Verrucous carcinoma of the female breast. (1/43)

Verrucous carcinoma is a rare skin malignancy of squamous cell origin. It is characterised by negligible cellular atypia and a low mitotic rate. These are reflected in slow locally invasive behaviour and very infrequent metastatic spread. The tumour is also recognised in oral and anogenital sites. Cutaneous lesions present most commonly on the sole of the foot. We report a unique case occurring in the female breast.  (+info)

Tobacco-associated lesions of the oral cavity: Part II. Malignant lesions. (2/43)

Nonmalignant tobacco-associated lesions of the oral cavity were discussed in the first part of this two-part article. Here, we describe malignant lesions associated with tobacco use, basic biopsy principles for such lesions and intervention strategies that dental professionals may use to reduce the chances of their patients developing precancerous lesions or primary malignancies.  (+info)

Elevated focal adhesion kinase expression facilitates oral tumor cell invasion. (3/43)

BACKGROUND: Understanding the molecular mechanisms of metastasis is critical with respect to oral tumorigenesis. The focal adhesion kinase (FAK) is an intracellular tyrosine kinase associated with the regulation of cell growth, migration, and survival. The purpose of the current study was to determine whether elevated FAK expression in oral malignancies was associated with increased invasiveness and oral carcinoma. METHODS: Immunohistochemical analysis was used to assess levels of FAK expression in archived oral carcinoma tissue samples. Invasion assays after transfections were used to assess the effect of increased FAK expression on invasive potential of oral tumor cells. RESULTS: The human oral carcinoma cell line SCC25 was significantly more invasive (P < 0.05) and expressed higher levels of FAK compared with the less invasive human oral carcinoma cell line SCC15. FAK expression was 3.0-fold higher in the SCC15 cell line and 5.0-fold higher in the SCC25 cell line compared with normal epithelial cells. In the highly invasive SCC25 cell line, FAK expression was 1.5-fold higher compared with the less invasive SCC15 cell line. FAK immunostaining in oral tumors was significantly more intense compared with the immunostaining in surrounding normal epithelium or chronic mucositis. Overexpression of FAK in low-invading SCC15 cells resulted in a 4.5-fold increase in the rate of invasion compared with untransfected or neotransfected control SCC15 cell lines and a nearly 1.5-fold greater rate compared with the highly invasive untransfected SCC25 cell line. CONCLUSIONS: The current results suggest that enhanced expression of FAK in oral carcinoma cells may lead to a selective growth advantage and increased invasive potential of the primary oral tumor.  (+info)

Capecitabine induces rapid, sustained response in two patients with extensive oral verrucous carcinoma. (4/43)

PURPOSE: Oral verrucous carcinoma (VC) has been traditionally treated with surgery or radiation with frequent recurrences and significant morbidity. We describe rapid and dramatic response to oral capecitabine in two patients with advanced refractory VC. EXPERIMENTAL DESIGN: VC is a rare tumor of the oral cavity. It does not metastasize but over time causes morbidity and mortality through local invasion. Radiation and surgery have been the main treatment modalities but are plagued by mutilating effects, recurrences, and possibly malignant degeneration in some cases. To date, no effective chemotherapy regimens have been described in the international literature. The clinical records of two elderly females with extensive oral VC are described. Both patients were prescribed one cycle of capecitabine, 1,000 mg bid for 14 days. Response was documented by photography in one patient. Immunohistochemical evaluation of three 5-fluorouracil metabolizing enzymes on pretreatment biopsies from both patients was also performed. A review of the literature with emphasis on treatment of oral VC is presented in view of our findings. RESULTS: Examination of the oral cavity before treatment revealed extensive involvement with an evenly spreading, exophytic, warty, whitish lesion in both patients. Microscopic examination of H&E-stained slides from biopsies of these lesions confirmed the clinical suspicion of VC. Both patients underwent treatment with oral capecitabine for one cycle (2 weeks on/1 week off) at a reduced dose of 1000 mg, p.o., bid. Both had a dramatic response with near complete resolution of their lesions within 3 weeks of initiating therapy. A durable partial response was documented at 1 year in the first patient and 6 months in the second. Immunohistochemical evaluation of pretreatment biopsies from both patients revealed a high level of expression of thymidine phosphorylase, a key enzyme in the metabolism of capecitabine. CONCLUSIONS: Oral VC is a rare entity with a progressive course over years and limited options in terms of treatment. Preliminary observations in two elderly patients demonstrate that capecitabine, an oral fluoropyrimidine, is well tolerated and may induce rapid, clinically significant response. Although not curative, it may provide a cost-effective alternative for elderly patients with a significant improvement in their quality of life.  (+info)

Invasive cutaneous verruco-cystic squamous cell carcinoma. A pattern commonly present in transplant recipients. (5/43)

