Neeta Mohanty

Cancer Stem Cells Accountability in Progression of Head and Neck Squamous Cell Carcinoma: The Most Recent Trends!

Cancer stem cells (CSCs) play a major role in local recurrence and metastatic spread in head and neck squamous cell carcinomas (HNSCC). Evidence suggests that cancer stem cells are resistant to conventional therapy. So the emerging concepts of the role of cancer stem cells in the pathobiology of HNSCC should be understood carefully to be able to create new paradigms in treatment plans.

Calcifying epithelial odontogenic tumor, a rare presentation in children: two case reports.

Calcifying epithelial odontogenic tumor (CEOT) is a rare and benign odontogenic neoplasm that affects the jaws. It is certainly an atypical instance to find this tumor in children. Here, we present two case reports of CEOT presenting in mandible of a 12- and 13-year-old female child, respectively. CEOT have been reported to show features of malignant transformation also.

Adenomatoid odontogenic tumor with clear cell changes.

Adenomatoid odontogenic tumor (AOT) has a limited biological profile and been an attention-grabbing tumor for a century for its origin. Though described earlier, it was widely accepted after Harbitz from Norway reported about this uncommon benign tumor in 1915. There has been a long debate as whether this tumor is a hamartoma or a neoplasm. Here, we present a case of AOT in a 20-year-old female with details of clinical, radiological and histological features along with clear cell changes, signifying AOT to be more aggressive in nature than assessed from earlier literature. Thus, we did an extensive search of PubMed literature on AOT with all its histopathological features associated until date to find the report of clear cell changes yet.

Unicystic Ameloblastoma Masquerading as Huge Periapical Lesion, both Clinically and Histopathologically: Two Case Reports with Review of Literature

Unicystic ameloblastoma (UA) is one of the variants of ameloblastoma. It manifests as unilocular radiolucency in the mandible or maxilla on X-ray scans. In very rare cases, it can appear as a localized periradicular radiolucent area, imitating a periapical lesion. In this article, we present two cases of UA that were initially misdiagnosed as periapical lesions. Subsequently, surgical enucleation was performed and the diagnosis of UA was confirmed histopathologically.

Papilliferous Keratoameloblastoma: An Extremely Rare Case Report

Odontogenic tumors develop in the jaw bones from the odontogenic tissue-oral epithelium in tooth germ, enamel organ, dental papilla, reduced enamel epithelium, remnants of Hertwigs root sheath or dental lamina, and so forth. Hence, a bewildering variety of tumors are encountered in the maxilla and mandible. Ameloblastoma is the second most common odontogenic neoplasm after odontomes, and it has numerous clinical and histologic variants. We report a very rare histologic variant: the papilliferous keratoameloblastoma which is the fifth reported case in the English literature.

Establishing Fascin over-expression as a strategic regulator of neoplastic aggression and lymph node metastasis in oral squamous cell carcinoma tumor microenvironment

INTRODUCTION Oral squamous cell carcinoma (OSCC) has an aggressive behaviour with high incidence of nodal metastasis, even in the early stages, leading to poor prognosis. For progression and metastasis of cancers, the dominant element considered is cell motility. Fascin, an actin-binding protein has emerged as a protein of general importance for a diverse set of cell protrusions with functions in cell adhesion, cell interactions, and cell migration. The role of Fascin in various carcinomas, including aggressive behaviour in OSCC has been documented, but its role as a key regulator in lymph nodes metastasis is yet to be validated. AIM This study was piloted to evaluate and correlate Fascin expression in OSCC lymph nodes and understand the role of Fascin in contemptuous Lesional tissue, as a predictor of survival. A retrospective study designed with 40 archival OSCC cases was included as sample, 20 each of both lymph node metastasis +ve (Group 1) and -ve (Group 2) groups. All the participants were smokeless tobacco user and had tumor located at gingivo-buccal complex. RESULTS We established that Fascin over-expression in lymph nodes were significantly associated with clinico-histopathological parameters like staging (p=0.01), tumor size (cT) (p=0.03) and differentiation; and furthermore it was highly significant in correlation to nodal status (cN) (*p≤0.001). Fascin over-expression in lymph node metastasis positive cases correlated with that of Fascin expression in contemptuous Lesional tissue signifying its role in promoting aggressive progression and metastasis. This association was found to be statistically significant (p value=0.05). Overall Survival Analysis of both lymph node metastasis +ve and -ve groups assessed by Kaplan-Meier analysis (taking death and recurrence into consideration) showed patients with high Fascin expression (in lymph node and Lesional tissue) had shorter overall survival than patients who had no to weak Fascin expression. CONCLUSION Our findings thereby establish Fascin expression as a regulator of metastasis in OSCC tumor microenvironment and predictor of survival.

