Oral Cavity Tumors Research Articles

Benign Soft Tissue Tumors of oral cavity, relevance to prosthodontics – Laconic Review.

The influence of oral soft tissue tumors on the surrounding structures and oral tissues makes them a considerable problem in prosthodontic treatment, regardless of their malignancy. Maintaining functional rehabilitation with prosthetic devices while addressing the tumor pathology is a delicate balance in the therapy of malignant tumors. Prosthodontics is relevant in this situation in a number of ways. Long-term side effects from cancer therapies, especially radiation therapy, can include mucositis, osteoradionecrosis, and xerostomia. The efficacy of prosthetic treatments may be significantly impacted by these negative effects. Patients with soft tissue tumors in the mouth cavity can greatly benefit from prosthodontic treatment, despite its difficulties. There is not much literature is available on the relevance of soft tissue tumors in various prosthodontic treatment procedures. Hence this laconic review aimed to discuss about various soft tissue tumors which are related to prosthodontic treatment and different precautions to be taken during prosthodontic procedures.

Outcomes in Minor Salivary Gland Tumors-A 20+ Year Tertiary-Care Center Experience.

Minor salivary gland carcinomas are challenging to study due to their rarity and heterogeneity. We aim to further characterize clinical characteristics, treatment, and outcomes over 20 years within a single institution. Retrospective chart review was conducted on 210 patients who received primary treatment for minor salivary gland malignancy from 2000 to 2022. Single tertiary-care center. Multivariable Cox proportional hazards method was used to examine the relationship between pre-determined clinically important variables and outcomes. Five-year overall survival was 77.8% (72.0-84.1). Advanced clinical T stage portended over a 2 times higher risk of death and recurrence. High pathologic grade was associated with a near 3 times higher risk of death and recurrence. There was a predominance of occult nodal metastases in level II for oral cavity and oropharynx site tumors. Clinical T stage and grade were important for overall survival, local, regional, and distant recurrence-free survival. Occult nodal metastases occurred most often in level II.

Reconstructing oral cavity tumor evolution through brush biopsy

Oral potentially malignant disorders (OPMDs) with genomic alterations have a heightened risk of evolving into oral squamous cell carcinoma (OSCC). Currently, genomic data are typically obtained through invasive tissue biopsy. However, brush biopsy is a non-invasive method that has been utilized for identifying dysplastic cells in OPMD but its effectiveness in reflecting the genomic landscape of OPMDs remains uncertain. This pilot study investigates the potential of brush biopsy samples in accurately reconstructing the genomic profile and tumor evolution in a patient with both OPMD and OSCC. We analyzed single nucleotide variants (SNVs), copy number aberrations (CNAs), and subclonal architectures in paired tissue and brush biopsy samples. The results showed that brush biopsy effectively captured 90% of SNVs and had similar CNA profiles as those seen in its paired tissue biopsies in all lesions. It was specific, as normal buccal mucosa did not share these genomic alterations. Interestingly, brush biopsy revealed shared SNVs and CNAs between the distinct OPMD and OSCC lesions from the same patient, indicating a common ancestral origin. Subclonal reconstruction confirmed this shared ancestry, followed by divergent evolution of the lesions. These findings highlight the potential of brush biopsies in accurately representing the genomic profile of OPL and OSCC, proving insight into reconstructing tumor evolution.