To determine whether certain histologic features are more common in cutaneous squamous cell carcinomas (CSCCs) arising in transplant recipients than in others, we assessed several features of CSCCs from 23 patients who had not undergone transplantation and 25 transplant recipients (size, depth of invasion, sun damage, nuclear atypia, keratinization, epidermal inclusion cyst [EIC]-like features, verrucous features [VFs], shape, and mitoses per 10 high-power fields). We analyzed relationships by using chi 2 and t tests and logistic regression analysis. Transplant recipients tended to be younger than control subjects (mean [SD] age, 56.2 [14.3]; 74.1 [10.6], respectively; P < .0001) and less likely to show severe sun damage (P = .0455; chi 2). CSCCs with VFs and EIC-like features were associated strongly with transplantation: odds ratio, 12.57 (95% confidence interval, 1.28-123.47; P = .0162). No other features were associated significantly with transplant status. Posttransplant tumors commonly showed verrucous and EIC-like features mimicking benign conditions. The younger age of these patients, the frequent absence of solar elastosis, and the infrequent occurrence of well-differentiated verruco-cystic CSCC in the nontransplant population suggest a different pathogenesis in the development of these neoplasms. Pathologists should be aware of this pattern, especially when diagnosing small biopsy specimens from transplant recipients.  (+info)

Surgical treatment of oral verrucous carcinoma. (6/43)

BACKGROUND: The aim of this study was to evaluate the outcome of patients with Verrucous carcinoma (VC) of oral cavity treated at the Chung Gung Memory Hospital with respect to the tumor control rates after surgery, the risk of lymph node metastasis and the role of radiation therapy. METHODS: Thirty-eight patients underwent primary treatment for VC of the oral cavity from January 1996 through February 2002. All of the patients had surgery as their primary treatment. In addition, all patients with sufficient details of the therapy and a minimum 1-year follow-up were selected for evaluation of survival and outcomes. RESULTS: In this study, 94.7% of patients were male and most of them had been exposed to betel nuts, cigarettes, and/or alcohol. The most common site was the buccal mucosa (57.9%), followed by the tongue (13.2%). T3 lesions were the most common type (34.2%). Only two patients had palpable cervical adenopathy during the initial evaluation. Twenty-five patients had free flap for reconstruction. The tumor control rate was 100%. At the time of analysis, no patient had suffered from recurrence in primary site or neck area. CONCLUSION: Surgical excision alone was effective for controlling VC, but elective neck dissection was not necessary even in patients in the advanced stages.  (+info)

Verrucous carcinoma of the bladder with koilocytosis unassociated with vesical schistosomiasis. (7/43)

CONTEXT: Verrucous carcinoma of the bladder is a very rare malignant neoplasm, histologically similar to condyloma acuminatum. Usually it shows association with vesical schistosomiasis (bilharziasis). Only 13 cases unrelated to bilharziasis have been reported to date, and none of them reported koilocytosis, a typical finding in human papillomavirus infection. CASE REPORT: We report a case of verrucous carcinoma of the bladder that was unrelated to bilharziasis, with koilocytosis and absence of human papillomavirus. The literature relating to the topic is discussed.  (+info)

Association of laryngeal cancer with previous gastric resection. (8/43)

OBJECTIVE: To investigate the association between gastric surgery and cancer of the larynx. SUMMARY BACKGROUND DATA: Biliary reflux is frequent after gastric surgery and may reach the proximal segment of the esophagus and the larynx. It is possible that duodenal content (consisting in bile acids, trypsin), together with pepsin and acid residues when gastric resection is partial, may cause harmful action on the multistratified epithelium of the larynx. METHODS: A retrospective case-control study on subjects admitted between January 1987 and May 2002 in the same hospital in Rome was carried out. The study included 828 consecutive patients with laryngeal cancer (cases) and 825 controls with acute myocardial infarction. Controls were randomly sampled out of a total of 10,000 and matched with cases for age, sex, and year of admission. Logistic regression models were used to assess the role of gastric resection in determining laryngeal cancer risk while controlling for potential confounding factors. RESULTS: Previous gastrectomy was reported by 8.1% of cases and 1.8% of the controls (P < 0.0001). A 4-fold association emerged between gastric surgery and laryngeal cancer risk (adjusted OR = 4.3, 95% CI: 2.4-7.9). The risk appeared strongly increased 20 years after surgery (OR = 14.8, 95% CI: 3.4-64.6). Heavy alcohol drinking (OR = 2.5, 95% CI: 1.8-3.5), smoking (OR = 4.7, 95% CI: 3.3-6.7), and blue-collar occupation (OR = 4.6, 95% CI: 3.2-6.7) were all independently associated with the risk of laryngeal cancer. CONCLUSIONS: Previous gastric surgery is associated with an increased risk of laryngeal cancer. A periodic laryngeal examination should be considered in long-term follow-up of patients with gastric resection.  (+info)

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