An 18 years old female patient suffered from cerebrovascular occlusive disease, moyamoya disease, showed a huge cyst in her left mandibular body in the radiological observation. The lesion was asymptomatic and found during routine dental check. She had no experience of traumatic injury on her jaw. The cystic lesion was ovoid with irregular scalloping margin and multilobular image,and occupied the whole marrow space of mandibular body with slight expansion of buccal cortical bone. During operation the lesion showed an empty space covered with grayish white fibrous tissue. The luminal fibrous tissue and underlying bony tissue were curettaged and examined pathologically. In the histological observation the lesion was a pseudocyst lined by thick fibrous tissue. Some large vessels underwent atherosclerotic change, exhibiting thickened vessel walls which were partly distorted with hemorrhage and thrombi, and some small capillaries were extremely dilated with hemorrhage and subsequently resulted in perivascular ischemic change with chronic vasculitis. This mandibular cystic lesion was finally diagnosed as simple bone cyst (SBC) associated with moyamoya disease differentially from aneurysmal bone cyst (ABC), traumatic bone cyst (TBC), periapical odontogenic keratocyst, and central giant cell granuloma. Therefore, it was presumed that the thromboembolic and atherosclerotic vessels of moyamoya disease might increase the hemodynamic pressure of mandibular bone marrow tissue and subsequently was able to induce SBC.

Nasolabial cyst is a rare benign lesion which is located in nasolabial fold and alar nose. In spite of the low occurrence of nasolabial cyst, it is important to recognize the differential diagnosis of odontogenic or non-odontogenic lesions that can occur in anterior maxilla or alar region. The diagnosis of the lesion can be made by clinical, radiographic and histopathological findings. In this paper wereport a rare case of nasolabial cyst in a 56-year-old woman and discuss the clinical presentation, differential diagnosis, and treatment in the light of the literature.

Lysyl oxidase (LOX) family, the copper dependent amine oxidase, oxidizes lysine residues in extracellular collagen and elastin. LOX increases the strength of the extracellular matrix and plays an important role in tumor development and metastasis. It has been reported that increased LOX protein and RNA are found in head and neck squamous cell carcinoma. Moreover some studies regarded LOX as a prognostic marker of oral and oropharyngeal squamous cell carcinoma. However there has not been any report on LOX expression of salivary gland tumors. Here, we investigated LOX expression in mucoepidermoid carcinoma (MEC) and adenoid cystic carcinoma (ACC) of salivary gland and compare it to those of pleomorphic adenoma (PA). We evaluated LOX expression in eighteen MEC, eighteen ACC and twenty PA cases by immunohistochemical examination. Whereas PA showed relatively low density of LOX expression, ACC revealed more cases that showing high staining intensities for LOX. Significantly increased LOX expression was found in the cases of ACC when compared to those of PA (P = 0.010).

Vitamin K (VK) is a fat-soluble vitamin and is known to have anticancer activity in various cancer cell lines. However, there is no report on the anticancer effect of VK2 in mucoepidermoid carcinoma cells. The effects of VK2 on anti-proliferative and apoptotic activity were recognized by the trypan blue exclusion assay, 4'-6-diamidino-2-phenylindole (DAPI) staining and Western blot analysis. The results showed that VK2 decreased cell viability and induced apoptotic programmed cell death in MC3 cells evidenced by the cleavages of caspase3 and PARP. VK2 treatment clearly increased Bak and truncated Bid (t-Bid) compared withthe control treatment whereas it did not alter other Bcl-2 family members.  Overall, our results suggest that VK2 can be a good apoptotic inducer accompanied by the increase in Bak and Bid protein. VK2 may be a potent target of anticancer drug candidate for the treatment of oral cancer.

