Chapter 14 - Oral Cavity - Part 2 Flashcards
What are two types of oral proliferative lesions?
fibroma
Pyrogenic granuloma
Where do fibroma MC occur?
buccal mucosa along the bite line
These are a submucosa modular fibrous tissue mass .
fibroma
How do fibroma’s occur?
Chronic irritation
The chronic irritation (in fibroma’s) lead to what?
Reactive connective tissue hyperplasia (modular mass)/fibrosis
This is a vascular mass on the gingiva.
Pyogenic granuloma
Is the pyrogenic granuloma benign or CA?
benign
What color is the pyrogenic granuloma? (Why?)
Red/purple
richly vascular
What population does this occur most commonly in?
Pregnant women (and children)
Pyogenic granuloma aka
Pregnancy tumor
Is a pyogenic granuloma slow or fast growing?
Rapid growth
What is the treatment for pyogenic granuloma?
remove irritant or excision
A dense proliferation of immature vessels similar to that seen in granulation tissue describes:
Pyogenic granuloma
A raised white patch that can’t be scraped off:
leukoplakia
Leukoplakia affects what percentage of the population?
3%
Who is affected more by leukoplakia and what age group?
Males (2x’s)
40-70 years old
5-25% of leukoplakia are what?
premalignant/precancerous
What type of CA can leukoplakia develop into?
Squamous cell carcinoma
What is the most common risk factor for leukoplakia and erythroplakia?
Tobacco use
What causes the white patch in leukoplakia?
dysplasia, epithelial hyperplasia and keratosis
What is the difference between leukoplakia and oral candidiasis?
Oral candidiasis can be scraped off, leukoplakia CANNOT be scraped off.
What are 3 leukoplakia-like conditions?
Erythroplakia
Hairy leukoplakia
verrucous leukoplakia
What percentage of erythroplakia lead to CA?
50%!
What does erythroplakia look like?
Red, velvety area with irregular borders
What is the risk for erythroplakia?
Tobacco use
What causes hairy leukoplakia?
EBV (Epstein Barr virus) + immunosuppression (AIDS)
EBV also causes?
mono
What causes verrucous leukoplakia?
HPV infection
What does verrucous leukoplakia look like?
Warty appearance
Verrucous leukoplakia, the cells are doing what?
hyperkeratosis
Verrucous leukoplakia commonly progresses to what?
Squamous cell carcinoma
Oral cavity cancers are most likely in men or women?
men
Oral cancer develops from dysplasia caused by mutations of what?
TP53 mutations
What is the treatment of oral cancer?
excision
95% or all oral cancer is what kind?
Squamous cell carcinoma
Are single or multiple tumors seen in oral cancer?
Multiple primary tumors
What is the prognosis for oral cancer?
Poor
What is the survival rate for oral cancer?
What can improve the prognosis for oral cancer?
Early detection
What are the risks for oral cancer?
Alcohol, tobacco, >30 years (usually 40’s/50’s) old, HPV -16
SCC lesions usually resemble what?
leukoplakia (whitish-gray) or erythematous
What are the 5 locations for SCC?
- Central (inferior) tongue
- Floor of mouth
- Lower lip
- Soft palate
- Gingiva
SCC has _____ borders and possible ______.
Irregular,
ulceration
The lesions of SCC are _____ plaque and ____.
Raised
firm
SCC is a local invasion followed by metastasis to what areas?
Cervical nodes
mediastinal nodes
Lungs
liver
What is the most common site of metastasis for SCC?
Cervical nodes
SCC is most commonly associated with which virus?
HPV 16 (and 18)
If the SCC is HPV-associated does it have a more favorable prognosis? If so, why?
Yes
Due to fewer mutations
What are the HPV-associated SCC anatomic sites of origin?
Base of tongue
tonsillar crypts
(harder to see)
