Oral cancer is increasing in prevalence and its treatment is associated with high degree of morbidity and mortality. Thus, prevention of oral cancer is of utmost importance. Chemoprevention is the use of natural, synthetic, or biologic compounds to halt, reverse, or prevent the initial phases of carcinogenesis or the progression of neoplastic cells to cancer. This modality has been extensively researched in the last two decades for the prevention of oral cancer with the emergence of new information. Retinoids were the first chemopreventive agents to be tested in clinical settings. Since then, a number of new agents such as COX2 inhibitors, EGFR inhibitors, p53 targeted agents, thiazolidinediones and several natural agents have shown promise in oral cancer prevention. Chemopreventive trials in oral cancer tend to be long term studies and are thus challenging. This review article looks into the clinical evidence for the application of chemopreventive agents in clinical settings and also highlights the recent trends in oral cancer chemopreventive trials.
Tag Archives: squamous cell carcinoma
Adenosquamous and squamous cell carcinoma of the pancreas: two histopathological variants of ductal adenocarcinoma
Introduction: Primary squamous cell carcinoma (SCC) and adenosquamous carcinoma of the pancreas are rare malignancies for which diagnostic and treatment strategy are challenging. In this paper we present a literature review of these tumors based on two case reports.
Case presentation: In the first case, a 55-year-old male presented with an inoperable pancreatic head/body junction tumor. Endoscopic ultrasound-guided fine needle aspiration was practiced, and histopathological examination revealed a squamous cell carcinoma of the pancreas. After exclusion of any another tumor, the diagnosis of cT4N0M0-staged primary pancreatic SCC was made. The patient is under treatment with gemcitabine and oxaliplatin. The second case is represented by a 73-year-old patient in which imagistic examinations highlighted a cystic mass of the pancreatic body. Following coporeo-caudal splenic-pancreatectomy and histopathological-proved diagnosis of adenosquamous carcinoma, the patient started chemotherapy but died at 11 months after surgery. Both tumor components displayed positivity for markers which prove ductal (cytokeratin19, maspin) and squamous differentiation (p63, cytokeratin5/6) same as vimentin, as indicator of epithelial mesenchymal transition (EMT).
Conclusions: SCC and adenosquamous carcinoma of the pancreas are aggressive malignancies which prognosis remains highly reserved. These tumors might be variants of ductal adenocarcinomas which are dedifferentiated through EMT phenomenon.
Lower Lip Reconstruction Using Unilateral Nasolabial Gate Flap (Fujimori Technique)
Background: In the medical literature there are multiple reconstructive procedures for small and medium size defects of the lower lip, but only a few methods for larger defects involving the whole lower lip. Choosing the repairing procedure for larger lower lip defects must take into account two aspects: flap or flaps used should be local flaps, and suture lines should correspond to the natural facial creases or follow the functional lines of different facial aesthetic units. Finally, the flap or flaps should be large enough to restore the entire postexcisional defect.
However, the more tissue is lost from the lower lip, the more challenging the reconstruction is from a functional and cosmetic point of view.
Material and methods: During the last 2 years in the Oral and Maxillofacial Surgery Department of the County Emergency Clinical Hospital in Tîrgu Mureş, the unilateral Fujimori technique has been successfully used for the reconstruction of large lower lip defects in 4 patients with extended, neglected squamous cell carcinomas involving almost the whole lower lip tissue. These patients underwent complex surgical and oncological treatment. Surgery was performed in two stages: first, excision of the tumor and immediate lip reconstruction, and then removal of submandibular lymph nodes (level I), in the second stage.
Results: The aesthetic and functional recovery of these patients was very good, with no need of other subsequent surgical corrections.
Conclusions: The postoperative reconstruction of large defects of the lower lip is far from optimal, but it is very important to restore an adequate muscle function, the lip continence and a satisfactory facial appearance.
Specific Characteristics of Head and Neck Squamous Cell Carcinoma in Mures Area
Although head and neck cancers have a rising incidence, these diseases are less investigated because of their localisations’ heterogenity. The major risk factors susceptible to influence the evolution of the disease are smoking, alcohol consumption and infection with human papilloma virus. Using data from Mures County Emergency Hospital’s histopathology register, we made a retrospective study of 190 cases from the last two years. Factors of interest included age, sex, localization, histopathological subtype and differentiation grade. Median age at diagnosis was 61.31 years, the disease presenting highest incidence in the 51-60 age subgroup and a clear male predominance (5.75:1). The most frequent localization is lower lip (28%) and the dominant histopathological subtype is cheratinised squamous cell carcinoma (83,8%) and G2 differentiation grade (48,1%). This study supports the finding of increased incidence of cheratinised squamous cell carcinoma in this region. However the literature emphasizes rising incidence of head and neck cancer in younger, we observed that increase in Mures area occurred in 51-60 age group. Lower lip most frequent localization makes possible an early diagnosis.