J Korean Assoc Oral Maxillofac Surg 2010; 36(3): 172~176
Epithelial-mesenchymal transition in osteogenic sarcoma of the neck following oral squamous cell carcinoma
Hyun Sil Kim1, Nam Hee Kim1, Seon Hui Han1, In Ho Cha2, Dong Jun Seo2, Wonse Park3, Jong In Yook1, Hyung Jun Kim2
© Korean Association of Oral and Maxillofacial Surgeons. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Postirradiation extraosseous osteogenic sarcomas are uncommon in the head and neck, despite the extensive use of high-dose radiation. It has been
described as de novo radiation-induced neoplasm. We present a 73-year-old male who had been treated by radiotherapy for gingival cancer 7 years
earlier and later developed extraosseous osteogenic sarcomas (EOSs) of the neck. Microscopically, the neck mass was composed with mesenchymal
malignant cells with cartilaginous and osteogenic differentiation. Immunohistochemical stain demonstrated strong positivity of tumor cells for Snail,
the one of major epithelial-mesenchymal transition (EMT) inducer. The E-cadherin expression was scarce, showing inverse relationship to Snail
expression. Compared with previous squamous cell carcinoma (SCC) of the gingiva, the present EOS sample revealed the remained epithelial cells on
cytokeratin immunohistochemistry, suggesting the tumor arise from the cells of epithelial origin. We have also reviewed the previous 6 cases of head
and neck EOSs carefully. The clinicopathologic features of the unusual lesion suggest that it is an incomplete EMT of precedent epithelial malignancy
rather than de novo pathology.
Keywords: Squamous cell carcinoma (SCC), Extraosseous osteogenic sarcoma (EOS), Epithelial-mesenchymal transition (EMT), Snail, E-cadherin, Mouth neoplasms

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