Ameloblastoma is an odontogenic tumor characterized by various sites of metastasis, malignant transformation, and a high recurrence rate over time. Ameloblastic carcinoma(AC) is the term reserved for an ameloblastoma with histologic evidence of malignancy in the primary tumor. AC is classified into two types: most ACs occur de novo, and only few cases of malignant transformation of ameloblastoma become apparent. Here, we report a case of AC, arising from recurrent acanthomatous ameloblastoma on the maxillary sinus, in a 60-year-old male patient. The mass was first diagnosed as acanthomatous ameloblastoma; subsequently, surgical curettage was performed thrice while partial maxillectomy was performed twice. On the fifth recurrence, the tumor was identified as AC.

Clear cell odontogenic carcinoma (CCOC) is an extremely rare odontogenic neoplasm; Only a few cases have been reported in the English literatures. It displays a propensity for the mandible, most commonly presenting in the fifth to seventh decades, with a female predilection. The clinical and radiological manifestations are multiple and the diagnosis is histological. Histological feature is of large islands and strands of uniform cells with round or ovoid nuclei and clear cytoplasm. Clinically, painless swelling is the most common symptom, followed by pain, teeth mobility, and paresthesia. CCOC has a good prognosis after surgery. This case report presents the histopathological and clinical features of CCOC excised from the mandible.

Background: Mucoepidermoid carcinoma (MEC) is the most common malignant epithelial tumor of the salivary gland in the oral cavity. In South Korea, it occurs most frequently in the palate, retromolar area, floor of the mouth, buccal mucosa, and other areas of the oral cavity. MEC is rare in children and adolescents under 20 years of age, but it is the most common malignant salivary gland tumor in this group. Reconstructive surgery is often required due to cystic lesions or resection of malignancy in the oral cavity. Buccal fat pad (BFP) is a flap that is reliable and suitable for reconstructing oral defects because it has a low complication rate and small volume change over time. Case Presentation: We report the case of a 12-year-old female patient with low-grade MEC on light soft palate with no neck metastasis. After tumor resection the palatal mucosal defect was reconstructed with a BFP flap. Conclusion: The purpose of this article is to discuss the features and treatment methods of MEC that is rarely occurring in children, and the usefulness of BFP for reconstruction. Therefore, we will make a precise diagnosis and treatment as we examine the clinical feature and review the literature.

It is well known that lymph node metastasis is a major prognostic factor in patients with oral squamous cell carcinoma (OSCC). 30-40% of patients with OSCC have already undergone regional metastasis at diagnosis. The survival rate of patients with metastasis is reduced by more than 50%. Therefore, prevention and early detection of metastasis are very important to increase the survival rate of patients. Many investigators have studied the molecular mechanism of metastasis and tried to develop the molecules to inhibit any step of metastatic cascade. Among those molecules, an interest in the metastasis suppressor gene has been increasing. Expression of metastasis suppressor KiSS-1 has shown to be significantly related to poor clinical outcome and worse survival rate of patient in various malignancies of different organs. In addition, our previous study in OSCC also revealed that downregulation of KiSS-1 expression correlated with the presence of cervical lymph node metastasis, one part of tumor progression. Therefore, further investigation was needed to identify the molecular function of KiSS-1 using OSCC cell line and to evaluate the possibility of KiSS-1 as a new therapeutic target.

