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Patho Phys Exam 1 > Oral Cancer Clinical Correlates > Flashcards

Oral Cancer Clinical Correlates Flashcards

1
Q

EPITHELIAL MALIGNANCY (SKIN, MUCOSA, GLANDS) IS TERMED ______

A

Carcinoma

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2
Q

WHEN TISSUES OF MESENCHYMAL ORIGIN BECOME MALIGNANT THEY ARE TERMED ______

A

Sarcomas

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3
Q

% increase in cancer since 70s

A

15%

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4
Q

Incidence of oral cancers (what % of all cancers are oral)

A

2.9%

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5
Q

Oral cancer is more common in who (men or women)

A

16.9 men and 6.2 in women (11.2/100,000 in US)

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6
Q

Squamous cell carcinoma probability if black

A

~Same in latest data

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7
Q

Localized vs metastatic survival rates Vs Regional

A

Metastatic has much worse survival rates than both

Localized > Regional

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8
Q

Prognosis of whites vs blacks

A

African Americans lower prognosis, probably SES

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9
Q

SEER

A

Surveillance Evaluation End Results-Data on cancer

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10
Q

Death rates of black vs white in oral cancer

A

Black higher death rates

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11
Q

THE ORAL CAVITY:

A

THE AREA BOUNDED BY THE LIPS, THE HARD AND SOFT PALATE, THE TONGUE AND THE FLOOR OF THE MOUTH-HIGHLY VASCULAR

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12
Q

What is significant regarding oral cavity metastisis

A

Lymph drainage into oral cavity

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13
Q

Why oral cancer diagnosis is so bad

A

Lymph drainage

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14
Q

Oral cancer and oral pharyngeal cancer? Same?

A

NO! Oral-pharyngeal cancer has much higher survival rates- not as bad

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15
Q

Most common type of oral cancer?

What are the rest?

A

95% cancer cell carcinoma

4% are adenocarcinoma

1% something else

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16
Q

Etiology of SCC

A

Tobacco-smoking is biggest factor

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17
Q

SCC is a _____ driven disease

A

Smoking/tobacco

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18
Q

Other etiology of SCCA

7

A 
 Alcohol
 UV radiation (lower lip)
 Protracted irritation
 Poor oral hygiene
 Betel nut
 Virus- human papilloma types 16,18 and 33
 Tobacco
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19
Q

Betel nut

A

Will cause SCC, wrap in a leaf and suck on it?

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20
Q

HPV virus types that cause SCC

A

16,18,33

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21
Q

_____ times more likely to have a second primary lesion after 5 year survival

A

20x

*Also at risk for other cancers

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22
Q

TNM classification used for

A

wide variety of tumors

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23
Q

Prognosis of TMN

A

always worse for higher stages

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24
Q

For most malignant tumors, stage ____ disease not generally considered curable

A

Stage IV

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25
Q

Tx tumor

A

cannot be assessed

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26
Q

T0 tumor

A

no evidence of primary tumor

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27
Q

Tis

A

Carcinoma in situ-has not penetrated to the CT beneath epithelial tissue

28
Q

T number gets bigger

A

gets worse

29
Q

T4 Tumor **IMPORTANT

A

T4 Tumor invades adjacent structures e.g.,
through cortical bone, into maxillary sinus,
skin, pterygoid muscle, deep muscle of
tongue. (Gingival tumors become T4 quickly)

**T4 not big here, but penetrates into adjacent structures

30
Q

“best T you can get”

31
Q

N means what in TNM

A

Nodes present?

Feel, radiographically?

32
Q

T in TNM means

A

Primary tumor

33
Q

Nx
N0
N1

A

NX Regional lymph nodes cannot be assessed

N0 No regional lymph node metastasis

N1 Metastasis in a single ipsilateral lymph node, 3 cm or less in
greatest dimension

34
Q

N3

A

N3 Metastasis in a lymph node more than 6 cm in greatest dimension

this is the biggest

35
Q

Staging of TNM cancer

0-IV

A 
 Stage 0 (carcinoma in situ)
Stage I Minimal Localized Disease
Stage II More extensive localized disease
Stage III Node positive disease
Stage IV Distant metastatic disease
36
Q

M of TNM

Mx, M0, M1

A

Distant Metastasis (M)
MX Distant metastasis cannot be assessed
M0 No distant metastasis
M1 Distant metastasis

37
Q

T4 lesions include what

A

(Remember T4 lesions include any that erode into bone)

38
Q

For most types of malignancies, Stage ___implies incurable disease.

