Charles L. Dunlap

Leiomyomas of the oral cavity. Review of the literature and clinicopathologic study of seven new cases.

Abstract Intraoral leiomyomas have been reported to be rare neoplasms because of the paucity of smooth muscle within the oral cavity. A review of the literature yielded twenty-eight cases, and a clinicopathologic study of the twenty-eight previously reported cases and our seven cases suggests that this tumor is not as rare as previously suspected. The results suggest that this entity has a predilection for the 40 to 59-year age group, a male: female ratio of 2:1, and was most frequently encountered on the tongue. The intraoral leiomyoma does not appear to be estrogen dependent, as are those seen in the uterus.

The Noonan syndrome/cherubism association

Noonan syndrome is characterized by short stature, unusual facies, congenital heart disease, chest deformity, mild mental retardation, and cryptorchidism in males. It may be sporadic or inherited as an autosomal dominant trait and occurs between 1 in 1000 and 1 in 2500 live births. Cherubism is a giant cell lesion of the jaws thought to be transmitted as an autosomal dominant trait. It is usually recognized by age 7 years, follows a variable course, and is not known to be related to other genetic disorders. We herein report on four patients with Noonan syndrome, all of whom had cherubism. Two other probable cases are cited in the literature for a total of six known cases.

Central odontogenic fibroma of the WHO type

Two examples of central odontogenic fibroma, WHO type, are reported. The radiographic and microscopic features are discussed and illustrated. Both were treated by curettage, and neither has recurred after 10 and 9 years, respectively. We postulate an ectomesenchymal-epithelial interaction in the histogenesis of this unusual tumor.

Necrotizing sialometaplasia: Report of five additional cases

Abstract Necrotizing sialometaplasia is a benign disease which, clinically and microscopically, is often confused with malignancy. Five cases are reported to publicize the existence of this uncommon oral lesion. The clinical appearance, history, and microscopic features are discussed and illustrated.

Giant-cell hyalin angiopathy

Seven examples of an unusual hyalin degenerative change in the walls of blood vessels are discussed. We believe this is a localized phenomenon, not connected to systemic vascular disease. Inflammation is usually present, and in each case a dental procedure had previously been performed. Dental extraction was the most common procedure. Giant cells of the foreign-body type are present, but particulate foreign material was seen in only one case.

Cystic odontoma with concomitant adenoameloblastoma (adenoameloblastic odontoma)

Abstract Reported is a case of odontogenic tumor in which there is production of enamel and dentin matrix, with the soft-tissue component resembling adenoameloblastoma.

Lichen sclerosus et atrophicus of the oral cavity: Report of two cases

Lichen sclerosus et atrophicus is a depigmenting mucocutaneous disease most frequently affecting the female genitalia. Genital lesions are symptomatic and may be functionally debilitating. Oral lesions are of little significance other than the esthetic concerns of perioral lesions. In view of the rarity of reported cases, one lesion of the labial mucocutaneous area and a second of the palate are presented along with a description of the diseases clinical and histopathologic findings and a brief review of the literature. The lip lesion was partially resolved with topical corticosteroids and was then fully eliminated with topical testosterone. Histologic verification and examination for the simultaneous occurrence or absence of oral and the more common genital-cutaneous lesions is essential if meaningful information in the medical-dental literature is to be obtained in the future.

Congenital teratoid cyst of the floor of the mouth

Erich’ first used the term “dysontogenetic,” meaning disturbance in embryologic development, in referring to the origin of dermoid cysts of the floor of the mouth. Several mechanisms have since been reported in the literature concerning the embryologic basis for their occurrence. Eppley3 listed four mechanisms. These included: 1) submergence of ectodermal cells that were pinched off at the time of closure of the anterior neuropore; 2) entrapment of ectodermal rests during closure of the first and second branchial arches at the midline position; 3) remnants of the anterior tongue precursor, the tuberculum impar; and 4) misplacement of the adjacent embryologic tissues (i.e., foregut). The term dermoid cyst appears frequently in the literature and Meyer4 suggested retaining its use for all types of developmental cysts of the mouth floor. In a review of the literature, Eppley3 states that two types of congenital floor of the mouth cysts exist; the dermoid and heterotopic gastrointestinal cysts. Gorlin,’ in a review of the literature, described 13 cases of the choriostomatic cyst of gastric or intestinal epithelium. He theorized that mixtures of endodermal and ectodermal tissue could give rise to cysts containing both germ layers. Dermoid cysts of the floor of the mouth are rare but well-documented in the literature. Erich and New6 reported 1495 dermoid cysts. In this population, 103 (6.9%) were located in the head and neck. Twenty-five percent of the head and neck dermoids were present in the oral

Melanocyte colonization of oral squamous cell carcinoma

Abstract This is a report of squamous carcinomas of the oral mucosa which have been colonized by benign melanocytes. In some tumors, melanocytes undergo hyperplasia and are found not only within the in situ portions of tumors but also in the infiltrative portion. Literature is cited which indicates that benign melanocytes may also colonize intravascular tumor emboli and metastatic foci.

Chronic pulmonary histoplasmosis with an oral lesion

Histoplasmosis is a fungal disease resulting from inhalation of airborne spores of the organism Histoplasma capsulatum. The disease is endemic to the Ohio and Mississippi river valleys. Oral lesions are not common, but when present, they are usually associated with the severe disseminated form of histoplasmosis. This particular case is presented as an example of chronic pulmonary histoplasmosis in which a localized gingival lesion represented the initial clinical manifestation of the disease. Diagnosis was based on a positive biopsy and the results of chest radiographic examination. If, as in this case, serologic, hematologic, and physical examination results are negative, the biopsy of suspicious lesions is of paramount importance to the clinical differential diagnosis.