Benign Epithelial Tumors Research Articles

Histopathological Aspects of the Prognostic Factors for Salivary Gland Cancers.

Salivary gland cancers (SGCs) are diagnosed using histopathological examination, which significantly contributes to their progression, including lymph node/distant metastasis or local recurrence. In the current World Health Organization (WHO) Classification of Head and Neck Tumors: Salivary Glands (5th edition), malignant and benign epithelial tumors are classified into 21 and 15 tumor types, respectively. All malignant tumors have the potential for lymph node/distant metastasis or local recurrence. In particular, mucoepidermoid carcinoma (MEC), adenoid cystic carcinoma (AdCC), salivary duct carcinoma, salivary carcinoma, not otherwise specified (NOS, formerly known as adenocarcinoma, NOS), myoepithelial carcinoma, epithelial-myoepithelial carcinoma, and carcinoma ex pleomorphic adenoma (PA) are relatively prevalent. High-grade transformation is an important aspect of tumor progression in SGCs. MEC, AdCC, salivary carcinoma, and NOS have a distinct grading system; however, a universal histological grading system for SGCs has not yet been recommended. Conversely, PA is considered benign; nonetheless, it should be cautiously treated to avoid the development of metastasizing/recurrent PA. The aim of this review is to describe the current histopathological aspects of the prognostic factors for SGCs and discuss the genes or molecules used as diagnostic tools that might have treatment target potential in the future.

Combined use of CA125, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio for the diagnosis of borderline and malignant epithelial ovarian tumors

BackgroundThe mortality rate of ovarian cancer ranks first among three common gynecological malignant tumors due to insidious onset and lack of effective early diagnosis methods. Borderline epithelial ovarian tumor (BEOT) is a type of low malignant potential tumor that is typically associated with better outcomes than ovarian cancer. However, BEOTs are easily confused with benign and malignant epithelial ovarian tumors (EOTs) due to similar clinical symptoms and lack of specific tumor biomarkers and imaging examinations. Notably, a small subset of BEOTs will transform into low-grade serous ovarian carcinoma with a poor prognosis. Therefore, searching for potential biomarkers that can be easily obtained and accurately identify malignant epithelial ovarian tumors (MEOTs) as well as BEOTs is essential for the clinician. Cancer antigen 125 (CA125) is a commonly used biomarker for the diagnosis of EOTs in the preoperative scenario but has low sensitivity and specificity. Nowadays, inflammatory biomarkers including inflammatory cell counts and derived ratios such as neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) have been proved to be associated with tumor progression and poor prognosis, and were considered to be the most economically potential surrogate biomarkers for various malignancies. The purpose of this study was to find appropriate combinations of inflammatory and tumor biomarkers to improve the diagnostic efficiency of EOTs, especially the BEOTs.ResultsCA125, NLR and PLR increased steadily among benign, borderline and malignant EOTs and tended to be higher in advanced (stage III-IV) and lymph node metastasis MEOT groups than in early stage (stage I-II) and non-lymph node metastasis MEOT groups. CA125, NLR and PLR could be used separately in the differentiation of EOTs but could not take into account both sensitivity and specificity. The combined use of CA125, NLR and PLR was evaluated to be more efficient, especially in the identification of BEOTs, with both high sensitivity and high specificity.ConclusionsThe levels of CA125, NLR and PLR were closely related to the nature of EOTs and malignant progression of MEOTs. The combination of CA125, NLR and PLR was more accurate in identifying the nature of EOTs than either alone or double combination, especially for BEOTs.

Pigmented eccrine poroma in collision with seborrheic keratosis: Dermoscopic description and histological correlation

Poromas are rare, benign neoplasms arising from the terminal ductal portion of the sweat glands. They are mainly characterized by flesh-colored or pink papules or nodules, usually located at the extremities. The pigmented variant is rare. Collisions with other benign epithelial tumors have been reported. The clinical appearance may be confused with several benign or malignant tumor pathologies, yet thanks to dermoscopy, which is a non-invasive means of exploration, some signs are highly useful in the diagnosis and in suspecting the collision of two distinct tumors before proceeding to histological confirmation. Herein, we report the original case of a collision between pigmented eccrine poroma of the leg and seborrheic keratosis. Key words: Pigmented poroma; Collision; Dermoscopy; Histology; Seborrheic keratosis

Lacrimal Sac Tumors: A Single-institution Experience, Including New Insights.

