Current efforts have been centered on diagnosing the occult lymph node metastasis accurately by using image modalities, CT, MRI, US, and PET, so that appropriate therapy can be administered. However, their limitations of spatial resolution and visualization have prevented them to diagnose the subclinical lymph node metastases effectively. Sentinel lymph node biopsy allows identification of occult metastases more accurately and more effectively. This procedure has been introduced for oral carcinoma as same as for several solid malignancies. In this procedure, small gamma cameras have the potential to be used to facilitate the procedure. The advancing technology, including nuclear medicine, molecular imaging, and optical imaging, has the promise to provide greater information on biological and anatomical characterization of the diseases and treatment for this challenging field．
The Chinese Journal of Dental Research （CJDR）, an official international journal, has been published by the Chinese Stomatology Association since 1998. 1） CJDR was registered with MEDLINE in 2010, but the impact factor has not been reported. 2） Peking University, Shanghai Jiao Tong University, Wuhan University, The Fourth Military Medical University, and Sun Yat-sen University are active contributors to CJDR. 3） The key national universities of China in the field of stomatology are Peking University, Sichuan University, Wuhan University, Shanghai Jiao Tong University, The Fourth Military Medical University, and Huazhong Agricultural University. 4） The Chinese key national universities aim to promote Chinese science and technology as national projects. The six key national universities selected in China for the field of stomatology as a national project should yield excellent results in the near feature. 5） CJDR is an international journal written in English for the entire Chinese nation （Zhonghua Minzu）.
Schwannoma is a benign tumor originating in Schwann cells of neurilemma. Schwannoma arising in the masseteric muscle is relatively rare. In this paper, a case of schwannoma arising in the masseteric muscle located at the mandibular notch is reported. A 16-year-old girl was referred to us because of a slight swelling in front of the left tragus. We found and palpated a cherry-sized elastic hard tumor located beneath the left zygomatic arch. Magnetic resonance imaging revealed a 23 × 15 mm solid tumor with a clear margin. The tumor was located from the left masseter muscle to the mandibular notch. The tumor was removed through an intraoral approach with the patient under general anesthesia. To secure an operative field, the left coronoid process was removed. The range of jaw movement recovered within 3 months postoperatively. The histopathological diagnosis was schwannoma. The postoperative course was uneventful, with no evidence of tumor recurrence.
Desmoplastic ameloblasotma （DA） is classified as a rare variant of ameloblastoma. We report a case of DA recurring in the soft tissue of maxilla. The patient was a 66-year-old man who visited our department because of swelling of the right cheek and maxillary gingiva. Biopsy of the soft tissue suggested an odontogenic tumor. The tumor was surgically removed with the patient under general anesthesia. DA was diagnosed on histopathological examination of the surgical specimen. After 3 months, we detected recurrence at the excision site, and extirpation was performed immediately. The postoperative course has been uneventful as of 20 months after surgery.
Spindle cell carcinoma is a unique and rare biphasic tumor consisting of a squamous cell carcinoma component and a sarcomatoid component of spindle cells. We report a rare case of spindle cell carcinoma of the mandible that was considered an intraosseous carcinoma. The patient was a 67-year-old woman with a chief complaint of paresthesia of the left lower lip. There was no particular sign of the left mandibular gingiva. A panoramic radiograph showed a radiolucent area in the left premolar region of the mandible. Computed tomographic scans showed a ring-enhanced mass lesion in the same location. A biopsy was performed for a diagnosis of mandibular osteomyelitis. Because the diagnosis was granulation tissue, we performed curettage of the mandibular bone. However, the surgical specimen was histopathologically and immunohistochemically diagnosed as spindle cell carcinoma. We performed a segmental mandibulectomy with a safety margin. There has been no sign of local recurrence or metastasis during a follow-up period of 1 year 9 months.
