Willie van Heerden

• Head of Department at University of Pretoria

Introduction Ameloblastic fibroma (AF), ameloblastic fibrodentinoma (AFD), and ameloblastic fibro-odontoma (AFO) are rare mixed odontogenic tumors. While some authors propose that some cases may evolve into odontomas, other tumors with aggressive clinical features suggest a neoplastic origin. A subset of AF and AFD/AFO harbor the pathogenic BRAF p....

Purpose This study aimed to investigate the role of DNA ploidy and proliferation index in distinguishing ameloblastoma (AB) from ameloblastic carcinoma (AC). Methods The study included 29 ACs, 6 conventional ABs that transformed into ACs, and a control cohort of 20 conventional ABs. The demographics and clinicopathologic details of the included ca...

Background: The study aimed to assess the radiologic-specific growth rate of ameloblastomas, evaluating potential associations with demographics, radiologic features, histopathologic variants and proliferation indices. The results of this study will hopefully establish if any clinical or histopathologic features can elude fast-growing ameloblastom...

Introduction The current study reviewed the postoperative radiologic findings of 156 cases of ameloblastoma diagnosed at a tertiary institution in South Africa. Methods Histologically diagnosed cases of ameloblastomas between 2012 and 2022 were retrospectively reviewed. Only cases with both pre‐ and postoperative radiographs of diagnostic quality...

A 41-year-old woman presented with a facial asymmetry in the mental region and a painful, well-circumscribed, tender mass in the right lower buccal vestibule, associated with extensive ill-defined bone rarefaction with subtle cortical bone resorption. Microscopically, a proliferation of bland spindle cells interspersed with collagen fibers and prom...

Purpose The current study aimed to investigate the use of surrogate immunohistochemical (IHC) markers of proliferation and stem cells to distinguish ameloblastoma (AB) from ameloblastic carcinoma (AC). Methods The study assessed a total of 29 ACs, 6 ABs that transformed into ACs, and a control cohort of 20 ABs. The demographics and clinicopatholog...

Background The purpose of the current study was to report on the clinical presentation and radiologic features of 155 cases of ameloblastoma (AB), representing a detailed, large, single‐centre radiologic study. Methods Histologically confirmed cases were reviewed over 11 years. Demographic and clinical data were retrieved from the patient's record...

Follicular lymphoma is a hematolymphoid neoplasm that originates from germinal center B cells. It is made up of a combination of small cleaved centrocytes and a varying quantity of larger non-cleaved centroblasts to describe the clinical, microscopic, immunohistochemical, and molecular features of oral follicular lymphomas. Follicular lymphomas aff...

Low-grade myofibroblastic sarcoma (LGMS) represents an atypical tumor composed of myofibroblasts with a variety of histological patterns and with a high tendency to local recurrence and a low probability of distant metastases. LGMS has predilection for the head and neck regions, especially the oral cavity. This study aimed to report 13 new cases of...

Objective: The objective of this systematic review with meta-analysis was to critically evaluate the available data on the association of the BRAF V600E mutation and recurrence rate of ameloblastomas. Materials and methods: This systematic review was registered in Prospero (CRD42020183645) and performed based on the PRISMA statement. A comprehen...

Objective: Salivary gland tumors (SGT) are a diverse group of uncommon neoplasms that are rare in pediatric patients. This study aimed to characterize the clinicopathological profile of pediatric patients affected by SGT from a large case series derived from an international group of academic centers. Study design: A retrospective analysis of pe...

Background: This systematic review aimed to investigate the radiological features of lymphomas and leukaemias affecting the jaws. Methods: A systematic literature review was conducted using the electronic databases of PubMed, Web of Science and Scopus. Articles that contained sufficient radiographic examinations (periapical, panoramic or compute...

Odontogenic keratocysts (OKCs) are common cysts of odontogenic origin that usually occur as a single nonsyndromic cyst in isolation (sporadic) or as syndromic multiple cysts as a manifestation of naevoid basal cell carcinoma syndrome. Alterations involving the PTCH gene are the most commonly identified factor associated with up to 85% and 84% of na...

