Oral Surgery Oral Medicine Oral Pathology Oral Radiology最新文献

{"title":"Role of the programmed death-ligand 1 (PD-L1) and antigen-presenting natural killer (AP-NK) cells in immunosuppressive tumor microenvironment (TME) of oral squamous cell carcinomas","authors":"Ida Varghese ,&nbsp;Safia Durab ,&nbsp;Nadarajah Vigneswaran ,&nbsp;Michelle Williams ,&nbsp;Yahuan Lou ,&nbsp;Jean Wu ,&nbsp;Julian Holland","doi":"10.1016/j.oooo.2025.04.064","DOIUrl":"10.1016/j.oooo.2025.04.064","url":null,"abstract":"<div><div>Immune checkpoint blockade (ICB) response rate targeting PD-1/PD-L1 in oral squamous cell carcinomas (OSCC) is lower (&lt; 20%) than other solid cancers. Identifying factors contributing to an immunosuppressive TME may inform cancer progression. AP-NK cells co-expressing CD8αα and HLA-DR antigens promote immunosuppression by selectively killing effector T-cells.</div><div>Methods: Tissue microarray of OSCC (<em>n</em> = 64), oral epithelial dysplasia (OED, <em>n</em> = 14), proliferative verrucous leukoplakia which progressed to OSCC (PVL; <em>n</em> = 6), and oral lichen planus (OLP; <em>n</em> = 5) were used in this study. By immunohistochemistry (IHC), we evaluated PD-L1 expression (Clone 22C3) in tumor cells by the Tumor Proportion Score (TPS) and in tumor infiltrating lymphocytes (TIL). IHC for CD3, CD8, and CD8 and HLA-DR double labeling was used for phenotyping the TIL. We used Fisher’s exact test to compare categorical variables and Student’s <em>t</em> test for continuous variables.</div></div><div><h3>Results</h3><div>PD-L1 expression in TIL (negative: 0%-5%; positive &gt; 5%) showed significant correlation with tumor site, nodal status, and survival. OSCC were classified into four TME types based on their TPS and the number of CD3-positive TIL. (1) <strong><em>PD-L1 negative (TPS &lt;5%) and scant CD3+TIL</em></strong> in <strong>39%</strong> (2) <strong><em>PD-L1 negative (TPS &lt;5%) and high CD3+TIL</em></strong> in <strong>34%</strong> (3) <strong><em>PD-L1 positive (TPS &gt;5%) and a high CD3+TIL (ICB responders)</em></strong> in <strong>14%</strong> (4) <strong><em>PD-L1 positive (TPS &gt; 5%) and scant CD3+TIL</em></strong> in <strong>13%</strong>. CD3+ve T-cells were significantly lower (<em>P</em> = .0075) in OED and PVL compared to OLP. There was a trend for increased AP-NK cells and % of AP-NK/CD3 cells in OED (56.7±10.1; 2%) and PVL (64.5 ± 24.2; 7%) compared to OLP (30.5±7.4; 0.7%). There was no statistically significant correlation between TPS and age, gender, smoking status, tumor site, histology grade, tumor stage, nodal status, survival, and TIL density.</div></div><div><h3>Conclusion</h3><div>In addition to PD1/PD-L1 pathway, our data supports AP-NK cells playing a role in promoting immunosuppressive TME in OSSC.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"140 3","pages":"Page e87"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term clinical and radiographic follow-up of presumptive intramuscular hemangioma of the masseter muscle: a case report","authors":"Mark Mintline ,&nbsp;Kylie Holliday ,&nbsp;Sevin Barghan ,&nbsp;Harry Morrison ,&nbsp;Lauren Lalakea","doi":"10.1016/j.oooo.2025.04.042","DOIUrl":"10.1016/j.oooo.2025.04.042","url":null,"abstract":"<div><div>We present a case of a 27-year-old Hispanic female with a presumptive intramuscular hemangioma (IMH) of the left masseter muscle. The tumor was first detected and imaged 15 years prior with computed tomography (CT), magnetic resonance (MR), and ultrasound (US) imaging studies. Serial MR studies reveal a lobulated mass involving the left masseter space with intermediate signal on T1 and bright signal on T2. CT images show anterior displacement of the facial vein and a calcification in the mass most consistent with a phlebolith or metaplastic ossification. The tumor exhibited mild growth during the patient’s youth but stabilized during adulthood. On clinical examination, the tumor is not readily apparent and the overlying oral mucosa and skin display no discoloration. However, a round 2.0 cm compressible mass of the buccal mucosa and overlying skin becomes visible when the patient masticates, clenches her jaw, is placed in Trendelenburg position, or vigorously exercises. These specific clinical features combined with the radiographic appearance of the tumor are most suggestive of an erectile IMH of the masseter muscle. Management of IMHs is individualized, but treatment is often wide local excision. In select cases, patients and clinicians may elect to monitor IMHs with routine clinical and radiographic examinations. This case highlights the clinical and radiographic appearance of an IMH of the masseter over a period of 15 years.