A poor prognosis of oral squamous cell carcinoma (SCC) is partly due to the invasiveness and metastasis of the tumor. One of key elements in tumor invasion and metastasis in the degradation of extracellular matrix is tissue inhibitors of metalloproteinases (TIMPs). This study was performed to determine the expression of TIMP-1 and TIMP-2 of oral SCCs with regard to the histologic invasiveness and differentiation in 5 normal oral mucosa and 36 oral SCCs. The histologic invasiveness of oral SCCs were classified into 4 grades. The differentiation of oral SCCs was divided into 3 grades. The StreptAvidin-Biotin immunohistochemical process, using TIMP-1 and TIMP-2 monoclonal antibodies, was performed to determine the expression of TIMP-1 and TIMP-2. The expression of TIMP-1 was positive in 5 of 17 oral SCCs with weak invasiveness and was positive in 8 of 19 oral SCCs with strong invasiveness. The TIMP-1expression did not increase significantly with respect to the invasiveness of oral SCCs (P>0.05). The expression of TIMP-2 was strongly positive in 5 out of 17 SCCs with weak invasiveness and was strongly positive in 15 of 19 SCCs with strong invasiveness. The TIMP-2 expression increased significantly with respect to the invasiveness of oral SCCs; the stronger the expression, the stronger the invasiveness (P<0.05). The expression of TIMP-1 and TIMP-2 did not increase significantly with respect to the histologic differentiation. We concludedthat with respect to the invasiveness, the TIMP-2 expression increases significantly in oral SCCs but the TIMP-1 expression does not; and that with respect to the histologic differentiation, their expressions do not increase significantly. These results suggested that TIMP-2 can be used as a tool to evaluate the invasiveness of oral SCCs.

Cinnamaldehyde is known to have the antitumor effects in vitro and in vivo. In this study, we showed a potent and irreversible cytotoxic activity of the Cinnamaldehyde derivative 2'-benzoyloxycinnamaldehyde (BCA) in human Squamous oral cell carcinoma cell, YD-10B. BCA induced YD-10B cell apoptosis in a dose-responsive manner. BCA-induced apoptosis was associated with corresponding increases in a series of key components in the mitochondria-mediated apoptosis pathways, followed by caspase cleavage and PARP activation. We also observed that BCA induced autophagy through Akt/mTOR pathway in YD-10B cells. BCA treatment increased LC3B-II expression, and induced the formation of autophagosomes and autophagic vacuoles. These experimental findings suggest that BCA is a potent inhibitor of cell proliferation in YD-10B cells and provide new insights about leading to the possible development of a new therapeutic agent.

Oral galvanism is known to induce chronic irritation on oral mucosa, but the related pathology rarely occurs. A 65 years old male complained of linear horizontal ulcerations on his bilateral buccal mucosa for one month. The oral ulcerations were parallel and approximated to his occlusal plane. He had multiple metallic crowns using gold and nickel cobalt alloy at bilateral upper and lower molar teeth, and also had accustomed to heavy smoking for more than twenty years. Biopsy examination was performed with immunohistochemicalstaining using antisera of PCNA, D2-40, and PARP. The epithelial ulcer had clear margin and was replaced by granulation tissue containing many dilated lymphatic vessels, which were positive for D2-40, but showed no feature of pseudo-necrotic membrane. Nearby epithelium showed the typical features of leukoedema, characterized by edematous keratinocytes with clear cytoplasmsand pyknotic nuclei, low rete ridges, and rough superficial epithelial layer, where PCNA was rarely positive. Some superficial edematous keratinocytes showed perinuclear cytoplasmic vacuolization, and their peripheral nuclear chromatins were positive for PARP. Taken together, the present mucosa ulceration was different from aphthous stomatitis, herpes stomititis, oral lichen planus, etc., thus it was postulated that the galvanic current generated from between the upper and lower dissimilar metal crowns could affect the precedent leukoedema caused by heavy smoking habit and produce the linear horizontal buccal ulceration. Therefore, the present case was diagnosed as galvanic mucositis associated with leukoedema, and it was also hypothesized that the mild and persistent galvanic current was able to deplete the cytoplasmic fluid of leukoedema keratinocytes via the osmotic pressure difference elicited by increased ionic concentration of galvanism, and followed by severe keratinocyte apoptosis and oral mucosa ulceration.

