Expression of the proliferating cell nuclear antigen (PCNA) was examined immunohistologically in 33 head and neck squamous cell carcinomas and its relationship with cancer progression, histological malignancy and prognosis was also examined. The results were as follows:
1. PCNA immunoreactivity significantly correlated with tumor size and lymph node metastasis.
2. PCNA immunoreactivity significantly correlated with histological malignancy according to the Anneroth classification, especially in the degree of nuclear polymorphism, the mode of invasion and the depth of invasion.
3. Concerning the prognosis, survival rate was significantly worse in cases with high PCNA immunoreactivity than in those with low PCNA immunoreactivity. From the above findings, expression of proliferating cell nuclear antigen (PCNA) revealed a correspondence to clinical and pathological findings, suggesting that PCNA may be useful information to grasp malignancy and the presumption of prognosis in head and neck squamous cell carcinoma.

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Growth activity of cancer cells in oral squamous cell carcinoma plays a key role in the biological behavior of tumor tissue. Immunohistochemical examination of proliferating cell nuclear antigen (PCNA) is thought to be a simple method to investigate proliferating activity of tumor cells. We studied the expression of PCNA in oral squamous cell carcinoma with special attention to histological (mode of invasion, differentiation) and clinical findings (TNM classification, clinical stage) . The cases with grade 4C and 4D (mode of invasion) tended to show a high level of PCNA-positive cells. In addition, well differentiated cases reveled a low level of PCNA-positive cells. No apparent relationship between the ratio of PCNA-positive cells and clinical findings was detected.
Immunohistochemical study for PCNA can demonstrate the proliferating activity of oral squamous cell carcinomas, especially in the degree of malignancy.

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We experienced an advanced case of oral undifferentiated carcinoma which was widely spread from lower lip to the entire region of lower gingiva and floor of mouth. The patient was a 50-year-old male who complained of gingival retraction and pain at lower frontal teeth. There were no abnormal findings in panoramic tomograph and CT, however, Tc-99m MDP accumulation was observed at the mandible in bone scintigraphy and Ga-67 accumulation at the region of both side of cervical lymph nodes in Ga-67 scintigraphy. Histopathological examination showed an undifferentiated carcinoma. The patient was successfully treated by concomitant chemo-radiotherapy (PEP : 120mg, ⁶⁰Co : 49.9 Gy), and the shape and function of the mouth was completely preserved. There have been no recurrences at least 1 year and 6 months after treatment.

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A case was reported of metastatic adenocarcinoma of the submandibular lymph node, in a 69 year old woman who was first treated for a maxillary gingival squamous cell carcinoma through partial resection of the upper jaw. After three months, swelling of the lymph node was observed on the same, right side as the maxillary gingival cancer, and an excisional biopsy was performed, revealing a metastatic adenocarcinoma. Extensive investigative procedures could not establish the cancer's primary site. A submandibular gland origin was suspected, and there for a radical neck dissection on the right side, and a submandibular neck dissection on the left side were performed, but did not reveal any cellular malignancy in either submandibular gland. After a further three months, a chest X-ray showed multiple opacities in the lungs, and a biopsy from the lung revealed a poorly differentiated adenocarcinoma. A similar tumor was also found in the stomach mucosa. The pathological findings were similar for the submandibular lymph node, lung, and stomach carcinomas. One year after the inception of her condition, the patient died. Diagnosis of the primary site of the adenocarcinoma of the submandibular lymph node was difficult until examination of the cancer in the patient's lungs confirmed those as the origin. It was established that the adenocarcinoma of the lung was a double cancer synchronous with S. C. C. of the maxillary gingiva.

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Neurilemmoma may be found in all parts of the body, however, the occurrence in the oral region is very rare and reports of Neurilemmoma of the oral floor are few. In this report, we discussed a case of Neurilemmoma in the oral floor which we experienced clinically.
A-74-year-old female was referred to our clinic with the chief complaint of a painless swelling of the oral floor. In the preoperative diagnosis, MRI and ultrasonography were very useful, especially ultrasonography provided much information concerning clinical and pathological behavior of the tumor. The removal of the tumor was performed by intraoral surgical procedure under general anesthesia. Histopathological diagnosis was Neurilemmoma (Antoni-type B) .
The clinical course of the patient was uneventful without evidence of recurrence after surgery.

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Tongue cancer patients with distant metastasis detected at the initial medical examination are rare. A case of tongue cancer in an elder patient suspected of metastasis to the hilus of the lung is reported.
An 84-year-old man was referred to our department with a chief complaint of pain in the left part of the tongue on swallowing. Clinical diagnosis was malignant tumor in the left portion of the tongue (T3N0M1) .
Chemotherapy and radiotherapy for primary tumor and lung metastasis were carried out. The size of the primary tumor was reduced by 65 %, and it was recognized that the treatments were also effective against the lung metastasis. However, fibrosis of lung developed. Thereafter, severe spontaneous pain in the tongue and necrosis of the tumor appeared. Therefore, partial resection of the tongue was performed under general anesthesia. Two months after surgery, the patient died of liver dysfunction.

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