P.104 Transformation of leukoplakia into squamouscell carcinoma

Diagqzosis. Radiotherapy. Combined treatments, Alternative and future treatments

Diagnosis, Radiotherapy, Combined treatments, Alternative and future treatments

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Tobacco and alcohol use among some oral carcinoma patients

L. Dimlttljevlc-Tanaskovlc 1, M. Babic 2, M. Dimitrijevic ~, L. Neskovlc 4. llnstttute of Pubhc Health Belgrade, Serbm

and Montenegro, Yugoslavta, 2MedicaI Academy US _Medical School, Serbta and Montenegro, Yugoslavia, JRepublic of Serbta, Nattonal Assembl~; Member of_Parliament, Serbia and Montenegro, Yugoslaota. 4StomatologtcaI FacuIt3: Chmc of MccrtlofactaI Surgery, Serbta and ~Iontenegro. t1¢goslavta Introduction: Carclnoma's is one of two nlaln causes of premature inortahty an Serbia as an n m c h of the rest o f Europe. Tobacco use and alcohohc dependence are one of tile ctnef preventable causes of oral cancer chseases. We surveyed three diagnoses: Carcinoma planocellulare nmcosae buccae, Ca planocellulare linguae (without baseos otis) and Ca planocellulare labll otis llffenoris and superloris. Materials and Methods: Tins is epldelmologlcal retrospective study of oral cancer pahents, previously nlentloned, who were hospltahzated undergoing a cancer treatment in a five years, 1999, 2000, 2001, 2002, 2003 at Stomatologlcal Faculty, m Chnlc of Maxflofaclal Surgery m Belgrade. There were 357 patients m total, but sample of 214 histories of (hseases were approachable, selected mid investigated. Results: Tins study has shown that there were t w o - t i e d (62.15%) pahents who had smoked cigarettes and two-fifth (42.52%) who were alcohohc depended. One-third of them (34.11) had practiced both habits. There were stalastlcal difference related on that habits by gender and by mentioned chseases. So, 66.21% o f m e n were smokers and 54.05°,; had alcohol used. Both (tobacco and alcohol) were mcldenced 46.62%. More than half (53.03%) of women patients were smokers mad one-sixth (16.66%) of them had alcohol used. Both of bad habits were mcldenced m 6.060,'0. The inost statistical difference was between results of tobacco use and alcohol prevalence of Ca linguae and Ca buccae by gender. Conelusion: The prevalence of tobacco and alcohol use among patients with researched diseases is higher than among total adult population m Serbia, men (52.9°,'0) women (36.92,3). The negative health consequences of these rlsc factors have been recognized.

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The clear cell odontogenic carcinoma

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B efore operation pathologically serum parameter o f NS E-levels could be observed. After total resection of the ~ r n o r NSE-level decreased remarkably and stayed in the normal range. Conclusion: NSE which is normally used for small cell bronchml carcinoma, reflects the typical serum parameter as an indicator of after-care.

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Oral cancer of the tongue in two Italian patients aged under 30 years

M. Petluzzi, M. De Benedittis, L. Pastore, M. Di Cosola, C. Giardina, R. Serpico. Departement of Odontostomatology

and Surgery, Untversz~ qf BarL Italy Introduction: The incidence of oral cancer m young adults seems to increase worldwide. From much anecdotal and some epidelmological evidence on this topic it emerges that many o f these patients have no exposure to trachtlonal risk factors such as tobacco and heavy alcohol abuse, or at least no exposure over decades usually associated with this disease. Additionally, tongue is reported to be the most frequent site o f involvement. Materials and Methods: To describe both the chnlcal and hlstopathologlcal aspect and tile exposure to potential risk factors of two male patients aged 24 and 26 years diagnosed Wltil squamous cell carclnolna of the tongue an the South o f Italy. Tobacco, alcohol, chet and previous ine(hcal visits were investigated. Results: Risk factor of tobacco use was present m both the patients; excessive alcohol assumption, cannabis and cocaine abuse were present an tile younger patient. Daily regular fresh fruit and vegetable consumption during the ten year period before cancer diagnosis was recorded to be low. A wrong provisional diagnosis (candldosls and syphilis) had been estabhshed by the primary care physician m both of them. The left margin o f the tongue was the only apparent site revolved m both the cases. Lesions appeared as asyrnptomatlc ulcers. Diagnostic delay was estimated as 24 moths for the 24-year aged patient and 6 inonths for the other one, while staging was T2NOM0 and T2N3aM0 respectively. Mean survival after surgery was 13 months. Conclusion: Some reports mchcate a lower survival rate for young patients compared to older patients. Others found no considerable (hfference m survival when comparing young adults to older patients. Others have shown better survival for young adults. While awaiting for the probity of these assertions n m c h attention must be devoted m evaluating chronic oral ulcers, mostly of the tongue, m young patients.

