significant. Meanwhile, the effects of LINC00511 on cells proliferation, cell cycle distribution, and invasion of TSCC cells were explored using RNA knockdown tools with CCK-8, flow cytometry analysis, colony formation, and transwell assay. Further, bioinformatic analysis and the dual-luciferase reporter assay both were conducted to invalidate the ceRNAs regulatory mechanism of LINC00511 in TSCC.Results: LINC00511 was obviously upregulated in TSCC tissues and cell lines. Moreover, it was found that LINC00511 served as a competing endogenous RNA (ceRNA) through sponging miR-765 and ultimately modulated the derepression of laminin subunit gamma 2 (LAMC2). The inhibitory effects of miR-765 on TSCC cells proliferation, invasion as well as cell cycle distribution can be restored by the ectopic overexpression of LINC00511. Additionally, the restored capacity of LINC00511 promoted the expression of LAMC2, which was a downstream target of miR-765 and can be negatively regulated by miR-765.Conclusions: A novel molecular axis of LINC00511/miR-765/LAMC2 was investigated to regulate the tumor development of TSCC. LINC00511 promoted the expression of LAMC2 via the ceRNA mechanism of sponging miR-765. The ceRNA regulatory network provided a novel understanding of TSCC pathogenesis and also shed light on exploiting the new field of lncRNA-directed therapy against TSCC. [ABSTRACT FROM AUTHOR]

Objectives: (1) To assess the statistical correlation between the tumor thickness (TT) by ultrasonography (USG) and microscopic measurement in cases of early oral tongue squamous cell carcinoma (OTSCC). (2) To assess the predictive capacity of TT by ultrasound in detecting nodal metastasis. Materials and Methods: Prospective analysis was performed in 24 patients for a period of 2 years from 2012 to 2013. Nodal status and TT measurement was done preoperatively by neck and intraoral USG respectively in cases of early (pT1 & T2, clinically N0) OTSCC. As per the institution protocol after histopathological confirmation of malignancy, all patients underwent resection of primary lesion and ipsilateral elective neck dissection (Level - I to IV). Measurement of TT was obtained intraoperatively from fresh glossectomy specimen and postoperatively from histopathological paraffin section examination. The statistical correlation between TT measured by USG and histopathology was assessed by Pearson's correlation coefficient. Chi-square test was used to find the association of pathological T stage, TT with pathological nodal status. Results: Significant statistical correlation was seen between TT by USG and microscopic measures. Between the two, TT measurements were within 1 mm in 37.5% (9/24) of cases, within 2 mm in 29.16% (7/24), and was greater than 2 mm in 8 cases. The Pearson's correlation r is 0.678 (P < 0.001) and ICC (interclass correlation coefficient) is 0.808. The average difference between microscopic and US thickness (Bias) is -0.14637 and the limits of agreement is (4.717, -4.863) with 95% limits of agreement. The rate of occult nodal metastasis was 16.6% and TT of <4 mm had no incidence of nodal metastasis. Conclusion: Ultrasonographic evaluation is reliable and cost-effective tool to measure the TT preoperatively, which will be of help in deciding the management in early OTSCC. TT of 4 mm and above was predictor of occult cervical nodal metastasis. [ABSTRACT FROM AUTHOR]