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"140 3","pages":"Page e80"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Olfactory neuroblastoma [esthesioneuroblastoma]: a retrospective review of 21 cases","authors":"Edirin Sido ,&nbsp;David Sauer ,&nbsp;Shafqut Shaheryar ,&nbsp;Elizabeth Palmer ,&nbsp;Paul Edwards ,&nbsp;Nasser Said Al Naief","doi":"10.1016/j.oooo.2025.04.030","DOIUrl":"10.1016/j.oooo.2025.04.030","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite the presence of non-neuroendocrine tumors with neuroendocrine characteristics within the sinonasal region, neuroendocrine tumors [NET] may be roughly separated into those derived from neuroectodermal origin, olfactory neuroblastomas [ONB], and those of epithelial origin, neuroendocrine carcinomas. A comprehensive review of 21 cases of ONB is presented.</div></div><div><h3>Materials and Methods</h3><div>Retrospective search of OHSU, Dept. of Pathology records [1990-2020] ICD codes for ONB/esthesioneuroblastoma, focusing on established inclusion criteria. Statistical analysis was performed using Kaplan–Meier method and the log-rank test. Statistical significance was considered at <em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>38.10% presented with Hyams grade <strong>I</strong>, 33.33% grade <strong>II</strong>, 9.52% grade <strong>III</strong>, and 19.05% grade <strong>IV</strong>. Most patients presented with modified Kadish stages <strong>III</strong> and <strong>IV</strong> [42.86%], followed by stages <strong>I</strong> [4.76%] and <strong>II</strong> [9.52%]. The majority of patients were managed by surgery + RT/IMRT, followed by surgery + RT/IMRT + chemo and surgery only. For patients with Hyams grade <strong>I</strong>, the 5- and 10-year recurrence rates were compared across Kadish staging: stage <strong>I</strong> [0%, 25%], stage <strong>II</strong> [14.3%, 48.6%], stage <strong>III</strong> and <strong>IV</strong> [50%, 100%]; and the 100% survival rate dropped to 83.1% at 10 years.</div></div><div><h3>Conclusion</h3><div>The current study highlights significant prognostic differences between different Hyams grades [<em>P</em> = .0384] but did not show the same for modified Kadish tumor stages [<em>P</em> = .3432], suggesting that Hyams grading was more predictive of patients’ outcomes when compared to Kadish staging.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"140 3","pages":"Pages e76-e77"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Avascular necrosis of the mandible as the initial presentation of undiagnosed acute myelogenous leukemia","authors":"Paolo Junior Fantozzi ,&nbsp;Zaid Khoury ,&nbsp;Gianluca Tenore ,&nbsp;Domenico Gaglioti ,&nbsp;Federica Bruno ,&nbsp;Cira Rosaria Tiziana Di Gioia ,&nbsp;Umberto Romeo ,&nbsp;Alessandro Villa ,&nbsp;Ahmed Sultan","doi":"10.1016/j.oooo.2025.04.012","DOIUrl":"10.1016/j.oooo.2025.04.012","url":null,"abstract":"<div><h3>Background</h3><div>Avascular Necrosis of the Bone (AVN) is a rare, yet a serious complication associated with metabolic bone disorders, radiation therapy as well as long-term treatment of solid/hematologic malignancies. Patients with leukemia rarely present with AVN, with most cases occurring due to corticosteroid treatment in acute lymphoblastic leukemia (ALL) or following IFN-α/TKI therapy in chronic myeloid leukemia (CML). Herein we present a case of AVN as the initial presentation of undiagnosed acute myelogenous leukemia (AML) in an otherwise healthy patient without previous radiation or antiresorptive therapy.