Recently chronic inflammation is focused on the association with cancer progression and acquisition of aggressive biologic behaviors, such as invasion, metastasis, and resistance to chemotherapeutic reagents. Due to the close vicinity within oral cavity, oral cancer may be intimately associated with chronic periodontitis. The present study was done to observe the effect of chronic periodontitis on oral cancer cells by utilizing P. gingivalis infection, a major pathogen in chronic periodontitis. We analyzed and compared the mRNA expression levels of epithelial-mesenchymal transition (EMT) markers in non-infected and P. gingivalis-infected oral cancer cells. Eighty-six genes, which are well known as EMT markers, were analyzed using commercially available EMT microarray plates, performed in triplicate. Among the 86 genes, the expression of 26 was increased (≥ 2 fold) by P. gingivalis, whereas that of 7 genes was decreased (≥ 2 fold). Our study suggests that P. gingivalis infection evokes significant changes in EMT-related genes. Further observations on molecular mechanisms underlying these changes may help to clarify the role of chronic periodontitis on cancer progression and to develop more efficient preventive and therapeutic modalities for oral cancer. (182 words)

Autophagy is recently receiving the spotlight as the development strategy for promising anticancer drugs. In particular, the majority of anticancer drugs originating from natural products are known to induce autophagy. Saururus chinensis has been used for treating various inflammatory diseases. Recent research has revealed that the extract of Saururus chinensis possess cytotoxicity for various types of human cancer cells. However, the exact action mechanism of Saururus chinensis extract for oral squamous cell carcinoma (OSCC) has not been studied yet. Therefore, the authors of this research aim to study the effect of methanol extract of S. chinensis (MESC) on OSCC cells. To observe the cell proliferation inhibitory effect of MESC on HSC3 cells, the authors conducted the trypan blue exclusion assay. Also, the action mechanism of MESC was studied by conducting the cell cycle analysis, acidic vesicular organelle (AVO) staining and flow cytometry analysis, monodansylcadaverine (MDC) staining, propidium iodide staining, and Western blotting on MESC-treated HSC3 cells. When HSC3 cells were treated in MESC, the cell proliferation was suppressed in time-dependent and dose-dependent manners. Also, the number of sub-G1 arrested cells increased in a dose-dependent manner. MDC punctate and AVO puncta significantly increased respectively. Western blot analysis demonstrated the expression of autophagy-related proteins increased, but apoptotic proteins were not observed. Also, the pAkt protein was reduced, while the p-p38 protein and pERK protein increased. According to our results, MESC induced autophagy and accompanied changes in the cell cycle in HSC3 cells. Also, the alteration in Akt, ERK, and p38 pathways were confirmed. This result suggested the possibility of MESC as the new promising adjuvant for treating OSCC patients.

Natural products are vastly utilized as a source of chemotherapeutic agents for human cancers. Kochia scopraia is traditionally used for the cure of urological and dermatological diseases. Recently, methanol extract of Kochia scoparia (MEKS) has been shown to have anti-cancer activity to various human cancers. However, there is no report demonstrating the anti-cancer activity of MEKS in human mucoepidermoid carcinoma (MEC) cells. In this study, the authors studied the effects of MEKS on the cell proliferation and underlying mechanism in YD15 human MEC cells. MEKS decreased YD15 cell proliferation proven by trypan blue exclusion assay and induced apoptosis, evidenced by cell cycle analysis and western blotting. Autophagy induction by MEKS was verified by western blotting. In addition, MEKS regulated the expression of phosphorylated Akt, phosphorylated p38 and Nrf2 protein. This results can imply that MEKS might be a potential candidate for the treatment of human MEC cells.

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.

급성 췌장염은 췌장의 염증성 질환으로 췌장성 복수 및 가 성 낭종과 같은 합병증을 일으킬 수 있다. 이러한 합병증은 심할 경우 결장, 복막 및 장간막의 이차성 변화를 일으켜 복막암 종과 구별하기 어려울 수 있다. 본 증례의 환자는 타 병원에 서 급성 췌장염 및 합병증으로 발생한 가성 낭종을 치료하는 도중 복막암의 가능성이 있어 추가 평가를 위하여 본원으로 전원되었다. 복막암의 가능성을 배제하기 위한 복막 조직검사 없이 순차적인 시술적 접근을 통하여 췌관의 손상으로 발생한 췌장성 복수와 가성 낭종으로 진단할 수 있었다.