Dermoid and epidermoid cysts in the oral cavity are uncommon and account for less than 0.01% of all oral cysts. The large majority of cases arise in the floor of the mouth and there are rare in other sites. We would like to report an unusual case of epidermoid cyst at the buccal mucosa in a 66-year-old male with a review of literature.

Clear cell odontogenic carcinoma (CCOC) is a very rare malignant neoplasm of jaw, with a significant clear cell component. It is nearly three times as common in the mandible with distinct female predominance. Past, identified as locally invasive tumor, CCOC is now considered to be malignant neoplasm, showing distant and regional lymph node metastasis. CCOC is histopathologically characterized by large glycogen-rich clear cells, often intermixed with eosinophilic cells. When diagnosing CCOC, ruling out salivary gland tumors, such as mucoepidermoid carcinoma or clear cell adenocarcinoma is important because they have overlapping histologic features with CCOC. Here in, we report a case of CCOC involving the right maxillary sinus of a 72-year-old female.

Intravascular papillary endothelial hyperplasia (IPEH) is a rare benign vascular lesion that rarely occurs in the oral cavity. Its clinical features are similar to neoplasms, which are easily identified in the oral cavity, and it can be misdiagnosed as an angiosarcoma. Therefore, it is important to recognize the characteristics of the lesion in order to both diagnose and treat it properly. We report a case of IPEH in a young Korean female patient, as well as discuss its differential diagnosis and treatment using a review of the related literature.

A mucocele is a pseudocyst containing spilt mucin from extravasation of the oral minor salivary gland. For this study, 115 cases of mucoceles diagnosed at the Department of Oral Pathology, Seoul National University Dental Hospital were reviewed with respect to gender, age, lesion’s site, size, color, histopathologic features, and recurrence. There was no significant difference between maleand female. Nearly 80% cases occurred in young people under the age of 30 (29.7% in the third decade with the highest prevalence). The lower lip (75.7%) was the most common site, followed by ventral surface of the tongue, mouth floor, and buccal mucosa. The lesions measured from 2 to 20 mm in diameter and appeared in various colors. Histopathologically, mucoceles showed pseudocysticcavities containing mucin surrounded by granulation tissues with foam cells. Among the 115cases, 14 showed recurrence on the adjacent sites. Those cases treated with and without removal of the feeding glands on excision of mucoceles showed recurrence rates of 9.2% and 18.0%, respectively. Based on these results, it is recommended that mucoceles be treated with surgical excision of the feeding salivary glands. There were no clinicopathological results significantly different from the established facts regarding the mucoceles of Korean patients.

Odontogenic cysts are classified into inflammatory and developmental origins. The most common representative inflammatory cyst is periapical cyst and the most common representative developmental cyst is dentigerous cyst and cyst which show character of tumor is odontogenic keratocyst and cyst of which cystic epithelial lining cells transform to ameloblastoma is unicystic ameloblastoma.Proliferation studies are needed because of various causes, different clinical and pathologic findings. Recently Ki67 has been generally used as cellular proliferation marker, which is closely related to proliferation. Because Ki67 exists in all the time of cell mitosis stage including G1, S, G2, and M, but disappear in resting phase, G0, it is widely used in the evaluation of cell and tissue proliferation activity. The purpose of this study was to establish clinical therapeutic standard through clinical prognosis associated with Ki67 protein expression because of various causes, different clinical and pathologic findings. Immunohistochemical study was performed in selected each 10 biopsy cases through LSAB reaction and HRP system using anti-Ki67 monoclonal antibody. Ki67 expression was mainly seen in the basal layer of periapical cyst, dentigerous cyst and unicystic ameloblastoma, and in suprabasal layer of odontogenic keratocyat, while positive cells appeared very low frequently in unicystic ameloblastoma. Ki67 expression was mainly observed around inflammatory area. Ki67 expression appeared to be independent on the destruction and recurrence of cystic lesion. Conclusively, high cellular proliferation could not represent destruction and recurrence degree of lesion, but this proliferation might be closely associated with circumstance such as inflammation.