</div></div><div><h3>Case Report</h3><div>A 37-year-old female presented with a 1-week history of painful necrotizing gingival ulceration interdentally between teeth #18 and 19. Oral bacterial and viral cultures were negative. At 1-week follow-up, there was a worsening of the ulceration with bony sequestration. Repeat bacterial culture results were presumptive of necrotizing periodontitis (NP). CBC with differential, HIV-RNA tests, and a mandibular CBCT were then obtained. A biopsy was made, and histopathologic examination revealed necrotic nonviable bone sequestrum lined by bacterial colonies and inflammatory cells. HIV-RNA test was negative; CBC demonstrated neutropenia and anemia whereas a peripheral blood smear showed blasts accounting for 52% of nucleated cells. Patient was then referred to hematology/oncology for further evaluation. Bone marrow aspirate showed blasts with large cytoplasmic granules with different stages of dysgranulopoiesis. Immunophenotyping confirmed the presence of CD117, CD34, HLADR, CD15, CD45, CD38, and CD4; cytogenetic analysis showed interstitial deletion of the long arm of chromosome 7 (q22-q36). Hence, a diagnosis of AML was made.</div></div><div><h3>Conclusion</h3><div>NP and AVN may represent a warning sign of an underlying undiagnosed AML as a consequence of an immune-system impairment. Although rare, AML should be included in the differential diagnosis for such oral presentations. Comprehensive workup for similar cases is of paramount importance for early detection of the disease.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"140 3","pages":"Pages e70-e71"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A clinical imaging study using a smartphone point-of-care autofluorescence device to facilitate the early detection of oral cancer in primary and community health clinical settings","authors":"Safia Durab ,&nbsp;Ruchika Mitbander ,&nbsp;Jackson Coole ,&nbsp;Alex Kortum ,&nbsp;Imran Vohra ,&nbsp;Jennifer Carns ,&nbsp;Richard Schwarz ,&nbsp;Ida Varghese ,&nbsp;Sean Anderson ,&nbsp;Hawraa Badaoui ,&nbsp;Loganayaki Anandasivam ,&nbsp;Rachel Giese ,&nbsp;Ann Gillenwater ,&nbsp;Rebecca Richards-Kortum ,&nbsp;Nadarajah Vigneswaran","doi":"10.1016/j.oooo.2025.04.081","DOIUrl":"10.1016/j.oooo.2025.04.081","url":null,"abstract":"<div><h3>Introduction</h3><div>Early diagnosis of oral cancer is key to improving prognosis and patient outcomes. Suspicious oral lesions are often encountered by front-line dental and medical practitioners who must decide whether to refer the patient to a specialist for biopsy and histopathology, which is the gold standard for diagnosis. The development of objective tools for screening of oral mucosal lesions that enable clinical risk stratification is imperative for improving early detection of oral cancer, especially in resource-limited primary care settings.</div></div><div><h3>Methods and Materials</h3><div>The mobile Detection of Oral Cancer (mDOC) device is a smartphone autofluorescence imaging system that captures wide field white light and autofluorescence images of the oral mucosa using optics in a custom 3D printed case. A custom Android application was developed to collect patient demographic information and to guide the clinician to collect widefield images in the oral cavity. Lesion specific characteristics are also recorded in the app. This study enrolled patients presenting to the UTHealth School of Dentistry and MD Anderson Cancer Center clinics for clinical evaluation. Referral decisions were determined by expert clinicians.</div></div><div><h3>Results</h3><div>Preliminary results consist of white light and autofluorescence image data from a total of 223 anatomic sites in 111 patients. Of these 223 sites, 174 sites prompted referral for further evaluation and 49 sites did not prompt referral for further evaluation based on expert clinical impression. This dataset is being used to develop an automated algorithm to generate a referral decision at the point of care.</div></div><div><h3>Conclusion</h3><div>The mDOC device serves as a simple tool to image the oral mucosa for objective screening, with the potential to enable earlier detection of oral lesions in primary care settings. Future work involves the implementation of diagnostic algorithms to inform site-level and patient-level referral decisions to determine whether a patient requires further evaluation.