Subrenal capsule (SRC) assay was initially developed by Bogden et al. and has been reported to be an effective chemosensitivity test for individual tumor patients. However, there still remain some inherent problem such as the influence of the host immune responses.
Meanwhile, peplomycin (PEP) is an analogue of bleomycin (BLM) with a broader antitumor spectrum and less pulmonary toxicity, and is often applied to the treatment of oral squamous cell carcinomas (SCC), especially highly differentiated SCCs.
However, we have experienced some cases in which PEP is ineffective in the case of highly differentiated SCCs.
Therefore, experimental studies were conducted to examine the possibility of an SRC assay of PEP modified by Kawahara et al.
Mice were pretreated with a minute immunosuppressive dose of X-ray irradiation. When PEP was administered on the Days 1, 3, 5, at the total dose of 60.0mg/kg, the antitumor effect was more pronounced than in the case of any other regimen.
Seventy-two cases were examined and it was possible to evaluate every case of 56 cases. Subjected to tumor differentiation and SRC assays, there was no significant correlationship between highly differentiated SCCs and other types of tumor differentiation. Sixteen correlations were established between the the results of the SRC assays and clinical responses, and 14 cases (87.5%) showed a good correlationship.
As results of the foregoing studies, the modified SRC assay was acceptable as an experimental model for predicting the sensitivity of PEP to highly differentiated SCCs. Since PEP is not always effective in the case of highly differentiated SCCs, it is necessary to apply the modified SRC assay before applying chemotherapy.

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Autopsy specimens from 10 patients with oral squamous cell carcinoma were investigated by applying the immunohistochemical technique. Five patients were male and 5 were female, ranging between 39 and 88 years old. The primary tumor sites were the buccal mucosa in four patients, the tongue in three, the maxilla in two, and the soft palate in one patient. One patient belonged in stage II, 2 in III, and 7 in IV. Five cases were treated by surgery and radiotherapy, 4 cases were treated with surgery, radiotherapy, and chemotherapy, and one was treated with radiotherapy and chemotherapy. The duration of survival was between 7 months and 38 years after the initial treatment. Histologically, there were 4 well and moderately differentiated types, respectively, and 2 cases of a poorly differentiated type. Cellular and structural atypia were observed in 8 cases. Regarding the mode of cancer invasion, there were one case each of type 2 (less marked borderline) and type 3 (no distinct borderline) and 8 cases of type 4 (diffuse invasion) . The stromal reaction showed a weak lymphocytic infiltration in 6 cases, strong infiltration in one case, and nothing in 3 cases. Immunohistochemical staining for CEA and keratin was present in all cases, but considerable variation occurred in their detection. SCC was expressed by the tumor cells, except in one cases of a poorly differentiated carcinoma. These results indicate that the expression of SCC, CEA, and keratin is related to the differentiation of tumor cells.

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Clinico-statistical observation was performed on 285 patients with malignant tumors treated in our clinic over the past 15 years, from January 1976 to December 1990. The results obtained were as follows.
1. The patients accounted for 267 carcinomas (93.7 %), 16 sarcomas (5.6 %) and 2 other malignancies (0.7 %) . Meanwhile 173 were male and 112 were fem ale giving a male: female ratio of 1.5: 1. The age ranged between 21 and 92 years and the mean age was 59.8 years. The highest prevalence was found in the 7 th decade.
2. The main symptoms were, in descending order, pain (29.6 %), mass (27.9 %) and erosion or ulceration (27.9%) while in 271 primary cases, the most common site was the tongue, accounting for 38.0 %.
3. Histopathologically, 234 cases were diagnosed as squamous cell carcinoma which accounted for 82.1 % of all cases and 87.6 % of all carcinomas.
4. With respect to therapy, 87 cases (30.5 %) were treated by preoperative chemotherapy plus surgery, and 85 cases (29.8 %) were treated by surgery alone.
5. The 5-year cumulative survival rate of 271 primary cases was 66.3 %, and according to histological typing, the survival rate of carcinoma, sarcoma and other malignancies were 67.1 %, 45.0 % and 100 %, respectively.

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We are often faced with a situation in which a tumor has increased in size, as a result of a recurrence, despite repeated operations and radiotherapy (coupled with all kinds of chemotherapy and immunotherapy), and where all possibilities have been exhausted and no operation or cure is possible.
In order to try to maintain the quality of life with respect to the terminal stadium of oral carcinoma, we tried a chemotherapy method using a totally implanted one-shot intraarterial injection system via A. thyroidea superior and A. carotis externa. We are submitting a summary report as it may be of some help.
Compared with intraarterial injection methods based on non-implanted devices that have been used to date, this method offers many advantages-no risks of infection; no need to worry about such contingencies as the catheter being occluded or pulled out; and no imposition of extra restrictions regarding daily activities such as the taking of baths, and so on. Moreover, apart from intraarterial injection, it can be used for dropinstillation and repeating blood sampling such as that used for determining blood gas. It was possible to pursue the course of treatment with about one visit per week to the hospital.