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Transformation of leukoplakia into squamous cell carcinoma

M. Molnar, B.M. Seplc Matanovlc, Z. Blazic Potockl. Dental

T. Fflhes, U. Meyer, U. Joos, H. Borger. Department of Cramo-

polyclinic Zagreb. Croatla

Maxtllofactal Surgery, Untverstty of A/Iuenste~; Germany

Introduction: The aim of this study was to present a case o f

Introduetion: The Clear cell odontogemc carcmolna is a very rare tumor of the oral cavity. Up to now 35 cases are described m literature. The recommended therapeutic strategies show a wide range of variation. Until now no minor dependent serum parameter is described during the cause of injury. Materials and Methods: In our case report we describe tile clinical and h]stopathological facts as well as our therapeutic proceeding by a 57 years old patient who was injured by a Clear cell odontogenic carcinoma o f the left upper jaw. In cause of treatment several possible serum parameters (CEA, S CC, N S E) were tested concerrmlg to their carcinoma sensitivity. Results: In our case, the clear cell odontogemc carcinoma show a positive staining for NSE (neuron specific enolase).

oral verrucous leukoplakla transfornlation into OSCC Materials and Methods: Tile case of 55 old male with verrucous leukoplaklal lesion transforming into the OSCC is presented Results: A 55 old male was referred for periodontal treatment during which a white vermcous leukoplaklal lesion was found in the left tipper molar region. The lesion was painless. The general dentist was aware of its existence for the past seven years, but did nothing. The lesion, in the words o f the patient, was growing steachly. Biopsy was taken, and acanthosis and parakeratosis of the upper epithehal layers and altered layers o f basal ceils, a corrupt basal membrane, posltiveKi-67 and altered p53 expression were fmmd. HPV test Hybrid capture

Poster Sessions

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II and PCR for HPV DNA was done. Ty-pe 16 was found and the patient was referred to oral surgery. He refused this kind of trealrnent, but in few months the lesion began to spread and surgery was preformed. Open stoma remained in the upper left quadrant, with no need for plastac surgery. Conclusion: Ichopathlc leukoplaklal of the oral cavity can arise from either keratmazed or non-keratnnzed epathehum. Most lesions follow a benign course, but some transform into squamous cell carcinoma. Proliferative verrucous leukoplakia (PVL), a high-rusk type of oral leukoplakia is unique oral white lesion m which human paplllomavtrus (HPV) may play a role. Unlike many other vtruses that reduce prohferatlve changes m these cells, winch result m both benagn and mahgnant tumors. To date, more than 70 dafferent HPV types have been isolated, with DNA types 16 and 18 having the strongest malignant potential.

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Brushing cytology in the interpretation of metastatic malignancies in the oral cavity

D. TasmolaklS2, V. ThomaldlS I, I. Tsamls i, M. Lambropoulou "~, G. Alexladls ~, N. Papadopoulos 3. ~Department of Oral

cmd M~zrtlIofactal Surgery. Regional Unteerstty Hospital of Alexandroupohs. Thrace. Greece. 2Depa~'tment of C~'topathology. Regional General Hospttal of Chama, Crete, Greece; 'Department of H~stology-Embryolog3; Democritus Untvers~(v of Thrace, FaculO' of Medtctne, Alexandroupohs. Thrace. Greece Introduction: Metastases to the oral regaon are unconmaon mad may occur m the oral soft tissues or the jawbones. Because of thetr raraty (1% of all mallgnaat oral newgrowths), they are challengang to chagnose. However, autopsies of cancer patients reveal a higher frequency of metastatic deposats in the jawbones, not clinically manifested. The most frequently reported prlmaraes are breast, lung, kidney, bones, and colorecaun. Symptoms develop m a short tmle. In the soft tassues, most lnchvaduals complain of a lump, m the jawbones swelling, pare and paresthesaa of the affected nerve are the chief complaints. In some cases, the metastasas as dasclosed m a recent extraction sate. Radaology as that of a lytac lesaon. Hastology is the comer stone for the daagnosas. Exfolaatlve oral cytology has become less amportant notably because of a high proportion of false negataves. More recently, however, the development of automated cytomorphometrlC devices, of DNA asmlyses and of technaques for the detectaon of ~ m o r n~arkers has reawakened interest m tins approach. Materials and Methods: In this study we evaluated the performance of brushing cytology with that of permanent sections hastology m twelve patients. We used dtrect smears and cell block preparations for mamunocytochermcal analyses. Results: There was a false negative result by direct smearing concerning a case of melanoma arising m the gmgava of a female patient w~th free medical Nstory. There were no false pomtwe resuRs. So positive predictive value was 100%, and negative prechctlve v a n e was 98°4. The false negative resuR was attributed to the apparent failure of a microscopic focus of metastatic deposit to adhere to the glass slide, a problem that seems unavoidable. Co~elasiom Brushing cytology as a valuable adjunct m the interpretation of oral neoplastic processes. It as performed easily and rapidly, and no tissue is lost. However knowledge of the climcal findings and past medical history is imperative.