Lacrimal sac tumors are rare tumor types, with a long time interval from disease onset to diagnosis. We aimed to investigate the characteristics and outcomes of patients with lacrimal sac tumors. The medical records of 25 patients with lacrimal sac tumors initially treated at the Kyushu university hospital from January 1996 to July 2020 were reviewed. Our analysis included 3 epithelial benign tumors (12.0%) and 22 malignant (88.0%) tumors (squamous cell carcinoma, n=6; adenoid cystic carcinoma, n=2; sebaceous adenocarcinoma, n=2; mucoepidermoid carcinoma, n=1; malignant lymphoma, n=10). The average time from symptom onset to diagnosis was 14.7 months (median=8 months; range=1-96 months). The analysis of patients revealed that lacrimal sac mass (22/25, 88.0%) was the most frequent symptom and a possible tumor marker. Most epithelial benign (n=3) and malignant epithelial (n=12) tumors were treated surgically (14/15, 93.3%). One malignant case was treated with heavy ion beam therapy. Eight patients were treated with postoperative (chemo)radiation therapy because of positive surgical margins (including one unanalyzed case). Local control was ultimately achieved in all but one case. The patient survived for 24 months with immune checkpoint inhibitors and subsequent chemotherapy for local and metastatic recurrence. We report our experience in the diagnosis and treatment of lacrimal sac tumors and analyze the clinical trends in cases involving these tumors. Postoperative radiotherapy and pharmacotherapy, including immune checkpoint inhibitors, may be useful for recurrent cases.

IL-6 Plays a Critical Role in Stromal Fibroblast RANKL Induction and Consequent Osteoclastogenesis in Ameloblastoma Progression

Ameloblastoma (AB) is the most common benign, epithelial odontogenic tumor that occurs in the jawbone. AB is a slow-growing, benign epithelial tumor but shows locally invasive growth, with bone resorption or recurrence if not adequately resected. From these points of view, understanding the mechanism of AB-induced bone resorption is necessary for better clinical therapy and improving patients’ quality of life. In bone resorption, osteoclasts play critical roles, and RANKL is a pivotal regulator of osteoclastogenesis. However, the source of RANKL-expressing cells in the AB tumor microenvironment is controversial, and the mechanism of osteoclastogenesis in AB progression is not fully understood. In this study, we investigated the distribution of the RNA expression of RANKL in AB specimens. We found that PDGFRα- and S100A4-positive stromal fibroblasts expressed RANKL in the AB tumor microenvironment. Moreover, we analyzed the mechanisms of osteoclastogenesis in the AB tumor microenvironment using the human AB cell line AM-1 and a human primary periodontal ligament fibroblast cells. The results of histopathologic and in vitro studies clarified that the interaction between AB cells and stromal fibroblasts upregulated IL-6 expression and that AB cells induced RANKL expression in stromal fibroblasts and consequent osteoclastogenesis in AB progression.

Detection and evaluation of the presence of the BRAF V600E mutation in ameloblastomas in an Indian population

Ameloblastoma is a benign epithelial odontogenic neoplasm that constitutes approximately 1% of all oral tumors and about 9 to 11% of all odontogenic tumors. They are slow-growing, locally invasive, and demonstrate a potential for metastasis and malignant transformation. The molecular pathogenesis of ameloblastoma is attributed to aberrant activity of the signal transduction pathways relating to developmental stages of odontogenesis including the mitogen-activated protein kinase (MAPK) pathway. The BRAF V600E mutation was identified as the most frequently mutated gene in this neoplasm. Studies have shown that use of BRAF inhibitors in patients diagnosed with ameloblastomas led to a significant reduction in tumor volume. To detect the expression of BRAF V600E mutation in ameloblastomas in an Indian population using immunohistochemistry. To compare the difference in the occurrence of the BRAF V600E mutation between mandibular and maxillary cases. Thirty-three formalin-fixed paraffin-embedded tissues of histopathologically proven cases of ameloblastoma were assessed for the BRAF V600E mutation by immunohistochemistry using the BRAF V600E monoclonal antibody. Patient data such as age, sex, anatomical site, recurrence were documented. The statistical analysis was performed using the Pearson Chi-square test and Student's t-test. The present study revealed a high expression of the BRAFV600E mutation in mandibular cases of ameloblastoma among Indians irrespective of the age, sex, site, recurrence or histological pattern. The identification of this driver mutation opens the possibility of an adjuvant therapeutic modality to reduce the significant facial disfigurement and morbidity following surgical management.

