Squamous Cell Carcinoma as the Most Common Lesion of the Tongue in Iranians: a 22-Year Retrospective Study

Oral Potentially Malignant Disorders and Squamous Cell Carcinoma at the Tongue: Clinicopathological Analysis in a Thai Population

Objective  Tongue is regarded as one of the common sites of oral squamous cell carcinoma (OSCC). This study aimed to determine the prevalence and clinicopathological profile of OSCC and oral potentially malignant disorders (OPMDs) at the tongue.

Materials and Methods  We retrospectively analyzed clinicopathological characteristics of 208 Thai patients diagnosed with SCC and OPMDs at the tongue in the period from 1996 to 2015. Chi-squared test was used to compare differences between patient’s clinical and histopathological features.

Results  Seventy-eight tongue SCC and 130 tongue OPMD cases were present over the study period. Slight male predominance was found for tongue SCC, while a slight female predominance was present for tongue OPMDs. Both tongue SCC and tongue OPMDs were mostly diagnosed in the old age patients (>40 years old). The majority of tongue SCC and OPMDs occurred at the tip and lateral of the tongue. The most common histologic grading of tongue SCC was well differentiated and no poor differentiation was found in this study. More than a half of tongue OPMDs showed epithelial dysplasia. Both tongue SCC and OPMDs demonstrated no significant correlation between clinical feature and histopathologic diagnosis.

Conclusions  Tongue SCC and OPMDs were particularly found in the elderly population and frequently developed at the tip and lateral of the tongue. Most of tongue OPMDs, particularly all of tongue erythroplakia, exhibited epithelial dysplasia. For dental practitioners, awareness in the early detection and diagnosis of these tongue lesions should be raised.

Hemangiomas of the tongue and the oral cavity in a myotonic dystrophy type 1 patient: A case report

RATIONALE

Myotonic dystrophy type 1 (DM1) is an autosomal dominant disease caused by a cytosine, guanine, thymine (CTG) trinucleotide repeat expansion in the non-coding region of dystrophia myotonica protein kinase gene, causing a multisystem involvement. To date, few studies have been performed to evaluate skin features in DM1 patients, but none reported on the possible association between the disease and tongue hemangiomas.

PATIENTS CONCERNS

We report a case of a 63-year-old woman affected by DM1 and presenting, at the intraoral examination, several swelling and buish lesions occurring on buccal and palatal mucosa, and in the anterior two-thirds and margins of the tongue.

DIAGNOSIS

Multiple tongue hemangiomas in DM1 patient.

INTERVENTIONS

Color Doppler ultrasound revealed hypoechoic lesions with intermittent color picking suggestive of vascular lesion. Surgical excision was performed under general anesthesia. Histopathological examination was compatible with the diagnosis of cavernous hemangiomas.

OUTCOMES

At 6 months follow-up, a part from the cosmetic deformity, patient's hemangiomas did not bleed, but caused functional problems with speaking, mastication, and deglutition, in addition to the same symptoms induced by DM1.

LESSONS

This case may add new details to better characterize the DM1 phenotype, suggesting that even tongue hemangiomas may be part of the DM1 multisystem involvement.

Immunocompetence and mechanism of the DRibble-DCs vaccine for oral squamous cell carcinoma

Background

Due to the high-quality immunogenicity of tumor-derived autophagosomes (DRibbles), we aimed to explore the antitumor ability and mechanism of DRibble-loaded dendritic cells (DRibble-DCs).

Materials and methods

DRibbles extracted from the oral squamous cell carcinoma cell line SCC7 express specific LC3-II and ubiquitination marker. Immunization of mice with the DRibble-DCs vaccine led to the proliferation and differentiation of CD3⁺CD4⁺IFN-γ⁺ and CD3⁺CD8⁺IFN-γ⁺ T cells. The expression of proteins in endoplasmic reticulum stress (ERS) pathways was determined by Western blotting. Additionally, the functional properties of the DRibble-DCs were examined in mice, and regulatory T cells were measured by flow cytometry.

Results

Excellent biocompatibility was observed in vitro when DCs were loaded with DRibbles. T cells of lymph nodes and spleens from mice immunized with DRibble-DCs had cytotoxic effects on SCC7 cells. DCs homeostasis and ERS-related proteins were affected by DRibbles. Moreover, the DRibble-DCs vaccine achieved significantly better antitumor efficacy than DRibbles and tumor cell lysate-loaded DCs.

Conclusion

The results validated the antitumor immune responses to the DRibble-DCs vaccine in vivo and in vitro. The ERS pathway can be affected by DRibbles.

Peripheral Exophytic Oral Lesions: A Clinical Decision Tree

Diagnosis of peripheral oral exophytic lesions might be quite challenging. This review article aimed to introduce a decision tree for oral exophytic lesions according to their clinical features. General search engines and specialized databases including PubMed, PubMed Central, Medline Plus, EBSCO, Science Direct, Scopus, Embase, and authenticated textbooks were used to find relevant topics by means of keywords such as “oral soft tissue lesion,” “oral tumor like lesion,” “oral mucosal enlargement,” and “oral exophytic lesion.” Related English-language articles published since 1988 to 2016 in both medical and dental journals were appraised. Upon compilation of data, peripheral oral exophytic lesions were categorized into two major groups according to their surface texture: smooth (mesenchymal or nonsquamous epithelium-originated) and rough (squamous epithelium-originated). Lesions with smooth surface were also categorized into three subgroups according to their general frequency: reactive hyperplastic lesions/inflammatory hyperplasia, salivary gland lesions (nonneoplastic and neoplastic), and mesenchymal lesions (benign and malignant neoplasms). In addition, lesions with rough surface were summarized in six more common lesions. In total, 29 entities were organized in the form of a decision tree in order to help clinicians establish a logical diagnosis by a stepwise progression method.