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Pattanayak Mohanty S.,Dr R Ahmed Dental College and Hospital
BMJ case reports | Year: 2010

Melanotic neuroectodermal tumour of infancy (MNTI) is a rare benign tumour of neural crest origin that was first described by Krompecher in 1918.1 It is predominantly found in infancy, with about 92% of cases below the age of 12 months and 82% below the age of 6 months. The predominant site of origin is in the premaxilla though it is reported at other sites also including the skull, the mandible, the epididymis and the brain.2 The lesions often have areas of bluish discolouration on the surface and are characterised by displacement of the involved tooth bud and local aggressiveness. The present report deals with two cases of MNTI, a 5-month-old baby girl and a 6-month-old baby boy who reported to the Department of Oral and Maxillofacial Pathology, Dr R Ahmed Dental College and Hospital, Kolkata, India. The clinical, radiological, histological and immunohistochemical findings, confirmed the diagnosis of MNTI. Flow cytometry was performed to analyse aneuploidy. The tumours were treated surgically with no history of recurrence to date.


Ray J.G.,Dr R Ahmed Dental College And Hospital | Ranganathan K.,Ragas Dental College and Hospital | Chattopadhyay A.,Case Western Reserve University
Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology | Year: 2016

Oral submucous fibrosis (OSF), first described in 1952, is a potentially malignant disorder associated with betel quid and areca nut chewing, mostly prevalent in the population of the Indian subcontinent and South East Asia. Malignant transformation of OSF to squamous cell carcinoma (SCC) has been estimated to be between 2% and 8%. Our study aimed to review the histopathologic changes that contribute to the understanding of the malignant transformation of OSF. Changes in epithelial thickness and dysplasia characterized by micronuclei, altered AgNOR counts and distribution, keratin protein alteration, and alteration of P63 and E-cadherin characterize the epithelial changes during the transformation of OSF to SCC. Common mechanisms have been proposed to be involved in OSF and SCC, through collagen maturation and their interaction with myofibroblasts and mast cells. Fibrosis-driven vascular constriction that results in epithelial hypoxia has also been proposed as an important mechanism for the malignant transformation of OSF. However, reassessment of the classical view is required, because with demonstration of large blood vasculature in the connective tissue stroma of OSF, the hypothesis associated with tissue hypoxia–induced malignant transformation of OSF can be questioned. © 2016 Elsevier Inc.


Ray J.G.,Dr R Ahmed Dental College and Hospital
BMJ case reports | Year: 2011

Hyalinising clear cell carcinoma (HCCC) is an infrequent distinct histological subtype of clear cell adenocarcinoma encountered in minor salivary glands which can be confused with a variety of clear cell-rich tumours. The entity of HCCC should be considered in patients presenting with well-circumscribed longstanding nodular enlargement without any other significant abnormality. HCCC is often difficult to diagnose due to its unusual presentation. This report presents a male patient who reported with a complaint of 2 month history of a large swelling on the tongue. The clinical, radiological, histological and immunohistochemical findings, confirmed the diagnosis of HCCC.


Ray J.G.,Dr R Ahmed Dental College And Hospital | Ganguly M.,Dr R Ahmed Dental College And Hospital | Rao Sripathi B.H.,Mangalore University | Mukherjee S.,CSIR - Central Electrochemical Research Institute | And 2 more authors.
Journal of Oral and Maxillofacial Pathology | Year: 2013

Context: With an increase in the abuse of various oral habitual products in India over the past few decades; the incidence of oral potentially malignant conditions as leukoplakia, oral submucous fibrosis and squamous cell carcinoma (SCC) rates have also increased. No recent study has been conducted reporting the scenario of oral cancer and potentially malignant conditions in Eastern India (specifically Kolkata). Aims: The present study was conducted at Dr. R. Ahmed Dental College, Kolkata during 2010-2011 to find a possible correlation between the effects of the different oral habits, age, sex and the different types of oral mucosal lesions among patients reported to the hospital. This study also enabled us to see the predilection of the various histopathological stages of the lesions for different sites of the oral cavity. Subjects and Methods: The study group consisted of 698 patients having either oral potentially malignant or malignant lesion. The control group consisted of 948 patients who had reported to the hospital for different oral/dental problems and had the habit of tobacco, areca nut and/or alcohol usage for at least 1 year. Statistical Analysis : The unadjusted odds ratio, the 95% confidence interval, and the P value were calculated to correlate patients with/without different kinds of habit and having/not having various kinds of oral lesions. Results: Our study shows that for males having the habit of taking smokeless tobacco or mixed habit poses the highest risk for developing SCC. For females, significant risk of developing SCC was found in patients habituated to processed areca nut chewing. Conclusion: This study presents probably for the first time in recent years the occurrence of oral potentially malignant and malignant conditions amongst patients having deleterious habits in a hospital based population of Kolkata.


