Lateral Border Of Tongue Research Articles

Malignant transformation of oral leukoplakia: Systematic review and comprehensive meta-analysis.

To update the current evidence on the malignant transformation of oral leukoplakia (OL), including all studies published worldwide on the subject, selected with the maximum rigor regarding eligibility. MEDLINE, Embase, Web of Science and Scopus were searched for studies published before June-2024, with no lower date limit. The risk of bias was analyzed using the Joanna Briggs Institute tool for meta-analyses of proportions. We carried out meta-analyses, explored heterogeneity across subgroups and identified risk factors with potential prognostic value. Fifty-five studies (41,231 with OL) were included. The pooled malignant transformation proportion for OL was 6.64% (95% CI = 5.21-8.21). The malignant transformation did not significantly vary by time periods (p = 0.75), 5.35% prior to 1978, 7.06% from 1979 to 2007 and 6.97% during more recent times. The risk factors that significantly had a higher impact on malignant transformation were the non-homogeneous leukoplakias (RR = 4.23, 95% CI = 3.31-5.39, p < 0.001), the larger size (RR = 2.08, 1.45-2.96, p < 0.001), leukoplakia located on the lateral border of tongue (malignant transformation = 12.71%; RR = 2.09, 95% CI = 1.48-2.95, p < 0.001), smoking (RR = 1.64, 95% CI = 1.25-2.15, p < 0.001), and the presence of epithelial dysplasia (RR = 2.75, 95% CI = 2.26-3.35, p < 0.001). OL presents a considerable malignant transformation probability that is especially increased in large non-homogeneous lesions in smokers, located on the lateral border of the tongue, with epithelial dysplasia.

Proliferative verrucous leukoplakia: a general dental practitioner-focused clinical review

Proliferative verrucous leukoplakia (PVL) is a distinct type of oral leukoplakia which has the potential to enlarge or develop into new areas of leukoplakia coupled with areas of a warty surface texture. PVL is usually diagnosed from the fifth decade onwards and is more common in female patients. The most frequent sites involved tend to be gingivae, followed by buccal mucosa and lateral border of tongue. It is one of the oral potentially malignant conditions with a high risk of malignant transformation. It is important for general dental practitioners (GDPs) to identify such lesions to facilitate referral for further investigation and diagnosis. Management is challenging with long-term monitoring and surgical excision when appropriate; however, PVL tends to recur following surgical excision. This article provides an up-to-date review tailored for GDPs on the present knowledge of PVL and illustrates the management challenges with clinical cases.

Oral squamous cell carcinomas and oral potentially malignant disorders: A Latin American study.

To determine the frequency of oral squamous cell carcinoma (OSCC) associated or not with oral potentially malignant disorders (OPMD), and the epidemiological profile and traditional risk factors in Latin America. A retrospective observational study was conducted in 17 Latin American centres. There were included cases of OSCC, analysing age, gender, OSCC and their association with previous OPMD. Clinicopathological variables were retrieved. The condition of sequential-OSCC versus OSCC-de novo (OSCC-dn) was analysed concerning the aforementioned variables. Quantitative variables were analysed using Student's t-test, and qualitative variables with chi-square. In total, 2705 OSCC were included with a mean age of 62.8 years old. 55.8% were men. 53.75% of the patients were smokers and 38% were common drinkers. The lateral tongue border was the most affected site (24.65%). There were regional variations in OPMD, being leukoplakia the most frequent. Of the overall 2705 OSCC cases, 81.4% corresponded to OSCC-dn, while s-OSCC were 18.6%. Regarding lip vermillion SCC, 35.7% corresponded to de novo lip SCC and 64.3% were associated with previous OPMD. In Latin America, OSCC-dn seems to be more frequent with regional variations of some clinical and histopathological features. Further prospective studies are needed to analyse this phenomenon.

Atypical Squamous Verrucous Lesions of the Oral Cavity: Challenges in Interpretation of Small Incisional Biopsies.