Research on enzymatic co-assembly nanomedicine in oral squamous cell carcinoma

Oral squamous cell carcinoma (OSCC) represents the predominant form of malignancy within the head and neck region, accounting for more than 90 ​% of all oral cavity tumors. OSC cells commonly overexpress epidermal growth factor receptor (EGFR), which is closely associated with the development, progression, and differentiation of tumors. Despite surgery and chemotherapy being the primary therapeutic interventions for OSCC, their efficacy is suboptimal compared with that of other oral malignancies. We engineered a polypeptide molecule (HCPT-GDFDFDpYERGD, designated HP), which features the chemotherapeutic agent 10-hydroxycamptothecin (HCPT) at its N-terminus and the tumor-homing ligand Arginine-Glycine-Aspartic acid (RGD) at its C-terminus. The RGD moiety confers upon the polypeptide the ability to co-target cancer cells synergistically. The EGFR inhibitor cetuximab was co-assembled with HP via an enzymatic catalysis co-assembly technique to create a nanofibrillar structure, resulting in antibody‒polypeptide coassembly. In vitro assays have demonstrated that the co-assembled nanomedicine exhibits high affinity for OSCC cells, is efficiently internalized, and elicits potent inhibitory effects. Furthermore, bioinformatics analysis suggested that the co-assembled nanomedicine downregulated genes enriched in the PI3K-Akt signaling cascade. The co-assembled nanomedicine dramatically reduces cancer while sparing negative effects, as shown by in vivo animal models. This research endeavors to develop a new nanomedicine delivery platform that integrates molecular targeting with efficient intracellular drug delivery. This system not only markedly augments the therapeutic efficacy of the chemotherapeutic agent HCPT but also substantially mitigates patient adverse effects, thus offering a more secure and efficacious therapeutic strategy for the management of OSCC.

Impact of Adjuvant Radiotherapy Setting on Quality-of-Life in Head and Neck Squamous Cell Carcinoma.

To determine differences in post-treatment QoL across treatment settings in patients receiving adjuvant radiation therapy for head and neck squamous cell carcinoma (HNSCC). This was a prospective observational cohort study of patients with HNSCC initially evaluated in a head and neck surgical oncologic and reconstructive clinic at an academic medical center (AMC). Participants were enrolled prior to treatment in a prospective registry collecting demographic, social, and clinical data. Physical and social-emotional QoL (phys-QoL and soc-QoL, respectively) was measured using the University of Washington-QoL questionnaire at pre-treatment and post-treatment visits. A cohort of 177 patients, primarily male and White with an average age of 61.2 ± 11.2 years, met inclusion criteria. Most patients presented with oral cavity tumors (n = 132, 74.6%), had non-HPV-mediated disease (n = 97, 61.8%), and were classified as Stage IVa (n = 72, 42.8%). After controlling for covariates, patients treated at community medical centers (CMCs) reported a 7.15-point lower phys-QoL compared with those treated at AMCs (95% CI: -13.96 to -0.35, p = 0.040) up to 12 months post-treatment. Additionally, patients who were treated at CMCs had a 5.77-point (-11.86-0.31, p = 0.063) lower soc-QoL score compared with those treated at an AMC, which was not statistically significant. This study revealed that HNSCC patients treated with radiation at AMCs reported significantly greater phys-QoL in their first-year post-treatment compared to those treated at CMCs, but soc-QoL did not differ significantly. Further observational studies are needed to explore potential factors, including treatment planning and cancer resource engagement, behind disparities between AMCs and CMCs. 3 Laryngoscope, 134:3645-3655, 2024.

Investigating the Effect of Smoking on Transcriptomics of Primary Oral Cavity Tumors using the Gene Expression Omnibus Dataset

Investigating the Effect of Smoking on Transcriptomics of Primary Oral Cavity Tumors using the Gene Expression Omnibus Dataset

Immune cell topography of head and neck cancer

BackgroundApproximately 50% of head and neck squamous cell carcinomas (HNSCC) recur after treatment with curative intent. Immune checkpoint inhibitors are treatment options for recurrent/metastatic HNSCC; however, less than 20% of...

Might photobiomodulation therapy interfere with the frequency of severe mucositis and oral candidiasis? A retrospective analysis in patients with head and neck carcinoma.