Swain N.,Mgm Dental College And Hospital | Dhariwal R.,M.M.C.D.S.R. | Ray J.G.,Dr R Ahmed Dental College And Hospital
Journal of Oral and Maxillofacial Pathology | Year: 2013

Clear cell odontogenic carcinoma is a rare odontogenic tumor occurring predominantly in posterior mandible during 5 th-7 th decades with a female predilection. It is a potentially aggressive tumor, capable of frequent recurrences and loco-regional and distant metastases. Till date, only 73 cases have been reported in the literature. Current case is of a 55-year-old woman with tumor mass extending from canine to molar region on the left maxillary arch. Being locally aggressive tumor with the capacity to metastasize, it demands to be distinguished from other primary and metastatic clear cell tumors of the oral and maxillofacial region. A brief compilation of the reported cases is being attempted in the current article to better understand the behavior of the tumor.


Swain N.,Mahatma Gandhi Mission Dental College and Hospital | Kumar S.V.,Dr R Ahmed Dental College And Hospital | Dhariwal R.,Dr R Ahmed Dental College And Hospital | Routray S.,Institute of Dental science
Journal of Oral and Maxillofacial Pathology | Year: 2013

Fibrosarcoma (FS) is a malignant mesenchymal neoplasm of the fibroblasts that is uncommon in the head and neck and constitutes less than 1% of malignancies and approximately 6% of the soft tissue sarcomas. FSs rarely occur before the third decade except infantile type. This condition primarily affects long bones, and its occurrence in the cranium is rare (15%), with the mandible being the most commonly involved cranial site. Here a case of primary FS in anterior maxilla of an 8-year-old male child is reported. This article is presented to document the rarity of FSs in the jaws of children with review of literature.


Chatterjee K.,Buddha Institute of Dental science | Bhattacharya S.,Dr R Ahmed Dental College and Hospital | Mukherjee C.G.,Buddha Institute of Dental science | Mazumdar A.,Burdwan Dental College and Hospital
Journal of Oral and Maxillofacial Pathology | Year: 2012

Aim: Well documented cases of oral lichen planus, a cell mediated immune condition is infrequently reported in paediatric population. This study was undertaken to obtain epidemiological data retrospectively and also to explore the possibility of any association that might exist among the clinical and histopathological features in paediatric patients suffering from oral lichen planus. Subjects and Methods: A retrospective study was carried out on 22 patients, younger than 18 years with clinical and histopathological diagnosis of oral lichen planus over a period of 14 years. The clinical characteristics and histopathological features were observed. The statistical analysis of the data was performed using Statistical Analysis Software (SAS), Version 9.1. Results: Analysis of data of 22 patients revealed that the average age of patient is 15.18 years with equal male and female predilection. The most common site is buccal mucosa (50%) and most frequent clinical form is erosive (63.64%). Focusing on the histopathological findings, parakeratosis was found in 86.36% of the cases, acanthosis in 63.64% of cases, moderate basal cell degeneration was identified in 63.64% of cases and dense lymphocytic infiltration at juxtaepithelial connective tissue region was found in 59.09% of cases. Conclusions: Oral lichen planus in paediatric population is rare and appeared between 8 to 18 years of age. There is no significant gender predominance. The most common clinical form is erosive, manifesting mainly in buccal mucosa. Histopathological findings characteristic of oral lichen planus in paediatric patients include parakeratosis, acanthosis, liquefaction degeneration of basal cells and lymphocytic infiltration in the subepithelial layer.