Immunostaining of stromal CD56 cells in ovarian malignancies.

The aim of this study was to evaluate CD56 immunostaining in the stroma of benign and malignant ovarian epithelial neoplasms and associate the CD56 immunostaining with prognostic factors and survival in ovarian cancer. Patients with ovarian epithelial neoplasia (n=77) were studied with a prospective cohort. The CD56 immunostaining was evaluated in the peritumoral stroma. Two groups were evaluated: benign ovarian neoplasms (n=40) and malignant ovarian neoplasms (n=37). Data were recorded for histological type and grade, International Federation of Gynecology and Obstetrics staging, molecular subtype, and lymph node metastases. Fisher's exact test and Kaplan-Meier survival curves were used, with a significance level of ≤0.05. We found greater CD56 stromal immunostaining in malignant neoplasms when compared to the group of benign neoplasms (p=0.00001). There was no significant difference in relation to the prognostic factors and survival. Malignant ovarian neoplasms showed higher stromal CD56 immunostaining. As the prognostic value of natural killer in ovarian cancer is controversial, knowing the specific function of each cell present both in the tumor tissue and systemically may help guide successful immunotherapies in the near future.

Synchronous nasal mass: a wolf in sheep’s disguise

Aim: To highlight the possibility of synchronous benign and malignant nasal masses. Schneiderian papilloma, also known as inverted papilloma, despite being a common benign epithelial sinonasal tumour, remains a conundrum to otorhinolaryngologists due to its locally aggressive nature, tendency to recur as well as potential of malignant transformation. A synchronous nasal lesion adds on to the complexity of patient management. Case presentation: Herein, we are reporting an unusual case of synchronous lesions: sinonasal inverted papilloma and low-grade mucoepidermoid carcinoma. Initial biopsy of the sinonasal mass revealed inverted papilloma. However, histopathological examination post endoscopic medial maxillectomy revealed evidence of both inverted papilloma and low-grade mucoepidermoid carcinoma. Conclusion: We want to highlight that seemingly benign sinonasal inverted papillomas ought to be taken seriously considering the possibility of a synchronous malignant nasal mass, as in our case.

Cytomorphological Characteristics Of Ameloblastoma By Fine Needle Aspiration Biopsy Procedure Confirmed With Histopathological Examination

Background: Ameloblastoma is the most common benign epithelial odontogenic tumor with malignant potential and is usually located in the jaw. It constitutes about 1-3% of all tumors and cysts of jaws. This entity has a very high recurrence rate of over 50% even after wide excision. Preoperative diagnosis of ameloblastoma can be made by fine-needle aspiration biopsy (FNAB) which is used as a guide for surgical planning. Case report: We report a case of a tumor in the mandible of a 41-year-old man with a preoperative diagnosis of ameloblastoma from a fine needle aspiration biopsy. Cytological examination of FNAB was confirmed by histopathological preparation of tumor tissue. Conclusion: The fine needle aspiration biopsy cytology is a reliable procedure for the pre-operative diagnosis of ameloblastoma. Pre-operative diagnosis of ameloblastoma can be used for planning therapy and early diagnosis of recurrence cases that can improve patient survival

Loss of Dok-3 in Non-tumor Cells Induces Malignant Transformation of Benign Epithelial Tumor Cells of the Intestine.

This study uncovers tumor cell-extrinsic cues that can induce malignant conversion of benign tumors without intensifying mutagenesis in tumors, a novel concept potentially providing a new therapeutic target in malignancy.

Adenoid Ameloblastoma: A Rare Case Report And Review Of Literature

Adenoid ameloblastoma is a rare benign epithelial odontogenic tumor. Although few cases are reported in earlier literature, it is very recently added in the new 2022 WHO odontogenic lesions classification, and represents the only newly defined entity in latest classification. Here, we report a rare case of an adenoid ameloblastoma occurring in the right posterior mandible, clinically presenting as a slow growing swelling in a 50 year-old female patient.

