Chapter 10 lecture 3 Flashcards
What is a chronic progressive scarring high-risk precancerous condition of the oral mucosa known as?
-Oral submucous fibrosis
What is oral submucous fibrosis linked to?
-Chronic placement of betel quid or paan
What ethnicity of people will you mostly find oral submucous fibrosis?
-India
What are the ingredients of quid?
- Areca nut
- Slaked lime
- Betel leaf
- Tobacco
- Sweeteners
What is the first chief complaint of a person with oral submucous fibrosis?
- Trismus
- Mucosal pain from eating spicy foods
What are the most commonly affected sights with oral submucous fibrosis?
- Buccal mucosa
- Retromolar areas
- Soft palate
If you stop using the betel quid or paan will the lesion regress?
-No
What is the risk of getting oral cancer when someone has oral submucous fibrosis?
-10%
What is nicotine stomatitis?
-White keratotic change on the palate
Is nicotine stomatitis premalignant?
-No
If you do reverse smoking what does that increase your chance for oral cancer?
-Yes significantly
T/F Nicotine stomatitis is completely reversible
True
-Returns to normal within 2 weeks of cessation
If they reverse smoke is it called nicotine stomatitis?
-No it is called reverse smokers palate (demands a biopsy)
What is a common cutaneous premalignant lesions caused by cumulative UV radiation known as?
-Actinic Keratosis
What does actinic keratosis appear as?
-Scaly, irregular plaques
What percent of actinic keratosis turn in to SCCA in 2 years?
-10%
What are the most common places to see actinic keratosis?
-Scalp
What is a common premalignant alteration of the lower lip vermilion resulting from long-term exposure to UV light?
-Actinic Cheilosis
If you have loss of definition of the vermillion border with crusting or white changes what should you be thinking?
-Actinic Cheilosis
What is the cause of oral Squamous cell carcinoma?
-Multifactorial
Do pipe and cigar smoking or cigarette smoking carry a greater oral cancer risk?
-Pipe and cigar smoking
If a person has SCC caused by iron deficiency what are the syndromes known as?
-Plummer-Vison
What can iron deficiency SCC produce?
-Esophageal webs
What is the most common site of the intraoral SCCA?
-Tongue
Where are the most common sites of intral oral SCCA?
1- Tongue
2- FOM
3-Soft palate
4-Gingiva
SCCA metastatic spread is largely done how?
-Lymphatics
How do nodes that have SCCA present?
- Firm
- Painless
- Enlarged
- Fixed
Distant metastasis below the clavicles is found where?
- Lungs
- Liver
- Bones
How is the staging of cancer determined?
- TNM system
- T = size of primary local tumor in centimeters
- N = Involvement of local lymph nodes
- M = Distant metastasis
T/F Clinical staging is a better prognostic indicator than histologic grading
True
How is lip carcinoma typically treated?
-Wedge resection with excellent results
What guides the treatment for intraoral carcinoma?
-Clinical stage guides
Between the lip and the oral cavity of SCCA what has a better survival rate?
-Lip
T/F Patients with one carcinoma of the mouth or throat are at an increased risk for an additional SCCA
True
If a person has a SCCA and then another carcinoma happens concurrently what is that known as?
-Synchronous
If a person had a SCCA and then develops another carcinoma at a different time what is that known as?
-Metachronous
What is field cancerization?
-Tendency toward development of multiple mucosal cancers
What is Snuff dippers cancer known as?
-Verrucous carcinoma
What are the most common sites of involvement of Verrucous carcinoma?
- Mandibular vestibule
- Gingiva
What is a low grade variant of oral SCC?
-Verrucous carcinoma (looks like cauliflower)
Who gets verrucous carcinoma?
-Smokeless tobacco users
What percent of verrucous carcinoma can have a SCCA developing within its borders?
20%
What refers to a group of malignancies that arise from the lining epithelium of the nospharynx?
-Nasopharyngeal carcinoma
What ethnicity is most likely to get nospharyngeal carcinoma?
-Chinese
What are possible contributory factors with nasopharyngeal carcinoma?
- EBV virus
- Vitamin C deficiency
- Consumption of salt fish with N-nitrosamines
What is the first sign in pats with nasopharyngeal carcinoma?
-Cervical lymph node metastasis
What is the most common of all cancers?
-Basal cell carcinoma
What are other clinicopathologic basal cell carcinomas?
- Pigmented
- Sclerosing
- Superficial
What is a malignant neoplasm of melanocytic origin known as?
-Melanoma
What type of skin cancer accounts for the most deaths?
-Melaonma
What are the two growth patterns of melonma?
- Radical (spreads laterally - flat)
- Vertical
What does basal cell carcinoma result from?
-UV radiation
What is the most common form of basal cell carcinoma?
-Noduloulcerative
What type of blood vessels are seen in noduloulcerative basal cell carcinoma?
-Telangieactatic
What is Mohs micrographic surgery?
-Frozen sections to evaluate margins during surgery
T/F Damage from UV radiation is a major causative factor of Melanoma
True
What raises addition risk factors for melanoma?
- Fair complexion
- Light hair
- Tendency to sunburn easily
- History of blistering sunburns in childhood
- Personal history of melanoma
- Personal history of dysplastic or congenital nevus
What type of skin cancer accounts for the most deaths?
-Melaonma
What is the ABCDE system to distinguish melanoma from a nevus?
- Asymmetry
- Border irregularity
- Color variation
- Diameter greater than 6 mm
- Evolving lesions
An invasion of how far in oral melanoma has a poor prognosis?
-0.5 mm
What areas have the worst prognosis with melanoma?
- Interscapular area of the back
- Posterior upper arm
- Posterior and lateral neck
- Scalp
List the malignant transformation from most potential to least?
- Proliferative veruccous leukoplakia
- Nicotine stomatitis in reverse smokers
- Erythroplakia
- Oral submucous fibrosis
- Erythroleukoplakia
- Granular leukoplakia
- Actinic cheilosis