Squamous verrucous proliferative lesions of oral cavity can pose a diagnostic challenge for the general pathologist, especially on small biopsies. The superficial nature of incisional biopsies and inconsistent histologic terminologies used for these lesions contribute to often-discrepant clinical diagnosis, resulting in delayed treatment.This study aims to explore the proliferative squamous lesions of oral cavity, correlate biopsy & resection diagnoses, and evaluate possible reasons for discrepant diagnosis (if any). A retrospective review of oral verrucous squamous lesions was undertaken. Pathology database was searched for oral cavity biopsies from January2018 through August2022 with the keywords: atypical, verrucous, squamous, and proliferative. Cases with follow-up were included in this study. A blinded review of the biopsy slides was performed and documented by a single head and neck pathologist. Demographic data, biopsy and final diagnosis were recorded. Twenty-three cases met criteria for inclusion. The mean patient age was 61.1years with a male: female ratio of 1.09. Most frequent site was lateral border of tongue (36%) followed by buccal mucosa and retromolar trigone. The most common biopsy diagnosis was "Atypical squamoproliferative lesion, excision recommended" (n = 16/23, 69%) with 13/16 showing conventional squamous cell carcinoma (SCC) on follow-up resection. 2/16 atypical cases underwent repeat biopsy for confirmation of diagnosis. Overall, conventional SCC was the most prevalent final diagnosis (73%, n = 17), followed by verrucous carcinoma (17%, n = 4). On slide review, six initial biopsies were reclassified as SCC, while one final diagnosis was reclassified as a hybrid carcinoma (on resection specimen). Diagnostic concordance (biopsy and resection) was observed in three cases, all three were recurrences. The primary reasons for discrepant diagnosis on initial biopsies were found to be 1. Obscuring inflammation, 2. Superficial biopsies, and 3. Under recognition of morphologic features (e.g., tear shaped rete, loss of polarity, dyskeratotic cells, paradoxical maturation) that help differentiate dysplasia from reactive atypia. This study highlights the rampant interobserver variability in diagnosis of oral cavity squamous lesions and emphasizes importance of identifying morphologic clues that can aid in correct diagnosis, thereby helping in adequate clinical management.

An Unusual Presentation of Oral Pyogenic Granuloma on the Tongue

Pyogenic granuloma is a non-neoplastic reactive lesion that commonly occurs in gingiva. It is rarely found in extra gingival sites such as tongue, lip, palate and buccal mucosa. Lesions affecting the tongue are rarer and very few cases are reported. Unusual site of such lesions can be a diagnostic challenge. This case report describes an uncommon location of pyogenic granuloma occurring on the lateral border of tongue in a 60 -year-old male patient.

MALIGNANT TRANSFORMATION OF ORAL LEUKOPLAKIA – A REVIEW

Oral Leukoplakia is one of the most common oral premalignant lesions and dened as white patch or plaque that does not rub off clinically identied as another entity. Etiological factors are smoking, viral and fungal agent and specic nutrients and deciency may have role in the development and progression. Clinically it can be classied as homogenous and non-homogenous. It most seen on buccal mucosa and lateral border of tongue. Malignant transformation of oral leukoplakia is about 5-18%. A higher chance of it transformation has been seen in non-homogeneous, high risk anatomic structures such as the oor of the mouth or the tongue, as well as a history of non-smoking. It can be diagnosed by biopsy, toluidine blue staining or lugol s iodine and exfoliative cytology. Management is surgical excision, cryosurgery, CO2 laser, retinoids, photodynamic therapy

Primary leiomyosarcoma of tongue: A relatively uncommon entity occurring at an exceedingly rare site

Primary leiomyosarcoma (LMS) of the tongue is an extremely rare, highly aggressive malignancy associated with poor survival outcome. We report a case of 60 years old male who presented with growth left lateral border of tongue since 6 months. Histopathological examination of the excised growth confirmed the diagnosis of LMS. An exhaustive panel of immunohistochemical markers helped in ruling out other malignant spindle cell differentials.

A specimen out of the blue, case of squamous cell carcinoma demonstrating various patterns of perineural Invasion

Oral squamous cell carcinoma (OSCC) is the fifth most frequent cancer in the world and about 3% of all malignant neoplasms are usually spread by lymphatic or rarely hematogenous spread. Perineural invasion (PNI) is an alternate method of tumor spread and an important prognostic factor for further treatment plans in OSCC. The patterns of PNI are categorized, according to various research articles and studies conducted, some of the common ones are complete encirclement, incomplete “crescent-like” encirclement, sandwiching, onion skin, partial invasion, and neural permeation. We received a hemiglossectomy specimen of a 62-year-old male diagnosed with squamous cell carcinoma (SCC) on a small biopsy with an ulceroproliferative lesion in the left lateral border of tongue. Microscopy showed an invasive tumor showing features of well-differentiated SCC with extensive various patterns of PNI such as complete encirclement, incomplete encirclement, sandwich pattern, onion skinning, crescenting and neural permeation. PNI indicates and predicts the local recurrence and also regional nodal metastasis in patients with OSCC. PNI should be searched and included in the histopathology report in every OSCC case including recurrent cases.

