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Metastasis in patients with oral squamous cell carcinoma has been associated with a poor prognosis. However, sensitive and reliable tests for monitoring their occurrence are unavailable, with the exception of PET-CT. Circulating tumor cells and cell-free DNA have emerged as promising biomarkers for determining treatment efficacy and as prognostic predictors in solid tumors such as breast cancer and colorectal cancer. Hence, this study aimed to determine the potential role of liquid biopsy, circulating tumor cells, and cell-free DNA as biomarkers of oral squamous cell carcinoma. Thirteen patients with primary oral squamous cell carcinoma who visited our hospital between 2022 and 2023 were recruited, and plasma samples were collected from each patient preoperatively and postoperatively. We examined the relationship between the prognosis, the number of circulating tumor cells per four milliliters of peripheral blood, and the amount of cell-free DNA per milliliter of serum or the gene mutation in cell-free DNA. We observed no correlation between the number of preoperative circulating tumor cells and metastatic events. However, the number of circulating tumor cell clusters or the amount of preoperative cell-free DNA in metastatic cases was higher than that in non-metastatic cases. In oral squamous cell carcinoma, circulating tumor cell clusters or cell-free DNA levels may help inform management decisions regarding metastasis. However, further studies are required to provide a possible window for therapeutic interventions. [ABSTRACT FROM AUTHOR]

Therapy-related myelodysplastic syndrome (t-MDS) is a rare but potentially fatal adverse event caused by chemotherapy or radiotherapy. We report a case of t-MDS diagnosed 8 months after radiotherapy for recurrent carcinoma of the floor of the mouth and cervical lymph node metastases after surgical treatment. A 74-year-old man visited our department with the chief complaint of pain in the lower part of the tongue. Tumor resection and right radical neck dissection (RND) were performed based on the diagnosis of carcinoma of the floor of the mouth (cT1N2bM0). A computed tomography scan at 10 months postoperatively showed metastatic lymph nodes in the left neck, right hyoid bone, right parotid subpolar, and anterior trachea. Therefore, the patient underwent left RND and excision of the right hyoid bone, subpolar right parotid and anterior tracheal metastatic lymph nodes. Postoperative radiation therapy (70 Gy) was administered to the neck bilaterally. An upper gastrointestinal examination revealed a carcinoma in situ in the lower esophagus, and endoscopic submucosal dissection of the esophagus was performed. He had pancytopenia preoperatively, which progressed postoperatively; therefore, a bone marrow examination was performed to rule out a hematological malignancy. Bone marrow smear and flow cytometric analyses indicated the development of t-MDS. He received supportive transfusion therapy but died 8 months after the diagnosis of t-MDS. During post-treatment follow-up, clinicians should be aware of t-MSD, in addition to cancer recurrence and metastasis. [ABSTRACT FROM AUTHOR]

Cemento-ossifying fibroma (COF) is a rare benign tumor consisting of fibrous tissue with cementum- or bone-like hard tissue that shows slow, distensible growth without clinical symptoms such as pain, but often results in facial deformity and malocclusion as the tumor grows. In this report, we present a case of a supermassive COF enlarged to the size of an adult's head, with symptoms including dysphagia and feeding difficulties, that was successfully treated surgically. [ABSTRACT FROM AUTHOR]

Background: Glycogen storage disease type 1a (GSD1a) is an autosomal recessive genetic disease with symptoms such as hypoglycemia, lactic acidosis, and bleeding tendency. Case Presentation: A 15‐year‐old male patient underwent cystectomy under general anesthesia. He had GSD1a. Despite perioperative blood glucose control, lactic acidosis worsened. No abnormal bleeding or infections were observed. A homozygous mutation of c.648G>T was detected by genetic testing for glucose‐6‐phosphatase (G6PC). Conclusion: Perioperative complications specific to this disease should be managed. [ABSTRACT FROM AUTHOR]

Background: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a fatal arrhythmic disease. Herein, we report a case of third molar extraction performed under general anesthesia to avoid ventricular tachycardia. Case Presentation: A 28‐year‐old woman presented with constant pain and bilateral mandibular gingival swelling. The patient had a history of CPVT diagnosis at 5 years of age, which had been managed with beta‐blockers and sodium channel blockers. Due to the contraindication of using epinephrine and the risk of CPVT induction due to pain, the extraction was conducted under general anesthesia. Conclusion: Oral surgery in CPVT patients requires appropriate anesthetic agent selection. [ABSTRACT FROM AUTHOR]

