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This case report describes the occurrence and treatment of an adenomatoid odontogenic tumor (AOT) presenting as a periodontal intrabony defect on a upper lateral incisor. Following incision and flap reflection, a solid, rubbery specimen was enucleated in one piece leaving a wide moat-like intrabony defect. A bioabsorbable membrane of glycolide and lactide copolymer was sutured over the defect to maximize regeneration and the flaps then sutured over the membrane. Microscopic analysis of the biopsied specimen revealed dental hard tissue interspersed in a field of odontogenic epithelium in a glandular configuration, consistent with a diagnosis of AOT. AOT is a rare odontogenic tumor usually associated with unerupted teeth or dentigerous cysts, not periodontal defects. Clinical evaluation 6 months postoperatively revealed restoration of clinical attachment and periodontal health.

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Solitary infantile myofibromatosis or myofibroma of the oral cavity is an uncommon condition with only 32 reported cases in the English-language literature. This article presents four additional cases of these solitary myofibroblastic lesions. In addition, the clinical and histologic features of this uncommon spindle cell neoplasm have been reviewed. The similarity in both the clinical and histopathologic features of the "adult" and "infantile" lesions support the proposal that myofibroma is a more accurate and acceptable term for these solitary myofibroblastic lesions of the oral cavity.

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Low-grade papillary adenocarcinoma of minor salivary glands is rare and tends to occur in the palate. This tumor has distinct but rather deceptive histomorphologic features, which may cause erroneous diagnosis. An extensive English-language literature review revealed reports of 22 well-documented low-grade papillary adenocarcinomas. Six of these tumors (27%) recurred locally between 12 months and 19 years after initial treatment. Low-grade papillary adenocarcinoma appears to have more aggressive biologic behavior compared with other low-grade adenocarcinomas in this region. Four of the reported cases (17%) had cervical lymph node metastases at the time of presentation. We report an additional case and discuss the literature.

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The pattern of keratin expression in hamster cheek pouch epithelium during 15-wk of DMBA-induced carcinogenesis was studied. The sequential changes in cytokeratins of premalignant and malignant tissues and comparative investigation of normal epithelial tissues were examined during a weekly sequential DMBA-induced chemical carcinogenesis. Keratin polypeptides of normal pouch epithelium appear in a molecular weight range of 43-67 kd and 5-6 proteins can be identified. The disappearance of high molecular weight keratin (61-67 kd) was observed from the 6-wk DMBA-treated premalignant group to the 15-wk DMBA-treated malignant group. An additional keratin polypeptide was noted initially on the 11th-wk-DMBA-treated group and remained to the 15th-wk-DMBA treated group.

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Malignant transformation of the squamous mucosa in the human oropharynx may be accompanied by alterations in carbohydrate production. Glycoconjugate expression was assessed by examining lectin-binding patterns and ABH isoantigen expression in human biopsy specimens from nine cases of carcinoma in situ and ten cases of invasive squamous cell carcinoma as well as adjacent normal squamous mucosa. Ten different fluorescein-conjugated lectins were used. Each lectin binds to specific nonreducing end-terminal carbohydrate residues. Wheat germ agglutinin and peanut agglutinin displayed intense cytoplasmic and/or membrane binding in more than 90% of the carcinoma in situ and squamous cell carcinoma specimens. However, only 40% of normal squamous epithelium specimens displayed intense cytoplasmic and/or membrane binding with wheat germ agglutinin and peanut agglutinin. Bandieraea simplicifolia I and Helix pomatia exhibited weak binding in less than 35% of normal and neoplastic tissues. Weak canavalia ensiformis binding was identified infrequently in the superficial layers of normal squamous mucosa, but was not found in neoplastic epithelium. None of the cases displayed binding for Dolichos biflorus, Ulex europaeus I, Sophora japonica, Glycine maximus, or Ricinus communis. Monoclonal antibodies directed against ABH blood group isoantigens showed increased cytoplasmic immunoreactivity for anti-H in dysplastic and neoplastic tissues, when compared with normal squamous mucosa. These findings indicate that wheat germ agglutinin and peanut agglutinin and H isoantigen are useful markers of malignancy in squamoproliferative lesions of the oropharynx, apparently reflecting alterations in expression of N-acetyl-D-glucosamine and galactose-related sugars, which appear following malignant transformation.

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A rare lesion, steatocystoma simplex, in a previously unreported location, the oral cavity, is described. A case report, the differential diagnosis, and a review of the literature are offered. Differentiation between this cyst and steatocystoma multiplex is important in terms of the need for clinical follow-up.

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Complementary DNA (cDNA) clones corresponding to the 55 kDa (K 14) and 59 kDa (K 10) keratins were used as probes for in situ hybridization analysis for the expression of keratin genes in human ameloblastomas and in oral mucosa. Transcripts for either the K 14 keratin or the K 10 keratin were restricted in their spatial distribution within stratified epithelia consistent with the stage of differentiation of the keratinocyte: the K 14 keratin gene transcript was restricted to the basal cell layers of the mucosa, while the K 10 keratin transcript was expressed predominantly in suprabasal cells, within the granular and prickle layers. In contrast, only the K 14 keratin transcript could be identified within the epithelial cells of human ameloblastomas. The differentiation-specific keratin transcript (K 10) was not present at detectable levels in this type of odontogenic tumors. In an atypical, infiltrating ameloblastoma, neither the K 10 nor the K 14 transcript could be identified. Granular cells within one ameloblastoma expressed the K 14 transcript. A detailed examination of the pattern of gene expression in these unique tumors may lead to a better understanding of their pathogenesis.

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Intraoral periosteal nodular fasciitis is an extremely rare tumor with only 2 cases having been previously recorded in the literature. We report here the 3rd case and review the characteristic features, the differential diagnosis and the treatment of intraoral periosteal nodular fasciitis.

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Individual keratin proteins were identified in 10 DMBA induced squamous cell carcinomas (SCC) of the hamster cheek pouch. SDS-polyacrylamide gel electrophoresis of water-insoluble cytoskeletal extracts from the tumor tissue demonstrated alterations in the protein distribution normal for the site. Immunoblot analysis with a broad spectrum polyclonal antikeratin antiserum identified the keratins in the preparations and confirmed changes in their distribution in the tumor preparations. The major keratin species for all the tumor tissues ranged in molecular weight from 45 to 57kd. The normal tissues had keratins with molecular weights from 45 to 73kd. The absence of high molecular weight keratins was a prominent feature in all the cancers. The histologic appearance of the tumors was varied but the distribution of the keratins was not correlated with the various histologies. The results demonstrate that changes in keratin gene expression occur in DMBA-induced cheek-pouch carcinomas but the precise alterations in the keratin proteins from those seen normally are not predictable.

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Spontaneous exfoliation of teeth and osteonecrosis of the alveolar bone are rare complications of HZ infection that usually follow the acute phase of infection. Awareness of osteonecrosis associated with secondary HZ infection is important for early detection and treatment of the condition to prevent further complications, particularly in high-risk patients.

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