Oral squamous cell carcinoma: an analysis of 1,564 cases showing advances in early detection.
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The present study aimed to detect possible differences in the data of oral squamous cell carcinomas (OSCC) cases diagnosed in a Dental School in Sao Paulo city over the last 40 years. The records of patients diagnosed as having OSCC between the years 1960 and 2008 were retrieved. The whole period was divided into four time periods. A total of 1,564 cases were reviewed. The variables analyzed were: sex, age, race, anatomical site, lesion duration, and lesion size. The chi-square test was used for statistical analysis. Overall, males were more affected than females (3:1), but when comparing the first and last time periods, the ratio decreased significantly (5.8:1 to 2.8:1). A significant increase in the rate of OSCC in patients over 80 years was observed in the last time periods. The gingiva was the most affected site, but the frequency of lower lip involvement increased in the last time period. Regarding lesion size and duration of symptoms at the time of diagnosis, there was a significant difference between the first and last time periods. Smaller lesions were found and the time of lesion development was shorter in the last few years of the study. These findings support the optimistic view that, in recent years, earlier diagnosis has resulted from early oral cancer detection in Sao Paulo city. (+info)
Merkel cell carcinoma on the upper lip of a 100-year-old woman.
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Merkel cell carcinoma (MCC) is a rare skin tumor that usually occurs on the head, neck, or extremities of elderly patients; it has a high incidence of local recurrence, regional lymph node metastasis, and subsequent distant metastasis. We report a MCC that developed rapidly on the left corner of the upper lip of a 100-year-old woman. An incisional skin biopsy was performed to confirm MCC. Computed tomography showed no metastasis. The tumor was widely excised with a margin of 1 cm. Immediate reconstruction with a reverse Estlander flap from the lower lip was performed under general anesthesia. Additional surgery was also performed under general anesthesia 2 weeks later to widen the patient's lips. The surgical results were satisfactory. The patient died of senile deterioration a year after hospitalization for long-term medical treatment, without any recurrence or metastasis of MCC. Despite the patient's age, we considered it necessary to resect the tumor widely because of its rapid growth. The tumor margin was 1 cm. No radiotherapy was performed, but we believe that surgery alone was effective in allowing this patient to live an additional year without recurrence or metastasis. To the best of our knowledge, this patient is the oldest person with MCC yet described. (+info)
Trichilemmal carcinoma associated with xeroderma pigmentosa: report of a rare case.
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Trichilemmal carcinoma is a rare malignant skin adnexal tumor derived from the outer root sheath epithelium of the hair follicle. We describe a rare case of trichilemmal carcinoma of the upper lip associated with xeroderma pigmentosa in a young patient. We demonstrate that this tumor, as well as the more frequently reported squamous cell carcinoma and basal cell carcinoma can occur in association with xeroderma pigmentosa. Making this diagnosis is imperative as the biological behavior of Trichilemmal carcinoma is less aggressive than that of other epithelial malignancies, requiring a different approach to treatment planning. (+info)
Outdoor work and risk for Parkinson's disease: a population-based case-control study.
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