Background Lymphomas affecting the sublingual glands are extremely rare and very few case reports are currently available. Therefore, the aim of the current study is to describe the clinicopathological features of a series of lymphomas involving the sublingual glands.Methods Cases diagnosed in four pathology services were assessed and the formalin-...

A hamartoma is the proliferation of normal tissues that are considered endogenous to the site of occurrence. Hamartomas are rarely seen in the oral cavity. The aim of this study is to report clinicopathologic features of 8 additional tongue hamartoma cases in pediatric patients. Female patients outnumbered male patients by 1:6, and the age of patie...

Objective : To investigate the clinicopathological features of mantle cell lymphoma (MCL) involving the oral and maxillofacial region. Methods : MCL cases were retrieved from the pathology database of six pathology laboratories. Original H&E slides and immunohistochemical reactions were reviewed for confirmation of the initial diagnosis. Clinical...

Background Keratoameloblastoma (KA) is an uncommon and controversial variant of ameloblastoma exhibiting central keratinisation. Due to their rarity, there is limited information in the literature on their clinical, radiologic and histologic features. This study adds seven additional cases of KA to the literature, and reviews the current published...

This study reports nine additional tongue hamartomas in children paired with a literature review. A retrospective analysis was performed from three Oral Pathology laboratories. Additionally, a literature review was conducted through 5 electronic databases and gray literature. A total of 9 cases were identified in the retrospective analysis. Females...

Objectives The aim of the current study was to analyse the demographic, clinical and radiological features of primary aneurysmal bone cysts (ABCs) involving the maxillofacial region. Methods Histologically confirmed cases affecting the maxillofacial region were retrospectively reviewed over a 21 year period (2000–2021). Cases were collected from t...

Oral squamous cell carcinoma (OSCC) commonly affects older patients; however, several studies have documented an increase in its incidence among younger patients. Therefore, it is important to investigate if this trend is also found in different geographic regions. The pathology files of diagnostic and therapeutic institutions from different parts...

Background Salivary gland tumours (SGT) are a relatively rare group of neoplasms with a wide range of histopathological appearance and clinical features. To date, most of the epidemiological studies on salivary gland tumours are limited for a variety of reason including being out of date, extrapolated from either a single centre or country studies,...

Objective: The purpose of the current study was to report on the clinical presentation and radiological features of 72 cases of oral and maxillofacial plasmablastic lymphomas (PBL). Methods: Histologically confirmed cases of PBL were retrospectively reviewed over a 10-year period. Demographic and clinical data were retrieved from the patient's r...

Mucoepidermoid carcinoma (MEC) is one of the most common primary salivary gland malignancies in both children and adults. MECs containing calcifications are rare, but well described in the literature. In contrast, there are only two case reports of MECs showing intra-tumoral bone formation. MECs associated with calcifications occur more frequently...

Abstract Good communication between clinicians and pathologists is a vital element in the diagnostic process, and poor communication can adversely affect patient care. There is a lack of research about communication in diagnostic oral and maxillofacial pathology. This narrative review explores different aspects of the quality of communication betwe...

Primary mixed neuroendocrine-nonneuroendocrine neoplasm (MiNEN) of the head and neck region is a rare biphasic tumor with an aggressive biological behavior. This report highlights an additional case of oropharyngeal MiNEN in a 46-year-old male patient with a previous long-term smoking history. Histologic evaluation revealed a biphasic tumor infiltr...

Objective This systematic review aimed to identify the molecular alterations of head and neck rhabdomyosarcomas (HNRMS) and their prognostic values. Methods An electronic search was performed using PubMed, Embase, Scopus, and Web of Science with a designed search strategy. Inclusion criteria comprised cases of primary HNRMS with an established his...

