Malignancies Of Surface Epithelium Flashcards
T/F: Neoplasms may be benign or malignant.
True
T/F: Basal cell carcinoma is the most common skin cancer.
True
T/F: The majority of basal cell carcinomas are found on the head/neck.
True
80%
What is the most common location on the head/neck to get basal cell carcinoma?
Middle 1/3 of face (includes ears)
What is the most common BCC?
Nodulo-ulcerative BCC
What is the least common BCC?
Sclerosing BCC
What are the clinical features of nodulo-ulcerative BCC?
- Firm, painless papule
- slow enlargement
- central depression (umbilication) with rolled borders
What is a rodent ulcer?
Nodule-ulcerative BCC that enlarges and destroys tissue
What is the major histopathological feature of nodulo-ulcerative BCC?
Uniform, dark staining basaloid cells that appear to “drop off” from the surface epithelium
Which type of BCC most resembles a nevus?
Pigmented BCC
What gives pigmented BCC the pigment?
Colonization by benign melanocytes
T/F: Sclerosing BCC is the most aggressive form of BCC.
True
What is the major clinical feature of sclerosing BCC?
Tissue resembles scar tissue and is more firm than surrounding skin
What differentiates sclerosing BCC from other BCC hisotopathologically?
Sclerosing BCC presents with tiny infiltrative nests of tumor cells
Other BCC have large globules of tumor cells
What is the prognosis for BCC?
Generally excellent, over 95% cured with first treatment
What is the most common oral malignancy?
Squamous Cell Carcinoma (SCC) - 90% or oral cancer
T/F: SCC can arise from salivary ductal epithelium.
True
What are three risk factors for cutaneous SCC?
- UV exposure
- Medical ionizing radiation
- Pre-existing actinic keratosis
What percentage of cutaneous SCC are found on the head and neck?
70%
T/F: Cutaneous SCC will not have keratin on the lesion.
False
Could be keratinized (keratin horn) or nonkeratinized
What is the prognosis of a cutaneous SCC?
Good if identified and treated early
T/F: Cutaneous SCC are generally well-differentiated under a microscope.
True
T/F: SCC of the lip is more common on the upper lip.
False
More common on lower lip
T/F: SCC of the upper lip has a worse prognosis than the lower lip.
True
May metastasize to lymph nodes
Oral squamous cell carcinoma is responsible for what percentage of all cancers in U.S.?
2%-3%
T/F: All OSCC are associated with identifiable risk factors.
False
25% have no risk factor
*mostly under 40 years old, and on lateral/ventral tongue
T/F: Heredity plays a major role in OSCC etiology.
False
What percentage of patients diagnosed with OSCC have history of tobacco smoking?
80%
How many years after cessation of smoking does risk of OSCC decrease to that of a non-smoker?
10 years without smoking
Which bacteria and viruses can increase risk for OSCC?
Tertiary syphilis
HIV, small sub-set of HPV
What are some intrinsic risk factors for OSCC?
- male > 50 y.o.
- malnutrition
- iron deficiency anemia
- immunosuppression
What are the most common sites for OSCC?
- Tongue - most common
- Floor of mouth - near midline
- Gingiva - more women
- Soft palate
- Labial/buccal mucosa
- Hard palate
What are the highest risk sites for OSCC?
Ventro-lateral tongue, floor of mouth, soft palate
T/F: OSCC will always present as exophytic.
False
May look exophytic or endophytic or both!
Exophytic - growing out, mass forming
Endophytic - invasive, ulcerating
How will OSCC look in a radiograph?
Moth-eaten radiolucency; bone invasion is a late feature
Invasive cords and nests of malignant epithelial cells arise from dysplastic epithelium in which type of cancer?
OSCC
What are the three options for treating OSCC?
Wide surgical excision, radiation, chemotherapy
T/F: Most OSCC present in stage I or II.
False
III or IV; poor prognosis
What does the TNM staging system stand for?
T - tumor size
N - lymph nodes
M - metastasis
T/F: Recurrent cancer is always stage III.
False
Not staged in TNM
What is the biggest cause for new upper aerodigestive tract malignancies after cancer treatment?
Continuation of carcinogenic habits
T/F: Verrucous carcinoma is a more aggressive form of squamous cell carcinoma.
False
Less aggressive
Verrucous carcinoma is heavily associated with __________.
Dry snuff
T/F: Verrucous carcinoma presents with very dysplastic cells.
False
Dx based on overall architecture
T/F: Prognosis of verrucous carcinoma is generally guarded.
False
90% disease free after 5 years
