Biomedical subjects
Publications and source records attributed to G Ficarra.
The human papillomavirus (HPV) causes a variety of cutaneous warts and proliferative squamous lesions of oral mucosa. This article reviews, on the basis of the literature and personal observations, the biology of HPV and its etiopathogenetic role in some uncommon oral diseases.
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Three cases of facial molluscum contagiosum in HIV-infected patients are reported. Unusual locations, multiple lesions and rapid recurrence after surgical excision may be seen in people who are infected with HIV.
Recently, an increasing incidence of oral Kaposi's sarcoma in association with acquired immunodeficiency syndrome (AIDS) has been observed. This article describes the clinical features and the histopathologic spectrum of oral epidemic Kaposi's sarcoma in six HIV-positive patients. Etiopathogenic, epidemiologic, therapeutic aspects of Kaposi's sarcoma of the oral cavity and its interrelationship with AIDS are discussed.
A case of cherubism, with a follow-up of ten years, is reported. The comparison between the radiographic examinations carried out now and ten years ago allows some considerations on the course of the disease.
The Authors report a case of mucoepidermoid tumor that began its growth inside the mandible. The central neoplasms of the jaws and of salivary origin are an unusual finding but the mucoepidermoid is the far more common with 45 cases already reported.
A patient with Kaposi's sarcoma of the oral cavity is reported. The intralesional use of vinblastine may be an effective treatment for small Kaposi's sarcoma lesions of the mouth or the skin that are painful or create cosmetic problems.
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During a prospective investigation of oral lesions of 120 consecutive patients positive for human immunodeficiency virus, belonging to the intravenous drug abuser risk group and other risk categories, we observed hairy leukoplakia (HL) in 23 cases (19%). The median age of the patients was 27 years (range, 20 to 50 years). Twenty patients were men and three were women. All but two of the twenty three patients used intravenous drugs for a median period of 6 years (range, 5 to 18 years) and were involved in several episodes of needle sharing. Eight men were also bisexual, one man was homosexual, and one man was hemophiliac and bisexual. Eleven patients had asymptomatic infection, five had lymphadenopathy syndrome, six had AIDS-related complex, and one had acquired immunodeficiency syndrome. In all patients, HL lesions were localized on the lateral borders of the tongue. In twelve patients, the lesion was unilateral, and in eleven patients, it was bilateral. Microscopically, hyperparakeratosis and the presence of koilocytes were observed in all cases. Surface candidiasis could be detected with staining with periodic acid-Schiff in two thirds of the cases. In four cases, electron microscopy showed the presence of intracellular and extracellular hyphae of Candida albicans in the parakeratin layer associated with coccobacilli in the spaces between surface epithelial cells. The spinous layer included koilocytes, which had a clear cytoplasmic matrix, sparse organelles and tonofilaments, and dispersed chromatin. These cells were found to be infected by a herpes-type virus in all cases examined. There was no ultrastructural evidence of human papillomavirus in the nuclei of the epithelial cells.(ABSTRACT TRUNCATED AT 250 WORDS)
Since our first description and profile of patients with Kaposi's sarcoma (KS) in 1984, the relative rate of KS in patients with the acquired immunodeficiency syndrome has dropped from 34% to 20%. However, the absolute number is increasing. The pathogenesis of KS is still obscure, and its interaction with the human immunodeficiency virus infection remains unclear. Cause of death is usually opportunistic infections in both endemic and epidemic KS. The most common intraoral site is the palate, which is involved in 95% of our cases. The oral cavity may be the only or first site of KS, and therefore, becomes important in the diagnosis. More than 20% of our current patient population had the oral cavity as the initial site of manifestation. Because of functional impairment, bleeding, pain, or cosmetic reasons, treatment is frequently required. There are many modalities used, including chemotherapy, radiation, and laser resection. Radiation appears to be a most effective and practical control measure for oral KS.
A case of mandibular metastasis of angiosarcoma is described, along with its clinical manifestations and histopathological features. This is the 5th case ever reported of metastasis of angiosarcoma to the mandible.
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Computer-assisted image analysis was used to measure four histopathologic parameters (number of giant cells, mean number of nuclei per giant cell, fractional surface area, and relative size index) in two groups of patients with central giant cell lesions in a search for possible histologic predictors of clinical behavior. The lesions of 22 patients were classified clinically into nonaggressive and the lesions of 10 patients were classified into aggressive categories in accordance with the method of Chuong and Kaban. The majority of patients with aggressive lesions had recurrent tumors within 2 years and/or experienced pain, root resorption, and cortical perforation. Giant cells were selected in 25 random high-power magnification (X400) fields and measured by means of the Leitz Texture Analysis System-Plus. Linear stepwise discriminant analysis was applied to each parameter studied. Clinically aggressive giant cell lesions were characterized by a higher number of giant cells and greater fractional surface area when compared with the nonaggressive tumors. With the use of the "jackknife" classification procedure, the accuracy of the two statistically significant parameters (number of giant cells and fractional surface area) in predicting the aggressiveness or the nonaggressiveness of our group of central giant cell granulomas was, respectively, 70% and 82%. This study provides further evidence that the use of cytometric analysis of giant cells may be helpful in predicting prognosis and in planning treatment for these often difficult-to-manage lesions.