Objective : The purpose of this multicenter retrospective study was to report the clinical and radiological features of 92 glandular odontogenic cysts (GOCs) diagnosed over a 20-year period. Study Design : Histologically confirmed cases of GOC were retrospectively reviewed from four Oral Pathology laboratories in South Africa and Brazil to categor...

Immunosuppressed patients may be affected by a wide range of lymphoproliferative disorders (LPDs) ranging from self-limiting disorders to malignant lymphoid proliferations. These LPDs may be associated with systemic immune disorders, develop following organ transplantation or occur in the background of other forms of iatrogenic immunosuppression. L...

Mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumour in both adults and children. His-tological grading of MEC is subjective, but plays an important role in predicting patient prognosis. Epithelial mucin (MUC) status may aid in establishing a more accurate grade. This study aimed to investigate the expression of various...

Background Plasmablastic lymphoma (PBL) is an aggressive neoplasm that commonly develops in HIV-positive patients, usually affecting the oral cavity. EBV is present in the majority of cases, therefore playing an important role in the pathogenesis of this neoplasm. Methods PBL diagnosed from 2000 to 2020 were retrieved from the archives of the Depa...

Background Burkitt lymphoma (BL) is an aggressive B-cell lymphoma with three variants (endemic, sporadic, and immunodeficiency-associated), presenting with specific epidemiological and clinical features. Burkitt lymphoma affects the head and neck region (BLHN) in approximately 10% of cases. The aim of this study was to undertake a comparative analy...

Background: Although uncommon, mature small B-cell lymphomas may arise in the oral/maxillofacial area and oral pathologists must be aware of the key characteristics of these neoplasms to perform an accurate diagnosis. In this manuscript, we attempted to integrate the currently available data on the clinicopathological features of follicular lympho...

Ameloblastoma is a locally aggressive, benign epithelial odontogenic neoplasm currently classified to include conventional, unicystic and extraosseous/peripheral subtypes. Giant cells have been reported in various malignancies, but rarely in odontogenic neoplasms. To date, only a single case of unicystic ameloblastoma with stromal giant cells has b...

Sublingual dermoid cysts and oral heterotopic gastrointestinal cysts are well-documented causes of sublingual swellings in infants. However, the simultaneous occurrence of both cysts is an extremely rare phenomenon, with only two previous cases reported in literature. We present a case of 1-month-old neonate with a cystic ventral tongue mass that o...

Objective Calcifying odontogenic cysts (COCs) exhibit diverse clinical behaviours, and may be associated with other benign odontogenic tumours. In this study, the clinical and radiological features of COCs were analysed according to subtypes based on the classification by Praetorius et al. Emphasis was placed on cases exhibiting atypical or aggress...

Epithelioid vascular tumours include benign epithelioid haemangioma and epithelioid angiomatous nodule, low grade malignant epithelioid haemangioendothelioma and high grade epithelioid angiosarcoma. These tumours share epithelioid cell morphologies and intracytoplasmic vacuoles, with distinction based on differing architectural and nuclear features...

A 53-year-old female patient presented with a two-week history of intermittently painful oral mucosal lesions when eating spicy, salty or sour foods. The patient reported a long-term history of psoriasis treated by topical corticosteroids only. The remainder of the patient's medical history was unremarkable. On intraoral examination, lesions were n...

During oral pathology daily practice, true amyloid may be identified in oral amyloidosis and several odontogenic tumors. However, histological examination often reveals other oral and perioral diseases with similar eosinophilic, acellular, amorphous substances. These include extensive areas of collagenous sclerosis, fibrin deposition, elastic fiber...

Ossifying fibromyxoid tumor (OFMT) is a rare mesenchymal soft tissue benign neoplasm with an uncertain line of differentiation, which arises most frequently in extremities. The head and neck region involvement is uncommon, with only ten intraoral cases published in the English-language literature. One additional case of OFMT is reported here, inclu...

