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A case of metastatic thyroid carcinoma near the left mandibular ramus with a cyst-like appearance on rotational panoramic radiographs is reported. A 55-year-old woman complained of a continuous sense of incongruity for 3–4 years since extraction of the left mandibular third molar. The lesion, with apparent gingival swelling around the left second molar, was painless and was cyst-like in appearance on plain radiographs. On the basis of the radiological findings, a benign odontogenic tumor was suspected, but computed tomography (CT) showed destruction of the lingual cortical bone with soft tissue invasion to the masticator space. The final histopathological diagnosis was metastatic follicular carcinoma of the thyroid gland. When investigating cyst-like radiolucent lesions with thick sclerotic margins and irregular areas on plain radiographs, we recommend using CT to evaluate the effect of the lesion on cortical bone.

Murine macrophage inflammatory protein-1 (MIP-1)α gene transfection into human oral squamous cell carcinoma cells (HSC3/MIP-1α) was examined for its effects on cell growth and cytokine mRNA expression. The human oral carcinoma cell line HSC3 was transfected separately with a control plasmid and an mu-MIP-1α expression vector. Immunocompetent BALB/c mice were inoculated into the back skin with the cells. Primary tumor growth and tumor immunogenicity were investigated, and morphological analyses were carried out. HSC3/MIP-1α cells synthesized relatively large amounts of MIP-1 protein, whereas the HSC3/vector mediated control did not synthesize MIP-1 protein or mRNA. Further, it was shown that the HSC3/MIP-1α culture supernatants showed chemo-attraction to macrophages. In vivo, the tumorigenicity of HSC3/MIP-1α was significantly reduced in BALB/c nu/nu mice when compared with vector transfection alone. In addition, histological examination showed that numerous MAC-1 positive cells were recruited to the HSC3/MIP-1α mediated tumor nests after 10 days, whereas no such activity was seen in the controls. These results indicate that liposome-mediated MIP-1α gene transfection is efficient for MIP-1α protein synthesis of tumor cells. Although the gene transient efficiency was available for only a limited period, MIP-1α gene transfection reduced tumor size. The present technique, which must still be further developed, may provide stable integration efficiency of a foreign gene for use in long-term gene expression.

Clinicopathological studies and flow cytometric analyses were performed for 62 cases of odontogenic keratocyst obtained from the file of the Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry between 1984 and 1998. The Patients ranged in age from 12 to 74 years, and the peak incidence was in the third decade. The male: female ratio was 1.5: 1. Cysts were most frequently found in the third molar region, including the ramus. Most cysts were found incidentally on radiographic examination and appeared as unilocular, smooth bordered, radiolucent lesions. Most lesions were less than 4cm in diameter. Impacted teeth were found in 24 of 70 cysts, and 18.6% of the cysts were associated with root resorption of neighboring teeth. When classified according to the keratin type of the cyst-wall epithelium, most cysts were type II (58.5%).Flow cytometric analysis was performed for lining epithelial cells isolated from paraffin embedded specimens. Nuclear staining was done with Ki-67 antibody. The Ki-67 antigen labeling rate of odontogenic keratocysts was significantly higher (7.9±5.7%) than that of radicular cysts (2.9±1.3%). The number of cysts with a high Ki-67 antigen labeling rate was higher in type III than in the other three groups. We found a significant correlation between the Ki-67 antigen labeling rate on flow cytometry and the Ki-67 antigen positive cell rate on immunohistochemical examination. An advantage of flow cytometric analysis is that it can precisely enumerate proliferating cells of odontogenic keratocysts.

To examine the expression of p53 protein and gene alterations in oral epithelial lesions including epithelial dysplasias and primary squamous cell carcinomas, immunohistochemical and temperature gradient gel electrophoresis (TGGE) methods were applied to formalin-fixed and paraffin-embedded tissues. Morphologically normal mucosal epithelium stained negatively for p53 protein. Three out of 11 (27.3 per cent) epithelial dysplasias and 19 out of 57 (33.3 per cent) primary squamous cell carcinomas stained positively for p53 protein. Although more than half of the cases were positive for p53 protein in stage I, the positive cancer cases were found at other stages with variable frequency. Immunoreactive products were localized in the nucleus, especially in the basal and suprabasal layers. The analysis by TGGE revealed gene alterations in exons 5-8 in 3 out of 3 epithelial dysplasias and 17 out of 19 (89.5 per cent) primary squamous cell carcinomas which were immunohistochemically positive for p53 protein. These results suggest that p53 gene mutation may be involved in carcinogenesis in the oral squamous epithelium even in the early stage of the dysplasia-carcinoma sequence.