Angiosarcoma is a malignant tumor of endothelial cells. It is a fatal disease because of the high risk of hematogenous metastasis. Angiosarcoma metastatic to the oral and maxillofacial region is extremely rare because angiosarcoma itself is rare. We report a case of angiosarcoma of the scalp that metastasized to the maxillary gingiva with a review the literature. A 72-year-old man was referred to our department in August 2009 because of a hemorrhagic mass in the right maxillary gingiva. The patient had been admitted to our hospital to receive treatment for an angiosarcoma of the scalp. He was aware that the mass was gradually growing during the past 2 months. Intraoral examination revealed a reddish-brown mass, approximately 20 mm in diameter, at the premolar region of the right maxillary gingiva. An X-ray film showed no resorption of the alveolar bone. A biopsy of the mass led to a diagnosis of angiosarcoma of the scalp metastatic to the maxillary gingiva. However, it was impossible to treat the oral metastatic lesion because of deterioration of the lung metastases. Two months later, he died of respiratory insufficiency.
Stevens-Johnson syndrome （SJS） is a serious systemic disease mainly caused by medications. We report our experience with a case of SJS that caused primary symptoms in the mouth and relapsed a short period of time after recession of the primary symptoms. The patient was a 41-year-old man. He took medication prescribed by a local doctor and then visited our office because he became aware of an acute exacerbation of stomatitis. Ambroxol hydrochloride and tranexamic acid showed positive reactions on drug-induced lymphocyte stimulation tests. Therefore, it was presumed that these medications had caused SJS. Participation of Herpes simplex virus was suspected at the time of recurrence and the first attack. Serious or intractable stomatitis is common in our field, and it is important to take potential primary symptoms of SJS into account on clinical examinations. This case suggests that oral medical care is very important in SJS.
Amyotrophic lateral sclerosis （ALS） is an incurable, progressive, and neurodegenerative disease specifically affecting both upper and lower motor neurons. It induces dysphagia, reduction of respiratory function, and limb muscle weakness, leading to aspiration pneumonia and respiratory insufficiency. ALS can be detected at dental visits on the basis of early oral symptoms such as dysphagia. However, there are few reports describing ALS in dental journals. We describe a man aged 59 years who visited our department because of functional changes, including decreased swallowing ability. Imaging studies demonstrated no tumor lesions, but tongue fasciculations were present. Videofluorographic evaluation revealed incorrect swallowing （aspiration） and food remaining in the larynx. We consulted the department of neurology in our university hospital. Because needle electromyography and other examinations ruled out other possible diseases, the patient was given a diagnosis of ALS. We made a palatal augmentation prosthesis to maintain deglutition function and followed up oral function. Oral symptoms of ALS are sometimes observed in its early stage. Therefore, oral surgeons and dentists need to possess adequate knowledge about this disease.
Monosomy 18p syndrome is caused by partial deletion of the short arm of chromosome 18. Monosomy 18p is an autosomal deletion syndrome. Since the first report of monosomy 18p in 1963, more than 150 cases have been reported. We describe a 2-month-old boy who had monosomy 18p with bilateral cleft lip and palate. Chromosome analysis showed that the karyotype was 45,XY,der （18;21） （q10;q10）. At 5 months 1 year of age, cheiloplasty was performed. At 3 years of age, palatoplasty was performed. Further follow-up will be continued to check his development, including maxillofacial growth.
Bone marrow transplantation （BMT） is widely used in the treatment of malignant hematological diseases. However, the occurrence of secondary malignancies is known to be a potential complication after BMT. We report a case of multiple oral squamous cell carcinoma （OSCC） concomitant with chronic graft versus host disease （GVHD） after BMT. A 42-year-old man was referred to our department by a hematologist in our hospital for evaluation of a right buccal tumor. He was given a diagnosis of chronic myelocytic leukemia （CML） in 2000. He underwent BMT to treat CML in 2001. Chronic GVHD developed, affecting the oral mucosa, kidney, liver, and skin, after BMT. There were multiple white lesions on the oral mucosa. Biopsy revealed squamous cell carcinoma of the right buccal mucosa and left lower gingiva. He underwent tumor resection under general anesthesia in March 2012. Another OSCC newly developed in the left lower mucobuccal fold in July 2012, and he underwent tumor resection. The patient has shown no evidence of recurrence or metastasis as of 1 year after the first operation.