Hemangiopericytoma/solitaryfibrous tumor of mandible: A rare entity.

The fourth edition of the World Health Organization (WHO) classification of tumors of soft tissue and bone “blue book” that was published in February 2013 has abandoned the term “HPC.” It is used only to describe a morphological pattern that is shared by different entities. Currently, solitary fibrous tumor (SFT), HPC, lipomatous HPC and giant cell angiofibroma are all grouped under the “extra‑pleural SFT” category.

Malignant peripheral nerve sheath tumour (MPNST) of mandible: solving the perplexity.

We present an extremely rare case of malignant peripheral nerve sheath tumour (MPNST) in a 30-year-old woman without associated neurofibromatosis 1. The patient presented with an 8 cm×4 cm lesion extending from 46 to the retro molar region involving the ramus of the right mandible associated with regional paraesthesia. Incisional biopsy revealed spindle cells with vesicular nuclei arranged in fascicles leading to a diagnosis of spindle cell lesion. Posterior segmental mandibulectomy was performed under general anaesthesia. On excisional biopsy, a definitive diagnosis of low-grade MPNST was established on the basis of immunohistochemistry. The patient was then lost to follow-up.

Recurrent osteomyelitis of the mandible in osteopetrosis: a common complication of an uncommon disease

Osteopetrosis is a congenital disease characterised by overtly dense bone with obliteration of marrow spaces, owing to defective osteoclast function, resulting in excessive and defective bone formation. It is rare, having an incidence of 1 in 250 000 births.1 Diffuse generalised osteosclerosis of bones is seen and serious oral complications such as osteomyelitis with exposed necrotic bone may occur in the jaws.2 Ten per cent of osteopetrosis cases develop osteomyelitis that usually involves the mandible. Osteomyelitis of the maxilla is very rare, probably because of the thin cortical bone and rich collateral blood supply. Osteopetrotic bones lack a bone marrow cavity, fail to resist normal physical loads, and are vulnerable for fractures due to lack of remodelling.1 Osteopetrosis is generally diagnosed through skeletal radiographs in which there is increased radiodensity and hence the name ‘Marble bone disease’.3 Dentists should be aware of the disease because tooth extraction in such patients results …

Basaloid squamous cell carcinoma of the maxilla

Basaloid squamous cell carcinoma (BSCC) is a distinctive aggressive variant of squamous cell carcinoma. We present a case of a 60-year-old man with tender swelling in the right cheek region for 6 months and continuous unilateral nasal discharge for 2 months. Extraoral examination revealed an ovoid, well-defined swelling from the right infraorbital rim to the angle of the mouth superoinferiorly and the right lateral wall of the nose to preauricular region anteroposteriorly. Intraorally, an ulceroproliferative growth from right upper gingivobuccal sulcus to mid palatine raphe with bicortical expansion was evident. CT revealed a hypodense mass obliterating the right maxillary sinus. Histopathology showed closely packed basaloid cells, with hyperchromatic palisading nuclei, arranged in a solid pattern with a lobular configuration. Prominent areas of comedo necrosis and keratin pearl formation were seen. These features suggested BSCC. The patient underwent surgical excision with adjuvant radiation but was lost to follow-up after 6 months of radiation therapy.