Introduction: Smoking and alcoholism are recognized factors associated with the prevalence of oral cancer. However, the role of these habits on the severity of lesions still needs to be elucidated.Objective: To evaluate the prevalence of tongue and mouth floor cancer according to the clinical stage and how it correlates with alcoholism and smoking habits in Brazil from 2000 to 2010.Methods: Data referring to 11,873 cases of tongue and mouth floor cancer were obtained from the Integrator Module of the Hospital Registry of Cancer. Internal inconsistencies (non-classified cases) and data with no relevant information were eliminated. The final sample value considered for statistical analysis was equal to 8417 cases. An analysis of frequency distribution and binary logistic regression modeling was performed, using a significance level of 5%.Results: The concomitant use of alcohol and tobacco (69%, n = 5808) and clinical stage grade IV (55.9%, n = 4703) were the most frequent findings. A higher prevalence of advanced lesions was observed in 2008 (PR = 1.715, 95% CI = 1.254-2.347, p < 0.01). The prevalence ratio of advanced tongue and mouth floor cancer (clinical stages III and IV) was observed to be significant for both smokers only (p < 0.01; PR = 1.460; 95% CI = 1.222-1.745) and for individuals who were both smokers and alcoholics (p < 0.05; RP = 2.279; 95% CI = 1.980-2.622). Conclusion: Data from the 11-year registry suggest that smoking contributes significantly to the prevalence of advanced cases of tongue and mouth floor cancer. It is also implied that concomitant use of alcohol and tobacco increases the prevalence of advanced-stage oral cancer. Prospective cohort studies are still necessary to prove such relationships. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the performance of surveillance F-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) 1 year after imaging in oral squamous cell carcinoma (OSCC) patients treated with definitive surgery and adjuvant (chemo)radiotherapy (RT). Methods and Materials: Surveillance PET/CT accuracy was retrospectively evaluated in OSCC patients receiving surgical resection and (chemo)RT. Pathologic risk factors were assessed for influence on accuracy of the post-RT PET/CT. Results: Fifty-four patients with median follow-up of 3.8 years met inclusion criteria. A PET/CT obtained a median of 3.4 months after RT revealed 11 (20.4%) instances of true disease recurrence: 4 locoregional alone, 6 distant alone, and 1 patient with locoregional and distant disease. Locoregional detection sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 55.6%, 75.0%, 33.3%, and 88.2%, respectively. For distant recurrence, the respective values were 100%, 95.2%, 77.8%, and 100%. Absence of bone invasion, absence of pT4 disease, and disease within the tongue were independently associated with higher sensitivity (P = .048). Perineural invasion was associated with increased specificity (P = .027), and tumor location in the tongue was associated with a higher PPV (P = .007) on surveillance PET/CT. Conclusions: Post-RT PET/CT accuracy information for surgically managed OSCC patients demonstrates significant associations with pathologic factors. [ABSTRACT FROM AUTHOR]

Renal transplant recipients are at a higher risk of malignancy. We report our experience and the critical differences in the presentation of malignancy in kidney transplant patients performed at our tertiary care center and followed up over the period of 1990–2015. A total of 338 live donor transplants performed in 332 patients were analyzed. Induction immunosuppression was used in 22 cases with interleukin-2 (IL-2) receptor antibody. Overall 299 patients were continued on calcineurin inhibitor (CNI)-based triple drug immunosuppression, 33 were off CNI with 13 of them receiving sirolimus additionally. A total of 16 malignancies including post transplant lymphoproliferative disease (5), oral cancer (5), lung cancer (2), hepatobiliary cancer (2), colon cancer (1), and skin cancer (1) were diagnosed in 15 patients. Over the 26-year follow up, 138 patients died of whom 12 died due to cancer. Cancer occurred in 4.7% of patients but accounted for 9.4% of deaths. Oral cancer occurred after a significantly longer latency of over 10 years (212 vs. 94 months, P = 0.00652). Despite the longer latency, oral cancer patients were younger at diagnosis (44.0 vs. 52 years, P = 0.01016) and had better outcome (Fisher's exact test, P = 0.0275). This was despite a longer overall follow-up for the oral cancer patients, reflecting the better outcome for these patients (24 vs. 4 months, P = 0.0278). This might be the result of relatively early diagnosis of oral cancers. [ABSTRACT FROM AUTHOR]

