Telangiectatic osteosarcoma(TAEOS) is a rare subtype of osteosarcoma(OS) composed of blood-filled or empty cystic architecture simulating aneurysmal bone cyst. TAEOSs account for 2-12% of all OSs. TAEOSs mostly develop around knee and proximal humerus, but TAEOSs of the jaws are rare. To the best of my knowledge, this is the fourth case of primary TAEOS affecting the jaws. A 36-year-old female who had been previously diagnosed osteosarcoma by biopsy reported with a chief complaint of throbbing and swelling of the right mandible. The patient received neoadjuvant chemotherapy followed by hemi-mandibulectomy. After surgery, patient received adjuvant chemotherapy. The patient is free of disease for 6 months after surgery. TAEOSs are mimicking other benign entities, such as aneurysmal bone cyst and central giant cell granuloma. Thus, careful diagnosis through thorough radiographic and histopathologic evaluation is important to establish a treatment plan, prognosis, prediction and management strategy.

It is well documented that giant cells can be observed in some types of odontogenic tumors such as central odontogenic tumor and dentinogenic ghost cell tumor. However, the presence of stromal giant cells has only rarely been reported in ameloblastoma, although being the most common epithelial odontogenic tumor. In this study, we present a novel case of peripheral ameloblastoma associated with peripheral giant cell granuloma arising in the mandibular alveolar mucosa of a 65-year-old male patient. The possible pathogenesis of this combined lesion will be discussed, in addition to the review of previous reports of ameloblastoma accompanied by stromal giant cells.

Sarcomatous transformation of fibrous dysplasia (FD) is rare and can occur in patients with McCune-Albright syndrome (MAS). To date, there have been several cases of malignant transformation of FD in the craniofacial area of patients with MAS. Here, we report an additional case of secondary osteosarcoma arising from FD in the mandible of a 41-year-old woman with MAS. The patient complained of rapid swelling in the right facial area, which was initially misdiagnosed as soft tissue sarcoma at another hospital. After neoadjuvant concurrent chemoradiotherapy resulting in poor response, the lesion was surgically resected in our hospital, and the final diagnosis of secondary osteosarcoma was rendered. Currently, post-operative adjuvant chemotherapy is in progress. As a result of our review of 17 reported cases showing malignant transformation in FD/MAS, the M/F ratio was 1:1.1, and the median age at onset of malignancy was 28.6 years. The most commonly affected site was the craniofacial bones (n=13; 76%), and the most common histopathologic type of malignancy was osteosarcoma (n=14; 82%). More than half of the patients (8/15; 53.3%) died within 1 year, mainly due to lung metastasis (6/8; 75%). Taken together, since MAS patients with malignant transformation of FD have a relatively poor prognosis, accurate diagnosis based on histopathologic findings as well as clinical and radiographic information is important to select optimal treatment.

Agarum clathratum (A. clathratum) is a marine brown algal species that belongs to the Costariaceae family and has antioxidant and anti-microbial properties. However, the anti-inflammatory effects of A. clathratum and the molecular mechanisms involved have not been determined so far. This study aimed to investigate the anti-inflammatory effects of A. clathratum extracts in THP-1 macrophages stimulated by lipopolysaccharide (LPS) derived from Porphyromonas gingivalis. The THP-1 cells were differentiated with 12-O-tetradecanoylphorbol-13-acetate and treated with A. clathratum before LPS stimulation. Cell viability was assessed using the trypan blue exclusion assay. The expression of pro-inflammatory response-associated molecules was evaluated by quantitative real-time polymerase chain reaction and Western blot analysis. A. clathratum treatment inhibited the expression of interleukin-1β in LPS-stimulated THP-1 macrophages without causing any cytotoxicity. The anti-inflammatory effect of A. clathratum resulted in a significant repression of the JNK/c-Jun signaling axis, a key regulator in inflammation responses. This study highlights the possible role of A. clathratum in the inhibition of pro-inflammatory cytokines via suppression of the JNK/c-Jun signaling axis and suggests that A. clathratum could serve as a marine-derived anti-inflammatory agent in periodontitis.

