John L. Doyle

Leiomyoma of the oral cavity: a light microscopic and immunohistochemical study with review of the literature from 1884 to 1992.

Leiomyoma is the most common benign neoplasm in the uterus and stomach but is rare in the oral cavity. There were only 5 oral cases in a series of 7748 leiomyomas of all sites. Benign smooth muscle neoplasms are classified into leiomyoma (solid leiomyoma), angiomyoma (vascular leiomyoma) and epithelioid leiomyoma (leiomyoblastoma). 6 cases diagnosed as leiomyoma were retrieved from the files of two oral biopsy services over the past 25 years. A light microscopic study including trichrome and phosphotungstic acid haematoxylin (PTAH) stains, and an immunohistochemical study with the following markers: desmin, muscle specific actin, myoglobin, vimentin, S-100 protein, neuron-specific enolase, factor VIII and Ulex europeus were done with suitable controls. The haematoxylin and eosin and Massons trichrome stains supported a diagnosis of leiomyoma in all 6 cases but PTAH was positive in only 3 of them. The immunohistochemical study confirmed the diagnosis of leiomyoma in 3 cases. The other 3 were identified as granular cell tumour, myofibroma and neurofibroma, respectively. The review of the literature contributed the following data: mean age was 41 and median age 39 in 134/142 patients. A male sex prevalence 72/137 patients (54.0%) was noted. The lips were the most common site with 39 cases (27.46%) followed by the tongue 26 (18.30%), cheeks and palate 22 (15.49%), gingiva 12 (8.45%), and mandible 8 (5.63%). Prognosis of oral leiomyomas is excellent. Immunohistochemistry is a precise and reliable method for definitive diagnosis of oral leiomyoma.

Clear cell odontogenic carcinoma with lymph node metastasis

Clear cell odontogenic tumors are rare. Review of the literature showed 9 cases with a prominent clear cell component. These lesions have exhibited an aggressive behavior characterized by an infiltrative local growth pattern, recurrence, or metastases. We report a case of an odontogenic tumor that exhibited a biphasic pattern and was characterized by lymph node involvement identical histologically to the primary tumor. We conclude that the presence of a clear cell component in an ameloblastomatous tumor should be viewed as a sign of de-differentiation, and that a malignancy with or without metastases should be considered and ruled out in such cases.

Squamous odontogenic tumor: Report of three cases including the first extraosseous case

Squamous odontogenic tumor is a distinct entity-separate from the more aggressive ameloblastoma. Only 33 squamous odontogenic tumors have been reported since the first description in 1975. We report three additional cases including the first completely extraosseous case.

Feulgen Microspectrophotometry of Oral Cancer and Leukoplakia

Feulgen microspectrophotometry was performed using the two wavelength method on 33 lesions and showed that five of ten carcinomas and 12 of 16 leukoplakias had diploid cell lines. This correlates well with similar findings in cervical cancer and dysplasia suggesting that changes in nuclear deoxyribonucleic acid content occur quite early in the evolution of cancer.

Odontogenic fibroma of the complex (WHO) type: report of six cases.

Six cases of the complex (World Health Organization) type of odontogenic fibroma are described. The relationships of these lesions to the simple type of odontogenic fibroma, desmoplastic fibroma, and to certain reactive lesions are discussed.

Unique odontogenic tumor with dentinogenesis and features of unicystic plexiform ameloblastoma

A case of an atypical odontogenic tumor with features of unicystic plexiform ameloblastoma and odontoblastic differentiation with deposition of tubular dentin matrix is reported. The significance of dentinogenesis, amelogenesis, and calcification in odontogenic tumors is discussed.

Malignant spindle cell tumor arising in the mandible of a patient with florid osseous dysplasia

Florid osseous dysplasia is a non-neoplastic condition of the alveolar processes of the jaws characterized by the replacement of multiple foci of bone by fibrous connective tissue, accompanied by gradual deposition of cementum, bone, or both. The lesions are not associated with inflammatory diseases of the dental pulp or periodontal tissues. In fully developed florid osseous dysplasia, there are multiple lobulated masses in the alveolar bone bilaterally in the mandible and sometimes in the maxilla. This is the first report of a malignancy originating within the jaws of a patient with florid osseous dysplasia. A spindle cell malignancy was diagnosed in the mandible of a 54-year-old black woman whose jaw was affected by florid osseous dysplasia bilaterally. Despite extensive surgery and radiotherapy, the patient died 20 months after diagnosis of the malignancy.

Benign lymphoid lesions of the oral mucosa: Preliminary classification

Abstract Twelve benign lymphoid lesions of the oral mucosa have been presented, and a tentative classification has been proposed.

Granular-cell schwannoma (myoblastoma)

Abstract We have presented a lingual granular-cell schwannoma (myoblastoma) and reviewed the evidence favoring the neurogenesis of this tumor.

Arteriovenous hemangioma of the palate

Arteriovenous hemangioma is an acquired vascular lesion usually occurring on the extremities and in the perioral skin, including the lips. The largest series of cases have been reported by Girard et al’ and Connelly and Winkelman.2 Koutlas and Jessurun3 have reported two intraoral cases. The arteriovenous hemangioma appears clinically as a small, red-blue, painless papule. Microscopically it consists of various sized vascular structures resembling veins and arteries that are separated by a poorly cellular fibrous stroma. It occurs predominantly in middle age, and there is no sex predilection. Treatment is by simple excision. Despite the presence of arteriovenous shunts in some lesions, bleeding during excision is not a problem. In many of the reported cases, there are increased numbers of mast cells in the stroma. Arteriovenous hemangiomas are thought to arise by proliferation of the subpapillary vascular plexus, possibly as a reaction to trauma or irritation.3 An alternative theory suggests a hamartomatous proliferation of the Sucquet-Hoyer glomus canal.4 The purpose of this article is to report an additional oral case.