Patients with early squamous cell carcinoma (SCC) of the oral cavity are treated by either surgery or radiotherapy. By either method, biopsy is routinely performed to determine malignancy. However, an incision into the neoplasm could enhance its spreading or could even increase malignancy. From this point of view, chemotherapy prior to biopsy has been performed to prevent neck metastasis caused by spreading of cancer cells due to biopsy.
To evaluate the effect of chemotherapy before biopsy on the incidence of neck metastasis in early cancers, 68 patients with stage I and II oral SCC were relrospectively studied. These patients were divided into three groups : group A, 33 patients without chemotherapy ; group B, 11 patients with chemotherapy following biopsy ; group C, 24 patients with chemotherapy prior to biopsy. Secondary neck metastasis was found in 30.3% (10/33) of group A, 18.2% (2/11) of group B, and 8.3% (2/24) of group C. respectively. Thus the mean survival rate was 78.8% in group A, 90.9% in group B, and 91.7% in group C.

View full abstract

Eruption of impacted teeth associated with an odontogenic tumor was successfully induced by marsupialization and/or orthodontic treatment in 5 cases. After removal of the tumor, in three cases, orthodontic treatment was carried out, and in two cases, marsupialization was performed for impacted teeth. Though impacted teeth erupted in all cases, eruption of the impacted tooth up to the occlusal plane was measured in a case without orthodontic treatment. As a result of the findings in this study, it was suggested that application of orthodontic treatment for impacted teeth, which were suspected to be lacking the ability of spontaneous eruption due to odontogenic tumors, would be useful for induction of tooth eruption.

View full abstract

A rare case of maxillary sinus-originated malignant hemagiopericytoma of a 71-year old female was reported. The tumor extended to pterygopalatine fossa with destruction of the alveolar process, maxillary bone, orbital floor, and zygomatic bone. She underwent tumor extirpation and hemimaxillectomy with resection of the orbital floor and zygomatic bone, and 65Gy of ⁶⁰ Co irradiation was performed after local treatment. A reconstruction of the orbital floor using a titanium mesh tray and forearm flap was performed. Following these therapies, she underwent two courses of adjuvant chemotherapy with Adriamycin, Ifosfamide, and Mesna. Although the disease was locally controlled distant metastases developed in a lung and a thoracic vertebrae.

View full abstract

A case of squamous cell carcinoma (SCC) occurring in the maxillary gingiva with an interesting histopathological appearance is reported.
A 58-year-old female visited our hospital with the chief complaint of spontaneous pain of the right maxillary gingiva. Physical examination revealed ulcer formation of the right lateral incisor and canine region of the maxilla.
Radiographic examination showed that the alveolar bone of this lesion was absorbed.
As a result of histopathological analysis, it was found that this lesion consised of both SCC cells and clear cells and many inflammatory cells had infiltrated the tumor tissue, SCC cells were of the well-differentiated type and formed cancer nests, which continued to the oral epithelium. Clear cells were observed in the periphery of these nests and contained cytoplasmic glycogen that was PAS positive, as well as diastase-digestible granules. Moreover, these clear cells were formed gradually and continuously from the cancer nests. These histological findings strongly suggested that the SCC cells might be transformed into the clear cells due to the effects of infiltrating inflammatory cells. The tumor was wholly resected under general anesthesia and the patient has been in good condition without relapse for 2 years and 4 months since the operation.

View full abstract

Cemento-ossifying fibroma is a slow-growing benign non-odontogenic neoplasm, commonly enucleated from normal bone with ease. However, some lesions behave aggressively, demanding special treatment.
A 27-year-old female patient with a cemento-ossifying fibroma extending from the anterior to the right condylar process of the mandible, was presented. Although a biopsied specimen showed a ‘typical’ feature of ossifying fibroma, X-ray and CT scan showed a mixed radiolucent/radiopaque lesion with a poorly-defined margin at the ramus, suggesting aggressive behavior of the tumor. Thus, hemimandibulectomy and immediate reconstruction by autogenious iliac bone graft were performed. On histologic evaluation of the surgical specimen, multiple tumor nests were found at the ramus. In conclusion, when the lesions do not clearly fit into a known diagnostic category clinically and histologically, treatment should be based on the biological behavior of the tumor.

View full abstract

Chemotherapy, radiation therapy, and surgery to treat a carcinoma of hard palatal mucosa in a 49-year-old male who had undergone an artifical hemodialysis for chronic renal failure were performed. In the chemotherapy, cisplatin and etoposide were administrated. Especially, pharmacokinetics for cisplatin, which has a characteristic of hemodialysis quality was measuned. The reasonable administrative methods and starting time of hemodialysis were investigated. As a result, it was considered that a reasonable administrative volume is 1/2 for a patient with a normal kidney and a resaonable starting time of hemodialysis is 1.5 hours after administration of CDDP.

View full abstract