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AU18: Oral Path 2 > Malignancies Of Surface Epithelium > Flashcards

Malignancies Of Surface Epithelium Flashcards

1
Q

T/F: Neoplasms may be benign or malignant.

A

True

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2
Q

T/F: Basal cell carcinoma is the most common skin cancer.

A

True

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3
Q

T/F: The majority of basal cell carcinomas are found on the head/neck.

A

True

80%

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4
Q

What is the most common location on the head/neck to get basal cell carcinoma?

A

Middle 1/3 of face (includes ears)

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5
Q

What is the most common BCC?

A

Nodulo-ulcerative BCC

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6
Q

What is the least common BCC?

A

Sclerosing BCC

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7
Q

What are the clinical features of nodulo-ulcerative BCC?

A
  • Firm, painless papule
  • slow enlargement
  • central depression (umbilication) with rolled borders
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8
Q

What is a rodent ulcer?

A

Nodule-ulcerative BCC that enlarges and destroys tissue

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9
Q

What is the major histopathological feature of nodulo-ulcerative BCC?

A

Uniform, dark staining basaloid cells that appear to “drop off” from the surface epithelium

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10
Q

Which type of BCC most resembles a nevus?

A

Pigmented BCC

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11
Q

What gives pigmented BCC the pigment?

A

Colonization by benign melanocytes

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12
Q

T/F: Sclerosing BCC is the most aggressive form of BCC.

A

True

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13
Q

What is the major clinical feature of sclerosing BCC?

A

Tissue resembles scar tissue and is more firm than surrounding skin

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14
Q

What differentiates sclerosing BCC from other BCC hisotopathologically?

A

Sclerosing BCC presents with tiny infiltrative nests of tumor cells

Other BCC have large globules of tumor cells

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15
Q

What is the prognosis for BCC?

A

Generally excellent, over 95% cured with first treatment

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16
Q

What is the most common oral malignancy?

A

Squamous Cell Carcinoma (SCC) - 90% or oral cancer

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17
Q

T/F: SCC can arise from salivary ductal epithelium.

A

True

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18
Q

What are three risk factors for cutaneous SCC?

A
  1. UV exposure
  2. Medical ionizing radiation
  3. Pre-existing actinic keratosis
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19
Q

What percentage of cutaneous SCC are found on the head and neck?

A

70%

20
Q

T/F: Cutaneous SCC will not have keratin on the lesion.

A

False

Could be keratinized (keratin horn) or nonkeratinized

21
Q

What is the prognosis of a cutaneous SCC?

A

Good if identified and treated early

22
Q

T/F: Cutaneous SCC are generally well-differentiated under a microscope.

A

True

23
Q

T/F: SCC of the lip is more common on the upper lip.

A

False

More common on lower lip

24
Q

T/F: SCC of the upper lip has a worse prognosis than the lower lip.

A

True

May metastasize to lymph nodes

25
Q

Oral squamous cell carcinoma is responsible for what percentage of all cancers in U.S.?

A

2%-3%

26
Q

T/F: All OSCC are associated with identifiable risk factors.

A

False

25% have no risk factor

*mostly under 40 years old, and on lateral/ventral tongue

27
Q

T/F: Heredity plays a major role in OSCC etiology.

A

False

28
Q

What percentage of patients diagnosed with OSCC have history of tobacco smoking?

A

80%

29
Q

How many years after cessation of smoking does risk of OSCC decrease to that of a non-smoker?

A

10 years without smoking

30
Q

Which bacteria and viruses can increase risk for OSCC?

A

Tertiary syphilis

HIV, small sub-set of HPV

31
Q

What are some intrinsic risk factors for OSCC?

A
  • male > 50 y.o.
  • malnutrition
  • iron deficiency anemia
  • immunosuppression
32
Q

What are the most common sites for OSCC?

A
  1. Tongue - most common
  2. Floor of mouth - near midline
  3. Gingiva - more women
  4. Soft palate
  5. Labial/buccal mucosa
  6. Hard palate
33
Q

What are the highest risk sites for OSCC?

A

Ventro-lateral tongue, floor of mouth, soft palate

34
Q

T/F: OSCC will always present as exophytic.

A

False

May look exophytic or endophytic or both!

Exophytic - growing out, mass forming
Endophytic - invasive, ulcerating

35
Q

How will OSCC look in a radiograph?

A

Moth-eaten radiolucency; bone invasion is a late feature

36
Q

Invasive cords and nests of malignant epithelial cells arise from dysplastic epithelium in which type of cancer?

A

OSCC

37
Q

What are the three options for treating OSCC?

A

Wide surgical excision, radiation, chemotherapy

38
Q

T/F: Most OSCC present in stage I or II.

A

False

III or IV; poor prognosis

39
Q

What does the TNM staging system stand for?

A

T - tumor size
N - lymph nodes
M - metastasis

40
Q

T/F: Recurrent cancer is always stage III.

A

False

Not staged in TNM

41
Q

What is the biggest cause for new upper aerodigestive tract malignancies after cancer treatment?

A

Continuation of carcinogenic habits

42
Q

T/F: Verrucous carcinoma is a more aggressive form of squamous cell carcinoma.

A

False

Less aggressive

43
Q

Verrucous carcinoma is heavily associated with __________.

A

Dry snuff

44
Q

T/F: Verrucous carcinoma presents with very dysplastic cells.

A

False

Dx based on overall architecture

45
Q

T/F: Prognosis of verrucous carcinoma is generally guarded.

A

False

90% disease free after 5 years

AU18: Oral Path 2 (18 decks)

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