case_images: PMC10687798_01
case_images: A - intraoral photograph revealing ulceroproliferative lesion on right pterygomandibular raphe; B - orthopantogram without soft tissue or bony changes.
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case_images: PMC10687798_01_autopsy-13-e2023450-g01.jpg
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case_images: An ulceroproliferative lesion was seen intraorally on the right pterygomandibular raphe, which was indurated, tender on palpation, and covered with necrotic slough (Figure 1A). On radiographic examination, orthopantomogram detected no soft tissue or bony changes (Figure 1B).
case_images: Photomicrographs of the biopsy. A - photomicrograph reveals dysplastic islands showing acantholytic cells (H&E, 20X); B - dysplastic islands showing clear cell change (H&E, 20X); C - acantholytic and clear cell change (H&E, 20X); D - tumor showing PAS-negative pseudoglandular appearance (20X).
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case_images: PMC10687798_01_autopsy-13-e2023450-g02.jpg
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case_images: The atypical islands' center had dyscohesive cells with hyperchromatic nuclei and eosinophilic cytoplasm (Figure 2A). Within these islands, there was also clear cell change (Figure 2B, 2C). The PAS stain- indicated that these formations were non-glandular and lacked mucinous components (Figure 2D).
case_images: Photomicrographs of the biopsy. Immunohistochemical reactions results for Acantholytic squamous cell carcinoma. A - positive reaction for p40 (10X); B - weak reaction for E-cadherin in acantholytic cells (20X); C and D - high index of Ki67 (4X and 20X respectively).
case_images: autopsy-13-e2023450-g03.jpg
case_images: PMC10687798_01_autopsy-13-e2023450-g03.jpg
case_images: gf03
case_images: The acantholytic cells within the tumor islands showed a robust expression of p40, a high Ki-67 index, and loss of E-cadherin (Figure 3A, 3B, 3C and 3D).