Joseph S. Giansanti

Adenoid cystic carcinoma: Analysis of fifty oral cases☆

Fifty cases of oral minor salivary gland adenoid cystic carcinoma (ACC) are analyzed and reported. Oral ACC frequently masquerades as a benign neoplasm, and in the majority of cases there is no pain or ulceration. The most common location is in the palate; a plea is made for incisional biopsy of all oral lesions suspected of salivary gland origin. Survival rates show a progressive decrease with time, and there were no survivors beyond 20 years. In this study, there was a positive correlation between duration of the lesion before diagnosis and the salvage rate, but no correlation was found with the size of the presenting lesion.

Sclerotic cemental masses of the jaws (so-called chronic sclerosing osteomyelitis, sclerosing osteitis, multiple enostosis, and gigantiform cementoma)

A series of thirty-eight cases of densely sclerotic lesions of the jaws was studied. The lesions were all at least 1.5 cm, in diameter. Pain, drainage, or localized expansion of the jaw was present in two thirds of the patients. Thirty-four of the thirty-eight patients were women, and twenty-five were negros. In fourteen instances, a radiographic survey of the entire jaws was available. Thirteen of these fourteen patients had multiple lesions which were usually symmetrically distributed throughout the jaws. In twenty-four patients radiographs of the lesional area only were available for review. In thirty-four of the thirty-eight cases (89 per cent), the sclerotic masses were interpreted as cementum. Although this condition has previously been described as chronic sclerosing osteomyelitis, sclerosing osteitis, multiple enostosis, or gigantiform cementoma, it appears more appropriate to consider these lesions as part of the spectrum of the benign fibro-osseous lesions of periodontal ligament origin. Four of the sclerotic lesions, which were radiographically indistinguishable from the cemental lesions, consisted only of bone. Two of these appeared to be examples of true chronic sclerosing osteomyelitis, and two may be appropriately designated as enostosis or osteomas.

The oral melanotic macule.

A clinical and histologic study of eighty oral melanotic lesions which do not readily fit into recognized categories of melanotic lesions was conducted. These lesions tend to occur in the fifth decade of life and are most frequently seen on the gingiva, with the buccal mucosa and palate the next most frequent sites. The lesions are usually single, smaller than 1 cm., but they may also occur as multiple lesions. There is no sex bias, and there seems to be a number of etiologic factors. In a few cases long-term follow-up was possible. There is no indication of a tendency toward recurrence or development of malignant lesions. Histologically, none of the lesions shows atypia. Melanin pigmentation tends to be present in significant amounts in the basal-cell layer and less often in the lamina propria. There are no outstanding histologic differences among the eighty specimens. It is suggested that the term oral melanotic macule be used for these lesions, unless a specific cause can be confirmed by clinical data. Although these lesions should not be considered premalignant, it would be prudent to remove them for histologic confirmation of clinical impressions.

The labial melanotic macule

Fifty-five cases of a melanotic lesion of the lips which is well known, but not well described, are reported. The lesions characteristically occur on the lower lips of young adults. Males and females are equally affected. These lesions may be ephelides, postinflammatory melanoses, or unique lesions for which there is no exact cutaneous counterpart. We suggest the term labial melanotic macule as a descriptive one which would encompass the three different constituent entities. On the basis of follow-up information obtained and the histopathologic character of the lesions, this entity is benign and does not, in our opinion, have any malignant potential.

Radioprotection of oral cavity structures by wr-2721

Abstract The finding of a high concentration of 35 S WR-2721 in mouse salivary glands led to studies of possible radioprotection of these glands from ionizing radiation. Oral effects of radiation in the presence of WR-2721 were studied in mice and dogs. The dose required to induce the oral radiation death syndrome (LD50/8–10) was increased by a factor of 2.1 in BALB/c mice when WR-2721 was given 30 minutes before irradiation of the head. Salivary flow in mongrel dogs following doses of 1000–3000 rad showed similar depression with and without the use of WR-2721. Therefore, the salivary gland may be an organ for metabolism or secretion of WR-2721 accounting for its high drug concentration. The skin and oral mucosa were protected by a factor of 1.7 (2500 rad with WR-2721 = 1500 rad without WR-2721) at moderate radiation reactions. This protection decreased to 1.2 at the level of radionecrosis (3000 rad with WR-2721 = 2500 rad without WR-2721). At clinically acceptable radiation reactions, WR-2721 offers the possibility of significant protection of normal epithelial structures of the head and neck.

Sialadenoma papilliferum of the oral cavity

Sialadenoma papilliferum is a rare tumor of salivary gland origin. A review of the English-language literature indicates that only four cases have been reported. This article describes the clinical and histologic characteristics of an additional case occurring on the left retromolar pad.

Dentin dysplasia, type II, or dentin dysplasia, coronal type.

Abstract The second reported family with an unusual dentin abnormality is presented. This abnormality is characterized by involvement of both the deciduous and the permanent dentitions, but the involvement in each is different. The deciduous teeth resemble the condition known as hereditary opalescent dentin, both clinically and radiographically. However, the permanent teeth appear normal clinically, but dilated pulpal chambers and pulp stones are evident radiographically.

Intraoral melanocytic cellular nevi

Eight cases of intraoral melanocytic cellular nevi are presented, together with the clinical features and limited follow-up information. These cases are added to those already published, so that a meaningful series may eventually be analyzed.

Oral nodular excrescences in epidermolysis bullosa

Two brothers are reported with what appears to be a recessive and dystrophic type of epidermolysis bullosa. The oral lesions seen in these patients consisted of small fibrous nodules that were liberally distributed on the bound-down mucosa. These lesions have not been previously reported. One of the offspring of these patients, who was not affected by epidermolysis bullosa, was missing a large number of teeth.