A 33-year-old female patient presented at a private specialist practice (Periodontics and Oral Medicine) with a main complaint of sore and bleeding gums, fever, headaches and sinus pain. The gingiva became irritated, red and swollen five weeks prior to the first consultation in July 2018. She was referred by her dentist one month after prescribing...

Ghost cell odontogenic carcinoma (GCOC) is a rare malignant neoplasm, representing 3% of all ghost cell lesions of the jaws. They can arise de novo or from a pre-existing calcifying odontogenic cyst (COC) or dentinogenic ghost cell tumour (DGCT). A systematic review of the literature reported only 12 cases of a GCOC arising from a pre-existing COC....

The aim of this study was to report the clinicopathologic and radiographic features of 80 cases of adenomatoid odontogenic tumor (AOT) from Guatemala, Brazil, and South Africa. Clinical data were collected from records of 4 oral pathology laboratories, and all cases were microscopically reviewed considering the current World Health Organization Cla...

A 12-year-old female patient presented with diffusely enlarged fibrous gingivae, enamel hypoplasia, an anterior open bite and impacted permanent maxillary canines (Figures 1-4). The patient's mother reported that the child had an unremarkable medical history and was currently not taking any medications. Radiographic examination showed features of a...

Adenomatoid odontogenic tumour (AOT) is a benign tumour that arises from odontogenic epithelial remnants. AOTs usually present as innocuous lesions with limited growth potential. Multiple AOTs are frequently reported in the literature, with reports of tumours associated with up to seven impacted teeth. Multiple AOTs have also been described in asso...

Objective The aim of this study was to report the clinicopathologic features of 105 new cases of adenomatoid odontogenic tumor (AOT) from Brazil, Guatemala, Mexico, and South Africa. Study design Clinical and radiographic data were collected from records of five Oral Pathology Laboratories and all cases were microscopically reviewed. Results The...

Objective The aim of this study was to describe the clinicopathologic features of a series of gnathic epithelioid osteoblastomas. As high levels of Proto-oncogene c-Fos proteins resulting from FOS-FOSB translocation were recently demonstrated in osteoblastomas, we also evaluated the immunoexpression of these proteins. Study Design Records of all c...

The lack of clinical biomarkers for head and neck cancer subtypes limits early diagnosis and monitoring of disease progression. This study investigates genetic alterations in clinically identical tumor, tumor-adjacent dysplastic epithelium (TADE) and normal epithelium (NE) in five oral cancer patients to identify differences and commonalities betwe...

Familial cases of benign fibro-osseous lesions of the jaws are rare and have been described under numerous terms including familial gigantiform cementoma, multiple cemento-ossifying fibromas, sclerotic cemental masses and familial florid cemento-osseous dysplasia. The synonymous and interchangeable use of these terms to describe distinct entities w...

The aim of this study was to determine if the distribution of Langerhans cells (LC) and interstitial dendritic cells (IDC) is altered in AIDS-associated oral Kaposi’s sarcoma when compared to HIV-negative highly vascular oral lesions. Fifty-one cases of AIDS-associated oral Kaposi’s sarcoma and 20 of highly vascular oral lesions were retrospectivel...

Fibroblasts are currently identified by exclusion, as no specific fibroblast marker is presently available. Positive identification of these cells therefore remains challenging. The anti-fibroblast antibody, TE-7 clone was proposed as a fibroblast-specific marker. This research aimed to evaluate the application of the anti-human anti-fibroblast TE-7 clone...

Objective: The aim of this study was to determine the proteome of adenoid cystic carcinoma (AdCC) and polymorphous adenocarcinoma (PAc) and to identify a protein signature useful in distinguishing these two neoplasms. Study design: Ten cases of AdCC and 10 cases of PAc were microdissected for enrichment of neoplastic tissue. The samples were sub...

Background The occurrence of oral tongue squamous cell carcinoma (TSCC) in nonsmoking young adults, especially females, has increased. Yet, there is no clear evidence to support the existence of any single determinant. This case reports the presence of TSCC in an 18‐year‐old female with no recognizable risk factor for oral cancer development. Meth...

