Solitary pigmented lesions on the oral mucosa of children, from melanin pigment or exogenous pigment, may have a similar clinical presentation, but melanotic lesions such as oral melanotic macules and nevi can be differentiated from one another only with histopathologic examination.
Sarcomatoid Carcinoma (SC) is an unusual and aggressive variant of squamous cell carcinoma, which frequently recurs and metastasizes; for this reason, the right diagnosis is very important. It is considered to be a biphasic tumor made up of cells from squamous and spindle cells carcinoma with a sarcomatous aspect, but of epithelial origin. The diagnosis often represents a clinical-pathological challenge where the study with immunohistochemical technique (IHC) is key to the histopathological diagnosis. The reported cases related to oral mucosa are limited. In this work we present two SC cases where the use of IHC allowed us to achieve a conclusive diagnosis.
The oral squamous cell carcinoma (OSCC), which has a high morbidity rate, affects patients worldwide. Changes in SPINK7 in precancerous lesions could promote oncogenesis. Our aim was to evaluate SPINK7 as a potential molecular biomarker which predicts OSCC stages, compared to: HER2, TP53, RB1, NFKB and CYP4B1. This study used oral biopsies from three patient groups: dysplasia (n = 33), less invasive (n = 28) and highly invasive OSCC (n = 18). The control group consisted of clinically suspicious cases later to be confirmed as normal mucosa (n = 20). Gene levels of SPINK7, P53, RB, NFKB and CYP4B1 were quantified by qPCR. SPINK7 levels were correlated with a cohort of 330 patients from the TCGA. Also, SPINK7, HER2, TP53, and RB1, were evaluated by immunohistofluorescence. One-way Kruskal–Wallis test and Dunn's post-hoc with a p < 0.05 significance was used to analyze data. In OSCC, the SPINK7 expression had down regulated while P53, RB, NFKB and CYP4B1 had up regulated (p < 0.001). SPINK7 had also diminished in TCGA patients (p = 2.10e-6). In less invasive OSCC, SPINK7 and HER2 proteins had decreased while TP53 and RB1 had increased with respect to the other groups (p < 0.05). The changes of SPINK7 accompanied by HER2, P53 and RB1 can be used to classify the molecular stage of OSCC lesions allowing a diagnosis at molecular and histopathological levels.
Lesions of the oral mucosa are a broad range of different alterations located in the soft tissue of the oral cavity. The studies that describe the prevalence of oral mucosal lesions have been carried out mainly in an adult population. Therefore, in the literature available both in Chile and abroad, there are few reports about pathological lesions and alterations of the normality of the oral mucosa in pediatric population. A descriptive observational cross-sectional study was conducted, with non-probability sampling for convenience, with a sample of 219 patients and a level of confidence of 95 %. We estimated 30 % of children with oral mucosal lesions. Patient history and the presence of oral mucosal lesions were registered in the clinical records specific to this study. In 101 patients a prevalence of 37.62 % of oral mucosal lesions was observed. The most frequent lesion was the minor aphthous ulcer (6.9 %), followed by irritation fibroma (5 %), traumatic ulcer (5 %), traumatic erosion (4 %), impetigo (4 %), pigmented lesion (3 %), and others, at lower rates. The most prevalent location was the lips with a 38.5 %.
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