Considering the tumor in the oral cavity or the oropharynx and nasopharynx region might be an aggravating factor for oral mucositis (OM) manifestation, the present study aimed to evaluate whether the location of the tumor and the use of photobiomodulation therapy (PBMT) might affect the frequency of oral candidiasis (OC) during radiotherapy (RT) and/or chemotherapy (CT) treatments. The medial records of seventy-four patients with head and neck cancer treated in a public service from 2016 to 2019 were evaluated. All these patients were submitted to RT in an accumulated dose of 48 to 70Gy of radiation. Data about OM and OC were collected and presented according to the application of a therapeutic protocol with laser photobiomodulation (PBMT) to control oral mucositis, or not (No-PBM), and the location of tumor (head and neck or oral cavity). In the PBMT group patients, a low-power laser device composed of InGaAlP diode (maximum output power of 86.7mW, active tip area of 0.1256cm2, and continuous wavelength of 660nm), was applied to the lips (three points each), right and left jugal mucosa (three points each), the limit between hard and soft palate (three points), buccal floor/sublingual gland (one point), lateral edge of the tongue (three points on each side), and back of the tongue (six points), three times weekly, for 5weeks. The dosimetry used in each application was 2J for 3s, thus totaling 56J. The correlation between clinical characteristics such as age, tumor size (T), metastatic lymph node (N), number of RT and CT sessions, candidiasis, and OM were analyzed. Mucositis grades 1 and 2 were the most common among all patients, especially before the 12th radiotherapy session, regardless of the treatment with PBM (p > 0.05). Additionally, no difference in the grade of OM and OC was significantly observed when comparing the two laser therapy groups. OC was more frequent after the 12th radiotherapy session in all groups. Nonetheless, OM and OC had a different correlation regarding to tumor location (head and neck and oral cavity) being PBMT a positive therapy to delay OM. It was observed a positive and statistically significant correlation between tumors at oral cavity and OM, regardless PBMT (R = 0.84, p < 0.05 to PBMT and R = 0.13, p < 0.05 to No-PBM). Otherwise, OC was positively correlated to local metastasis in patients with oral tumors undergoing PBMT (R = 0.84, p < 0.05). Patients with oral cavity tumor presented more OM, especially high grades, then patients with tumors in other regions of the head and neck, which seems to be related to the irradiation parameters of radiotherapy and/or with the limitation of conduction of PBMT in tumor areas. OM and OC were not changed by PBMT, although it helped to reduce the incidence of severe cases of OM.

A rare case of a vascular benign tumor in oral cavity – Case report

Leiomyomas are benign tumors arising from smooth muscle and can be classified as solid, epithelioid, and vascular leiomyoma (angioleiomyoma). Angioleiomyoma frequently occurs on the skin. Due to the lack of smooth muscle in the oral cavity, this tumor is rarely located in the mouth. This study aims to present a rare case of a 36-year-old woman with a painless submucosal nodule in the left cheek mucosa, measuring approximately 2 cm x 1 cm, with 5-years of evolution. Morphological and histochemical examination evidenced the proliferation of smooth muscle around the blood vessels of various calibers. The diagnosis of angioleiomyoma was confirmed, the tumor was surgically removed, and the patient had no further complications after 9-months of follow-up. The diagnosis of oral angioleiomyoma is challenging since this tumor is rare and can mimic or transform into malignancy. For this reason, histological examination in association with immunohistochemical is invaluable to establishing an accurate diagnosis and delivering suitable treatment.

Dermoid Cysts on the Floor of the Mouth.

The authors analyzed the clinical features and treatment results of surgical patients with a final diagnosis of dermoid cyst on the floor of the mouth over 14 years at our hospital. A total of 5 patients with a final diagnosis of dermoid cyst of the floor of the mouth from January 2010 to December 2023 were enrolled. All patients complained of swelling in the submentum or floor of the mouth. The mean tumor size was 4.2±1.0cm. All patients underwent complete surgical resection. A transcervical approach was performed in 3 patients, and an intraoral approach was implemented in 2 patients. There were no major complications after surgery with either method. The follow-up period was 71.4±75.7 months. There was no disease recurrence during follow-up. Dermoid cysts rarely occur on the floor of the mouth but should be considered in the differential diagnosis of other oral cavity tumors. Dermoid cysts on the floor of the mouth can be safely removed using the current transoral approach without scarring or recurrence.

Personalized ctDNA for Monitoring Disease Status in Head and Neck Squamous Cell Carcinoma.