39
Q

Curative intent curing

A

chemo/radiation

40
Q

Dentist role in oral cancer

A

Diagnose/catch early!

41
Q

Pallative treatment

A

without curative intent, more for comfort

42
Q

Oral cancer visible?

A

Yes, and palpable

43
Q

Squamous cell carcinoma often arises from “______” which appear as

A

pre-malignant

white, red, or white and red lesions.

44
Q

Tumor looks like what

A

a painless, non-healing ulcer

45
Q

Are leukoplakia and erthroplakia diagnostic **KNOW THIS

Describe these

Potential to do what?

A

Leukoplakia and erythroplakia are descriptive terms, not diagnoses

A white plaque or red plaque that cannot be characterized as any other disease. -CANNOT BE WIPED OFF

No uniform histologic appearance

Both can potentially give rise to (or be) oral scca

46
Q

Dysplasia is characterized by four major pathological microscopic changes:

(histological findings of cancer cells)

A

 4.Presence of mitotic figures (an unusual number
of cells which are currently dividing – often
abnormal mitotic figures)
Dysplasia is characterized by four major pathological microscopic changes:
 1.Anisocytosis (cells of unequal size)
 2.Poikilocytosis (abnormally shaped cells)
 3.Hyperchromatism (excessive pigmentation)

*NOT on his section by had with Maloney

47
Q

Diffuse leukoplakia lateral border tongue

A

invasive s.c.c.

48
Q

ERYTHROPLAKIA

A

A RED LESION, VELVETY, OFTEN GRANULAR, CIRCUMSCRIBED AREAS THAT MAY OR MAY NOT BE RAISED WITH POORLY DEFINED BOUNDARIES.

HISTOLOGICALLY, ERYTHROPLAKIA ALMOST ALWAYS REVEALS MARKED DYSPLASIA

49
Q

Verrucous carcinoma maxillary ridge

A

Wart like, not as bad

50
Q

Erythroplakia % transformation to SCC

A

50% **KNOW THIS

51
Q

Leukoplakia or erythroplakia worse?

A

Erythro-transform to SCC 50%

52
Q

ERYTHROPLAKIA:

A

“SPECKLED” LESIONS (MIXED RED AND WHITE) BEHAVE LIKE ERYTHROPLAKIA

53
Q

MINOR GLANDS ______ PROGNOSIS THAN MAJOR GLANDS

54
Q

Melanomas

Appearance? Might look like?

A

Pigmented, hard to distinguish.

Melanotic macule, amalgam tatoo

55
Q

Melanotic macule

A

freckle in the mouth

56
Q

Melanomas spread through

57
Q

Why do you not cut across pigmented lesions

A

Melanomas-spread through blood

58
Q

Frequency of oral sarcomas, scca and salivary tumors, metastatic tumors to the jaws

A

ORAL SARCOMA (AND OTHER SARCOMAS) MUCH LESS COMMON THAN SCCA OR SALIVARY TUMORS.

ALSO LESS COMMON THAN METASTATIC TUMORS TO THE JAWS.

59
Q

Metastasis to the jaw indicates

A

Metastasis to the jaw indicates stage IV disease, very poor prognosis

60
Q

Tumors most commonly metastasize from where to the mouth

A

Lung, Breast, Colon, Kidney

61
Q

Brush-biopsy of mouth

Can you diagnose cancer with it?

A

take scraping and -not very telling

NO

62
Q

Remove more or less teeth in cancer patients

63
Q

Remove more or less teeth in cancer patients

64
Q

Clinical diagnostic aids

A

Do not replace biopsies

65
Q

Clinical practice for biopsing lesions

A

Best clinical practice is to not biopsy lesions that

are strongly suspicious for cancer – refer it to the treating surgeon untouched

Patho Phys Exam 1 (14 decks)

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