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An Official Publication of the Indian Association of Oral and Maxillofacial Pathologists


 
KNOW THIS FIELD Table of Contents   
Year : 2003  |  Volume : 7  |  Issue : 2  |  Page : 46
 

Know this field


1 Department of Oral and Maxillo Facial Pathology, Meenakshi Ammal Dental College and Hospital, Chennai, India
2 Oral and Maxillo Facial Pathology, College of Dentistry, OSU, Columbus, Ohio, USA
3 Department of Oral and Maxillo Facial Pathology, Ragas Dental College and Hospital, Chennai, India

Correspondence Address:
B Sivapathasundharam
Department of Oral and Maxillo Facial Pathology, Meenakshi Ammal Dental College and Hospital, Chennai
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Sivapathasundharam B, Carl M A, Ranganathan K, Einstein T B. Know this field. J Oral Maxillofac Pathol 2003;7:46

How to cite this URL:
Sivapathasundharam B, Carl M A, Ranganathan K, Einstein T B. Know this field. J Oral Maxillofac Pathol [serial online] 2003 [cited 2019 Sep 22];7:46. Available from: http://www.jomfp.in/text.asp?2003/7/2/46/40937



   Case Details Top


A 40-year-old male presented with the complaint of swelling and pain in the right lower back tooth region, the swelling present for about 8 months with a non healing ulcer. On examination, a diffuse, erythematous swelling was seen in the right retromolar area, in relation to 47, 78 region extending upto the ramus. The swelling was tender and firm on palpation.


   Microscopic Findings Top


  1. Islands of basaloid epithelial cells [Figure 1],[Figure 2],[Figure 3],[Figure 4],[Figure 5],[Figure 6]
  2. These islands show microcyst formation giving rise to a 'cribriform' appearance [Figure 1],[Figure 2],[Figure 3]
  3. Microcystic spaces contain mucin-like material [Figure 3]
  4. Basaloid cells show increased mitosis [Figure 4]
  5. In the superficial area of the section, the islands seem to abut from the surface epithelium [Figure 5]
  6. Superficial epithelium shows dysplastic features [Figure 6]



   Impression Top


Epidermoid predominant mucoepidermoid carcinoma

The presence of islands made of basaloid cells showing microcyst formation and containing mucin like material suggests a diagnosis of epidermoid predominant mucoepidermoid carcinoma.

Basal cell adenocarcinoma

Basal cell adenocarcinoma can be considered in the differential diagnosis because of the presence of isomorphic dark staining tumour cells even though larger, polygonal-elongated cells are not observed.

Adenoid cystic carcinoma- solid variant

The presence of sheets and solid areas of basaloid tumor cells with a cribriform pattern and the presence of significant mitotic activity of the tumour cells mimics a solid variant of adenoid cystic carcinoma.

Basaloid squamous cell carcinoma

An interesting microscopic observation was the presence of dysplasia of the surface epithelium and abutting of the tumour islands from the surface epithelium. This finding suggested that the basaloid tumour cells have possibly differentiated from the surface epithelium and not from the glandular component. Thus, adenoid cystic carcinoma, basal cell adenocarcinoma and epidermoid predominant mucoepidermoid carcinoma were excluded from the diagnosis.

This finding along with the presence of basaloid tumour islands exhibiting mitotic activity and microcyst formation concluded the diagnosis as basaloid squamous cell carcinoma.


   Final Diagnosis Top


Basaloid squamous cell carcinoma


    Figures

  [Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4], [Figure - 5], [Figure - 6]



 

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Journal of Oral and Maxillofacial Pathology | Published by Wolters Kluwer - Medknow
Online since 15th Aug, 2007