Oral, Head and Neck Epithelial Malignancies

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What percentage of oral cancers are squamous cell carcinomas (SCC)?

85%

95% (correct)

75%

99%

What are the three anatomical locations included in the term "oral"?

Lip vermilion, oral cavity proper, nasopharynx

Lip vermilion, gingiva, oropharynx

Lip vermilion, oral cavity proper, larynx

Lip vermilion, oral cavity proper, oropharynx (correct)

What is the primary type of cancer affecting the oral region, as mentioned in the text?

Squamous cell carcinoma (correct)

Adenocarcinoma

Melanoma

Basal cell carcinoma

What percentage of lip vermilion squamous cell carcinomas occur on the lower lip?

90% Signup and view all the answers

What is a possible risk factor for lip vermilion SCC mentioned in the text?

Chronic UV light exposure Signup and view all the answers

In the context of TNM staging for OSCC, what does "T1" represent?

Primary tumor size less than 2 cm Signup and view all the answers

Which of the following N categories in the TNM staging system indicates involvement of bilateral or contralateral lymph nodes?

N2c Signup and view all the answers

What is a characteristic of OSCC in individuals with light skin?

Relatively slow growth Signup and view all the answers

What is the difference in the TNM staging system for HPV-positive and HPV-negative OSCC?

There is no difference in the staging system. Signup and view all the answers

What is the maximum size of a lymph node that would be categorized as N2b in the TNM staging system?

6 cm Signup and view all the answers

Which of the following is a possible complication of OSCC that could lead to difficulty swallowing?

Invasion of the floor of the mouth Signup and view all the answers

What does the term "mets" refer to in the context of OSCC?

Metastasis Signup and view all the answers

Which of the following terms is most associated with an abnormal, red, velvety patch of tissue in the oral cavity?

Erythroplakia Signup and view all the answers

What is a key characteristic of oral squamous cell carcinoma (SCC) in younger patients?

It is usually diagnosed at a more advanced stage. Signup and view all the answers

What does the term 'exophytic' describe in the context of oral lesions?

A lesion that grows outwards Signup and view all the answers

Which of the following is a characteristic of leukoplakia?

A white, thickened patch of tissue Signup and view all the answers

What is the significance of erythroleukoplakia in the oral cavity?

It is a precancerous lesion that requires close monitoring. Signup and view all the answers

What is the name of the specific type of cancer that is mentioned in the text as a potential complication of oral lichen planus?

Carcinoma cuniculatum Signup and view all the answers

What is a key difference between erythroleukoplakia and leukoplakia?

Erythroleukoplakia is characterized by a red patch, while leukoplakia is characterized by a white patch. Signup and view all the answers

Which of the following anatomical subsites has a better prognosis than the others?

Soft palate Signup and view all the answers

What is the most common presenting morphology of Oral SCC?

Exophytic Signup and view all the answers

Which of the following is NOT an intrinsic factor contributing to Oral SCC etiology?

Microbiome dysbiosis Signup and view all the answers

Which of these factors is a known risk factor for Oral SCC?

Heavy alcohol consumption Signup and view all the answers

What is the typical presentation of an Erythroplakic Oral SCC?

A red patch on the oral mucosa Signup and view all the answers

What is the primary difference between endophytic and exophytic Oral SCC?

Exophytic lesions grow outward, while endophytic lesions grow inward. Signup and view all the answers

Which of these is an oncogenic virus known to be associated with Oral SCC?

Human papillomavirus (HPV) Signup and view all the answers

What is the significance of the retromolar trigone?

It is a difficult area to examine clinically. Signup and view all the answers

Which of these is a potential clinical feature of Oral SCC?

All of the above Signup and view all the answers

Study Notes

Learning Objectives

Understand epidemiology, etiopathogenesis, clinical features, staging, management, and prognosis of epithelial malignancies in the oral and head/neck regions.
Compare squamous cell carcinomas (SCC) in the oral cavity versus the oropharynx.
Discuss oral health concerns and side effects of antineoplastic therapy.

Oral Cancer Overview

Approximately 95% of oral cancers are squamous cell carcinomas (SCC).

Terminology

"Oral" includes:
- Lip vermilion
- Oral cavity proper
- Oropharynx

Anatomy

Oral Cavity Subsites:
- Hard palate, anterior two-thirds of tongue, labial mucosa, buccal mucosa, floor of mouth, alveolar ridge/gingiva, retromolar trigone.
Oropharynx Subsites:
- Soft palate, posterior one-third (base) of tongue, palatine tonsils, palatoglossal folds, valleculae, posterior pharyngeal wall.

Epidemiology

Oral SCC is more prevalent in males than females.
Risk for developing oral SCC increases with age.

Etiology

Extrinsic Risk Factors:
- Tobacco, alcohol, betel quid, sunlight exposure (lip vermilion), x-irradiation.
- Microbiome dysbiosis and infections (e.g., syphilis, oncogenic viruses like HPV16).
Intrinsic Risk Factors:
- Nutritional deficiencies (iron, vitamin A), immunosuppression, and genetic mutations (TP53, RB1, CDKN2A, RAS, MYC, EGFR, PIK3CA).

Clinical Features

Morphological types of Oral SCC:
- Exophytic: Grows outward from mucosa.
- Endophytic: Grows into tissue, often forming a broad base.
- Leukoplakic: White patches.
- Erythroplakic: Red lesions or mixed red and white.
Symptoms may include pain, induration, destruction of underlying bone, and paresthesia.

High-Risk Sites for Oral SCC

Particularly high-risk areas include:
- Tongue (especially posterior lateral and ventral surfaces)
- Floor of mouth
- Other sites: gingiva, buccal mucosa, labial mucosa, hard palate.

Lip Vermilion SCC

Approximately 90% of cases occur on the lower lip, often due to chronic UV light exposure.
Typically presents in light-skinned individuals; growth is relatively slow.
Metastases occur later, often when the tumor size exceeds 3-6 cm with a depth of invasion >10 mm.

TNM Staging for Oropharyngeal SCC

HPV-positive oropharyngeal SCC uses specific criteria for staging based on primary tumor size, regional lymph node involvement, and distant metastasis.
TNM categories indicate various classifications based on tumor size, regional nodes (ipsilateral, contralateral, bilateral), and distant metastases.
Staging for HPV-negative oropharyngeal SCC follows similar but distinct classification criteria.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

fall d1 chi