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Multiple granular cell tumors of the oral cavity are very rare. We reported clinical and pathological finding of two granular cell tumors on the left lateral border of the tongue in an 18-year-old female.

A 21-year-old Japanese woman presented with trismus and spontaneous pain (especially at night) around the left temporomandibular joint. Radiographic examination showed a subcortical sclerosed nodule measuring approximately 8 mm in diameter on the infero-lateral aspect of the left mandibular condyle. Amputation of the condyle was performed under general anesthesia. The patient has been in good condition 8 years postoperatively. The histopathology of the specimen consisted of actively proliferating osteoblasts mixed with an interlacing network of woven bone and osteoid trabeculae. Histopathological diagnosis was osteoid osteoma.

Muscle is thought to be highly resistant both to involvement by primary and metastatic carcinoma, and it is apparently vulnerable mainly to invasion of malignant tumors from the adjacent tissues. Metastatic tumors to muscle are distinctly uncommon,1-3 although intramuscle metastases have been reported in skeletal muscle,1 the diaphragm,4 the extraocular muscles,5 and the tongue.6,7 Tumors metastatic to the masseter muscle have not been reported in the literature. This report is the first to describe a case of metastatic tumor of the masseter muscle that originated in the rectum.

Chondroma of the hyoid bone is extremely rare. We report the case of a 24-year-old woman with a chondroma of the greater cornu of the hyoid bone. In addition, we discuss the clinical and pathologic differential diagnoses.

Based on previous observations of the presence of both insulin-like growth factors I and II (IGF-I and IGF-II) in murine saliva (Kerr et al. , Biochem Pharmacol 49 : 1521–1531, 1995), the saliva from BALB/c and Non-obese diabetic (NOD) mice was examined for the presence of insulin-like growth factor binding proteins (IGFBPs). Using a western-blot type ligand binding assay with 125 I-labeled IGF-I, a series of binding proteins with molecular masses ( M r ) between 25 and 45 kDa were detected in the sera, but not saliva, from both BALB/c and diabetic NOD mice. In the diabetic NOD mice, there were detectable changes in the concentrations of several of the IGFBPs relative to BALB/c mice. Using specific antibody to the binding proteins, one of these was identified as IGFBP-2. Gavage administration of [ 125 I]IGF-I indicated substantial uptake from the gastrointestinal tract and significant tissue distribution. There was an increase in serum concentrations of radiolabeled IGF-I in diabetic NOD mice over that in BALB/c mice but less recovered from most of the tissues. Intact 125 I-labeled IGF-I was extracted and purified from various tissues, following gavage, and shown to retain biological activity. Thus, the uptake of biologically active IGFs from saliva would appear to take place independently of specific binding proteins.

A case of primary amyloidosis diagnosed by morphological and immunological examination was reported. The patient was a 71 year-old woman who had tumorous masses at the retromolar pad, the left buccal mucosa and the tongue. The specimens taken from the lesions displayed green birefriegence after Congo red staining on polarization microscopy, and proliferation of plasma cell around the amyloid substance was obsereved. Also, positive reaction of λ type antisera with those cells, as well as the amyloid substance were shown by immunohistochemical method. Besides, the quantitative analysis of immunogloblin and immunoelectrophoresis of the patient's serum wre examined; increased IgGλ type monoclonal protein was revealed. However, there were no findings associatedwith multiple myeloma by several systemic examinations, e. g., X-ray and Tc-scintigram. From those findings described above, this case was finally diagnosed as “primary amyloidosis with plasma cell dyscrasia”.

Osteopetrosis is a rare disorder characterized by symmetrical systemic sclerosis of skeletal bone which gives rise to susceptibility to fracture and osteomyelitis. Frequently dentition development is affected. A case of osteopetrosis in a 20-year-old female including various forms of dentition disorders i.e., impaction of 765 678 E3 B3, distorted crowns of 5 5, enamel hypoplasia of 43 3 4 4, arrested root development of 35, curved roots of 3 3, delayed root development of 5 and dentigerous cyst of 3, is described. In family history, the parents were consanguinity and the younger brother died of unknown etiology at one year old. Systemic roentogenological examination revealed characteristic findings e.g., sclerosis of the base of skull, “sandwich” appearance of the spine, “bone within a bone” appearance of the epiphises of long bones. By clinical examinations, anemia and cerebral nerve palsy were not observed. The serum calcium, phosphorus, alkaline phosphatase, thyrocalcitonin and parathormone levels were within normal limits. Impacted E3 B and 3 associated with dentigerous cyst were surgically removed under local anesthesia and intravenous dripping infusion of piperacillin. The wounds healed uneventfully. Microscopically, hyperplastic cementum of the root of 3 showed ankylosis with bone. Sclerosed cancellous bone of the mandible was composed of thickened lamellar bone exhibiting mosaic pattern with cement lines.

