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The spindle cell variant of ameloblastic carcinoma is an extremely rare, malignant, odontogenic tumor. In the updated 2017 World Health Organization classification of odontogenic and maxillofacial bone tumors, ameloblastic carcinoma is classified as an odontogenic carcinoma, with the spindle cell variant following an aggressive course. We report a rare autopsy case of spindle cell variant of ameloblastic carcinoma, for which the patient underwent repeated surgical operations because of its persistent recurrence. The patient died 13 months after the final operation. Autopsy examination showed that the wobbliness (staggering) that the patient reported was caused by a metastatic lesion on the skull base. There was autopsy evidence of metastases in the lungs and pleura as well.

Intraosseous schwannoma in the oral and maxillofacial regions is rare. It arises most commonly in the posterior region of the mandible due to the presence of the inferior alveolar nerve. There have been only seven reported cases of intraosseous schwannoma localized in the anterior region of the mandible, all of which involved unilocular radiolucency. In this study, we report the rare case of an intraosseous schwannoma localized in the anterior mandible with multilocular radiolucency. The radiographic and clinical features of this case may be helpful for providing a correct diagnosis and treatment in the future.

We present a case of pyogenic granuloma arising in the dorsum of the tongue in a 1-month-old boy with cleft palate. Pyogenic granuloma was apparently caused by chronic mechanical irritation to the tongue caused by sucking an artificial nipple.The observation of his tongue movements while nursing were examined with an X-ray TV system to determe how the irritation developed.

Iatrogenic tooth displacement is a rare complication during extraction of impacted molars, but displacement of a maxillary third molar into the maxillary sinus, infratemporal fossa, buccal space, pterygomandibular space, and lateral pharyngeal space has been reported. Currently, 6 published reports describe third molar displacement into the lateral pharyngeal space, only 1 of which involved the loss of a maxillary third molar into this area, which occurred after an attempted self-extraction by the patient. There have been no reported cases of iatrogenic displacement of the maxillary third molar during an extraction procedure. This article describes the recovery, under general anesthesia, of a maxillary third molar from the lateral pharyngeal space after an iatrogenic displacement.

We report a 53-year-old female patient with an unresectable metastasis to the supraclavicular lymph node from a primary gingival carcinoma of the mandible. The patient had a history of tongue carcinoma and had undergone a radical neck dissection for the treatment of gingival carcinoma. She underwent combined chemotherapy consisting of S-1 (80 mg on days 1-14, followed by a 7-day rest), docetaxel (35mg/m2 by intravenous infusion on days 1 and 8), and CDDP (10mg/m2 by intravenous infusion on days 1 and 8) every 3 weeks. After three courses of the above chemotherapy regimen, a computerized tomography examination revealed a complete response. The patient did not experience any severe side effects during the course of chemotherapy. Combined S-1, docetaxel, and CDDP chemotherapy can thus be effective for unresectable recurrences of oral cancer in lymph nodes.

For a clinical application of Cefazolin (CEZ, Cefamezin (R) ) in the maxillofacial region, CEZ 2g was administered by intravenous drip infusion to 26 patients and a pharmacokinetic analysis was performed for CEZ concentrations in the mandibular and maxillary bones.The serum concentration of CEZ was 82.0 μg/ml after 1 hour, 46.8 μg/ml after 2 hours, 15.3 μg/ml after 4 hours and 5.0 μg/ml after 6 hours. The half life of CEZ in the serum was 1.24 hour. The concentration of CEZ in the bone was 5.7 μg/mg after 1 hour, 4.0 μg/mg after 2 hours, 2.0 μg/mg after 4 hours and 1.0 μg/mg after 6 hours. The half life of CEZ in the bone was 1.99 hour. The concentration in the bone relative to that in the serum ranged from 6 to 20%.As for the intraosseous concentration and MIC80 values of bacteria, the former exceeded the latter in most bacterial strains.The above results suggest that CEZ is useful for the treatment of various infections in the maxillofacial regions.

A case of angiokeratoma occurring at the dorsal surface of the tongue is presented. The patient was a 6-year-old girl who had no other complication. The lesion was diagnosed clinically as a hemangioma. We examined biopsy specimens and performed cryosurgery. Histologically, cavernous dilatation of the papillary vessels and so-called “blood cyst” formation were observed. The pathological diagnosis was angiokeratoma. The postoperative murse was uneventful.