Ray J.G.,Dr R Ahmed Dental College and Hospital
BMJ case reports | Year: 2011

The clinico-histopathological diagnosis of oral verrucous carcinoma (OVC) is often exclusionary and extremely difficult. Distinction from the classical oral squamous-cell carcinoma (OSCC) is a frequent problem for both clinicians and pathologists because of the extensive nature of the lesion mimicking an invasive cancer. Immunohistochemistry in this case provides a platform for studying distinct molecular mechanism by variation in expression of protein markers. In this study, the authors have attempted to differentiate OVC (case no 1) and OSCC (case no 2) by studying the expression pattern of some well-known tumour marker proteins (vascular endothelial growth factor, matrix metalloproteinases 2 and 9, superoxide dismutase 2 and nicotinamide adenine dinucleotide phosphate quinone oxidoreductase 1). A distinction in expression of these proteins provides a clear understanding that OVC do not show characteristics of a classical carcinoma and may be regarded as a misnomer. This may also provide a better guide for clinicians to differentiate between these two.


Mukherjee S.,CSIR - Central Electrochemical Research Institute | Bhowmik A.D.,Manovikas Biomedical Research and Diagnostic Center | Roychoudhury P.,Manovikas Biomedical Research and Diagnostic Center | Mukhopadhyay K.,Manovikas Biomedical Research and Diagnostic Center | And 2 more authors.
Journal of Oral Pathology and Medicine | Year: 2012

Background: Arecanut and smokeless tobacco usage is a major cause for oral submucous fibrosis (OSF) and its subsequent development to oral squamous cell carcinoma in South-east Asian population. Polymorphisms at N-acetyltransferase 2 locus, coding for an enzyme catalyzing acetylation of aromatic amines, might cause DNA adduct formation because of improper acetylation of these polyaromatic hydrocarbons. DNA repair enzymes remove these adduct to prevent malignancy. Methods: In this hospital-based study, 100 controls and 88 OSF patients were genotyped at four polymorphic sites on NAT2 481 (C>T; silent), 590 (G>A; Arg197>Gln), 803 (A>G; Lys268>Arg), 857 (G>A; Gly286>Glu) and two on XRCC1 18067 (C>T Arg 194>Trp), 28152 (G>A Arg 399>Gln), and one of XRCC3 26304 (C>T Thr 241>Met) loci by PCR-RFLP to determine the risk of the disease. Results: Heterozygous XRCC3 codon 241 [OR 2.07 (1.05-4.06)], homozygous variant of NAT C481T [OR 2.81 (1.09-7.21)], and both heterozygous and homozygous variants of NAT codon 268 and 286 [OR 2.31 (1.20-4.45) and 4.98 (1.87-13.14), and 6.12 (2.75-13.62) and 2.65 (1.04-6.72)] individually influenced susceptibility to OSF in the population. Conclusion: Gene-gene interaction analysis by multifactor dimensionality reduction (MDR) revealed that XRCC3 Thr 241 Met had the largest univariate effect followed by XRCC3 Thr 241 Met - NAT2 A857G in men that presents a highly synergistic interaction as one of the potential combinations of single nucleotide polymorphisms (SNPs) to increase the risk of OSF in men if exposed to arecanut or smokeless tobacco usage. These observations can speculate the impact of the studied SNPs on the etiology of OSF. © 2011 John Wiley & Sons A/S.


PubMed | Ragas Dental College and Hospital, Case Western Reserve University and Dr R Ahmed Dental College And Hospital
Type: Journal Article | Journal: Oral surgery, oral medicine, oral pathology and oral radiology | Year: 2016

Oral submucous fibrosis (OSF), first described in 1952, is a potentially malignant disorder associated with betel quid and areca nut chewing, mostly prevalent in the population of the Indian subcontinent and South East Asia. Malignant transformation of OSF to squamous cell carcinoma (SCC) has been estimated to be between 2% and 8%. Our study aimed to review the histopathologic changes that contribute to the understanding of the malignant transformation of OSF. Changes in epithelial thickness and dysplasia characterized by micronuclei, altered AgNOR counts and distribution, keratin protein alteration, and alteration of P63 and E-cadherin characterize the epithelial changes during the transformation of OSF to SCC. Common mechanisms have been proposed to be involved in OSF and SCC, through collagen maturation and their interaction with myofibroblasts and mast cells. Fibrosis-driven vascular constriction that results in epithelial hypoxia has also been proposed as an important mechanism for the malignant transformation of OSF. However, reassessment of the classical view is required, because with demonstration of large blood vasculature in the connective tissue stroma of OSF, the hypothesis associated with tissue hypoxia-induced malignant transformation of OSF can be questioned.

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