Many patients with locoregionally advanced human papillomavirus-negative head and neck squamous cell carcinoma (HNSCC) relapse. ctDNA has the potential to identify minimal residual disease, but its clinical utility for virus-negative HNSCC is not well understood. We retrospectively evaluated a personalized, commercial ctDNA assay (Signatera, Natera) during clinical care of patients treated for predominantly newly diagnosed human papillomavirus-negative HNSCC. Signatera utilizes 16-plex PCR from matched tumor and blood. Objectives were to understand ctDNA detectability and correlate changes posttreatment with disease outcomes. Testing was successful in 100/116 (86%) patients (median age: 65 years, 68% male, 65% smokers); testing failed in 16 (14%) because of insufficient tissue. Oral cavity (55, 47%) tumors were most common; most had stage III to IV disease (82, 71%), whereas 17 (15%) had distant metastases. Pretreatment, 75/100 patients with successful testing (75%) had detectable ctDNA (range: 0.03-4049.69 mean tumor molecules/mL). No clinical features predicted ctDNA detectability or levels (multivariate analysis). At a median follow-up of 5.1 months (range: 0.2-15.1), 55 (55%) had >1 test result (range: 1-7; 194 samples). Of 55 patients, 17 (31%) remained ctDNA positive after starting treatment. Progression-free survival was significantly worse for patients who were ctDNA positive versus ctDNA negative posttreatment (HR, 7.33; 95% confidence interval, 3.12-17.2; P < 0.001); 1-year overall survival was 89.1% versus 100%, respectively (HR, 7.46; 95% confidence interval, 0.46-119.5; P = 0.155). Tumor-informed ctDNA testing is feasible in nonviral HNSCC. ctDNA positivity is an indicator of disease progression and associated with inferior survival. Further research is warranted to understand whether ctDNA may be leveraged to guide therapy in HNSCC.

A hybrid epithelial/mesenchymal state in head and neck cancer: A biomarker for survival with differential prognosis by self-reported race

Head and neck squamous cell carcinoma (HNSCC) is the 6th leading cause of cancer-related mortality, with racial disparities amplifying the challenges in treatment. Although the relationship between hybrid epithelial/mesenchymal (E/M) states and tumor progression is of interest, no studies have characterized the clinical relevance of hybrid E/M states in head and neck cancer outcomes among self-reported racial cohorts. Given the overlap in gene expression between hybrid E/M malignant cells and cancer-associated fibroblasts, we utilized deconvolution of bulk RNA sequencing data from oral cavity and laryngeal squamous cell carcinoma tumors from The Cancer Genome Atlas. We utilized our previously collected single-cell profiles to generate inferred malignant profiles and then scored these for hybrid E/M. We then conducted a survival analysis on overall and disease-free survival among self-reported Black and White Americans. The hybrid E/M state was differentially associated with head and neck cancer survival by self-reported race and ethnicity, with a stronger association in non-Hispanic Black patients. Black patients with a high hybrid E/M score had a higher risk of death or recurrence (hazard ratio [HR]: 4.18 [95% confidence interval (CI): 2.06, 8.49]) than White patients with a high hybrid E/M score (HR: 1.58 [95% CI: 1.11, 2.26]). Our results suggest a complex interplay of social structure, racism, and genetic diversity. We implore researchers to consider the social and biological context contributing to disparities. A.L.M. received support from the National Institute of Minority Health and Health Disparities (K01MD013897 [principal investigator (PI), A.L.M.]). S.V.P. received support from the National Institute of Dental and Craniofacial Research (R01DE032865 [PI, S.V.P.] and R01DE032371 [PI, S.V.P.]).

A phase I/II study evaluating the feasibility and safety of delivering adjuvant hypofractionated radiotherapy in resected oral cavity cancers (HYPO-ART study)

Background and purposeTo evaluate the tolerability and efficacy of adjuvant Hypofractionated radiotherapy in resected oral cavity cancer patients. Materials and methodsPost-operative oral cavity cancer patients with indications for adjuvant (chemo) radiotherapy were enrolled. T3/T4 disease, positive lymph nodes(s), lympho-vascular invasion, and/or perineural invasion were considered intermediate risk factors for which a radiation dose of 50Gy over four weeks was delivered. Extra-nodal extension and/or positive margins were considered high-risk factors for which a radiation dose of 62.5Gy over five weeks was delivered. The primary end-point was the incidence of acute radiation-induced toxicities. Secondary endpoints were locoregional control and overall survival. Results38 patients were enrolled in the trial and completed planned radiotherapy treatment. No grade 4 toxicity was observed. Acute grade 3 toxicity included oral mucositis in 60.5 % of patients and dysphagia in 18.3 % of patients. 71 % of patients required nasogastric tube placement and 50 % needed day-care support. At a median follow-up of 20.35 months, 57.9 % were alive with no evidence of disease, and 31.6 % of patients had a loco-regional recurrence. Loco-regional control and overall survival at one year were 68 % and 84 %; at two years, they were 59 % and 59 %, respectively. ConclusionsModerately hypofractionated radiotherapy is well tolerated and can safely be delivered for resected oral cavity tumors with optimal supportive care while maintaining similar oncological outcomes compared to conventional fractionation.