Canine T-zone lymphoma (TZL) is a subtype of T-cell lymphoma characterized by unique histologic pattern and cytomorphology, immunophenotypic loss of CD45 expression, and an indolent clinical behaviour. Dogs with TZL typically present with 1 or more enlarged lymph nodes and/or lymphocytosis. We describe a novel extranodal presentation of TZL involving the tongue. Twelve dogs with tongue masses were diagnosed with lingual TZL based on a variable combination of immunophenotyping via flow cytometry, cytology, histopathology, immunohistochemistry and/or PCR for antigen receptor rearrangement (PARR) assay. Eleven dogs exhibited concurrent lymphocytosis and/or lymph node enlargement. Three cases were initially diagnosed as plasma cell tumours based on histology alone, thereby revealing a potential diagnostic challenge. Seven dogs achieved clinical remission and 4 achieved stable disease following variable treatment, consistent with the indolent nature of typical TZL involving the lymph nodes and peripheral blood. In 1 case the TZL resulted in progressive disease and failure to respond to treatment. In this case, the TZL exhibited histologic features of a higher grade neoplasm. This case series highlights a unique presentation of TZL and identifies a new differential diagnosis for lingual neoplasia. In this study, we characterize the clinical presentation, diagnostic features and patient outcomes of 12 dogs with lingual TZL. [ABSTRACT FROM AUTHOR]

Oral carcinoma develops from squamous epithelial cells by the acquisition of multiple (epi) genetic alterations that target different genes and molecular pathways. Herein, we performed a comprehensive genomic and epigenetic characterization of the HSC-3 cell line through karyotyping, multicolor fluorescence in situ hybridization, array comparative genomic hybridization, and methylation-specific multiplex ligation-dependent probe amplification. HSC-3 turned out to be a near-triploid cell line with a modal number of 61 chromosomes. Banding and molecular cytogenetic analyses revealed that nonrandom gains of chromosomal segments occurred more frequently than losses. Overall, gains of chromosome 1, 3q, 5p, 7p, 8q, 9q, 10, 11p, 11q13, 12, 13, 14, 17, 18p, 20, Yp, and Xq were observed. The largest region affected by copy number loss was observed at chromosome 18q. Several of the observed genomic imbalances and their mapped genes were already associated with oral carcinoma and/or adverse prognosis, invasion, and metastasis in cancer. The most common rearrangements observed were translocations in the centromeric/near-centromeric regions. RARB, ESR1, and CADM1 genes were methylated and showed copy number losses, whereas TP73 and GATA5 presented with methylation and copy number gains. Thus, the current study presents a comprehensive characterization of the HSC-3 cell line; the use of this cell line may contribute to enriching the resources available for oral cancer research, especially for the testing of therapeutic agents. [ABSTRACT FROM AUTHOR]

The glycolytic enzyme Hexokinase (HKII) participates in tumor glycolysis and the progression of various cancers, but its clinicopathological effect on the progression of tongue squamous cell carcinoma (TSCC) and its role in glycolysis, autophagy, and the epithelial-mesenchymal transition of TSCC in a hypoxic microenvironment remain unknown. Our results showed that HKII expression was dramatically increased in TSCC tissues and that its upregulation was significantly associated with the presence of pathological differentiation, lymph node metastasis, and clinical stage. The level of autophagy-specific protein LC3, EMT-related proteins, and the migration and invasion capabilities of TSCC cells all increased under hypoxia. Moreover, hypoxia increased the glucose consumption and lactate production of TSCC cells, and we demonstrated that the expression of the glycolytic key gene HKII was significantly higher than in that of the control group. Notably, the downregulation of HKII resulted in a significant decrease of TSCC cell glucose consumption lactate production and autophagic activity during hypoxia. HKII knockdown blocked the migratory and invasive capacity of TSCC cells and we specifically determined that the EMT ability decreased. Therefore, our findings revealed that the upregulation of HKII enhanced glycolysis and increased autophagy and the epithelial-mesenchymal transition of tongue squamous cell carcinoma under hypoxia. [ABSTRACT FROM AUTHOR]