Squamous Cell Carcinoma of Left Lateral Border of Tongue followed by Therapy Induced Mucositis Grade 4

Carcinomas are the major serious health issue in today’s healthcare system. while its prognosis is difficult at earlier stages. OSSC oral squamous cell carcinomas are reported more than 3 lakhs new cases world-wide and it is sixth most common cancer world-wide. Squamous cell carcinoma is defined as the cancer of soft, flat, thin squamous cells mainly affect the soft cell regions like tongue diagnosed by various investigational imaging and biochemistry parameters. In this case patient was diagnosed with High Grade Squamous Cell Carcinoma. Radiation therapy along with chemotherapy is the option for better therapeutic outcomes. Hence, EBRT therapy is given and in 2 gray every cycle and a total of 59.8 gray, 20 cycle therapy depending on condition of patient. In 90% cases radiation therapy leads to RIOM (Radiation Induced Oral Mucositis) which is totally unprotectable and there in no specific treatment option available in market approved by US-FDA yet. RIOM is diagnosed by WHO grading system based on the parameters and observations. In this condition patient suffers from inflammation, mouth ulcers and progressive condition and patient can not be able to swallow anything. It’s five stage process which treated by giving antibiotic in case of RIOM and oral hygenine, mouthpaints are advised. Levofloxaccin 750mg with clotrimazole mouthpaint was given to the patient. Radiation therapy continued with curative and Supportive therapy and was successful radiation therapy also shows good response and reduction in growth of tumor was observed and therapeutic goals were achieved.

ORAL LICHEN PLANUS: CASE REPORT

Lichen planus is a chronic and T cell–mediated inflammatory disorder of the skin and mucous membranes. This case report describes a case of oral lichen planus in an 82-year-old female patient. The patient's history revealed severe pain and burning sensation in the entire oral cavity. On intraoral examination, diffuse lesions in the form of erythematous areas were seen interspersed within white keratotic areas present on the lateral border of tongue and buccal mucosa bilaterally. Based on the patient's history and clinical findings, the lesion was provisionally diagnosed as oral erosive lichen planus. Histopathologic examination of the biopsied tissue confirmed the diagnosis of lichen planus. The patient was treated with systemic corticosteroid. Complete remission of lesions was observed after 2 months of treatment. The patient was monitored continuously and at 8 months of follow-up did not present exacerbation of the lesions.

TONGUE MICROINVASIVE CARCINOMA: CASE REPORT

Squamous cell carcinoma (SCC) represents the main malignancy of oral mucosa and lips and is the sixth most common cancer in the world. The tongue is the most common anatomical site. Microinvasive carcinoma is an early-stage, relatively thin tumor, without invasion of deep tissues. The objective of this work is to report a case of microinvasive SCC and present its clinical characteristics, emphasizing early diagnosis and clinical management. A 64-year-old male patient reported a "sore on the tongue that doesn't heal." The clinical examination demonstrated 2 white plaques on the lateral border of tongue associated with an erythematous area (atrophic). The diagnostic hypotheses were erosive lichen planus and lichenoid reaction. Incisional biopsies were performed, and histopathologic reports revealed microinvasive SCC. The patient was referred for treatment. Because microinvasive lesions tend to present clinically as premalignant lesions, accurate clinical examination is essential if misdiagnosis of early lesions is to be avoided.

FOREIGN BODY ON RIGHT LATERAL BORDER OF TONGUE THAT MIMICKS VARIX: A CASE REPORT

Foreign body impaction in the oral cavity either due to traumatic injury or iatrogenically is not uncommon. Most commonly encountered iatrogenic foreign bodies is restorative materials such as amalgam, obturation materials, broken instruments and needles. Majority of foreign bodies are impacted in tonsils, base of tongue, maxillary sinus and vallecula. However, foreign bodies impaction in the mobile tongue is rare. We present a case of unusual foreign body impaction on the right lateral border of tongue appeared as bluish mass. A 40-year-old female military personnel came to Oral and Maxillofacial Surgery Department of 94 Armed Forces Hospital Terendak Camp complaining of bluish, painless mass on the right side of her tongue for 4 years. Excisional biopsy has been done and histopathological examination reveals foreign body impaction, likely amalgam tattoo. Amalgam tattoo can sometimes be confused with other foreign body pigmentations, being then biopsied. Once amalgam tattoos have been established, the removal of lesions is not necessary, except for esthetic reasons.