Oral cavity disorders in traditional, ethnic and original people communities

This chapter describes a worrying scenario and the territory of multidisciplinary health work in Brazil, a diverse country: the knowledge on the part of the dentist and the multidisciplinary team about the health of the black population corresponds to a demand in health, since this group has a predisposition to certain diseases, which if diagnosed early, will be possible to contribute to better therapeutic planning, predictability, and a favorable prognosis in certain clinical manifestations. However, such semiological methodological research may also contribute to the investigation and better understanding of oral cavity disorders that occur in members of traditional communities, in addition to displaced people (indigenous and gypsies), in an urban presence in Rio de Janeiro/Brazil. , envisioning better health outcomes for these vulnerable populations. Periodontal disease can be defined as a multifactorial chronic inflammatory process that affects the protective and supporting tissues of the teeth. Several factors related to this process are currently recognized, such as environmental, genetic, socioeconomic, systemic, ethnic factors and individual susceptibility of the host (very well covered technically by Semiology and repertorization). The manifestations of periodontal disease in people of African descent and the possible causal relationships that make them more susceptible (as described for sickle cell anemia) were presented, thus indicating the need for an individualized preventive approach to this population. Habits that are harmful to the health of the oral cavity were also listed. Finally, we emphasize the culminating point that was the meeting in the health space of the 7th ward of the Homeopathy Service of the Hospital Geral Santa Casa da Misericórdia in Rio de Janeiro, when it was possible to talk about the importance of interventions on habits that compromise the style of life and quality of life also contribute to the emergence of oral cavity neoplasms. The path of health promotion via multidisciplinary health education carried out jointly by professionals who are members of Homeopathy institutions in Rio de Janeiro stood out in relevance.

Reconstruction of oral mucosal defects with regenerative dermal matrix after T1-T2 squamocellular carcinoma resection

ObjectiveResection of tumors of oral cavity usually causes short- or long-term sequelae such as chewing, speech and swallowing impairment. To preserve this function it is necessary to maintain the lining of the oral cavity, the mobility and sensitivity of the tongue. Reconstructive options for oral mucosal defects resulting from tumor resection included primary closure, mucosal and skin grafts, pedicle and microvascular free flaps, and dermal matrix. Study designRetrospective study on patients undergoing reconstruction of intraoral defects, after removal of T1, T2 malignant tumors, by placement of bilayer dermal matrix. MethodsFrom 2021 to 2022, 47 patients with oral mucosa defects after removal of squamous cell carcinoma were treated. All patients were affected by a T1-T2 squamous cell carcinoma.For each patient, data were collected regarding the site of the disease, the initial staging, the size of the surgical defect, the complications and the outcome months after the operation. ResultsIn all treated cases the surgical defect involved the mucosa of the cheek, the oral floor or the tongue with an average size of 5.45cm2.Patients who underwent this type of reconstruction benefited from excellent healing of intraoral wounds and good restoration of oral function 6 months after surgery. Out of the total number of patients, membrane attachment failure was reported in only two cases. ConclusionAs emerges from the data reported in our study, the dermal matrix represents a valid alternative in oncological reconstructive surgery for small/medium-sized intraoral mucosal defects because it allows re-epithelialization of the wound.

The Occurrence of a Rare Mandibular Retromolar Triangle Schwannoma and Its Differentiation from Other Rare and Atypical Oral Cavity Tumours

The Occurrence of a Rare Mandibular Retromolar Triangle Schwannoma and Its Differentiation from Other Rare and Atypical Oral Cavity Tumours

AKR1B10 accelerates glycolysis through binding HK2 to promote the malignant progression of oral squamous cell carcinoma