The prevalence of peculiar gingival hyperplasia was studied periodontically in 169 patients treated with antihypertensive agents. A total of 129 patients were receiving calcium antagonists and the other 40 were receiving other types of antihypertensive agents.Gingival hyperplasia was observed in 19 % of the patients in the calcium antagonist group. There was no clear relationship between oral hygiene indexes and the occurrence of gingival hyperplasia. Among patients in the calcium antagonist group, there was no significant difference in the duration of treatment between those with gingival hyperplasia and those with no gingival hyperplasia.The results suggest that the peculiar gingival hyperplasia associated with calcium antagonists is not related only to the dose of these drugs.

Acanthosis nigricans, which generally appears on the skin and only uncommonly occurs on the oral mucosa, is characterized by papillary proliferation, hyperkeratosis, and pigmentation. A rare case of acanthosis nigricans of the hard palate is presented.A 64-year-old woman presented with a slight rough feeling of the hard palate. During the past 3 months, she noticed multiple papillary lesions in the mouth and dark pigmentation extending from the neck to the back. Oral examination indicated multiple, amall, nonpigmented, papillomatous nodules on the hard palate. Histological examination revealed papillomatosis and acanthosis of the epithelium. We made a diagnosis of acanthosis nigricans and immediately searched for malignant visceral tumors. A gastric carcinoma was detected by gastroscopy, and it was associated with pericarditis carcinomatosa. Three months later she died of pulmonary embolism.Acanthosis nigricans associated with oral lesions may be malignamt; the diagnosis of this condition is therefore important for the early detection and treatment of underlying cancer.

A chondrosarcoma on the mandibular condyle is described. The patient was a 58-year-old woman with left preauricular swelling. Examination disclosed a nontender, hard mass overlying the left TMJ region. The mandibular movement was limited to 26 mm of interincisal distance and the mandible deviated to the left with mouth opening. Radiographic investigation revealed a tumorous mass around the condyle showing partial resorption. The bone scintigram showed accumulation of 99mTc into the tumor mass. The lesion, which was clinically suspected to be a chondrosarcoma, was surgically excised with the mandibular ramus, the temporal muscle and the external pterygoid muscle. Histologically, the lesion was composed of translucent cartilage and many cells with enlarged and hyperchromatic nuclei. The histopathological diagnosis was chondrosarcoma.The patient is now being followed up, with special attention to lung metastasis.

A 49-year old female with palatal perforation due to congenital syphilis is reported. She was diagnosed on the basis of clinical, serological and epidemiological features. Clinical examination showed a ‘Saddle nose’ deformity, and ‘palatal perforation’. Her clinical course was as follows: Her hard palate perforated at the at the age of 10 years. At the age of 16, a fistula closure operation was executed, but soon after the operation perforation of the hard palate recurred. At the age of 37, she lost all teeth of the upper jaw.She has been using a complete denture of the upper jaw since age 41.She recently felt uneasiness with the denture, probably due to thinning of the bone around the premaxilla. She therefore visited our clinic through the introduction of a dental practitioner for examination of the palatal perforation. Her disease history was unnoteworthy. Her laboratory data were all within the normal except for a positive TPHA reaction. Her father was treated for syphilis before her birth. Due to advances in treatment against syphilis, progressively fewer cases of syphilis are encountered. Late congenital syphilis has become particularly rare recently.

Two cases of Apert's syndrome were presented. The manifestations of Oxycephaly, Syndactyly, Frontal bossing, and Midfacial retrusion with some intraoral minor anomalies were associated with the patients.The craniofacial forms in both patients were examined by the measurement analysis of x-ray cephalograms.Discussions were mainly focused on the relation between the cranial forms and the maxillary retrusion, and on the role of the cranial base synchondrosis and synostosis concerning the maxillary growth.

A case of multiple myeloma detected by the first symptom of severe postextraction bleeding was presented. Although laboratory data showed severe anemia, rouleaux formation of erythrocytes, abnormal hemostatic parameters, elevated erythrocyte sedimentation rate and hyperglobulinemia, no involvement of bones such as the jaws, skull, ribs or sternum was demonstrated roentgenologically. Final diagnosis obtained by immunoelectrophoresis was Ig A . K type myeloma. During a therapeutic period with melphalan and predonine, bleeding from the extracted wound was repeated. 2 months after the onset of the first symptoms, the patient died of systemic bleeding. Autopsy findings revealed many hemorrhagic sites in the lungs, stomach, kidney and bladder and the existence of plasma cell-like tumor cells in the bone marrow of lumber vertebra and sternum.