Oral Cancer

Question 1

Name the four Potentially premalignant oral epithelial lesions

Answer 1

Oral Lichen planus
- erosive OLP
- Oral lichenoid lesions
Leukoplakia
Erythroplakias
Actinic cheilitis/keratosis

Question 2

6 main points when describing suspicious lesions

Answer 2

• Location
• Size (length, width)
• Colour (homogenous, non-homogenous)
• Outline
• Fixed or mobile
• Texture (smooth/rough, hard/rubbery, flat/raised, dome-shaped, ulcerated etc.)

Question 3

What is Oral lichen planus?

Answer 3

Chronic inflammatory autoimmune mucocutaneous condition affecting the stratified squamous epithelium

Question 4

What is the presentation of OLP?

Answer 4

White patches on gums, tongue, buccal mucosa

Maybe associated with burning/stinging in the mouth, more often when eating/drinking

Question 5

What is leukoplakia?

Answer 5

White patches within the lateral border of the tongue or Floor of Mouth

Question 6

What are the two subtypes of Leukplakia?

Answer 6

Homogenous
- asymptomatic, thin, flat and smooth
Non-homogenous
- speckled (erythroplakia), nodular or verrucous

Question 7

What are erythroplakias?

Answer 7

• Fiery red patches,
• with a velvety surface,
• irregular outline,
• most often occurring in the soft palate

Question 8

What is actinic keratosis?

Answer 8

• can affect ears, nose, lips, face, scalp or forehead
• sun-induced change (Too much UV light)
• White lesions, with crusting, flaking and dryness

Question 9

What are some signs/symptoms of oral cancer?

Answer 9

Ulcers which don’t heal
White or red patches on the inside of mouth
Unexplained loose teeth
Unexplained persistent lump on inside of mouth
Mouth pain
Ear pain
Dysphagia
Unexplained persistent lumps in the lymph glands of the neck

Question 10

What are the NICAN Guidelines for urgent referral for Oral Cancer?

Answer 10

• Unexplained lump in the neck or recently changing lump
• Unexplained ulceration of the oral mucosa persisting for > 3 weeks
• Unexplained tooth mobility lasting > 3 weeks
• Unexplained red/ white patched of the oral mucosa which are painful or swollen or bleeding
• Monitor confirmed OLP for oral cancer