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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Case report
Full Version
Myoepithelioma of Right Buccal Mucosa: A Rare Case Report
Correspondence Address :
Amita Aditya,
Department of Oral Medicine and Radiology, Dr. D. Y. Patil Dental College and Hospital, Sant Tukaram Nagar, Pimpri, Pune-411018, Maharashtra, India.
E-mail: dr.amitaaditya@gmail.com
Myoepithelioma is a rare benign salivary gland tumour that has been reported sporadically. It is most often seen to be associated with the parotid gland, and the involvement of minor salivary glands remains a rarity. Amongst the minor salivary glands, myoepithelioma has been reported to occur most commonly in the palate, most commonly, followed by the tongue and upper lips. Its occurrence in the buccal mucosa is an extremely rare phenomenon and to date, only a few cases have been reported. This is a rare case of myoepithelioma of the minor salivary gland of the right buccal mucosa, adding to the list. Hereby, the authors present a case report of a 40-year-old female who visited with a complaint of tooth decay and an asymptomatic, long-standing tissue growth was noted in the right buccal mucosa. What was initially and provisionally diagnosed as irritational hyperplasia and was turned out to be rare benign tumour, i.e., myoepithelioma, on detailed investigation. It was successfully managed with surgical excision, and no recurrence has been reported to date.
Benign, Immunohistochemistry, Minor salivary gland, Neoplasia, Tumour
A 40-year-old female reported to the Department of Oral Medicine and Radiology with the chief complaint of pain in the upper left back region of her jaw for 4-5 months, related to a reinfection of a root canal-treated tooth. The pain was gradual in onset, intermittent in nature with moderate intensity, lasted for 1-2 minutes, aggravated on eating on the left side, and relieved on its own or sometimes by taking over-the-counter painkillers. She did not have any contributory past medical or family history but had a past dental history of root canal treatment at a private clinic with three of her teeth: two in the upper left back teeth four years ago and one in the upper right back tooth three years ago. She had relatively good oral hygiene and no adverse habits. Extraoral examination did not reveal any abnormality, and lymph nodes were non palpable.
During the intraoral examination, a single soft tissue growth was noted, about which the patient was unconcerned as it was asymptomatic and had been present for 4-5 years. It was seen on the right buccal mucosa, had an ovoid shape, and measured approximately 2×1.5 cm. The growth had a broad base with a soft tissue peduncle, and its location appeared to correspond to the occlusal plane from the right first premolar to the first molar region, mesio-laterally. The colour of the growth was slightly yellowish in the peduncle region and was erythematous near the base, with an area showing petechiae. The surface of the growth superiorly showed indentation, which was due to the opposing teeth (Table/Fig 1).
On palpation, all the inspection findings were confirmed. The growth was non tender, firm in consistency, non pulsatile, non fluctuant, non reducible, and non compressible. Sharp cusps were noted with the maxillary right second premolar and molars. Considering the clinical presentation, a provisional diagnosis of irritational fibroma was given, and benign salivary gland tumour, lipoma, and mucocele were considered as differential diagnosis.
Regarding her chief complaint, a radiologic evaluation was carried out, followed by root canal treatment for the concerned teeth. Also, enameloplasty was done for the sharp cusps of the affected teeth.
An excisional biopsy of the lesion was planned. Haematological investigations performed prior to the procedure did not reveal abnormal findings. The biopsy was performed under local anesthesia, and while excision, the lesion was surprisingly found to be invading deep into the submucosa (Table/Fig 2)a. The excision left a defect, which was filled by bringing in a vascularised buccal fat pad that was sutured in place along with the dressing (Table/Fig 2)b. The excised specimen was sent for histopathological evaluation (Table/Fig 2)c. Considering the unusual features of the lesion during excision, Immunohistochemical (IHC) evaluation was also considered.
The specimen measured approximately 1.7×1.6 cm in dimensions. Histologically, it showed a varied picture with few areas of inflammatory cell infiltration, neoplastic cells, areas showing a ductal pattern of cells, and monomorphic cells. Epithelioid cells were observed displaying a plasmacytoid appearance with a scanty and focally myxoid stroma. It underwent further Immunohistochemistry (IHC) examination, which showed that neoplastic cells tested positive for Cytokeratin, S-100 protein, and C-Kit (Focal) (Table/Fig 3)a-d. These features were suggestive of myoepithelioma of the minor salivary gland with no definite features of malignancy noted. An adequate healing of the excised area was noted in the 14-day follow-up visit (Table/Fig 4). The patient is currently under follow-up, and the lesion has not shown any recurrence in the last seven months.