Primary intraosseous odontogenic carcinoma (PIOC) is a carcinoma arising within the jaws, putatively developing from remnants of odontogenic epithelium. We describe a case of PIOC arising from odontogenic cyst affecting the left posterior mandible of 72-year-old Korean man. Clinical examination showed a symptom-free hard mass. There was no evidence of ulceration, and there was no pain or bleeding. The overlying mucosa was intact and no regional lymph nodes were palpable. Clinical and radiological studies for other distant primary sites were negative. Radiographically, the tumor showed multilocular radiolucency with a noncorticated, ill defined border surrounding an impacted third molar tooth. Histology exhibited sheets or islands of nonkeratinizing malignant epithelial cells with minimal clear cell component in continuity with begin or dysplastic cyst lining epithelium. Immunostaining for PCNA and p53 protein showed a higher percentage of positive cells and more intense staining in the carcinomatous tissues than in the benign and dysplastic lesions.

Acinic cell carcinoma is a well-differentiated, low-grade tumor that accounts for 1-3% of salivary gland tumors. Among the variant of acinic cell carcinoma, papillary cystic variant of acinic cell carcinoma is much more rare and it is known to be difficult to diagnose and has a poor prognosis. In this paper, we report a case of 58 - year - old man diagnosed as papillary cystic variant of acinic cell carcinoma and the characteristics of the lesion by integrating the recent cases of papillary cystic variant of acinic cell carcinoma. This study emphasizes the need for long-term studies and further investigation of papillary cystic variants of acinic cell carcinoma.

Carcinoma ex pleomorphic adenoma (Ca ex PA) is an uncommon malignant tumor. It is an aggressive salivary carcinoma, arising from a primary or recurrent benign pleomorphic adenoma (PA). The most common clinical presentation of Ca ex PA is a firm mass in the parotid gland. Here we report a case of Ca ex PA, arising from a recurrent benign PA in the right parotid gland, in a 70-year old female patient. The lesion was first diagnosed as a PA and a superficial parotidectomy was performed. Re-operation was performed for recurrent PA. The second recurrence was diagnosed as Ca ex PA.

The fruit of Kochia scoparia Scharder is traditionally used as a medicinal ingredient to treat allergic skin diseases and inflammatory diseases in China, Japan and Korea. Recently, several studies reported that K. scoparia had potential for the cytotoxicity of human cancer cells. To investigate the anti-cancer effect of K. scoparia on oral cancer and to determine the specific type of cell death induced by MEKS treatment. We investigated the anti-cancer effects of K. scoparia, methanol extract (MEKS) in HSC4 human oral cancer cells. We examined the effects of MEKS on the proliferation rate, cell cycle arrest, 7-AAD-ANNEXIN V double stain, reactive oxygen species (ROS) generation and activation of apoptosis and necroptosis-associated proteins in HSC4 cells. MTT assay results demonstrated that MEKS decreased the proliferation rates of HSC4 cells in a dose-dependent manner with an IC50 value of 45.3 μg/ml. MEKS at 50 μg/ml significantly increased the sub-G1 DNA contents of HSC4 cells to 84.8%, versus untreated cells. However, the activation of apoptosis-associated proteins such as cleaved caspase 3, cleaved caspase 8, cleaved caspase 9 and cleaved Poly (ADP-ribose) polymerase (PARP) did not detect. The level of Bax protein markedly increased in MEKS-treated HSC4 cells. In addition, the cell viability of the DPQ pre-treated HSC4 cells with MEKS treatment was significantly greater than that of MEKS treated-cells. These results suggest that MEKS inhibits cell proliferation and induces necroptosis in oral cancer cells and that MEKS may have potential chemotherapeutic value for the treatment of human oral cancer.

