Introduction: Cancer stem cells (CSCs) are responsible for initiating the process of carcinogenesis by enabling the self-renewal and self-proliferation of the cancer cells. This study aimed to investigate the presence of epithelial cells with cancer stem cells characteristics (ALDH+) in the early stages of oral precancerous lesions (Oral Leukoplakias) and the frequency of these cells in the different stages of oral squamous cell carcinomas (OSCCs). Materials & methods: The aim of this study was the detection of the immunohistochemical pattern of expression of CSC protein-biomarker ALDH1&2 (sc-166362, Santa Cruz Co, Dallas, Texas, USA) in paraffin-embedded samples of 30 cases of leukoplakia of all degrees of dysplasia and 21 cases of oral squamous cell carcinomas (OSCC) of all degrees of differentiation compared to the histologically normal oral epithelium. The samples were retrieved from 2009-2019 from the archives of the Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece. The samples were evaluated through a three-tier scale (positive cells Ι: 6-35%, ΙΙ: 36-70%, ΙΙΙ: 71-100%). Statistical analysis was performed through SPSS Pearson Chi-square, and the significance level was set at 0.05 (p=0.05). Results: The staining of ALDH1&2 was observed mildly in the cell membrane of cells in the stratum spinosum of the normal epithelium and the cell membrane of cells in the stratum basale of the normal epithelium, characteristically at the interface point with the basal membrane. ALDH1&2 were expressed significantly more in the OSCC than in the leukoplakia (p-value=0.0001) and the normal epithelium (p-value=0.0001). Mainly, ALDH1&2 were expressed significantly more in the severely and moderately dysplastic oral leukoplakia compared to the mildly dysplastic and non-dysplastic leukoplakia (p-value=0.001). Discussion: The characteristic expression of ALDH in potentially malignant oral and OSCC lesions suggests the presence of CSCs and their possible implication in the early stages of oral tumorigenesis, even at the stage of oral leukoplakia.
Introduction A thyroglossal duct cyst (TGDC) is the most frequent embryonic-origin cervical mass situated in the anterior of the neck. This anomaly occurs in approximately in 7% of people, usually in children. Mainly it presents as a mobile, non-tender, usually inferior to the hyoid bone (~75% of patients) painless swelling but it can be painful when accompanied by local inflammation. The recommended management for TGDC is the Sistrunk procedure, ensuring removal of the full length of the duct remnants by including the midportion of the hyoid bone. Case series presentation The aim of this paper is to present a case series of five patients who were operated in the OMFS department of Papanikolaou Hospital of Thessaloniki within 2.5 years (9/2019-2/2022). The patients were four males (80%) (mean age 50.5 years, outliers 36 and 71years) and one (20%) 63 years old female. All of them presented with a mobile painless neck swelling and they had normal thyroid function. All patients underwent a surgical excision of thyroglossal cyst including the midportion of hyoid bone (Sistrunk procedure). None of them presented a recurrence. Conclusion A TGDC, although it is rare in adults as it is typically diagnosed and treated surgically in childhood, it can be complicated with inflammation. In any case, surgical resection and histological confirmation are required as cases of malignant lesion have been reported.
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