Oral Pathology Biopsy Service Research Articles

Botryoid odontogenic cyst: analysis of 33 cases.

The botryoid odontogenic cyst is considered to be a multiloculated variant of the lateral periodontal cyst. Fewer than 40 of these lesions have been described, many of which have recurred. This paper describes the demographic, clinical, microscopic, and radiographic features of 33 unreported cases from the files of the Oral Pathology Biopsy Service at the University of North Carolina School of Dentistry. Our findings are in agreement with previously published cases for an average age of 57 years and the most common site for occurrence in the lower premolar area. Follow-up information on 12 patients determined that 2 had recurrences.

An assessment of oral cancer underregistration at the Connecticut Tumor Registry

The purpose of this study was to investigate whether and to what extent cases of oral cancer diagnosed through the University of Connecticut Health Center Oral Pathology Biopsy Service went unregistered by the Connecticut Tumor Registry during the period 1984 to 1988. All Oral Pathology Biopsy Service pathology reports generated from 1984 to 1988 were reviewed to identify diagnosed oral cancer cases (International Classification of Diseases, 9th revision codes 140, 141, 143 to 145). The names of all identified patients were computer-linked to previously registered cases. Nineteen (8.6%) of the 221 reportable cases of oral cancer diagnosed through the Oral Pathology Biopsy Service from 1984 to 1988 went unregistered. The 19 unregistered cases represented 1.6% of all known Connecticut oral cancer cases diagnosed during the period. The finding of a past, albeit small, "gap" in oral cancer cases registered with the Connecticut Tumor Registry suggests that oral pathologists should confirm that cases of oral cancer diagnosed through their pathology services are being registered by their regional tumor registries.

Smoking, gender, and age as risk factors for site-specific intraoral squamous cell carcinoma. A case-series analysis

Studies assessing risk factors for oral cancer do not generally report results for specific oral sites. The purpose of the current study was to examine differences in the distribution of age, gender, and tobacco use by intraoral site in a series of oral cancer cases. Information on gender, age at diagnosis, and lesion location was obtained for all incident cases of oral squamous cell carcinoma diagnosed through the University of Connecticut Oral Pathology Biopsy Service during the period 1987-1991 (N = 150). Information on tobacco use was obtained through a telephone interview or from medical or dental records. The tongue, floor of the mouth (FOM), and gingiva, respectively, were the most commonly affected sites. The male-to-female ratio was greatest for FOM cancer (3.4) and lowest for gingival cancer (0.5). The mean age at diagnosis did not differ significantly by site. The percentage of smokers among cases of FOM, tongue, and gingival cancer was 97%, 64%, and 50%, respectively. When multiple logistic regression was used to compare FOM and gingival cancer, gender and smoking remained significant predictors. The odds of smoking among patients with FOM cancer were 32 times the odds of smoking among patients with gingival cancer (odds ratio for age, gender adjusted = 32.6, 3.3-323.5). The findings suggest that cancer of the FOM is more strongly associated with smoking than is cancer of the gingiva and, perhaps, the tongue. The reported results should be interpreted cautiously in light of study limitations, which include the absence of information on alcohol consumption and lack of a noncancer control group.

Changing trends in oral cancer in the United States, 1935 to 1985: A Connecticut study

An extensive epidemiologic study was undertaken in an attempt to analyze patterns of oral cancer distribution and demography in Connecticut between 1935 and 1985. Sources of data for the investigation included both the Connecticut Tumor Registry (CTR) and the University of Connecticut Oral Pathology Biopsy Service. During the 51-year study period, 9,708 cases of primary oral cancer were reported to the CTR. Male age-adjusted incidence rates for overall oral cancer remained stable between 1935 and 1964 (14.5 to 14.8 per 100,000), with a gradual decline to 10.9 per 100,000 in the early 1980s. In contrast, age-adjusted rates for females advanced approximately threefold, from 1.4 per 100,000 in the 1930s to 4.1 per 100,000 in the early 1980s. There was a decrease in age-specific rates of oral cancer in males aged 70 and older; in contrast, age-specific incidence rates in females increased steadily over the same period. It was also found that female birth cohorts born in 1900 and later exhibited higher oral cancer incidence rates than those of previous cohorts. Between the 1960s and the present, male patients 30 to 39 years of age exhibited a nearly fourfold increase in oral cancer incidence; this was not observed among similarly aged females. Connecticut counties with highest oral cancer incidence rates in both sexes were the more densely populated Hartford and New Haven counties. In general, the picture of oral cancer, as revealed through analysis of cases accessioned by the University biopsy service between 1975 and 1986, exhibited similar trends to those disclosed by analysis of CTR data. The increase in female oral cancer incidence combined with the reduced incidence in males appears to account for the dramatic decline in male-to-female ratio for oral cancer in Connecticut between 1935 and 1985. If this trend continues, the incidence of oral cancer in Connecticut women will equal that of men by the mid-1990s.

