Oral Cancer Flashcards
what is oral sub mucous fibrosis
chronic, progressive oral potentially malignant disorder associated with betel quid/ Areca nut
how does oral sub mucous fibrosis present clinically
pale coloured mucosa, firm to palpate
what is epithelial dysplasia
cytological epithelial changes resulting from accumulation of genetic alterations, usually arising in a range of oral potentially malignant disorders and indicating a risk of malignant transformation to squamous cell carcinoma
epithelial dysplasia grading
mild
moderate
severe
differential feature of dysplasia compared with oral squamous cell carcinoma
in dysplasia the atypical cells are confined to the surface epithelium
management of epithelial dysplasia
modify risk factors
anti fungal tx
excision
what percentage of oral cancers are squamous cell carcinoma
over 90%
does oral cancer have a screening programme
no
risk factors for oral cancer
tobacco
alcohol
betel quid
previous oral cancer
UV light exposure
poor diet
immune suppression
oral potential malignant disorders
High risk sites for oral cancer
lateral/ventral tongue
floor of mouth
retromolar trigone
signs and symptoms of oral cancer
lumps
ulcers
white patches
red patches
speckled patches
non healing socket
tooth mobility - not perio
induration of mucosa
dysphagia
pain/ paraesthesia
bleeding
additional detection tests
toluene blue
autofluorescence
referral guidelines for suspected cancer
persistent and unexplained head and neck lump > 3 weeks
unexplained ulcer or swelling/ induration > 3 weeks
red or mixed red and white patch > 3 weeks
persistent hoarseness > 3 weeks
persistent pain in throat > 3 weeks
when should an appointment be made for suspected oral cancer - time like how many weeks
an appointment in 2 weeks
how is diagnosis of oral squamous cell carcinoma confirmed
biopsy
how is squamous cell carcinoma graded
by degree of differentiation
tx for oral cancer
surgery
+/- adjuvant therapy
monoclonal antibodies
classification of malignant tumours
TNM staging
TNM components
T - extent of primary tumour
N - regional lymph node metastasis
M - distant metasis
the higher the number the more extensive or less extensive the diseae
the higher the number the more extensive the disease
core data items included in pathology report
maximum dimension of tumour
tumour type
tumour grade
depth of invasion
pattern of invasive front
bone invasion
perineurial invasion
lymph-vascular invasion
core data items for neck dissection specimens
total number of lymph nodes at each anatomical level
number of nodes involved in metastatic carcinoma
size of largest metastatic deposits
extra capsular spread
pathological staging
