James J. Sciubba

Myoepithelioma of salivary glands: Report of 23 cases

Twenty‐three neoplasms arising in major and minor salivary glands have been found to be composed of two types of myoepithelial cells–‐the plasmacytoid and spindle‐cell form. Twelve of these were located within the parotid gland and the submandibular gland and intraoral minor salivary glands accounted for five each. A solitary example was found within the upper lip. Sixteen (70%) of the cases were of the spindle‐cell type, four (17%) were composed of plasmacytoid cells, and three cases (13%) contained both cell forms in approximately equal quantity. Differences in behavior, recurrence rate, frequency, age of the patient, and location were not related to cell type. Ultrastructural analysis of selected cases showed myofilament aggregation patterns to vary between the two subtypes. Previously published cases confirmed by electron microscopy have been reviewed and compared with the 23 cases reported. Conservative surgical management is curative. Follow‐up information on 16 cases is presented.

Oral manifestations of HIV infection. Definitions, diagnostic criteria, and principles of therapy. The U.S.A. Oral AIDS Collaborative Group.

A set of definitions and diagnostic criteria for the more common oral features of human immunodeficiency virus infection were prepared as the result of a consensus reached by a group of dental and medical clinicians, epidemiologists, and other experts. These are intended for use in epidemiologic surveys, where the presumptive diagnoses are recommended, and in clinical care, pathogenesis and therapy studies, where the definitive diagnoses are appropriate.

Adenocarcinomas of the oral cavity: a clinicopathologic study of terminal duct carcinomas.

A clinico-pathologic study of 12 patients, each harboring a hitherto not delineated adenocarcinoma of salivary origin is presented. The authors have designated this histologically unique carcinoma as terminal duct adenocarcinoma in deference not only to its light-optic appearance, but also to a putative origin from the reserve cells (epithelial and myoepithelial) of the intercalated duct. The tumors local invasive properties with extension into nerves and adjacent bone suggest their biologic behavior is like that of adenoid cystic carcinomas.

Epithelial-myoepithelial Carcinoma of intercalated duct origin

A clinicopathologic and ultrastructural analysis of sixteen cases of epithelial-myoepithelial carcinoma of intercalated duct origin was undertaken, together with a review and correlation of eight previously reported cases. The neoplasm is found predominantly in women, with the majority occurring in the seventh and eighth decades of life. Most of these tumors occurred in the parotid gland. Five patients had one or more recurrences, and one patient died of tumor. Histologically, these tumors are composed of two cell types, generally exhibiting a glandular or ductlike arrangement. Ultrastructural findings confirm the duality of the cell population.

Myoepithelioma: Review of the literature and report of a case with ultrastructural confirmation

The myoepithelioma is a rare salivary gland tumor composed nearly exclusively of myoepithelial cells. A case occurring on the palate of a 22-year-old man is reported. Electron microscopic findings of occasional desmosomes, a basal lamina associated with the plasma memb;rane, and perinuclear cytoplasmic filaments confirmed the diagnosis. The myoepithelioma appears to resemble the pleomorphic adenoma clinically and may be a development variant of the pleomorphic adenoma.

Odontogenic epithelial hamartoma

Abstract Dental lamina and enamel organ hamartomas are rare occurrences and are considered to represent a transitional stage between a true odontogenic tumor and a developmental anomaly. Microscopically, there are many similarities between the odontogenic hamartoma and the peripheral ameloblastoma.

Chemotherapy for head and neck cancer relapsing after radiotherapy.

Thirty‐nine patients (28 men and 11 women, ages 43 to 83 years) with advanced head and neck epidermoid carcinoma (33 had relapsed from previous radiotherapy) were treated with a three‐day bleomycin administration (30 by continuous intravenous infusion and nine by subcutaneous route) followed on the fifth day by intravenous administration of cyclophosphamide + methotrexate + 5‐fluorouracil (Bleo‐CMF). This drug schedule was based on the cell cycle synchrony principle. Twenty‐one of 39 patients (54%) responded (seven complete, 14 partial remission) lasting from 4 to 20 months. The median duration of survival for complete remission, partial remission, and disease progression was 15, ten, and four months, respectively. The Bleo‐CMF was well tolerated with minimal toxicity. The effectiveness of this regimen in previously irradiated patients compels us to pursue its application in a randomized study as an adjuvant for Stages III and IV head and neck cancer following maximum eradication of the local disease by surgery and/or radiotherapy.

Oral-facial manifestations of Klippel-Trenaunay-Weber syndrome. Report of two cases.

Two cases of the Klippel-Trenaunay-Weber syndrome are presented. In one of the cases postsurgical complications arose in association with the vascular component of the syndrome complex. Oral surgeons and dentists must remain aware of the potentially serious complications of dental and/or surgical procedures in such cases. Other stigmata of the syndrome are discussed and related to similar conditions.

Evidence base, epidemiology, correlations, and cause and effect: dental caries and head and neck cancer

Reader beware. With the ever-increasing number of journals comes an ever-increasing number of publications that require an ever-increasing number of reviewers and fact checkers. However, I am finding that the ever-increasing pace and number of activities authors and reviewers are required to manage is resulting in many examples of less than stellar articles making their way into the publication world. I also am concerned by the fact that many readers may not be aware of the inaccuracies and errors found in publications and would assume that all published findings are accurate. I welcome this editorial from Drs Epstein, Sciubba, and Abt as an example of the importance that health care providers must place on becoming familiar with the principles of evidence-based practice. Otherwise, scientific accuracy and critical analysis will be left to only those who know better. Craig S. Miller, DMD, MS Editor, Oral Medicine Section

Radiation-induced pseudosarcoma of the tongue☆

Abstract An 88-year-old man received radiation therapy for squamous-cell carcinoma of the right maxillary buccal vestibule. Four years later a polypoid lesion arose on the right lateral border of the tongue. The mass was removed by conservative wedge resection and there has been no recurrence in the ensuing 4 years. Our search of the literature has failed to reveal a similar recorded occurrence in this location.