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Introduction: The spectrum of myofibroblastic lesions of the oral cavity ranges from reactive to benign to malignant lesions with overlapping histopathologic and immunohistologic characteristics posing a diagnostic dilemma. Observation: A 30-year-old male presented with a spontaneous swelling over the right lower buccal gingiva giving a clinical suspicion of a benign mesenchymal tumor. The lesion presented with a varied biphasic microscopic appearance that posed as a challenge for diagnosis. Commentaries: The incisional biopsy of the lesion showed a highly collagenous stroma with spindle-shaped cells, while the excision biopsy revealed myxoid and hyalinized stroma. A panel of markers comprising of SMA (smooth muscle actin). CD-34, β-Catenin, and Alcian blue stain was employed to arrive at a diagnosis. Conclusion: Most myofibroblastic lesions present with diverse histological appearance which warrants a thorough assessment of the cellular and stromal components for an accurate diagnosis.

Objective: Oral lichen planus (OLP) is a chronic, inflammatory disorder that affects the oral mucous membrane. During an inflammatory response, several chemokines and cytokines are released by the cells of the immune system. Activation of MMPs, along with mast cell-derived chymase and tryptase, degrades the basement membrane structural proteins, resulting in basement membrane breaks.Aim: To investigate the association between the COX-2 expressions, presence of intact or degranulating mast cells within the connective tissue and the extent of basement membrane discontinuity in OLP cases.Methods: This study included a total of 50 formalin-fixed paraffin-embedded specimens (FFPE) of histologically confirmed cases of idiopathic oral lichen planus. A retrospective cross-sectional analysis was carried out by immunohistochemistry to study the epithelial expression of COX-2 and by the use of special stains such as toluidine blue and periodic acid-Schiff (PAS) to study the mast cell count and basement membrane changes in the oral mucosal tissue, respectively.Results: There was a significant (P = 0.03) association between the COX-2 expressions and mast cell count. As the intensity of COX-2 expression increased from mild to moderate or severe, the number of mast cell count almost doubled.Conclusion: Interaction between upregulation of COX-2, mast cell and basement membrane sets a vicious cycle which relates to the chronic nature of the disease. Inhibitors of COX-2 may reduce the inflammatory process preceding the immune dysregulation in OLP. [ABSTRACT FROM AUTHOR]

Background: Recent studies have indicated that although malignant cells at the invasive tumor front, bare morphological resemblance to the cells at central portion of the tumor, their molecular character differs significantly. E-cadherin is a cell-cell adhesion molecule that connects epithelial cells. This study attempts to correlate the E-cadherin expression at the invasive tumor front with tumor differentiation along with its clinico-pathological parameters. Materials and Methods: Immunohistochemical staining with E-cadherin was carried out on archival cases of primary oral squamous cell carcinomas (n = 30). The E-cadherin expression at the invasive tumor front was analyzed and was linked to clinico-pathological parameters including patient prognosis. Results: The downregulation of E-cadherin expression at the invasive tumor edge when compared with patient's prognosis yielded a significant correlation (P = 0.041) but its correlation with the degree of differentiation determined was not significant (P = 0.27). Also, its association with tumor size and lymph node status was negative. Conclusions: Loss of E-cadherin expression at the invasive tumor front is an important event in the progression of oral squamous cell carcinomas. Tumors with a loss of expression of E-cadherin are those which had a poor prognosis [ABSTRACT FROM AUTHOR]

Benign Cementoblastoma is a rare tumor of Odontogenic ectomesenchyme origin characterized by proliferation of cementum- like tissue. The neoplasm is closely related to and partly surrounds the roots of teeth. In most cases, this lesion is asymptomatic and was considered as an indolent lesion for several years. Nevertheless, recent studies have demonstrated that some cementoblastoma may exhibit an aggressive biological behavior and can affect several teeth. An unusual case of benign cementoblastoma that was clinically extensive, involving multiple deciduous and permanent teeth is presented. This report also corroborates with some papers that have demonstrated the aggressive behavior of cementoblastomas. [ABSTRACT FROM AUTHOR]

Orofacial granulomatosis (OFG) is an uncommon chronic inflammatory disorder with multifactorial etiology and pathogenesis affecting the orofacial region which appears usually as a persistent and/or recurrent swelling that may involve one or both the lips and/or recurrent ulcers along with other orofacial features. The diagnosis of OFG is challenging and it should be ruled out from other conditions characterized by granulomatous inflammation. This article describes a case of a 30-year-old female patient with upper lip swelling as the main manifestation without any systemic involvement and we have also laid down a proposal of a diagnostic algorithm for differential diagnoses and treatment modalities for OFG which could be helpful for the clinician and dentists alike to rule out other granulomatous disorders thus in effective management of OFG., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Oral and Maxillofacial Pathology.)