Assessment of perineural infiltration and spread of oral squamous cell carcinoma: a clinicohistopathologic study

BACKGROUND

As the tumor spreads through the pathway of least resistance, the present study was carried out to evaluate the presence of perineural infiltration and spread of oral squamous cell carcinoma (OSCC) along the perineural spaces in gingivobuccal sulcus tumors infiltrating into the mandible.

AIMS AND OBJECTIVES

(1) To investigate the incidence of perineural invasion of OSCC along the inferior alveolar nerve and (2) to investigate the neurovascular bundle as a potential route of spread of OSCC.

MATERIALS AND METHODS

Twenty-six patients with histopathologically proven OSCC of the gingivobuccal sulcus with radiographic infiltration of the mandible were included. The surgical specimens were decalcified and serially sectioned. Each section was stained with hematoxylin and eosin and was screened for the presence of perineural invasion and spread. Results : Twenty-five specimens showed perineural infiltration but none of the cases showed perineural spread along the inferior alveolar canal. Also, not all cases showed any neurologic deficit. Follow-up of these cases showed early recurrence (6-8 months) in the study group.

CONCLUSION

Perineural infiltration is present in OSCC but perineural spread along the inferior alveolar canal is absent. It is a bad prognostic indicator.

Hypercalcemia in patients of oral squamous cell carcinoma

PURPOSE

This study was performed to measure the total and ionic serum calcium levels and incidence of hypercalcemia in patients with Oral Squamous Cell Carcinoma (OSCC) and its clinical significance and relevance.

MATERIALS AND METHODS

A randomly selected sample of seventy patients of histologically confirmed Oral Squamous Cell Carcinoma (OSCC) at any of the standard clinical stages were included. Fasting blood samples were obtained for measuring serum calcium levels. The elevated values of serum calcium levels were correlated with clinical features of hypercalcemia to draw inference.

RESULTS

Total serum calcium was found to be elevated in 12 patients (17.4%) and serum ionic calcium was elevated in 3 patients (4.29%).

CONCLUSION

The data suggests that hypercalcemia occurred in advanced stages of oral squamous cell carcinoma and its management may be relevant in providing terminal care and prolonging the life span of the patients.

Management of oral submucous fibrosis: a conservative approach

Three hundred twenty-six patients with oral submucous fibrosis were divided into two groups and treated either with conventional submucosal injections of steroids and hyaluronidase, or with topical vitamin A, steroid applications, and oral iron preparations. The results were compared. The conventional treatment with injections was found to be hazardous, whereas the conservative treatment was found to be safe. Both treatments were purely palliative.

Estimation of complement C3 in oral submucous fibrosis

Oral submucous fibrosis is a chronic disease of obscure aetiology. Considering the significant immunological findings in oral submucous fibrosis, the serum C3 levels were estimated by RID method and were found to be unaltered.

Noma neonatorum

Noma neonatorum is a gangrenous process involving oral, nasal and anal area and occasionally, the eyelids and scrotum. It is seen during the first few weeks of neonatal life. The disease is caused by P. aeruginosa and is usually fatal. Noma neonatorum should be distinguished from the regular noma as it comprises a distinct age group, clinical course, microbiology and prognosis.

Osteomyelitis of the mandible in marble bone disease

Marble bone disease is a rare skeletal disorder. Osteomyelitic changes in the jaw bones are frequently seen in this disease. Considering the rarity of the disease, a case of osteomyelitis of the mandible in marble bone disease is presented, together with a review of the available literature.

Pan-mandibular keratocyst with eosinophilia

A case of pan-mandibular keratocyst with eosinophilia is presented. The authors have not so far in the literature come across such an extensive cystic lesion involving complete mandible and showing no preponderant signs or symptoms.