Verrucous carcinoma

Ackerman's Tumour - A Case Report

Ackerman's tumour or Verrucous Carcinoma (VC) is a distinct form of Squamous Cell Carcinoma (SCC). It is predominantly seen in elderly men and strongly associated with the use of tobacco. In oral cavity it occurs predominantly in buccal mucosa followed by gingiva, palate and floor of the mouth. Clinically it manifests as proliferative finger like projections resembling a cauliflower which is characteristic of its diagnosis. Histologically, papillary or verruciform surface and parakeratin plugs between the surface projections are seen with an intense infiltrate of chronic inflammatory cells in the connective tissue thus it requires enormous expertize for diagnosis. Although VC is illustrated as a benign lesion with minimum aggressive potential over a period of time it can evolve into SCC. Hence most appropriate management of Ackerman's tumour is early diagnosis and surgical excision of the lesion. With this above background, we hereby report an enticing case of verrucous carcinoma in a left retromolar trigone extending into lower alveolar ridge in a 52-year-old male patient.

Comparison of myofibroblasts expression in oral squamous cell carcinoma, verrucous carcinoma, high risk epithelial dysplasia, low risk epithelial dysplasia and normal oral mucosa

The aim was to evaluate and compare the presence of myofibroblasts in oral squamous cell carcinoma (OSCC), verrucous carcinoma (VC), high-risk epithelial dysplasia (HRED), low-risk epithelial dysplasia (LRED), and normal oral mucosa (NOM). The study consisted of 37 OSCC, 15 VC, 15 HRED, 15 LRED and 15 NOM. α-smooth muscle actin (α-SMA) antibody was used to identify myofibroblasts. The α-SMA expression was not observed in NOM and LRED. The α-SMA was expressed in 97.29% of OSCC, 86.66% of VC, 46.66 % of HRED. The α-SMA expression was significantly higher in OSCC than VC (p = 0.023) and HRED (p < 0.000). The α-SMA expression was significantly higher in VC than HRED (p = 0.043). Myofibroblastic expression, as highlighted by α-SMA, is undetectable in NOM and LRED but increases as the disease progresses from potentially malignant disorders, as HRED to VC to invasive OSCC. Thus, proliferation of myofibroblasts may be used as a stromal marker of oral premalignancy and malignancy.

Expression of αB-crystallin and its potential anti-apoptotic role in oral verrucous carcinoma

αB-crystallin, a member of the small heat shock protein family, acts as a molecular chaperone. αB-crystallin has been found to be overexpressed in a number of cancer tissues, including head and neck cancers. Overexpression of αB-crystallin in cancer tissue may be related to its anti-apoptotic properties; however, its mechanism of action remains unclear. The aim of this study was to investigate the anti-apoptotic role of αB-crystallin in oral verrucous carcinoma (OVC). Since oral squamous cell carcinoma (OSCC) is the most common tumor of the oral cavity, we selected OSCC as a control group. Immunohistochemical staining was used to evaluate the expression levels. The results showed that the expression of αB-crystallin was detected in OVC, OSCC and normal oral mucosa (NM). The expression in OVC was higher compared to that of NM, but lower compared to OSCC, indicating that OVC was less aggressive than OSCC with respect to malignancy potential. Furthermore, we found that in OVC, the increased expression of αB-crystallin coincided with the decreased expression of activated caspase-3. The results indicated that αB-crystallin may play an anti-apoptotic role via inhibition of the activation of caspase-3 in OVC.