Titanium plates have been used for primary reconstruction after mandibular resection in patients with oral cancer and mandibular osteomyelitis. However, complications—including plate fracture and screw breakage—have led to problems in the recovery of strength and aesthetics. Computer-assisted fabrication of custom-made plates has recently been developed, such as with Cosmofix®. Developed in Japan, it is a fully custom-made plate created by layered fabrication using three-dimensional (3D) printing technology after designing a plate that fits the mandibular defect based on the patient's computed tomography (CT) data. In this study, we treated two cases of medication-related osteonecrosis of the jaw (MRONJ) with mandibular dissection and primary reconstruction of the mandible with Cosmofix® using a self-made surgical guide made with PROPLAN CMF™ virtual planning software. Case 1: A 68-year-old female patient with stage 2 MRONJ underwent mandibular reconstruction using Cosmofix® after mandibular dissection from the┌4-centrum to the angle of the mandible. Case 2: A 78-year-old female patient with MRONJ stage 3 underwent mandibular dissection from 4┐to┌7, and her mandible was reconstructed using CosmofixⓇ. The patient was highly satisfied with the aesthetic result, as the preoperative facial appearance was almost restored. Long-term follow-up is needed to assess for plate fracture, screw breakage, and other issues. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Sturge–Weber syndrome (SWS) is a neurocutaneous syndrome characterized by angiomas. This report presents airway management using submental intubation in sagittal split ramus osteotomy under general anesthesia and aimed to explore better anesthetic management for avoiding the rupture of angiomas in a patient with SWS. [ABSTRACT FROM AUTHOR]

Background: Early-stage tongue cancer has a good prognosis in general; however, high-risk patients with late cervical lymph node and distant metastases have a poor prognosis. Elective neck dissection and postoperative chemoradiotherapy are considered for these patients, although no clear criteria have been identified for their evaluation. Methods: This retrospective observational study aimed to determine the predictive factors for late cervical lymph node and distant metastases in 102 patients with cT1-2N0 tongue cancer. The data regarding the demographic characteristics, as well as the depth of invasion, tumor budding, histological grade, and tumor–stromal ratio, among other things, were extracted from medical records. Results: We found that the potential lymph node metastasis rate was 27.5%. The significant clinical predictors of late cervical lymph node metastasis were the tumor thickness and endophytic growth pattern and the significant histopathological factors were poorly and moderately differentiated tumors and ≥3 tumor buds. In addition, the prognostic factors for distant metastasis included ≥4 lymph node metastases, ≥7 tumor budding, and moderate and poor tumor differentiation. Conclusions: The usefulness of tumor budding as a predictor of metastasis for tongue cancer was suggested. The findings of this study can help establish the criteria for evaluating the metastasis risk and prognosis of patients with tongue cancers. [ABSTRACT FROM AUTHOR]

This study aimed to identify new molecular and histopathological features of the malignant transformation of proliferative verrucous leukoplakia (PVL), which grows verrucously into verrucous carcinoma (VC) and/or squamous cell carcinoma (SCC) with malignant transformation potential different from that of common leukoplakia. Wnt- related oncogenes were analyzed by real-time quantitative PCR using excised specimens from a PVL patient who was successfully controlled for 15 years. The resected specimens, including normal-to-verrucous lesions, were examined immunohistochemically and evaluated for β-catenin, p63, and p53 expression. Histopathological examination revealed verrucous hyperplasia in the left upper-lip mucosa and SCC in the left buccal mucosa; p53 and p21 expression was higher in the left upper-lip mucosa than in the normal oral mucosa, whereas HDM2 , Axin2 , and ref 1 expression was lower in the upper-lip mucosa than in the normal oral mucosa. p53 and HDM2 expression was higher in SCC than in normal oral mucosa, while p21 , Axin2 , and ref 1 was lower than those in normal oral mucosa. SCC showed higher expression of p53 and HDM2 than the normal oral mucosa. In transitional lesions of the left upper-lip mucosa, β-catenin accumulated transiently in the cytoplasm, with no regularity of cell morphology and basement membrane continuity. However, for verrucous lesions, cell morphology and intercellular adhesion were preserved, and β-catenin was localized almost exclusively to the plasma membrane. In this case, p53-p21 signaling suppressed carcinogenesis in the precancerous stage, suggesting that high-grade carcinogenesis by epithelial–mesenchymal transition-mediated β-catenin-Wnt signaling did not occur in transition lesions. [ABSTRACT FROM AUTHOR]