췌장의 파골세포양 거대세포 미분화 암종은 그 발생 빈도는 드물지만 높은 악성도를 가지는 외분비 췌장암이다. 췌장 의 파골세포양 거대세포 미분화 암종은, 복부 전산화단층촬 영에서 괴사와 출혈을 동반한 낭성 및 고형 종괴의 소견을 보이며, 다른 췌장의 낭성 종양과 감별이 필요하다. 현재까 지 명확하게 정립된 치료법은 없으며, 조기 진단 및 종양의 완전 절제만이 생존률 향상을 가져온다고 보고되고 있다. 본 증례는 58세 남성 환자에서 발생한 췌장의 파골세포양 거대 세포 미분화 암종이 수술 및 항암치료에도 불구하고 연조직 전이로 진행하여 사망한 1예로 문헌고찰과 함께 보고한다.

This study was performed to investigate the correlation between the primary squamous cell carcinoma in oral cavity (POSCC) and paired metastatic oral squamous cell carcinoma in cervical lymph node (MOSCC) via immunohistochemical staining with Ki-67 and p53. The subjects included ten patients (20 specimens) who were diagnosed with OSCC with metastatic lymph nodes from 2010 to 2015 and surgically treated involving neck dissection in Kyungpook National University Hospital. Twenty specimens were stained immunohistochemically with Ki-67 and p53. The degrees of immunostaining by Ki-67 and p53 was evaluated as 0 (no positive cells), weak (1~25% positive cells), moderate (26-50% positive cells) and strong (>50% positive cells). Despite the strong tendency, there was no statistically significant result between expressions of Ki-67 and p53 in POSCC or MOSCC. We found that high expression of Ki-67 was significantly correlated with poor degree of differentiation. Our results suggest that expression of Ki-67 may be a predictable factor for degree of differentiation of POSCC and MOSCC.

혼합 간세포-담관암종은 조직학적 특성이 다양한 원발성 간암의 드문 형태이다. 혼합 간세포-담관암종의 근치적 치료 법은 수술적 절제가 유일하나, 진행성 혼합 간세포-담관암종의 치료에 대해서는 잘 정립되어 있지 않다. 저자들은 진행성 혼합 간세포-담관암종에서 선행항암화학요법을 시행 후 근치적 수술이 가능하였고, 수술 15개월 후까지 재발을 보이지 않은 증례를 보고하는 바이다.

췌장의 점액성 낭성 종양(mucinous cystic neoplasm)은 국내 다기관 연구에 의하면 전체 췌장 낭성 종양의 약 25%를 차지하고 있다. 대부분 중년 여성에게 호발하고, 병변은 췌장 체부 및 미부에 위치하며, 점액성 낭선암(mucinous cystadenocarcinoma) 으로 악화될 수 있는데, 크기가 서서히 증가하므로 이의 파열은 매우 드문 합병증이다. 저자들은 72세 남성에서 발생한 췌장 점액성 낭선암의 자발 파열 증례를 문헌 고찰과 함께 보고하는 바이다.

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.

cording to histopathological characteristics. One is composite tumor, and the other is collision tumor. Composite tumor is a lesion showing the combined histopathological characteristics of two or more previously recognized tumor and/or cysts of different categories. Two constituent parts are mixed with each other, and histological transition is often observed. On the other hand, collision tumor is a lesion showing the independent histopathological characteristics of two or more previously recognized tumor and/or cysts of different categories. Two constituent parts are separated each other by connective tissue, and histological transition is not observed. Their origin is still unclear. In this study, a collision tumor was reported. 77-year old woman was referred to CNUH with a neck mass in right submandibular area. Incisional biopsy was carried out, and the patient was diagnosed as collision tumor of squamous cell carcinoma and neurofibroma. After reviewing studies reporting collision tumor from head and neck area, formation of a collision tumor was most frequent from a cervical area and average age is 59.6. A collision tumor commonly lead to misdiagnosis, and the prognosis is not always transparent. The variety symptom of collision tumor has to be kept in mind in the diagnosis and treatment of the lesions in head and neck area.