Oral cancer: A survey of 566 cases from the University of Connecticut Oral Pathology Biopsy Service, 1975–1986

A survey of the University of Connecticut Oral Pathology Biopsy Service was undertaken to analyze cases of oral cancer accessioned during the 12-year period, 1975 through 1986 inclusive. Of 33,429 total specimens accessioned, there were 546 malignant oral neoplasms diagnosed and reported. Sixty-five (11.5%) originated from out of state. Invasive intraoral squamous cell carcinoma was the predominant tumor (69.7% of total), whereas lip cancer constituted only 2.8% of all malignancies. Minor salivary gland adenocarcinomas accounted for 11% of total malignancies whereas verrucous carcinoma, carcinoma in situ, and miscellaneous other forms of oral cancer accounted for the remainder (4.6%, 5.3%, and 6.6%, respectively). Cases of invasive squamous cell carcinoma were further analyzed by year, sex distribution, location subsite, age at diagnosis, and histologic grade. With the exception of histologic grading, we found that the characterization of cases of squamous cell carcinoma within the biopsy service tended to parallel results from a separate but related statewide analysis of both oral cancer and intraoral squamous cell carcinoma from Connecticut over a much longer time span. We concluded that the picture of oral cancer as characterized by cases within the University of Connecticut Oral Pathology Biopsy Service is generally reflective of the disease on a statewide level.

A diagnostic and epidemiologic survey of 15,783 oral lesions

Tissue specimens submitted to an oral pathology biopsy service during a 17 1/2-year period were studied to determine the types of diagnoses rendered, the general types of pathological processes represented, and the epidemiologic distribution of patients. A total of 15,783 cases were studied. Normal structures were observed in 480 cases, mostly dental follicles, and were eliminated from the study. The remaining 15,303 cases had been diagnosed as pathological entities. A majority of the oral biopsies were taken from either infectious or reactive conditions. Fibromas, periapical granulomas, periodontitis, mucoceles, and radicular cysts were the most frequently encountered lesions. Neoplasms constituted nearly 15% of all the specimens, with approximately 18% of these being malignant. An additional 360 lesions (2.4% of the total number of specimens) harbored dysplasia and might be considered premalignant. The peak age groups represented in these patients were the third through sixth decades of life. More oral biopsies were performed on females than males. A majority of the patients were white. The purpose of this study was to determine the relative frequency of oral lesions that were considered to be of sufficient clinical significance to merit a biopsy. Although this data might be used as a guide for forming clinical impressions about oral lesions, the clinician must always be aware of the possible occurrence of more rare lesions.

Squamous cell carcinoma of the oral mucosa: a review of 244 cases in Australia.

In an attempt to extend and update information relating to oral cancer in Australia and to provide a basis for international comparison a group of 244 patients suffering from oral cancer have been studied in detail. These patients were all diagnosed in one Oral Pathology Biopsy Service used almost exclusively by oral surgeons and dentists, and although this introduced bias into the sample it had the advantage of standardising documentation. The male: female ratio (1.3 : 1) of patients with oral cancer was lower than that previously reported in Australia, but the average age of patients (60 years) was comparable with many previous reports. The floor of the mouth was the most common site of cancer. There was a significant over-representation of tobacco and alcohol consumers amongst the patients, but a group of elderly females who had never used tobacco or alcohol, yet developed oral cancer, was identified. It was of particular interest that these elderly females had significantly lower haemoglobin and serum iron levels than a sex- and age-matched control group.

A survey of 4,793 oral lesions with emphasis on neoplasia and premalignancy

A survey was taken of a selected group of 4,793 oral lesions submitted to the oral pathology biopsy service between 1950 and 1970. About two thirds of all the specimens examined microscopically were classified as inflammatory, infectious, or reactive hyperplasia. Of the 12.6% of the sample classified as neoplasms, one of every five was malignant. Three of every four of the malignant neoplasms were microscopically diagnosed as squamous cell carcinomas. Benign neoplasms were most common in ages 40 to 60, whereas premalignancies and malignancies were most commonly discovered in the slightly older age group of 50 to 70. Although malignant neoplasms were found more often in men than women, there was a striking increase in the incidence of malignancies in women in the second ten-year period of the study. There were unexplainably few malignant neoplasms found in blacks. Patients should be taught to recognize the early signs of oral premalignancy and malignancy through the use of a simple method of self-examination at home. They should be discouraged from the frequent use of tobacco and alcohol, which have long been known to be predisposing factors in the production of oral squamous cell carcinomas.