The role of CXCR7, a seven-transmembrane G-protein coupled chemokine receptor, which binds with high affinity to chemokine CXCL11 and CXCL12 in oral cancer cells and the effect of transient CXCR7-downregulation on proliferation and migration of oral squamous cell carcinoma (OSCC) cells have not been reported. The aim of the present study was to evaluate the effects of CXCR7 on an OSCC cell line. In this study, we down-regulated CXCR7 in the KOSCC25B OSCC cell line by siRNA. In vitro cell proliferation and migration assays were used to investigate the effect of CXCR7- downregulation on cell proliferation and migration in si.KOSCC25B cells. The CXCR7 down-regulated OSCC cells grew significantly slower than the negative control siRNA transfected KOSCC25B cells (p<0.05). Additionally, migration of si.KOSCC25B cells decreased significantly compared with non-transfected KOSCC25B cells (p<0.007). These results suggest that down-regulation of CXCR7 induces anti-proliferative and anti-migratory effects in OSCC, and that CXCR7 may be a useful target molecule for the treatment of OSCC.

The aim of this study was to present the clinical, radiological, and histopathological findings of 20 new Korean GOC cases with a brief literature review. The mean age of 20 GOC patients was 43.5 years (range, 29-73 years) with a strong predilection for male (male-to-female ratio, 4:1). Nine cases were located in the maxilla and 11 cases in the mandible. Eight cases involved the anterior areas of the jaws and 12 cases were located in the posterior area. Most of the cases (16/20, 80.0%) showed a well-defined unilocular radiolucency and some showed cortical perforation (55.6%) and bony expansion (72.2%) in computed tomography. The most common histopathological feature was eosinophilic cuboidal cells (100%), followed by clear cells (95.0%), mucous cells (85.0%), variations in thickness (85.0%), and intraepithelial microcysts (80.0%). All cases were surgically treated by enucleation and no recurrences were found in routine follow-up.

Human DEK gene on chromosome 6p encodes a 43kD nuclear phospoprotein that was originally identified as part of a fusion protein found in a subset of acute myeloid leukemia carrying a t(6;9) translocation. Although DEK upregulation has been described in a number of human malignancies and was significantly associated with high histologic grade, lymph node metastasis and/or advanced clinical stage, no previous report has evaluated the expression of DEK protein and its clinical significance in oral squamous cell carcinoma (OSCC). Our aims were to determine DEK expression in tissue samples of normal oral mucosa and OSCC by immunohistochemistry, to analyze the correlation between DEK expression and clinicopathological parameters, and to evaluate the value of DEK as a prognostic marker for patient’s survival. Ten normal oral mucosa, 10 epithelial dysplasia, and 60 OSCC samples were studied by immunohistochemistry. DEK expression tended to increase through the full thickness of epithelium in the dysplastic mucosa when compared with those in normal oral mucosa. High expression of DEK protein (score ≥ 2) was found in 68.3% of OSCC cases. Statistical analysis revealed that DEK overexpression in OSCC was positively correlated with high histologic grade (p=0.001), lymph node metastasis (p=0.003), and advanced clinical stage (p=0.039). In the Kaplan-Meier survival analysis, DEK overexpression was significantly associated with decreased overall survival in patients with OSCC (p=0.019). Our results suggest that DEK overexpression may be a reliable marker to predict the clinical outcome in OSCC.

Fibromatoses are benign fibroblastic proliferation, which forms infiltrating tumor-like mass. Their histologic features cannot reflect the biologic behavior; local recurrence and aggressive infiltration to the adjacent tissue make fibromatoses intermediate tumor, between benign and malignant. Infantile fibromatosis consists of desmoid-type tumor and lipofibromatosis, and mainly affects children under age of 10. While desmoid-type tumor is characterized by elongated mature fibroblastic proliferation, the fibroblasts in lipofibromatosis look more primitive and accompany adipocytes. Here, we report a case of infantile fibromatosis of 4 month old boy involving the tongue.

