Immunohistochemical studies to detect keratins were performed on basal cell carcinoma of the skin (n=9), using monoclonal antibodies to keratins-KL1, K8.12, K4, K7, K8, K10, K13, K17, K18 and K19-employing immunohistochemical techniques. Differential expression of keratins in basal cell carcinoma and tumor of skin, hair follicle, sebaceous gland and sweat gland were evaluated.
Basal cells in skin epidermis and hair follicle showed positive immunostaining for MoAb K8.12, and spinous cells and follicular epithelial cells were positive for MoAb KL1, K8.12, K10 and K17. Tumor cells of basal cell carcinoma expressed K8.12 and K17, but other keratins remained unstained. The pattern of expression of keratins using those MoAbs in basal cell carcinoma showed different expression for keratin in squamous cell carcinoma of oral mucosa.

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Ten oral multiple cancer cases were used in the present clinical and histological in-vestigation. The 1st and 2nd tumors were observed simultaneously in 2 cases, and the remaining 8 cases of 2nd tumors occurred 11 months to 8 years and 11 months after treatment of each first tumor. Except in 3 cases, both 1st and 2nd tumors were associated with leukoplakia, erythroplakia and lichen planes. Eight and 9 cases of the 1st and 2nd tumors, respectively, were in the early T stage (T1 and T2), and they were almost well differentiated and nonsporadic in the tumor cell invasion, however, tumor cells in the 2nd tumors were slightly sporadic. In 4 patients with the 1st tumor positive for mutant type p53 protein, the 2nd tumors were also positive for this antigen. Seven cases of the 1st tumors expressed both PCNA and EGF-R, and 8 and 7 cases of the 2nd tumors were positive for PCNA and EGF-R, respectively. Both 1st and 2nd tumors were controlled finally without metastasis, however, local recurrence occurred in 2 cases each. These results indicate that oral multiple cancer is highly associated with precancerous lesions and condition, that the tumor cells possess ordinary growing activity in spite of low malignancy, and that oral tumor associating with precancerous lesion is preferable to be removed widely but not deeply.

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A clinical study on 62 patients with oral squamous cell carcinoma (oral SCC), who were older than 65 years treated in our clinic from 1988 to 1993, was carried out to review the management and outcome of oral SCC in geriatric patients.
1) The 62 patients in this study ranged in age from 65 to 89 years, with the mean age of 72 years. The male : female ratio was 1.7 : 1; 39 were men and 23 were women. Of the 62 patients, 11 patients were older than 80 years (11/62, 18 %) .
2) Slightly more than half the patients visited our clinic within 3 months after the time of an awareness of subjective symptoms.
3) The most frequent chief complaint was pain.
4) The patient distribution by tumor location was as follows : tongue ; 19/62 patients (31%), upper gum ; 10/62 patients (16%), floor of the mouth and oropharynx ; 8/62 patients (13%) respectively, lower gum and buccal mucosa ; 7/62 patients (11%) respectively, and lip ; 3/62 patients (5%) .
5) According to the UICC staging system (1987), comparatively numerous patients with stage III, N were found (32/62, 52%) .
6) All patients had other illnesses : cardiovasucular diseases ; 38 patients, digestive diseases ; 24 patients, pulmonary diseases ; 22 patients, metabolic diseases ; 11 patients, hemato-logic diseases ; 6 patients, renal diseases ; 3 patients.
7) Of the 62 patients, 10 patients underwent palliative therapy and 52 patients were radically treated. Forty-eight of 52 patients, who underwent radical therapy, had surgical removal. The 5-year cumulative survival rate was 57 % for all patients and 67% for patients who underwent radical therapy.

