Page 17 - AAOMP Meeting 2019

Monday, June 10 - 10:00 am
A RETROSPECTIVE STUDY OF BUCCAL MUCOSAL SALIVARY NEOPLASMS
Dr. Saja Alramadhan (University of Florida College of Dentistry), Dr. Nadim Islam (University of
Florida College of Dentistry), Dr. Sarah Fitzpatrick (University of Florida College of Dentistry), Dr.
Indraneel Bhattacharyya (University of Florida College of Dentistry), Dr. Donald Cohen (University
of Florida College of Dentistry)
Introduction: Salivary gland neoplasms of the buccal mucosa are relatively rare and often present with an
unusual profile when compared with the same neoplasms seen in more common locations such as the hard
palate and upper lip. We present a series of minor salivary gland neoplasms of the buccal mucosa and discuss
demographics, clinical presentation, and histologic findings. Materials and Methods: With IRB approval,
the archives of the University of Florida Oral Pathology Biopsy Service was retrospectively searched from
1994-2018 and all benign and malignant salivary gland neoplasms of the buccal mucosa were identified.
Age, gender, clinical presentation, diagnosis, and category of neoplasm were recorded. Results: 68 cases
were included. Most patients were female (71.6%). Patient age at presentation ranged from 11 to 93 years
with a mean of 62.8 years. Clinical impression in descending order of frequency included: mucocele,
papilloma, salivary tumor, sialolith, lipoma, fibroma, and sebaceous cyst. Benign neoplasms represented
57.4% of overall cases, while malignant lesions comprised 42.6%. Mucoepidermoid carcinoma was the
most common neoplasm (26/68, 38.2%), followed by monomorphic adenoma) (18/68, 26.5 %), ductal
papilloma (10/68, 14.7%), cystadenoma (9/68, 13.2%), pleomorphic adenoma (2/68, 2.9%), and 1(1.5%)
each for mammary analogue secretory carcinoma, adenoid cystic carcinoma and adenocarcinoma NOS.
Conclusion: Our patient demographics and percentage of benign and malignant buccal mucosal salivary
gland neoplasms aligned with previously published studies. However, benign neoplasms occurring in the
buccal mucosa were more diverse than those found in other minor salivary gland locations. In addition,
lesions in this location are less likely to be recognized as possible salivary gland neoplasms. Both benign
and malignant salivary gland neoplasms should be included in the differential diagnosis of submucosal
buccal masses. Additional large studies with more detailed treatment and outcome data would assist in
further understanding the behavior of these neoplasms.

Monday, June 10 - 10:12 am:
CAMTA 1 AND TFE 3 CONfiRMATION OF ORAL CAVITY EPITHELIOID
HEMANGIOENDOTHELIOMA
Dr. Abdulaziz Banasser (University of Florida College of Dentistry), Dr. Molly Housley Smith
(University of Kentucky), Dr. Donald Cohen (University of Florida College of Dentistry), Dr. Sarah
Fitzpatrick (University of Florida College of Dentistry), Dr. Indraneel Bhattacharyya (University of
Florida College of Dentistry), Dr. Nadim Islam (University of Florida College of Dentistry)
Introduction: Epithelioid hemangioendothelioma (EHE) is an unusual vascular neoplasm of indeterminate
biologic behavior, classified as intermediate between benign and malignant. It may microscopically mimic
other vascular and spindle cell lesions, and definitive diagnosis is paramount owing to its potential for local
recurrence and infiltrative nature. Recently, WWTR1-CAMTA1 (CAMTA1) fusion gene has been described in
EHE allowing for a more definitive diagnosis. Moreover, a subset of cases have also been found to be positive
for YAP1-TFE3 translocation (TFE3) which may be associated with more aggressive behavior. The purpose of
this study is to evaluate archived oral cavity cases of EHE for immunohistochemical expression of CAMTA1
and TFE3, and to confirm the diagnosis and evaluate utility of these markers in diagnosing oral EHE. Materials
and methods: With IRB approval cases diagnosed as EHE were retrieved from the archives of the oral
pathology biopsy services at University of Florida and Kentucky Colleges of Dentistry from 1994-2018. The
slides were reviewed in order to assure diagnostic agreement, and case demographic and diagnostic
information was aggregated. All included cases were submitted for immuno- histochemical (IHC) testing for
both CAMTA1 and TFE3 antibodies. Results: A total of 6 cases were included. The mean age was 35.8 years
(range 14-69). Three of 6 cases were found to affect the gingiva. Other affected sites were mandible (2) and
buccal mucosa (1). All cases had previous IHC demonstrating positive vascular markers. CAMTA1 expression
in all the six cases exhibited diffuse positive nuclear staining. However, positive TFE3 expression was found
in only one case. Conclusion: CAMTA1 appears to be of diagnostic value in confirmation of diagnosis of oral
EHE. However, expression of TFE3 in oral EHE appears to be rare, and since TFE3 positivity may affect
prognosis, additional studies are warranted.