Endoscopic mucosal resection with a circumferential incision in the removal of colorectal neoplasms (preliminary results of the prospective randomized study)

AIM: to assess the early results in patients with benign epithelial colorectal neoplasms which underwent endoscopic mucosal resection with a circumferential incision (C-EMR).PATIENTS AND METHODS: a prospective randomized trial included 50 patients who underwent endoscopic removal of benign epithelial colorectal neoplasms sized 20–30 mm (November 2020 — January 2022). The main group included 26 patients which underwent C-EMR. The control group included 24 patients which underwent endoscopic submucosal dissection (ESD).RESULTS: postoperative complications developed in the C-EMR group in 5 (19.2%), and in the ESD group — in 7 (29.2%) cases (p = 0.51). The operative time in the C-EMR group was significantly less than in the ESD group — 30 vs 60 min., respectively (p < 0.001). In all cases in both groups, tumors were removed en bloc. There R0 resection were performed in 22 (84.6%) and in 23 (95.8%) cases in the main and control groups, respectively (p = 0.3). Two (8.3%) procedures in the control group were converted to the C-EMR procedure.CONCLUSION: endoscopic mucosal resection with a circumferential incision is an effective and safe method for removing benign epithelial neoplasms sized 20–30 mm, as well as submucosal dissection. The removal of the tumor by the C-EMR method reduces operative time by half compared with ESD method.

Histopathologic prevalence of benign and malignant canine neoplasms in small animal hospital, Rajamangala University of Technology Tawan-Ok, Chonburi, Thailand: A retrospective study

This retrospective study surveyed the histological prevalence of 180 canine neoplasms registered during 2016-2020 in the small animal hospital, the Rajamangala University of Technology Tawan-Ok, Chonburi, Thailand. Histopathologic diagnosis of each neoplasia was performed using its published diagnosis criteria. The neoplasms were categorized into epithelial, mesenchymal and round-cell neoplasms. Their parameters were related to sex, breed, and neoplastic location. The study consequence revealed that benign neoplasms occurred in the same frequency as malignant neoplasia. Some neoplasms were sex-dependent, particularly mammary adenocarcinoma in females and perianal (hepatoid) gland adenoma in males. The purebred dogs were prone to the malignant mammary gland and benign mesenchymal neoplasia; meanwhile, the crossbred dogs had more frequencies of benign epithelial, benign round cell and malignant mesenchymal neoplasms than the purebreds. The buttock and head were the primary locations of benign epithelial neoplasms. The mammary gland was common for mammary cancers, while the hindlimb was the predilection site of the malignant mesenchymal neoplasia. These results are similar to the thosedescribed in the previous studies from other regions of Thailand and the rest of the world with a few different points. Therefore, regional veterinarians, particularly in Chonburi province, can confidently use our study findings to set up their preliminary diagnoses for their neoplastic patients.

Adenoid ameloblastoma harbors beta-catenin mutations

AbstractAdenoid ameloblastoma is a very rare benign epithelial odontogenic tumor characterized microscopically by epithelium resembling conventional ameloblastoma, with additional duct-like structures, epithelial whorls, and cribriform architecture. Dentinoid deposits, clusters of clear cells, and ghost-cell keratinization may also be present. These tumors do not harbor BRAF or KRAS mutations and their molecular basis appears distinct from conventional ameloblastoma but remains unknown. We assessed CTNNB1 (beta-catenin) exon 3 mutations in a cohort of 11 samples of adenoid ameloblastomas from 9 patients. Two of the 9 patients were female and 7 male and in 7/9 patients the tumors occurred in the maxilla. Tumors of 4 of these 9 patients harbored CTNNB1 mutations, specifically p.Ser33Cys, p.Gly34Arg, and p.Ser37Phe. Notably, for one patient 3 samples were analyzed including the primary tumour and two consecutive recurrences, and results were positive for the mutation in all three tumors. Therefore, 6/11 samples tested positive for the mutation. In the 6 mutation-positive samples, ghost cells were present in only 2/6, indicating beta-catenin mutations are not always revealed by ghost cell formation. Dentinoid matrix deposition was observed in 5/6 mutation-positive samples and clear cells in all 6 cases. None of the cases harbored either BRAF or KRAS mutations. Beta-catenin immunoexpression was assessed in the samples of 8 patients. Except for one wild-type case, all cases showed focal nuclear expression irrespective of the mutational status. Together with the absence of BRAF mutation, the detection of beta-catenin mutation in adenoid ameloblastomas supports its classification as a separate entity, and not as a subtype of ameloblastoma. The presence of this mutation may help in the diagnosis of challenging cases.

