Oral Cancer Flashcards
1
Q
Premalignant 6
A
- Leukoplakia
- Proliferative verrucous leukoplakia
- Tobacco pouch keratosis
- Oral submucous fibrosis
- Actinic chelitis
- Erythroplakia
2
Q
Malignant 3
A
- Squamous cell carcinoma
- Verrucous carcinoma
- Basal cell carcinoma
3
Q
Leukoplakia
Definition
A
- White patch
- Cant be characterized clinically or pathologically as any other disease
- Term is strictly clinical, does not imply a specific tissue change
- Diagnosis of exclusion what it isnt rather than what is it
4
Q
Leukoplakia
Habits
Age
A
- 80% smokers
- May ressolve after cessation
- Alcohol synergistic effect with tobacco
- No assoc with leukoplakia
- Affects ppl over 40
5
Q
Leukoplakia
Distribution
% of cancer in certain areas
A
- Affects 40 or older
- Most on
- Tongue
- Vermillion
- Buccal mucosa
- Gingiva
- Those on the vermilion, tongue, floor of mouth
- 90% dysplasia or cancer
- Lesions may have varied apperance and change over time
6
Q
Microscopic Diagnosis of leukoplakia could be 5
A
- Hyperkeratosis= benign callous (most are this)
- Dysplasia= abnormal growth/cells
- can regress or progress
- Carcinoma in situ
- Cancer within epithelium
- Will progress to invasive carcinoma
- Superficially invasive carcinoma
- Squamous cell carcinoma
7
Q
Proliferative Verrucous Leukoplakia
Risk
Apperance
Risk
Requires
A
- High risk form, progressive growth–> Cancer
- Characterized by multiple white plaques with rough warty surface projections
- Multiple plaques tend to grow slowly
- Significantly increased tendency to develop into squamous cell carcinoma
- Requires close pt follow up
8
Q
Smokeless Tobacco Keratiosis
App
Risk
A
- Gingival recession w/ no bone loss
- Gray white translucent plaque border blends
- No link to cancer
9
Q
Oral Submucous Fibrosis
Cause
Apperance
Dist
Tx
Risk
A
- Chronic progressive high risk precancerous
- Betel quid or paan
- App
- Brown red color mucosa
- Palor (pale) and fibrosis (excess fibrous CT)
- Biccal mucosa, retromolar pad and soft palate
- Trismus
- Does not regress with cessation
- Surgery and meds can help improve fibrosis
- Pts 19X more likely to develop cancer
10
Q
Erythroplakia
App
Age
Dist
Risk
A
- Red patch that cannot be clinically/micro diagnosed
- Middle aged to older alduts
- App
- Red Well-demarcated macule/plaque with velvety texture
- Dist
- Floor of mouth lateral/ventral tongue, soft palate
- Multifocal and recurrence common
- Greater potential for malignancy
- 90% show severe dysplasia, carcinoma in situ or frankly invasive cancer
11
Q
Actinic Chelitis
Due to
Population
App
A
- Common premalignant change of lower lip
- Due to long term UV light
- Rare in ppl younger than 45
- Common in males
- App
- Atrophy of vermillion border
- Smooth surface paleness
- Rough scaly areas
- Leukoplakia appears
- Multifocal ulcers
12
Q
Most common oral cancer
Pop
Prognosis survival rate
A
95% Squamous cell carcinoma
M: F 3:1
Prognosis 5 yr survival rate is low, 58%
13
Q
Why poop prognosis for SCC
A
Many cases are advanced when diagnosed
14
Q
Advanced SCC app
A
- Indurated tumor mass
- Ulceration or bleeding
- Pain
- Cervical lymph node enlargement
15
Q
Early SCC
Arise from
Growth
A
- Arise from clinically visible precursor lesion
- Evolution to cancer is slow
- Most are preventable and curable
18
Q
Verrucous Carcinoma
App
Risk
A
- White rough warty surface
- Low grade malignancy
- Slow growing
