Chi-Sheng Cheng

Nutritional factors and survival of patients with oral cancer.

Our objective was to determine the survival rate of patients with oral cancer who were treated at a medical center in central Taiwan. Furthermore, we attempted to investigate whether nutritional factors influence the survival.

Clinical implications of recent exodontia before diagnosis of gingival squamous cell carcinoma: A new classification.

The purpose of this study was to clarify the clinical implications of cases with recent dental extractions to establish a new classification of gingival squamous cell carcinoma (SCC).

The Prognostic Significance of Adequate Surgical Margin for Head and Neck Sarcomas: A Retrospective Study of Thirty-one Cases

The aim of this study is to report our experience in the treatment of head and neck sarcomas. The medical charts and histopathologic features of thirty- one head and neck sarcomas at Taichung Veterans General Hospital between 1982 and 2007 were reviewed. Seventeen (54.8%) of the patients were male, while 14 (45.2%) were female. The common sites were the mandible (n=13), maxilla (n=7) and neck (n=7). Malignant fibrous histiocytoma (n=11) and osteosarcoma (n=8) are the most common lesions. Surgical resections were performed in 28 cases. Among them, local recurrence was found in 9 patients, and distant metastasis was proved in 4 patients. The overall 5-year survival rate was 50%. Surgical margin involvement and local recurrence were the main causes of death (P=0.006 and P=0.010, respectively). Of 13 patients with margin involvement, six developed local recurrence within a mean period of 20 months; and the mean survival period of expired patients with margin involvement was 33 months. In our series, young-to-middle-aged (＜50 years) females had poor 5-year survival rates (30%). Inadequate soft tissue margin resection may be due to gender, age and cosmetic concerns.

Intra-osseous Lipoma of the Mandible: Review of the Literature and Case Report

Intra-osseous lipoma is extremely rare in the jaw bones. Characteristic histopathological finding consists of the presence of only mature adipose cells. The majority of jawbone intra-osseous lipomas are found in adults, and of uncertain origin and etiology but are usually associated with molar teeth. We present here a case of a fifteen-year-old boy who experienced a painless, gradual swelling of the right side mandibular angle for 3 years. We also discuss and compare this case with the other intra-osseous lipoma cases.

Sclerosing Mucoepidermoid Carcinoma of the Parotid Gland with Neuralgia-A Case Report

In several recently reported cases, sclerosing mucoepidermoid carcinoma has been proposed as a new subtype variant because of its specific histological pattern and low-malignancy potential, when compared with high-grade mucoepidermoid carcinoma in clinical observation. It is believed that tumor infarction and extravasation of mucus are the two mechanisms which cause the sclerosing pattern. Herein, we report a case of sclerosing mucoepidermoid carcinoma. The patient did not receive chemotherapy or radiotherapy after the first operation. Four years later, the patient presented with electric-shock pain over the left facial region. Neuralgia attack was suspected. An anticonvulsant agent (Tegretol) was prescribed and microvascular decompression was performed by a neurosurgeon, but symptoms persisted. CT scan showed a recurrent mass over the left parotid gland. After tumor ablation and sacrifice of the auriculotemporal nerve, the neuralgia symptom subsided. Histology showed rare mucus-secreting cells and no obvious epidermoid cell atypia. Collagen deposition and desmoplastic change were found in stroma. After reviewing the literature, we determined that the characteristic was similar to that of sclerosing mucoepidermoid carcinoma.

Desmoplastic Ameloblastoma: A Retrospective Study

Desmoplastic ameloblastoma is a variant of ameloblastoma first described in 1984. The histopathologic features of 60 ameloblastomas diagnosed at Taichung Veterans General Hospital during years 1982-2001 were reviewed with special reference to the incidence of the desmoplastic variant. Only two cases fulfilled the criteria of a desmoplastic ameloblastoma, representing 3.3% (2/60) of all the intraosseous ameloblastomas. One of the rumor occurred in the mandible and the other located in the maxilla. Both cases contained abundant coarse collagenous stroma, and scattered islands and nests of atypical odontogenic epithelium with a surrounding acellular or hyalinized zone. Stellate cells within the central area of some of the neoplastic cell nests were observed. Radiographically, both cases exhibited a mixed radiolucent/radiopaque appearance with poorly defined borders, suggestive of fibro-osseous lesions. The clinical, radiographic, ad microscopic aspects of this unusual lesion are presented, and the relevant literature is reviewed.