The term “myoepithelioma” was first introduced by Sheldon in 1943 (1). It accounts for 1-1.5% of all salivary gland neoplasms. It generally affects the parotid gland, with minor salivary glands are involved infrequently involved (2),(3). Among the minor salivary glands, it is generally seen affecting the palatal region, tongue, and upper lips. Till date, there have been few reported cases of myoepithelioma involving the buccal mucosa of the oral cavity, making the present case an extremely rare one. A comparative summary of some of the cases reported has been presented in (Table/Fig 5) (4),(5),(6),(7),(8),(9).
Myoepithelioma originates from epithelial origin and phenotypically resembles smooth muscle. Previously, myoepithelioma was considered an extreme variant of pleomorphic adenoma; however, it has been considered as a separate entity by the World Health Organisation (WHO) since 1991. They can appear any time during the 3rd and 9th decades of life, with a median age of 53 years. Clinically, myoepithelioma typically presents as circumscribed, painless masses. However, in present case, its appearance was unconventional, giving more of a fibrosed look (4),(10)
Given the location of the lesion in the buccal mucosa, it is important to consider other potential lesions in the differential diagnosis. Most commonly these may include fibrous hyperplasia, mucocele, and lipoma. Radiologic imaging modalities, such as Computed Tomography (CT) scans and Magnetic Resonance Imaging (MRI), can be used for investigation purposes to know about the extent, invasion, and spread of lesions if malignancy is suspected. MRI is considered the best imaging modality for evaluating salivary gland tumours, particularly for malignant palatal tumours (1). However, a definitive diagnosis requires tissue histology.
Microscopically, myoepithelioma is composed of neoplastic myoepithelial cells, which under normal conditions are seen surrounding the ducts and acini of the exocrine glands. The cytoarchitecture of myoepithelial plasmacytoid neoplastic cells includes round to ovoid cells with eccentric nuclei and eosinophilic cytoplasm. Various growth patterns and appearances characterise it. Histologic growth patterns may be solid, myxoid (resembling pleomorphic adenoma), reticular, or a combination of these. In addition, neoplastic myoepithelial cells may have different histologic appearances (spindle, plasmacytoid, clear, and epithelioid cells). Epithelioid or clear cells may also be present. Generally no cellular atypia, necrosis, or increased mitotic figures. While a lack of ductal structures is evident, occasionally ductal cells may be present. Architecturally, myoepithelioma displays non myxoid (solid), myxoid (pleomorphic adenoma-like), reticular (canalicular-like), or mixed growth patterns. The tumour is often difficult to diagnose definitively diagnose at the light microscopic level due to its resemblance to pleomorphic adenoma (2),(5),(10). Furthermore, as stated previously, there are varied histological appearances, adding to the diagnostic dilemma (10).
Immunohistochemistry (IHC) staining can aid in reducing the diagnostic challenge (4). Positive immunoreactivity against S-100 protein, calponin, glial fibrillary acidic protein, actin, Cytokeratin (CK) 14, and various cytokeratins (AE/AE3, CAM5.2, and CK7) is a focally sensitive diagnostic tool that helps in diagnosing the exact cell of origin in cases of myoepithelioma. With the cytomorphologic features of tumour cells and IHC characteristics, a definitive diagnosis of benign myoepithelioma can be rendered with much conviction, as done in the present case (2),(4),(11).
Cases are generally reported to be managed effectively by conservatively excision lesions arising in minor salivary glands along with a thin rim of surrounding normal tissue. The prognosis of benign myoepithelioma is good, provided complete surgical excision is complete. Radiation therapy may be considered in cases where surgery is not feasible. Regular follow-up is indicated in cases of myoepithelioma as local recurrence can occur even after many years, and in rare cases it can turn malignant (4),(10).
Myoepithelioma is a rare lesion that poses a diagnostic challenge to clinicians. Like any other rare lesions of the oral cavity, meticulous work-up is required for its efficient diagnosis as well as management, and oral physicians must be cognizant of the same.
Authors would like to thank Excel Diagnostics Centre, Erandwane, Pune for advanced histopathological services.
DOI: 10.7860/JCDR/2024/69561.19567
Date of Submission: Jan 18, 2024
Date of Peer Review: Mar 02, 2024
Date of Acceptance: May 10, 2024
Date of Publishing: Jun 01, 2024
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jan 23, 2024
• Manual Googling: Mar 12, 2024
• iThenticate Software: May 09, 2024 (13%)
ETYMOLOGY: Author Origin
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