The International Agency for Research on Cancer(IARC)and World Health Organization(WHO)collaboratively produce the'WHO Blue Books'essential tools standardizing the diagnostic process for human cancers.Regular ...The International Agency for Research on Cancer(IARC)and World Health Organization(WHO)collaboratively produce the'WHO Blue Books'essential tools standardizing the diagnostic process for human cancers.Regular updates in this classification accommodate emerging molecular discoveries,advances in immunohistochemical techniques,and evolving clinical insights.The 5th edition of the WHO/IARC classification of head and neck tumors refines the'Oral Cavity and Mobile Tongue'chapter,including sections for non-neoplastic lesions,epithelial tumors,and tumors of uncertain histogenesis.Notably,the epithelial tumors section is rearranged by tumor behavior,starting with benign squamous papillomas and progressing through potentially malignant oral disorders to oral squamous cell carcinoma(OSCC).The section on OSCC reflects recent information on epidemiology,pathogenesis,and histological prognostic factors.Noteworthy is the specific categorization of verrucous carcinoma(VC)and carcinoma cuniculatum(CC),both associated with the oral cavity and distinct in clinical and histologic characteristics.This classification adjustment emphasizes the oral cavity as their predominant site in the head and neck.Designating specific sections for VC and CC aims to provide comprehensive insights into these unique subtypes,elucidating their clinical features,distinct histological characteristics,prevalence,significance,and clinical relevance.By categorizing these subtypes into specific sections,the 5th edition of the WHO classification aims to provide a more nuanced and detailed account,enhancing our understanding of these specific variants within the broader spectrum of head and neck tumors.展开更多
BACKGROUND Multiple intraoral dermoid cysts of large magnitude generally appear in the second or third decade of life.They are rare in infants and are usually solitary.In this case,a large mass was identified in utero...BACKGROUND Multiple intraoral dermoid cysts of large magnitude generally appear in the second or third decade of life.They are rare in infants and are usually solitary.In this case,a large mass was identified in utero during prenatal exams.CASE SUMMARY We introduce a rare case on multiple dermoid cysts in the floor of the mouth of an infant who underwent two surgeries for this.Preoperative magnetic resonance imaging confirmed a large well-circumscribed cystic lesion that originated at the former midline region in the floor of the mouth in which a suspicious lesion of minute size was likely compressed by the bulkier mass and overlooked.Therefore,the infant underwent two surgeries by an intraoral approach within 9 mo.At 5 mo after the second operation,a routine follow-up ultrasound showed evidence of an additional cyst.No further surgery was planned because the tumor had no immediate effect.CONCLUSION This report demonstrates the importance of carefully analyzing preoperative imaging to avoid multiple operations for a seemingly isolated oral cyst.展开更多
