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Presented by William Westra, M.D. and prepared by Amy Duffield, M.D., Ph.D.
Case 6: 65 year-old man with mandible resection for recurrent squamous cell carcinoma of the oral cavity.
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Week 361: Case 6
65 year-old man with mandible resection for recurrent squamous cell carcinoma of the oral cavityimages/8_11_08 6A.jpg
images/8_11_08 6B.jpg
images/8_11_08 6C.jpg
images/8_11_08 6D.jpg
images/8_11_08 6E.jpgCorrect
Answer: Juxtaoral organ of Chievitz
Histology: There is a lobulated collection of solid epithelial nests within a fibrotic stroma. Within the nests, the cells have pink swirling cytoplasm imparting a squamoid appearance. Rare ductal formations are also noted. A few of the nests involve small nerves.
Discussion: The dreaded juxtaoral Organ of Chievitz is believed to be a vestigial epithelial remnant. It consistently occurs along the medial aspect of the mandible along its angle. Its purpose has not been clearly defined, but it may serve some mechanosensory function. There importance to pathologists has to do with there resemblance to invasive squamous cell carcinoma of the oral cavity. The nests of JOC have a distinctly squamoid appearance, and they are intimately associated with small nerves. Awareness of these histologic curiosities is important as they are sometimes incidentally encountered during frozen sections evaluation for margin status of oral cancer resections. Unlike invasive squamous carcinoma, they do not show cytologic atypia.
Incorrect
Answer: Juxtaoral organ of Chievitz
Histology: There is a lobulated collection of solid epithelial nests within a fibrotic stroma. Within the nests, the cells have pink swirling cytoplasm imparting a squamoid appearance. Rare ductal formations are also noted. A few of the nests involve small nerves.
Discussion: The dreaded juxtaoral Organ of Chievitz is believed to be a vestigial epithelial remnant. It consistently occurs along the medial aspect of the mandible along its angle. Its purpose has not been clearly defined, but it may serve some mechanosensory function. There importance to pathologists has to do with there resemblance to invasive squamous cell carcinoma of the oral cavity. The nests of JOC have a distinctly squamoid appearance, and they are intimately associated with small nerves. Awareness of these histologic curiosities is important as they are sometimes incidentally encountered during frozen sections evaluation for margin status of oral cancer resections. Unlike invasive squamous carcinoma, they do not show cytologic atypia.