BACKGROUND: Conditions associated with catabolism of bone are common and progress sub-clinically with devastating skeletal consequences. Over the past two decades, bisphosphonates have become increasingly popular for the preventative management of the skeleton in these conditions METHODS: Recent literature pertaining to the mechanisms of action, cl...

Background Oral field cancerization describes a multifocal development process involving many cells at once in response to prolong exposure to carcinogens. This case demonstrated differential p16 expression in different sections of the same HPV negative tumor on the floor of mouth in a patient with history of prolonged smoking. Methods Histologica...

INTRODUCTION: Biochemical characterisation of the autocrine, paracrine and endocrine mediators of bone remodelling provides a scientific basis for the development of pharmaceuticals and autoantibodies which could induce a desired skeletal phenotype. The manipulation of bone remodelling in patients at risk for skeletal disease is gaining clinical mo...

Background: Primary intestinal-type adenocarcinoma of the tongue is rare. This represents the first reported case of a primary mixed adenoneuroendocrine carcinoma (MANEC) of the tongue arising within a congenital enteric cyst. Methods: A 52-year-old man presented with a midline tongue mass that was connected to the mucosal surface with an epithe...

Human papillomavirus induced cervical cancer is the fourth most prevalent malignancy affecting females globally. Over the past two decades scientific information unveiled an increasing role for the virus in the pathogenesis of malignancies developing from the mucosal surfaces of the oropharynx. It is feasible to postulate that we may be in the begi...

Autocrine, paracrine and endocrine signals regulate the activities of cells involved in skeletal remodelling. Mapping of the metabolic pathways of bone cells and characterization of their chemical mediators have prompted the pharmaceutical industry to develop patented drugs and auto-antibodies which modulate the anabolic and catabolic activities in...

Oral squamous cell carcinoma (OSCC) is a well-documented form of malignancy with established aetiological risk factors that remains a global burden. Trends show an increased incidence in developing countries despite advances in therapeutic management and disease control. The morbidity and mortality associated with OSCC are significant public health...

The incidence of human papilloma virus-induced oropharyngeal carcinoma is steadily rising globally and the observation has become widely publicised in recent times. Human papilloma virus (HPV) is therefore an important infectious oncogenic agent. The aim of this article is to highlight the modes of transmission in HPV-related oral and oropharyngeal...

Objective: The aim of this study was to correlate the clinical, demographic, and radiographic aspects of 82 cases of florid osseous dysplasia (FOD) from four countries assessed by five reviewers. Study design: Retrospective data of patients diagnosed with FOD were obtained from archives of five institutes and analyzed according to clinical and r...

To investigate the expression of CD56 in dog odontogenesis in order to elucidate the expression found in ameloblastomas. Immunohistochemical analysis of CD56 expression of developing dog teeth in the bud, cap and bell stages including the remnants of the dental lamina. Weak CD56 expression was observed in the dental epithelium during the bud stage...

Candida albicans and caries are frequently investigated among healthy and immunosuppressed individuals. The objective of this study was to demonstrate the presence of C. albicans on both oral soft and hard tissue and to investigate, at molecular level, the genetic subtype of the organism from the two oral sites. Tongue swabs and dentine scrapings f...

To present 2 cases of Epstein-Barr virus (EBV)-positive mucocutaneous ulcer of the oral mucosa in association with human immunodeficiency virus infection. Two recently diagnosed cases of EBV-positive mucocutaneous ulcer of the oral mucosa in patients with human immunodeficiency virus (HIV) were reviewed with regard to their clinical, histomorpholog...

Objective. To describe an unusual variant of oral epithelial dysplasia and to provide an appraisal of its immunohistochemical profile. Study Design. An unusual form of epithelial dysplasia, which we have termed adenoid dysplasia, was evaluated for staining of cytokeratins AE1/AE3, vimentin, E-cadherin, and b-catenin. The immunohistochemical results...