BACKGROUND Oral liposarcoma is an extremely rare lesion that is often clinically misdiagnosed as a benign tumor due to its asymptomatic and indolent clinical course.Here,we report a case of massive low-grade myxoid li...BACKGROUND Oral liposarcoma is an extremely rare lesion that is often clinically misdiagnosed as a benign tumor due to its asymptomatic and indolent clinical course.Here,we report a case of massive low-grade myxoid liposarcoma(MLS)of the floor of the mouth.CASE SUMMARY A 71-year-old man presented with a huge mass in the left floor of the mouth.A biopsy was performed,and a diagnosis of a myxoid tumor suspicious for lowgrade MLS or myxoma was made.Gadolinium-enhanced T1-weighted magnetic resonance imaging showed an intensely enhanced tumor lesion that occupies the left sublingual space and extends to the submandibular space.Submandibular dissection,tumor resection,and reconstruction with a radial forearm flap were performed.The surgical specimen exhibited histologically low-grade MLS.Fused in sarcoma(FUS,also known as TLS)and DNA damage-inducible transcript 3(DDIT3,also known as CHOP)break-apart was not detected in the fluorescence in situ hybridization analysis.The tumor was completely encapsulated and did not require additional treatment.Furthermore,no recurrence was reported 40 mo after surgery.CONCLUSION We experienced an extremely rare,massive,low-grade MLS emerging from the floor of the mouth.Oftentimes,an MLS of the floor of the mouth lacks significant clinical findings and is often misdiagnosed.Although no FUS-DDIT3 fusion gene was detected,a low-grade MLS was ultimately diagnosed based on the histological findings.展开更多
Dermoid cyst of the oral floor is rare benign tumour, who having three histological aspects: dermoid, teratoid and epidermoid. This one is characterized by the presence of a squamous stratified epithelium with cutaneo...Dermoid cyst of the oral floor is rare benign tumour, who having three histological aspects: dermoid, teratoid and epidermoid. This one is characterized by the presence of a squamous stratified epithelium with cutaneous remnants. It may occur in any part of the body, however their frequency in the ENT sphere is relatively scarce. Seven per cent (7%) only of epidermoid cysts occur in the cervico-facial area, 1.6% of which locate at the floor level. When they are located submandibular, they can pose diagnostic difficulties and look like a tumour of the submaxillary gland. We report two cases of epidermoid cyst of the floor. Both patients suffered from swelling of the submandibular gland. Magnetic Resonance Imaging was not requested due to lack of resources. However, surgery allowed in both cases the excision of a cyst next to a normal submandibular gland. Patients did well post operatively.展开更多
Background: The collection of data on cancers is essential to assess their importance in a population and plan control strategies. In Benin as in many sub-Saharan Africa countries, cancer data are often not well infor...Background: The collection of data on cancers is essential to assess their importance in a population and plan control strategies. In Benin as in many sub-Saharan Africa countries, cancer data are often not well informed. Purpose: To study the epidemiological and anatomopathological profiles of head and neck cancers. Methods: This was a descriptive cross-sectional study of head and neck cancers in Benin from January 2009 to 31 December 2014. These tumours were collected in the registers of the 5 anatomy-pathological laboratories in Benin as well as in that of the only hospital in the country that sends its requests for histological examination abroad. Results: During the period, 611 cases of head and neck tumour were reported, including 298 malignant cases, or 48.8%. The average age was 45.3 ± 18.7 years (extremes: 1 year and 91 years) with a maximum of cases between 50 and 60 years (19.1%). The sex ratio was 1.2. The cancers occurred mainly in the pharynx (27.9%), the oral cavity (19.8%), the nose, sinuses and jaws (18.1%), the thyroid (12.8%), the salivary glands (8.7%) and the larynx (8.4%). They were of epithelial origin in 79.5% of cases, mainly squamous cell carcinomas (50.3%) and lymphomas in 12.8% of cases. Conclusion: Head and neck cancer is preventable. A special place should be given to the fight against cancer in Benin. Strategies to prevent and manage these cancers cannot be put in place without accurate data collection.展开更多