We reported here a case of Lymphoepithelial cyst arising at the ventral surface of the tongue in a 34 year old male.Histopathological examination revealed that the cyst was composed of fibrous tissue, thin squamous epithelium and lymphoid tissue with a prominent germinal center. This case was considered to be a typical, oral lymphoepithelial cyst.We also examined the distribution of immunoglobulins, T and B cells and lysozyme.Immunohistological examination revealed that immunoglobulin-positive cells (IgG, IgA and IgM) were distributed between the lining epithelium and lymphoid tissue with a variation in number. Localization of lysozyme-positive cells was similar to that of immunoglobulin-positive cells. Similar to tonsil and lymph node, B cells were observed in the cap area and medulla of lymphoid tissue while decreased numbers of T cells were found in fibrous connective tissue beneath the lining epithelium.

Spindle cell carcinoma is considered a subtype of squamous cell carcinoma that has a sarcomatoid appearance. In the head and neck region, cases of spindle cell carcinoma of the larynx have occasionally been reported. However, spindle cell cacrcinoma of the maxillary sinus is extremely rare. We describe a case of spindle cell carcinoma of the maxillary sinus in a 53-year-old woman. Surgical treatment was performed under the clinical diagnosis of a maxillary neoplasm. During the operation, a biopsy specimen was taken, and the histopathological diagnosis was a spindle cell carcinoma. The lesion was removed under general anesthesia. Radiotherapy and chemotherapy were additionally given to prevent recurrence and metastasis of the tumor.There has been no evidence of recurrence as of 5 years 6 months after surgrey.

Suppurative arthritis usually occurs by hematogeneous dissemination of an infection localized in some other organ of the body. Much less frequently, bacteria may invade the joint either by direct spread of a neighboring infection or through a perforating injury. We reported an unusual case of suppurative arthritis in the left temporomandibular joint of a 53-year-old woman. The arthritis presented after a certain period after tooth extraction of the left lower 2nd molar tooth, and detachment of the cartilage cap. The joint was surgically removed because of resistance to long-term antibiotic therapy.

A 14-year retrospective study was performed on 47 odontomas from the files of the 1st Department of Oral and Maxillofacial Surgery at Nihon University School of Dentistry. Fifty-seven percent of the patients were male and 42.6% were female. The age distribution was 8 to 48 years with a mean age of 22 +/- 9.0 years. There were no particular symptoms associated with the odontomas, and 63.8% of our patients had no symptoms. However, 12 patients complained of swelling and 9 of pain. The tumor was found in the maxilla in 42.6% and in the mandible in 57.4%. According to the WHO histological type classification, 53.2% of the tumors were classified as compound odontoma and 46.8% as complex odontoma. The size of the tumor ranged from 5 mm to 42 mm in diameter. The average complex odontoma was much bigger than the average compound odontoma. Ghost cells were found 11 cases in our series. In addition, odontogenic epithelium was found in 16 cases. Twenty seven patients had impacted teeth in association with odontoma and 24 of the 27 teeth were removed at the time of surgical enucleation of the tumor, while 3 cases were treated by orthodontically assisted eruption. There was no recurrence in any of the studied cases.

A reciprocating bone file has been developed to facilitate access to the medial surface of the mandibular ramus by avoiding trauma to the medial soft tissues and consequent bleeding prior to performing a sagittal osteotomy. This report describes the technique.

