Mucoepidermoid carcinoma (MEC) is the most prevalent malignant tumor originating from the salivary gland. The gradation of MEC is determined histologically based on cellular composition, with high-grade MEC presenting with distinct characteristics and clinical implications. A 56-year-old male presented with a 3-month history of right facial swelling and a recent onset of pain. A subsequent biopsy confirmed a malignant epithelial tumor, with further imaging assisting in determining the surgical approach. Comprehensive surgery, involving the removal of the right submandibular gland and reconstructive procedures, was undertaken. Histopathological evaluation post-surgery confirmed a high-grade MEC. The differentiation between inflammatory conditions and neoplastic lesions in the orofacial region can be challenging. The gradation of MEC is important in guiding therapeutic decisions. Among various classification systems, the Brandwein system offers detailed histopathological criteria that correlate reliably with clinical features. High-grade MECs, although less frequent, are aggressive and have a lower 5-year survival rate. Accurate histopathological diagnosis is crucial in devising an effective treatment plan. The presented case underlines the importance of a meticulous yet periodic follow-up, considering the aggressive nature of high-grade MECs.

According to the classification of World Health Organization, primary adenocarcinomas of the sinonasal tract can be initially classified as salivary and non-salivary types. The latter are further divided into intestinal and non-intestinal types. Sinonasal intestinal-type adenocarcinoma(ITAC) is rare adenocarcinoma subtype, which is closely occupational exposure to hardwood dusts, leather. In this study, we present a case of ITAC in a 68-year-old man. We successfully treated with wide excision and soft tissue reconstruction with free anterolateral thigh flap.

Sarcoma is rare malignant tumors that develop from mesenchymal cells. Metastasis to the oral cavity is a rare occurrence. Undifferentiated Pleomorphic sarcoma(UPS), formerly known as Malignant fibrous histiocytoma(MFH), is rare spindle cell neoplasm that can have poorly prognosis with metastasis and local recurrence. This report describes a case of a 77-year-old man who was diagnosed with Undifferentiated Pleomorphic Sarcoma of the chest wall and underwent adjuvant radiation therapy after surgical resection. Although there was success of wide excision, two years later, he presented with metastasis to the several organs including tongue. We retrospectively analyzed results of Next Generation Sequencing(NGS), and we figured out RB1 gene mutation. Until now targeted therapy of RB1 gene mutation is not established. Surgeon needs to consider metastatic tumors through identifying patients’ chief complaints and past medical & dental history. We need to research through NGS, and take a step closer to find targeted therapy for tumors.

EBV-positive mucocutaneous ulcer (EBVMCU) is an indolent, superficial lymphoproliferative disorder that occurs in either iatrogenic or age-associated immunocompromised patients with latent Epstein-Barr virus (EBV) infection. Although EBVMCU is histologically similar with other lymphoproliferative disorders, such as EBV-positive diffuse large B cell lymphoma, the diseases are classified as distinct entities by the World Health Organization with different clinical manifestations, prognosis, and genetic profiles. EBVMCU commonly shows spontaneous regression by conservative management, reduction or cessation of immunosuppressive treatment, but local progression is possible. Complete remission of disease can be achieved with combination of surgical resection, chemotherapy and local radiation therapy. Herein, we report 2 cases of oral superficial lymphoproliferative disorders arising adjacent to the gnathic bone with striking differences in prognosis and bone involvement. One of the cases induced extensive osteomyelitis in the underlying bone. Furthermore, we discussed the differential diagnosis of EBVMCU and reviewed the former literature.

Plunging ranula is a mucous retention cyst with extension below to the mylohyoid muscle. It can occur by an extravasation of saliva from the salivary gland due to trauma or obstruction of the duct. Fluid from the obstructed gland penetrate through the defect of mylohyoid muscle or through the posterior edge of mylohyoid muscle, and spreading to the cervical area. The “tail sign” has been widely reported as pathognomonic for their diagnosis. It indicates the communication between the collapsed sublingual and submandibular space over the posterior edge of the mylohyoid muscle. In this case, in addition to simple ranula in the right floor of mouth, MRI findings showed homogeneous contrast enhancement in front of the right cervical carotid artery and in the deep part of sternocleidomastoid muscle, but tail sign was not observed. Therefore it was clinically diagnosed as a branchial cleft cyst and was removed through surgical procedure. As a result of the final pathologic biopsy, the lesion, which has been suggested to be simple ranula in the floor of mouth, was diagnosed as reactive pyogenic granuloma, and the cervical lesion was diagnosed as a plunging ranula. This is a case report in which these two lesions are decided to have been separated from one before surgery. This report indicate that plunging ranula can be observed without tail sign and how to make an accurate diagnosis of plunging ranula by reporting misdiagnosis case.