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Oral Diseases Nov 2021Oral potentially malignant disorders (OPMDs) are associated with an increased risk of occurrence of cancers of the lip or oral cavity. This paper presents an updated... (Review)
Review
Oral potentially malignant disorders: A consensus report from an international seminar on nomenclature and classification, convened by the WHO Collaborating Centre for Oral Cancer.
Oral potentially malignant disorders (OPMDs) are associated with an increased risk of occurrence of cancers of the lip or oral cavity. This paper presents an updated report on the nomenclature and the classification of OPMDs, based predominantly on their clinical features, following discussions by an expert group at a workshop held by the World Health Organization (WHO) Collaborating Centre for Oral Cancer in the UK. The first workshop held in London in 2005 considered a wide spectrum of disorders under the term "potentially malignant disorders of the oral mucosa" (PMD) (now referred to as oral potentially malignant disorders: OPMD) including leukoplakia, erythroplakia, proliferative verrucous leukoplakia, oral lichen planus, oral submucous fibrosis, palatal lesions in reverse smokers, lupus erythematosus, epidermolysis bullosa, and dyskeratosis congenita. Any new evidence published in the intervening period was considered to make essential changes to the 2007 classification. In the current update, most entities were retained with minor changes to their definition. There is sufficient evidence for an increased risk of oral cancer among patients diagnosed with "oral lichenoid lesions" and among those diagnosed with oral manifestations of 'chronic graft-versus-host disease'. These have now been added to the list of OPMDs. There is, to date, insufficient evidence concerning the malignant potential of chronic hyperplastic candidosis and of oral exophytic verrucous hyperplasia to consider these conditions as OPMDs. Furthermore, due to lack of clear evidence of an OPMD in epidermolysis bullosa this was moved to the category with limited evidence. We recommend the establishment of a global research consortium to further study the natural history of OPMDs based on the classification and nomenclature proposed here. This will require multi-center longitudinal studies with uniform diagnostic criteria to improve the identification and cancer risk stratification of patients with OPMDs, link them to evidence-based interventions, with a goal to facilitate the prevention and management of lip and oral cavity cancer.
Topics: Cell Transformation, Neoplastic; Consensus; Humans; Leukoplakia, Oral; Lichen Planus, Oral; Mouth Neoplasms; Precancerous Conditions; World Health Organization
PubMed: 33128420
DOI: 10.1111/odi.13704 -
Prague Medical Report 2021Melanoma is a malignant neoplasm of the epidermal melanocytes. Awareness and early recognition of pigmented lesion inside oral cavity helps in initial diagnosis and... (Review)
Review
Melanoma is a malignant neoplasm of the epidermal melanocytes. Awareness and early recognition of pigmented lesion inside oral cavity helps in initial diagnosis and further investigation and treatment. Oral malignant melanoma is a rare aggressive neoplasm commonly seen among middle age. The diagnosis of melanoma initiates from the pre-existing pigmented lesions. The poor prognosis of oral melanomas requires that pigmented lesions of undetermined origin be routinely biopsied. A case of malignant melanoma of hard palate with its clinical, radiological and histopathological presentation along with brief review is presented. Prognosis of these lesion is poor with survival rate of 5 years.
Topics: Humans; Melanoma; Middle Aged; Mouth Neoplasms; Prognosis; Skin Neoplasms
PubMed: 34606435
DOI: 10.14712/23362936.2021.20 -
BMC Oral Health Apr 2022This prospective randomized clinical trial aimed to evaluate the immediate and short-term skeletal, dentoalveolar, and periodontal effects of rapid palatal expansion... (Randomized Controlled Trial)
Randomized Controlled Trial
Skeletal and alveolar changes in conventional rapid palatal expansion (RPE) and miniscrew-assisted RPE (MARPE): a prospective randomized clinical trial using low-dose CBCT.
BACKGROUND
This prospective randomized clinical trial aimed to evaluate the immediate and short-term skeletal, dentoalveolar, and periodontal effects of rapid palatal expansion (RPE) and miniscrew-assisted RPE (MARPE) in adolescent and young adult patients.