Primary intraosseous carcinoma (PIOC) of the jaw is defined as squamous cell carcinoma without continuity with the oral mucosa, and has not been frequently reported. Hodgkin's lymphoma (HL) occurring in the head and neck region is considered to be relatively rare. In the present case, we encountered synchronous double cancer of PIOC and HL arising in the cervical region in a 61-year-old male. He presented to our department with chief complaints of pain in the left mandibular molar region. Biopsies from the oral cavity and neck led to the diagnosis of synchronous double cancer with PIOC on the left side of the mandible and HL in the cervical region. The patient underwent mandibulectomy followed by chemotherapy for HL. Five years have passed since the surgery, and no recurrence or metastasis of the oral cancer and malignant lymphoma have been detected. [ABSTRACT FROM AUTHOR]

Severe congenital neutropenia (SCN) is a rare heterogeneous genetic disorder characterized by marked chronic neutropenia leading to recurrent bacterial infections. Perioperative management is vital for surgical treatment in these patients because of the high risk of postoperative infection. Herein, we report a case of a woman with SCN who underwent orthognathic surgery for mandibular protrusion. The treatment was carried out in collaboration with the related specialist medical department because of the possibility of severe postoperative infection. Although several cases of relatively minor interventions in patients with SCN have been reported in the literature, to the best of our knowledge, this is the first reported case of orthognathic surgery. Multidisciplinary collaborations with related specialists are imperative to prevent postoperative infections in high-risk patients. [ABSTRACT FROM AUTHOR]

Multiple myeloma is a hematologic malignancy characterized by neoplastic proliferation of monoclonal plasma cells. The mass formed within the soft tissue is particularly called extramedullary disease in multiple myeloma. This disease rarely occurs in the head and neck regions. Notably, submandibular extramedullary lesions have not been reported. Therefore, we report a case of multiple myeloma diagnosed with extramedullary disease in the submandibular region. A 70-year-old woman was referred to our clinic due to painless swelling on the left side of the submandibular region. We confirmed the presence of a relatively well-circumscribed subglobular tumor on the left side of the submandibular region on contrast-enhanced computed tomography and magnetic resonance imaging. The tumor was resected surgically, including the circumferential tissue, with the patient under general anesthesia. The tumor was histologically diagnosed as a plasma cell neoplasm. Positron emission tomography-computed tomography showed an osteolytic lesion in the sacral region. A bone marrow examination diagnosed multiple myeloma of IgG-λ-type, ISS Ⅱ stage. The patient has been receiving continuous chemotherapy for multiple myeloma for 1 year after operation and has no recurrence in the submandibular region. The data presented in this study are available on request from the corresponding author. Publicly available datasets were analyzed in this study. [ABSTRACT FROM AUTHOR]

Simple Summary: Tumor-infiltrating lymphocytes (TILs) have long been used to predict the prognosis of solid tumors. TIL levels have been reported to be closely associated with the prognosis of patients with squamous cell carcinoma. In contrast, major histocompatibility complex (MHC) class I chain-related molecule A (MICA), which acts as a ligand for NKG2D in natural killer (NK) cells and CD8+ T cells, is related to a higher survival rate in patients with oral squamous cell carcinoma (OSCC). In this study, we investigated the association of OSCC with TILs and MICA in patients with OSCC and its potential as a biomarker. Background: Tumor-infiltrating lymphocytes (TILs) have been used to predict the prognosis of solid tumors. In this study, we investigated which molecules in TILs play a role in the prognosis of patients with oral squamous cell carcinoma (OSCC). Methods: In a retrospective case-control study, we immunohistochemically evaluated the expression of CD3, CD8, CD45RO, Granzyme B, and the major histocompatibility complex class I chain-related molecule A (MICA) of the histocompatibility complex as predictors of prognosis in 33 patients with OSCC. The patients were classified as TILsHigh or TILsLow according to the number of TILs for each molecule in the central tumor (CT) and invasive margin (IM). Furthermore, MICA expression scores were determined based on the intensity of the staining. Results: CD45RO+/TIL in the nonrecurrent group were significantly higher than those in the recurrent group in the CT and IM areas (p < 0.05). The disease-free survival/overall survival rate of the CD45RO+/TILsLow group in the CT and IM areas and the Granzyme B+/TILsLow group in the IM area was significantly lower than that of the CD45RO+/TILsHigh group and the Granzyme B+/TILsHigh group, respectively (p < 0.05). Furthermore, the MICA expression score of tumors around the CD45RO+/TILsHigh group was significantly higher than that of the CD45RO+/TILsLow group (p < 0.05). Conclusions: A high ratio of CD45RO-expressing TILs was associated with a disease-free/overall survival improvement in OSCC patients. Furthermore, the number of TILs that express CD45RO was associated with the expression of MICA in tumors. These results suggest that CD45RO-expressing TILs are useful biomarkers for OSCC. [ABSTRACT FROM AUTHOR]