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Since 1978, fourteen patients with squamous cell carcinoma of the upper gum have been treated at the Department of Oral Surgery, Kanazawa University. Among them, from the viewpoint of clinical features and the local relation between a tumor and long-term wearing, seven cases seemed to originate in the mucous membrane, which contacted with an improperaly worn upper denture. In this paper, a retrospective analysis of these cases were performed clinico-pathologocally.
Seven patients consisted of 2 males and 5 females with a ratio of 1: 2.5. There ages of the patients ranged between 67 and 94 with an average age of 79 years. Moreover, 6 of the patients were over seventy years old. Tumor tissue has been found mostly at the unilateral molar gum, and in the palate and maxillary tubercle which were under the denture base. Regarding the complaint, the incidence of tumor formation without pain was higher than that with pain. On the first visit, tumor size in some cases have already locally advanced. Histopathologically, they had low grade malignancy and all of them proved to be well differentiated squamous cell carcinoma. Therefore, none of them showed metastasis formation in the regional lymphonode or in any distant organ.
They had been wearing a wrong denture all day and all night for a long time. This suggested that wearing the wrong denture for a long time is associated with the occurrence of cancer.

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Three cases of verrucous carcinoma in the oral cavity are presented. Case 1: A 68-year-old male with a tumor in the buccal mucosa. Case 2: A 78-year-old female with a tumor of the upper gingiva. Case 3: A 95-year-old female with a tumor of the upper gingiva. CO₂ laser vaporization was effective for treating verrucous carcinoma in the oral cavity because patients did not need to stay in the hospital to be treated, and wounds made by the CO₂ laser formed only a little scar. In our patients, the post-operative course has been uneventful for 15-20 months.

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Twenty six cases of mandibular reconstruction using metal bone plates treated at the Shinshu University School of Medicine's Department of Dentistry and Oral Surgery in the period from January 1986 to December 1990 were reviewed.
In 22 cases of segmental resection and 4 cases of hemimandibular resection (19 malignant neoplasms and 7 benign lesions), immediate reconstruction using free or vascularized bone grafts was performed in 7 cases, secondary reconstruction was done in 9 cases and reconstruction using metal plates was only done in 10 cases.
The success rate of mandibular reconstruction was good in the immediate reconstruction group (100 %) and in the secondary reconstruction group (77.8 %), but was relatively poor (40 %) in the group where reconstruction was carried out using only metal plates.
The following postoperative complications were observed in many unsuccessful cases; postoperative infection (9 cases), plate exposure (3 cases), and plate detachment (1 case) .
Though plate breakage occurred in 3 cases, reconstruction was successful in each of those cases.

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One hundred and thirty-eight cases of primary malignant tumor, treated at the Department of Oral and Maxillofacial Surgery at Saga Medical School from October 1981 to October 1991 were reviewed and clinically analyzed.
The patients included 84 men and 54 women, whose ages ranged from 16 to 93 years old with a mean age of 63.7. The locations of the 138 malignant tumors were as follows; 37 in the tongue, 29 in the lower gum, 26 in the oral floor, 15 in the upper gum, 11 in the hard palate, 6 in the buccal mucosa, 5 in the submandible, 4 in the maxilla, 2 in the mandible, one in the lower lip, one in the parotid gland, and one unknown site. Histopatologically, 117 cases were diagnosed as squamous cell carcinoma (including verrucous carcinoma), 8 cases as malignant lymphoma, 4 cases as adenocarcinoma, etc.
According to the UICC TNM classification of 1978, the 120 cases of primary oral cancer (except for maxillary sinus cases) were classified as 18 cases of T1, 55 cases of T2, 9 cases of T3, and 38 cases of T4. Among these, cervical lymph nodal metastasis was found in 58 cases. No cases of distant metastasis were observed among these primary cases. In terms of stage grouping, 16 cases were categorized as stage I, 28 cases as stage II, 26 cases as stage III, and 50 cases as stage IV.
Forty-eight cases were treated with a combination of chemotherapy, radiation therapy, and surgery (combined modality therapy), which was a predominant in all cases. Kaplan-Meier survival curves showed that the commulative survival rate of all the patients was 58.9 % for 5 years, and 63.7 % in the curative treatment group of cancer patients.

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A rare case of oral manifestation resulting from malignant melanoma arising in the maxillary sinus was reported. Histologically, the tumor was amelanotic. Clinically, the patient had multiple abdominal metastases upon his first visit and had a miserable clinical course. The incidence, symptoms and reasons for the poor prognosis of malignant melanoma in the maxillary sinus were discussed.

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Neurilemmoma is a common benign tumor related to neurogenic tissue in the oral and maxillofacial region. Herein, we report on a case of this tumor measuring 80×50×30 mm and located at the left cheek, a relatively uncommon site. The features of this case are summarized as an asymmetric appearance related to overgrowth, absorption of maxilla radiologically, and mixed type in Antoni classification pathologically.
We reviewed the relevant literature related to tumors found in buccal-pterygopalatine fossa-infratemporal fossa area published in Japan over the last thirty-one years. Females were predominant, their average age was 37.7 years old, and a pathologically mixed type in Antoni classification was common.

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The incidence of multiple primary cancer has been recently increasing; however, it is extremely rare for all cancers to be satisfactorily treated. We experienced a case of nonsynchronous quadruple cancer found in a 67-year-old female, who had a mixed type signet ring cell carcinoma and a poorly differentiated adenocarcinoma in the stomach, a solid-tubular carcinoma in the left breast, a scirrhous carcinoma in the right breast and a squamous cell carcinoma in the buccal mucosa. The origin and histological type of each of the four cancers were different. The patient was successfully treated, and there were no recurrences for at least 3 years after treatment.

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