Background Oral squamous cell carcinoma （OSCC） is the most prevalent malignant tumor in the head and neck region, comprising more than 90% of all oral malignancies. A feasible approach for an animal model to study O...Background Oral squamous cell carcinoma （OSCC） is the most prevalent malignant tumor in the head and neck region, comprising more than 90% of all oral malignancies. A feasible approach for an animal model to study OSCC lymph node metastasis was established and biological behaviors of three oral squamous cell carcinoma cell lines were compared. Methods After implanting three kinds of cell lines （GDC185, Tca8113, Tca83） into three different anatomical sites in nude mice, namely the tongue, floor of the mouth, and axillary fossa, we observed the tumorigenicity and the metastatic capacity, which was confirmed by histopathology under a surgical microscope. Results The animal model injected with GDC185 cells into the floor of the mouth had the highest rate of neck lymph node metastasis （55.6%） and the cell lines had significantly different biological behaviors. Conclusions Nude mice injected with GDC185 cells into the floor of the mouth could be used as a feasible animal model to study neck metastasis of oral squamous cell carcinoma.展开更多
Aim:The causative role of human papillomavirus(HPV)has been established into the aetiology of oral squamous cell carcinoma(OSCC).Some authors believe that HPV can determinate the prognosis and module treatment respons...Aim:The causative role of human papillomavirus(HPV)has been established into the aetiology of oral squamous cell carcinoma(OSCC).Some authors believe that HPV can determinate the prognosis and module treatment response from this kind of malignancies.Methods:Articles published in the last 10 years,focusing on the role of HPV in the development,molecular biology,prognosis and treatment of OSCC were reviewed.Results:Thirty-nine articles from 252 were selected,highlighting 4 meta-analysis,3 prospective and 2 retrospective studies.According to its role in the development of cervical cancer,HPV is classified into a high risk for malignant lesions subtype and a low-grade malignant lesions subtype.Epidemiology and prevalence of HPV varies according to the published data:large studies tend to have lower rates of HPV(<50%)than smaller ones(0-100%).Interestingly,HPV+patients are usually diagnosed at a younger age,mainly those with oropharyngeal tumours.There is a predilection for the oropharynx and Waldeyer ring tumours.Regarding prognosis,OSCC HPV+patients tend to have better outcome and treatment response.Conclusion:HPV divides OSCC in two types of tumours with different prognostic and therapeutic implications,with increased survival,better treatment response rates and lower risk of death and recurrences.展开更多
利用监测、流行病学和最终结果(surveillance,epidemiology and end results,SEER)数据库进行口底鳞状细胞癌淋巴转移的危险因素分析及预测模型列线图构建。回顾分析2010年至2015年间美国SEER数据库中口底鳞状细胞癌患者的临床随访资料...利用监测、流行病学和最终结果(surveillance,epidemiology and end results,SEER)数据库进行口底鳞状细胞癌淋巴转移的危险因素分析及预测模型列线图构建。回顾分析2010年至2015年间美国SEER数据库中口底鳞状细胞癌患者的临床随访资料。将所有纳入研究的患者,按7∶3比例随机划分为训练集和验证集,采用方差分析对训练集及验证集的基本临床特征进行比较。通过生存分析及logistic回归,对口底鳞状细胞癌患者淋巴转移的预后及危险因素进行分析,并建立淋巴转移风险预测模型。最后,通过建立接收者操作特征(receiver operating characteristic,ROC)曲线、校准曲线及临床决策(decision curve analysis,DCA)曲线,对预测模型进行验证。本研究共纳入1946例患者,其中训练集1362例,验证集584例。方差分析显示,训练集和验证集各变量间差异无统计学意义(P>0.05)。生存分析显示,相较于无淋巴转移者,伴有淋巴转移者预后较差(P<0.05)。单因素logistic回归分析结果显示,年龄、性别、种族、Grade分级、是否为首要恶性肿瘤、T分期、M分期及肿瘤大小与淋巴转移相关(P<0.05)。多因素logistic回归分析结果则显示,年龄小于等于60岁、较高的Grade分级、为首要恶性肿瘤及较大的肿瘤尺寸,是口底鳞癌患者发生淋巴转移的独立风险预测因素(P<0.05)。基于多因素logistic回归结果,成功构建了预测口底鳞癌患者淋巴转移风险的列线图。ROC曲线、校准曲线及DCA曲线分析结果显示,该模型具有良好的预测性能及较高的临床获益。本研究确定了口底鳞癌患者淋巴转移的危险因素,建立并验证了口底鳞癌患者淋巴转移风险预测模型,该预测模型可作为口底鳞癌患者淋巴转移的评估工具。展开更多