A case of large mucous cyst occurred under the buccal mucosa of a 47year-old male was reported.Minor salivary gland cysts are usually small, 1cm or less indiameter. This cyst extended from the posterior lip to the, retromolar region, 5cm in diameter. From surgical findings, this cyst originated in the glan dula, labiales.Histological examination revealed a well defined mucous cyst, no epithelial lining. Histopathological diagnosis was an extravasation.

Thirteen cases of actinomycosis in oral and maxillofacial regions were reported. They were histologically diagnosed by detecting sulfur granules in pus and granulomatous tissue. Clinical, bacteriological and histological studies of these cases revealed the following:1. Clinically, five types were recognized: non-abscess indurative type, subcutaneous abscess type, deep abscess type, mandibular ostitis type and secondary infection of cyst type. Subcutaneous abscess type showed the most typical clinical symptoms of actinomycosis.2. Histologically, sulfur granules were detected in all the cases, and typical sulfur granules with club formation were seen in 4 cases. In other cases, club formations were not so clear, and their central mass of granules were variable, i. e., a loosely-tangled mass of filaments, a compact mass of filaments or a mixture of them.3. Bacteriologically, Actinomyces were detected in 4 cases, and Bacteroides and Streptococcus were dominant in isolated strains from pus.4. Treatments of these cases consisted of administration of antibiotics combined with incision, drainage and elimination of predisposing pathologic condition. Penicillins and cephems were mainly administered in duration of 3 days to 3 months. In the non-abscess induration type, the longest term of treatment was needed, although the treatment proved effective eventually.

We recently encountered d 14-year-old male with bilateral odontomas in the lower jaw associated with unilateral mandible cyst. Odontomas and the cyst were removed under general anesthesia, the postoperative course was uneventful.Bilateral odontomas and cystic odontoma are rarely seen, particularly together.The bilateral odontomas appeared related to the change of general and regional conditions associated with the development of the mandibular second molars.

Two cases of verruciform xanthoma are reported with the review of 39 cases in domestic literature. Case 1, a 48-year-old female had a slightly elevated yellowish lesion on lingual aspect of mandibular left premolar-molar gingiva. Case 2, a 40-year-old female had a crescent shaped yellowish area on the gingiva buccal to the mandibular left first molar. Both were uneventful after simple surgical excision. Histologically, pebbly surface was covered by parakeratotic squamous epithelium. Characteristic accumulation of lipid laden foam cells were identified in connective tissue papillae between equally elongated rate pegs to a uniform depth. Especially in case 1, examination with the serial sections revealed gradual transformation to papillary architecture of the squamous epithelium in peripheral portion.The cause of verruciform xanthoma is still uncertain, but mild chronic inflammatory irritation may play the important role of its genesis.

Vascular lesion of the jaws are rare but special consideration should be paid because of the potential for fatality. A case of arteriovenous fistula of the mandible was reported with its course and treatment.A ten year-old girl was admitted to our hospital as an emergency with a bleeding of the left gingiva of the mandible. Orthopantomography showed an irregular radiolucency extending from left canine region to mandibular ramus. Angiography proved arteriovenous fistula of the mandible, and the main vessels to the lesion appeared to be the left external carotid artery and the abnormal extension of right inferior alveolar artery.Operation was postponed because the patient was young and her lesion was very large, so brisk bleeding and danger to her life was predicted during operation. Her course was closely watched for about four years. During this early period, she came several times by ambulance because of gingival bleeding, but during the middle period no gingiva bleeding or radiographically decrease of the lesion were noticed. Although in the latter period, frequent gingival bleeding and lesion enlargement were observed again. She was operated on at age fifteen. The left external carotid artery, afferent and efferent vessels to the lesion were ligated and marginal resection of the left mandible and enucleation of the tumor were carried out. The postoperative course was entirely good and without com

The treatment of facial bone fracture complicated with other severe traumata, head and/or viscera injury, is often postponed because of the emergency care for survival.A case of 45-year-old male who had a chief complaint of malocculusion caused by malunited mid-third facial fracture of Le Fort II and Le Fort II type was reported. Surgical treatment of Le Fort I osteotomy was selected for the correction of malocclusion. In the osteotomy, pre-traumatic occlusion and mandibular position were presumed by the observation of facial expression, mandibular rest position, denture model and roentogen cephalogram, and the position was reproduced by using face bow.

Based upon the autopsy findings, the incidence of distant metastasis was studied to seek the relativity between the method of treatment and the TNM system at the time of initial examination on 31 cases with squamous cell carcinoma in the maxilla-facial region. The results are summarized as follows: 1) The incidence of distant metastasis among all of these cases was 58 per cent. 2) There was no significant difference in the incidence between the groups with radiation therapy and chemotherapy. 3) There was no relativity with the TNM system. 4) In the group with radiation therapy, the incidence at the “sites of the movable mucosa” was significantly higher than that at the “sites of the non-movable mucosa.” 5) There was no relationship to the performance of radical neck dissection.