METHODS
This study followed a two-arm, parallel, randomized clinical trial design that recruited patients with transverse maxillary deficiency in a 1:1 allocation ratio. Forty patients (14 men and 26 women) requiring maxillary expansion were randomly allocated to the RPE (n = 20, age = 14.0 ± 4.5) or MARPE (n = 20, age = 14.1 ± 4.2) groups. The assignment was performed via computer-generated block randomization, with a block size of four. Upon identical (35 turns) amount of expansion, low-dose cone-beam computed tomography images were taken before treatment (T0), immediately after expansion (T1), and after a 3-month consolidation period (T2). The primary outcome of this study comprised the assessment of midpalatal suture separation. Secondary outcomes included, skeletal, dentoalveolar, and periodontal measurements, which were performed at each time point.
RESULTS
The frequency of midpalatal suture separation was 90% (18/20) and 95% (19/20) for the RPE and MARPE groups, respectively. A greater increase in nasal width in the molar region (M-NW) and greater palatine foramen (GPF) was observed immediately after the expansion (T1-T0) and consolidation periods (T2-T0) in the MARPE group compared to the RPE group (P < 0.05). The MARPE and RPE groups showed similar dentoalveolar changes except for the maxillary width (PM-MW, M-MW). The MARPE group presented greater bilateral first premolar (PM-MW) and molar (M-MW) maxillary width in relation to the RPE group (P < 0.05). Through the expansion and consolidation periods (T2-T0), lesser buccal displacement of the anchor teeth was observed in the MARPE group (PM-BBPT, PM-PBPT, M-BBPT [mesial and distal roots], and M-PBPT)( P < 0.05).
CONCLUSIONS
Midpalatal suture separation was observed in 90% and 95% of patients in the RPE and MARPE groups, respectively. Both RPE and MARPE groups exhibited significant triangular basal bone expansion and skeletal relapse during consolidation. Under identical amounts of expansion, the MARPE group showed lower decrease in the skeletal, dentoalveolar and periodontal variables after consolidation. The reinforcement of RPE with miniscrews contributes to the maintenance of the basal bone during consolidation period. Trial registration WHO Institutional Clinical Trials Registry Platform (IRB No. KCT0006871 / Registration date 27/12/2021).
Topics: Adolescent; Child; Cone-Beam Computed Tomography; Female; Humans; Male; Maxilla; Neoplasm Recurrence, Local; Palatal Expansion Technique; Palate; Prospective Studies; Spiral Cone-Beam Computed Tomography; Young Adult
PubMed: 35395801
DOI: 10.1186/s12903-022-02138-w -
The Pan African Medical Journal 2021Pleomorphic adenoma is a benign mixed tumor, which is composed of myoepithelial and epithelial cells. A fibrous capsule separates these cells from the surrounding...
Pleomorphic adenoma is a benign mixed tumor, which is composed of myoepithelial and epithelial cells. A fibrous capsule separates these cells from the surrounding tissues. Pleomorphic adenoma is the most common salivary gland tumour accounting for 40-70% of all major and minor salivary gland tumours. It is also the commonest minor salivary gland benign tumours accounting for 70% of all tumours. Hard palate is the commonest site followed by upper lip, buccal mucosa, tongue, floor of mouth, retromolar trigone. This case report discusses a case of pleomorphic adenoma of hard palate in an old man after complete excision of the tumour, which was confirmed by a biopsy specimen.
Topics: Adenoma, Pleomorphic; Adult; Humans; Male; Palatal Neoplasms; Palate, Hard
PubMed: 33912316
DOI: 10.11604/pamj.2021.38.146.26508 -
Clinical, Cosmetic and Investigational... 2022AIDS-associated Kaposi sarcoma (KS) is the most common HIV-associated neoplasm. Disseminated Kaposi sarcoma became rare with the application of antiretroviral therapy....