目的：回顾性分析41例口底重症多间隙感染患者的临床诊治资料。方法：对患者性别、年龄、流行病学特征、感染的诱因、症状、初步诊断、重要伴发疾病、合并症、临床诊断、抗生素的使用（种类及疗程）、手术干预及转归等方面进行总结及系...目的：回顾性分析41例口底重症多间隙感染患者的临床诊治资料。方法：对患者性别、年龄、流行病学特征、感染的诱因、症状、初步诊断、重要伴发疾病、合并症、临床诊断、抗生素的使用（种类及疗程）、手术干预及转归等方面进行总结及系统性分析。结果：男女比例为2．4∶1，年龄10～93岁（平均46．23岁），农村城市比例为3∶1。14．6％患者初步诊断不准确。31％患者在发病后5 d 内就诊。82．9％患者为牙源性感染，35％患者初诊时炎症已扩散至咽旁间隙、翼下颌间隙或者合并颈部感染，7．5％患者感染扩散至纵膈；2例患者入院后已合并严重纵膈及肺部感染，转呼吸内科治疗，1例因肾衰转泌尿外科治疗；38例患者入院后及时给予静脉滴注抗生素抗感染治疗、尽早完成切开引流，痊愈出院，平均住院21 d。结论：牙源性感染的重症口底多间隙感染最多见，其治疗的关键在于早期诊断，维持呼吸道通畅，选择合适的抗生素，尽早切开引流、综合治疗去除病因。展开更多
文摘The International Agency for Research on Cancer(IARC)and World Health Organization(WHO)collaboratively produce the'WHO Blue Books'essential tools standardizing the diagnostic process for human cancers.Regular updates in this classification accommodate emerging molecular discoveries,advances in immunohistochemical techniques,and evolving clinical insights.The 5th edition of the WHO/IARC classification of head and neck tumors refines the'Oral Cavity and Mobile Tongue'chapter,including sections for non-neoplastic lesions,epithelial tumors,and tumors of uncertain histogenesis.Notably,the epithelial tumors section is rearranged by tumor behavior,starting with benign squamous papillomas and progressing through potentially malignant oral disorders to oral squamous cell carcinoma(OSCC).The section on OSCC reflects recent information on epidemiology,pathogenesis,and histological prognostic factors.Noteworthy is the specific categorization of verrucous carcinoma(VC)and carcinoma cuniculatum(CC),both associated with the oral cavity and distinct in clinical and histologic characteristics.This classification adjustment emphasizes the oral cavity as their predominant site in the head and neck.Designating specific sections for VC and CC aims to provide comprehensive insights into these unique subtypes,elucidating their clinical features,distinct histological characteristics,prevalence,significance,and clinical relevance.By categorizing these subtypes into specific sections,the 5th edition of the WHO classification aims to provide a more nuanced and detailed account,enhancing our understanding of these specific variants within the broader spectrum of head and neck tumors.
基金Supported by 345 Talent Project of Shengjing HospitalNatural Science Foundation of Liaoning Province,No.20170541042.
文摘BACKGROUND Multiple intraoral dermoid cysts of large magnitude generally appear in the second or third decade of life.They are rare in infants and are usually solitary.In this case,a large mass was identified in utero during prenatal exams.CASE SUMMARY We introduce a rare case on multiple dermoid cysts in the floor of the mouth of an infant who underwent two surgeries for this.Preoperative magnetic resonance imaging confirmed a large well-circumscribed cystic lesion that originated at the former midline region in the floor of the mouth in which a suspicious lesion of minute size was likely compressed by the bulkier mass and overlooked.Therefore,the infant underwent two surgeries by an intraoral approach within 9 mo.At 5 mo after the second operation,a routine follow-up ultrasound showed evidence of an additional cyst.No further surgery was planned because the tumor had no immediate effect.CONCLUSION This report demonstrates the importance of carefully analyzing preoperative imaging to avoid multiple operations for a seemingly isolated oral cyst.
