The distribution of PCNA in the epithelium adjacent to a tongue carcinoma was studied by investigating the correlation of proliferating-cell nucler antigen (PCNA) labeling index (LI) and the histological features.
Biopsied materials were obtained from 18 cases with a squamous-cell carcinoma in the tongue. The specimens were fixed in a 10 % formalin solution. The sections were immunohistochemically stained using an anti-PCNA antibody. PC 10 (DAKO, Denmark) . The positive cells for immunostaining were counted under a microscope and the PCNA LI was obtained.
The following results were obtained. The PCNA was immunohistochemically labelled with different positive rates in different cases and areas of the epithelium adjacent to the tongue carcinoma, the PCNA LI for immunostaining revealed a low value of m±SD=11.8±6.9 (%) in tongue epithelium of 7 cases, a relatively high value of m±SD=15.1±5.9 (%) in the hyperplastic epithelium, and a remarkably high value of m±SD=32.5±9.5 (%) in the dysplastic epithelium.
The present results indicate that the cells in the dysplastic epithelium possessd a high proliferative activity that may be closely associated with carcinogenesis.

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Fourteen oral squamous-cell carcinomas with histological skin invasion, which had undergone curative resection, were investigated. The primary carcinomas were distributed throughout various sites in the oral cavity. All the skin which was invaded by the carcinoma was covering the site of the primary, primary recurrence or the metastatic lymph node.
A recurrence after surgical resection was noted in 7 out of the 14 patients. A recurrence with satellitosis was observed in 5 of the 7 cases, and all 5 of these patients died from failure of the primary focus control. It is assumed that satellitosis of the carcinomas might have resulted from retrograde lymphatic metastasis. It remains unclear whether radiation therapy or chemotherapy with the surgical precedure was effective in controlling the satellitosis. The accumulated 3-and 5-year survival rates of the 14 cases were 64.3 % and 35.7 %, respectively. It is suggested that the oral squamous cell carcinomas with the skin invasion should be resected as soon as possible before the incidence of satellitosis.

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Patients with squamous cell carcinoma in the oral cavity were treated with neoadjuvant chemotherapy combined with cisplatin (CDDP) . Eleven cases, which were evaluated as CR, were investivated to histologically assess both biopsy materials, and whole specimens were surgically excised following neo-adjuvant chemotherapy. Histological assessment of preoperative biopsy materials showed 4 cases to be Grade II b and 7 cases to be Grade IV according to the Shimosato's grading system. Moreover, 8 of the 11 cases were closely related to the histological assessment of postoperative serial sections. In CR cases, even though the histological assessment was determined the cases to be Grade II b, tumor remnants were limited to just under the surface of the central portion of the primary tumor. Therefore, reductive excision may be possible in CR cases.

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We studied 69 cases of stage I and II squamous-cell carcinoma in the oral cavity, Which were cytologically examined at our clinic between January 1984 and October 1992.
The following results were obtained.
1. The percentage of correct cytodiagnosis was 76.1% in stage I cases and 95.7% in stage II cases.
2. The percentage of correct cytodiagnosis was low in the cases occurring in the tongue and in the leukoplakic cases.
3. The malignancy of cytodiagnosis Class III is doubtful.

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We report a case of metachronous triplicated malignant tumors, and discuss a radiationinduced carcinoma. A 74-year-old man was referred to us because of a long-standing ulcer in the left cheek. The ulcer appeared three years prior to his initial visit, and had been treated under a diagnosis of“radiation-induced ulcer”. An incisional biopsy subsequently provided a diagnosis of well-differentiated squamous-cell carcinoma, and the patient was treated on an inpatient basis. The patient's medical history revealed a well-differentiated squamous-cell carcinoma of the tongue approximately 31 years prior to the visit, this cancer consequently being eradicated with interstitial radiation using radium needle (total dosage, 1, 212 mg⋅hrs), followed by a partial glossectomy and an external beam radiation (total dosage, 12OGy) despite two local relapses. A hepatic cellular carcinoma was diagnosed one year before the visit, and was treated with a percutaneous ethanol injection.
Administration of cisplatin and 5-FU was employed as a preoperative therapeutic regimen for the cancer. A tumor excision combined with an ipsilateral upper neck dissection was performed, followed by immediate reconstruction. The postoperative course was uneventful, and the patient was discharged five months after admission. Since then, the patient had received several follow-ups, and he has shown no indication of recurrence. Local relapse and metastasis may be negligible for the pathogenesis because there is a relatively long interval between the tongue and cheek cancers, during which time the primary lesion remains in a fairly stable condition. The site of the cheek cancer was involved in the field of radiation. The cheek cancer was, therefore, believed to be an end-result of radiationinduced carcinogenesis.

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Verrucous carcinoma, a variant form of well-cliff erented squamous cell carcinoma, was first described by Ackerman in 1948. In Japan, 52 cases were reported by Asaumi et al. in 1990.
In this paper, we reported 3 more cases of verrucous carcinoma (buccal mucosa, tongue and lower gum) . Two cases, occurring in buccal mucosa and tongue, were resected, while the other case, occurring in the lower gum was treated by laser cutting and vaporization.
In the case of such a tumor, chemotherapy and radiation therapy is not commonly applied because of the frequent occurrence of anaplastic transformation. In our cases, surgical treatment was selected and local control was possible.

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A case of a cervical subcutaneous mass lesion, clinically diagnosed as a cyst, was studied using some imaging modalities, such as computed tomography (CT), ultrasonography (US), and sialography (SL) . The CT and SL images informed us how the lesion had become enlarged in the major salivary glands and the surrounding tissues. The US images informed us how the internal structures of the lesion had been formed. Therefore, we were suspected that the lesion was extrinsic to the major salivary glands, and that it might be diagnosed as a malignant tumor. Thereafter, a histological diagnosis revealed a squamouscell carcinoma.

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Ameloblastomas are generally located in the molars or premolars of the jaws and in the portion of the ramus, but rarely occur in the anterior portion. We report a case of ameloblastoma which developed in a 33-year-old man, localized in the apex of the mandibular canine. Incidentally the patient's family dentist found an“unexplained radiolucent lesion”at the apex of vital canine, and referred him to our hospital for further evaluation. An X-ray examination disclosed a soybean-sized radiolucency with an irregular border and a honeycomb appearance. The lesion was suspected to be an odontogenic tumor, and was therefore resected. Microscopically, the tumor showed an acanthomatous ameloblastoma characterized by squamous metaplasia in the central zones of the epithelial islands. These findings, suggest that this tumor is a primitive type of ameloblastoma arising from the epithelial rests of Malassez. The patient has received follow-up treatment, and has remained asymptomatic for 7 months.

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