BackgroundOral squamous cell carcinoma (OSCC) remains a rampant oral cavity neoplasm with high degree of aggressiveness. Aldo–keto reductase 1B10 (AKR1B10) that is an oxidoreductase dependent on nicotinamide adenine dinucleotide phosphate (NADPH) has been introduced to possess prognostic potential in OSCC. The present work was focused on specifying the involvement of AKR1B10 in the process of OSCC and its latent functional mechanism.MethodsAKR1B10 expression in OSCC tissues and cells were detected by RT-qPCR and Western blot analysis. CCK-8 method, EdU staining, wound healing and transwell assays respectively assayed cell viability, proliferation, migration and invasion. Immunofluorescence staining and Western blot evaluated epithelial mesenchymal transition (EMT). Adenosine triphosphate (ATP) contents, glucose consumption and extracellular acidification rate (ECAR) were measured by relevant commercially available kits and Seahorse XF96 Glycolysis Analyzer, severally. The expressions of proteins associated with metastasis and glycolysis were examined with Western blot. Co-IP assay confirmed the binding between AKR1B10 and hexokinase 2 (HK2).ResultsIt was observed that AKR1B10 expression was increased in OSCC tissues and cells. After AKR1B10 was knocked down, the proliferation, migration, invasion and EMT of OSCC cells were all hampered. Additionally, AKR1B10 silencing suppressed glycolysis and bound to HK2 in OSCC cells. Up-regulation of HK2 partially abolished the hampered glycolysis, proliferation, migration, invasion and EMT of AKR1B10-silenced OSCC cells.ConclusionTo sum up, AKR1B10 could bind to HK2 to accelerate glycolysis, thereby facilitating the proliferation, migration, invasion and EMT of OSCC cells.

Rare Tumor of oral Cavity: soft Palate Hemangioma: Case Report and Literature Review

Rare Tumor of oral Cavity: soft Palate Hemangioma: Case Report and Literature Review

Ultrasound diagnostics: assessment of tumor thickness and depth of invasion in squamous cell carcinoma of the oral cavity

Aim. To evaluate the capabilities of ultrasound using various approaches in determining the depth of invasion of squamous cell carcinoma of the oral cavity and to compare the results obtained with data obtained by the use of other diagnostic methods. Materials and methods. In our reserch, ultrasonography was performed on 193 patients with primary malignant tumors of the mobile part of the tongue, floor of the oral cavity and tumors of rare locations (mucous membranes of the lip, cheek, alveolar processes). The age of the patients ranged from 15 to 85 years. In all patients, tumors were squamous cell carcinoma. ultrasound was performed using submandibular, intraoral and transbuccal approaches. ultrasonic data were compared with the results of pathomorphological examination, as well as of X-ray computed tomography and of magnetic resonance imaging with contrast. Results. A statistically significantly high correlation was obtained for all ultrasound approaches (submandibular, intraoral and transbuccal) with the depth of invasion of the oral tumor determined pathomorphologically (r = 0.78; r = 0.89; r = 0.93; p &lt;0.001). Ultrasound using all approaches shows statistically significantly better results in determining the thickness of tumorsof the tongue and mouth floor in comparison with X-ray computed tomography and magnetic resonance imaging (p &lt;0.001). All diagnostic methods are characterized by an overestimation of the tumor invasion depth (overdiagnosis) as compared with pathomorphological examination. for exophytic tumors and oral cavity tumors of mixed growth with an exophytic component, the depth of invasion was less than the tumor thickness. Conclusion. Ultrasound is an accessible, easily reproducible, radiation-free method, the resolution of which makes it possible to accurately determine not only the depth of invasion of oral tumors, but also the distance from the tumor to the midline of the tongue, that represents an important information when choosing the extent of surgical intervention.

A Rare Lipoma of Tongue in a 4-Year-Old Child: A Case Report With Literature Review.

Lipoma of the tongue is a rare benign tumor that accounts for approximately 1% to 5% of all oral cavity tumors while 0.3% of tumors are of the tongue. Notably, it is rarer in children. In this article, we report the case of a 4-year-old girl with lipomas of the tongue. The lipomas were found at age 1 year by her parents, located on the tip, ventro, and dorsum of the tongue, and presenting with a trend to increase gradually. At the time of presentation to the hospital at age 4 years, the articulatory function of the patient was partially affected, and surgical excision was performed. The surgery was uneventful, and no evidence of recurrence was noted at 3 month follow-up.