Oral squamous cell carcinomas comprise a heterogeneous tumor cell population with varied molecular characteristics, which makes prognostication of these tumors a complex and challenging issue. Thus, molecular profiling of these tumors is advantageous for an accurate prognostication and treatment planning. This is a retrospective study on a cohort of primary locally advanced oral squamous cell carcinomas (n = 178) of an Indian rural population. The expression of EGFR, p53, cyclin D1, Bcl-2 and p16 in a cohort of primary locally advanced oral squamous cell carcinomas was evaluated. A potential biomarker that can predict the tumor response to treatment was identified. Formalin-fixed paraffin-embedded tumor blocks of (n = 178) of histopathologically diagnosed cases of locally advanced oral squamous cell carcinomas were selected. Tissue microarray blocks were constructed with 2 cores of 2 mm diameter from each tumor block. Four-micron-thick sections were cut from these tissue microarray blocks. These tissue microarray sections were immunohistochemically stained for EGFR, p53, Bcl-2, cyclin D1 and p16. In this cohort, EGFR was the most frequently expressed 150/178 (84%) biomarker of the cases. Kaplan-Meier analysis showed a significant association (p = 0.038) between expression of p53 and a poor prognosis. A Poisson regression analysis showed that tumors that expressed p53 had a two times greater chance of recurrence (unadjusted IRR-95% CI 2.08 (1.03, 4.5), adjusted IRR-2.29 (1.08, 4.8) compared with the tumors that did not express this biomarker. Molecular profiling of oral squamous cell carcinomas will enable us to categorize our patients into more realistic risk groups. With biologically guided tumor characterization, personalized treatment protocols can be designed for individual patients, which will improve the quality of life of these patients.
Benign fibrous histiocytoma (BFH) is a soft tissue neoplasm which occurs mostly on the skin of extremities. BFH rarely occurs in bone and may affect femur, tibia, and pelvic bone. Jaw bone involvement is very unusual with only 11 cases reported till date. This report describes a case of BFH occurring in a 30-year-old female patient affecting left mandibular posterior region. Computed tomography revealed a well-defined expansile lytic lesion in the posterior mandible. Gross examination of the tumor revealed an admixture of fibroblasts and histiocytes in a fascicular and storiform pattern. Immunohistochemical staining was positive for CD68.
Migrating foreign bodies in the aerodigestive tract are uncommon but can pose serious complications. Long-standing migrating foreign bodies can exist manifesting chronic and unusual symptoms such as chronic cough, recurrent episodes of dyspnoea and fever. Adverse body reactions to foreign objects such as adhesions can cause difficulty in their diagnosis, localisation and removal. A thorough clinical and radiographical approach is of immense value in such cases. We report two difficult cases of migrated foreign bodies: a 2-year-old child with a long-standing foreign body that migrated to the upper mediastinum, and an adult patient with a fish bone that migrated to the oropharyngeal muscles. Presentations of these cases were not alike, with chronic unusual recurrent symptoms in one and typical acute symptoms in the other. The diagnosis and precise localisation of both foreign bodies was challenging, and an open approach was employed to remove them.
Background: Tympanoplasty is the preferred treatment for chronic suppurative otitis media (CSOM) of tubotympanic disease. Numerous varieties of grafts are employed to repair the tympanic membrane in such cases. Our study compared the graft take up rate and conductive hearing gain after type 1 tympanoplasties using temporalis fascia and tragal cartilage grafts.Materials and method: One hundred and twenty patients who had undergone type 1 tympanoplasty using temporal fascia and tragal cartilage were retrospectively reviewed. Eighty seven patients underwent tympanoplasty using temporal fascia graft while in 33 patients, tragal cartilage with perichondrium was employed. Graft take up was analyzed at 6 weeks post-operatively, in both the groups. Pre-operative mean of calculated averages of air bone gap was compared with postoperative mean in both groups. Conductive hearing gain was also compared.
Results and conclusion:Although conductive hearing gain was noteworthy in both, but still there was no statistically significant difference when the two groups were compared. Similarly, our study demonstrated no significant difference in graft take up rate and conductive hearing gain in both the groups. Consequently, both temporal fascia and cartilage can be used unconventionally as suitable graft materials in type 1 tympanoplasty surgeries.
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