Incidence of Traumatic Ulcer among the Patients Visiting Private Dental Hospital- Retrospective Study

Introduction: Oral mucosal ulcers are one of the most common types of ulcer of which Traumatic ulcers are common and acute in nature, caused by some form of trauma to the mucous membrane in the oral cavity. It is most commonly seen in the Buccal Mucosa, Lips, and occasionally in the Palate and Lateral border of tongue. It is caused by physical, chemical or thermal trauma resulting in damage and ulcer formation.&#x0D; Materials and Methods: The data for the present study n = 345 patients was collected by analysing case sheets of patients who visited Saveetha Dental College from June 2019- February 2021. The collected data was subjected to statistical analysis using the SPSS software by IBM of version 23.&#x0D; Results: From the results of the study, Traumatic Ulcer has Male predilection with incidence rate of 62.2% compared to females with incidence of 37.7%. Most of them were in the age group of 21-30 years age group (34.5%) and least in the 71-85 years age group (2.9%). Traumatic ulcer was most common in the Alveolar mucosa (32.2% )&#x0D; Conclusion: From the present study it can be concluded that Traumatic ulcer is more common in Males. However, Gender, Age, Oral Hygiene, Usage of Tobacco products were not significantly influencing the rate of incidence of Traumatic Ulcer.

Spectrum of biopsied oral and maxillofacial lesions in a tertiary care hospital of Karachi, Pakistan

Objectives: The burden of benign and malignant maxillofacial lesions in developing countries has increased rapidly over the years. Objective of this study was to provide a spectrum of oral and maxillofacial lesions biopsied in a tertiary care hospital of Karachi, Pakistan and to contribute in baseline data of target population.&#x0D; Patients and methods: This descriptive cross sectional study was made of biopsies performed in patients presenting to OPD of Oral and Maxillofacial Surgery Department, Abbasi Shaheed Hospital Karachi, Pakistan, between July 2018 till June 2020. A total of 652 patients belonging to either gender, 18-75 years of age, incisional or excisional biopsy were included. Recurrent or previously diagnosed lesions and patients not willing to give informed consent were excluded. Data including age, gender, site and histopathological diagnosis was recorded on a performa. Descriptive statistical analysis was done using SPSS version 26.&#x0D; Result: Out of 652 biopsies performed, (82.9%, n=541) belonged to soft tissues and (17.1%, n=111) were hard tissue lesions. The mean age of patients was 41.82 years, with a male to female ratio of 2.9:1. The most frequent sites biopsied were buccal mucosa (50.9%, n=332) and posterior mandible (10.6%, n=69). Oral squamous cell carcinoma (OSCC) (55.1%, n=359) was the most commonly reported soft tissue lesion with major involved sites buccal mucosa (74.4%, n=267), dentoalveolar mucosa (8%, n=29) and lateral border of tongue (7.2%, n=26) and for hard tissue the most common lesion was ameloblastoma of posterior mandible (3.5%, n=23).&#x0D; Conclusion: This study provides useful information about distribution of oral and maxillofacial lesions and highlights OSCC as the single most frequent diagnosis involving a much younger male population.

Rare location of Universal tumor

Lipomas are one of the most common benign mesenchymal tumor in human. Lipoma occurring in the tongue is rare as tongue has paucity of normal adipose tissue. Here we present an unusual case of lipoma presented in the tongue, and removal of which comforted patient by regaining of the functional task of tongue. Fifty two year’s old Muslim women presented with painless swelling on right lateral border of tongue for 5 years for which excision was done and histopathology evaluation was performed. The histopathology was consistent with the diagnosis of Lingual Lipoma. Existence of lipoma in the tongue is very rare, which can be managed by simple excision. Histopathology is the gold standard in the diagnosis.

Unusual Presentation of a Giant Schwannoma of Left Lateral Border of Tongue: A Rare Case Report.

Schwannoma is a benign, encapsulated, slow-growing and generally solitary tumour that arise from Schwann cells of the peripheral nerve sheath. Approximately 1-12% occur intraorally with the tongue being one of the site. We report a case of schwannoma of the tongue in a 33-year-old male patient. It presented as a slow growing mass of the tongue. We did the surgical excision of the tumour with the help of CO2 laser, and the patient is in follow-up and is asymptomatic from the last 7months.

Oral Hairy Leukoplakia in Immunocompetent Patients Revisited with Literature Review.

