Adenoid cystic carcinoma (ACC) is a rare neoplasm known for its indolent clinical course, risk of perineural invasion, and late onset of distant metastasis. Due to the scarcity of samples and the tumor’s rarity, progress in developing effective treatments has been historically limited. To tackle this issue, a high-throughput screening of epigenetic drugs was conducted to identify compounds capable of disrupting the invasive properties of the tumor and its cancer stem cells (CSCs). ACC cells were screened for changes in tumor viability, chromatin decondensation, Snail inhibition along tumor migration, and disruption of cancer stem cells. Seven compounds showed potential clinical interest, and further validation showed that Scriptaid emerged as a promising candidate for treating ACC invasion. Scriptaid demonstrated a favorable cellular toxicity index, effectively inhibited Snail expression, induced hyperacetylation of histone, reduced cell migration, and effectively disrupted tumorspheres. Additionally, LMK235 displayed encouraging results in four out of five validation assays, further highlighting its potential in combating tumor invasion in ACC. By targeting the invasive properties of the tumor and CSCs, Scriptaid and LMK235 hold promise as potential treatments for ACC, with the potential to improve patient outcomes and pave the way for further research in this critical area.

Aims: To describe a probable oral mucosal injury associated with the off‐label sublingual administration of captopril in a medically complex patient, and to illustrate the role of structured clinical reasoning in identifying route‐related adverse drug reactions, with exploratory insights into AI‐assisted reasoning. Methods and Results: A 77‐year‐old patient presented with persistent burning pain and a progressive oral mucosal lesion on the floor of the mouth. Despite appropriate management of local infectious and mechanical factors, symptoms worsened over time. A consistent temporal relationship was observed between lesion exacerbation and repeated sublingual captopril use during hypertensive episodes. Structured clinical reasoning, including iterative causal analysis, supported identification of a probable route‐related adverse drug reaction. Discontinuation of sublingual captopril, combined with topical corticosteroid therapy, resulted in complete resolution of the lesion. An exploratory interaction with a large language model was conducted to examine how structured clinical input may influence the coherence and clinical relevance of AI‐assisted reasoning. Conclusion: Sublingual administration of captopril may cause localized chemical injury to the oral mucosa, particularly in vulnerable patients with complex medical conditions. Recognition of route‐specific adverse effects is essential to avoid unnecessary interventions and improve patient outcomes. This case also illustrates that AI‐assisted reasoning is highly dependent on the structure and quality of clinical input, supporting its role as a complementary cognitive tool rather than an autonomous diagnostic system.

Oral vascular malformations (VMs) are low blood flow vascular anomalies that present therapeutic challenges, often requiring minimally invasive approaches. This study aims to evaluate, through a comprehensive literature review, the clinical effectiveness of sclerotherapy and FDIP in managing VMs in the oral cavity, particularly regarding lesion volume reduction and symptomatic relief. This narrative review examined the clinical outcomes of sclerotherapy and forced dehydration with induced photocoagulation (FDIP) in the treatment of oral VMs. A total of ten studies published between 2014 and 2024, encompassing 2,120 patients, were included. The lower lip, tongue, and buccal mucosa were the most affected sites. Monoethanolamine oleate (5%) and polidocanol, particularly in foam form, were the most effective agents, yielding high rates of lesion regression with low complication rates. Pingyangmycin/Bleomycin showed promising results, especially in combination with electrochemical therapy, while sodium tetradecyl sulfate demonstrated lower efficacy but favorable safety. FDIP emerged as an effective alternative, though its broader use is limited by cost. The findings support sclerotherapy as a first-line, safe, and effective treatment for low-flow oral vascular malformations.