From 1970 to 1996, 129 cases of intraoral minor salivary gland tumors were diagnosed at the Department of Pathology, Nihon University School of Dentistry. The diagnosis of each case was based on the 1991 WHO classification. Eighty benign and 49 malignant minor salivary gland tumors were found in the approximately 9,300 oral biopsies submitted during the 27-year period. Pleomorphic adenomas were the most commonly histologic type of the benign tumors identified and 51% of the malignant tumors were diagnosed as mucoepidermoid carcinoma. The most common primary location of the tumors was the palate. Sixty percent of all tumors occurred in females and the peak age for incidences of all tumors was found in the third, fourth, sixth and seventh decades. These results were compared with those of the studies in different world population groups.

Synovial chondromatosis (SC) involving the temporomandibular joint (TMJ) is very rare and can occur in either or both cavities. Differentiation of the affected cavity in SC is therefore as important as making the diagnosis. This report presents a case of SC in which both cavities were thought to be affected, but arthrography using cone beam CT (CBCT) allowed us to see that involvement was limited to the superior joint cavity. In addition, we describe the usefulness of arthrographic CBCT for diagnosis and treatment planning in SC of the TMJ.

We carried out a detailed total body examination of a 62-year-old woman with osteoporosis who had bilateral defects in the mandibular processes. It was inferred that the defects in both articular heads were caused by resorption of small bone fragments following fracture. The quantity of bone salt was determined by microdensitometry, and a diagnosis of osteoporosis was then established. An improved bite was obtained by treatment consisting of tooth extraction and the preparation of partial dentures.

We have described two cases of ossifying fibroma in this paper.The first one was a recurrent case which occurred in a 52 year-old male patient. Tumor masses were found in the lower rim of mandible and in scar tissue close to previously operated areas. Histopthological examination revealed that tumor masses were composed of a proliferation of spherical and trabecular bones and dense fibrous tissue with a high cellularity.The second one was a case observed in a 26 year-old female patient. Histopathological examination revealed that the majority of tumors consisted of a proliferated fibrous tissue and a few immature fibrous bony tissues that were scattered at the peripheral region of this fibrous tissue.Although the enucleation of tumor or marginal resection of mandible were recommended for the treatment of ossifying fibroma, more extensive continuous resection of mandible should be applied to the cases which small tumor nests were scattered throughout the mandible such as case 1.

We recently experienced two cases of relatively rare bilateral submandibular sialolithiasis, which are describe in ditail in this paper.Case No.1 was a 26-year-old male having a swollen submandibular region of the left only X-ray films showed a presence of salivary stone not only in the left but also in the submandibular. Both stones could be surgically removed from the oral cavity.Case No.2, a 20-year-old female, attended our department with a chief complant of diffuse swelling of the left submandibular. Symptoms appeared only in the left side but subsequent X-ray films showed a presence of salivary stone in both sides. However, neither of stones could be removed surgically.The structures of both right and left salivary stones were observed in the former case using a scanning electron microscopy.Both right and left stones were consisted of three layers (center core, laminated structure outer layer), showing a remarkable difference in the center core and outer layer between two stones.

A case was reported of squamous cell carcinoma arising in left upper neck of 61-for 1 year old male.The patient complained that had been suffered painful swelling in left upper neck region for 1 month since he had his left upper teeth extracted.An elastic hard tumor the size of a baby's fist with adhesion underneath was found in the first visit examination.An en-block resection of tumor with adhesive surroundings was performed, though preoperative biopsy showed no evidence of malignancy.Histopathological examination of the specimen revealed that the tumor was squamous cell carcinoma. Even though we had not found tumor cell remained on surgical margin area, 60Co (5, 000 rad) irradiation and Peplomycin (50mg) chemotherapy was performed after the resection. The patient was followed up for 2 years administering Picibanil (5KE/week) and had no local reccurance or metastasis.We concluded that this case was Branchiogenic carcinoma because of the below characteristics;1.Tumor was located between M. sternocleidmastoideus and V.juglaris internal of upper neck region.2.Tumor had cystic cavity with keratinized substance inside.3.Histopathological examination revealed that the cystic structure was not formed by necrosis caused by carcinoma.4.Numbers of lymphoid tissues with germinal center were found in the specimen.5.Even though we tried Otorhinolaryngologic, internal examinations and further research of maxillofacial region, we could not find any primary lesion so that the tumor of the upper neck was deened not metastatic.