Clinical evaluation of fenestration decompression combined with secondary curettage for ameloblastoma of the jaw: retrospective radiographic analysis

BackgroundAmeloblastoma is a benign odontogenic epithelial tumor with local infiltration and a high recurrence rate that occurs most frequently in the jawbone. The aim of this study was to investigate the outcomes of fenestration decompression combined with secondary curettage (FDSC) in the surgical treatment of jaw ameloblastoma, and clarify the possibility of FDSC to become an appropriate therapeutic method for ameloblastoma with large lesion.MethodsA retrospective analysis was carried out in 145 patients diagnosed with multicystic ameloblastoma (MA) and 88 patients with unicystic ameloblastoma (UA). These patients were divided into two groups based on the therapeutic regimen: the FDSC group and the local curettage (LC) group. Panoramic radiography was taken 2 years after curettage to evaluate the change in lesion area in each case, and the therapeutic effects of different treatment methods were further assessed by the chi square test.ResultsFor MA, the effective rate of cystic cavity area reduction in the FDSC group (71.19%) was higher than that in the LC group (30.23%) (P < 0.001). For UA patients, the effective rate of lesion area reduction after FDSC was 93.02%, which was higher than that after LC (53.33%) (P < 0.001). Moreover, the recurrence rate of the FDSC group in the MA was 30.51%, which was significantly different from that of the LC group (P < 0.001). Regarding UA, the recurrence rates were 13.95% and 28.89%, after FDSC and LC, respectively, with no significant differences between the two groups (P > 0.05).ConclusionsFDSC exhibits a much better curative effect than LC in both MA and UA, whereas the recurrence rate of these two therapeutic strategies did not significantly differ in UA. The above data demonstrated that FDSC may serve as a routine, safe, effective and appropriate surgical treatment plan for MA or UA patients with large lesions.

Characteristic and Management of Ameloblastoma In Oral And Maxillofacial Surgery At Hasan Sadikin General Hospital: Retrospective Study

Introduction Ameloblastoma is common benign epithelial tumor of odontogenic origin. The presentation of ameloblastoma is unique as it locally aggressive tumor with high recurrence rate if not treated adequately. This study aimed to conduct retrospective study to analyze the characteristics and management of ameloblastoma in patient Oral and Maxillofacial Surgery at Hasan Sadikin General Hospital between periods of January 2020 – December 2020. Material and Method This was a retrospective, descriptive feature of all histopathologically diagnosed ameloblastoma during 2020. We took data from each patient such as demographic (gender, age), radiological features, histopatholoical diagnosis, location, management, defect and reconstruction of ameloblastoma. Result A total 23 patients were diagnosed with conventional ameloblastoma, including 11 plexiform (48%), ten follicular (43%), and two mixed types of plexiform-follicular (9%). Among them, 6 (21%) patients were treated conservatively (Enucleation and dredging) and 17 patients were treated radically with segmental resection in 9 (39%) patients, hemimandibulectomy in 5 (22%) patients, marginal resection in 2 (9%) patients, and hemimaxillectomy in one (4%) patient. Conclusion The common characteristic of ameloblastoma is follicular and plexiform ameloblastoma with the most predilection location in mandible region and the peak of incidence in third decades of life. Radical treatment is more often used to reduce recurrence rates, whereas conservative measures are normally preserved in children and adolescent. Keywords: Ameloblastoma, Epidemiology, Odontogenic, Tumour

Prognostic relevance of autophagy-related markers p62, LC3, and Beclin1 in ovarian cancer

To analyze the expression of autophagy markers p62, LC3, and Beclin1 in ovarian cancer tissue and evaluate the prognostic potential of these markers. The study enrolled 328 patients: 122 with epithelial ovarian carcinoma, 42 with atypical proliferative tumor, and 164 with benign epithelial ovarian tumor. The expression of p62, LC3, and Beclin1 was analyzed in central and invasive tumor segments with immunohistochemistry combined with tissue microarray. The expression levels of the analyzed markers were correlated with relevant histopathology parameters. The expression of all analyzed markers was most remarkable in epithelial ovarian carcinoma. There was a strong positive correlation between the expressions of p62 and LC3, while these two markers negatively correlated with Beclin1. High-grade serous carcinoma had higher p62 and LC3 levels, and lower Beclin1 levels than other tumor types. This expression profile was also observed in more advanced tumor stages. Prominent p62 and LC3 expression in combination with weak Beclin1 expression in high-grade serous carcinoma indicates potential for the application of autophagy inhibitors in patients with this tumor subtype.

