Giant cell reparative granuloma (GCRG) is a rare nonneoplastic proliferative lesion of unknown etiology. It most commonly occurs in the mandible, but also occurs in other bones of the facial skeleton and cranial vault. Two cases of GCRG arising from the maxilla are presented. Histological and radiological features, and the pertinent literature on the subject are reviewed.

Functional reconstruction of the oral cavity after tumor ablation is challenging. A variety of methods are available for reconstruction including primary closure, skin grafts, local cutaneous flaps, musculocutaneous flaps, and free flaps. Appropriate reconstruction addresses the size, location, and tissue needs of the defect. The melolabial flap allows for reliable and effective intraoral reconstruction with minimal donor morbidity, making it ideal for select defects. From 1989 to 1993 16 patients aged 51 to 81 years underwent reconstruction of intraoral defects with 24 melolabial flaps. Twenty-two flaps survived without complication and two flaps failed, for success rate of 91.7%. The two failed flaps occurred in the same patient. Of the remaining patients 8 had prior radiation therapy and 11 had prior or concomitant neck dissections. The flaps were used to reconstruct 13 floor-of-mouth, 1 buccal mucosa, 1 retromolar trigone, and 1 gingival defect. We conclude that the melolabial flap is ideal for select intraoral defects.

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Introduction and Objectives: The Natural Products Branch of the National Cancer Institute examined extracts from a number of plants from South Africa. One extract in particularly, from the Phyllanthus engleri plant exhibited selective toxicity towards renal cancer cells in the NCI panel of 60 cell lines. The active ingredient from the plant extract has been recently isolated and identified as Englerin A (Beutler, J., et al). Renal cancers are notorious for their resistance to various therapies. Therefore, the potential for any agent that has selective anti-tumor activity is attractive. In additions, renal cancers are associated with a variety of metabolic changes, regardless of the tumors VHL status (wild type vs. mutant). Using the synthetic, optically active compound to Englerin A, we have examined its impact on global metabolism in the sensitive human renal carcinoma cell line A498. Methods: Using the synthetic material of Englerin A (Applichem Co., Germany) and A498 renal cancer cell line (ATCC, Baltimore MD), we tested for cytotoxicity and growth inhibition using the CellTiter-Glo® assay (Promega). Cell Titer-Glo measures the number of viable cells in culture based on quantitation of the ATP present, an indicator of metabolically active cells. Cell cycle was determined with the aid of flow cytometry following propidium iodide staining. Global metabolism was determined by GC and LC/mass SPEC in the A498 cells receiving treatment with Englerin A (30nM and 150nM) at 0, 2, 4, 8 and 24 hour time points (Metabolon, Durham, N.C.). Statistical analysis of the 2,000 standard metabolites (and unknown metabolites) is compared between treated/non-treated cells, at the various time periods, utilizing the commercial package JMP (SAS). Following log transformation and samples in which the metabolite was detected within at least two/thirds of the specimens will be included in the analysis. Results: In the A498 cells, we observed an IC50 of 3nM, comparable to reported studies for Englerin A. Flow cytometry data revealed a delayed cell cycle progression through S phase. In the metabolic studies, the most sensitive aspect of the Englerin A toxin was the alteration of carnitine metabolism. Conclusion: Englerin A is a newly isolated molecule that has selective toxicity towards renal cancer cell lines, but also inhibits other types of tumor lines and cancers. Renal cell cancers are notorious for their insensitivity to treatment with a variety of therapies. The low dose of Englerin A required producing selective toxicity towards renal cell cancers, suggests that this newly identified toxin is likely to be impacting a novel signaling pathway. Identification of that signaling pathway may provide additional means for targeted tumor therapies. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 983. doi:10.1158/1538-7445.AM2011-983

Functional reconstruction of the oral cavity after tumor ablation is challenging. A variety of methods are available for reconstruction including primary closure, skin grafts, local cutaneous flaps, musculocutaneous flaps, and free flaps. Appropriate reconstruction addresses the size, location, and tissue needs of the defect. The melolabial flap allows for reliable and effective intraoral reconstruction with minimal donor morbidity, making it ideal for select defects. From 1989 to 1993 16 patients aged 51 to 81 years underwent reconstruction of intraoral defects with 24 melolabial flaps. Twenty-two flaps survived without complication and two flaps failed, for success rate of 91.7%. The two failed flaps occurred in the same patient. Of the remaining patients 8 had prior radiation therapy and 11 had prior or concomitant neck dissections. The flaps were used to reconstruct 13 floor-of-mouth, 1 buccal mucosa, 1 retromolar trigone, and 1 gingival defect. We conclude that the melolabial flap is ideal for select intraoral defects.

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