Aim Distal metastases to oral cavity are very rare. Adenocarcinoma, renal cell carcinoma (RCC) and squamous cell carcinoma are the most common metastatic tumours. The aim of this study was to assess the diagnostic relevance of metastatic renal cell carcinoma on tongue manifestations in large patient series. Methods A patient with distal RCC metastases to the tongue and neck lymph nodes as the first manifestations of malignancy was presented. Also, all reports described during 106-year period relating to distal RCC metastasis to the tongue were evaluated. Results In the presented patient, initial presentation of RCC was metastasis to the tongue. Three months after nephrectomy, tongue tumour resection and radical neck dissection were performed. Histopathological analysis confirmed RCC metastasis. Postoperatively, the patient underwent radiotherapy and polychemotherapy. Tongue metastasis from RCC is extremely rare with only 51 cases reported during the 106-year period. In only 7 patients tongue metastasis was reported as an initial presentation of RCC. Conclusion The RCC metastasizing to the tongue is extremely rare and thus it poses a diagnostic challenge especially when it is the first sign of malignancy. Therapeutic decisions should maximize patient comfort and minimize morbidity considering the poor long-term prognosis. [ABSTRACT FROM AUTHOR]

Background:Appropriate selection of tongue cancer patients considering surgery is critical in ensuring optimal outcomes. The American College of Surgeons' National Surgical Quality Improvement Program (‘ACS-NSQIP’) risk calculator was developed to assess patients' 30-day post-operative risk, providing surgeons with information to guide decision making.Method:A retrospective review of 30-day actual mortality and morbidity of tongue cancer patients was undertaken to investigate the validity of this tool for South Australian patients treated from 2005 to 2015.Results:One hundred and twenty patients had undergone glossectomy. Predicted length of stay using the risk calculator was significantly different from actual length of stay. Predicted mortality and other complications were found to be similar to actual outcomes.Conclusion:The American College of Surgeons' National Surgical Quality Improvement Program risk calculator was found to be effective in predicting post-operative complication rates in South Australian tongue cancer patients. However, significant discrepancies in predicted and actual length of stay may limit its use in this population. [ABSTRACT FROM PUBLISHER]

Objective: The objective of this study is to examine therapeutic effect of the combination of radiotherapy and ozone which features increasing of the destruction of cancer cells by increasing oxygen level of the body on advanced tongue cancer induced in rats.Methods: A total of 36 female rats were included in this study as 4 groups. Group 1 (Cancer, n=8): 4NQO. Group 2 (Cancer+Radiotherapy, n=10): 4NQO+Radiotherapy. Group 3 (Cancer+Ozone+Radiotherapy, n=10): 4NQO+Ozone+Radiotherapy. Group 4 (Cancer+Ozone, n=10): 4NQO+Ozone. Group 5 (Control, n=8): Physiological saline solution. At the end of the week 20, rats in Groups 1 and 5 were sacrified. The rats in Groups 2,3 and 4 were waited until oral food intake was disrupted. The necessary applicatione were then carried out and survivals were evaluated. Each rat was sacrified after death. Tongues of the rats were excised, stained with hematoxylin & eosin and histopathologically evaluated.Results: Histopathologic evaluation: The model that we applied was seen to achieve success in Group 1 in which 7 of the rats developed squamous cell carcinoma and one rat developed dysplasia at the end of the week 20. In Group 2 squamous cell cancer was seen in 6 and dysplasia in 4 rats. Six rats presented normal tongue tissues and 4 rats developed hyperplasia in Group 3. In Group 4; 3 rats had squamous cell cancer, 2 rats dysplasia, 3 rats hyperplasia and 2 rats had normal tissue. In Group 5, normal tongue tissues were observed in all rats. A significant histopathological improvement was observed in Group 3 compared to Group 2 (p<0.05). Histopathologic scorings were similar in Groups 3 and 5 (p>0.05). No statistically significant difference was found in histopathologic scorings between Group 1 and Group 2 (p>0.05). A significant improvement was observed in Group 4 compared to Group 1 (p<0.05). Group 3 showed a significant histologic improvement compared to Group 4 (p<0.05). Evaluation of survival: Survival times were found as 3.4±1.3 days, 76.4±14.9days and 76.4±14.9 days in the Groups 2, 3 and 4; respectively. Survival was significantly longer in Group 3 than in Groups 2 and 4 (p<0.05). Survival was significantly longer in Group 4 compared to Group 2 (p<0.05).Conclusion: In this study, demonstrated that radiotherapy plus ozone application both provided histopathological improvement and prolonged survival in advanced tongue cancer rat model. [ABSTRACT FROM AUTHOR]