Oral hairy leukoplakia (OHL) is an Epstein-Barr virus (EBV) related lesion seen in severely immunocompromised patients especially, those with concomitant human immunodeficiency virus (HIV) infection. It has been rarely reported in immunocompetent patients. OHL most often presents on the lateral border of the tongue as an asymptomatic, white, and corrugated plaque that does not rub off. With Institutional Review Board (IRB) approval, the University of Florida Oral & Maxillofacial Pathology Biopsy Service archives spanning 1994-2020 were queried. All cases of OHL affecting immunocompetent patients were identified. Data related to age, gender, clinical presentation, results of Epstein-Barr virus in situ hybridization (EBER-ISH), and periodic acid-Schiff (PAS)-fungus stains were recorded. Medical history and histology of all cases were reviewed for confirmation of diagnosis. A total of 11 cases were identified, the majority of which were males (63.6%) with a mean age of 62years. All patients were Caucasian. Lesions entirely were located on the lateral borders of the tongue. OHL should not be considered pathognomonic for HIV infection and should be included in the differential diagnoses of keratotic lesions affecting the lateral border of tongue even in immunocompetent elderly patients. The etiology of OHL in this group of patients is not clearly understood.

Squamous cell carcinoma of tongue with isolated inguinal node metastasis: A case report and literature review

Most of the patients with squamous cell carcinoma of tongue present with distant metastasis to lung, bone, and liver. However, some rare presentation of tongue cancer metastasizing to cutaneous, cardiac, and axillary lymph nodes has been reported. We present a case of 55-year-old man diagnosed with squamous cell carcinoma of right lateral border of tongue, underwent right hemiglossectomy and right modified neck dissection, levels 1–5 with pathological staging pT2N0M0 (AJCC 8th edition) followed by adjuvant radiotherapy to a total dose of 60 Gy in 30 fractions. After 6-month post-treatment, the patient presented with right inguinal swelling which was associated with pain. Ultrasonography of the groin region confirmed lymphadenopathy and fine-needle aspiration cytology (FNAC) from lymph node came out as metastatic deposits of squamous cell carcinoma. Positron emission tomography and computed tomography (PET-CT) showed isolated right inguinal lymph node metastasis. He underwent right inguinal block dissection and adjuvant radiotherapy. Hence, isolated inguinal node metastasis is extremely rare but possible. Patient should be examined thoroughly during follow-up.

Study of p53 gene over expression as a prognostic marker in squamous cell carcinoma of the oral cavity

The present study entitled ”Study of p53 gene expression as a prognostic marker in squamous cell carcinoma of oral cavity” was conducted in the department of pathology SRMSIMS Bareilly, 66 cases diagnosed on histopathology as squamous cell carcinoma of oral cavity from Jan 2016 to Jan 2017 were included in the study. Various parameters analysed for each case included age, gender, site, history of tobacco chewing, smoking &, alcohol consumption, histopathological grade of tumor and p53 expression. The patients age ranged from 24 to 85 years with mean age; 52.09 years and median age; 53 years. Maximum no of patients were male 54(81.8%) and 12 (18.2%) were female. Male: female ratio was 9:2. The most common site of presentation was lateral border of tongue (34.8). In the present study 89.4% were tobacco chewers, 72.7% were alcoholics and 57.6% were smokers.34 cases (51.5%) were diagnosed as well differentiated, 26 cases(39.4%) as moderately differentiated and 6 cases (9.1)% as poorly differentiated squamous cell carcinoma. The p53 expression was observed in 41(62.1%) of cases. The expression of p53 increased with the grade of tumor. The positivity being 17(50%) in cases of well differentiated, 19(73%) in moderately differentiated and 5(83%) in poorly differentiated squamous cell carcinoma. In present study p53 expression is found to be significantly related with tobacco chewing (p value= 0.034), smoking (p value= 0.0046) and tumor grade (p value=0.030). However no association was found with alcohol consumption (p value=0.917) the increasing prevalence of p53 expression with increasing grade of tumor suggests that it can be used as a prognostic indicator in oral cavity cancers. Keywords: Squamous cell carcinoma, p53 expression, Prognostic indicator, Oral cancer.

Hemangiopericytoma- A solitary tongue lesion

Hemangiopericytoma (HPC) is a mesenchymal tumour that is usually benign, but has definite malignant counterpart. 16-25 % cases of all reported HPC’s are observed involving Head and Neck region. We report a case of HPC on the left lateral border of tongue. The histopathology features revealed increased cellularity, vascularity with some staghorn pattern. Observed nuclear pleomorphism and vesicular as well as hyperchromatic nuclei suggest an intermediate grade characterized by unpredictable clinical behaviour. Therefore long follow up is essential. No local recurrence or distant metastasis was noticed in a 5 year follow-up period. Keywords: Hemangiopericytoma, Vascularity, Staghorn