The granular cell tumor is a rare lesion with a predilection for the subcutaneous region and the tongue, it's histogenesis is still controversial. A 59 year-old female presented with a granular cell tumor in the left floor of the mouth.The tumor was excised together with a part of the sublingual gland, but invasion of the Wharton's duct was not observed. In the excised specimen, there was no encapsulation and the tumor had partially invaded the sublingual gland. Beneath the overlying stratified squamous epithelium associated with pseudo-epitheliomatous hyperplasia, the tumor cells had proliferated diffusely and/or were arranged in small nests especially around the peripheral nerve bundles. Scattered axon like dark brown fibrils were seen in the tumor nests after Bodian silver staining. The intracytoplasmic granules of the tumor cell showed either a weak or sometimes a strong PAS positive reaction which was diastase resistant. The tumor cells and Schwann cells were positive when tested by the immunohistochemical method using anti S-100 protein antiserum. Electron microscopical observation revealed granules of various sizes and shapes bounded by a membrane in the cytoplasm of the tumor cell. The tumor nest, which was bounded by a basement membrane, consisted of tightly packed spindle shaped cells with long pseudopodial-like processes. Isolated tumor cells were also found within the basement membrane of peripheral unmyelinated nerve fibers adjacent to Schwann cells and axons.These findings suggest that histogenesis in this case is from Schwann cells of the peripheral unmyelinated nerve fibers.

It is pointed out that minor salivary gland calculi are more common than previously supposed in the English language literature. But in Japan, reports of them are still rare and as far as we know only sixteen cases have been reported.This report contributes three additional cases of sialolithiasis in the minor salivary gland located in the upper lip of elderly persons. They were solitary, firm, freely movable, small masses. Histopathologically, all the calculi revealed similar findings that contained homogenous non mineralized organic matrix. Chronically inflamated granulation tissue surrounded the calculus in 2 cases and the dilated duct surrounded the calculus in 1 case. Chronic lobular inflamation and diffuse lobular fibrosis were common findings.The authors suggested that clinicians and pathologists tend to fail to diagnose the calculi of minor salivary gland if the calculus was small and nonmineralized, and soft tissue inflamation was prominent.

Malignant fibrous histiocytoma of the oral region is rare. Clinical course, histopathological observations and biochemical analysis of malignant fibrous histiocytoma of the mandible in an 18-year-old male is reported.The clinical findings revealed rapid enlargement of two nodular tumors 5 cm and 3cm diameter, in the molar region of the right mandible and tender regional lymph nodes. Radiographically, separation of the wisdom tooth and the second molar tooth and an irregular radiolucent area reaching to the mandibular canal were shown. Segmentary resection of the mandible and radical neck dissection were carried out. Postoperative course of the patient was uneventful and no recurrence or metastasis was found after 2 years.Histopathologically, most of the tumor consisted of a highly myxoid tissue. In the myxoid area widely spaced spindle cells, pleomorphic cells and giant cells were arranged in a matrix.In electron microscopic examination, fibroblast-like cells, histiocyte-like cells and polynuclear giant cells were observed.By the biochemical methods, type I, III and V collagen were detected by the SDS-PAGE method. Dihydroxylysinonorleucine was found to be the major reducible cross-link in this collagen and its ratio to hydroxylysinonorleucine is 2.4. This suggested that the collagen is similar to the hard tissue collagen or at the young and growing stage. Pyridinoline and histidinoalanine were found to be the noreducible cross-link in this collagen.

Bleomycin, ein neues Antibiotikum mit antitumoröser Wirksamkeit, wurde in die Therapie gegen maligne Tumoren im Kiefer- und Gesichtsbcreich an 21 kieferchirurgischen Universitätskliniken und Krankenhäusern in Japan von 1968 bis 1971 aufgenommen und 551 Patienten behandelt. Hier wird über die Behandlungsergebnisse von 409 Fällen mit Plattenepithelkarzinomen berichtet. Die Gesamtdosis der Bleo-Rehandlung einer Kur betrug 300 mg bei den meisten Fällen. Bei 90% von 409 Fällen ist Bleomycin intravenös und bei 10% intraarteriell oder intramuskulär verabreicht worden. Die zusammengefassten Behandlungsergebnisse mit Bleomycin zeigten uns, daB eine sehr gute oder gute Wirkung in 126 Fällen, das entspricht 37% der Patienten, erzielt werden konnte, während 36% keine Beeinflussung zeigten. Als Nebenwirkung beobachteten wir bei 73% Fällen verschiedene Hautveränderungen. Die Lungenfibrose als Nebenwirkungen, clavor man am stärksten fürchtet, wurcle bei 5 Fallen durch Au topsie festgestellt.