9.2 Benign, premalignant and malignant tumours of relavence to dentistry Flashcards
How have mouth cancer rates increased over the past decae?
Increase in cases by over 30%
Why do dentists play an important role in mouth cancer?
- We see asymptomatic patients (check-ups) and are ideally placed to detect head and neck cancers at early stages
- Dentists may be involved in the treatment of tumours in the head and neck, and treating patients with cancers at other sites
- Restorative dentists may be involved in treating the dentition of mouth cancer pts
- See patients over a period of years so can identify changes over time
What are the oral consequences of radio and chemo therapy?
- Damage to salivary glands and salivary flow, xerostomia and increased caries risk
- Risk of osteo-radionecrosis of the jaws
What is the most common oral malignancy?
Oral squamous cell carcinoma.
What is the difference between reactive vs neoplastic cell proliferations?
Reactive = response to a stimulus, lesion regresses when stimulus is removed
Neoplastic = proliferation of cells which is autonomous and persists after the initiating stimulus has been removed, can be benign or malignant.
What is the difference between hyperplasia and hypertrophy?
Hyperplasia = increase in number of cells
Hypertrophy = increase in size of cells
Name some reactive oral mucosal lesions.
- Fibro-epithelial polyps
- Fibrous epulis
- Denture-induced granuloma
- Pulp polyp
- Pyogenic granuloma
- Peripheral giant cell granuolma (giant cell epulis)
- Traumatic ulcer
Name some neoplastic benign tumours of the oral cavity.
- Squamous cell papilloma
- Fibroma
- Haemangioma
- Lymphangioma
- Neurofibroma
- Neurilemmoma
- Pleomorphic adenoma
- Lipoma
- Adenoma
- Osteoma
- Ossifying fibroma
Name some neoplastic malignant tumours of the oral cavity.
- SCC
- BCC (most common, rarely metastasise)
- Malignant melanoma
- Fibrosarcoma
- Liposarcoma
- Malignant lymphoma
- Minor salivary gland adenocarcinomas
- Osteosarcoma
- Range of malignant salivary gland tumours
Which sites are most commonly affected by SCC?
- Larynx, oral cavity and paranasal sinuses
- Frequently metastasise to the lymph nodes of the neck with a poor long term survival rate
What is the 5 year survival rate for adults with mouth cancer in England?
56%
Where is mouth cancer most commonly located?
- Tongue
- Tonsils and oropharynx
- Floor of mouth (under tongue)
What is the average size of oral cancer tumour at presentation?
3-4cm
Large! Late tumour, likely to have metastasised to lymph nodes of the neck.
What is the association between social class and mouth cancer?
- Oral cancer 3 times more common in lowest social class vs highest
- Poorer 5 year survival for those more deprived
Where is oral SCC usually found?
- Lower lip (sun exposure)
- Lateral margin of tongue
- Ventral surface of tongue
- Floor of mouth
- Lingual sulcus
- Retromolar area/fauces
75-80% of oral carcinomas occur at these sites.
Describe salivary gland tumours.
- Relatively uncommon
- Major glands = 80-85%
- Minor glands = 15-20%
- Parotid gland most common, followed by submandibular, sublingual rare
- Minor glands: palate (55%), upper lip (20%), lower lip rare