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Withdrawn

P.1071 Oral squamous cell carcinoma around dental implants in a patient with oral lichen planusa case report R. Czerninski, G. Almoznino, A. Maly, E. Regev. The Hebrew

Untverstty- Hadassah School of dentaI medtcme. Jerusalem, Israel Introd~lefion: Oral Squamous Cell Carcinoma (OSCC) is related to rask factors such as smoking and alcohol, and with premallgnaat conditions such as Erosive Lichen Planus (ELP). Although osseo-mtegrated dental amplants have rarely been reported m assoclataon of OSCC, the questaon of the safety of placing dental implants in patients with pre-malignant lemons and risk habits has not been resolved yet. Materials and Methods: Case Report: A 52 year old female presented wath a 2.5 cm non-healing ulcer m the left lower alveolar radge, m proxmnty to a dental mlplant placed 3 years prevaously. She had been chagnosed wath ELP 5 years praor to the implant procedure, and had not ceased smoking heavaly m spate of being reformed of the rasks. Res~dts: The hlstopathologacal daagnosas was SCC. The pataent underwent a complete worknp, which faded out bone nodal or distant organ involvement, resulting m a classification of local, stage II disease, The pataent was treated by local wide resection including the adjacent alveolar bone and lpsalateral modafied neck dlssectaon. Conelus|on: The pataent had 2 risk factors for oral malagnancy, however, the tumor developed m close proxnmty to the amplaslt site and not elsewhere m the oral cavity. There may be an increased risk assocaated wath the Lrnplas~t ~tselI\ the surgical procedure or the perl-tmplant envtrorm~ent which m addataon to the pre-existing risk factors may lead to full-blown malagnancy. Further research as needed to establish the safety of dental tmplants m tugh risk patients.

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Lectin histochemistry of mucoepidermoid carcinoma

M.J.B.M. R~go 1, L.X. Santos I, L.B. Carvalho Jr. ~2, E.I.C. Beltr;~ 1,2, A.P.V. Sobral 1,3. ;LIKA Laboratorto de

Imunopatologm Ke~zo Asamt UFPE.Braztl. 2Departamento de Btoquimtca. CCB/UFPE. Bras~l, SDtsctphna de Patolog~a Bucal -Faculdade de Odontologta de Pe~7,ambuco, Brawl Introd~lefion: Mucoepadermold carcinoma (MEC) as the most

conmaon malignant sahvary tumour, classified as low, mtermedaate and t~gh grade. Regarding the pathology of salivary gland tmnottrs chscusslons related to morphology, histogenetic, diagnosis and classxficatxon have taken place specmlly to characterlze the constxtuent turnout cells to establish d~fferences among turnout types. Traditionally mmamlOhlStochen~stry has been the choice for exploiting such features but lectm t~stochennstry has been increasingly used as an auxdrary tool for dxagnosls. Lectms are ubxqtutous proteins which recogmze carbohydrates specifically and reversxbly. In this work lectms are used as tustochermstry markers for normal and transformed sahvary glands. M a t e r ~ l s and Methods: Bxopsxes of mucoepldermold carcmoma (low grade, n = l : mtermedaate grade, n = l and high grade, n = 3) were sliced (4~m), treated wxth 0.1 o~'o (w/v) trypsin and 0.3% (v/v) methanol-H202 solutions and incubated with lectins conjugated to peroxidase, HRP (Concanavalin A, Con A-HRP and Ulex europeus I, UEA-HRP). Peroxldase was VlSUahzed with a solution of daan~nobei~zldme-H202 and evaluated by hght microscopy. Results: Neoplaslc cells m MEC (high grade) were recognized by UEA where it was observed a weak cytoplasmic