AIDS-associated Kaposi sarcoma (KS) is the most common HIV-associated neoplasm. Disseminated Kaposi sarcoma became rare with the application of antiretroviral therapy. Oral AIDS-associated KS has prognostic relevance, indicating higher mortality than those with cutaneous lesions only. In this study, we reported a 40-year-old man presented with ulcerated violaceous plaques on his hard palate. Similar lesion can be observed on his left groin and anus, as well as on esophagus and gastric fundus under upper gastrointestinal endoscopy. Histological examination accorded with KS. After five cycles of doxorubicin, his oral, skin and esophagus lesions regressed considerably.
PubMed: 36032412
DOI: 10.2147/CCID.S376060 -
Journal of Oncology Practice Oct 2019Extranodal natural killer (NK)/T-cell lymphoma, nasal type, is a rare peripheral T-cell lymphoma associated with Epstein-Barr virus. It most often presents as... (Review)
Review
Extranodal natural killer (NK)/T-cell lymphoma, nasal type, is a rare peripheral T-cell lymphoma associated with Epstein-Barr virus. It most often presents as limited-stage disease in patients of East Asian descent with a palatal deformity caused by erosion of the tumor through the hard palate. Limited-stage disease is often curable with the use of l-asparaginase-based chemotherapy and high-dose radiation therapy. Obtaining an accurate diagnosis is essential, because treatment with standard lymphoma regimens and omission of radiation severely compromise the likelihood of long-term survival. Conversely, patients with advanced disease have a poor prognosis and are recommended for asparaginase-based chemotherapy followed by consolidation with autologous transplantation as a potentially curative approach. Progress often has been hampered by the rarity of this disease. However, discovery of common genetic alterations in pathways that promote growth and inhibit apoptosis, and actionable markers such as CD30 (among others), have begun to broaden the availability of novel drugs (eg, targeted therapies). There is also cautious optimism about immunotherapies, such as checkpoint blockade and novel cellular therapies that target Epstein-Barr virus. Advances in treatment and understanding of the genetic landscape of this disease offer hope for improved treatment outcomes.
Topics: Combined Modality Therapy; Disease Management; Humans; Lymphoma, Extranodal NK-T-Cell; Neoplasm Staging; SEER Program; Treatment Outcome
PubMed: 31600461
DOI: 10.1200/JOP.18.00719 -
Molecular and Clinical Oncology Sep 2021Infrastructure maxillectomy is a surgical procedure to remove the lower part of the maxilla and hard palate. The objective of the present study was to analyze clinical...
Infrastructure maxillectomy is a surgical procedure to remove the lower part of the maxilla and hard palate. The objective of the present study was to analyze clinical data and treatment outcome of patients who underwent infrastructure maxillectomy between 2011 and 2019. A total of 13 patients who underwent infrastructure maxillectomy for maxillary sinus and hard palate neoplasms between 2011 and 2019 were analyzed. These patients were subdivided into maxillary sinus neoplasm (n=5) and hard palate neoplasm (n=8) groups. All patients except one underwent infrastructure maxillectomy using the sublabial approach. One patient underwent an external approach through lateral rhinotomy. Postoperative reconstruction was performed for 11 patients using obturator, 6 patients using skin grafts and 3 patients using free flaps. A total of 6 patients had radiotherapy (RT), 3 had concurrent chemoradiotherapy (CCRT) and 2 had chemotherapy after surgery. The survival rate and recurrence rate were 61.5% (8/13) and 46.2% (6/13), respectively. The current results suggested that infrastructure maxillectomy may be an effective treatment for maxillary sinus neoplasms in the lower part of the maxillary sinus and hard palate neoplasms without causing marked functional or cosmetic morbidity. Postoperative RT or CCRT may be recommended to decrease the recurrence after infrastructure maxillectomy.