Recurrent tumors of ameloblastoma: Clinicopathologic features and diagnostic outcome.

Ameloblastoma is a benign epithelial odontogenic tumor with a tendency for recurrence. Some recurrent tumors could behave unpredictably with atypical microscopic changes. To study the clinicopathologic features and diagnoses of recurrent tumors of ameloblastoma. This is a 5-year (2012-2017) retrospective study of 17 consecutive patients with recurrent tumors of ameloblastoma in a Teaching Hospital in Enugu. The relevant clinicopathologic information, histology slides, and blocks were retrieved and reviewed. Descriptive analysis was used to determine the frequency, tables for categorical variables, and a Chi-square test was used to determine the statistical significance. Recurrent tumors constituted 33.3% (17/51) of all confirmed diagnoses of ameloblastoma. The histopathologic diagnosis of the recurrent tumors includes conventional ameloblastoma 58.8% (10/17), unicystic ameloblastoma 5.9% (1/17), and ameloblastic carcinoma 35.3% (6/17). There was bilateral mandibular involvement in 60.0%, pain 58.8%, ulceration 29.4%, and matted lymph nodes 5.9%. Tumors with positive fluid aspirates 82.4% (14/17) yielded dark-brown fluids in 90.0% (9/10) of recurrent ameloblastomas and in 66.7% (2/3) of ameloblastic carcinomas. There was a high recurrence rate of recurrent tumors of ameloblastoma demonstrated in the present study, with a malignant presentation in some cases.

Intraoral Sialadenoma Papilliferum: A Comprehensive Review of the Literature with Emphasis on Clinical and Histopathological Diagnostic Features

Background. Sialadenoma papilliferum (SP) is a rare benign epithelial tumor of salivary gland origin, its diagnosis being potentially challenging. It was first described by Abrams and Finck in 1969 as an analog of the cutaneous syringocystadenoma papilliferum. The aim of this comprehensive review is to highlight the clinical and histopathological diagnostic aspects of intraoral SP, analyzing cases previously described and reporting new cases. Methods. Medline, Scopus, and Web of Science were searched up to February 2022, using as entry term “sialadenoma papilliferum”. No time limits were applied and only studies in English were taken into account. Only cases involving the mouth were included. Conference proceedings, personal communications, and letters to the editor were excluded. Results. In total, 42 out of 234 articles fulfilled the inclusion criteria, with 64 cases reported. Mean age of patients with SP was 57.2 years, with a higher prevalence among males. The most affected site was the palate, particularly the hard palate. Four cases with uncertain malignant features have been reported. While clinical manifestations of SP are rather unspecific (e.g., submucosal swelling with ulceration), histopathological and immunohistochemical features are quite peculiar, SP have a limited growth potential, leading to conservative excision as treatment of choice. Conclusions. SP, though rare, should be taken into consideration in the differential diagnosis of intraoral swellings, particularly those located on the palate.

Serous papillary cystadenofibroma of ovary: A rare entity diagnosed on frozen section

Ovarian cystadenofibroma are rare slow growing benign epithelial ovarian neoplasms. It usually occurs as solid and cystic component. Most of the tumours are asymptomatic and detected incidentally during abdominal ultrasound for some other purpose. They may mimick malignant neoplasm with their gross appearance and imaging modalities. So a diagnosis of serous papillary cystadenofibroma of ovary on frozen section can save the patient from unwanted extensive surgery. We here in discuss a case of serous papillary cystadenofibroma of ovary in a 45 year old multipara that was diagnosed initially on frozen section and later confirmed on histopathology, thus highlighting the role of frozen section in diagnosis of intraoperative ovarian neoplasms.