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In order to evaluate the clinical efficacy of granisetron as an antiemetic agent for the prevention of nausea and vomiting induced by carboplatin (CBDCA), a multi-center study has been conducted.
Thirty cases of patients with oral cancer were selected for this study from six hospitals, and to each patient 3 mg/body of granisetron was given intravenously immediately before CBDCA administration (200-350mg/m²) . The incidence and severity of nausea and vomiting were observed for a period of 5 days after administration of CBDCA.
Nausea occurred in 8 out of 30 patients, occurring slightly in 5 patients only on the first day as well as continuing in 3 patients for two or three days.
Only one patient complained of moderate nausea on the third day. Vomiting was observed in only one patient who vomited three times on the third day and once on the fourth day. This was the same patient who complained of moderate nausea.
In this study. 73.3% of patients were free from nausea and 96.7 % were free from vomiting. Concerning the efficacy of granisetron in this study, granisetron was considered to be “remarkably effective” in 96.7 % of patients and it was considered to be “effective” in 3.3 % of patients.

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An extremely rare case of acinic cell carcinoma derived from the mucous membrane of lower lip is reported. A 72-year-old woman consulted a physician for a big pedunculated mass (60×40×40mm) in the left lower lip, with bleeding and respiratory disturbance. The patient was referred to our clinic for detailed examination and treatment by a physician.
Radiological examination and initial biopsy were performed. The diagnosis was suspected malignant tumor and its metastasis. Tumorectomy and total neck dissection were performed for malignant tumor. Estlander's flap was used for repairment in defect of the lip. On the basis of histological findings of surgical specimens including primary tumor and lymph nodes of submental and submandibular regions, acinic cell carcinoma and its metastasis were confirmed. Intercalated duct-like cells were identified in the electron micrographs of the tumor cells, and intercalated duct-like cells were regarded as the histogenesis of tumor cells. The patient demonstrated no recurrence and functional disturbance for 51 months after operation.

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Malignant lymphoma is malignant lesion derived from the basic cells of lymphoid tissue and consists of Hodgkin lymphoma and non-Hodgkin lymphoma. This lesion primarily occurs in lymphnode or extra lymphnode tissue.
This is a report of a case of a 63-year-old woman that underwent surgery for malignant lymphoma, which was diagnosed in the right upper arm, 3 years ago underwent extirpation of a right buccal mucosa tumor histologically diagnosed as non-Hodgkin lymphoma (diffuse medium cell, B cell) . Since chemotherapy, she has had no relapse.
Since experiencing recrudescense towards extra tissue due to extra tissue of malignant lymphoma, numerous suggestion have been reported as well.

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A case of periapical cemental dysplasia of the mandible, which was histopathologically suspected of plasmacytoma, is reported.
The patient was a 45-year-old woman, who visited our clinic with a complaint of swelling of the left lower molar gingiva. On radiographic examination, radio-opaque lesions associated with 67, 8765 and 7 were observed. Extirpation of the lesion of 67 area was carried out with a tentative diagnosis of periapical cemental dysplasia. Histologically, the extirpated specimen consisted of a cement-like hard mass and soft tissue containing many plasmacytic cells, and a pathological diagnosis of plasmacytoma was made. A marginal resection of the left posterior mandible was performed, and pathological examination revealed no evidence of plasmacytoma. The postoperative course has been uneventful without recurrence.

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Three cases of radiation-induced cancer in oral cavity were reported in relation to radiation therapy.
Case 1: The patient was a 73-year-old woman. She underwent radiation therapy (50Gy) and right mandibular resection for rabdomyosarcoma of the right mandible 17 years previously. She had a tumor measuring 25×9mm at the left premolar lesion which was diagnosed as squamous cell carcinoma.
Case 2: The patient was a 25-year-old man. He underwent radiotherapy for squamous cell carcinoma of the left tongue 27 years previously. He visited our hospital with a complaint of pain in the right mandible, and the tumor was 35×20mm at the right molar lesion and was diagnosed as squamous cell carcinoma.
Case 3 : The patient was a 72-year-old man. He underwent radiotherapy for squamous cell carcinoma of the oral floor 17 years previously. At the first examination, a tumor was revealed, measuring 33×20mm, on the anterior part of the mandible. It was diagnosed as squamous cell carinoma.
Case 1 (A-1 group), Case 2 (A-2 group), and Case 3 (B-1 group of Sakai's diagnostic criteria for radiation induced cancer), occurred after radiotherapy for malignant tumors.

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