PubMed: 34276999
DOI: 10.3892/mco.2021.2342 -
Discovery Medicine Jun 2019Juvenile nasopharyngeal angiofibroma (JNA) is a histopathologically benign and highly vascular neoplasm, which is mainly seen in young adolescent men. It is a rare... (Review)
Review
Juvenile nasopharyngeal angiofibroma (JNA) is a histopathologically benign and highly vascular neoplasm, which is mainly seen in young adolescent men. It is a rare tumor, accounting for 0.05% of all head and neck neoplasms. The etiology of JNA has always been a controversial topic. Some researchers believe that it is a genuine tumor. Others consider that it is the result of vascular malformation caused by the non-absorption of artery residues in the first branchial arch during development, and that hormone and genetic effects are also related to its etiology. In addition, the JNA was so called because it was previously thought to originate from the nasopharynx. However, the origin site of JNA is not completely clear. Several studies emphasized that it originated from the upper lip of the sphenopalatine foramen at the junction of the sphenoid process of the palate and the pterygoid process, while others stressed that it originated from the pterygoid canal. Thus, further studies are needed for identifying the ultimate origin.
Topics: Adolescent; Angiofibroma; Genetic Predisposition to Disease; Hormones; Humans; Nasopharyngeal Neoplasms; Papillomavirus Infections
PubMed: 31421693
DOI: No ID Found -
The Journal of Cell Biology Sep 2023The GPI-anchoring pathway plays important roles in normal development and immune modulation. MHC Class I Polypeptide-related Sequence A (MICA) is a stress-induced...
The GPI-anchoring pathway plays important roles in normal development and immune modulation. MHC Class I Polypeptide-related Sequence A (MICA) is a stress-induced ligand, downregulated by human cytomegalovirus (HCMV) to escape immune recognition. Its most prevalent allele, MICA*008, is GPI-anchored via an uncharacterized pathway. Here, we identify cleft lip and palate transmembrane protein 1-like protein (CLPTM1L) as a GPI-anchoring pathway component and show that during infection, the HCMV protein US9 downregulates MICA*008 via CLPTM1L. We show that the expression of some GPI-anchored proteins (CD109, CD59, and MELTF)-but not others (ULBP2, ULBP3)-is CLPTM1L-dependent, and further show that like MICA*008, MELTF is downregulated by US9 via CLPTM1L during infection. Mechanistically, we suggest that CLPTM1L's function depends on its interaction with a free form of PIG-T, normally a part of the GPI transamidase complex. We suggest that US9 inhibits this interaction and thereby downregulates the expression of CLPTM1L-dependent proteins. Altogether, we report on a new GPI-anchoring pathway component that is targeted by HCMV.
Topics: Humans; Alleles; Cytomegalovirus; Membrane Proteins; Neoplasm Proteins; Transcription Factors; Cytomegalovirus Infections
PubMed: 37389656
DOI: 10.1083/jcb.202207104 -
Saudi Medical Journal Mar 2017Nasal septal surgery is one of the most common otolaryngology procedures performed, with rare occurrences of major postoperative complications. Oronasal fistula is a...
Nasal septal surgery is one of the most common otolaryngology procedures performed, with rare occurrences of major postoperative complications. Oronasal fistula is a rare complication of septal surgery, with only few cases being reported in the literature. It is commonly caused by a congenital cleft palate, cleft palate surgery, traumatic injuries, infections, or neoplasms; however, it does not usually occur post-septal surgery. Here, we report the case of a 55-year-old male who presented with a symptomatic oronasal fistula post-septoplasty. Unlike other reported cases, there were no features of underlying palatal pathologies, and no previous history of other nasal or oral procedures. We described a multilayer surgical closure technique that was utilized in this case, with no recurrence seen during a 6-month follow-up period. Additionally, we reviewed the other 3 reported cases of this complication, and discussed the possible etiology in this case.
Topics: Endoscopy; Humans; Male; Middle Aged; Nasal Septum; Nose Diseases; Oral Fistula; Otorhinolaryngologic Surgical Procedures; Postoperative Complications; Plastic Surgery Procedures
PubMed: 28251229
DOI: 10.15537/smj.2017.3.16114