The aim of this case study was to describe an international case series of polymorphous low-grade adenocarcinoma (PLGA) affecting the upper lip. Over a 30-year-period, the files of five pathology services were reviewed for PLGA affecting the upper lip. Hematoxylin and eosin-stained slides were reviewed by three oral and maxillofacial pathologists,...

Infants frequently present with oral lesions and conditions that may lead to anxiety among parents. The most common lesions and conditions include natal and neonatal teeth, the different oral mucosal cysts of the newborn, ankyloglossia and congenital epulis of the gingiva. The diagnostic features and management principles of these lesions are discu...

Burning mouth syndrome (BMS) is a chronic condition characterised by a burning sensation of the tongue and other sites, usually without associated clinical or laboratory findings. These patients, mainly postmenopausal women, often present with dry mouth (xerostomia) and taste alterations. BMS may present in an idiopathic (primary) form or in associ...

Many conditions within the oral cavity require the use of a mouthwash. This can vary from breath fresheners to treatment of life threatening secondary infections such as oral mucositis in patients undergoing bone marrow transplant therapy. The use of mouthwashes requires a correct diagnosis of the oral condition and a thorough knowledge of the prod...

Examination of the oral cavity is an integral part of every clinical examination. The clinical presentation of various viral conditions is discussed in this article and will provide the family practitioner with an up to date guide to better diagnosis and management. SA Fam Pract 2006;48(8): 20-24 Introduction Viral infections of the oral mucosa are...

Human papillomavirus (HPV)-associated oropharyngeal cancer (OPC) is on the increase and accounts for 18% to 63% of OPC. It occurs mostly in young males with no other identifiable risk factors. The vast majority of HPV-associated OPC is attributable to HPV16. The prognosis of patients with HPV-positive OPC is better than patients with HPV-negative O...

Oral malodour may affect up to three billion people worldwide, with millions of dollars spent on treatment. Halitosis is often used synonymously, but oral malodour is the preferred term for any bad breath emanating from the mouth. Oral causes account for the majority of bad breath cases. It is the objective of this article to review the causes, cla...

Objective To describe an unusual variant of oral epithelial dysplasia and to provide an appraisal of its immunohistochemical profile. Study design An unusual form of epithelial dysplasia which we have termed adenoid dysplasia (AD) was evaluated for staining of AE1/AE3, vimentin, E-cadherin and ß-catenin. The immunohistochemical results were compar...

Speciality training in oral and maxillofacial pathology (OMFP) across the world would be aided by guidance on a generic curriculum and training programme that all countries could use as a template. In order to facilitate this, we require an understanding of the various forms which OMFP training takes across the world. We sent a questionnaire to OMF...

Kaposi sarcoma is the most common HIV-associated neoplasm, frequently presenting with oral mucosal involvement. This retrospective study aimed to assess and highlight the histomorphological spectrum of oral Kaposi sarcoma. A total of 135 cases diagnosed between 1990 and 2011 were retrieved from the archives of the Oral and Dental Hospital of the Un...

The National Cancer Registry (NCR) of South Africa publishes the pathology-based cancer incidence in the country and is the main cancer data source. The data published by the NCR have been used extensively in the development of the draft national guidelines for cancer prevention and control as well as for cancer research. The list of contributing p...

HPV-related oropharyngeal carcinoma (OPC) is a clinically and molecularly distinct form of squamous cell carcinoma (SCC) which has recently shown a dramatc increase in global incidence. The aetiology, clinical presentation and overall prognosis differ from conventional tobacco and alcohol related SCC of the oral cavity. OPC is seen in a subset of y...

Patients with HIV/AIDS are at increased risk for the development of malignancy. Kaposi's sarcoma, non-Hodgkin's lymphoma and cervical carcinoma in women are regarded as AIDS-defining malignancies. The spectrum of malignancy is, however, changing, particularly where patients receive highly active antiretroviral therapy (HAART). South Africa has the...