PMC4756081_01
Squamous cell carcinoma in the oral mucosa of the mandible.. Nest of atypical keratinizing squamous cells arising from the mucosal epithelium (left side) infiltrate the deeper layers. The center of the nests show formation of horn pearls.
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In May 2014, a 'commando' procedure was performed for the cT2 N1M0 squamous cell carcinoma (see Fig. 1), consisting of a tracheotomy, bilateral elective (supraomohyoidal) neck dissection, segmental mandibular resection (on the median side of the foramen mentalis) and en-bloc resection of the primary tumor (with resection margins of 1 cm).
Tumor localized in a lymph node from the neck dissection.. The lymph node (cell rich tissue at the right side) contains a papillary/follicular tumor (left side) in which the cells have intra nuclear inclusions giving them the appearance of so called "orphan Annie eyes". This and the "psammoma body" (purple laminated dot on the left) indicate a metastasis from a papillary carcinoma of the thyroid.
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Lymph nodes were negative for squamous cell carcinoma but three lymph nodes (level II and III on the left side of the neck) were found positive for papillary thyroid gland carcinoma (see Fig. 2).
Thyroidectomy with left sided follicular variant of papillary carcinoma.. Tumor fields (black arrows) infiltrate the muscular tissue (arrow heads) surrounding the thyroid, indicating malignancy.
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The histological examination of the thyroid lesion was a follicular variant of a papillary thyroid carcinoma (see Fig. 3).