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"140 3","pages":"Page e93"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral manifestations of syphilis: an alarming trend in Kuwait","authors":"Anwar AlMuzaini ,&nbsp;Dalal Alomar ,&nbsp;Tareq Mohammad ,&nbsp;Jassem Bastaki","doi":"10.1016/j.oooo.2025.04.034","DOIUrl":"10.1016/j.oooo.2025.04.034","url":null,"abstract":"<div><h3>Introduction</h3><div>Syphilis, a sexually transmitted bacterial disease, is caused by <em>Treponema pallidum</em> (<em>T. pallidum</em>). The diagnosis of syphilis can be difficult without suspicion, and it’s made through serologic testing or direct detection of (<em>T. pallidum</em>) in biopsies<em>.</em> The stage at diagnosis and neurologic involvement determine the treatment.</div></div><div><h3>Case Series</h3><div>Eleven patients presented to different governmental clinics in Kuwait. Ten were males, and the patients ranged in age from 21 to 39.5 years old. While one patient had only a peri-anal lesion, the remainder presented with generalized oral/oropharyngeal painful lesions. The oral manifestations consisted of red/violaceous macules that progress into “waxy” mucosal thickening, “Mucus Patches.” Exophytic rough/papillary growth, “condylomata lata,” can develop. Less frequently, mucosal nodularity and “cobble-stoning,” similar to those seen in granulomatous processes, is observed. One peri-anal lesion from a male patient was only examined histologically in consultation and was clinically ulcerated pyogenic granuloma-like. Treponema IHC testing confirmed the diagnoses, while Warthin starry histochemical testing done on at least 5 cases was negative. Histologically, the lesions exhibited certain general diagnostically helpful features with different degree of manifestation across all biopsies. They are the presence of plasmacytic infiltrate submucosally, combined with the presence of neutrophils in the mucosal lining. Hyperplasia of the mucosa is helpful as well and can range from slight elongation of the rete ridges to a papillary/exophytic hyperplasia. The submucosal plasmacytic infiltrate also varies in the percentage of lymphocytes present and may extended deeper and with a perivascular pattern.</div></div><div><h3>Conclusion</h3><div>Syphilis can present a diagnostic challenge to unsuspecting diagnosticians. Oral lesions may be the first sign; thus dentists are on the frontline and must be familiar with it. Pathologists must be quick to test with Treponema IHC when certain histologic signs are observed in the biopsies. If misdiagnosed, or left untreated, the consequences can be a public health catastrophe.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"140 3","pages":"Page e78"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastatic calcinosis as a rare manifestation of end-stage rental disease—a case report with review of the literature","authors":"Madhu Shrestha ,&nbsp;Ramsey M. Fanous ,&nbsp;Daniel Baumhoer ,&nbsp;Yi-Shing Lisa Cheng","doi":"10.1016/j.oooo.2025.04.037","DOIUrl":"10.1016/j.oooo.2025.04.037","url":null,"abstract":"<div><div>A consequence of end-stage renal disease (ESRD) is altered calcium and phosphate metabolism, and it often leads to higher risk of calcium deposition in the soft tissue. Calcinosis could be classified into metastatic, dystrophic, iatrogenic, and idiopathic. Metastatic calcification (MC) or metastatic calcinosis is the term given to abnormal deposition of calcified products in otherwise normal tissue, because of hyperphosphatemia, with or without hypercalcemia. Although hyperphosphatemia itself plays a key role in this process, hypercalcemia itself without hyperphosphatemia may not be enough to induce this process. MC mostly occurs in visceral organs such as kidneys, lungs, gastric mucosa, and even joints, skin, and eyes. However, MC rarely presents in the oral cavity. Herein, we present a rare case of metastatic calcification in a 57-year-old female secondary to ESRD. Clinically, there was a palpable hard mass in the anterior maxillary vestibule. The radiographic presentation was that of a large radiopaque mass in the anterior nasal spine and nasal septum. Histologically it showed amorphous, granular, calcified material. A detailed clinical, characteristic histopathologic feature along with a review of literature will be discussed.