文摘BACKGROUND Oral liposarcoma is an extremely rare lesion that is often clinically misdiagnosed as a benign tumor due to its asymptomatic and indolent clinical course.Here,we report a case of massive low-grade myxoid liposarcoma(MLS)of the floor of the mouth.CASE SUMMARY A 71-year-old man presented with a huge mass in the left floor of the mouth.A biopsy was performed,and a diagnosis of a myxoid tumor suspicious for lowgrade MLS or myxoma was made.Gadolinium-enhanced T1-weighted magnetic resonance imaging showed an intensely enhanced tumor lesion that occupies the left sublingual space and extends to the submandibular space.Submandibular dissection,tumor resection,and reconstruction with a radial forearm flap were performed.The surgical specimen exhibited histologically low-grade MLS.Fused in sarcoma(FUS,also known as TLS)and DNA damage-inducible transcript 3(DDIT3,also known as CHOP)break-apart was not detected in the fluorescence in situ hybridization analysis.The tumor was completely encapsulated and did not require additional treatment.Furthermore,no recurrence was reported 40 mo after surgery.CONCLUSION We experienced an extremely rare,massive,low-grade MLS emerging from the floor of the mouth.Oftentimes,an MLS of the floor of the mouth lacks significant clinical findings and is often misdiagnosed.Although no FUS-DDIT3 fusion gene was detected,a low-grade MLS was ultimately diagnosed based on the histological findings.
文摘Dermoid cyst of the oral floor is rare benign tumour, who having three histological aspects: dermoid, teratoid and epidermoid. This one is characterized by the presence of a squamous stratified epithelium with cutaneous remnants. It may occur in any part of the body, however their frequency in the ENT sphere is relatively scarce. Seven per cent (7%) only of epidermoid cysts occur in the cervico-facial area, 1.6% of which locate at the floor level. When they are located submandibular, they can pose diagnostic difficulties and look like a tumour of the submaxillary gland. We report two cases of epidermoid cyst of the floor. Both patients suffered from swelling of the submandibular gland. Magnetic Resonance Imaging was not requested due to lack of resources. However, surgery allowed in both cases the excision of a cyst next to a normal submandibular gland. Patients did well post operatively.
文摘Background: The collection of data on cancers is essential to assess their importance in a population and plan control strategies. In Benin as in many sub-Saharan Africa countries, cancer data are often not well informed. Purpose: To study the epidemiological and anatomopathological profiles of head and neck cancers. Methods: This was a descriptive cross-sectional study of head and neck cancers in Benin from January 2009 to 31 December 2014. These tumours were collected in the registers of the 5 anatomy-pathological laboratories in Benin as well as in that of the only hospital in the country that sends its requests for histological examination abroad. Results: During the period, 611 cases of head and neck tumour were reported, including 298 malignant cases, or 48.8%. The average age was 45.3 ± 18.7 years (extremes: 1 year and 91 years) with a maximum of cases between 50 and 60 years (19.1%). The sex ratio was 1.2. The cancers occurred mainly in the pharynx (27.9%), the oral cavity (19.8%), the nose, sinuses and jaws (18.1%), the thyroid (12.8%), the salivary glands (8.7%) and the larynx (8.4%). They were of epithelial origin in 79.5% of cases, mainly squamous cell carcinomas (50.3%) and lymphomas in 12.8% of cases. Conclusion: Head and neck cancer is preventable. A special place should be given to the fight against cancer in Benin. Strategies to prevent and manage these cancers cannot be put in place without accurate data collection.
文摘Background Oral squamous cell carcinoma （OSCC） is the most prevalent malignant tumor in the head and neck region, comprising more than 90% of all oral malignancies. A feasible approach for an animal model to study OSCC lymph node metastasis was established and biological behaviors of three oral squamous cell carcinoma cell lines were compared. Methods After implanting three kinds of cell lines （GDC185, Tca8113, Tca83） into three different anatomical sites in nude mice, namely the tongue, floor of the mouth, and axillary fossa, we observed the tumorigenicity and the metastatic capacity, which was confirmed by histopathology under a surgical microscope. Results The animal model injected with GDC185 cells into the floor of the mouth had the highest rate of neck lymph node metastasis （55.6%） and the cell lines had significantly different biological behaviors. Conclusions Nude mice injected with GDC185 cells into the floor of the mouth could be used as a feasible animal model to study neck metastasis of oral squamous cell carcinoma.