Voice quality outcome becomes an important factor in the choice of the therapeutic option. The differences between radiotherapy and laser cordectomy have been extensively debated in the literature. We analyzed the vocal outcomes after carbon dioxide (CO2) laser cordectomy and radiotherapy treatment for T1a-b early glottic cancer by means of objective and subjective voice evaluation. A retrospective study was performed on 56 cancer patients, 30 treated with cordectomy and 26 with radiotherapy. All patients underwent laser cordectomy which was performed under general anesthesia using a surgical microscope in laryngeal suspension. The laser we used was an Ultrapulse one, 10.6-μm wavelength, and a power setting of 2 to 4 W in an Ultrapulse mode was selected. Two different sets of data were recorded: (a) voice acoustic analysis (jitter, shimmer, fundamental frequency and noise/harmonic ratio) and (b) voice handicap index (VHI). Data collected were statistically analyzed using SPSS 20.0 for Windows. Jitter, shimmer, and signal-to-noise ratio were significantly altered in both glottic cancer patient groups as compared to the control group. On the contrary, no statistically significant alteration of the fundamental frequency was found in both treatment groups. Interestingly, jitter and shimmer values were significantly more compromised in transoral laser surgery patients as compared with radiotherapy-treated patients. The VHI was also significantly altered in both cancer patient groups as compared to the control group. More importantly, however, the self-evaluation voice analysis was not significantly different between the two treatment groups, contrary to what we observed for two of the four parameters measured in the objective voice analysis. Given the importance of the self-perception of the voice quality, no treatment can be considered superior from the patients' point of view. Therefore, we suggest that priority should be given to the endoscopic surgery, due to lower costs, lower morbidity, and shorter hospitalization. [ABSTRACT FROM AUTHOR]

Objectives: Margin status and invasion pattern are prognostic factors for oral tongue squamous cell carcinoma (OTSCC). Current methods to identify these factors are limited to 2D observation; it is necessary to explore 3D reconstruction with whole-mount sample to improve the accuracy of analysis. This study aimed to study the tissue preparation, section generation, and 3D reconstruction with whole-mount OTSCC specimen.Study Design: Two OTSCC samples were retrieved from Nanjing Stomatological Hospital, Medical School of Nanjing University. One sample was sliced into 3 equal-sized pieces and subjected to different processing schedules to determine the best method. The second sample was processed accordingly. Serial whole-mount sections of the second sample were generated, stained with HE/anticytokine antibody in intersection manner, and scanned into digital images. Digital images were aligned and reconstructed into 3D images with Hetero Genius Medical Image Manager 3D Pathology Add-On [HGMIM3D].Results: Successful serial whole-mount sections of comparable quality to traditional sections were generated. Three-dimensional images with serial whole-mount sections were successfully generated.Conclusions: Whole-mount histopathological 3D reconstruction of OTSCC was successfully generated, providing a solid foundation for comprehensive margin and invasion analysis. Although future study and improvement were needed, whole-mount histopathological 3D reconstruction proved to be a promising method in OTSCC study. [ABSTRACT FROM AUTHOR]

Schwannomas (also known as neurilemomas) are benign tumors that arise from the Schwann cells of the nerve sheath. While they seldom occur in the oral cavity, the tongue is the most common site. Palatal schwannomas are extremely rare. This article reports a case of a large, slowly developing schwannoma that caused bone erosion in the hard palate of an 18-year-old man. The diagnosis was based on histopathologic and immunohistochemical findings. The tumor was completely excised, and no recurrence was observed at a 1-year follow-up. This case is notable for the large dimensions, long period of evolution, and the uncommon anatomical site of the tumor. A review of the main clinical and histologic characteristics of palatal schwannomas reported in the last 40 years is also provided. [ABSTRACT FROM AUTHOR]