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"140 3","pages":"Page e79"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benign fibro-osseous lesions of the jaws (BFOLJ): a pilot study of 88 cases","authors":"Anika Moffitt ,&nbsp;Quinn Saluan ,&nbsp;Kristin K. McNamara ,&nbsp;Prokopios P. Argyris ,&nbsp;John R. Kalmar","doi":"10.1016/j.oooo.2025.04.052","DOIUrl":"10.1016/j.oooo.2025.04.052","url":null,"abstract":"<div><h3>Introduction</h3><div>BFOLJ comprise a heterogeneous group of conditions with variable biologic behavior and overlapping radiographic and histopathologic features. Their diagnosis relies heavily on clinicopathologic correlation. Generally, BFOLJ is sub-categorized into cemento-osseous dysplasia (COD), ossifying fibroma (OF), and fibrous dysplasia (FD). Herein, we present our institutional experience regarding the epidemiologic and clinicopathologic characteristics of BFOLJ.</div></div><div><h3>Material and Methods</h3><div>Archived BFOLJ cases over a 4-year period (2018-2022) were retrieved from the electronic laboratory databases of the OSU oral pathology service. Available information regarding patient age and gender, anatomic location, lesion focality, i.e., solitary or multifocal, radiographic appearance and size, clinical impression, and subtype was recorded.</div></div><div><h3>Results</h3><div>Among 21,462 biopsies, 88 (0.41%) cases of BFOLJ were identified; 68 (77.3%) affected women and 20 (22.7%) men (F:M = 3.4:1; age range = 7-90 years, mean = 38.8 years). The posterior mandible was the most common location (62, 70%). Seventy-seven (87.5%) BFOLJ were unifocal and 11 (12.5%) showed a multifocal pattern. Radiographically, 42 (48%) cases presented as well-defined, mixed radiopacity/radiolucency, 15 (17%) as unilocular radiolucency, and 9 (10%) as radiopacity (mean size = 1.9 cm, range = 0.4-10 cm). BFOLJ was a clinical consideration in 49 (56%) cases. Seventy-one (81%) BFOLJ were diagnosed as COD (F:M = 6.1:1; age range = 7-90 years, mean = 39 years). Other BFOLJ included OF (9, 10%; F:M = 4:5; age range = 12-47 years, mean = 28 years), juvenile OF (3, 3.5%), FD (3, 3.5%), osteoblastoma (1, 1%) and renal osteodystrophy (1, 1%). Twelve (13.6%) BFOLJ were associated with other lesions including traumatic bone cyst (4, 33.3%), as well as 2 (16.7%) each of periapical cyst, xanthoma of bone, odontoma, and central giant cell lesion.</div></div><div><h3>Conclusions</h3><div>BFOLJ are relatively uncommon, largely representing forms of COD with a strong predilection for the posterior mandible of women in their 4th decade. Overall, BFOLJ displays nonpathognomonic radiographic features. Histopathologic examination and clinical-radiographic correlation are required for definitive diagnosis and proper management.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"140 3","pages":"Page e83"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mucoepidermoid carcinoma, involving the surface epithelium, not to be confused with OSCC","authors":"Gehan Abdel Naser Abdel Rahman ,&nbsp;Najwa Yousef ,&nbsp;Kathrine Lin ,&nbsp;Donita Dyalram ,&nbsp;John R. Basile ,&nbsp;John Papadimitriou ,&nbsp;Robert Foss ,&nbsp;Rania Younis","doi":"10.1016/j.oooo.2025.04.029","DOIUrl":"10.1016/j.oooo.2025.04.029","url":null,"abstract":"<div><h3>Introduction</h3><div>Mucoepidermoid carcinoma (MEC) is the most common primary salivary gland malignancy worldwide. MEC can be categorized histologically into low, intermediate, and high-grade tumor. When the epidermoid component predominates, MEC may mimic oral squamous cell carcinoma (OSCC) which contribute to diagnostic challenge. Meticulous evaluation would be warranted to differentiate between moderate or high-grade MEC and OSCC. Differentiating these two entities is necessary to prognosticate survival and to determine the most appropriate treatment plan.