Hippo signaling is one of the signal transduction pathways revealed in Drosophila and mammalian. This signaling is known to control proliferation and growth of normal cells or cancer cells, in which many signaling proteins form a network. In this network, tumor suppressor kinases include MST and LATS while YAP and TAZ exist as oncoproteins. Combined with transcription factor, YAP the oncoprotien starts to secrete growth factors such as CTGF, FGF, and Cry61 regulating the growth of cells or the organ sizes. The YAP is also associated with the development of early embryo and the regeneration of the skin wound as well as abnormal growth of cancers in case of over-expression. Although many previous studies have found various tumors with YAP over-expressed, the expression of YAP is not yet clearly identified in oral cancer. The aim of this study was to check the expression level of YAP in oral squamous cell carcinoma. So we performed PCR and Western blot to check YAP expression in mRNA and protein level respectively. In result, all of the 13 cell lines examined has presented the expression of YAP, and especially in HSC2 and KOSCC11 cell lines has been observed the remarkable level of expression. In conclusion, we confirmed the overexpression of YAP cell line in oral squamous cell carcinoma, it will be a great help to the study carried out in the future. Once you understand the mechanism of oncoprotien YAP in oral cancer cells, it seems possible to research and development of targeted tumor therapy agents in oral cancer.

Many researchers have been reported recent trends for rising incidence particularly related to cancer of the tongue in young people. The purpose of this study is to exam the changes of OSCC(oral squamous cell carcinoma) incidence distribution. After Institutional Review Board approval, 1,345cases of OSCC were reviewed from 1993 to 2012 at the department of Oral Pathology at the University of Seoul National Dental Hospital with respect to gender, age, locations. As the results, the most prevalence ages were between 45-69 years old(mean:59.68). There is a noticeable incidence on the eighth decade of life. There are no changes of incidence distribution on se (male:female=69:31) at each year. The most common incidence area was tongue at 1993 but the mandible was the most popular site after 2001. Comparing the incidence rates of the predilection sites over and under 44 years old patients, among patients under 44 years old showed the tongue is the common site steadily. On the other hand, there is a significant increase on the mandible in the over 44 years old patients. In conclusion, this study showed similar results on overall sex distribution and median ages. The trends of locations over 20 years have been increased on the old adult’s mandible. Also, tongue is the common site for the young adults constantly. There are needs for further studies to elucidate the behind etiology. In addition, the true impact of young age on OSCC clinical behavior will remain difficult to determine unless intranational and multi-institutional databases will be combined.

Lysyl oxidase (LOX) family, the copper dependent amine oxidase, oxidizes lysine residues in extracellular collagen and elastin. LOX increases the strength of the extracellular matrix and plays an important role in tumor development and metastasis. It has been reported that increased LOX protein and RNA are found in head and neck squamous cell carcinoma. Moreover some studies regarded LOX as a prognostic marker of oral and oropharyngeal squamous cell carcinoma. However there has not been any report on LOX expression of salivary gland tumors. Here, we investigated LOX expression in mucoepidermoid carcinoma (MEC) and adenoid cystic carcinoma (ACC) of salivary gland and compare it to those of pleomorphic adenoma (PA). We evaluated LOX expression in eighteen MEC, eighteen ACC and twenty PA cases by immunohistochemical examination. Whereas PA showed relatively low density of LOX expression, ACC revealed more cases that showing high staining intensities for LOX. Significantly increased LOX expression was found in the cases of ACC when compared to those of PA (P = 0.010).

