The clinical presentation of diffuse pigmentation can be alarming to the patient as well as the clinician. A histopathologic examination of a pigmented lesion is necessary in most of the cases in the oral cavity. Oral melanoacanthoma is a very rare diffuse pigmentation with no specific treatment required. It shows increased number of dendritic melanocytes in an acanthotic epithelium. We present a rare case of diffuse pigmentation in the oral cavity whose diagnosis was done on the basis of clinical presentation and histopathology. Also immunohistochemistry was done.

Despite the fact that numerous researches have been carried out to prevent head and neck cancer (HNC) and treat those patients, there is no reduction in morbidity rate because the underlying molecular pathogenesis is still poorly understood. Endocrine microenvironment is another vital factor besides other traditional risk factors like tobacco smoking, infections, and alcohol. It has been proven that sex hormone receptors are also expressed in larynx and lungs, in addition to sex organs. Sex hormones play a vital role in gene expression involved in the plethora of biological and neoplastic processes. The role of sex hormones in HNC is still divisive and very few researches have been conducted to describe their role. So, this article is an effort to attract the attention of researchers, endocrinologists, pathologists, and clinicians toward the impending role of sex hormones, with special emphasis on progesterone, estrogen, and prolactin in HNC onset and progression, along with their therapeutic role.

A 52-year-old male patient, a farmer by occupation presented to the Outdoor Department of RKDF Dental College, Bhopal, Madhya Pradesh, India with ulcero-proliferative lesion on the left side of cheek [Table/ Fig-1] with mild continuous pain, localized to the lesional area with no aggravating and relieving factors. Growth was sudden in onset and increased to present size within 40 d duration. The intra-oral examination revealed an irregular diffuse erythematous ulceroproliferative growth covered by fibrinous exudates with irregular and indurated margins over his left buccal mucosa. Lesion is about 5 × 6 cm in size extending with respect to 31-38 tooth region.An extra-oral examination revealed bilateral, palpable, single, firm, mobile and tender submandibular lymph node with no any obvious facial asymmetry. Medical history of the patient was not significant and he did not report any history of alcohol or tobacco addiction. Computed tomography scan of patient revealed evidence of 2×2×1 cm heterogeneously enhancing relatively well defined mass lesion in left buccal space.Under the impression of malignancy, an incisional biopsy was performed on the same day. Histopathological examination showed sheets of predominantly clear cells invading into underlying connective stroma [Table/ Fig-2]. The clear cells were round to polygonal in shape consisting of clear cytoplasm with dysplastic features such as nuclear and cellular pleomorphism, hyperchromatic nucleus and abnormal mitotic figures suggestive of malignancy [Table /Fig-3]. Few areas were showing keratin pearl formation also [Table /Fig-4]. Tissue sections were subjected to histochemical and immunohistochemical (IHC) analysis to define the origin of tumour cells. The sections were negative for PAS, and mucicarmine stains ruling out the tumour of odontogenic and salivary gland origin. It also came out to negative for Oil red O (Fat stain) ruling out sebaceous neoplasm. IHC investigation revealed negative staining for Vimentin and S-100 hence, ruled out the possibility of malignancy of connective tissue and malignant melanoma also. Sections showed strong positive immunoreactivity for cytokeratins 8 and 18 (CK8 and CK18) [Table/ Fig-5] suggestive of well differentiated SCC [Table/ Fig-6].In the present case, the staging of the tumour according to the TNM system proposed by American Joint committee on Cancer (AJCC) [1] was evaluated and it was found to be stage II (T2N0M0). aBstRaCtClear cell squamous cell carcinoma (SCC) is an extremely rare heterogenous group of malignant tumour with incompletely understood aetiology. We, hereby present a case of clear cell variant of squamous carcinoma on buccal mucosa in 52-year-old male patient. Histopathology showed sheets of squamous cells with clear cell differentiation and malignant features. Histochemical findings showed negative staining for Periodic Acid-Schiff (PAS), mucicarmine and Oil Red O. Immunohistochemical investigations revealed positive staining for CK 8-18 and negative for S-100. We conclude by emphasizing on the ne...

Periapical infection in the primary tooth may lead to periapical abscess, granuloma, radicular cyst and even osteomyelitis. The infection in primary teeth can also affect the developing successor teeth leading to hypomineralization, hypoplasia, arrest of tooth development, regional odontodysplasia, delayed eruption etc. The purpose of this article is to report a case of malformed permanent tooth in relation to overlying infected deciduous teeth. The probable role of inflammation in pathogenesis of the present condition is also being discussed.

Context:Early detection of potentially malignant lesions and invasive squamous-cell carcinoma in the oral cavity could be greatly improved through techniques that permit visualization of subtle cellular changes indicative of the neoplastic transformation process. One such technique is confocal microscopy. Combining rapidity with reliability, an innovative idea has been put forward using confocal microscope in exfoliative cytology.Aims:The main objective of this study was to assess confocal microscopy for cytological diagnosis and the results were compared with that of the standard PAP stain.Settings and Design:Confocal microscope, acridine orange (AO) stain, PAP (Papanicolaou) stain. The study was designed to assess confocal microscopy for cytological diagnosis. In the process, smears of patients with (clinically diagnosed and/or suspected) oral squamous cell carcinoma as well as those of controls (normal people) were stained with acridine orange and observed under confocal microscope. The results were compared with those of the standard PAP method.Materials and Methods:Samples of buccal mucosa smears from normal patients and squamous cell carcinoma patients were made, fixed in 100% alcohol, followed by AO staining. The corresponding set of smears was stained with PAP stain using rapid PAP stain kit. The results obtained were compared with those obtained with AO confocal microscopy.Results:The study had shown nuclear changes (malignant cells) in the smears of squamous cell carcinoma patients as increased intensity of fluorescence of the nucleus, when observed under confocal microscope. Acridine orange confocal microscopy showed good amount of sensitivity and specificity (93%) in identifying malignant cells in exfoliative cytological smears.Conclusion:Confocal microscopy was found to have good sensitivity in the identification of cancer (malignant) cells in exfoliative cytology, at par with the PAP method. The rapidity of processing and screening a specimen resulted in saving of time. It added a certain amount of objectivity to the process of arriving at a diagnosis.