Odontogenic cysts are classified into inflammatory and developmental origins. The most common representative inflammatory cyst is periapical cyst and the most common representative developmental cyst is dentigerous cyst and cyst which show character of tumor is odontogenic keratocyst and cyst of which cystic epithelial lining cells transform to ameloblastoma is unicystic ameloblastoma. Proliferation studies are needed because of various causes, different clinical and pathologic findings. Recently Ki67 has been generally used as cellular proliferation marker, which is closely related to proliferation. Because Ki67 exists in all the time of cell mitosis stage including G1, S, G2, and M, but disappear in resting phase, G0, it is widely used in the evaluation of cell and tissue proliferation activity. The purpose of this study was to establish clinical therapeutic standard through clinical prognosis associated with Ki67 protein expression because of various causes, different clinical and pathologic findings. Immunohistochemical study was performed in selected each 10 biopsy cases through LSAB reaction and HRP system using anti-Ki67 monoclonal antibody. Ki67 expression was mainly seen in the basal layer of periapical cyst, dentigerous cyst and unicystic ameloblastoma, and in suprabasal layer of odontogenic keratocyat, while positive cells appeared very low frequently in unicystic ameloblastoma. Ki67 expression was mainly observed around inflammatory area. Ki67 expression appeared to be independent on the destruction and recurrence of cystic lesion. Conclusively, high cellular proliferation could not represent destruction and recurrence degree of lesion, but this proliferation might be closely associated with circumstance such as inflammation
A mucocele is a pseudocyst containing spilt mucin from extravasation of the oral minor salivary gland. For this study, 115 cases of mucoceles diagnosed at the Department of Oral Pathology, Seoul National University Dental Hospital were reviewed with respect to gender, age, lesion’s site, size, color, histopathologic features, and recurrence. There was no significant difference between male and female. Nearly 80% cases occurred in young people under the age of 30 (29.7% in the third decade with the highest prevalence). The lower lip (75.7%) was the most common site, followed by ventral surface of the tongue, mouth floor, and buccal mucosa. The lesions measured from 2 to 20 mm in diameter and appeared in various colors. Histopathologically, mucoceles showed pseudocystic cavities containing mucin surrounded by granulation tissues with foam cells. Among the 115cases, 14 showed recurrence on the adjacent sites. Those cases treated with and without removal of the feeding glands on excision of mucoceles showed recurrence rates of 9.2% and 18.0%, respectively. Based on these results, it is recommended that mucoceles be treated with surgical excision of the feeding salivary glands. There were no clinicopathological results significantly different from the established facts regarding the mucoceles of Korean patients
Intravascular papillary endothelial hyperplasia (IPEH) is a rare benign vascular lesion that rarely occurs in the oral cavity. Its clinical features are similar to neoplasms, which are easily identified in the oral cavity, and it can be misdiagnosed as an angiosarcoma. Therefore, it is important to recognize the characteristics of the lesion in order to both diagnose and treat it properly. We report a case of IPEH in a young Korean female patient, as well as discuss its differential diagnosis and treatment using a review of the related literature.
Clear cell odontogenic carcinoma (CCOC) is a very rare malignant neoplasm of jaw, with a significant clear cell component. It is nearly three times as common in the mandible with distinct female predominance. Past, identified as locally invasive tumor, CCOC is now considered to be malignant neoplasm, showing distant and regional lymph node metastasis. CCOC is histopathologically characterized by large glycogen-rich clear cells, often intermixed with eosinophilic cells. When diagnosing CCOC, ruling out salivary gland tumors, such as mucoepidermoid carcinoma or clear cell adenocarcinoma is important because they have overlapping histologic features with CCOC. Here in, we report a case of CCOC involving the right maxillary sinus of a 72-year-old female.
Dermoid and epidermoid cysts in the oral cavity are uncommon and account for less than 0.01% of all oral cysts. The large majority of cases arise in the floor of the mouth and there are rare in other sites. We would like to report an unusual case of epidermoid cyst at the buccal mucosa in a 66-year-old male with a review of literature.
Oral galvanism is known to induce chronic irritation on oral mucosa, but the related pathology rarely occurs. A 65 years old male complained of linear horizontal ulcerations on his bilateral buccal mucosa for one month. The oral ulcerations were parallel and approximated to his occlusal plane. He had multiple metallic crowns using gold and nickel cobalt alloy at bilateral upper and lower molar teeth, and also had accustomed to heavy smoking for more than twenty years. Biopsy examination was performed with immunohistochemical staining using antisera of PCNA, D2-40, and PARP. The epithelial ulcer had clear margin and was replaced by granulation tissue containing many dilated lymphatic vessels, which were positive for D2-40, but showed no feature of pseudo-necrotic membrane. Nearby epithelium showed the typical features of leukoedema, characterized by edematous keratinocytes with clear cytoplasms and pyknotic nuclei, low rete ridges, and rough superficial epithelial layer, where PCNA was rarely positive. Some superficial edematous keratinocytes showed perinuclear cytoplasmic vacuolization, and their peripheral nuclear chromatins were positive for PARP. Taken together, the present mucosa ulceration was different from aphthous stomatitis, herpes stomititis, oral lichen planus, etc., thus it was postulated that the galvanic current generated from between the upper and lower dissimilar metal crowns could affect the precedent leukoedema caused by heavy smoking habit and produce the linear horizontal buccal ulceration. Therefore, the present case was diagnosed as galvanic mucositis associated with leukoedema, and it was also hypothesized that the mild and persistent galvanic current was able to deplete the cytoplasmic fluid of leukoedema keratinocytes via the osmotic pressure difference elicited by increased ionic concentration of galvanism, and followed by severe keratinocyte apoptosis and oral mucosa ulceration.
Mucoepidermoid carcinoma, a malignant neoplasm of salivary gland, rarely arises within the jaws. Differential diagnosis should include an odontogenic cyst because the central mucoepidermoid carcinoma usually reveals either an unilocular or multilocular radiolucency with hyperostotic border. Long-term follow-up is needed due to late recurrence and clinical slow progress like other salivary gland tumors. We would like to report an unusual case of central mucoepidermoid carcinoma with a review of literature.