文摘Aim:The causative role of human papillomavirus(HPV)has been established into the aetiology of oral squamous cell carcinoma(OSCC).Some authors believe that HPV can determinate the prognosis and module treatment response from this kind of malignancies.Methods:Articles published in the last 10 years,focusing on the role of HPV in the development,molecular biology,prognosis and treatment of OSCC were reviewed.Results:Thirty-nine articles from 252 were selected,highlighting 4 meta-analysis,3 prospective and 2 retrospective studies.According to its role in the development of cervical cancer,HPV is classified into a high risk for malignant lesions subtype and a low-grade malignant lesions subtype.Epidemiology and prevalence of HPV varies according to the published data:large studies tend to have lower rates of HPV(<50%)than smaller ones(0-100%).Interestingly,HPV+patients are usually diagnosed at a younger age,mainly those with oropharyngeal tumours.There is a predilection for the oropharynx and Waldeyer ring tumours.Regarding prognosis,OSCC HPV+patients tend to have better outcome and treatment response.Conclusion:HPV divides OSCC in two types of tumours with different prognostic and therapeutic implications,with increased survival,better treatment response rates and lower risk of death and recurrences.
文摘利用监测、流行病学和最终结果(surveillance,epidemiology and end results,SEER)数据库进行口底鳞状细胞癌淋巴转移的危险因素分析及预测模型列线图构建。回顾分析2010年至2015年间美国SEER数据库中口底鳞状细胞癌患者的临床随访资料。将所有纳入研究的患者,按7∶3比例随机划分为训练集和验证集,采用方差分析对训练集及验证集的基本临床特征进行比较。通过生存分析及logistic回归,对口底鳞状细胞癌患者淋巴转移的预后及危险因素进行分析,并建立淋巴转移风险预测模型。最后,通过建立接收者操作特征(receiver operating characteristic,ROC)曲线、校准曲线及临床决策(decision curve analysis,DCA)曲线,对预测模型进行验证。本研究共纳入1946例患者,其中训练集1362例,验证集584例。方差分析显示,训练集和验证集各变量间差异无统计学意义(P>0.05)。生存分析显示,相较于无淋巴转移者,伴有淋巴转移者预后较差(P<0.05)。单因素logistic回归分析结果显示,年龄、性别、种族、Grade分级、是否为首要恶性肿瘤、T分期、M分期及肿瘤大小与淋巴转移相关(P<0.05)。多因素logistic回归分析结果则显示,年龄小于等于60岁、较高的Grade分级、为首要恶性肿瘤及较大的肿瘤尺寸,是口底鳞癌患者发生淋巴转移的独立风险预测因素(P<0.05)。基于多因素logistic回归结果,成功构建了预测口底鳞癌患者淋巴转移风险的列线图。ROC曲线、校准曲线及DCA曲线分析结果显示,该模型具有良好的预测性能及较高的临床获益。本研究确定了口底鳞癌患者淋巴转移的危险因素,建立并验证了口底鳞癌患者淋巴转移风险预测模型,该预测模型可作为口底鳞癌患者淋巴转移的评估工具。
文摘目的：回顾性分析41例口底重症多间隙感染患者的临床诊治资料。方法：对患者性别、年龄、流行病学特征、感染的诱因、症状、初步诊断、重要伴发疾病、合并症、临床诊断、抗生素的使用（种类及疗程）、手术干预及转归等方面进行总结及系统性分析。结果：男女比例为2．4∶1，年龄10～93岁（平均46．23岁），农村城市比例为3∶1。14．6％患者初步诊断不准确。31％患者在发病后5 d 内就诊。82．9％患者为牙源性感染，35％患者初诊时炎症已扩散至咽旁间隙、翼下颌间隙或者合并颈部感染，7．5％患者感染扩散至纵膈；2例患者入院后已合并严重纵膈及肺部感染，转呼吸内科治疗，1例因肾衰转泌尿外科治疗；38例患者入院后及时给予静脉滴注抗生素抗感染治疗、尽早完成切开引流，痊愈出院，平均住院21 d。结论：牙源性感染的重症口底多间隙感染最多见，其治疗的关键在于早期诊断，维持呼吸道通畅，选择合适的抗生素，尽早切开引流、综合治疗去除病因。