Background: Tongue squamous cell carcinoma is one of the prominent cancers in the oral cavity. Molecular investigations based on interaction analysis can be promising towards providing a better resolution of malignant neoplasms. Here, the protein-protein interaction network of tongue cancer is studied. Methods: The protein-protein interaction network was constructed by the application of Cytoscape 3.5.1 and the related algorithms. Centrality analysis via the degree, betweenness, and closeness centralities was conducted. Results: The result indicated that there are seven chief proteins in the network foundation. Moreover, enrichment evaluation suggested two associated biological processes including Response to UV-A, Response to interlukin-7, cellular response to alcohol, and catenin import into nucleus process using CluePedia. Conclusions: It can be concluded that the identified central panel proteins and their related biological processes can shed light on the neoplasm mechanisms and are worth pursuing for clinical approaches. [ABSTRACT FROM AUTHOR]

Objectives: To improve margin revision, this study characterizes the number, fragmentation, and orientation of tumor bed margins (TBM) in patients with pT1-2 pN0 squamous cell carcinoma (SCC) of the oral tongue.Materials and Methods: Pathology reports (n=346) were reviewed. TBM parameters were indexed. In Group 1 patients all margins were obtained from the glossectomy specimen and there were no TBM. In Revision Group/Group 2 (n=103), tumor bed was sampled to revise suboptimal margins identified by examination of the glossectomy specimen. In Group 3 (n=124), TBM were obtained before examination of the glossectomy specimen.Results and Conclusions: Fewer TBMs were obtained per patient in Group 2 compared to Group 3 (57/103, 55% of patients with <3 vs. 117/124, 94%, ≥3 TBMs, respectively). The new margin surface was more frequently indicated in Group 2 compared to Group 3 (59/103, 57%, vs. 19/124, 15%, p<.001). If glossectomy specimen margins are accepted as the reference standard, then the TBM was 15% sensitive in Group 2 (95% confidence interval [CI], 7-29) and 32% sensitive in Group 3 (95% CI, 15-55). TBM fragmentation (23/103, 22% vs. 42/124, 34%) and frozen vs. permanent discrepancies (8/103, 3% vs. 3/124, 2%) were similar between Groups 2 and 3. The new margin surface was not indicated in 6 of 11 cases with discrepant frozen vs. permanent pathology findings, precluding judgment on final margin status. To facilitate the assessment of final margins, TBM should be represented by one tissue fragment with a marked new margin surface. [ABSTRACT FROM AUTHOR]

Extramedullary plasmacytomas (EPs) are responsible for 2.5% of neoplasms in dogs. They are solitary, smooth, elevated, pink or red nodules, of 1 to 2cm in diameter. Cutaneous and oral extramedullary plasmacytomas in dogs are usually benign tumors, treated with local therapies. Prognosis is generally good. Recurrence and metastatic rates are low. Electrochemotherapy is a local treatment that combines chemotherapy and electroporation and shows objective responses of 70% to 94% with few local and systemic side effects. This scientific communication has the objective to report treatment of three canine patients with oral extramedullary plasmacytoma. Nodules were located on the tongue and patients were submitted to one or two electrochemotherapy sessions, which preserved the tongue without mutilation and cured the patients. [ABSTRACT FROM AUTHOR]

Background: Non-traumatic bone fractures in cancer patients are usually pathological fractures due to bone metastases. In head and neck cancer patients, clavicle stress fractures may occur as a result of atrophy of the trapezius muscle after neck dissection in which the accessory nerve becomes structurally or functionally damaged. Case report: A 71-year-old man underwent modified radical neck dissection with accessory nerve preservation and post-operative radiotherapy for submandibular lymph node metastases of tongue cancer. Four weeks after the radiotherapy, a clavicle fracture, with osteomyelitis and abscess formation in the pectoralis major muscle, occurred. Unlike in simple stress fracture, long-term antibiotic administration and drainage surgery were required to suppress the inflammation. Conclusion: As seen in the present patient, clavicle stress fractures may occur even after neck dissection in which the accessory nerve is preserved, and may be complicated by osteomyelitis and abscess formation owing to risk factors such as radiotherapy, tracheostomy and contiguous infection. [ABSTRACT FROM AUTHOR]