A poor prognosis of oral squamous cell carcinoma (SCC) is partly due to the invasiveness and metastasis of the tumor. One of key elements in tumor invasion and metastasis in the degradation of extracellular matrix is tissue inhibitors of metalloproteinases (TIMPs). This study was performed to determine the expression of TIMP-1 and TIMP-2 of oral SCCs with regard to the histologic invasiveness and differentiation in 5 normal oral mucosa and 36 oral SCCs. The histologic invasiveness of oral SCCs were classified into 4 grades. The differentiation of oral SCCs was divided into 3 grades. The StreptAvidin-Biotin immunohistochemical process, using TIMP-1 and TIMP-2 monoclonal antibodies, was performed to determine the expression of TIMP-1 and TIMP-2. The expression of TIMP-1 was positive in 5 of 17 oral SCCs with weak invasiveness and was positive in 8 of 19 oral SCCs with strong invasiveness. The TIMP-1 expression did not increase significantly with respect to the invasiveness of oral SCCs (P>0.05). The expression of TIMP-2 was strongly positive in 5 out of 17 SCCs with weak invasiveness and was strongly positive in 15 of 19 SCCs with strong invasiveness. The TIMP-2 expression increased significantly with respect to the invasiveness of oral SCCs; the stronger the expression, the stronger the invasiveness (P<0.05). The expression of TIMP-1 and TIMP-2 did not increase significantly with respect to the histologic differentiation. We concluded that with respect to the invasiveness, the TIMP-2 expression increases significantly in oral SCCs but the TIMP-1 expression does not; and that with respect to the histologic differentiation, their expressions do not increase significantly. These results suggested that TIMP-2 can be used as a tool to evaluate the invasiveness of oral SCCs.

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.

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

Clear cell adenocarcinoma (CCA) is a rare malignant neoplasm of salivary gland that represents only 1% of all salivary gland tumors. CCA is histopathologically characterized by monotonous, glycogen-rich, round to ovoid clear cells intermixed with hyalinized stroma. However, other salivary gland tumors such as mucoepidermoid carcinoma, acinic cell adenocarcinoma, oncocytoma, epithelial-myoepithelial carcinoma, and myoepithelial carcinoma should be ruled out to diagnosis CCA. We herein report a case of CCA involving the soft palate in a 56-year-old female. It is essential to consider CCA in the differential diagnoses of clear cell tumors.

Neurotized melanocytic nevus (NMN) is categorized into intradermal/intramucosal type of acquired melanocytic nevus. In contrast to typical intramucosal nevus which has relatively distinct histological features, the diagnosis of NMN requires more attention due to its mimicry of benign neural tumors such as neurofibroma. The majority of lesional cells, NMN cells, showed a spindle cell morphology and abundant, eosinophilic cytoplasm which were positive for S-100, vimentin, and collagen type IV. Positive reaction for MART-1 was detected in the NMN cells as well as in the epithelioid nevus cells beneath the epithelium. Neurofibroma exhibited diffuse positivity for S-100, vimentin, CD34 and collagen type IV, but never expressed MART-1. Toluidine blue stained the numerous mast cells scattered in the lesion of neurofibroma, compared to the relatively minor detection of mast cells in NMN. Therefore, MART-1 is a useful marker in differentiating NMN from neurofibroma.

Oral squamous cell carcinoma (OSCC) is one of the most common carcinomas in the head and neck area. Bitter melon extraction (Momordicacharantia, BME) has been used as a functional food to prevent and treat human health related issues. It has recently been reported that BME inhibits breast cancer cell growth by arresting cell cycle and promoting apoptosis. In this study, we aimed at proving the inhibitory action of BME on OSCC proliferation. We used two OSCC cell lines, SCC4 and Ca9-22. Both cell lines were treated with different concentrations (1%, 2%, and 5%) of BME. Cell viability was examined by MTT assay. DNA condensation was visualized by immunofluorescence microscope to determine the signs of the cell apoptosis. Cell numbers were significantly decreased in a dose-dependent manner by bitter melon at concentration of 1% of BME on Ca9-22 cell line (P=0.001) but no significant effect on SCC4 (P=0.124) at the same concentration. 2% BME treatment of the Ca9-22 cell line induces chromatin condensation and DNA fragmentation after 20 hours. It seems that BME inhibits the proliferation of Ca9-22 cell line by inducing apoptosis. Thus, BME may be used as a dietary supplement for prevention of OSCC.

