Lec 5: Oral Cancer and Precursor Lesions Flashcards
Oral cancer and precursor lesions- premalignant?
Leukoplakia Proliferative verrucous leukoplakia Tobacco pouch keratosis Oral submucous fibrosis Actinic cheilitis Erythroplakia
Oral cancer and precursor lesions- malignant?
Squamous cell carcinoma
Verrucous carcinoma
Basal cell carcionoma
Diagnosis of exclusion:
“what it isn’t, rather than what it is”
Proliferative verrucous leukoplakia:
frequent in gingiva, starts as typical leukoplakia but exhibits progressive growth, and eventually transforms into cancer
Microscopic features of Leukoplakia are
Microscopic features of hyperkeratosis, epithelial dysplasia, carcinoma-in-situ, and squamous cell carcinoma
Hyperkeratosis (focal keratosis) shows
Increased thickness of keratin layer.
Note uniform maturation of squamous cells.
Epithelial dysplasia shows:
variation in size, shape & staining of nuclei.
Epithelial dysplasia showing pleomorphism:
variation in size, shape and staining of nuclei
mild–>moderate–>severe dysplasia shows
increasing severity of hyperchromatism and crowding
PROLIFERATIVE VERRUCOUS LEUKOPLAKIA is a? characterized by? significantly increased tendency to? Requires?
A special high-risk form of leukoplakia
Characterized by multiple white plaques with rough, warty surface projections
Significantly increased tendency to develop into squamous cell carcinoma
Requires close patient follow-up
Smokeless tobacco keratosis main concern
Gingival recession
Smokeless tobacco keratosis has a risk for?
cancer
Smokeless tobacco also associated with
caries, gingival recession and halitosis. Possibly also related to periodontal bone loss.
Most common chief complaint is trismus describes what disease?
Oral submucous fibrosis
95% of oral cancer is?
Squamous cell carcinoma
The prognosis of oral squamous cell carcinoma has a 5-year survival rate for oral cancer
that is relatively low
People without risk factors can and do develop oral cancer–true or false?
true
HPV is linked to? role in oral cancer?
oropharyngeal cancer; still unclear
Intra-oral locations for oral cancer?
50% tongue
35% floor of mouth
Most oral squamous cell carcinoma arises from _________ precursor lesionsd
clinically visible
Evolution from precursor lesion to invasive cancer is often a __________
slow process
Most oral cancers are ___________ if detected early in development
preventable or curable
IF A SINGLE ULCER SHOWS NO SIGN OF HEALING 14 DAYS AFTER THE PUTATIVE CAUSE IS REMOVED, IT SHOULD BE CONSIDERED?
MALIGNANT UNTIL PROVEN OTHERWISE
VERRUCOUS CARCINOMA-grade of malignancy?
low-grade malignancy
BASAL CELL CARCINOMA aka
rodent tumor
Does BBC occur in the mouth?
No
BCC clinical findings?
Smooth, raised, shiny or translucent border with telangectasias
Depressed center, often ulcerated
Very infiltrative and destructive, but rarely metastasizes
Shiny translucent surface with blood vessels describes?
Basal Cell Carcinoma
Squamous Cell Carcinoma vs. Basal Cell Carcinoma
BASAL CELL CARCINOMA
Above the lip-tragus line
Chronic sun exposure
SQUAMOUS CELL CARCINOMA
Below lip-tragus line
Acute sun damage (sunburn)
Oral cancer is often preceded by
premalignant lesions
Mild, Moderate, Severe dysplasia do we excise?
Only moderate and severe do we excise.
What type of leukoplakia has high propensity to turn into cancer?
Proliferative Verrucous Leukoplakia
Greater risk for malignancy leukoplakia or erythroplakia?
Erythroplakia
*Think red–Stop!
1 Cancer originating in mouth?
Squamous Cell Carcinoma
Malignant Potential Order
Proliferative Verrucous Leukoplakia (6) > Nicotine palatinus in reverse smokers (5) >Erythroplakia (5) > Erythroleukoplakia (4)> Smooth thick leukoplakia (2) > Smokless tobacco keratosis (1) > Lichen Planus> Smooth, thin leukoplakia
What carcinoma does not occur in the oral cavity/mouth?
Basal Cell Carcinoma
