Background/Aim. Apoptotic Protease Activating Factor-1 (Apaf-1) is a key molecule in the intrinsic or mitochondrial pathway of apoptosis. Some pathological conditions such as cancer, stroke, and neurodegenerative diseases, are the result of disregulation in the intrinsic apoptosis pathway. The aim of this study was to analyse the immunohistochemical expression of Apaf-1 in ACC tumor cells of the salivary glands and its correlation with clinicopathological parameters (gender, age, localization, histological type and overall survival). Methods. Formalin-fixed, paraffin-embedded tissues from 50 human ACC of the salivary glands, male and female, average age 58 years, were used for our present study. We used the technique of tissue microarray (TMA blocks). Sections from the TMA mould, 5?m thick, were stained with the streptavidin-biotin immunohistochemical technique using primary antibodies specific for Apaf-1 (Leica Biosystems, Newcastle, UK). Stained tissue sections were analyzed by the light microscope (Olympus type BH-2). Based on the data collected, the database was created in SPSS software v. 22.0 (SPSS Inc., Chicago, ILL, USA), which was used for a further statistical analysis. The statistical data analysis included methods of descriptive and analytical (inferential) statistics. Results. The results of the immunohistochemical analysis of Apaf-1 expression in the samples of patients with ACC of the salivary glands were compared with the clinicopathological parameters of these patients. The immunohistochemical expression of Apaf-1 showed no statistical significance with regard to the patients gender (p=0.552), age (p=0.106), histological tumor type (p=0.654) and localization of ACC in the salivary glands (p=0.486). There was no statistically significant correlation observed between overall survival of ACC patients and Apaf-1 expression in tumor cells (p=0.340,Long-Rank test). Conclusion. With regard to ACC, Apaf-1 expression is not in correlation with clinicopathological parameters (gender, age, localization, histological tumor type, outcome of the disease, and overall survival). Therefore, we believe Apaf-1 cannot be regarded as an independent prognostic factor.

Leiomyosarcomas belong to one of the histological subtypes of soft tissue sarcomas. They most often occur in genital, gastrointestinal tract and extremities, and the appearance of these tumors in the bones (especially head and neck) is very rare. Clinically, leiomyosarcomas are aggressive tumors. Treatment is multidisciplinary and includes surgery, radiotherapy, and chemotherapy. This case report presents a 61-year-old patient who was referred to a maxillofacial surgeon due to congestion of the right side of the nose, pain in the right eye, and occasional epistaxis. After complete examination, including biopsy with histopathology and immunohistochemistry, primary intraosseous leiomyosarcoma of the nose and paranasal cavities was diagnosed. Since the tumor lesion was assessed as inoperable, the treatment started with radiotherapy. Two and half years after the radiotherapy was completed, there was good local control of the disease and no dissemination. The case report illustrates the rarity of localization, challenges and difficulties in multimodal treatment, and contribution of radiotherapy to good treatment results.

Malignant tumors of the maxillofacial and oral region are relatively rare and form a very heterogeneous group of tumors whose incidence is constantly increasing. It is a disease of the elderly population, with a slight prevalence of males. The most common histological type is squamous cell carcinoma, and the most common localization of the tumor is on the skin and mucous membranes of this region. In the treatment of these tumors, the cooperation of different specialties is necessary. According to all modern recommendations for treatment, surgery is the first method of treatment, and radiotherapy has its place in both adjuvant and definitive approaches. Chemotherapy with limited effect is used for disseminated disease. The aim of the study was to present the role of radiotherapy in multidisciplinary treatment of malignant tumors of the oral and maxillofacial region.