</div></div><div><h3>Case Presentation</h3><div>A 20-year female presented with painless lesion, persisted for 1-2 years, and hasn’t changed in size for last 6 months. Clinical examination showed 1.5 × 0.5 cm elevated lesion of posterior hard palate with central ulcerated area. Incisional biopsy demonstrated evidence of proliferating tumor islands some of which were connected to overlying surface epithelium. That consisted of predominantly epidermoid cells, with scattered mucinous component. Small cystic islands lined by mucous, intermediate, and epidermoid cells, that contributed to less than 20% of tumor were noted. Mucicarmine and PAS-diastase positive highlighted scattered mucous cells. Tumor cells were p63 positive, and negative for Calponin and GATA-3. Findings were consistent with MEC, low grade. Upon excision, surgical impression included erosion of underlying bone. Excisional biopsy showed tumor infiltration of terminal duct and overlying surface epithelium and more prominent cystic component. S100 highlighted perineural invasion. Final diagnosis of MEC, low grade, according to AFIP classification criteria was rendered.</div></div><div><h3>Conclusion</h3><div>MEC arising from terminal duct ending in surface epithelium, might be erroneously interpreted as OSCC, especially when predominated with epidermoid cells on small incisional biopsies. Extensive tumor sampling, demonstration of intracellular mucin assisted by special stains, and presence of intermediate cells, represent important clue to diagnosis. It is important to use the most objective histopathologic features to grade MEC and to determine prognosis or treatment modality more accurately.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"140 3","pages":"Page e76"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burkholderia infections in the head and neck: a new tenant in the block","authors":"Irit Allon","doi":"10.1016/j.oooo.2025.04.016","DOIUrl":"10.1016/j.oooo.2025.04.016","url":null,"abstract":"<div><h3>Introduction</h3><div>Burkholderia is a less familiar family of gram-negative bacteria with potential to harm human, usually reported in immunocompromised patients. The aims of this study are to present a case report of Burkholderia infection in the head and neck area and to discuss the clinical and histopathological features of Burkholderia infections in general in the head and neck region including treatment options.</div></div><div><h3>Methods</h3><div>A comprehensive English literature analysis between years 1995 and 2022, which were included in the current review.</div></div><div><h3>Results</h3><div>A total of 29 patients, M:F ratio 1.07. The age ranged from 5 to 77 years with an average of 41.4 + 17.4 years. The most common infection site was the lower neck. Most of the patients developed an abscess. Systemic presentation mainly included fever. Overall, 55.17% of the patients had some form of immunosuppression. The most common specie was <em>Burkholderia pseudomallei</em>. Five of the patients had a combined infections. Patients received 1-12 types of antibiotics. A total of 26 patients required surgical treatment in addition to antibiotics. A total of 27 patients recovered, while 2 patients died from the infection. The histopathological spectrum included: Necrotizing granuloma, chronic or acute inflammation and necrotizing fasciitis.</div></div><div><h3>Conclusion</h3><div>This study consolidates for the first time all cases of Burkholderia infections, a relatively unknown type of bacterium in the head and neck area. This is a rare phenomenon, with patients that are usually immunosuppressed, and the treatment is usually a long-term combination of surgery and medication. The attending clinician should be familiar with the pathogen, the clinical signs of infection, and the patient’s treatment options. This bacterium can manifest as an abscess, acute and chronic inflammation, and necrotizing granulomas. The prognosis is excellent when an early diagnosis is made and appropriate treatment administered. Burkholderia infection should be considered in the differential diagnosis of abscesses and granulomas with necrosis in the head and neck area.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"140 3","pages":"Page e72"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}