Pre-malignant conditions and lesions Flashcards
What is Oral Submucous Fibrosis?
Who is it most prevalent in?
Fibrosis of oral mucosa and difficulty opening mouth
Paan, betel chewers
At what age is leukoplakia most prevalent?
Middle aged (increasing prevalanece with age)
Define pre-malignant lesion
Morphologically altered tissue in which cancer is more likely to occur than in its normal counterpart
What type of pre-malignant oral condition is linked to syphillis?
Leukoplakias on central dorsum of tongue (rare)
What is the most common cause of leukoplakia?
Tobacco use (90%)
Other 10% idiopathic (spontaneous)
What are fordyce spots?
Enlarged, slightly raised sebaceous (oil) glands that appear in hairless areas of your skin
Purely anatomical no issues
What clinical feature relating to the colour of a luekoplakia lesion is suggestive of an increased risk of malignant transformation?
Increased if red / white (speckled)
What are common sites of leukoplakia?
Buccal mucosa (25%)
Mandibular gingivae (20%)
Tongue (10%)
FoM (10%)
How should you manage a patient that has lichen planus?
What would you do if the lesion develops the following; increased whiteness, speckling (red & white) or solitary ulceration?
Pt should be kept under regular review by GDP
Further specialist opinion & possible biopsy
What two things are needed for a leukoplakia diagnosis?
Leukoplakia diagnosis can only be made after careful clinical examination & biopsy (of area including both normal & affected tissue)
What advice should you give to patients with oral lichen planus?
Should be advised of controversial malignant potential
Avoid tobacco & alcohol
Have diet rich in Vit A, C & E / anti-oxidants
Maintain good OH
Which sex is more affected by leukoplakia?
Male > Female
What is White sponge nevus?
Benign devolmental white spot lesions in oral mucosa
Confirmed by biopsy
As benign no tx needed
What are some benign white spot lesions caused by trauma?
Frictional keratosis
Cheek biting
Trauma
What sites of a luekoplakia lesion are suggestive of an increased risk of malignant transformation?
- Floor of mouth
- Lateral border of tongue
- Retromolar region
- Buccal sulcus (paan chewers)
- Labial Commissure
Describe the appearance of homogenous luekoplakia
- Uniform flat appearance or wrinkled surface (shallow cracks)
- Smooth, wrinkled or corrugated surface with consistent texture throughout
Describe the appearance of non-homogenous luekoplakia
- Predominantly white or white & red lesion (speckled erythroleukoplakia)
- Irregularly flat, nodular & exophytic (outwardly growing)
Nodular - Raised, rounded, red and/or white excrescences
Exophytic - Irregular blunt or sharp projections
What type of infection causes oral hairy leukoplakia?
EBV
What clinical features of the surface of a luekoplakia lesion are suggestive of an increased risk of malignant transformation?
Increased risk if raised or nodular
What is leukoplakia?
White patches of questionable risk, having excluded other known diseases or disorders which carry no increased cancer risk
(leuko=white, plakia=patch)
What is the most common cause of leukoplakia?
Tobacco use (90%)
Other 10% idiopathic (spontaneous)
Define pre-malignant condition
Generalised state associated with a significantly increased risk of developing cancer
What is the appearnce of erythroplakia?
Comment on malignancy risk
Bright red, velvety plaque which cannot be characterised as any other definable lesion/disease
High risk lesions ALWAYS associated with dysplasia or carcinoma
Rate of Malignant Change: 80%