Oral squamous papilloma (OSP) is a common benign lesion of the oral mucosa that is induced by the human papillomavirus. To investigate the clinicopathological characteristics of OSP, we selected 135 patients diagnosed at the Seoul National University Dental Hospital. OSPs occurring in Koreans had a slight female predilection, with the male to female ratio being 1:1.6. The age ranged from 4 to 80 years old (average age: 47 years). The most frequent location was the soft palate (43.7%), followed by the tongue and gingiva. 11.1% of all patients presented with pain. There have been no reported cases of recurrence. On microscopic examination, two‐thirds of the lesions were parakeratinized, with almost all cases (99%) containing the koilocytes. In conclusion, there were no significant differences between the clinicopathological features of OSP in Korean and findings from previous studies

Numerous reports on the immunopathogenesis of an oral lichen planus (OLP) have shown some inconsistency in terms of the role and distribution of CD4+ and CD8+ T cells, and Langerhans cells (LC). This has led to the hypothesis that although the clinical and histopathological manifestations of OLPs appear similar, they can be grouped into CD4+ predominant lesions and CD8+ ones on the varied immunopathogenesis or clinical progress. This study investigated the distribution of CD4+ T cells, CD8+ T cells, LC and the ratio of CD4/CD8 and defined the important immunocompetent cells. In addition, the clinicopathological and histopathological correlation with those immunocompetent cells were investigated. Frozen sections of 16 OLPs and 5 normal buccal mucosae were immunostained. Quantification was done using KAPPA Imagebase software and statistical analysis using SPSS 10.0 statistical package. CD8+ T cells were consistently more abundant in the epithelium of the OLP than CD4+ T cells, but no difference between the two cells was detected in the lamina propria. The intra-epithelial CD4+ T cells revealed a positive linear correlation with the intra-epithelial CD8+ T cells. In the lamina propria, the number of LC had a positive linear correlation with CD4/CD8 ratio. The number of LCs was higher in the reticular type of OLP compared to the erosive type. The histopathological features such as hyperkeratosis, acanthosis, the band-like infiltration of mononuclear cells, and liquefaction degeneration did not show significant correlation with the CD4/CD8 ratio. The results suggest that CD8+ T cells play major role in immunopathogenesis of OLP. The immunopathogenesis of OLP appears to vary from lesion to lesion in relation to the clinical progress.

Chronic hyperplastic candidiasis (CHC) is characterized by epithelial hyperplasia of the oral mucosa associated with candidal hyphae. The immune status of host is one of the factors that induce clinically evident candidal infection. Host defense mechanisms include inflammatory cells, epithelial barrier, and antimicrobial peptides such as human beta 2 defensin (hBD-2). In the present study, we investigated the densities of CD4+/CD8+ T lymphocytes and hBD-2 expression of epithelial cells in CHC. Immunohistochemical staining was performed on 10 cases of CHC using CD4, CD8 and hBD-2. Ten specimens of chronic mucositis were selected for comparison, and went through the same examination. hBD-2 was expressed in the spinous cell layers and the keratin layers of 7 CHC patients, while the epithelium of chronic mucositis did not demonstrate the hBD-2 expression except for one case. Also, hBD-2 expression was stronger when the hyphae invaded the upper stratum spinosum (P =.019). However, the densities of CD8+ T lymphocytes were significantly lower in the CHC patients, suggesting that the ability of CD8+ T cells to enter the epithelium and target the pathogenic hyphae was decreased in CHC. Increased hBD-2 expression seemed to be significantly associated with the candidal infection, while not promoting the cell-mediated immune reaction in CHC.